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Biomedical subjects

G Ciuffetti

Publications and source records attributed to G Ciuffetti.

87 records · Page 5Linked to original sources
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Blood pressure and functional aspects of the aging brain.

This study was carried out to define the effects of both long-term hypertension and hypotension on the cerebral functioning of the elderly, comparing them to the effects of normotension. Ninety-eight subjects of both sexes, between 70 and 82 years of age, were divided into three groups on the basis of their mean blood pressure: 33 normotensives, 36 hypotensives and 29 hypertensives. They underwent a neuropsychological assessment, a haemorrheological evaluation and an EEG monitoring while awake. The results show that the three parameters were almost always within normal limits in the normotensives, while EEG alterations, lower neurophysiological scores and blood hyperviscosity were noted in both the hypertensives and hypotensives. Our results would seem to confirm that long-term hypertension may induce alterations in the cerebral electrogenesis and intellectual functions of the elderly and that also long-term hypotension might negatively interfere with some functional aspects of the aging brain.

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Free radical production in peripheral vascular disease. A risk for critical ischaemia?

Malondialdehyde (MDA) plasma concentrations (marker of lipid free radical peroxidation) and the unfractionated leucocyte and erythrocyte filterability rates (through 5 micron Nuclepore filters in a positive pressure filtration system) were determined during a partial ischaemia induced by two consecutive treadmill tests in 64 stage II peripheral vascular disease (PVD) patients and in 32 matched controls. Transcutaneous oxygen pressure (tcPO2) was monitored constantly throughout the walking tests and recovery periods. In the PVD patients impairments in the flow properties of leucocytes and erythrocytes were associated with increases in MDA plasma concentrations which correlated significantly with a lengthening of the tcPO2 half recovery times--index of the worsening of ischaemia. Patients could be divided into two sub-groups on the basis of these impairments and their half recovery times, suggesting this experimental model may provide a means to identify those stage II PVD patients most likely to develop critical limb ischaemia.

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[Rheologic effects of salmon calcitonin on post-menopausal osteoporosis. Results of a preliminary study].

The aim of this random blind vs placebo study was to assess the effect of salmon calcitonin (sCT) (100 UI/day intermuscular for 4 weeks) on the haemorheological pattern of 20 women, all non-smokers, aged between 50 and 65 years of age and affected by post-menopausal osteoporosis. Hematocrit, whole blood viscosity at high and low shear rates, plasma viscosity, red blood cell aggregation, dynamic deformation and viscosity were monitored. Our results show sCT ex vivo seems to act upon mechanisms regulating the plastic properties of the red blood cell membrane.

Calcitonin↗
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Effect of physical training on leukocyte rheology throughout induced ischaemia.

Before and after a physical training programme a treadmill exercise was used to stress leg circulation and induce ischaemia in 20 patients affected by peripheral arterial occlusive disease (PAOD). Transcutaneous oxygen pressure (TcPO2) was monitored constantly and blood samples drawn at baseline, the onset of calf pain, the maximum walking time, the minimum TcPO2 value, and when the TcPO2 recovered half its basal value. The mononuclear and polymorphonuclear leucocyte subfractions were separated by density and their filterability rates (through 5 microns pore diameter Nuclepore filters) measured using a positive pressure filtration system. The mononuclear filterability rate was significantly impaired throughout the ischaemic event and inversely correlated with the TcPO2 values. Physical training while delaying the onset and progress of ischaemia did not modify this pattern, implying that regular exercise does not affect the rheological properties of leukocytes--impairments in which are markers of ischaemia.

Carbon Dioxide↗
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[Infection and blood filterability].

Some markers of inflammation were monitored, and whole blood filterability was measured using a low shear positive pressure nuclepore filtration system in 21 patients at the onset of an acute bacterial infection and again after full clinical recovery 4 weeks later and compared to the filterability of 40 matched healthy controls. Impairments in whole blood filterability persisted even after convalescence.

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[Peripheral arterial occlusive disease in old age: the role of leukocytes].

Transcutaneous oxygen pressure (tcPO2), the unfractionated leukocyte filterability rate (ULFR), and plasma oxydant activity (POA) were monitored during a standard treadmill exercise test (2 km/h, 12 degrees slope) in two groups of stage-II peripheral vascular disease patients: one middle-aged group with an average age of 55 +/- 3 s.d. years, the other group elderly (average age 68 +/- 4 s.d. years). The results were compared to a healthy control group of 20 volunteers (average age 52 +/- 4 s.d. years). At the maximum walking time, the ULFR was significantly (p less than 0.001) impaired in both groups of patients compared to controls, and the level of plasma oxidant activity increased significantly (p less than 0.001). When the tcPO2 recovered half its basal value, the level of plasma oxidant activity approached basal values but the ULFR remained significantly (p less than 0.001) impaired. Inter-group analysis showed the total walking time was significantly (p less than 0.05) shorter in the elderly patients, and at the tcPO2 half recovery time the ULFR was significantly (p less than 0.01) more impaired.

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[Infection and tissue ischemia: role of cellular rheology].

It is not clear how acute infection is associated with a subsequent ischaemic brain infarction. Infection may, indeed, cause changes in blood fluidity. Abnormalities in blood flow, particularly in white blood cell rheology, are known to be precipitating factors for ischaemic events. Therefore, the rheological behaviour of the erythrocytes and of the main leucocyte subpopulations (granulocytes = G; mononuclear cells = MNL) were studied in 29 patients 30 days after the onset of acute bacterial infections. A group of 49 controls (matched for sex, body mass index and cardiovascular risk factors) was also evaluated. A significant impairment in the flow properties of the mononuclear leucocyte subpopulation was found in the patients as compared to control. These results indicate that disturbances in leucocyte rheology might be considered an additional risk factor for ischaemic brain infarction when this occurs shortly after febrile infection.

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Severe osteomalacia due to gluten-sensitive enteropathy.

This report discusses a severe case of osteomalacia due to gluten-sensitive enteropathy: it stresses the clinical features and describes an atypical form of gluten-sensitive enteropathy, in which gastroenterological symptoms were absent. Wasting and osteomalacia causing skeletal deformation with spontaneous fractures were observed in a 31-year-old woman who had marked hypophosphoremia, a tendency to low serum calcium levels and slight multi-deficiency anaemia. The patient was in a state of depression. The causes of osteomalacia and then a general malabsorption syndrome were investigated. Anti-gliadin antibodies were positive. Histological tests on duodenal mucous revealed a pattern indicative of gluten-sensitive enteropathy. A gluten-free diet was prescribed and at a check-up one month later the patient had improved markedly. Skeletal symptoms are predominant in 30% of atypical forms of gluten-sensitive enteropathy. The severity of this case was due to a late diagnosis.

Acute Disease↗
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Leucocyte-endothelial interactions in chronic critical limb ischaemia.

Forearm blood samples were drawn from 18 patients with critical limb ischaemia (stage IIIb peripheral arterial obliterative disease) and 18 age- and sex-matched controls at 8.00 a.m., 2.00 p.m. and 8.00 p.m. We monitored the total and differential leucocyte counts and leucocyte expression of CD11/CD18 integrins (on whole blood samples by indirect immunofluorescence on a FACScan flow cytometer). Our results show no significant difference in any parameter at any stage of the day. At all study times, the total and differential leucocyte counts and granulocyte expression of CD11/CD18 were significantly (p < 0.001) greater in patients compared with controls. Associated with a high leucocyte count, constant up-regulation appears to be a feature of chronic tissue ischaemia. Activated neutrophils seem to aggravate peripheral arterial obliterative disease locally and may contribute to disseminated organ damage.

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