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Biomedical subjects

L Pavan

Publications and source records attributed to L Pavan.

At least 19 recordsLinked to original sources

SOPRoxi: a research-intervention project for suicide survivors.

In Italy, postvention models specifically designed for people surviving the suicide of a loved one are very scarce. The SOPRoxi project was developed to respond to this particular lack. By involving different professional and nonprofessional figures (GPs, mental health professionals, social workers, volunteers, etc), the SOPRoxi project aims to remove the stigma associated with this condition and to offer adequate, multifaceted help to survivors.

Crisis Intervention↗

PPARgamma/RXRalpha heterodimers control human trophoblast invasion.

The ligand-dependent nuclear receptors PPARgamma and RXRalpha/beta were recently determined to be essential for murine placental development and trophoblast differentiation. In the current study we examined the expression and role of the PPARgamma/RXRalpha heterodimers in human invasive trophoblasts. We first report that in human first trimester placenta, PPARgamma and RXRalpha are highly expressed in cytotrophoblasts at the feto-maternal interface, especially in the extravillous cytotrophoblasts involved in uterus invasion. The coexpression of PPARgamma and RXRalpha genes in extravillous cytotrophoblast nuclei were then confirmed by immunocytochemistry, immunoblot, and real-time quantitative PCR using cultured purified primary extravillous cytotrophoblasts. We next examined, using the extravillous cytotrophoblast culture model, the biological role of PPARgamma/RXRalpha heterodimers in vitro, and we showed that both synthetic (rosiglitazone) and natural [15-deoxy-delta-(12,14)PGJ(2)] PPARgamma agonists inhibit extravillous cytotrophoblast invasion in a concentration-dependent manner and synergize with pan-RXR agonists. Conversely, PPARgamma or pan-RXR antagonists promoted extravillous cytotrophoblast invasion. Furthermore, the pan-RXR antagonist abolished the inhibitory effect of the PPARgamma agonists. Together these data underscore an important function of PPARgamma/RXRalpha heterodimers in the modulation of trophoblast invasion.

Cell Differentiation↗

Effects of a traditional lifestyle on the cardiovascular risk profile: the Amondava population of the Brazilian Amazon. Comparison with matched African, Italian and Polish populations.

OBJECTIVE: To determine the relationships between lifestyle and cardiovascular risk factors among the Brazilian Amondava, one of the world's most isolated populations. DESIGN: Cross-sectional, population-based study. Four age- and sex-matched samples from Brazil Africa, Italy and Poland, representing different levels of modernization, were compared. Body weight, height, blood pressure, serum cholesterol and glycaemia were measured, and a standard questionnaire administered. Data concerning dietary habits and physical activity were collected. A personal socio-economic score was calculated, on the basis of type of economy, level of formal education, type of occupation, type of habitat, availability of piped water and electricity, main source of income, housing conditions, availability of radio, television or personal computer, knowledge of a second language, and organized health facilities. SETTING: Primary epidemiological screening, at an institution. RESULTS: Among the Amondava blood pressure was always <140/90 mm Hg, it did not increase with age and was not correlated with any other variable; 46.6% of subjects had systolic blood pressure <100 mm Hg. Blood pressure among the Amondava (109.6+/-11.1/69.5+/-6.4 mm Hg) was on average lower (P<0.0001) than in all other samples. Among the Amondava, the concentration of total cholesterol was always <200 mg/dl, i.e. similar to that of Africans whose diet included large amounts of vegetable foodstuffs; 90% had glycaemia (<80 mg/dl), and their mean value was the lowest (55.1+/-14.9 mg/dl) of all the groups. CONCLUSIONS: In addition to a possible genetic predisposition not analysed in this study, a traditional lifestyle (no contact with civilization, diet based on complex carbohydrates and vegetables, high energy expenditure) may protect against the development of hypertension, hypercholesterolaemia, and diabetes.

Adolescent↗

Acute effects of the oral administration of midodrine, an alpha-adrenergic agonist, on renal hemodynamics and renal function in cirrhotic patients with ascites.

The effects of the acute administration of arterial vasoconstrictors on renal plasma flow (RPF) and urinary sodium excretion (UNaV) in cirrhotic patients with ascites with or without hepatorenal syndrome (HRS) are still controversial. As a consequence, vasoconstrictors are not actually used in the treatment of renal sodium retention or HRS in these patients, regardless of the several lines of evidence suggesting that these renal functional abnormalities are related to a marked arterial vasodilation. The lack of an orally available effective arterial vasoconstrictor probably represents a further reason for this omission. Consequently, the present study was made to evaluate the acute effects of the oral administration of midodrine, an orally available -mimetic drug, on systemic and renal hemodynamics and on UNaV in cirrhotic patients with ascites. Mean arterial pressure (MAP), heart rate (HR), cardiac index (CI), systemic vascular resistance (SVR), left forearm blood flow (LFBF), left leg blood flow (LLBF), RPF, glomerular filtration rate (GFR), UNaV, plasma renin activity (PRA), plasma concentration of antidiuretic hormone (ADH), and the serum levels of nitrite and nitrate (NOx) were evaluated in 25 cirrhotic patients with ascites (17 without HRS and 8 with type 2 HRS) before and during the 6 hours following the oral administration of 15 mg of midodrine. During the first 3 hours after the drug administration, a significant increase in MAP (89.6 +/- 1.7 vs. 81.80 +/- 1.3 mm Hg; P < .0001) and SVR (1, 313.9 +/- 44.4 vs. 1,121.2 +/- 60.1 dyn . sec . cm-5; P < .0001) accompanied by a decrease in HR (69 +/- 2 vs. 77 +/- 3 bpm; P < .005) and CI (2,932.7 +/- 131.4 vs. 3,152.5 +/- 131.4 mL . min-1 . m2 BSA; P < .0025) was observed in patients without HRS. No change was observed in LFBF and LLBF. The improvement in systemic hemodynamics, which was also maintained during the the 3- to 6-hour period after midodrine administration, was accompanied by a significant increase in RPF (541.5 +/- 43.1 vs. 385.7 +/- 39.9 mL . min-1; P < .005), GFR (93.1 +/- 6.5 vs. 77.0 +/- 6.7 mL . min-1; P < .025), and UNaV (92.7 +/- 16.4 vs. 72.2 +/- 10.7 microEq . min-1; P < .025). In addition, a decrease in PRA (5.33 +/- 1.47 vs. 7.74 +/- 2.17 ng . mL-1 . h; P < .05), ADH (1.4 +/- 0.2 vs. 1.7 +/- 0.2 pg . mL-1; P < .05), and NOx (33.4 +/- 5.0 vs. 49.3 +/- 7.3 micromol-1; P < .05) was found. In patients with HRS, the effects of the drug on the systemic hemodynamics was smaller and shorter. Accordingly, regardless of a significant decrease in PRA (15.87 +/- 3.70 vs. 20.70 +/- 4.82 ng . mL-1 . h; P < .0025) in patients with HRS, no significant improvement was observed in RPF, GFR, or UNaV. In conclusion, the acute oral administration of midodrine is associated with a significant improvement in systemic hemodynamics in nonazotemic cirrhotic patients with ascites. As a result, renal perfusion and UNaV also improve in these patients. By contrast, midodrine only slightly improves systemic hemodynamics in patients with type 2 HRS, with no effect on renal hemodynamics and renal function.

Administration, Oral↗

Leg versus forearm flow: 24 h monitoring in 14 normotensive subjects and in 14 age-matched hypertensive patients confined to bed.

A circadian blood pressure rhythm has been demonstrated in the majority of subjects, even if inactive during daytime. A rhythm of leg blood flow and peripheral resistance, with higher values during sleep than during waking, has also been recently shown in subjects confined to bed. Doubts still persist on whether such a rhythm also exists in the forearm, and whether or not its trend is similar to that found in the leg. In this study, leg and forearm blood flow and resistance were monitored noninvasively every 15 min for 22 h in 14 normotensives and 14 age-matched hypertensives confined to bed. A significant blood pressure fall (normotensives, -4.8%/-6.1%; hypertensives, -7.1%/-6.3%; all P <.0001), heart rate decrease (-14.9 in the former, -10% in the latter; both P <.0001) and leg flow increase (normotensives, +47.4%, hypertensives, +36.1%; both P <.0001) were found during sleep in all subjects, because of a blood redistribution probably attributable to activation of the cholinergic system. Forearm flow was significantly higher during sleep (+26.1%, P <.0001) in the normotensives, whereas in the hypertensives a slight nocturnal decrease (-1.9%) was found. In conclusion, the hypertensives had lower leg and forearm flow than the normotensives during sleep and similar during daytime. Peripheral resistance measured in the leg and in the forearm was greater in the former than in the latter, both during sleep and during waking.

Blood Pressure↗

Effects of caffeine on glucose tolerance: a placebo-controlled study.

OBJECTIVE: The investigation was performed to study the effects of 200 mg oral caffeine on glucose tolerance. DESIGN: Single-blind Latin square with active treatment (caffeine) and placebo. SETTING: The University of Padova, Department of Internal Medicine. SUBJECTS: 30 nonsmoking healthy subjects aged 26-32 years who abstained not only from coffee but also from tea, chocolate and cola for 4 weeks and who had given their informed consent. INTERVENTIONS: A 75 g oral glucose tolerance test (OGTT) was performed after giving caffeine or placebo (highly decaffeinated coffee). RESULTS: The glycaemic curve was normal in all subjects and was similar in the two groups until the second hour; in subjects taking caffeine a shift towards the right was detected at the 2nd, 3rd and 4th hours in comparison to those taking the placebo. Blood insulin levels were comparable after caffeine and after placebo along the entire OGTT. CONCLUSIONS: The data suggest that caffeine intake induces a rise in blood glucose levels that is insulin independent.

Adult↗

Subjects with obstructive pulmonary disease tend to be chronically vasodilated.

1. In 12 unselected outpatients with chronic obstructive pulmonary disease and six controls, arterial pH, PaO2, PaCO2 and oxygen saturation (SaO2), forced expiratory volume in 1.0 s (FEV1.0) and vital capacity were measured. Subjects were grouped into those with or without obstruction based on the Tiffenau index. The Baseline Dyspnoea Index was employed to objectify the severity of dyspnoea and the Borg index to evaluate the subjective sensation. Blood pressure was measured with a sphygmomanometer; calf arterial flow both at rest and during reactive hyperaemia with a plethysmograph. Basal and minimal resistance were calculated.2.FEV1.0 was 26% lower in patients with obstruction than in controls, and was also lower in patients with moderate-to-severe obstruction compared with those with mild or no obstruction. Arterial flow (75% greater in the patients with obstruction) progressively increased with increasing severity of obstruction, being 54% higher in those with mild obstruction than in those with no obstruction (P<0.001), and 28% higher in moderate-severe than in mild obstruction (P<0.005). In multiple regressions, F correlated inversely with FEV1.0, PaO2 and SaO2, and directly with PaCO2. Basal resistance correlated positively with FEV1.0, SaO2 and the Tiffenau index, and inversely with PaCO2 (r=-0.52, P=0.02). Minimal resistance was significantly lower in obstructed than in non-obstructed subjects. Both basal and minimal resistance progressively decreased, although insignificantly, with worsening bronchial obstruction. PaCO2 did not correlate with any haemodynamic parameter. Borg index correlated indirectly with FEV1.0 and basal resistance directly with arterial flow.3. Patients with chronic obstructive pulmonary disease therefore tend to show chronic vasodilatation depending on hypoxia rather than PaCO2. Other mechanisms could be involved in this phenomenon. The Borg index is a good indicator of oxygen desaturation and vasodilatation.

Aged↗

Blood pressure, serum cholesterol and nutritional state in Tanzania and in the Amazon: comparison with an Italian population.

OBJECTIVE: To confirm that westernization of dietary habits represents a stimulus for the expression of cardiovascular risk. DESIGN: Three representative age- and sex-matched samples of general populations of three continents were compared cross-sectionally by analysis of variance. PARTICIPANTS: In total 1110 subjects aged 22-89 years, divided into three groups (370 from Tanzania and Uganda, 370 from the Amazonian region of Brazil, and 370 from northern Italy; 111 men and 259 women in each group). RESULTS: The blood pressure of Africans eating a low-salt fish and vegetable' diet was lower than those of Brazilians, whose diet was based on cereals and meat, and highly urbanized Italians. The systolic blood pressure was correlated to the body mass index for all three populations, but with age only for the Brazilians and Italians. The total cholesterol level and body mass index, both of which are low among Africans, increased progressively with increasing economic level. CONCLUSIONS: Transition from a rural to an urbanized lifestyle is accompanied by a rise in the main cardiovascular risk factors; the present data also show that environmental rather than racial factors have a crucial impact on the risk pattern of populations.

Adult↗

Impaired glucose tolerance and its co-variates among 2079 non-diabetic elderly subjects. Ten-year mortality and morbidity in the CASTEL study. CArdiovascular STudy in the ELderly.

This study evaluated the role of impaired glucose tolerance (IGT) as a risk factor in a general population of 2079 non-diabetic elderly subjects. The 10-year cardiovascular morbidity was similar in normal and IGT subjects. Mortality was greater in IGT, but the Cox equations of the hazard rate were different in younger and older subjects: age, sex, lung function (forced expiratory volume in 1 s, FEV1), serum uric acid, IGT and proteinuria were predictors of overall mortality in the age class 65-79 years, while only the first 4 were associated with cardiovascular mortality. The same four items also predicted overall survival in subjects over 79 years old, while only age and uric acid were predictors of cardiovascular mortality. In older subjects, total cholesterol showed an inverse predictive value. Hyperuricaemia (> 6.4 mg/dl) and proteinuria did predict mortality in normal but not in IGT subjects, while reduced FEV1 (< 60% theoretical) was predictive in all. In 65-79-year old subjects IGT predicted mortality provided that FEV1 was normal, while in those 380 years old IGT was not a predictor. These interrelationships should be taken into account to better understand the factors underlying mortality.

Aged↗

Haemodynamic effects of coffee and purified caffeine in normal volunteers: a placebo-controlled clinical study.

In order to evaluate the effects of 'espresso' Italian coffee on resting flow, blood pressure, and peripheral resistance, 15 non-coffee drinking healthy volunteers received 2 cups of regular coffee, 200 mg purified caffeine or placebo in a latin square double-blind crossover protocol. Before and 30, 60, 90 and 120 min after ingestion, segmental resting flow and BP were measured and peripheral resistance was calculated. An echocardiogram was also performed before and 60 and 120 min after caffeine intake. Both regular coffee and caffeine produced a significant decrease in resting flow and a significant increase in resistance; both systolic and diastolic BP also increased, although not significantly. No variation was observed in heart rate and in cardiac contractility. Placebo (highly decaffeinated coffee for regular coffee and china bitter extract for caffeine) did not produce any haemodynamic effect. In five other healthy volunteers used to drinking more than 5 cups of coffee a day, coffee administration had no effect. These data demonstrate that the caffeine contained in espresso Italian coffee is a vasoconstrictor agent whose effects however are completely blunted in usual coffee drinkers as a consequence of adaptation.

Adult↗

Possible dopaminergic involvement in biting compulsion induced by large doses of clonidine.

The effects of amphetamine, scopolamine, phenoxybenzamine, haloperidol and clozapine on biting compulsion induced by large doses of clonidine were studied in mice. Clonidine-induced biting compulsion was potentiated by amphetamine and scopolamine, and inhibited by phenoxybenzamine, haloperidol and clozapine. It appears that biting compulsion elicited by clonidine is mediated by the stimulation of both noradrenaline and dopamine in the brain. Since clorapine, an atypical neuroleptic agent, inhibits this response, the possibility is discussed to use clonidine-induced biting compulsion to detect neuroleptic agents devoid of extrapyramidal side effects.

Aggression↗

Modifications of libido and sex drive during treatment of minor depression with viloxazine.

The effects of viloxazine hydrochloride on the libido and sex drive of 20 outpatients suffering from minor depression were assessed. For this purpose the Zung Self-Rating Depression Scale and a questionnaire devised by the authors to evaluate libido and sex drive were used. A dose of 300 mg viloxazine/day for 4 weeks was administered. Test-retest assessments showed a significant improvement of depression and an increase in libido and sex drive. These latter effects were marked, but did not appear to be related to the improvement of depression.

Adult↗

Losses, Hostility, and depression.

Forty outpatients with a primary unipolar major depression of recent onset and a matched control group of employees were administered the hostility scale of the Kellner Symptom Questionnaire, depression was rated with the Hamilton Rating Scale for Depression, and life events were recorded in a structured interview. In a subgroup of depressives who had not reported losses, there was an association of hostility and depression, whereas no such association was found in depressives who had reported losses. The findings are consistent with those of previous studies showing that hostility is largely limited to a subgroup of depressives. In a substantial proportion of the depressives, depression and hostility are independent affects.

Depressive Disorder↗

The Hamilton Depression Rating Scale in normals and depressives.

The Hamilton Rating Scale for depression (HDRS) has become the standard observer rating scale for depression, yet there are no adequate data from normal samples. The present study was carried out in northern Italy. The purposes were 1) to examine the ratings in normals and 2) to examine the scale's validity in the different language and culture. The scale was used in 40 normals and 40 depressives who were matched. Two self-rating scales of depression were administered: the Symptom Rating Test and the Symptom Questionnaire. The results show that the HDRS is a valid measure in that it sensitively discriminates between depressed patients and normals. The findings support Hamilton's view that only the first 17 items of the scale are appropriate for computing the score. The use of self-rating scales yielded additional information. The misclassification rate of the Symptom Rating Test was similar to that of the HDRS. The combined use of Research Diagnostic Criteria (RDC) and HDRS appears to be more reliable for the selection of depressed patients for research than the RDC only.

Ambulatory Care↗

Life events and depression. A replication.

A study which was first carried out in the United States was repeated in Northern Italy. Life events reported to have occurred 6 months before the onset of illness were compared in 40 outpatients who had a first episode of primary depression, and a matched normal control group. Depressives reported significantly more events than the control groups, and had significantly more of the following: undesirable events, exits from the social field, events which had an 'objective negative impact' (rated as being traumatic) and 'independent events' (events which were unlikely to be a consequence of the depression); the last 2 were judged by a rater who was unaware whether the event had occurred in a depressed patient or in a control subject. There were no significant differences in desirable events, entrances into the social field and events which were within the subjects' control. These findings replicate previous results and are consistent with the view that certain recent life events play a substantial role as precipitants in some depressed patients.

Adult↗

Consultation psychiatry in an Italian general hospital: a report on 500 referrals.

Five-hundred consecutive referrals to the psychiatric consultation service at the University of Padua School of Medicine have been reviewed. In 69% of cases concurrent physical and psychiatric disorders were reported. There was a prevalence of females, working class patients, and individuals with limited schooling. Depression was the most common psychiatric disorder in all classes of organic disease and accounted for 37% of all psychiatric diagnoses, followed by anxiety neurosis (18.6%) and drug dependence (13.8%). In 10.8% of cases no psychiatric diagnosis was made.

Adolescent↗