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Biomedical subjects

L Di Lorenzo

Publications and source records attributed to L Di Lorenzo.

At least 19 recordsLinked to original sources
PubMed2006

Pain relief in early rehabilitation of rotator cuff tendinitis: any role for indirect suprascapular nerve block?

AIM: The purpose of the trial was to evaluate the efficacy of suprascapular nerve block (SSNB) to relieve the shoulder pain, ameliorate recovery after physiotherapy and reduce disability due to a rotator cuff tendinitis (RCT). A prospective, randomized, comparison cross over investigation was performed in the setting of a large inpatient rehabilitation unit with more than 200 admissions annually. METHODS: A total of 40 potential study subjects, who complained of shoulder pain from a RCT, were enrolled and randomly assigned to standard rehabilitation treatment plus SSNB (Group A) or to standard rehabilitation treatment alone (Group B). The UCLA shoulder rating scale was used to assess the shoulder mobility on admission and discharge, and to calculate the percentage of potential improvement achieved during rehabilitation (effectiveness). A pain visual analogic scale was used to serially assess pain. At the end of the trial, a self-report questionnaire evaluated whether patients could sleep and achieve activity of day life carry out everyday activities better than they could before treatment. RESULTS: Forty patients suffering from RCT entered the study. Those receiving nerve block from the beginning of the treatment in addition to standard rehabilitation therapy reported significantly less pain during physiotherapy and better final outcomes. During treatment with SSNBs, patients reported a more significant reduction in the intensity of pain and a better reduction of pain during sleep and rehabilitation exercises in comparison to with the standard therapy alone. A statistically significant inverse correlation was found between shoulder pain and mobility. CONCLUSIONS: The results indicate that combining nerve block with standard rehabilitative therapy may improve the final outcome of painful RCT. It decreased the severity and frequency of the perceived pain, improved the compliance with physiotherapy, restored more normal sleep patterns, and increased compliance with the rehabilitation program. This result proves to be an effective, safe and inexpensive therapeutic option for patients suffering from painful disabling shoulder tendinitis.

Chi-Square Distribution↗
PubMed2003

Effect of shift work on body mass index: results of a study performed in 319 glucose-tolerant men working in a Southern Italian industry.

OBJECTIVE: To examine the influence of shift work on metabolic and cardiovascular risk factors in subjects working in an industry sited in Apulia, Southern Italy. DESIGN: Cross-sectional study of metabolic effects of shift work in glucose tolerant workers in a chemical industry in southern Italy. SUBJECTS: The subjects included 319 glucose tolerant male individuals, aged 35-60 y. MEASUREMENTS: Anthropometric parameters (body mass index (BMI) and waist-to-hip ratio (WHR)), fasting concentrations of glucose, insulin, and lipids (total cholesterol, HDL-cholesterol, triglycerides), the sum of glucose levels during 75 g-oral glucose tolerance test (Sigma-OGTT), and systolic and diastolic blood pressure (SBP and DBP, respectively). RESULTS: The prevalence of obesity was higher among shift workers compared to day workers, whereas body fat distribution was not different between the two groups. Shift workers had higher BMI than day workers, and shift working was associated with BMI, independently of age and work duration. Shift workers had significantly higher SBP levels, which were independently influenced by BMI, but not by shift work, thus suggesting that the difference in SBP may well be mediated by the increased body fatness. CONCLUSION: In workers of an industry sited in Southern Italy, shift work may be directly responsible for increased body fatness and is indirectly associated with higher blood pressure levels and some features of metabolic syndrome.

Adult↗
PubMed1999

Plasma plasminogen activator inhibitor-I is associated with plasma leptin irrespective of body mass index, body fat mass, and plasma insulin and metabolic parameters in premenopausal women.

Leptin, the satiety hormone expressed almost exclusively in adipose tissue, is a marker of body fat accumulation in humans. Recent studies have shown that plasminogen activator inhibitor-1 (PAI-1), a prothrombotic factor associated with atherosclerosis complications, is also produced in adipose tissue. The objective of the present study was to determine whether PAI-1 antigen plasma concentrations are associated with leptin plasma levels or the body fat mass (FM) independently of the variables known to influence PAI-1 production. Sixty-one nondiabetic women aged 18 to 45 years with a wide range of values for the body mass index ([BMI] 18.1 to 37.7 kg/m2) were evaluated for (1) body FM and fasting plasma levels of (2) PAI-1 antigen, (3) PAI-1 activity, (4) leptin, (5) insulin, (6) blood glucose, and (7) lipids (cholesterol, high-density lipoprotein [HDL]-cholesterol, and triglycerides [TG]). Body FM and fat-free mass (FFM) were estimated during fasting conditions by the bioimpedance analysis (BIA) method using a tetrapolar device. Body fat distribution was evaluated by the waist circumference and the waist to hip ratio (WHR). FM was directly associated with both PAI-1 antigen (r = .585, P < .001) and PAI-1 activity (r = .339, P < .001). Seemingly, leptin was positively related to both PAI-1 antigen (r = .630, P < .001) and PAI-1 activity (r = .497, P < .001). Moreover, both PAI-I antigen and PAI-1 activity were directly correlated with FFM (r = .285, P < .05, and r = .336, P < .01, respectively), BMI (r = .594, P < .001, and r = .458, P < .001, respectively), and WHR (r = .510, P < .001, and r = .391, P < .005, respectively). Insulin was directly related to PAI-1 antigen (r = .540, P < .001), PAI-1 activity (r = .259, P < .05), leptin (r = .447, P < .001), and FM (r = .435, P < .001). The association between PAI-1 antigen (dependent variable) and leptin or FM was tested by a stepwise regression model simultaneously including leptin, FM, BMI, WHR, age, FFM, and fasting insulin, blood glucose, TG, cholesterol, and HDL-cholesterol as independent variables. PAI-1 antigen maintained a significant positive independent relationship only with leptin (t = 2.923, P < .01), insulin (t = 3.489, P < .001), and fasting blood glucose (t = 2.092, P < .05), and a negative independent relationship with HDL-cholesterol (t = -2.634, P < .05). In conclusion, the strong relationship between PAI-1 antigen and leptin irrespective of other variables known to influence these factors seems to indicate that leptin per se may potentially increase PAI-1 plasma concentrations in obese subjects.

Adipose Tissue↗
PubMed1996

Acute radiodermatitis from accidental overexposure to X-rays.

Approximately 2 weeks after accidental overexposure to X-ray radiation, a worker developed acute radiodermatitis on fingers of both hands. Exposure simulation indicated that total ionizing radiation absorbed by his fingers amounted to about 20 Gy. After 2 years, acute radiodermatitis evolved to chronicity of lesions with presence of atrophic skin, teleangiectasia, alopecia, and dyskeratosis on three right-hand fingers. Cytogenetic dosimetry of peripheral blood lymphocytes, performed 2 months after acute radiation, showed an increase of micronuclei (7% vs. 1 +/- 0.4% according to laboratory reference data). The increase was ascribed to the high dose of ionizing radiation absorbed by circulating lymphocytes in the vessels of overexposed tissues. The cytogenetic examination was repeated 27 months after acute irradiation; it was found that the percentage of micronuclei had been restored to within reference levels. The possibility of using cytogenetic dosimetry, following acute partial exposure to X-rays, not just as an indicator of previous exposure, but also as an indicator of the absorbed radiation dose is examined. Lastly, the possible stochastic effects that may set in on the skin of the affected fingers and the need for periodically monitoring the evolution of chronic skin lesions, are discussed.

Absorption↗
PubMed1996

Lung cinescintigraphy in the dynamic assessment of ventilation and mucociliary clearance of asbestos cement workers.

OBJECTIVES: To verify in vivo whether lung cinescintigraphy confirms the effect of asbestos on the patency of the smallest airways and on the efficiency of mucociliary clearance in asbestos cement workers. METHODS: 39 male subjects were examined: 30 asbestos cement workers and nine workers never exposed to occupational respiratory irritants. All subjects had a chest radiograph (International Labour Organisation (ILO) 1980); standard questionnaire on chronic bronchitis; spirometry; arterial blood gas analysis; carbon monoxide transfer factor (TLcosb); pulmonary O2 and CO2 ductances (DuO2, DuCO2); electrocardiogram; and lung cinescintigraphy after radioaerosol inhalation for the measurement of mucociliary clearance time in vivo in the smallest ciliated airways and for the assessment of radioaerosol deposition in alveoli (alveolar deposition index). RESULTS: Apart from nine non-exposed subjects, the 30 asbestos cement workers were so classified on the basis of chest radiography: nine of them as healthy exposed, 10 with pleural plaques, and 11 with asbestosis. The four groups had similar ages, work seniority, and smoking habits. Exercise dyspnoea was significantly more frequent in asbestos cement workers. Lung function variables of workers with effects related to asbestos were significantly lower than the other two groups. The PaO2, TLcOsb and DuO2 mean values were significantly lower in exposed workers than non-exposed. The mean PacO2 value was significantly higher in the asbestosis group than in the other three groups. Workers with effects related to asbestos showed a significantly lower alveolar deposition index and a significantly higher mucociliary clearance time than the other two groups. Subjects with asbestosis showed similar differences from those with pleural plaques. CONCLUSIONS: Lung cinescintigraphy confirms in vivo the effects of asbestos on bronchiolar and alveolar patency and on efficiency of mucociliary clearance in the smallest ciliated airways. Finally, lung cinescintigraphic variables are able to discriminate workers with asbestosis from those with pleural plaques.

Asbestos↗
PubMed1995

Auditory brainstem responses in thyroid diseases before and after therapy.

The aim of this study was to evaluate through the auditory brainstem responses (ABRs) the electrical events generated along the auditory pathway in 56 adult patients affected with hyper- and hypothyroidism. Twenty-four normal-hearing hyperthyroid patients affected with Graves' disease and 32 normal-hearing hypothyroid patients (9 with subclinical and 23 with overt hypothyroidism) were subjected to standard (clicks at 21 pps) and sensitized ABR with masking wide-band (masking noise). In addition, thyroid scintiscan and ultrasonography, free T3 and T4, total T3 and T4, TSH, antimicrosomal and antithyroglobulin antibodies, audiogram and impedance tests were performed in all the patients. This study was repeated after 6-12 months of treatment in conditions of euthyroidism. The results showed changes of ABRs both in the standard procedure as well as in the sensitized test in 6 hyperthyroid (25%) and 8 hypothyroid patients (25%). All the patients with abnormal ABRs had overt hypothyroidism (8/23; 34.7%). The ABRs became normal in 5 out of 6 Graves' patients after 6-12 months of methimazole treatment. ABRs remained abnormal in all the hypothyroid patients despite their having been on L-thyroxine treatment for 6-12 months and were euthyroid for at least 5 months before the study was repeated. These findings suggest that ABR abnormalities are indicative only of a nonspecific injury in the bulbo-ponto-mesencephalic centers. Alterations of ABRs in thyroid diseases are not specific in relation to hyper- or hypothyroidism. Lastly, there is a relationship between ABR abnormalities and the degree of hypothyroidism, even if ABR alterations are not always reversible after long-term therapy.

Adult↗
PubMed1993

Effects of lithium treatment on hypothalamic-pituitary-thyroid axis: a longitudinal study.

Lithium carbonate, widely used in the treatment of bipolar patients, is well known to induce thyroid alterations. In this longitudinal study the thyroid function was investigated during lithium treatment over a period of 12 months in 12 euthymic bipolar patients with a normal thyroid function and absence of thyroid antibodies. Nine of the 12 patients were further studied on the 15th month, 5 of these 9 on the 18th month and 4 of the last-mentioned 5 on the 24th month. The mean basal and TRH-stimulated TSH values during lithium therapy were significantly higher as compared to those at the beginning of the treatment. More particularly, during lithium therapy, a significant increase of basal TSH over the normal range was found in 10 out of the 12 patients. A rise of TRH-stimulated TSH was found in 11 out of the 12 patients. The impairment of the hypothalamic-pituitary-thyroid (HPT) axis was transitory in the majority of cases. Two patients developed a nodular goiter during the treatment. Plasma T3, T4, FT3 and FT4 levels did not change during the treatment. Thyroid antibodies remained undetectable. The conclusions of the study are twofold: 1) Subclinical hypothyroidism during lithium therapy is much more frequent than previous cross-sectional studies suggest; 2) Thyroxine replacement in lithium-treated patients is advisable in order to prevent subclinical hypothyroidism and the risk of a subsequent goiter.

Adult↗
PubMed1989

Effects of nicardipine on left ventricular hemodynamic patterns in systemic hypertension.

To assess left ventricular (LV) functional and structural changes associated with the reduction of blood pressure (BP) values during nicardipine administration (60 mg daily, for two months), 17 hypertensive patients were studied by M-mode echocardiography, according to a double-blind design (11 with nicardipine and six with placebo). Decrease in BP induced by nicardipine was associated with decrease in myocardial afterload (end-systolic stress) (P less than .002) and improvement of systolic function (fractional shortening) (P less than .02), without changes in inotropic state (assessed by systolic BP/end-systolic dimension/posterior wall thickness ratio). At the end of trial, a 5% reduction was found in LV mass (P less than .002), whereas relative wall thickness did not change. Diastolic phase (assessed by relaxation time index, and the slope of EF tract of the anterior mitral valve leaflet) was improved (.01 less than P less than .001). Patients with concentric and eccentric hypertrophy were separately considered. Relaxation time index and fractional shortening were significantly improved only in patients with concentric hypertrophy (P less than .01), whereas in the other ones the effect of treatment was variable. These differences were probably due to different effects on preload in the two LV hemodynamic patterns. Thus, nicardipine shows powerful effects on cardiac mechanics in systemic hypertension, but these effects are different according to LV anatomic pattern. Only in the presence of concentric hypertrophy is it possible to foresee the improvement of LV function; LV hypertrophy can be also reduced in concentric hypertrophy, but in the short term the reduction is too small to assume pathophysiologic significance.

Adult↗
PubMed1988

Supernormal contractility in primary hypertension without left ventricular hypertrophy.

Forty-three subjects with uncomplicated primary hypertension and without echocardiographic left ventricular hypertrophy and 54 normotensive volunteers were studied by two-dimensional targeted M-mode echocardiography to evaluate systolic function and contractility before the development of compensatory hypertrophy. The ratio of peak systolic pressure to end-systolic dimension was used to assess left ventricular performance and was divided for either posterior wall thickness or cross-sectional area to generate hypertrophy-independent indices of inotropic state. Fractional shortening was normal in the hypertensive group, despite the increase in end-systolic stress. Systolic pressure/dimension ratio was higher in hypertensive subjects (p less than 0.001), as were hypertrophy-independent indices of inotropic state (p less than 0.005), which were inversely correlated to left ventricular mass (p less than 0.001). Values in 11 hypertensive subjects were above the upper confidence limit of the normal shortening/stress relation, which provides a load-independent measure of inotropic state. They showed high hypertrophy-independent indices of inotropic state (p less than 0.01), while the other hypertensive subjects did not. High fractional shortening, wall stress, and systolic pressure (p less than 0.01) were found in the subgroup with supernormal performance, while left ventricular mass was not different from that of other subgroups, depicting inadequate left ventricular hypertrophy. The duration of hypertension was the same in the subgroups. Supernormal inotropic state could be considered one form of primary adaptation to high wall stress that serves to maintain systolic ventricular performance.

Adult↗
PubMed1988

[Echocardiographic analysis of anatomical and functional changes in the left heart ventricle during antihypertensive treatment with nicardipine].

Changes in hemodynamic variables regulating systolic function were assessed by M-mode echocardiography, under 2D control, in 11 patients with primary uncomplicated hypertension treated with nicardipine (60 mg/daily). At the end of treatment (8 weeks) blood pressure and end-systolic stress were greatly reduced (p less than 0.001), and systolic fractional shortening was increase (p less than 0.02). The percentage increase in fractional shortening was correlated with a decreased in end-systolic stress (r = 0.67). The index of left ventricular performance (systolic pressure/end-systolic dimension ratio) was reduced: no variation was found in the hypertrophy-independent index of the inotropic state (systolic pressure/end-systolic dimension ratio normalized for posterior wall thickness). No change in the inotropic state was caused by a negligible sympathetic reflex outflow: heart rate also remained unchanged. The only index of left ventricular hypertrophy which was slightly reduced after two months of treatment was left ventricular mass (p less than 0.001). In conclusion, the short-term treatment with nicardipine, in hypertensive patients, showed powerful effects in the improvement of systolic function; the possible regression of left ventricular hypertrophy must be confirmed in long-term therapy.

Adult↗
PubMed1987

Hemodynamic hypertrophied left ventricular patterns in systemic hypertension.

The hemodynamic pattern of hypertrophied left ventricle in systemic hypertension was studied by M-mode echocardiography in 42 untreated hypertensive patients with left ventricular (LV) mass index greater than 2 standard deviations from the sex-specific mean of 114 normal subjects (normal values of our laboratory), and in 45 normotensive volunteers. Hypertensive patients showed cardiac dimensions, relative diastolic wall thickness, ratio of systolic pressure to end-systolic dimension, cardiac index and stroke index greater than normotensive control subjects (0.01 less than p less than 0.0001). Pressure/dimension ratio was correlated to relative wall thickness (p less than 0.005). End-systolic stress/volume ratio was normal as was systolic pressure to dimension ratio normalized for end-diastolic wall thickness. LV hypertrophy was concentric in 26% and eccentric in 74% of patients and suggested 2 different heart adaptations to overload: eccentric hypertrophy was associated with increased cardiac dimensions, high peak stress, normal systolic function and moderately increased LV contractility; concentric hypertrophy was associated with the highest blood pressure values, normal cardiac dimension, normal peak stress, normal systolic function and much increased LV contractility. Because stress/volume ratio and wall thickness-corrected systolic pressure/dimension ratio were normal in hypertensive patients, LV contractile capacity might be supported by the increase in myocardium available for contraction, rather than by increase in inotropic state.

Adult↗
PubMed1986

Low-renin primary hypertension in a young patient treated with dexamethasone.

We have studied a young untreated patient with low-renin hypertension. All the clinical tests were in normal range, except plasma renin activity, which was low. Also all traditional tests evaluating the adrenal function were normal. A test of supraphysiological ACTH stimulation revealed a partial enzymatic defect of adrenal 11-hydroxylase. The patient has been treated with dexamethasone (0.75 mg once daily), during 4 weeks. At the end of the treatment blood pressure reached normal values. The traditional adrenal function tests are not sufficient to exclude enzymatic abnormalities and their possible involvement in the pathogenesis of hypertension.

Adrenocorticotropic Hormone↗
PubMed1986

A role for steroid hormones in the variability of blood pressure determination.

Blood pressure variability was studied in eight patients with renovascular hypertension (group 1) and eight patients with hypertension and partial deficiency of adrenal zona fasciculata 11-hydroxylase (group 2). Systolic, diastolic and mean blood pressure were found to be higher in group 1 than in group 2 when measured at home (P less than 0.001), while no difference was measured when blood pressure was taken in the outpatient clinic. Heart rate was higher in group 1 than in group 2 both at home and in the clinic (P less than 0.005 and P less than 0.05, respectively); a significant increase was observed only in the hospital clinic for group 2 (P less than 0.001). No difference in systolic function and left ventricular mass was found between the two groups. Finally, group 2 exhibited a significant increase (P less than 0.0001) in systolic, diastolic and mean blood pressure in the clinic, compared with that found at home, while group 1 showed a poor increase (P less than 0.05) in systolic blood pressure only. It is suggested that the enzymatic impairment of adrenal glands in group 2 may play a role in the disparity of blood pressure levels determined at home and in the outpatient clinic. Furthermore, our data suggest that differences in blood pressure measurement at home and in the hospital clinic should be taken into account when screening patients with partial deficiency of 11-hydroxylase.

Adrenal Glands↗