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Biomedical subjects

C Barbieri

Publications and source records attributed to C Barbieri.

97 records · Page 6Linked to original sources
PubMedDate not supplied

Stimulation of prolactin release by intravenous cimetidine: a dose-response study.

The PRL response to iv cimetidine was tested in 8 healthy males and 8 females at 4 different dose levels (0.75, 1.5, 3.0 and 6.0 mg/kg bw). Serum PRL levels were significantly increased in comparison with a placebo study by the second cimetidine dose in both sexes. The PRL response was significantly higher in females than in males at all but the lowest dose tested. A significant correlation between the cimetidine dose and the PRL response was observed. There was no significant modifications in serum GH, LH, FSH, IRI and glucose. Present findings demonstrate that the stimulation of PRL release by iv cimetidine is quite specific and dose-dependent.

Adult↗
PubMedDate not supplied

Endocrine and metabolic effects of labetalol in man.

The effects of intravenous infusion of the alpha- and beta-adrenoceptor blocking drug labetalol (100 mg over 10 min) on heart rate, blood pressure, and several endocrine and metabolic variables have been evaluated in 12 hypertensive patients (6 men and 6 women). Drug administration was associated with significant lowering of heart rate and systolic and diastolic blood pressure in comparison with a control study performed with saline infusion. Plasma glucose was significantly increased, while no changes were observed in serum-free fatty acids, insulin, C-peptide, and growth hormone levels. Serum prolactin concentration was significantly increased in the whole group, a marked rise occurred in females, while only a trend upward was observed in males. The acute lowering of blood pressure suggests a predominant activity on alpha-adrenoceptors following intravenous labetalol infusion, although the reduction in heart rate is consistent with the beta-adrenoceptor blocking effect of the drug. Although the reason for the increase in plasma glucose is not apparent, it might depend on the rise in norepinephrine levels observed after labetalol. Stimulation of prolactin release by intravenous labetalol is not easily attributable to interference with adrenergic receptors. The mechanism of this action of the drug is presently obscure, although a possible antidopaminergic activity of labetalol might be involved.

Adult↗
PubMedDate not supplied

Effects of advance care education in cardiovascular rehabilitation programs: a prospective randomized study.

PURPOSE: To determine the effect of advance care education provided to patients enrolled in cardiovascular rehabilitation (CVR) programs and assess patients' acceptance of the educational program. METHODS: In a multicenter, prospective, randomized study, the authors administered two questionnaires 6 months apart to 284 patients enrolled in 14 CVR programs in 11 states. An educational group (99 subjects) participated in educational programs related to advance care planning and received advance directive forms after completing the first questionnaires; 185 subjects served as controls. Primary outcomes were completion of patient-physician discussions of end-of-life issues and patient confidence that their end-of-life wishes were understood by their physicians. Secondary outcomes were completion of formal advance directives and patient acceptance of the educational program. RESULTS: Both the educational and control groups demonstrated a larger proportion of patients at the end of the study, compared with the amount at the beginning of the study, who had completed living wills, durable powers of attorney for healthcare, and discussions with their physicians about advance directives and life support care. These outcomes were not observed more commonly after the educational intervention. Neither groups gained confidence, however, that their physicians understood their end-of-life wishes. Only 8.6% of patients had a negative response to the educational program. CONCLUSIONS: Advance care education is well received by patients enrolled in CVR programs. Enrollment in CVR promotes advance care planning to a small but measurable degree CVR rehabilitation programs appear to be acceptable sites for advance care planning but further research is needed to develop effective educational interventions.

Adult↗
PubMedDate not supplied

[A heap of trouble. Resistant hypertension and aneurysm of the renal artery].

A 47-year-old female, was referred to our renal and vascular ultrasound unit by the cardiologists, because of a long history of uncontrolled hypertension resistant to multiple antihypertensive drug treatment. The question was if the patient had a secondary form of hypertension, i.e. a renal artery stenosis. An accurate evaluation by echo-color Doppler ultrasound displayed an aneurysm located at the bifurcation of the right renal artery. The surgical correction of the aneurysm normalized the arterial pressure and avoided a rupture, which is always a dramatic event.

Aneurysm↗
PubMedDate not supplied

[Diffusive and convective treatments in the clinical practice: observation study of the Pavia district nephrology group].

UNLABELLED: PURPOSE. Although convective treatments are widely used, there is no evidence that they can improve patient survival or hospitalizations nor clinical criteria indicating which patients could benefit from them. This study was carried out to evaluate the dialysis modality distribution and the clinical criteria used in choosing the dialysis therapy by the four dialysis Centers in the district of Pavia, a district characterized by a quite homogeneous population. METHODS: We evaluated age, gender, body mass index (BMI), time on dialysis, number of sessions per week, dialysis duration, dialysis modality, criteria used in choosing dialysis therapy, vascular access (VA), Kt/V, and the number of hypotensive episodes. RESULTS: Two hundred and seventy-two patients were enrolled in the study. Mean age was 67.3 +/- 12 yrs, BMI was 26.3 +/- 6.1, dialytic age was 5.49 +/- 5.5 yrs, Kt/V was 1.4 +/- 0.3, mean session time was 238 min. Fifty-two patients (19.2%) were on a convective treatment. Age, BMI, time on dialysis, dialysis duration and number of sessions per week were no different between convective treatment patients and diffusive treatment patients. Kt/V was significantly different between convective and diffusive methods (1.55 +/- 0.37 vs 1.4 +/- 0.28, p<0.05). Convective treatments were prescribed for cardiovascular (CV) instability by the nephrologists from the Pavia district in the majority of patients (90.9%). There was no difference in hypotensive episodes between convective and diffusive methods. CONCLUSIONS: Our study demonstrated that lacking clinical evidence indicating an improvement in the long-term outcome with convective techniques, nephrologists in the Pavia district choose this type of dialysis treatment to ameliorate CV stability in uremic patients.

Aged↗
PubMedDate not supplied

Involvement of cardiovascular rehabilitation programs in advance directive education.

BACKGROUND: Cardiac rehabilitation programs represent opportunities to educate patients with cardiac disease about living wills and durable powers of attorney for health care. The extent of advance directive education that is currently provided in cardiac rehabilitation programs, however, is unknown. METHODS: A questionnaire was mailed to nonphysician directors of cardiac rehabilitation programs to determine the programs' involvement in educating enrollees about end-of-life issues and the directors' opinions regarding the appropriateness of such education in cardiac rehabilitation curricula. Data were presented as proportions with 95% confidence intervals (Cls). RESULTS: Of the 1013 cardiac rehabilitation program directors, 845 (83%) responded to the questionnaire, of which 48 stated they were no longer enrolling patients. Of the remaining 797 program directors (83%), 71% (95% CI, 67%-74%) informed patients of their prognosis, but only 18% (95% CI, 15%-20%) and 12% (95% CI, 9%-14%) asked patients if they had a living will or a durable power of attorney for health care, respectively. Only 9% (95% CI, 7%-11%) offered educational sessions on advance directives and 17% distributed advance directive informational material. Education about cardiopulmonary resuscitation was provided by 27% (95% CI, 23%-30%), but only 3% (95% CI, 2%-4%) provided information on do-not-resuscitate topics. Fifty percent (95% CI, 46%-53%) were in favor of including advance directive education and 49% (95% CI, 45%-52%) favored inclusion of do-not-resuscitate topics into curricula. CONCLUSIONS: Cardiac rehabilitation programs are potentially valuable but not widely used sites for educating patients with cardiac disease about advance directives.

Advance Care Planning↗