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Biomedical subjects

A Strano

Publications and source records attributed to A Strano.

At least 37 records · Page 2Linked to original sources
PubMed1989

The relationship of insulin antibodies, platelet-fixing immune complexes and platelet-associated IgG to in vitro platelet aggregation and thromboxane B2 synthesis in childhood type 1 (insulin-dependent) diabetes mellitus.

The relationship of insulin antibodies, platelet-fixing soluble immune complexes and platelet associated IgG to in vitro platelet aggregation and thromboxane B2 synthesis was studied in a group of children with type 1 (insulin-dependent) diabetes mellitus. Insulin antibodies, through the formation of insulin anti-insulin platelet-fixing immune complexes, seem to increase the levels of platelet associated IgG and both insulin immunity and increased platelet associated IgG are associated with the highest degree of platelet aggregation and thromboxane synthesis. These data suggest a possible role of immune factors in the platelet disfunction of diabetic subjects. Both platelet abnormalities and immune factors have been thought to play a role in the pathogenesis of the late diabetic complications. In this paper data concerning a possible interaction between these two factors are presented.

Adenosine Diphosphate↗
PubMed1989

[Cardiac arrhythmia in relation to the leaflet morphology in subjects with mitral valve prolapse].

Aim of this study was to verify the prevalence of cardiac arrhythmias in subjects with mitral valve prolapse (MVP) and redundant leaflets in comparison with subjects with MVP without leaflets redundance. So, 60 subjects (aged 13 to 39 years), were subdivided in 3 groups on the basis of mitral leaflets shape at 2D-echocardiography; a continuous ECG monitoring (24 hours) was also performed. Arrhythmias were more frequent and more severe in the Group III (subjects with MVP and redundant leaflets), in comparison with both Group II (subjects with MVP without leaflets redundance) and Group I (control subjects). In particular, analysing the mean values of the single arrhythmias in the 24 hours, ventricular ectopic beats (VEB), were more frequent in Group II (p less than 0.01) and Group III (p less than 0.05) in comparison with Group I; the couplets and the runs of ventricular tachycardia were more frequent in Group III than in the other groups (p less than 0.001). The number of the subjects with a Lown class greater than 3 was higher in Group III than in the other groups (p less than 0.01). In conclusion, this study confirms that MVP is a disease presenting a large variability arrhythmic risk, that seems to be real only for a subgroup of these subjects.

Adolescent↗
PubMed1989

Platelet function in hypo- and hyperthyroidism.

Alterations in cardiovascular hemodynamics are found in patients with hypofunction of the thyroid. Frank hypothyroidism favours the development of coronary heart disease. Platelets are thought to be important in atherosclerotic lesions initiation and progression. We studied platelet sensitivity to several agonists and to a physiological antagonist, prostacyclin, and thromboxane production in patients with hyperthyroidism and hypothyroidism. No statistically significant differences were found between platelets activities in patients and control subjects. We conclude that increased platelet function is not a direct indicator of susceptibility to cardiovascular diseases in patients with hypothyroidism whereas the hyperdynamic state, cardinal manifestation of thyrotoxicosis, is not associated with platelet activation.

Adult↗
PubMed1989

[Effect of a long-term treatment with simvastatin, an inhibitor of HMG-CoA reductase, in dyslipidemic patients at high risk].

The reduction of total and LDL cholesterol (TC and LDLc), apoprotein B (ApoB) and in some instances triglycerides (TG) and the increase of HDL cholesterol (HDLc) and apoprotein A (ApoA) seem to be associated to a reduced coronary risk. Aim of our work was to evaluate the effects of a chronic treatment with the HMG-CoA reductase inhibitor simvastatin (MK-733), in a group of 8 dyslipidemic patients, 5 women and 3 men, aged between 48 and 69 years (mean age 59 +/- 8 years) at high risk being already affected by clinical compliances of atherosclerosis and not previously controlled by diet and/or other antidyslipidemic drugs. At the beginning and at the end (6 months) of this open study it was performed a clinical, ECG and ophthalmological examination, as well as an evaluation of the routine laboratory parameters. The initial dosage of simvastatin was a tablet of 10 mg/day, increased after a month to 20 mg and then to 40 mg/die. The mean dosage was 26.25 mg at the 3rd month and 21.25 mg at the 6th. Long-term simvastatin treatment was well tolerated (lack of important side effects as well as of significant changes of other clinical and laboratory parameters) and effective, reducing significantly (p less than 0.01) TC (317.9 +/- 30.8 vs 238.5 +/- 37.9 mg/dl), LDLc (210.6 +/- 48 vs 147.9 +/- 52 mg/dl), ApoB (144.7 +/- 17.5 vs 104.5 +/- 18), and TG (272.9 +/- 184 vs 200.5 +/- 117.6 mg/dl) and increasing in contrast HDL and ApoA values.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1989

Platelet function in patients with type 2 diabetes mellitus: the effect of glycaemic control.

In the present study the effects of a short term intensive glycaemic control obtained with subcutaneous insulin therapy on lipids and apoprotein levels, platelet aggregation, platelet sensitivity to prostacyclin and platelet thromboxane production were investigated in 20 patients with type 2 diabetes and vascular disease. In 11 out of the 20 patients there was a significant improvement of glycaemic control (fructosamine reduction). Only with tight improvement of glycaemic control there was significant change in the concentration of ADP and collagen required to produce 50% of the maximum aggregation wave response, in the responsiveness of platelet to PGI2 and in the TxB2 synthesis. Lower Apo B levels were also shown in the tight control group suggesting that Apo B changes may have influenced platelet aggregation and thromboxane synthesis.

Adult↗
PubMed1989

[Antiplatelet effects of combined therapy with ticlopidine and low doses of aspirin on patients with ischemic cardiopathy].

The aim of study was to evaluate the effects on platelet function, in 8 patients with ischemic heart disease, of the following treatments administered consecutively: ticlopidine in a daily dose of 500 mg (10 days); aspirin in a daily dose of 50 mg (10 days); ticlopidine plus ASA, at the same dosages, for the last 10 days. Only ticlopidine plus ASA significantly inhibited EC 50 of ADP, collagen and arachidonate. Platelet activation and platelet sensitivity to prostacyclin was affected by ticlopidine and ticlopidine plus ASA but not by ASA alone. We conclude that in our ischemic heart disease patients the association of ticlopidine and low dose aspirin seems superior to each drug alone in inhibiting platelet activity.

Aged↗
PubMed1988

Plasma lipid lowering activity of acipimox in patients with type II and type IV hyperlipoproteinemia. Results of a multicenter trial.

A multicenter study was carried out in 130 out-patients to assess the plasma lipid lowering activity of acipimox in type IIa, IIb and IV hyperlipoproteinemia. The study consisted of two periods, an 8-week randomized, double-blind comparison of active drug versus placebo and a 16-week open follow-up with acipimox (400 mg and 250 mg t.i.d., respectively, in type II and IV patients). During the double-blind phase acipimox, compared to placebo, showed a highly significant triglyceride lowering effect in type IV patients (-43% vs. +4%, P less than 0.01), while reducing plasma cholesterol significantly in type II patients (-7% vs. -3%, P less than 0.05). Further reductions in plasma lipids were obtained in both types of hyperlipoproteinemia after the 16-week follow-up. In type II patients, total cholesterol fell by 9% in the former acipimox group and 17% in the former placebo group, whereas a 34% reduction in triglycerides was found in type IV patients previously treated with placebo. Treatment had to be discontinued in 4 patients during the double-blind phase and in 5 patients during follow-up, because of adverse events such as skin reactions and gastric disturbances. Statistical analysis of hematological and biochemical variables expressing safety did not show any significant change during treatment.

Adult↗
PubMed1988

Asymptomatic episodes of ischaemia and their relation to heart rate changes in patients with chronic ischaemic heart disease.

The aim of our study was to evaluate the prevalence of asymptomatic episodes of ischaemia and their relation to heart rate in patients with effort angina pectoris undergoing continuous electrocardiographic monitoring for 24 h. We studied 91 patients with typical history of effort angina and positive stress testing (angina and rectilinear or downsloping ST segment depression more than 1 mm). During electrocardiographic monitoring 81 patients showed symptomatic or asymptomatic ischaemic episodes with ST segment depression, four patients a T wave inversion, while six patients did not show ischaemic episodes. The total number of ischaemic episodes registered was 284, of which 106 (37.32%) were symptomatic with significant heart rate increase, 130 (45.78%) asymptomatic with heart rate increase and 48 (16.9%) asymptomatic without heart rate changes. Twelve patients (13.18%) showed only symptomatic episodes of ischaemia with increase of heart rate, 26 patients (28.57%) symptomatic and asymptomatic episodes with heart rate enhancement, 12 patients (13.18%) only asymptomatic episodes with heart rate increase, eight patients (8.79%) symptomatic episodes of ischaemia with heart rate increase and asymptomatic ones with and without heart rate changes, and finally 23 patients (25.57%) showed symptomatic episodes with heart rate increase and asymptomatic ones without heart rate changes. In total, 31 (34.06%) of these patients showed during continuous electrocardiographic monitoring asymptomatic episodes of ischaemia without heart rate changes. These findings suggest a possible intervention of coronary tone modifications in determining asymptomatic ischaemic episodes without heart rate change in patients with effort angina.

Adult↗
PubMed1988

Effects of low doses of amiodarone on cardiac arrhythmias in patients with chronic ischaemic heart disease.

Continuous ECG monitoring is a useful method to evaluate the efficacy of antiarrhythmic drugs. The aim of our study was to evaluate the effects of amiodarone (400 mg day-1 for seven days and then 200 mg day-1, five days a week, for 60 days) in 20 patients with chronic ischaemic heart disease ascertained by stress test, thallium-201 myocardial scintigraphy and coronary angiography and with qualitatively and quantitatively similar cardiac arrhythmias in two continuous ECG monitoring sessions performed before starting treatment. All patients were previously on treatment with isosorbide 5-mononitrate (Is-5-Mn). Patients underwent two ECG monitoring sessions for 48 h, with an ICR instrument with two leads, first during pharmacological treatment with Is-5-Mn plus placebo and then after 60 days on treatment with Is-5-Mn and amiodarone. Heart rate decreased significantly with amiodarone (from 76.9 to 69.5 beats min-1) as did premature ventricular complexes (from 4686 to 329 day-1), ventricular couplets (from 154.3 to 5.0 day-1), ventricular tachycardia runs (from 91.7 to 0). ST segment depression more than 1.5 mm was present for 93.8 min day-1 on Is-5-Mn plus placebo, and was significantly less frequently observed (for 13.8 min day-1) on Is-5-Mn plus amiodarone. Finally, transient episodes of ischaemia, both symptomatic and asymptomatic, diminished on amiodarone from 22 to 9 day-1 in a significant way. In conclusion, amiodarone is a useful drug to obtain a reduction of ventricular arrhythmias and symptomatic and asymptomatic episodes of ischaemia in patients with ischaemic heart disease.

Aged↗
PubMed1988

In vitro effects of gallopamil on platelet aggregation and thromboxane generation.

The in vitro effects of gallopamil, a highly specific calcium-channel blocker, on platelet function were investigated. Gallopamil caused a dose-dependent inhibition of platelet aggregation. In fact, the drug in concentrations as low as 0.5 microgram/ml inhibited platelet activating factor and epinephrine-induced platelet aggregation. Similarly, the inhibition of adenosine diphosphate and epinephrine-induced thromboxane generation was demonstrated. Since platelet activation and thromboxane release may be related to myocardial ischemia, it is conceivable that some of the antianginal effects of gallopamil may in part be due to platelet inhibitory effects.

Blood Platelets↗
PubMed1987

Changes of angiotensin converting enzyme (ACE) levels during activation of the renin-angiotensin-aldosterone system (RAAs).

The aim of this study was to evaluate the changes of ACE levels during RAAs activation induced by: 1) a continuous graded bicycle ergometer test performed in a group of 15 males health youths aged between 21 and 30 years, with average age of 25.8 +/- 2.85 years; 2) i.m. injection of 20 mg of frusemide in 11 health youths (10 males and 1 female), aged between 20 and 30 years, with average age of 24.09 +/- 2.77 years; 3) dialytic treatment in 25 patients (12 males and 13 females), suffering from chronic renal failure, aged between 26 and 68 years, with average age of 54 +/- 15.42 years. Plasmatic renin activity (PRA), aldosterone (ALD) and ACE levels were determined by RIA in basal conditions and at peak of exercise in group 1, 15 minutes after i.m. injection of frusemide in group 2 and after a session of dialysis in group 3. In all the experimental conditions studied there was an activation of the renin-angiotensin system with significant increase of the PRA, ALD and ACE levels.

Adult↗
PubMed1987

An evaluation of the effects of isosorbide 5-mononitrate in patients with angina on effort using dynamic electrocardiography and echocardiography.

We studied 14 patients, 9 males and 5 females, with an average age of 53.6 +/- 9.2 years, having been suffering from effort angina for over 6 months, with positive ergometer test for angina and ST-segment depression greater than 1 mm. All the patients performed a washout period of 7 days at the end of which, before and after acute administration (90 min) of isosorbide 5-mononitrate or placebo some echocardiographic parameters were controlled according to a double-blind, randomized, crossover design. Moreover, after 2 months of open treatment with isosorbide 5-mononitrate (20 mg three times daily), echocardiographic parameters were investigated again. Continuous ECG monitoring (24 h) was performed after the washout period and after 2 months of treatment. After acute administration of isosorbide 5-mononitrate, we observed a reduction in pre- and afterload, whereas after 2 months of treatment the reduction in preload seems to play a more important role. Together with other mechanisms these haemodynamic changes are responsible for the substantial diminution of myocardial oxygen consumption, and consequently for the reduction of transient ischaemic episodes, both symptomatic and asymptomatic with heart rate increase. These results suggest that isosorbide 5-mononitrate exhibits a definite nitrate-typical vascular activity that is evident both after single administration and after 2 months of treatment.

Angina Pectoris↗
PubMed1987

Ketanserin versus propranolol in the treatment of mild and moderate essential hypertension: corroboration with ambulatory blood pressure monitoring.

In order to assess the medium-term efficacy of ketanserin in comparison with that of the beta-blocker, propranolol, a randomized double-blind crossover trial was conducted involving 13 patients suffering from mild or moderate essential hypertension. Six of these patients were also evaluated on an ambulatory basis using noninvasive intermittent blood pressure monitoring to corroborate these values. Results indicated that both ketanserin and propranolol significantly lowered systolic, diastolic, and mean blood pressure levels after 60-day treatment periods. Diastolic blood pressure levels of less than or equal to 90 mm Hg were achieved in seven patients following ketanserin therapy and in six patients after treatment with propranolol. Both ketanserin and propranolol reduced arterial blood pressure without interfering with its circadian rhythm and variability. A tendency for the blood pressure lowering effect of ketanserin to increase with age was also noted. Side effects were minimal. The results of this trial confirm the efficacy and safety of ketanserin for the treatment of mild or moderate hypertension.

Adult↗