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Biomedical subjects

G Germanò

Publications and source records attributed to G Germanò.

At least 19 recordsLinked to original sources

Polyphenols synergistically inhibit oxidative stress in subjects given red and white wine.

Aim of this study was to analyse the relationship between the plasma levels of polyphenols and the antioxidant activity of red and white wine. Twenty healthy subjects (HS) were randomly allocated to drink 300 ml of red (n = 10) or white n = 10 wine for 15 days. Ten HS who refrained from any alcohol beverage for 15 days were used as control. Urinary PGF-2alpha-III, a marker of oxidative stress and plasma levels of polyphenols were measured. Urinary PGF-2alpha-III significantly fell in subjects taking wine with a higher percentage decrease in subjects given red wine (-38.5 +/- 6%, p < 0.001) than in those given white wine (-23.1 +/- 6%). Subjects taking red wine had higher plasma polyphenols than those taking white wine (1.9 +/- 0.6 microM versus 1.5 +/- 0.33 microM, p < 0.001). Plasma polyphenols were inversely correlated with urinary PGF2alpha (r = 0.77, p < 0.001). No changes of urinary isoprostanes were observed in subjects who refrained from wine intake. In vitro study demonstrated that only a mixture of polyphenols, all in a range corresponding to that found in human circulation, inhibited LDL oxidation and PKC-mediated NADPH oxidase activation. Such inhibitory effects were more marked using the concentrations of polyphenols detected in human circulation after red wine intake. This study shows that red wine is more antioxidant than white wine in virtue of its higher content of polyphenols, an effect that may be dependent upon a synergism among polyphenols.

Dinoprost↗

The (dP/dt)max derived from arterial pulse waveforms during 24 h blood pressure oscillometric recording.

BACKGROUND: The modern developments in engineering allow one to record the speed at which the blood pressure rises on the advancing pulse wave front. It was possible to obtain this through the conversion of a conventional pulse from a single suprasystolic oscillation to the oscillometric envelope into its first derivative with respect to time. OBJECTIVE: The aim of this study was to report a preliminary comparison between healthy subjects and patients with heart failure as a first step towards the clinical ujse of this first derivative of a time-dependent function (dP/dt).METHODS: For 10 normal healthy subjects (aged 37 +/- 5 yhears) and five subjects with ischaemic cardiomyopathy (aged 41 +/- 7 years), whose ejection fractions (invasively assessed) wee < 40%, we evaluated six sequential oscillometric measurements of blood pressure obtain by using a Dynapulse Ps5000 (Pulse Metric, San Diego, California, USA) device, which simultaneously records blood pressure and analyses every arterial waveform. The mean and SD of (dP/dt)max for each subject were calculated, together with the relative mean distribution and the significance of the differences. RESULTS: The data show that (dP/dt)max of subjects with an impairment of cardiac function is less than normal. The mean (dP/dt)max of normalk subjects was significantly different (P < 0.05) from that of patients with ischaemic cardiomyopathy and lower than normalk ejection fractions. CONCLUSION: These preliminary results allowed us to raise the hypothesis that this parameter, being representative of the cardiac function, because many data are obtained, is extremely useful for monitoring changes during daily activities or to outline the nycthoemeral rhythm. We have to test the hypotheses that the analyses of the correlations between (dP/dt)max and other haemodynamic parameters may be used in the pathphysiological study of cardiomyopathies and that the comparison of differences in (dP/dt)max can be used in the evaluation of the effects of the treatment.

Journal Article↗

Analysis of blood pressure rhythms for drug efficacy evaluation.

This study analyzes some methods of evaluating the effects of antihypertensive drugs on blood pressure circadian rhythm. We reviewed four different approaches: hourly averages, trough-to-peak ratio, cosinor method, and Fourier series applied to the same data to prove the time course of the effects of isradipine administered once daily. A total of 141 patients of both sexes (mean age 53 years, range 30-76) with mild to moderate essential hypertension were enrolled in this multicenter trial after a 2-week placebo run-in. Treatment with isradipine SRO 5 mg/day administered between 8 and 9 AM was started. Each patient underwent ambulatory BP monitoring at the time of entry and after 6 weeks of treatment. Calculation of hourly averages showed decreases after 4 AM, and from about 8-9 AM, when the drug was administered, and the decreases practically did not vary until about 10 PM. Subsequently, the decreases became smaller and indicated reduced drug activity. However, this hypothesis no longer held after 4 AM. The trough-to-peak ratio was calculated including hourly averages after the dose divided by the lowest hourly average. Both systolic and diastolic blood pressure showed constant reduction from 3 PM (time of peak) to 11 PM. However, after 11 PM, higher trough-to-peak ratios paradoxically occurred due to a major reduction obtained with placebo, and the negative percentages just before the next dose cannot be attributed to treatment. Applying the cosinor method, maximal values were greatly underestimated, nocturnal values were overestimated, and the absolute maximum occurred in proximity to the minimum relating to postprandial dip. The generalized cosinor model, known as Fourier partial series, was always curtailed to the third harmonic. Fourier analysis was able to describe the daily trend of BP both before and after isradipine administration. We used statistical tests to determine if the differences described by the models were significant. The tests indicated significant mean level reductions after therapy and no appreciable amplitude and phase-related variations. The nocturnal and periawakening intervals, in which BP changed linearly, oscillated between 3 and 4 hours. Within these intervals BP rose by 13-16 mm Hg or fell by 14-19 mm Hg. The intervals, ranges, and speed differences were tested and were never significant. The medication tested was effective only at the mean level, the variables used to characterize the time course of its effect remaining unchanged. There was no significant phase shift of the curves, and BP rhythm was preserved.

Adult↗

[A validation of the data obtained with the simultaneous recording of blood pressure and the 24-hour electrocardiogram].

Aim of this study was to evaluate the blood pressure (BP) measurement reliability of a light weight ambulatory BP and ECG recorder. Micro AM is a new 300 g portable apparatus that combines in one device both the ambulatory BP and solid state ECG recording. The dimensions of the Micro AM are 75 x 140 x 29 mm. The monitor measures BP using Korotkoff phase 1 for systolic and phase 5 for diastolic BP, and concurrently measures oscillometric BP, one method validating the other. In addition, the manual and programmed BP measurement modes can be supplemented by an "intelligent" mode in which the ECG triggers an ambulatory BP reading during an abnormal ST segment change. A standard mercury manometer was connected with the cuff of the Micro AM with a Y-shaped part, and 12 BP measurements were simultaneously taken at 5 min intervals by the automatic device in auscultatory mode and by a trained technician in 86 normotensive volunteers (aged from 18 to 44 years, 37 males and 49 females). The algebraic differences, the frequency distribution and the difference distribution of systolic and diastolic data between the 2 methods were calculated. The results show that the automatic method gives values for systolic BP that are lower than conventional ones (average differences -0.643 mmHg), whereas for diastolic BP, the values are higher (average differences +0.229 mmHg). Then, Student's paired t-test was used to evaluate statistically significant differences. The test relative to systolic BP was significant to the critical level of 0.1%, but the differences being 3 times smaller than the instrumental tolerance. On the contrary, diastolic BP differences were non significant. In conclusion, we found a good agreement between BP recorded automatically and by sphygmomanometer.

Adolescent↗

Plasma insulin levels do not change during atrial natriuretic factor infusion in human essential hypertensives.

In order to evaluate the effects of atrial natriuretic factor (ANF) infusion on plasma insulin (IRI) in hypertension, 32 essential hypertensives (aged 40 to 62 years) were studied. After 1 week of pharmacologic washout under normal sodium intake (120 mEq of Na+/day), patients were randomly assigned to receive either ANF (0.04 micrograms/kg/min) or its vehicle (50 mL of isotonic saline) over a 60-min period in supine position. Plasma IRI and glucose were measured at -60, 0, 20, 40, 60, 120, 180, and 240 min (infusion time: from 0 to 60 min). Plasma levels of IRI and glucose did not change significantly during ANF infusion. On the contrary, after ANF discontinuation plasma IRI rose from levels of 13.5 +/- 6.4 microU/mL at 60 min to values of 20.1 +/- 11.3 microU/mL at 240 min (P less than .0001 v time 0). Plasma glucose showed a similar behavior, increasing from values of 100.4 +/- 5.0 mg/dL at 60 min to values of 120.0 +/- 5.1 mg/dL at 240 min (P less than .02 v time 0). Our findings suggest that ANF did not influence insulin release in hypertensives. The increase of plasma glucose and IRI observed after ANF discontinuation could be due to the relapse of sympathetic activity, suppressed during ANF infusion.

Adult↗

[Effects of nicardipine in hypertensive patients with chronic kidney insufficiency].

There has been a increasing awareness that calcium antagonists may have beneficial effects on the kidney. Therefore we evaluated the renal and antihypertensive effects of nicardipine treatment in 12 hypertensive patients with chronic renal failure. The drug was given at a dose of 20 mg three times a day. Blood pressure was normalized in almost all cases while the indexes of renal function were improved. A transient deterioration of renal function, probably due to reduction of glomerular capillary pressure was observed in some cases. In conclusion, our data showed a beneficial effect on renal function during nicardipine therapy. This effect could be absent in the most advanced degree of renal damage.

Adult↗

Evaluation of the effect-duration of once-daily enalapril compared with once-daily captopril.

The extent and duration of the antihypertensive effect of enalapril and captopril, both given once daily, were evaluated in 12 mild-to-moderate essential hypertensives by 24-hour noninvasive blood pressure (BP) monitoring (Pressurometer IV-mod 1990-1991, Del Mar Avionics). Patients were randomized to a cross-over regimen either with enalapril, 10-20 mg, followed by captopril, 50-100 mg (first group), or with captopril followed by enalapril (second group). The dose was doubled if, at week 3 of each treatment, the diastolic BP remained at 90 mm Hg. Doubling of the 2 drugs was not required in 4 patients; in 7 patients the dose of both drugs was doubled; and in 1 patient the dose of only captopril was doubled. Two of the 7 patients who required doubling of both drugs were considered nonresponders to enalapril and captopril. The circadian rhythm was not altered by the treatments, and the drugs reduced BP mainly during the waking hours. However, the second peak of systolic BP in the late afternoon did not graphically appear to be modified by captopril administration. A periodic asymmetric model with 3 harmonics analysis carried out on 24-hour BP data justifies only the use of enalapril for once-daily administration.

Adult↗

[Nitrendipine: evaluation of the duration of the antihypertensive effect at different doses using the conventional method and ambulatory monitoring of arterial pressure].

To evaluate the effect-duration of nitrendipine in 20 moderate essential hypertensives (aged from 42 to 66, mean +/- SD: 55 +/- 7) when treated with 20 mg once or twice a day, we utilized the blood pressure standard method of measurement and the ambulatory monitoring. Blood pressure determinations were made during the follow-up at 2- week intervals for 3 months, each measurement being made with a mercury sphygmomanometer, 24 +/- 3 hours after the last dose; laboratory parameters, 2 24-hour blood pressure monitoring (ICR 5200, Spacelabs) and standard ECG were performed at baseline and after 3 months. Following a 2-week run-in period with placebo bid (at 10.00 am and 10.00 pm) a 20 mg morning dose of nitrendipine was started continuing the administration of the placebo tablet at 10.00 pm. The dosage was changed to a twice active daily regimen, with an increase in the daily dose (20 mg twice a day) in those patients whose diastolic blood pressure remained greater than 90 mmHg after a 4-week control. After the twelfth week, another 2-week placebo run-in followed the active treatment. Supine blood pressure recorded after 3-month therapy, showed a significant (p less than 0.0001) reduction in both systolic and diastolic mean values (22/15 mmHg) at the end of active treatment in the 16 patients who ended the trial. In particular, the responders to 20 mg (5 patients) showed a blood pressure reduction of 18 mmHg in comparison with the run-in period; in the other group of responders to increasing dosage of 40 mg (11 patients), we observed a 8 mmHg diastolic blood pressure reduction at 28 days and a successive 7 mmHg at the end of the treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Use of the CO2 laser in the treatment of cutaneous malignant melanoma: lymphoadenectomy].

The Authors, after pointing out the incidence of complications subsequent to lymphoadenectomy performed with the traditional means (lymphorrhea, dehiscence of the pound, etc.), report their experience concerning the removal of inguinal or aqillary lymphnodes of patients suffering from cutaneous malignant melanoma (N+), performed pith laser lancet. After a short description of the peculiar features of the Laser Surgical Unit they used, the Authors emphasize that, thanks to the peculiar power for the laser lancet to close the lymphatic vessels during the lancing itself, surgeons can prevent the postoperative lymphorrhea, which is the main cause of dehiscence of such surgical wounds.

Carbon Dioxide↗