Does an endocrinal phase of chronic heart failure exist?
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Adult↗
Biomedical subjects
C Sapio
Publications and source records attributed to C Sapio.
L-arginine improves post-ischemic vasodilation in coronary heart disease patients taking vasodilating drugs.
BACKGROUND: The hypothesis that intravenous L-arginine infusion improves the vasodilatory response to ischemia in the resistance vessels of human lower limbs in relatively young coronary heart disease patients taking vasodilating drugs was tested. METHODS: Twenty patients with onset of symptoms of coronary artery disease before age 50, operated for aortocoronary bypass and taking vasodilating drugs, were compared with 20 control subjects of comparable age and gender; neither group included heavy smokers (>10 cigarettes/day). Blood flow in the lower limbs was measured noninvasively with strain-gauge plethysmography, both at rest and during a reactive hyperemia test. Intravenous infusion of L-arginine was performed in nine coronary heart disease patients and in nine control subjects. RESULTS: Resting blood flow to the lower limbs was 2.3 mL/min/100 mL in control subjects vs 3.4 mL/min/100 mL in patients (difference not statistically significant). Peak blood flow measured after a 3-minute arterial occlusion was 24.0 mL/min/100 mL in control subjects vs 20.3 mL/min/100 mL in coronary heart disease patients (P<0.05). Peripheral minimal vascular resistances were 4.28 and 5.46 peripheral resistances units (p.r.u.) in control subjects and patients, respectively (P<0.05). Intravenous infusion of L-arginine was followed by increased resting blood flow in cases and controls (P=0.009), with a parallel reduction in peripheral resting vascular resistances (P=0.009). Coronary heart disease patients showed increased peak blood flow (P=0.04) and reduced minimal vascular resistances (P=0.02), whereas no statistically significant changes in these parameters were detectable in control subjects. Intravenous glucose infusion, leading to increased serum insulin concentration, did not modify any hemodynamic parameter. CONCLUSIONS: Hemodynamic responses in the skeletal muscle are impaired during a reactive hyperemia test in relatively young coronary heart disease patients taking vasodilating drugs. Intravenous L-arginine infusion corrects the impaired vasodilatory response of the lower limbs to an acute increase in flow following a cuff thigh occlusion.
Adult↗
[Control of plasma aluminium in hemodialyzed patients. Optimization of the method].
As concerning biological matrix, the analytic technique in AA-ETA if on one hand shows remarkable sensitivity, on the other it offers reasons that make it not much reproducible. Our aim has been to optimize and standardize the methodic for the dosage of the Al-s paying a special attention on the contamination risks and on the interference problems in reading phase. If we choose accurately consumption materials and the reagents, aluminium contamination problems may be remarkably reduced avoiding all those decontamination operations often complicated; besides it is possible optimize a thermical program which allows the dosage of the Al-s without using chemical modificator. In this work has been practiced a quality control on 103 couples of samples relative to 62 dialyzed patients and blinded compared to the operator, obtaining a CV of 5.4% on the total average of 45.2 micrograms/l. We are convinced that at the present state the high quality of reagents and the utilisation of disposable materials individually wrapped, and even less the remarkable progress of electronics instrumentation of the last generation allow the use of this technique in a widespread way also in laboratories not particularly specialized.
Adult↗
Predicted and measured resting energy expenditure in healthy young women.
Basal energy expenditure (BEE) was either measured by indirect calorimetry or predicted by different formulae in 104 young women: 74 lean and overweight subjects (normal weight, NWt) and 30 obese subjects. The predictive equations were based on weight alone (Owen, FAO-1, Schofield-1) or on weight and height (Harris-Benedict, Mifflin, Kleiber, and again FAO-2 and Schofield-2). With the exception of the Owen equation all the equations over-estimated measured BEE in both study groups. The ratio between measured and predicted value (% MP) varied between 102.3 (Owen) and 87.7 (Kleiber) in the NWt subjects and between 113.2 (Owen) and 89.3 (Schofield-1) in the obese subjects. The range including 95% of the predicted-measured differences (PMdiff) was larger than 1700 kJ/d in the NWt group and 2300 kJ/d in the obese group. In both study groups most of the equations showed a significant relationship between PMdiff and/or % MP with body weight and the magnitude of BEE. In conclusion, these equations are of little help in predicting BEE in a single subject and should be used with caution when assessing energy requirements in populations or groups of subjects.
Journal Article↗
[Treatment of hyperlipidemia in patients with ischemic heart disease].
Do patients with coronary heart disease benefit from lipid lowering treatment? In the last 20 years clinical research has addressed this question considering 3 different endpoints: clinical events, progression and regression of atherosclerotic plaque, and vascular tone. Eight major secondary prevention trials showed that a 10% reduction in serum cholesterol led to reduction of 15% in the number of all myocardial infarctions. Seven secondary prevention trials based on coronary angiography showed that a 20% serum cholesterol reduction can induce regression and/or reduce progression of plaques in as short as 2 years. In vivo experiments have also shown that coronary spasms are the most common response to various stimulations in hypercholesterolemic individuals; vasodilation is the most common coronary response in subjects with low cholesterol levels.
Cholesterol↗
Primary prevention: HBV vaccination in hemodialysis unit.
The authors evaluated the response rate to HBV vaccination in 27 dialyzed patients. In the 1st stage, the response was 70.37%; nonresponder patients (n = 8) were treated with thymostimulin and revaccinated. The total percentage increased to 85.18%. In order to restore a normal response, the authors suggest to treat nonresponder patients with thymostimulin before revaccination.
Adult↗
A population study on the prevalence of gallstone disease: the Sirmione Study.
The prevalence of gallstone disease (cholelithiasis and previous cholecystectomy for gallstones) in the population of the town of Sirmione, Italy, examined by ultrasonography, was 6.7% in men and 14.6% in women, ranging from 18 to 65 yr of age (overall prevalence = 11%). The prevalence of cholelithiasis in the same age span was 6.9% (4.5% in men and 8.9% in women). Prevalence of cholelithiasis increased with age in both sexes. Twenty-two percent of gallstone subjects suffered from biliary pain vs. 2% of subjects without gallstones. No difference was observed in the frequency of nonspecific symptoms between subjects with and without gallstones. Of the 132 gallstone subjects, 108 (82%) were not aware of having gallstones prior to the study. Prevalence of gallstone disease was found to be higher in obese and hypertriglyceridemic subjects and to increase with the number of pregnancies.
Adolescent↗
[Respiratory function abnormalities in uremic patients].
Patients with end-stage renal disease treated by hemodialysis are exposed to continuous pulmonary insults of multifactorial origin. Alterations in respiratory drive, mechanics, muscle function and gas exchange are frequent in hemodialysis patients. Pulmonary dysfunction may be the direct consequence of circulating uraemic toxins or may result indirectly from volume overload, anaemia, immune suppression, extraosseous calcification, malnutrition, electrolyte disorders, and/or acid-base imbalances. We have emphasised how derangement of diffusing capacity represents the most frequent and important respiratory abnormality in haemodialysed patients. It has been postulated that some forms of selective damage in the alveolo-capillary wall interferes with alveolar gas exchange.
Humans↗
[Basal metabolism and postprandial thermogenesis in anorexia nervosa and constitutional leanness].
Body composition and energy expenditure (basal metabolic rate--BMR--and postprandial thermogenesis--PPT) were evaluated in 11 anorectic patients, 16 very lean young women and 26 control female subjects. BMR in absolute terms was severely depressed in the anorectics when compared to the other two groups (p less than 0.01). After adjustment for fat free mass BMR was significantly higher in the lean subjects than the controls (p less than 0.05). PTT was studied for 240 minutes after the ingestion of a 3.56 MJ mixed meal (16% Prot, 50% CHO and 34% Fat) in 7 anorectics, 7 lean and 8 control women. PPT was similar in the anorectics and in the controls, but lower in the lean subjects (p less than 0.05) than in the other two groups. This study shows that a sharp decline in BMR occurs in severely undernourished anorectic patients who, however, have a normal PPT. On the other hand, very lean healthy women tend to have higher BMR but a decreased thermic response to a mixed test meal.
Adipose Tissue↗
[Glycosylated hemoglobin in chronic renal insufficiency. Case contribution].
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Female↗