Biomedical subjects

G Laurora

Publications and source records attributed to G Laurora.

At least 19 recordsLinked to original sources

PubMed1995

Doppler ultrasonography of the central retinal artery in patients with diabetes and vascular disease treated with topical timolol.

Using high-resolution duplex scanning it is possible to evaluate the blood flow velocity in the central retinal artery of the eye. Four different patient groups were studied with this technique: normals, diabetics with a decreased flow, diabetics with an increased flow and vascular patients with a decreased flow. The eyes of these patients were then treated with topical timolol and the flow measured again. An increase in the flow was found in three of the four groups. This increased flow velocity may be due to a vasodilatory effect of timolol. The results are presented and discussed.

Administration, Topical↗

PubMed1995

[Lymphedema. New non-invasive methods for diagnosis and follow up].

Lymphedema is still a difficult clinical problem, poorly investigated and new methods of evaluation are needed to improve the understanding of its pathophysiology. Lymphoscintigraphy is diagnostic but cannot be repeated frequently in the follow-up. In this study we have evaluated four new methods of evaluation of lymphedema which may be used to quantify the problem and to follow-up patients. These methods are: A. the evaluation of the ratio between the concentration of lymphatic fluid proteins and plasma proteins concentration (CL/CP); B. the test of the spontaneous clearance of a haematoma; C. high-resolution ultrasound imaging of low density spaces (SBD) in the subcutaneous tissue, possibly corresponding to dilated lymphatic spaces; D. the combination of imaging and CL/CP ratio. Comparable groups of normal subjects, patients with primary lymphedema diagnosed with lymphoscintigraphy and patients with chronic venous insufficiency have been evaluated. The four methods appeared useful to differentiate normal subjects from those with lymphedema. However the separation between lymphedema and chronic venous insufficiency was less evident. Edema due to systemic causes (cardiac failure, nephrotic syndrome or chronic venous insufficiency) is also differentiated from lymphedema. In conclusion these tests may be useful to evaluate lymphedema (particularly in the early phases, when the clinical presentation is unclear), to follow-up its evolution and possibly to evaluate the effects of treatments.

Chronic Disease↗

PubMed1995

Microcirculation in high perfusion microangiopathy.

Using laser-Doppler flowmetry in association with other noninvasive microcirculatory techniques such as transcutaneous PO2 and PCO2 and capillary filtration measurements it is possible to define two major types of microangiopathy. Low perfusion microangiopathy (LPM) is observed in peripheral vascular disease, essential hypertension, Raynaud's disease etc. High perfusion microangiopathy (HPM) is observed in venous hypertensive microangiopathy and diabetic microangiopathy. In both these conditions there is an increased skin flux, decreased venoarteriolar response and increased capillary filtration leading to edema formation. In HPM elastic compression and drugs acting on capillary filtration effectively reduce skin flux and the increased capillary leakage and edema formation.

Bandages↗

PubMed1995

Progression of subclinical atherosclerosis in 6 years. Ultrasound evaluation of the average, combined femoral and carotid bifurcation intima-media thickness.

The intima-media complex thickness (IMT) was evaluated in 472 asymptomatic subjects in a 6-year follow-up study. Four age groups were included (40-45, 46-50, 51-55 and 56-60) with the aim of obtaining a random equal number of men and women sample. The baseline IMT ranged from 0.42 to 2.12 mm (mean 0.63 mm, SD 0.14 mm). In 4.66% subjects completing the 6-year follow-up, the IMT decreased by more than 0.1 mm and in 18% there was no significant IMT change (> 0.1 mm). In the remaining individuals (77.33%) the IMT increased by at least 0.1 mm. The IMT increase in the 56-60 age group was significantly higher than in the remaining age groups (p < 0.02). A significantly higher percentage of smokers was also observed in the 56-60 age group (p < 0.05). However, the IMT increase in the smoker subgroups was not significantly different from the mean IMT increase observed in the whole group or from the IMT increase observed in the non-smoker group. Blood pressure variations were not associated with change of IMT over six years. The main difference between the four groups was an average weight 5.7% higher in the oldest age group at the end of the study (4.44% higher at inclusion). In conclusion the increase in IMT appeared to be greater in older subjects and the effect of smoking did not apparently affect IMT increase. The method of IMT measurements is able to demonstrate the age-related evolution of intima-media in a population.

Adult↗

PubMed1994

Effects of trandolapril on 24-h ambulatory blood pressure in patients with mild-to-moderate essential hypertension.

The effects of trandolapril on 24-h blood pressure in mild-to-moderate hypertensive patients of both sexes were investigated by conventional (clinic) and ambulatory recording in a double-blind study at two dosages, 1 mg (n = 14) and 2 mg (n = 13) once daily for 2 weeks. Both methods of measurement showed significant end-of-treatment decreases (p < 0.01 in all cases) in diastolic and systolic pressure in the 1- and 2-mg groups. Although intergroup differences were not significant, inspection of the mean changes from baseline in the eight 3-h periods constituting the 24-h profile showed that reductions were consistently greater in the 2-mg than in the 1-mg group, by 2 mm Hg diastolic blood pressure and 6 mm Hg systolic blood pressure. Values in the last segment of the placebo washout (46-48 h after the last active dose) showed that these reductions were well maintained, notably in the 2-mg group, with a minimal tendency to drift toward pretreatment levels. No effect was observed on the normal circadian blood pressure rhythm. Both doses were well tolerated. In conclusion, trandolapril is an effective, well-tolerated antihypertensive agent for once-daily dosing at either 1 or 2 mg.

Adult↗

PubMed1992

[The prevention of venous thromboembolism in Italy].

A questionnaire concerning the prophylaxis of venous thromboembolism was filled in by 326 surgical departments in Italy. In 58% the prophylaxis was routinely used and in 29% more than one method was used. The most used method of prevention was subcutaneous heparin followed by elastic compression. In 51% of the centers the prophylaxis was used only in high risk patients and in 22% it was not used at all. The most relevant risk factors in the development of thrombosis were considered age, tumors and obesity. Finally in a questionnaire sent to 350 vascular laboratories it was found that--according to the operators--76% of all documented thromboses were possibly consequent to surgical procedures (in 86% no prophylaxis had been used).

Bandages↗

PubMed1992

Fibrinolytic enhancement in diabetic microangiopathy with defibrotide.

Skin microcirculation was evaluated in 117 patients with diabetic microangiopathy over a period of six months. They were divided into two groups. Group 1 (64 patients) was treated with oral defibrotide, a new profibrinolytic drug, in association with diet and oral antidiabetic drugs. Group 2 (53 patients) was treated only with diet and antidiabetic agents. The microcirculation was studied by means of laser-Doppler flowmetry transcutaneous partial pressure of oxygen and carbon dioxide pressure measurements, and evaluation of capillary filtration. After six months, patients in group 1 improved their microcirculatory parameters in association with an improvement in signs and symptoms. Moreover, 30 patients in group 1 and 36 in group 2 were followed up for eighteen months, and the authors observed that the deterioration of the microcirculatory parameters was significantly slowed in diabetics treated with defibrotide. A decrease in plasma fibrinogen during defibrotide treatment was observed in all treated patients in association with an increased fibrinolytic activity. In conclusion, it appears that defibrotide, enhancing fibrinolysis, improved the microcirculation in diabetics, preventing further, progressive deterioration.

Adult↗

PubMed1992

Microcirculation in systemic hypertension.

In 40 patients with idiopathic systemic hypertension, skin blood flow was evaluated with laser-Doppler flowmetry, transcutaneous measurements of partial pressure of oxygen (PO2) and partial pressure of carbon dioxide (PCO2), and determination of capillary permeability before and after treatment with nifedipine (10 mg tid for four weeks). Also 35 normal subjects matched for age and sex distribution were studied. Before treatment, microcirculatory studies showed a significant decrease in skin flow and venoarteriolar response in hypertensive patients in comparison with normal subjects. Moreover, PO2, PCO2, and capillary permeability were significantly lower in hypertensives. All these microcirculatory parameters significantly increased after nifedipine treatment while both systolic and diastolic pressures decreased. In conclusion, laser-Doppler flowmetry used with other microcirculatory techniques was able to discriminate between normal subjects and hypertensive patients, and it was able to show the improvement in the microcirculation after nifedipine treatment.

Adult↗

PubMed1992

[Skin blood flow and veno-arteriolar response in essential hypertension].

High arteriolar resistance and vasoconstriction are considered an important factor in essential hypertension. In 98 patients with essential hypertension and 60 normals we evaluated skin flow at rest (RF) and the veno-arteriolar response (VAR = the vasoconstriction due to leg dependency) using laser-Doppler flowmetry. Measurements were repeated after four weeks in normals and after treatment with nifedipine (10 mg tid) in hypertensives. At the beginning of the study in hypertensives RF and VAR were lower than in normals. After nifedipine treatment a decrease in blood pressure was associated with an increase in RF and VAR. A difference was also observed between responders and non responders (16.3%). RF and VAR at the beginning of the study were both higher in non responders and did not change after treatment indicating that the degree of vasoconstriction in these patients was lower. In conclusion microcirculation changes in hypertension may be quantified by laser-Doppler flowmetry and used to evaluate vasoconstriction and the effects of drugs.

Adult↗

PubMed1992

[Activity of Centella asiatica in venous insufficiency].

In this a review concerning TTFCA, its effects on metabolism in the connective tissue of the vascular wall and on the microcirculation are presented and discussed. This compound is effective in venous insufficiency, reducing ankle edema, foot swelling, capillary filtration rate and by improving microcirculatory parameters (RF, VAR PO2-PCO2). TTFCA displays a significant activity in venous hypertensive microangiopathy and its effects are dose-dependent.

Humans↗

PubMed1992

Acute effects of hydroxyethylrutosides on capillary filtration in normal volunteers, patients with venous hypertension and in patients with diabetic microangiopathy (a dose comparison study).

The acute effects of hydroxyethylrutosides on capillary filtration were studied in 12 normal subjects, 25 patients with venous hypertension and 22 diabetics with microangiopathy. The two groups of patients randomly received a single oral dose (500 or 1000 mg) of hydroxyethylrutosides. A single dose of 500 mg was used for normal volunteers. In the following 6 hours capillary filtration was studied with straingauge plethysmography. The decrease in capillary filtration was evident within the first hour and was at its peak between the second and fourth hour. After 6 hours it was still significantly below baseline values in patients. The 1000 mg dose was significantly more effective in both groups of patients. This study confirms the efficacy of hydroxyethylrutosides in decreasing capillary filtration. It suggests that the effect of one dose lasts at least 6 hours and also that the higher dose is more effective.

Adult↗

PubMed1992

Retinal duplex scanning in cerebrovascular disease and hypertension.

Using Doppler duplex scanning retinal flow velocity was evaluated in 100 patients with carotid plaques, in 40 with hypertension and in 200 normal subjects. The reproducibility of the test was good. Peak systolic velocity was 12.5 cm/s in normals and significantly lower in patients with carotid plaques (9.8 +/- 6) and in patients with hypertension (8.3 +/- 6). The end diastolic velocity was also lower in both groups of patients. The ratio between the systolic and diastolic component was 2.3 in normals. It was increased in cerebrovascular disease (3.5) and in hypertension (5.5) as a consequence of the decrease in the diastolic component. In conclusion duplex retinal flow velocity evaluation is easy and reproducible and may be possibly used to study retinal flow in patients with cerebrovascular disease and in hypertension.

Adult↗

PubMed1992

Elastic stockings in diabetic microangiopathy. Long-term clinical and microcirculatory evaluation.

One hundred and forty nine diabetics with microangiopathy were followed up for 4 years and studied by laser-Doppler flowmetry - measuring skin blood flux at rest [RF] and the venoarteriolar response [VAR]. Seventy four patients were advised to wear elastic stockings and 75 were kept as controls with the aim of evaluating the effects of stockings on the evolution of diabetic microangiopathy. After 4 years a significant deterioration was found in RF (increased) and VAR (decreased) in the untreated group in comparison with controls. Also 10 ulcerations developed in the untreated subjects (6.6% of limbs) in comparison with 3 ulcerations (2.02%) in the treated group. The difference was statistically significant. Therefore elastic stockings appear to be useful in diabetics with microangiopathy as they protect against the deterioration of the microcirculation and reduce the development of ulcerations.

Adult↗

PubMed1991

[Plication of the sapheno-femoral junction].

Plication of the long saphena at the sapheno-femoral junction (SFJ) is an alternative to flush ligation and stripping. This technique abolishes reflux at the SFJ without altering the vein which may be used for arterial surgery or coronary grafting. The selection of the candidate for plication is done with ambulatory venous pressure measurements and duplex scanning which indicate and quantify the superficial incompetence. The plication of the SFJ reduces the calibre of the vein to 60-70% for a length of 1.5 cm allowing the valvular cusps to close when flow in the femoral vein is reversed. In this study we evaluated 20 limbs (in 20 patients) 6, 12 and 24 months after plication. Venous reflux was significantly reduced with improvement of signs and symptoms. In conclusion, SFJ plication seems to be an effective physiological alternative to flush ligation. However long term results (greater than 5 years) must be still evaluated.

Adult↗

PubMed1991

[Correlation of arterial lesions evaluated with "ultrasonic biopsy", occult coronary disease and incidence of cardiovascular events in 4 years].

Two thousand normal subjects and 600 vascular patients, divided into 9 age groups were studied with the techniques of the "ultrasonic biopsy" based on high resolution scans of the arterial walls. Subjects in Class I had normal walls while patients in Class V were asymptomatic with complex plaques and those in Class VI were symptomatic. The variation in UB score (the score relative to the classes) with age was found to be proportional to age. Also the UB score was significantly higher in vascular patients. The incidence of occult coronary ischemia was increasingly high in the 6 classes and the incidence of cardiovascular events in 4 years was proportionally higher in Class V and VI. No events were observed in patients belonging to Class I and II. The progression of arterial changes in 4 years in the patients of each class was observed.

Adolescent↗

PubMed1991

[Efficacy of TTFCA in reducing the ratio between lymphatic and plasma protein concentration in lymphatic and postphlebitic edema].

In subjects with lymphatic problems and postphlebitic edema there is a significant difference in the ratio between lymphatic and plasma concentration of protein (CL/CP) in the foot. Two groups of patients were studied (one group with lymphedema and the other with postphlebitic limbs) in order to assess the CL/CP ratio before and after TTCFA treatment (Centellase). The study confirmed the efficacy of treatment in achieving a significant reduction of CL/CP and distal edema.

Adult↗

PubMed1989

Treatment of acute superficial thrombosis and follow-up by computerized thermography.

Superficial vein thrombosis (SVT) is a common complication of varicose veins. Treatment may be surgical by removal of the superficial clots under local anesthetic or medical in association with elastic compression and mobilization. In this study 83 patients with SVT were randomised in treatments groups: A--superficial thrombectomy and elastic compression (EC); B--Ca Heparin (0.5 mgs b.i.b.) + EC; C--Venoruton (1 g, t.i.d.) + EC; D--Venoruton (1 g, t.i.d.) after superficial thrombectomy + EC; E--elastic compression. All treatments were applied for 8 weeks. The evolution of SVT was studied by a system, based on thermography, which analyse by a computerized system the variation of the hyperthermic areas (HA) on thermograms. This was associated with subjective and objective clinical evaluation. Results indicate a decrease of HA in all groups but patients treated with superficial thrombectomy show a significantly (p, 0.05) greater and faster reduction of HA. The reduction of HA produced by Venoruton was also significantly greater (p less than 0.05) than that observed in patients treated by Ca Heparin or elastic compression and it determined also a faster and greater (p less than 0.05) decrease of HA after thrombectomy. These results were confirmed by clinical observations. In conclusion results from this study indicate a positive effect of Venoruton in SVT in determining a faster decrease of hyperthermic areas probably by decreasing local inflammation.

Adult↗

PubMed1989

[Chronic treatment of vascular diseases with indobufen].

The effects of chronic treatment with indobufen, an inhibitor of platelet aggregation, was studied in a group of 1428 patients with vascular problems treated in a period of about 6 years in our Units. Venous problems were the major vascular problem in 313 patients, peripheral vascular diseases in 553 and cerebrovascular problems in 562. In patients with venous problems the range of the treatment period in different groups of patients varied from 2 to 42 months. The range was from 1 to 48 months in the group of patients with peripheral vascular diseases and from 2 to 48 in patients with cerebrovascular diseases. An analogic score was used to evaluate the efficacy of indobufen, which was also compared for the occurrence of side-effects with ASA (acetylsalicylic acid) and dipyridamole. Results obtained in this large, chronic open study confirmed the efficacy of indobufen in preventing (or reducing the occurrence) of vascular problems which was significantly greater than that observed with the other two drugs used for comparison. Indobufen also resulted in a lower incidence of side-effects (particularly gastrointestinal disorders) and it was better tolerated than both dipyridamole and ASA.

Adult↗