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Biomedical subjects

L Chiandussi

Publications and source records attributed to L Chiandussi.

At least 55 records · Page 3Linked to original sources

Plasma endothelin in essential hypertension and diabetes mellitus.

This study was designed to determine plasma endothelin-1 levels in patients with essential hypertension and diabetes mellitus. Endothelin immunoreactivity was measured in normal controls (n = 30), mild-moderate essential hypertensives (n = 25), Type II diabetic normotensives (n = 25) and hypertensive patients (n = 20). In addition, in ten patients of each group we investigated the relationships of endothelin with other vasoactive hormones. Plasma endothelin concentrations were similar in healthy controls, in essential hypertensives and in diabetic patients with or without hypertension, averaging 8.23 +/- 1.68 pg/ml, 7.7 +/- 1.1 pg/ml, 5.05 +/- 0.94 pg/ml, 7.88 +/- 1.41 pg/ml, respectively. No correlations were observed between endothelin and concentrations of plasma renin activity, aldosterone, catecholamines, atrial natriuretic peptide and arginine-vasopressin. The present study suggests that Type II diabetic patients with or without essential hypertension do not have demonstrably higher values of plasma endothelin than essential hypertensives or healthy subjects.

Adult↗

Plasma endothelin levels in cirrhotic subjects.

Endothelin-1, a potent vasoconstrictor peptide with 21 amino acid residues, is released by the vascular endothelium. Plasma immunoreactive endothelin levels were measured in 23 patients with cirrhosis and in 20 healthy subjects. Concentrations were significantly lower in patients with non-uraemic cirrhosis than in normal subjects (19.4 +/- 8.9 pmol/l vs. 48.8 +/- 24.8 pmol/l, p less than 0.002). Plasma renin, aldosterone, atrial natriuretic peptide, arginine-vasopressin and catecholamines did not show significant correlations with plasma endothelin-1 levels. Furthermore, there were no significant differences in plasma endothelin levels for etiology of cirrhosis, presence of ascites or varices. These data suggest that low circulating endothelin may be involved in the development or maintenance of systemic vasodilatation in cirrhosis.

Adult↗

Histologic changes in liver biopsy specimens produced by recombinant interferon alpha-2b therapy for chronic non-A,non-B viral hepatitis. A randomized controlled trial.

The effects of interferon therapy on liver histologic findings were assessed in a randomized controlled trial consisting of 80 patients with chronic non-A,non-B hepatitis. Twenty-eight patients received 1 million units of recombinant interferon alpha-2b; 25 patients received 3 million units, subcutaneously, three times a week for 24 weeks; and 21 patients were observed as untreated controls; all of them underwent liver biopsy within 6 months from the beginning of the study and on the last day of therapy. Six patients were withdrawn from the study because of inadequate liver biopsy specimens. Alanine aminotransferase levels were determined before, during, and after therapy. For each biopsy, a semiquantitative score of histologic features, the histologic activity index, and the overall histologic assessment were performed. Ninety-five percent of patients tested positive for hepatitis C virus antibody. Portal inflammation, piecemeal and spotty necrosis, and bile duct proliferation were significantly decreased in patients with normalized alanine aminotransferase. The effectiveness of therapy was dose dependent: piecemeal and spotty necrosis and the histologic activity index showed a significant decrease only in 3-million-unit-treated patients. Hepatocellular degeneration and fibrosis did not change significantly after treatment.

Alanine Transaminase↗

Renal resistive index after captopril test by echo-Doppler in essential hypertension.

In 45 patients with essential hypertension and 15 age-matched normotensive control subjects, the renal resistive index, as an expression of arterial impedance, was determined using Doppler ultrasound. In both kidneys the resistive index was assessed at baseline and after captopril test (50 mg orally). In the moderate and severe hypertensives, compared to mild hypertensives and control subjects, the baseline resistive index was significantly higher (P less than .05). Following captopril, the resistive index increased only in normotensives (P less than .05) and in mild hypertensives (P less than .05). Univariate and multivariate analyses show that the duration and severity of hypertension correlated with an increase of the resistive index both in basal and in dynamic conditions. Thus, the use of the resistive index, as determined by echo-Doppler, could provide useful information for the assessment of renal vascular impedance in essential hypertensive patients. This would help us detect the evolution of hypertensive disease to the higher degrees of severity that are correlated to renal arteriolar damage.

Adult↗

Quantitative assessment of histological changes in chronic gastritis after eradication of Helicobacter pylori.

AIMS: To evaluate the effect of 10 day triple treatment on H pylori eradication and associated gastritis. METHODS: Fifty patients with H pylori positive non-ulcer dyspepsia were treated for 10 days with amoxicillin, tinidazole, and bismuth salts. Histological examination of the antral mucosa was performed before (T0), six weeks (T1), and six months (T2) after treatment. The new Sydney classification of gastritis was used, using a score from 0 to 3 to grade degree of inflammation, atrophy, activity (intraepithelial or lamina propria damage) and H pylori. RESULTS: At T0 all patients had chronic active gastritis. Lymphoid follicules were present in 12 cases. At T1 33 patients were H pylori negative: the score showed a decrease of activity (from 2.5 to 0.54). The result was confirmed at T2 (mean score 0.22). Inflammation decreased from 1.8 to 1.4 at T2. Only one case of follicular gastritis was observed. In H pylori positive patients the scores did not show significant modifications. CONCLUSIONS: Ten day triple treatment is effective in eradicating H pylori in 69% of cases, causing a decrease of the total score for gastritis. Activity, defined by polymorph infiltration, was promptly reduced when H pylori was eradicated. There was a trend to a reduction in inflammation, but atrophy was irreversible.

Amoxicillin↗

Hormonal aspects of the relation of liver cirrhosis to essential hypertension.

The association of liver cirrhosis with arterial essential hypertension has been previously described. The present study extends the previous reports by investigating the hormonal relationships that may occur in patients with established essential hypertension associated to liver cirrhosis. We studied the renin-angiotensin, the adrenergic systems and other vasoactive hormones such as arginine-vasopressin, atrial natriuretic peptide, endothelin and parathyroid hormone in cirrhotic patients with and without essential hypertension. The data suggested that the coincidence of arterial hypertension in cirrhotic patients was characterized by the following findings: a decreased renin-angiotensin activity; a reduced systemic vasodilatation; an increased peripheral pressor effect of vasoactive hormones and an increased effective blood volume.

Adult↗

[Paget's disease: the prospects with ipriflavone].

Paget's disease is a bone disorder characterized by high rates of bone remodelling. We have evaluated the efficacy of the new drug, ipriflavone, which has a double effect on the inhibition of bone reabsorption and on the activation of bone neodeposition. We studied 20 patients with active Paget's disease: 10 have been treated with 600 mg/die and 10 with 1200 mg/die of ipriflavone, for six months. In pharmacological wash-out, we have measured alkaline phosphatase, plasmatic BGP, the urinary hydroxyproline/creatinine ratio and the urinary calcium (Nordin Test). These valuations have been repeated after three and six months from the beginning of the administration of the drug. We have verified a propitious and speedy effect on pain, independent of dosage, and efficacy of treatment in function of bone turn-over parameter changes, by using no parametric statistical tests. In all subjects favourable effects have been found after three months treatment with 1200 mg/die. These have shown a greater efficacy than the lower dosage. After six months treatment we have not found significant differences as regards the efficacy of both dosages. These results may suggest to start therapy with higher initial doses and to carry-on with lower supporting doses. It's necessary to investigate further confirmation regarding the consolidation and perseverance of obtained favourable results, even after interruption of the treatment.

Aged↗

[The calcium salt of folinic acid for the treatment of deficiency anemia].

Thirty patients (20 adults and 10 children) suffering from nutritional anaemias were treated with folinic acid for 15 days per os at a dosage of 4-8 mg daily. For each patient routine laboratory tests, folic acid assays in the serum and in the erythrocytes have carried out and the clinical parameters have been recorded at the beginning and at the end of the treatment. The results showed statistically significant increase in the number of red cells per cmm, in folic acid content both in the serum and in the erythrocytes; at the same time a decrease of mean corpuscular haemoglobin concentration (MCHC) and mean corpuscular haemoglobin (MCH) was observed.

Adult↗

A randomized controlled trial of interferon alfa-2b as therapy for chronic non-A, non-B hepatitis.

Eighty patients with chronic non-A, non-B hepatitis completed a randomized controlled trial of the therapeutic efficacy of recombinant interferon alfa-2b. Twenty-nine received 1 million units and 26 received 3 million units of interferon subcutaneously thrice weekly for 6 months, and 25 were controls. Normalization or a significant decrease of alanine aminotransferase values was obtained in 19/29 (66%) patients treated with 1 million units, in 18/26 (69%) patients treated with 3 million units and in one control patient (4%, p less than 0.05). However, when control patients were randomized after the initial 24 weeks to receive 1 or 3 million units of interferon for 48 weeks, 12/14 (86%) patients receiving 3 million units responded to therapy versus 3/11 patients receiving 1 million units (27%, p less than 0.05). After a 1 to 6 months follow-up period post treatment, an alanine aminotransferase relapse was observed in 18/30 (60%) responders to 3 million units and in 17/22 (77%) responders to 1 million units. Cirrhotic patients responded less than patients with non-cirrhotic disease (47 vs. 78%, p less than 0.05). Only responders treated with 3 million units significantly ameliorated their histologic picture (pre-therapy Knodell's index = 8.9, post-therapy = 6.0, p less than 0.05). The data confirm that treatment with interferon is of benefit in patients with chronic non-A, non-B hepatitis.

Adult↗

Autoantibodies and response to alpha-interferon in patients with chronic viral hepatitis.

One hundred and fifteen patients with chronic type B, D and non-A, non-B hepatitis treated with recombinant alpha-interferon were tested for six different autoantibodies prior to or during therapy, and the course of treatment was compared in autoantibody-positive and -negative patients. Three out of 25 (12%) hepatitis B patients, 14 out of 30 (47%) hepatitis D patients and 19 out of 60 (32%) chronic non-A, non-B hepatitis carriers had baseline or post-therapy autoantibodies. The rate of response between patients with and without autoantibodies among B, D and non-A, non-B patients was, respectively, 67 vs. 79%, 23 vs. 25%, 70 vs. 61% (p = N.S.). No adverse reaction was observed in the 36 patients who had or developed nuclear, smooth muscle, parietal cells and thyroid autoantibodies during therapy. A patient with baseline antibodies against liver and kidney microsomes developed an icteric acute hepatitis at the fourth month of therapy, but five other patients with this reactivity responded to therapy uneventfully. The presence of autoantibodies before therapy or their induction following therapy is not a contraindication to the use of interferon in patients with chronic viral hepatitis.

Animals↗

Two cases of congenital hepatic fibrosis in children of consanguineous marriage.

An association of congenital hepatic fibrosis (CHF), Caroli's disease, medullary sponge kidney, type II interventricular defect with right transposition of the aorta, multiple cervical vertebra malformations, and first sacral vertebra schisis in a 16 year old son of consanguineous parents (consanguinity factor = 1/32), is described. The patient's sister presented asymptomatic CHF and medullary sponge kidney only. Parental consanguinity in this case lends support to the view that CHF, medullary sponge kidney and cardiac malformations are more likely to be manifestation of a single recessive gene, with a varying phenotypic expression, than of different mutant genes.

Adolescent↗

Efficacy of nicardipine slow release (SR) on hypertension, potassium balance and plasma aldosterone in idiopathic aldosteronism.

We evaluated the efficacy and tolerance of a dihydropyridine calcium antagonist, nicardipine slow release, in eight patients with idiopathic aldosternism. Nicardipine (80 mg/day) was given orally for 12 weeks and no dietary restrictions were imposed. During the study measurements were made of supine blood pressure, plasma renin activity, plasma aldosterone concentration, and serum potassium. Nicardipine lowered systolic and diastolic blood pressure to normal, plasma aldosterone was reduced and serum potassium levels were increased. Basal renin concentration was not altered by nicardipine. There were no side effects sufficient to cause withdrawal from the study. These results suggest that nicardipine, for efficacy and tolerance, may represent an alternative among Ca2+ channel blockers, either controlling blood pressure or reducing aldosterone levels in patients with idiopathic aldosteronism.

Administration, Oral↗

Failure of nomifensine to reduce serum prolactin levels in patients with hepatic encephalopathy.

In order to investigate whether the variations in prolactin (PRL) secretion found in patients with liver cirrhosis are related to the derangement of neurotransmitter metabolism, serum PRL levels were measured in 8 patients with hepatic encephalopathy (a condition where neurotransmission is severely deranged), in 10 patients with liver cirrhosis but without encephalopathy and in 10 control subjects under control conditions and in response to nomifensine, levodopa and synthetic TRH administration. Inhibition of endogenous catecholamine reuptake by nomifensine was able to significantly reduce PRL levels in normal subjects and in patients with liver cirrhosis, whereas only one out of 8 patients with hepatic encephalopathy showed a reduction in PRL levels. On the contrary, levodopa administration was able to reduce PRL secretion in all the subjects studied. PRL release by TRH was greater in patients with liver disease than in controls. The results seem to indicate that the derangement in neurotransmitter metabolism which occurs in liver cirrhosis is one, but not the sole cause of alterations of PRL secretion in liver cirrhosis. The failure of nomifensine to depress PRL is an early finding in the course of encephalopathy and may be of diagnostic value.

Adult↗

Growth hormone (GH) secretion in hepatic encephalopathy.

Elevated plasma concentrations and abnormal secretory patterns of GH have been found in patients with cirrhosis of the liver. Displacement of brain dopaminergic monoamines by false "neurotransmitters' produced in the gut has been postulated as a cause of encephalopathy. In this study basal GH plasma levels and their response to TRH and L-DOPA were determined in thirty-nine cirrhotic patients and fifteen controls. Eleven patients had evidence of encephalopathy (Group 1), twenty-eight did not (Group 2). Both basal levels and the mean peak response to TRH were significantly higher in the cirrhotic patients that in the controls (Group 3). Peak values were moderately, but not significantly, higher in Group 1 than in Group 2. The response to L-DOPA was considerably lower in the encephalopathic patients in comparison with the subjects of both Group 2 and Group 3. This finding is consistent with depletion of active "neurotransmitters' in CNS. Our data fail to demonstrate clearly whether the paradoxical response to TRH can also be related to these abnormalities of monoamine metabolism in cirrhotics.

Adult↗

Acute hepatitis with bridging necrosis due to hydralazine intake. Report of a case.

A 59-year-old woman was admitted to the hospital for evaluation of her hypertension. She was treated with hydralazine; two days later a severe acute hepatitis supervened. On discontinuation of the agent, the liver damage disappeared, relapsed during inadvertent rechallenge, and healed following permanent withdrawal from the drug. Histologic study of the liver showed severe acute hepatitis with bridging necrosis (so-called subacute hepatitis). Six months after discontinuation of hydralazine, a second liver biopsy specimen showed a complete remission of the disease. This hydralazine-induced hepatitis appears to be fully reversible and to differ both on clinical and histological grounds from two previous reports documenting a granulomatous liver disease.

Acute Disease↗