PubMed Health⌕ Search

Biomedical subjects

A Borghetti

Publications and source records attributed to A Borghetti.

At least 19 recordsLinked to original sources
PubMed1995

Effect of aging on left ventricular filling in untreated hypertensive patients.

The aim of this study was to evaluate the influence of age and other clinical and echocardiographic parameters on left ventricular filling in a group of 174 untreated patients with mild to moderate hypertension (aged 20-82 years; mean 51.2 years) and in 189 age-matched normotensive subjects. All subjects underwent an echocardiographic study with pulsed Doppler evaluation of left ventricular filling. Left ventricular dimensions and indexes of systolic function were similar and within normal limits in both groups. Left ventricular filling was altered in hypertensive subjects < 65 years with a decrease of peak early velocity (peak E), an increase of peak atrial velocity (peak A) and a reduced E/A ratio. However in subjects > or = 65 years, we did not observe any differences in transmitral flow velocity pattern between hypertensive and normotensive subjects. The stepwise regression analysis showed that age alone explains up to 8% of peak E variance, 14% of peak A and 26% of E/A ratio in hypertensives, while in normotensives it explains up to 18% of peak E variance, 50% of peak A and 61% of E/A ratio. The other variables entered into the regression slightly improved the predictive power. In conclusion, age is the major independent factor affecting left ventricular filling in both groups, even if its predictive power was smaller in the hypertensive group. The similarity of diastolic filling pattern in elderly hypertensive and normotensive subjects suggests that the 'aging factor' plays an important role in influencing left ventricular filling pattern so as to mask the effect of hypertension in the elderly patients.

Adult↗
PubMed1994

Renal effects of nifedipine and captopril in patients with essential hypertension and reduced renal reserve.

In this study we investigated the short-term effects of calcium channel blockers and angiotensin-converting enzyme inhibitors on renal hemodynamics and the urinary excretion of proteins with different relative mass in subjects with mild to moderate essential hypertension and apparently normal glomerular filtration rate but reduced renal functional reserve. Sixteen subjects underwent the following four treatments: (1) low-protein meal (0.2 g protein/kg body wt), (2) high-protein meal (1.3 g protein/kg body wt), (3) high-protein meal plus oral nifedipine (20 mg), and (4) high-protein meal plus oral captopril (50 mg). Two urine samples were obtained after meals. Blood samples were drawn at the midpoint of each 120-minute urine collection period. Urine and serum were tested for total protein, immunoglobulin G, albumin, alpha 1-microglobulin, retinol binding protein, and beta 2-microglobulin. Glomerular filtration rate and renal plasma flow were assessed by iothalamate and p-aminohippuric clearance, respectively. Compared with the high-protein meal alone, nifedipine elicited a clear-cut increase in the urinary excretion of total protein (+60%, P < .01), immunoglobulin G (+58%, P < .01), albumin (+25%, P < .05), retinol binding protein (+47%, P < .05), and beta 2-microglobulin (+52%, P < .05); captopril decreased the urinary excretion rate of immunoglobulin G (-26%, P < .05), albumin (-22%, P < .05), and beta 2-microglobulin (-34%, P < .05). The ratio between the clearances of immunoglobulin G and albumin was higher after nifedipine (+21%, P < .01) and unchanged after captopril (-9%, P = NS) compared with the high-protein meal alone.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Controlled clinical evaluation of the subpedicle connective tissue graft for the coverage of gingival recession.

The purpose of this study was to clinically evaluate the 1-year coverage of gingival recessions by a subpedicle connective tissue graft according to the original technique compared to untreated recessions by measuring probing sulcus depth (PSD), height of keratinized tissue (HKT), and mucogingival junction location changes. Paired gingival recessions were selected in 15 patients. In each patient, one recession was randomly assigned for treatment (test group) and the other recession was left untreated (control group) for 1 year. Surgery consisted of a connective tissue graft covered by a double papilla full thickness flap. Height of recession (HR), PSD, HKT, and cemento-enamel junction to mucogingival junction distance (CEJ-MGJ) were recorded with a calibrated probe before surgery and 1 year postoperatively. The control group showed no statistically significant differences in any of the parameters. In the test group, HR mean decreased significantly (P < 0.0006) from 3.66 mm to 1.09 mm, representing a mean root coverage of 70.5%. HKT mean increased significantly (P < 0.0006) from 1.60 mm to 4.30 mm, and PSD mean showed no statistical difference. CEJ-MGJ remained statistically unchanged. The subpedicle connective tissue graft may provide a good amount of root coverage and a substantial increase of keratinized tissue. Connective tissue grafted beneath the alveolar mucosa does not induce its transformation into keratinized gingival tissue.

Adult↗
PubMed1992

Glomerular hyperfiltration in essential hypertension: hormonal aspects.

Glomerular hyperfiltration is thought to play a pivotal role in causing renal damage in essential hypertension. An increase in glomerular filtration rate can be experimentally induced by an acute oral protein load through still unclarified mechanisms, although hormonal factors have been postulated; in already hyperfiltering nephrons, the capacity to further increase glomerular filtration rate upon stimulation with an acute protein load (i.e. renal functional reserve) would conceivably be reduced, even in the presence of apparently normal renal function. The present study aimed at assessing whether renal functional reserve is preserved and/or is affected by different antihypertensive drugs in essential hypertensive patients without signs of renal function impairment; moreover, we tried to highlight changes in the plasma levels of natriuretic and antinatriuretic hormones potentially involved in the modulation of renal hemodynamics under the chosen experimental conditions. Renal hemodynamic parameters, plasma renin activity, aldosterone and atrial natriuretic factor were measured in fourteen essential hypertensives submitted to an acute oral protein load, alone or with a concomitant administration of either nifedipine or enalapril, as compared with a control carbohydrate meal. Glomerula filtration rate and renal plasma flow rose slightly but not significantly following an acute oral protein load as compared with a carbohydrate meal; no changes were noted in plasma atrial natriuretic factor levels, whereas plasma renin activity decreased. When nifedipine was administered together with the protein meal, both glomerular filtration rate and renal plasma flow increased significantly; there were also, parallel increases in plasma renin activity and atrial natriuretic factor. Administration of enalapril was associated with a decrease in both glomerular filtration rate and renal plasma flow; plasma renin activity showed an expected marked rise, whereas the plasma levels of atrial natriuretic factor were only slightly but not significantly reduced and plasma aldosterone fell. In conclusion, our data suggest that in our patients renal functional reserve was blunted. Clear-cut hyperfiltration was brought about by administration of nifedipine together with a protein meal, whereas enalapril completely abolished even the small increase in glomerular filtration rate seen after protein meal alone. The concomitant alterations in plasma renin activity, aldosterone and atrial natriuretic factor seemed to play no major role in the determinism of the observed renal hemodynamic changes.

Adult↗
PubMed1992

Histologic case reports of coralline hydroxyapatite grafts placed in human intraosseous lesions: results 6 to 36 months postimplantation.

Four intrabony lesions from four patients were studied. Presurgical measurements included clinical attachment level, degree of recession, probing pocket depth, Plaque Index, Gingival Index, and Sulcular Bleeding Index. These measurements were also taken at 6-month intervals after surgery. Surgery involved exposing the intrabony defects by a papillary preservation technique, planing, and placing blocks of coralline hydroxyapatite. Three biopsy specimens and one block section were removed from the treated lesions at various periods ranging from 6 to 36 months. Clinical and histologic observation provided evidence of osteogenesis around and through the coralline hydroxyapatite.

Adult↗
PubMed1991

[Frenectomy associated with a triangular gingival graft].

In periodontal therapy, frenectomy is indicated when the frenum exerts tension on the gingival margin and interferes with proper oral hygiene. The procedure is also employed when the frenum prevents closure of a diastema during orthodontic therapy. Frenectomy should be done after the canines have erupted and before retention is started to prevent separation of the teeth. For an improved surgical and cosmetic result, the authors propose a triangular-shaped gingival graft after the frenum has been excised. The advantage of the procedure is to create an area of attached gingiva and enhance healing.

Diastema↗
PubMed1991

[Clinical and histological evaluation of implantation of a microporous resin in periodontitis. Report of a case after 13 months].

A patient with adult periodontitis was treated for a 2 and 3-walled intrabony lesion on tooth n degrees 27. After scaling and root planing, the defect was surgically exposed and filled with a micro-porous resin. Following healing, there was a reduction in pocket depth as a result of gingival recession and a gain in probing attachment levels. This was confirmed 13 months post-operatively by clinical observation on re-entry. A biopsy of the treated site was taken at that time and undecalcified sections were studied by light microscopy and microradiography. New bone formation was noted inside and on the surface of the resin granules and at a distance from the particles. From a clinical and histologic point of view, the material seemed to be well tolerated by the host.

Adult↗
PubMed1991

[The effect of a formaldehyde-tyrothricin combination placed in periodontal pockets in association with scaling and root planing].

A solution of formaldehyde and tyrothricin was placed in periodontal pockets of 14 patients. One maxillary quadrant was used as the experimental side, while the contralateral quadrant was employed as the control. A placebo solution was placed in the pockets of the control side. Both the experimental and control sides were treated on days -3, 0, +4, +7, +11 and +14. Scaling and root planing was accomplished on day 0. Plaque and gingival indices, and gingival fluid volume were recorded on all of the treatment days, as well as on day +28. Pocket depths were noted on days -3, 0, +14 and +28. Improvements were noted in all parameters measured on both the experimental and control sides, although statistical analyses revealed that plaque and gingival indices were slightly better in the experimental side. The author concludes that placing a Formaldehyde-Tyrothricin solution in periodontal pockets offers some therapeutic gain over scaling and root planing alone.

Adult↗
PubMed1991

[Clinical evaluation of natural coral implantation in osseous periodontal defects. Results after one year].

17 intrabony periodontal defects on 14 patients were surgically treated by a alloplastic graft using micro-granules of natural coral. Criteria of evaluation were standardized probing and reproducible radiographs. The measures, made at day 0 and one year post-implantation showed a reduction in probing pocket depth (4.38 mm +/- 0.43) assessed more through a gain of clinical attachment (3.38 mm +/-0.30) than an increase of the gingival recession (1.00 mm +/- 0.20). These results are statistically significant.

Adult↗
PubMed1990

Urinary excretion of brush-border antigen and plasma proteins in early stages of diabetic nephropathy.

In 109 patients with insulin-dependent diabetes mellitus (IDDM), we measured the urinary excretion of albumin, the low molecular weight proteins (LMWP) retinol-binding protein (RBP) and beta 2-microglobulin (beta 2m), and brush-border antigens (BBA) revealed by monoclonal antibodies. All such markers of kidney damage and/or dysfunction were higher in diabetic patients than in 44 controls. Increased urinary levels of BBA (p = 0.0001) were associated with higher values of albumin (p = 0.0002), RBP (p = 0.0005) and, to a lesser extent, of beta 2m (p = 0.1), different combinations of values above the reference limits being observed. Some 30 and 40% of patients with and without microalbuminuria, respectively, also exhibited signs of tubulopathy. Although under certain circumstances tubular defects may give rise to small increases in albuminuria, the most likely explanation for our findings is the coexistence of glomerular and tubular damage in some patients with IDDM. Neither the prognostic value nor the pathophysiological meaning of tubular damage and/or dysfunction can be assessed by the present study, owing to its cross-sectional design. Tubular markers thus deserve further studies to clarify whether in diabetic patients they indicate a more severe or diffuse kidney impairment.

Adolescent↗
PubMed1990

Hypophosphatemia in course of chronic obstructive pulmonary disease. Prevalence, mechanisms, and relationships with skeletal muscle phosphorus content.

Serum phosphorus levels (Ps), dietary intake of phosphorus, and renal phosphate handling indexes were evaluated in 158 patients with chronic obstructive pulmonary disease (COPD) of varying degrees of severity; moreover, skeletal muscle phosphorus content (Pm) was measured in muscle samples obtained by quadriceps femoris needle biopsy in 14 of the same patients. Hypophosphatemia (Ps less than or equal to 2.5 mg/dl) was found in 34 (21.5 percent) of 158 patients without differences between groups of COPD patients presenting increasing severity of respiratory illness. No relationship was found between serum levels and dietary intake of phosphorus; hypophosphatemia was associated with low renal phosphate threshold (TmPO4/GFR) values in 31 (91 percent) of 34 patients. The prevalence of hypophosphatemia was significantly higher among COPD patients taking one or more drugs commonly used in COPD and known as negatively influencing renal phosphate handling: xanthine derivatives, corticosteroids, loop diuretics, and beta 2-adrenergic bronchodilators. Short-term administration of therapeutic doses of these drugs in COPD patients previously not taking any drug reduced TmPO4/GFR values; phosphaturic effect of short-term theophylline administration on renal phosphate handling was additive to that of long-term assumption of the drug. Muscle phosphorus content was both reduced in COPD patients as compared with control subjects and significantly correlated to serum phosphorus levels and to TmPO4/GFR values. The present investigation revealed a high prevalence of hypophosphatemia among COPD patients as well as a defect in renal phosphate reabsorption secondary, at least in part, to pharmacologic therapy. Moreover, it also suggests that in COPD patients muscle phosphorus content is likely to be reduced in presence of hypophosphatemia.

Adult↗
PubMed1990

[Gingival thickening with a submerged connective tissue graft].

Gingival thickness is a clinical characteristic which should be given more consideration in evaluating muco-gingival problems. It is proposed that thick gingiva prevents gingival recession and is of particular significance when fixed prosthesis is being employed. The technique outlined includes a connective graft from the lamina propria of the palatal mucosa into the gingival connective tissue. A case report documents the technique.

Connective Tissue↗
PubMed1990

A comparative clinical study on the effects of cardiopulmonary bypass with different flows and pressures on skeletal muscle cell metabolism in patients undergoing coronary bypass grafting.

This study compares the effects of cardiopulmonary bypass with different flows and pressures on intracellular energy metabolism, acid-base equilibrium, and muscle water compartments in two groups of patients undergoing coronary artery bypass grafting. Eighteen patients (16 men and two women aged 54 +/- 7 years, New York Heart Association class I-II) undergoing low flow (flow rate 1.5 L/min/m2 at 26 degrees C), low pressure (mean arterial pressure 40 to 60 mm Hg) cardiopulmonary bypass, as well as 10 age-matched and sex-matched patients undergoing normal flow (flow rate 2.2 L/min/m2 at 26 degrees C), normal pressure (mean arterial pressure 60 to 80 mm Hg) bypass were studied. Intracellular acid-base equilibrium (intracellular pH and intracellular bicarbonate), cell energetics (adenosine triphosphate, diphosphate, and monophosphate, phosphocreatine, and lactate), and muscle water compartments were evaluated in specimens of the quadriceps femoris muscle obtained by needle biopsy before and at the end of cardiopulmonary bypass. In both the low flow-low pressure and normal flow-normal pressure groups, adenosine triphosphate levels were unchanged at the end of bypass, whereas phosphocreatine concentration was decreased; muscle total water and extracellular water increased without variations of intracellular water; muscle and plasma lactate increased as intracellular bicarbonate decreased; intracellular pH values remained unchanged. The present study suggests the following: (1) Cardiopulmonary bypass is associated with the overall preservation of intracellular compartment metabolism in skeletal muscle (about 40% of body cell mass) of patients undergoing coronary bypass grafting, even though low phosphocreatine values and increased plasma and muscle lactate values found at the end of bypass could be an expression of cell functional reserve exhaustion; (2) the effects of cardiopulmonary bypass on cell metabolism are comparable, regardless of the flows and pressures used.

Blood Pressure↗