Biomedical subjects

D Dal Monte

Publications and source records attributed to D Dal Monte.

5 recordsLinked to original sources

PubMed2001

Circadian differences in the individual sensitivity to opiate overdose.

OBJECTIVE: The aim of the present study was to test whether circadian differences in the response to opiates exist in humans and, if so, whether they are synchronized with the well-known circadian variations in overdose frequency. DESIGN: Daily variations in opiate overdose frequency, total amount of naloxone necessary to treat the comatose state, and frequency of hospitalization were examined in pure, nonlethal, consecutive cases of opiate (presumably intravenous heroin) overdoses. Furthermore, daily variations in the frequency of lethal overdoses were examined in all cases observed during the same period. SETTING: An 8-yr prospective, observational study in the city and suburban area of Ferrara, Italy. PATIENTS: A total of 518 consecutive cases of nonlethal opiate overdoses in 327 different patients, plus 110 consecutive cases of lethal opiate overdoses with precise or presumptive time of death. RESULTS: Analysis of the circadian distribution of nonlethal overdoses showed a significant peak in the afternoon to early evening. Analysis of the distribution of the hourly average amount of naloxone used to rescue patients from coma showed an opposite circadian variation, with a significant peak in the early morning. The hospitalization risk was also significantly higher from 3:00 to 8:59 am. However, in a subset of representative cases, plasma morphine concentrations did not change significantly in different hours of the day. Analysis of circadian distribution of lethal overdoses showed a significant peak in the evening hours. The death risk (calculated as the percentage of lethal events in the total number of intoxications within a given time frame) was significantly higher from 3:00 to 8:59 am. CONCLUSION: The present data provide evidence for the existence of circadian variations in the individual sensitivity to opiate overdose.

Adult↗

PubMed1996

The time for suicide.

To evaluate whether a time pattern exists in the occurrence of suicide, 223 cases observed in Ferrara, Italy, over a 10-year period were considered. The determination of the hour of suicide was precise in 99 cases, presumptive (within a range of 1 hour) in 53, while for another 44 cases it was possible to define a probable time of suicide, grouping into four 6-hour periods (night, morning, afternoon, and evening). The remaining 27 cases were excluded as it was impossible to determine the time reliably. The data were analysed both by means of chi 2 test for goodness-of-fit and by single cosinor. A specific pattern, characterized by a significant peak in the late morning -early afternoon hours was found for the entire sample and sex subgroups.

Adult↗

PubMed1994

Sudden death in diabetic subjects: evidence for a peculiar circadian variation in occurrence.

Anatomo-physiopathological and chronobiological features of 59 diabetic subjects out of 610 non hospitalized individuals observed for sudden death (SD) in an Emergency Room, over an 8-year period, were studied. Mean age and anatomopathological causes of SD were not different between diabetic (DMs) and non-diabetic subjects (NDs). However the frequency of DMs was higher among subjects who died from circulatory failure death (CFD), rather than from arrhythmic death (AD). Diabetics presented a prevalent peak incidence of SD in the afternoon-late evening; whereas in NDs two peaks were present, respectively in the morning and in the afternoon. According to anatomo-physiopathological causes, DMs presented a higher incidence of acute myocardial infarction (AMI) and CFD between 21:01 and 24:00, whereas in NDs the prevalent peak of AMI was observed in the early afternoon (13:01 to 16:00). Moreover, in DMs SD from acute myocardial failure prevalently occurred in the early afternoon (13:01 to 16:00), whereas in NDs it was uniformly distributed throughout the day. The present study seems to indicate that different anatomo-physiopathological causes of SD may present specific temporal patterns in diabetics.

Circadian Rhythm↗

PubMed1994

Anatomoclinical and chronobiological aspects of sudden death in elderly subjects.

Anatomoclinical and chronobiological aspects of sudden death (SD) of 671 subjects observed at the Emergency Room of Ferrara Hospital from January 1983 to December 1991 were prospectively investigated. 3 groups stratified by age were considered: group A with age < 65 years (no. = 251, 37.4%), group B with age between 65 and 74 years (no. = 210, 31.3%), and group C with age > or = 75 years (no. = 210, 31.3%). SD was classified on the basis of either anatomopathological (i.e.: acute myocardial infarction, acute myocardial failure, intracerebral hemorrhage, rupture of aortic aneurysm, pulmonary embolism), and clinical findings (i.e.: arrhythmic death and circulatory failure death). Patients were grouped into six 4-hour periods according to the time of onset of symptoms, and circadian distribution was tested for uniformity by a chi 2 test for goodness of fit. The analysis found in group C an increased frequency of SD due to pulmonary embolism and rupture of aortic aneurysm, and an increment of males/females ratio in deaths from cardiac causes. In group C the mean age of SD, in particular from acute myocardial infarction, pulmonary embolism or arrhythmic death proved higher in females compared to males. Only for group B was a significant circadian periodicity found for SD from acute myocardial infarction and arrhythmic death, with a peak in the morning.

Age Factors↗

PubMed1993

Sudden death may show a circadian time of risk depending on its anatomo-clinical causes and age.

The aim of this study was to determine whether the time of occurrence of sudden death exhibits a circadian rhythm depending on its different anatomoclinical causes. A longitudinal prospective investigation of 610 nonhospitalized subjects who died suddenly in the Emergency Room of Ferrara Hospital between January 1983 and December 1990 was conducted. All subjects underwent autopsy. Sudden death was classified on the basis of the following pathological causes; acute myocardial infarction, acute myocardial failure, intracerebral hemorrhage, rupture of aortic aneurysm, pulmonary embolism, and clinical causes, i.e., arrhythmia and circulatory failure. The investigated cases were stratified into 2 groups according to age; Group A = age < 70 years (n = 301, 49.3%), and Group B = age > or = to 70 (n = 309, 51.7%). The assessment of circadian rhythmicity was performed utilizing the single cosinor method. The results by cosinor analysis found a circadian rhythmicity for cases of sudden death (peak at 14.04, n = 610, p = 0.036), and in particular for females (peak at 13.12, n = 200, p = 0.004). Spectral analysis detected a statistical ultradian cycle in males having an 8-hour period (p = 0.015). A statistically significant circadian rhythm was found for cases of sudden death due to acute myocardial infarction (peak at 15.28, n = 330, p = 0.013), pulmonary embolism (peak at 11.46, n = 56, p = 0.003) and arrhythmia (peak at 13.08, n = 291, p = 0.04). In Group A no significant circadian rhythm was found, whereas in Group B a significant rhythmicity was found for sudden death from cardiac causes at 13.32 (n = 249, p = 0.015), from myocardial infarction at 15.02 (n = 154, p = 0.018) and from arrhythmia at 13.07 (n = 122, p = 0.014). Different circadian patterns of onset of sudden death may be shown in various subgroups of patients, due not only to different pathophysiologic mechanisms but also to anatomo-clinical aspects.

Age Factors↗