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Biomedical subjects

L Poli

Publications and source records attributed to L Poli.

At least 55 records · Page 3Linked to original sources

Risk factors for atherosclerosis and aging.

In order to investigate the association between atherosclerosis and risk factors in aged subjects, Doppler ultrasound scans were used to identify the presence and severity of carotid and femoral atherosclerosis in a sample of 457 community living subjects (mean age 55.4 +/- 18.7 years) of the metropolitan area; the ultrasonographic findings were then related to primary cardiovascular risk factors. Carotid and femoral plaques were found respectively in 178 (38.5%) and in 180 (39.4%) subjects. Prevalence of atherosclerosis, number of plaques and percentage of stenosis have been observed to increase with age. All the main cardiovascular risk factors (age, male sex, hypertension, cigarette smoking, diabetes and hypercholesterolemia) resulted significantly associated with both carotid and femoral atherosclerosis in the total series and, more strongly, in subjects aged under 65. On the contrary, most of these associations disappeared in subjects aged 65 or more. Multiple logistic regression analysis confirmed that in this age group only age and male sex were independently associated with carotid and femoral atherosclerosis; of the other risk factors cigarette smoking alone was an independent risk factor for femoral atherosclerosis. We conclude that in the elderly, in spite of the age-related increase in carotid and femoral atherosclerosis, the association between risk factors and atherosclerotic disease is less relevant than at younger ages.

Age Factors↗

Autopsy and multiple pathology in the elderly.

We examined autopsy reports and the clinical diagnoses of 600 patients (200 in 1967 and 400 in 1987). For each patient we considered age, diagnostic error, main diseases and presence of multiple pathology. The number of diagnostic errors increased from 1967 to 1987. The diagnostic error was particularly high for pulmonary embolism and septic shock and significantly higher in patients > 65 than < or = 65 years old. Multiple pathology was higher in old patients: we found 4 or more diseases in 195/270 (72.2%) patients > 65 years and in only 135/330 (40.9%) patients < or = 65 years. The average period of hospitalization was directly proportional to the number of diseases present in the same patient.

Age Factors↗

Serum levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and interleukin-1 beta (IL-1 beta) in dengue-infected patients.

Sensitive immunoenzymatic assays were used to study the levels of tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6), and IL-1 beta in sera from dengue-infected patients obtained during the 1989-1990 outbreak of dengue-3 in Tahiti, French Polynesia. The patients, both children (n = 47) and adults (n = 18), were clinically classified as having dengue hemorrhagic fever (DHF) and graded according to the severity of illness (grade I = fever, grade II = fever with spontaneous hemorrhagic manifestations, grade III = circulatory failure, grade IV = deep shock). The serum samples were obtained from day 1 to day 10 after the onset of the disease. High levels of TNF-alpha were observed in dengue-infected children of all severity grades. The highest values of TNF-alpha were found before day 6 after the onset of the infection, these values decreased from day 6 to day 10. The highest values were observed in sera from grade III and IV patients. High values of IL-6 were observed in serum samples of grade I and II patients on day 1, which decreased on day 4, and by day 5 were similar to those obtained from 25 control children. In grade III and IV patients, the highest values of IL-6 were observed from day 3 to day 5 after the onset of infection; after day 5, these values were very low.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Risk factors for atherosclerosis: ultrasound evaluation of carotid and femoral arteries in patients examined by coronary angiography.

The carotid and femoral arteries of 209 subjects (161 men and 48 women), consecutively tested by coronary angiography during the first four months of 1990, were examined using a B-Mode Echo-doppler. The angiographic examination was performed for suspected ischemic disease or to complement hemodynamic tests for valvular cardiopathy. The relationship between the main risk factors and the degree of atherosclerotic vascular involvement in the coronary, carotid and femoral districts was examined using standardised partial correlation coefficients. Cigarette smoke (expressed as number of cigarettes per day or as duration of exposure to smoke), total blood cholesterol concentration and age were positively correlated with the degree of atherosclerotic involvement in all three vascular regions; triglyceridemia values were correlated only in the coronary region. These relations were observed both in patients below and above 65 years of age; in the elderly group no correlation was found between blood cholesterol concentration and coronary involvement and between triglycerides levels and atherosclerotic disease in the three districts. Our results suggest that some risk factors (high blood cholesterol concentration and history of smoking) correlate with severity of atherosclerotic involvement even in advanced age.

Age Factors↗

[Ischemic stroke and transient ischemic attacks: a case-control study of the risk factors in elderly hospitalized patients].

We have evaluated in a case-control study the association of the main risk factors with cerebrovascular ischemic accidents in elderly patients. Two hundred and twenty patients aged 65 year or more (average age 77.3 +/- 7.3 yr, 93 males and 127 females) admitted to our Division for stroke (122) or transient ischemic attacks (TIA) (98) were enrolled: 220 hospitalized patients, age and sex-matched, without actual or previous cardiovascular clinical manifestations were the control group. Advanced senile decay, hepatic or renale failure and malignancies were considered exclusion criteria for both groups. The following risk factors have been considered: family history, obesity, cigarette smoking, diabetes, hypercholesterolemia, hypertriglyceridemia, atrial fibrillation, left ventricular hypertrophy, and related continuous variables. After logistic multiple regression analysis, atrial fibrillation, hypertension and blood cholesterol concentration above 240 mg/dl were significantly and independently associated with stroke, while only hypertension and hypercholesterolemia were associated with TIA. The unexpected finding of a significant association between hypercholesterolemia and cerebrovascular ischemia seems attributable to the choice of hospitalized patients as control group. These results indicate that hypertension and atrial fibrillation are independently associated with ischemic stroke even in advanced age.

Aged↗

A four year clinical and echographic follow-up of asymptomatic carotid plaque.

Eighty-five patients with asymptomatic carotid plaque--a diagnosis revealed by B-mode high-resolution echotomography--were followed up for four years; the echoplaque changes were compared with the clinical history. Eight patients died (2 from stroke, 4 from myocardial infarction, and 2 from lung tumor) and were excluded from the follow-up. Three patients underwent carotid thromboendarterectomy (TEA) (1 bilateral), and these 4 carotids were not considered in the total series. At the first echo Doppler evaluation of 150 carotids, plaques were observed in 112; 38 vessels were free of lesions. Of the 150 carotids, 8 revealed a new plaques. In regard to the echogenic pattern, 95 of the 112 plaques (84.8%) remained unchanged, 16 (14.3%) progressed, and regression of a small homogeneous plaque was observed in 1 patient (0.9%). An increase of the degree of vascular stenosis, was observed in 23 of the 150 carotids (15.3%). Cerebral ischemic symptoms occurred in 5 patients. In 1 patient who suffered from stroke, a new, soft, dyshomogeneous plaque in the carotid of the side of the lesion was observed. In 3 patients (2 with strokes, 1 with transient ischemic attack) the occlusion of a previous severe stenosis was observed. The fifth patient had a stroke on the side of an unchanged, ulcerated hemodynamic lesion. A valid criterion for identifying a risky plaque should be the joint evaluation of the echostructural characteristics and the degree of stenosis.

Arteriosclerosis↗

[Lipid parameters and cardiovascular risks in elderly patients hospitalized for ischemic cardiopathy. A case-control study].

In order to evaluate whether and to what extent elevated blood lipid concentrations and clinical expressions of coronary heart disease (CHD) are associated in the elderly, we studied the risk of CHD (myocardial infarction and angina pectoris) in a population of elderly hospitalized patients (210 subjects, 126 men and 84 women, average age 76 +/- 6 years) exposed to risk factors. 210 patients, free from current and previous cardiovascular diseases, age and sex matched, were recruited as the control group. Advanced senile decline, severe hepatic or renal failure and malignancies were considered exclusion criteria for both groups. The following dichotomic variables (familial history of CHD, cigarette smoking, clinical history of arterial hypertension or diabetes mellitus, hypercholesterolemia, hypertriglyceridemia) and continuous variables (total, LDL and HDL cholesterol, triglycerides, total/HDL cholesterol ratio, body mass index (BMI), years of exposure to risk factors) were considered. Using a stepwise multiple logistic regression forward method, the following variables resulted significantly associated with the risk of CHD: total/HDL cholesterol ratio (OR 1,89), BMI (OR 1,04), period of hypertension (OR 1,04) and cigarette smoke exposure (OR 1,007). We conclude that in the elderly the total/HDL cholesterol ratio can be a more predictive and reliable index of coronary risk than blood total cholesterol concentration.

Aged↗

[Prevalence and risk factors of carotid and femoral atherosclerosis in a sample of the city of Turin].

Presence and severity of carotid and femoral atherosclerosis, in relation to the principal cardiovascular risk factors, have been non invasively evaluated using echodoppler in a sample of 457 subjects (average age 55.4 +/- 18.7 years) of the metropolitan area of Turin. Data of prevalence have been standardized for age and gender in order to obtain an estimate of prevalence representative of the city. In both districts, prevalence of lesions, echo structural characteristics of the plaques and related degree of stenosis have been considered. Results indicate a high prevalence of carotid and femoral atherosclerosis (38.5% and 39.4% respectively), and, particularly, of concomitant involvement of both districts (30%). Prevalence of the lesions and degree of stenosis rise with advancing age; nevertheless stenosis > 75% were not found among the oldest patients. Bifurcations were the most frequent site of lesion and the "hard" echo structure was the most commonly represented, especially in subjects over 45 years. After multiple logistic regression model both carotid and femoral atherosclerosis were strongly and independently associated with age, male sex, smoke of cigarette and plasma cholesterol concentration.

Adolescent↗