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Biomedical subjects

G Ciuffetti

Publications and source records attributed to G Ciuffetti.

At least 37 records · Page 2Linked to original sources

Plasma profiles of adrenocorticotropic hormone, cortisol, growth hormone and prolactin in patients with untreated Parkinson's disease.

Plasma profiles of prolactin, growth hormone, adrenocorticotropic hormone (ACTH) and cortisol were evaluated in a group of untreated patients with idiopathic Parkinson's disease and a group of healthy age-matched controls. Plasma integrated concentrations of all hormones except prolactin were significantly lower in the patients as compared with the controls; however, prolactin nocturnal peak concentration was significantly elevated in the patients; nocturnal growth hormone levels were significantly reduced in the Parkinson group; ACTH and cortisol plasma concentrations were also consistently lower during most of the day in the patients with Parkinson's disease. These data confirm the presence of a hypothalamic disturbance in patients with idiopathic Parkinson's disease, which can affect pituitary function.

Adrenocorticotropic Hormone↗

Blood rheology during bacterial infection in the elderly and early middle-aged.

The aim of this study was to ascertain if the hemorheological profiles in 35 elderly and 20 young to middle-aged patients returned to normal after bacterial infection. Erythrocyte sedimentation rates, fibrinogen levels, plasma viscosity, hematocrit, white blood cell count and filterability rates (through 5 mu diameter pore filters, using a low shear positive pressure Nuclepore filtration system) of red blood cells and unfractionated leucocytes were determined at the onset of acute bacterial infection, after 3 weeks at full clinical recovery, and again 2 weeks later at the end of convalescence. Our data confirm that rheological impairments exist at the onset of bacterial infection, and persist up to clinical recovery. At the end of convalescence the unfractionated leucocyte filterability rate was still significantly higher in the elderly patients, compared not only to our normal standard, but also to average values in the younger group.

Adult↗

Are leucocyte-derived free radicals involved in ischaemia in human legs?

Leucocyte-derived free radicals were monitored in 30 stage II peripheral vascular disease (PVD) patients in an open placebo-controlled study. Linked to a transcutaneous oxygen pressure (TcPO2) monitor, they performed two consecutive standard treadmill tests (5 min, 2 km h-1, 12% slope) before and after 15-days treatment with placebo or a leucocyte-derived free radical scavenger (Piroxicam, 20 mg day-1), the second test being carried out at the TcPO2 half-recovery time. Blood samples were collected at baseline, at the maximum walking times and the TcPO2 half recovery times. The total and differential leucocyte counts, the percentage of cells with pseudopodia or cytoplasmatic irregularities, the filterability rates (using a positive pressure Nuclepore filter system) of the main leucocyte subfractions and plasma oxidant activity were monitored. Compared with values before treatment and with the placebo-treated group Piroxicam therapy significantly (P less than 0.001) reduced the final half-recovery time, the percentage of cells with pseudopodia and the level of plasma oxidant activity (P less than 0.01) and kept the granulocyte filterability rate stable, showing leucocyte-derived free radicals are involved in peripheral ischaemia.

Exercise↗

Efficacy of low-molecular-weight heparin in the management of intermittent claudication.

Treating chronic arterial occlusive disease with heparin is controversial because of the risks associated with long-term anticoagulant therapy. Low molecular weight (LMW) heparin (mw about 5000 Dalton), which selectively inhibits the Xa factor with minimal risk of hemorrhage, seems to offer new possibilities in the prevention and treatment of both venous and acute arterial thromboembolism. Therefore, 44 patients with intermittent claudication were recruited to a randomized, double-blind, controlled study. Twenty-two were treated for six months with a single daily subcutaneous dose (15,000 UaXa) of LMW heparin and 22 with placebo administered in the same way over the same period of time. After six months, LMW heparin treatment not only improved walking capacity (by lengthening the pain-free walking time by 25%) but also significantly modified the hemorrheologic pattern (by reducing fibrinogen concentrations and whole blood viscosity at low shear rates). LMW heparin also exerted an antithrombotic and profibrinolytic effect by significantly increasing both the anti-Xa factor and plasminogen activity without markedly modifying activated partial thromboplastin time (+20%). No LMW heparin-treated patient hemorrhaged or reported other noteworthy side effects. These results suggest LMW heparin might be a useful drug in the long-term treatment of chronic arterial occlusive disease of the limbs.

Aged↗

Bacterial infection and peripheral vascular disease.

Whole blood filterability was monitored in 16 nondiabetic peripheral vascular disease (PVD) patients within forty-eight hours of onset of bacterial infection, after ten to seventeen days antibiotic therapy and again, ten days later, after convalescence. The whole blood filterability rate was constantly disturbed before infection in these patients; the impairment worsened significantly (as was expected during infection), but after convalescence the whole blood filterability rate did not return to preinfection levels. This further significant impairment in whole blood filterability was inversely correlated with a reduction in the patients' pain-free walking time as determined by a standard treadmell test performed after convalescence and compared with their average times before infection.

Bacterial Infections↗

Physical training and antiplatelet treatment in stage II peripheral arterial occlusive disease: alone or combined?

The efficacy of physical training alone or combined with antiplatelet therapy (dipyridamole and aspirin) was studied in 30 patients with stage II peripheral arterial occlusive disease (PAOD). Patients were randomly allocated to one of the following groups: Group A--dipyridamole 75 mg three times daily and aspirin 330 mg once daily: Group B--physical exercise; Group C--physical exercise and dipyridamole 75 mg three time daily and aspirin 330 mg once daily. After six months' treatment the pain-free walking time (PFWT) and the maximum walking time (MWT) improved significantly (p less than 0.05) in all three groups. In group A the PFWT lengthened by 35% (from 101.00 +/- 34.56 to 137.32 +/- 40.50 s) and the MWT by 38% (from 150.34 +/- 55.60 to 207.26 +/- 60.67 s); in group B the PFWT lengthened by 90% (from 90.65 +/- 40.54 to 171.45 +/- 55.60 s) and the MWT by 86% (from 145.39 +/- 60.50 to 270.63 +/- 63.61 s). When physical exercise was associated with drugs as in group C, the PFWT lengthened by 120% (from 89.51 +/- 43.89 to 196.72 +/- 51.73 s) and the MWT by 105% (from 160.43 +/- 59.84 to 329.05 +/- 63.96 s). No significant variations were observed at any stage of the study in the ankle/arm pressure ratio at rest and after standard treadmill exercise, in the plethysmographic rest and peak flows, or in the transcutaneous oxygen pressure in basal conditions and in its half recovery time after an induced ischemia. The results confirm the benefits of regular exercise in stage II PAOD patients but suggest they may be enhanced by antiplatelet therapy.

Aspirin↗

Whole-blood filterability in sudden deafness.

Sixteen patients with sudden deafness (SD), diagnosed on the basis of a battery of audiometric tests, but with no other medical or surgical pathology requiring drug treatment, underwent monitoring of their hemorheological profiles to see whether disturbances in the microcirculation could be linked to SD. Plasma viscosity, the filterabilities, (using a low-shear positive pressure system) through 5-microns-diameter pore Nuclepore filters, of whole blood and red and unfractionated white cells were monitored in 16 SD patients and 32 controls matched for age, sex and socioeconomic status. Whole blood filterability and the filterability of the red blood cells were significantly impaired in the SD patients, which suggests that alterations in the microcirculation are linked, in some way, to sudden deafness.

Adult↗

Blood rheology during induced ischaemia of the lower limbs.

The filterability rate of whole blood, the red and white blood cell sub-populations, and the erythrocyte and leucocyte count variations were studied during exercise in 20 male non-diabetic smokers, all with Stage II peripheral vascular disease (PVD), and 20 matched controls. A controlled ischaemia was induced using treadmill exercise. Blood samples were taken at rest, at the onset of calf pain and at haemodynamic recovery from peak exercise. Leucocytes were counted, separated using Ficoll-Hypaque into their sub-populations by centrifugation, and adherence to Petri dishes, re-suspended in buffer and filtered through 5 micron pore diameter filters. Whole blood filterability and the leucocyte count were significantly increased at the onset of calf pain. A significant increase was observed in the filterability of the monocyte sub-fraction and this persisted throughout the recovery period.

Blood Viscosity↗

Double-blind multicenter trial on a new medium molecular weight glycosaminoglycan. Current therapeutic effects and perspectives for clinical use.

The ability of glycosaminoglycans to bind to a wide number of biologically active macromolecules has already been investigated. Recent clinical trials on the possible therapeutic benefits of glycosaminoglycans must be placed in perspective, even if they appear to be particularly encouraging, especially as regards the glycosaminoglycan effects on certain coagulation factors. A multicenter, medium-term, double-blind, crossover trial was performed by several Italian Lipid Clinics to determine whether administration of a medium molecular weight glycosaminoglycan (Sulodexide) has a significant clinical effect. Patients affected by peripheral vascular disease and/or hyperlipidemia (type IIa, IIb and IV) were submitted to a 4-week wash-out period, followed by parenteral Sulodexide (S) or placebo (P) administration for 2 weeks, another 2 week wash-out period, parenteral crossover drug or P administration for 2 weeks and, finally, oral S administration for 6 months. Sulodexide lowered plasma viscosity and plasma fibrinogen in all patients. There was also a drop in triglycerides together with a rise in apo A-I and HDL-C in type IV hyperlipoproteinemics, whereas there was no significant effect on total or LDL-plasma cholesterol in type IIa and IIb patients. Moreover, there was a percent increase in peak flow and rest flow in the lower limbs of peripheral vascular disease patients. No side effects or intolerance phenomena were detected. The results indicate that Sulodexide administration may be useful in long-term treatment of patients with peripheral vascular disease and a concomitant increase in plasma triglycerides and/or fibrinogen and/or viscosity.

Adult↗

Stable angina pectoris and controlled ischemia: what causes the abnormalities in whole blood filterability?

The determinants of the altered whole blood filterability observed during coronary ischemia are still under discussion. Since no studies have been carried out to date on what exactly causes these alterations during the early stages of controlled ischemia in coronary heart disease, a model was set up using a bicycle ergometer test (with a 25 W increase every 2 minutes). Blood samples were taken from 48 stable angina pectoris patients and from a group of 28 matched controls before and immediately after exercise and 8 minutes later. Plasma viscosity, the filterability (through 5 microns diameter pore filters) of whole blood, erythrocytes, and polymorphonuclear and mononuclear leukocytes (separated by density gradient) were monitored. Alterations in whole blood filterability could be linked only to an impairment in polymorphonuclear cell filterability in those stable angina pectoris patients who reported chest pain and/or whose ST segment depression was greater than or equal to 2 mm.

Angina Pectoris↗

Temporal arteritis presenting as an extrapyramidal disorder.

A case of temporal arteritis presenting with extrapyramidal symptoms (tremor, rigidity and extrapyramidal hypertonus) unresponsive to conventional treatment is here described. The onset of headache and laboratory abnormalities suggestive of temporal arteritis prompted a temporal artery biopsy which confirmed the diagnosis; the administration of corticosteroids led to the resolution of all symptoms.

Aged↗

Physical exercise and blood flow properties.

In 46 executive level managers at risk for cardiovascular disease, whole blood filterability through five micron pore Nuclepore filters was monitored using a constant flow positive pressure system before and after treadmill exercise and compared to our laboratory standard. Our results show regular exercise compensates not only for the potential damage risk factors represent but also for the physical stress provoked by vigorous exercise.

Blood Circulation↗

Effects of ticlopidine on the neurologic outcome and the hemorheologic pattern in the postacute phase of ischemic stroke: a pilot study.

This double-blind pilot study observed the effects of a twenty-one day oral ticlopidine treatment (250 mg/twice daily) on the neurologic outcome and the hemorheologic pattern of 15 patients and 15 placebo-treated controls. Patients and controls (age range sixty-six to eighty-six years) were included in the study within twelve hours of the onset of ischemic stroke, confirmed clinically and by computerized tomography. Scores on Hachinski's Scale and the following hemorheologic parameters were monitored weekly for twenty-one days: fibrinogen levels, the whole blood, unfractionated white and red blood cell filterability rates (through 5-micron-pore-diameter filters using a constant-flow positive-pressure system), and the leukocyte count and activation (by microscopic observation). The results showed treatment with ticlopidine improved the neurologic outcome (Hachinski's Score +36%, p less than 0.03) slightly but significantly (p less than 0.001) increased the average values of the whole blood (+19%) and red cell (+17%) filterability rates and decreased fibrinogen levels (-17%).

Aged↗

B-mode imaging and histomorphometric evaluation of carotid atherosclerosis.

The quantitative and qualitative evaluation of atherosclerotic lesions by the ultrasonography has presented several problems, above all, the determination of accuracy and reproducibility of this methodology in humans. The present study aims to evaluated the results of B-mode imaging of extracranial carotid arteries in patients selected for surgery as compared with histologic results of the observations of the samples obtained by endarterectomy. Shrinkage effects of the histologic samples were taken into consideration. Several bidimensional images of atherosclerotic lesions, as obtained by ultrasound at different incident angles, were used to establish their maximum thickness. The maximum degree of the vessel stenosis calculated by ultrasound showed a high correlation (Y = 0.47X + 42.4, se = 0.11, r = 0.5, p less than 0.001) compared with the one obtained by histology. The imaging methodology provided however, a mean overestimation of the stenosis of about 7%. Relationships among the amount of calcium (p less than 0.03); necrotic core p less than 0.056); and echogenic types, ie, soft, mixed, and hard; have been suggested by a statistical trend. The results suggested that of the vascular lumen due to advanced atherosclerotic lesions. Qualitative interpretation of atherosclerosis by B-mode imaging, ie, morphologic characteristics, seem, at present, to be of value, but more investigations in depth are needed.

Arteriosclerosis↗

Reactive oxygen metabolites in peripheral arterial occlusive disease.

Plasma oxidant activity (marker of reactive oxygen metabolites) and the unfractionated leucocyte filterability rate (determined through 5 micron pore diameter Nuclepore filters, using a positive pressure system) were monitored in 15 stage II peripheral vascular disease (PVD) patients before and after ischaemia was induced by treadmill exercise (12 degrees slope/2 km/hour). Plasma oxidant activity increased (+ 115%) significantly (p less than 0.001) at the maximum walking time, correlating (r = 0.79) with a significant (p less than 0.001) impairment (+23%) in the unfractionated leucocyte filterability rate. At the transcutaneous oxygen pressure (tcPO2) half recovery time the plasma oxidant activity approached basal values but the unfractionated leucocyte filterability rate remained significantly (p less than 0.001) impaired (+16%). It returned to basal values at the full tcPO2 recovery time. These results show reactive oxygen metabolites are released during ischaemia of the lower limbs and are correlated with a significant impairment in the flow properties of leucocytes.

Arterial Occlusive Diseases↗

[The behavior of leukocyte rheology in induced ischemia in peripheral arterial occlusive disease].

We studied the quantitative and qualitative behaviour of white blood cells (WBCs) at rest and after standard treadmill exercise in 20 male stage II peripheral vascular disease (PVD) patients, compared to 20 healthy matched controls. The aim of this study was to define the role of WBCs in PVD. The results confirm the WBC count was significantly increased in PVD patients. Surprisingly, however, the only rheological WBC variable which showed a significant variation during the ischaemic pain caused by treadmill exercise was the filterability of mononuclear leukocytes. This would seem to identify disturbances in mononuclear filter-ability, associated with ischaemic pain resulting from claudication, as a functional sign of PVD.

Aged↗