Biomedical subjects

F Binaghi

Publications and source records attributed to F Binaghi.

At least 19 recordsLinked to original sources

PubMed2002

Nailfold capillaroscopy and laser Doppler flowmetry during standardised cold challenge to evaluate capillary pattern and digital flow in idiopathic acrocyanosis.

Quantitative correlation between capillary morphologic patterns and digital pulp flow in idiopathic acrocyanosis (IA) is as yet unexplained. We studied capillary pattern, scored according mainly to capillary dilatation and tortuosity. Digital flow was recorded by laser Doppler flowmetry during a standardised cooling and rewarming thermal challenge in a controlled thermostatic chamber. A negative correlation was found by linear regression analysis between increasing capillary abnormalities and decreasing flow rates both at rest and during cooling, while a positive correlation was observed among the presence and intensity of the flow stop reaction during cold challenge and the decrease of hyperaemic re-flow in the rewarming phase. Further investigations may be justified to assess the nature of these abnormalities, whether constitutional or induced by prolonged cold exposure. For this purpose, a standardised method, as the cooling-rewarming challenge, could verify the several pathophysiological hypotheses proposed for vascular acrosyndromes. We need to use a subjective method such as capillaroscopy-based scoring (as in our study endorsed by an objective technique) to acquire the necessary reliability and reproducibility in the functional diagnosis. In fact IA patients with lower morphologic scores show better flow properties.

Blood Flow Velocity↗

PubMed1998

Anticipation of age at onset in panic disorder.

OBJECTIVE: Anticipation (i.e., the decrease in age at onset or the increase in severity of a disorder in successive generations) has recently been reappraised as a key to understanding the genetics of some familial illnesses. The purpose of this study was to search for possible anticipation in panic disorder. METHOD: Thirty-eight unilineal, multigenerational families with multiple directly interviewed members who had panic disorder were compared across two successive generations for 1) age at the first panic attack, 2) age at the onset of panic disorder, and 3) the highest degree of agoraphobia ever experienced, as a tentative index of severity of illness. Intergenerational pairwise comparisons were implemented according to four different sampling schemes: random pairs, random transmitting pairs, all possible pairs, and all possible transmitting pairs. RESULTS: Life table analyses showed a significant decrease in the time before the first episode of panic and onset of panic disorder from the older to the younger generation. Evidence for anticipation was found for both indexes of onset in all four sampling schemes. No evidence of a generational effect on the index of severity of agoraphobia was found. Corrections for possible biases suggested that these results are not likely to be simple artifacts. CONCLUSIONS: Anticipation is supported in this specific set of families and, if it is confirmed by other studies, a role for trinucleotide repeat sequences may be considered to account for the familial aggregation of panic disorder.

Adolescent↗

PubMed1996

Plasma levels of the molecular markers of coagulation and fibrinolysis in patients with peripheral arterial disease.

In 103 patients with peripheral arterial disease (PAD) of the lower limbs, coagulation and fibrinolytic parameters were evaluated to identify hemostatic abnormalities characteristic of this patient population. PAD was defined as clinically stable Leriche stage 2 (based on clinical history, peripheral pulses, ankle-arm index, and treadmill test) for at least 3 months, walking distance > 100 m, and no other major illnesses, rest pain, or trophic lesions. Defibrotide, a polydeoxyribonucleotide derivative with vascular effects, was administered to the patients as part of a multicenter trial. The PAD patients exhibited a prothrombotic state as evidenced by high D-dimer in all but 24% of the patients (average 797 +/- 802 vs. 163 +/- 54 ng/mL normal population; p < 0.001) and high thrombin-antithrombin III complex (TAT) levels (10.2 +/- 8.9 vs. 2.5 + 1.5 ng/mL; p < 0.001) with low to normal levels of protein C (86 +/- 25 vs. 102 +/- 18%; p < 0.01) and plasminogen activator inhibitor-1 (PAI-1) antigen (5.9 +/- 4.5 vs. 1.3 + 0.7 ng/mL; p < 0.001) were elevated in 79% of the patients. These results suggest that there is ongoing thrombosis in the majority of PAD patients. Differences from normal controls were observed for t-PA, PAI-1, protein C, and protein S; however, it is not certain that the thrombosis in patients with PAD is due to these factors.

Adult↗

PubMed1994

[The evaluation of the oximetric and Doppler sonographic parameters in patients with chronic venous insufficiency. A controlled double-blind clinical study versus placebo].

Twenty four patients suffering from chronic venous insufficiency of the lower limbs were treated with sulfo-mucopolysaccharides (SMPS) or placebo in a double-blind controlled study. At recruitment, and again at 60 and 120 days of ongoing treatment, each patient was tested for transcutaneous partial oxygen tension and for pressure in the posterior tibial vein and saphena by Doppler sonography. Findings were assessed in each case separately for the affected limb versus the unaffected, or for the more severely affected versus the contralateral limb in patients affected bilaterally. Patients treated with the test product, but not those treated with placebo, showed definite reduction of venous pressure in the posterior tibial vein and internal saphena of the affected or more severely affected limb at 60 days of treatment: namely -35% from basal for the posterior tibial vein and -28% for the internal saphena. Again on the affected or more severely affected side, patients treated with SMPS showed improved transcutaneous oxygen tension amounting to +13.8% from basal at 60 days, as opposed to worsening condition in the placebo group.

Adult↗

PubMed1994

Prevalence of peripheral arterial occlusive disease and associated risk factors in a sample of southern Sardinian population.

We studied a sample of adult population over 20 years old of Donori (totally 2049 inhabitants), a small town near Cagliari, South Sardinia, to: (1) Evaluate the prevalence of peripheral arterial occlusive disease of lower limbs (PAOD) diagnosed by standard questionnaire and US CW Doppler examination and associated risk factors in South Sardinia. (2) Compare the reliability of these two diagnostic methods. Our study included the answers to a standard anamnestic questionnaire (according to the WHO recommendations), physical examination and CW Doppler study of the lower limb arteries, the determination of the arterial systolic and diastolic pressure, ankle/arm pressure ratio, Body Mass Index, blood glucose, total and HDL-cholesterol, triglycerides and fibrinogen (the hematochemical examination only on 50% of the sample). The surveyed sample was of 577 subjects (37.96% of 1520, the eligible subjects over 20 years old), 237 males and 340 females. An arteriopathy was diagnosed by means of CW Doppler in 27 subjects, 20 M and 7 F. The overall prevalence of PAOD was 4.67% of the sample (2.06% of females, 8.43% of males). Prevalence steadily increased with age, and, surprisingly, the disease was not absent in young people (2 cases within males with age < or = 40 years). Conversely only 18.5% of PAOD patients were symptomatic. The overall prevalence of associated risk factors was: diabetes 3.6%, hypercholesterolaemia 59.1%, smoking 21.3%, arterial hypertension 21.6%, obesity 17.9%, hypertriglyceridaemia 9.3%, hyperfibrinogenaemia 4.67%. Among the males a significant correlation has been found, among the values of BMI vs age and total cholesterol, age vs total cholesterol, systolic blood pressure, diastolic pressure, fibrinogenaemia. Among the females, the systolic and diastolic pressure, BMI, total cholesterol, LDL-cholesterol, triglycerides and fibrinogen are significantly correlated with age; BMI correlates with systolic and diastolic blood pressure, fibrinogen; a nearly significant correlation has been found between BMI and triglycerides.

Adult↗

PubMed1994

[Relation between changes in the microcirculation in the capillaries supplying the toenails and the degree of chronic venous insufficiency].

Chronic venous insufficiency (CVI) is characterised by stasis which may lead to an imbalance in the cutaneous microcirculation resulting in a wide spectrum of complications. The use of capillaroscopy on the toenail folds of patients with CVI allows the morphological and microhemorrheological aspects of microcirculatory disorders to be studied. The aim of this study was to clarify the correlation between the extent of abnormalities of the nutritional capillary and the degree of severity of CVI according to Widmer's classification. Capillaroscopy of the toenail fold was used to study 100 patients suffering from essential varicose disease (EVD) and post-thrombotic syndrome (PTS) with CVI of various degrees, giving a total of 110 limbs grouped as follows: 30 limbs at stage 0; 49 at stage 1; 20 at stage 2 and 12 at stage 3. In addition, a further 30 limbs of normal subject without a family history of varicose disease were included in the study. All patients and control subjects were examined clinically and using ultrasound c.w. Doppler and eco-color-Doppler of the lower limbs. The results highlighted a progressive deterioration of the capillaroscopic conditions in relation to the severity of CVI. In particular, during stage 1 microcirculatory alterations found in patients with primary varicose syndromes appeared to be more severe than those with PTS. This apparent contradiction may be attributed to the unique topography of this hemodynamic disorders since the subpapillary circulation in EVD is topographically in direct continuity with the site of venous hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

Chronic Disease↗

PubMed1991

A double-blind, multicenter, placebo-controlled, dose comparison study of orally administered defibrotide: preliminary results in patients with peripheral arterial disease.

Defibrotide is a polydeoxyribonucleotide drug known to modulate the endothelial cell release of t-PA, PAI, and PGI-2 and to improve blood flow and perfusion. A double-blind, multicenter, placebo-controlled, dose comparison study was carried out to test the long-term efficacy and safety of defibrotide in patients with PAD (Leriche stage 2). Informed patients suffering from PAD were enrolled, and after a 15-day washout period were randomly allocated in a double-blind fashion to one of the three following treatments: defibrotide 400 mg (1 cps) b.i.d. for 6 months, defibrotide 400 mg o.d., or placebo. Absolute walking distance (AWD, treadmill) and ankle-arm pressure ratio (Winsor Index, WI) were evaluated at the beginning and after 30, 90, and 180 days after therapy. Two hundred twenty seven patients were recruited and 193 patients were included in the final analysis (800 mg: 67; 400 mg: 60; placebo: 66). All treatments brought about an increase in AWD placebo = +17%; 400 mg = +47%, 800 mg = +52%); however, patients treated with defibrotide exhibited a significantly better AWD at the end of treatment in comparison with placebo (p less than 0.01). AWD was not significantly different in the 400-mg and 800-mg groups. There was a trend indicating a possible improvement of WI after defibrotide, with higher WI in 800-mg patients in comparison with placebo (p less than 0.05). However, this difference was partly due to a decrease in arterial blood pressure elicited by the drug. The tolerability in all groups was optimal. These results indicate that orally administered defibrotide exerts symtomatic benefit in PAD patients and daily doses of 400 or 800 mg seem to be equivalent.

Administration, Oral↗

PubMed1991

[Effects of physical exercise and indobufen in patients with intermittent claudication. Results after a 2-year follow-up].

The study included 18 patients suffering from intermittent claudication before (stage 1) and after (stage 2) 3 months of rehabilitative training and after 2 years of follow-up (stage 3) during which patients undertook regular exercise (walking for 1 hour 3-4 days a week) and antiplatelet aggregating therapy with indobufen (200 mg x 2/day). A comparison of the data revealed that:a) there was a significant and gradual increase in the claudication pain distance (CPD) and maximal walking distance (MWD), and a reduced recovery time between stages 1 and 3 (parameters were assessed during and after walking on a treadmill (rolling mat) at a speed of 3.2 Km/h on a 12% slope); b) the resting ankle/arm pressure ratio was unchanged, but a significant increase was observed when the ratio was measured after exercise between stages 1 and 3; c) fibrinogenemia was significantly reduced between stages 1 and 2. Out of 18 subjects studied, 8 exceeded an MWD of 640 metres (maximum limit of exercise test which was suspended after 12'), 3 became asymptomatic, and 1 showed a significantly reduced capacity to walk. The paper concludes that, although it is necessary to obtain a confirmation from controlled studies, indobufen therapy and regular physical exercise represent an efficacious therapeutic approach, even over a long-term period, to stage II chronic arteriopathies of the lower limbs.

Aged↗

PubMed1988

[Laser Doppler flowmetry. Principles and clinical applications in vascular acro-syndromes].

Twenty-seven subjects with vasospastic diseases: 13 primary and 5 secondary Raynaud phenomenon (RP), 3 primary RP treated with raubasin 60 mg/day, 6 acrocyanosis and 9 normal subjects were studied in a standardized experimental set (thermostatic chamber), recording cutaneous digital micro-vascular reactions to cold and heat exposure by laser Doppler flowmetry, a relatively new method for the objective and reliable assessment of blood flow in the cutaneous microvasculature. The data suggest that patients with vasospastic disease have a defect in local microvascular flow regulation, that is revealed by low temperature exposure. The major difference between primary and secondary RF was recovery time (stop reaction) after cold test, that is easily recorded by this instrumental set. The morphology of the recording and the flow recovery time of acrocyanosis were found to be similar to those of secondary RF.

Blood Flow Velocity↗

PubMed1988