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Biomedical subjects

G Leonardi

Publications and source records attributed to G Leonardi.

At least 19 recordsLinked to original sources

A double-blind comparison of bisoprolol and captopril for treatment of essential hypertension in the elderly.

The aim of the study was to compare the antihypertensive efficacy and safety of a new beta blocker with high beta 1 selectivity, bisoprolol, with captopril in 28 elderly patients, aged over 65 years, with mild-to-moderate essential hypertension (WHO classes I and II). After a placebo run-in period of 4 weeks, the patients were randomly allocated to receive bisoprolol (5 mg od) or captopril (25 mg bid) (double-dummy technique) for 6 weeks, according to a crossover double-blind design, with a 4-week washout period between the two active treatments. The doses were doubled after 2 weeks if the supine blood pressure was greater than 160/95 mmHg. In basal conditions and after 2, 4, and 6 weeks of each treatment, the blood pressure and heart rate were assessed both in the supine and erect positions. At the same time, the side effects and quality of life were investigated by a checklist and a self-assessment questionnaire. Standard laboratory tests and a resting ECG tracing were performed before and after each active treatment. The data from 24 patients (4 dropouts) showed a significant antihypertensive effect of both treatments (p less than 0.01) with a reduction of diastolic blood pressure to values less than or equal to 95 mmHg in 75% (18/24) of the patients treated with bisoprolol and in 83.3% (20/24) of those treated with captopril, without significant differences between the two drugs. Bisoprolol also produces a marked but symptom-free reduction of heart rate compared with captopril (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic beta-Antagonists

Emergency treatment with recombinant tissue plasminogen activator of pulmonary embolism in a pregnant woman with antithrombin III deficiency.

Thromboembolic complications during pregnancy are frequent in patients with congenital antithrombin III deficiency. We report on a 29-year-old patient with congenital antithrombin III deficiency and severe pulmonary embolism treated with recombinant tissue plasminogen activator. The diagnosis of antithrombin deficiency is retrospective. This case indicates that the risk of thrombolytic therapy in this clinical setting might have been overemphasized.

Adult

[Comparison of 6 and 8 French catheters for arterial catheterization and coronarography: prospects of the development of coronarography in ambulatory care].

The aim of this study was to evaluate day-hospital coronary angiography as a valid method to reduce hospital recovery costs and patient waiting lists. We evaluated its technical feasibility by randomizing sixty hospital patients. These were divided into two groups, and 6 or 8 French Judkins of Amplatz coronary angiography catheters were used for each group following the Judkins technique. Patients were invited to walk after four hours. Local complications, the number of catheters used, their stability and maneuverability, as well as the radiological resolution of the image were evaluated. No major cardiac complications occurred. One transient cerebral ischemic episode during 6F coronary angiography was quickly resolved by medical therapy. Two local haemorrhages and three cases of hypotension were observed in the 8 French group, while minor bleeding phenomena were similar in both groups (3 vs 5). Differences occurred in local haematoma incidence after 24 hours (13 in 8F vs 2 in 6F); there was no difference in the number of catheters used, the completion time of the examination, or the radiological resolution. Maneuverability and stability of the 6F group were reduced, but not so much as to compromise examination. The AA concluded that 6F catheters are useful in day-hospital coronary angiography, with a similar examination quality, and a reduction in local complication.

Aged

[Analysis of clinical history and predictive factors in the prognosis of a group of young patients with acute myocardial infarct].

A retrospective study was carried out to examine the clinical history and coronarographic and ventriculographic aspects of a young group of patients aged under 40 affected by acute myocardial infarction. The study confirmed previously published findings with regard to the low rate of mortality, both in hospital and shortly after necrosis. On the other hand, non-fatal ischemic attacks were common in this population and were significantly correlated to the extension of coronary disease. Ischemic complications in this group of patients were mainly treated using coronary revascularisation (by-pass or PTCA), procedures which have been proved efficacious in preventing further ischemic events during the medium term. The results of the study indicate the need for a more aggressive approach, with the use of predischarge coronarography even in the absence of residual ischemia. This would not only serve to ascertain the degree of coronary disease or revascularisation, but above all would enable a prognosis to be given regarding the patient who, in psychological terms, should not be considered an invalid following acute ischemia.

Adult

In vivo and in vitro HeNe laser effects on phagocyte functions.

The goal of this work was to evaluate the effect of helium-neon (HeNe) laser irradiation on immunocompetent cells. We used the in vivo skin window method and in vitro granulocyte function tests. The study of cellular migration showed a marked decrease in vitro and in vivo in a dose-independent manner. Superoxide release was not modified by laser irradiation. The granulocyte's aggregation, when using PHA and PMA, presented a reduction that was statistically very significant, not as a subordinate dose. An increase of the release of ATP was demonstrated only at 4 joules and precedes granulocyte aggregation. When using Ca2+ ionophore A23187 as stimulus, laser irradiation at 1, 2 or 4J did not show any modification of granulocyte aggregation. The monoclonal antibody 60.1, which identifies a membrane antigen fundamental for aggregation and chemotaxis, is expressed in normal amounts on granulocyte membranes both before and after irradiation with a HeNe laser. In fact, Laser irradiation preferentially attacks the area of the cellular centrosome that determines a modification of cellular morphology. The electron microscope and immunofluorescence study with a monoclonal antibody have pointed out a disorganization of the microtubules. The alteration of some of the granulocyte functions is correlated to the damage in the centrioles. The granulocyte mitochondrial system and surface membrane remain intact, and this explains the normal production and release of free radicals. Further experiments are necessary to evaluate the clinical application of lasers in various diseases with immunophagocytic pathogenesis.

Adenosine Triphosphate

[Hemorrheologic disorders in obese patients. Study of the viscosity of the blood, erythrocytes, plasma, fibrinogen and the erythrocyte filtration index].

Risk factors for atherosclerosis are often associated with haemorheological changes. On this point, obesity (recently advocated as an independent risk factor) was not much studied and with not univocal results. We have studied 70 obese patients (BMI greater than 30) and 50 healthy subjects (BMI less than 25). Among obese 26 had no more pathologies, 29 had hypertension, 3 suffered from ischemic heart disease, 3 suffered from occlusive arteriopathy, 9 were hyperlipidemic, 10 were smokers. We determined plasma viscosity and whole blood viscosity (at haematocrit corrected to 45% too). Washed erythrocytes, poor in leucocytes and platelets and resuspended in phosphate-buffered saline, were used for study of erythrocyte viscosity and deformability. Obese patients showed raised mean blood viscosity values when compared to healthy controls (p less than 0.01); an even more significant increase (p less than 0.001) was found concerning plasma viscosity and fibrinogen. Erythrocyte viscosity and red blood cell filterability index did not show any significant difference. We found no significant correlation between viscosity values and presence of hypertension, hyperlipidemia and smoking habit among obese. In conclusion, the higher vasculopathy incidence might be caused by an increase in blood viscosity, mostly due to plasmatic component. This fact appears to be independent from the presence of atherosclerosis complications or other risk factors.

Adult

[Blood, plasma, erythrocyte viscosity and index of erythrocyte filtration in subjects with hyperlipemia].

40 hyperlipidaemic patients (26 type II a and b, 14 type IV) and 50 healthy controls were studied. The patients were not suffering from any other pathology of note and were under no drug treatment. Blood viscosity at natural Ht and at Ht 45% and plasma viscosity were measured. Red blood cell viscosity and deformability was studied on washed red cells, poor in leucocytes and platelets and suspended in a saline phosphate buffer. The patients with hyperlipidaemia had blood viscosity higher than healthy people. Red blood cell and plasma viscosity were higher in subjects with hyperlipidaemia. There was no difference in the filtration index between the people under study. The increased blood viscosity found in people with hyperlipidaemia appears to be attributable to changes in both the plasma and the erythrocytes.

Adult

[Treatment of chronic lumbosacral pain by transcutaneous electrical stimulation in laminectomized patients: preliminary results (author's transl)].

The authors have tried transcutaneous electrical stimulation for the treatment of chronic lumbosacral pain in 27 patients already treated by laminectomy without benefit. Six patients experienced a 55% mean reduction of pain; another six had a 35% reduction; and the remaining 15 a 16% reduction of pain severity. From these results and a review of published data the authors conclude that the method is of limited value in alleviating chronic lumbosacral pain in laminectomized patients.

Back Pain