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Biomedical subjects

P Cugini

Publications and source records attributed to P Cugini.

At least 19 recordsLinked to original sources
PubMed2001

Is melatonin circadian rhythm a physiological feature associated with healthy longevity? A study of long-living subjects and their progeny.

The study investigates the circadian rhythm (CR) of urinary 6-sulphatoxy-melatonin (aMT6s) in long-living (longevous) subjects and their progeny. The aim is to detect whether or not the melatonin CR is a physiological feature associated with healthy longevity. The aMT6s CR was investigated in 10 longevous subjects, 8 of their children and 9 of their grandchildren, all in good health. Control data were obtained respectively from 13 adult subjects and 9 young subjects, in good health, but characterized by a negative family history for longevity. All the subjects were born and living in the same city. The study was performed in the summer of 1996. The aMT6s CR was found to persist in longevous subjects, being characterized by a lower mesor and amplitude. The aMT6s CR was found not to show properties consistently different in children and grandchildren as compared respectively to their adult and young controls. Because of its preservation in longevous subjects, it can be argued that the melatonin CR is a physiological feature associated with healthy longevity. Because of the comparability of aMT6s CR in children and grandchildren, with respect to their controls without a positive family history of longevity, it can be argued that the melatonin CR is not a marker that can be used for an earlier identification of the candidates for longevity.

Adult↗
PubMed2000

Daily hunger sensation monitoring as a tool for investigating human circadian synchronization.

This study investigates within-day hunger sensation (HS) variability in Clinically Healthy Subjects Adapted to Living in Antarctica (CHSALA), as compared to their coeval subjects living in their mother country. The aim is to detect how the orectic stimulus behaves in those environmental conditions and occupational schemes, in order to investigate the individual synchronization to sleep-wake alternation and meal time schedule. HS was estimated via a self-rating score of its intensity on a Visual Analog Scale, repeating the subjective perception every 30 min, unless sleeping. The individual HS time-qualified scores (orexigram) were analyzed according to conventional and chronobiological procedures. The orexigrams of the CHSALA were seen to show a more cadenced intermittence during the diurnal part of the day, strictly related to the meal timing, and a preserved circadian rhythm as well. In addition, these orexigrams were resolved in a spectrum of harmonic components which indicated a subsidiary number of ultradian formants. These findings are convincing evidence that the individual orexigram may be used to investigate whether or not a single subject is synchronized to sleep-wake cycle, meal time schedule and socio-occupational routines, instead of using more complex and expensive techniques, involving automated equipments and biohumoral assays.

Acclimatization↗
PubMed2000

Endoscope washers--a protocol for their use.

A protocol for the disinfection of gastroduodenoscopes, retrograde cholangiopancreatography endoscopes and colonoscopes using endoscope washers is described. The process recommends initial manual washing with a disinfectant containing didecyldimethylammonium chloride, surfactants and enzymes, a second washing in the endoscope washer using a detergent associated with a bacteriostatic, fungistatic substance (benzoisothiazolone) and finally the use of a 2% glutaraldehyde product buffered at pH6. After treatment with 2% Steranios added to the washer, less than 1 micro-organism/ml liquid was found in the following units: 83% of the colonoscopes, 83% of the oesophagogastroduodenoscopes, 83% of the main channels of the retrograde cholangiopancreatography endoscopes and 75% of the auxiliary channels of the latter instruments. In 14% of the colonoscopes, 42% of the gastroduodenoscopes, 42% of the main and 50% of auxiliary channels in the retrograde cholangiopancreatography endoscopes there were no signs of microbial growth in the wash liquid. The results obtained indicated that this protocol allowed adequate disinfection of the endoscope channels, structurally the most difficult part of the instrument to disinfect. Emphasis is given to the degree by which instrument contamination can increase during overnight storage, suggesting that endoscopes need to be submitted to further disinfection after overnight storage. Moreover, the water flowing into the washers can also cause instrument recontamination, particularly during the final rinses. Therefore, to better safeguard the health of patients undergoing endoscopy, special care must be taken to maintain the filters and disinfect the washers themselves, no matter how effective the disinfection protocol used may be.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1999

Daily hunger sensation and body compartments: II. Their relationships in obese patients.

Hunger sensation (HS) is a signal whose levels change during the 24-h day. The daily mean level of HS was correlated with the human body compartments, as investigated by bioelectrical impedance analysis, to detect the relationship between the orectic perception and both the free fat mass (FFM) and the fat body mass (FBM) in 22 clinically healthy subjects (CHS) (2 M, 20 W, BMI: 18.5-24.0 kg/m2) and 48 obese patients (OP) (4 M, 44 W, BMI: 25.2-54.7 kg/m2). In CHS, the daily mean level of HS correlated positively with the FFM and negatively with the FBM. These correlations were not present in OP. This lack of relationships between HS and the body compartments where energy is maximally consumed (i.e., the FFM) and maximally stored (i.e., the FBM) indicates that the orectic response to energy expenditure and the orectic inhibition to fat accumulation are feedback mechanisms which are impaired in obesity.

Adipose Tissue↗
PubMed1999

Anxiety, depression, hunger and body composition: III. Their relationships in obese patients.

The present paper explores the relationships between anxiety, depression, hunger sensation and body composition in obese patients (OP). The aim is to detect whether or not there are abnormalities in these relationships in OP as compared to clinically healthy subjects (CHS). The study was performed on 22 CHS (2 M, 20 W; mean age = 24 +/- 2 years; mean body mass index = 21 +/- 2 kg/m2) and 48 OP (4 M, 44 W; mean age = 40 +/- 17 years; mean body mass index = 32 +/- 7 kg/m2). Anxiety and depression were found to be correlated, negatively, with the relative lean body mass, and, positively, with the fat body mass in OP but not in CHS. These findings corroborate the idea that anxiety and depression can reach an abnormal expression when obesity shows its worst loss in lean body mass and its highest expansion in adipocyte mass. As hunger sensation was found not to correlate with either anxiety or depression in OP, the opinion is expressed that the impairment of anxio-depressive integrity is a corollary of obesity rather than a primary affective disorder leading to obesity via an enhanced food intake.

Adult↗
PubMed1999

Preserved blood pressure and heart rate circadian rhythm in early stage Alzheimer's disease.

BACKGROUND: This study investigated the blood pressure (BP) values over the day-night period in 11 noninstitutionalized patients affected by probable Alzheimer's disease (AD) in its early stage. The scientific aim was to detect whether the BP circadian rhythm (CR) was preserved, given the fact that CR disruption was observed in advanced or institutionalized AD patients. METHODS: The BP within-day values were gathered via noninvasive ambulatory monitoring. The BP time series were analyzed according to the chronobiological procedure, called Cosinor method with three harmonic components. RESULTS: The biometric analysis was able to document that BP changes over the 24-h scale in AD patients as a function of a significant CR. Such a preserved circadian regulation is, however, compromised in the second and third harmonic component, suggesting that the BP within-day variability is desynchronized by the environmental clues that act as synchronizers during the diurnal part of the day. CONCLUSIONS: The preservation of the BP CR in the early stage of AD suggests using such a finding as a clinical tool for confirming the recent onset of the disease. As a matter of fact, it is presumed that the disease is not evolved enough to reach the suprachiasmatic nuclei, wherein is located the BP circadian pacemaker. The abolition of the ultradian components is another precocious sign that, in turn, indicates early-stage AD patients to be particularly compromised in their synchronization to diurnal cues, such as social routines, meal timing schedule, psycho-physical activity, and occupational schemes.

Aged↗
PubMed1999

Rationale for time-qualified reference standards for 24-hour blood pressure values and their circadian rhythms in Japanese normotensive adults: a study by the Ambulatory Blood Pressure Monitoring Research Group.

The aim of this study was to demonstrate that blood pressure (BP) has to be standardized according to its circadian variability, including the properties shown in its circadian rhythm. The BP time-qualified standards were derived from a sample of 644 clinically healthy normotensive Japanese subjects (320 males, 324 females; age range, 18-93 years), stratified by age-group and gender, who underwent noninvasive ambulatory monitoring according to a fixed protocol. The monitored data series shows that BP exhibits a within-day variability at any age of life in both males and females. Additionally, the monitored data series shows that BP exhibits a significant circadian rhythm at any age of life in both males and females. The age- and sex-related reference limits for the BP within-day variability constitute the time-qualified standards against which both the casual and monitored BP measurements can be compared in order to detect whether or not they are compatible with normotension. The reference limits for the BP circadian rhythm represent the rhythmometric standards against which the BP oscillatory curve can be compared in order to detect whether or not they are compatible with a physiological circadian rhythm.

Adolescent↗
PubMed1998

Hunger sensation: a chronobiometric approach to its within-day and intra-day recursivity in anorexia nervosa restricting type.

Hunger sensation (HS) is a perception with a daily (circadian) and within-day (ultradian) recursive pattern. In human beings, circadian repeatability was investigated by means of the Single Cosinor method, while the ultradian recursivity was investigated by means of the spectral analysis, both applied to the 24-h HS profile (orexigram). Orexigrams were provided by each subject investigated, who self-rated her subjective orectic stimulus (OS) (from 1 to 10 hunger units) every half hour. The study was performed in 19 female patients aged 13-52 newly diagnosed as in the first episode of Anorexia Nervosa Restricting Type, with a BMI below 18.7. The control group consisted of 10 clinically healthy women aged 21 to 52 years with a BMI from 23 to 25. Two types of orexigrams were found. The first was characterized by a low profile with negligible ultradian variability, in which the HS circadian rhythm (CR) was still detectable, but the power spectrum (PS) was composed of unusual ultradian components associated with a very diminished amplitude for the circadian harmonics. The second was characterized by an almost regular profile, in which the ultradian variability was clearly detectable, the CR regularly fluctuated, and the PS was almost regularly composed. These findings indicate that anorectic patients (AP) can be recognized by their orexigram as "hyporectic", or "eurectic". Therefore, the term "anorexia" seems to be appropriate for AP who exhibit the first type of orexigram (anorectic aphagia nervosa), whereas the second identifying those who could be defined as suffering from "eurectic aphagia nervosa".

Activity Cycles↗
PubMed1998

Daily hunger sensation and body composition: I. Their relationships in clinically healthy subjects.

The human hunger sensation (HS) is a perceptive signal characterized by day-night variability (DNV). This pattern was investigated with respect to its relations with the body compartments in 22 clinically healthy subjects (CHS, 11 males and 11 females, mean age: 24 +/- 2.5 years, mean BMI: 21 +/- 1.7). The DNV was investigated by means of conventional descriptive statistics and the single cosinor method (SCM). Both procedures were applied to the orexigram, i.e., the 24-h profile of the orectic stimulus (OS) provided by each subject, who self-rated his/her HS (from 1 to 10 hunger units) every half hour. Body composition was investigated by Bioelectrical Impedance Analysis (BIA) on the day when the orexigrams were compiled. It was found that the daily HS level correlates positively with the Free Fat Body Mass (FFBM) and negatively with the Fat Body Mass (FBM). These opposite relations indicate that HS is stimulated by the needs of the FFBM, and inhibited by expansion of the FBM, and provide further evidence of the existence of an "adipostat" anorectic mechanism.

Adult↗
PubMed1998

[From Chronos to Chaos: from the determinism of circadian rhythm of arterial pressure to the undeterminism of hypertensive crises].

This paper delineates the scientific though about the disorder (chaos) in dynamic phenomena. The discussion shows how the periodic functions, which are intrinsically deterministic, can break down into chaotic patterns, either global or catastrophic, because of their "dependence on the limits in the oscillatory modulation" (cycle stress limits). The argumentations demonstrate that order and disorder, chronos and chaos, are intrinsic aspects of dynamic phenomena. The text presents the fractal mathematics for analysing nonlinear events. The fractal interpolation is proposed for predicting the potential risk of hypertensive crisis using the noninvasive ambulatory blood pressure monitoring.

Blood Pressure↗
PubMed1998

[The concept of "preclinical arterial hypertension" - in light of non-invasive, ambulatory blood pressure monitoring].

In clinical medicine it is possible to find subjects who show initial signs of hypertensive damage being normotensive at the "casual" sphygmomanometry. In order to verify whether or not these subjects are "true normotensives", it was applied the noninvasive ambulatory monitoring of blood pressure (BP). Five studies were performed: I. Normotensives with initial hypertensive retinopathy; II. normotensives with initial hypertensive cardiohypertrophy; III. Normotensives with initial hypertensive cardiohypertrophy of the transplanted heart; IV. Normotensive pregnant women with altered uterine blood flow; V. Normotensive pregnant women with intrauterine growth retardation. From all the studies, it was possible to derive that the subjects were all true normotensive. However, they were characterized by BP values on average higher than those of their controls, but below the reference limits given by WHO. Because of the relative elevation of BP, it was possible to argue that there exists a BP regimen which is potentially dangerous for the target organs, even though there is no evidence of manifest arterial hypertension. Such a hemodynamic condition causing hypertensive cardiovascular damage was defined "arterial pre-hypertension".

Blood Flow Velocity↗
PubMed1997

Liddle's syndrome: a 14-year follow-up of the youngest diagnosed case.

The 14-year follow-up of a female patient with Liddle's syndrome (LS), a rare disease characterized by hypertension, hypokalemic alkalosis, and negligible aldosterone secretion due to renin suppression, is described. The disease was diagnosed at the age of 10 months (youngest identification). The patient was repeatedly investigated during follow-up for plasma renin activity (PRA), plasma aldosterone concentration (PA), serum sodium and potassium (K) concentration, blood pressure (BP), somatic anthropometry, and mental development. Noteworthy results included: persistent low circulating K, PRA, and PA and high BP, coinciding with unauthorized withdrawal of the triamterene therapy. These findings are in keeping with the hypothesis that LS results from a pathogenetic disorder which is not correctable with age. The triamterene therapy was effective in correcting the endocrine and metabolic disorders as well as arterial hypertension, but did not prevent a deficit in mental and physical development. However, the information derived from this study allows further clarification of the clinical picture of the disease.

Aldosterone↗
PubMed1997

[Minimal lesion hypertensive retinopathy and arterial pre-hypertension: evidence of arterial pressure monitoring in presumed normotensive subjects at zero risk].

The present study investigates the blood pressure (BP) 24 h pattern in 25 subjects who were found to show some incipient signs of hypertensive retinopathy, although they were diagnosed as normotensive by means of casual sphygmomanometry. BP was controlled by means of non invasive ambulatory monitoring. A comparable number of normotensive subjects without fundoscopic signs of hypertensive retinopathy was investigated as a control group. BP times series were analyzed by means of conventional and rhythmometric biometry. The biometric estimates suggest that the subjects with incipient hypertensive retinopathy show a significantly higher level of daily systolic BP even though their BP values remain below the reference limits. This finding suggests that the hypertensive retinopathy may exist in a non-zero stage characterizable as minimal change tensive retinopathy. This retinal picture occurs in subjects who show a pre-hypertensive stage in their BP 24 h pattern.

Adolescent↗
PubMed1997

[Who are the "non-dippers": an insight from the ambulatory monitoring of arterial pressure in heart transplant patients].

This study was performed in order to define who are the "non-dippers", knowing that their present definition does not imply any explanation about the mechanisms. The investigation was performed on 34 heart transplanted patients, 28 males (mean age 52 +/- 11 years) and 6 women (mean age 35 +/- 14 years), knowing that the "non-dippers" were described as the hypertensives who are devoid of the expected nocturnal fall in blood pressure (BP). The "non-dipping" phenomenon was investigated by exploring the BP 24-h pattern via ambulatory non-invasive BP monitoring, and by applying the rhythmometric analysis for quantifying the BP circadian rhythm. The study provided evidence that the "non-dippers" can be found among the hypertensives as well as the normotensives, suggesting that high BP is not a necessary condition for the "non-dipping" phenomenon, and vice versa. Both the normotensive and hypertensive "non-dippers" were seen to show stereotypic changes in BP circadian rhythm. There are normotensive and hypertensive "non-dippers" with or without the BP circadian rhythm. The "rhythmic non-dippers" show a BP circadian rhythm which is inverted in phase or demodulated in amplitude. The "non-dippers" are, thus, a heterogeneous category.

Adult↗
PubMed1997

Ambulatory blood pressure monitoring in clinically healthy subjects adapted to living in Antarctica.

This study investigates 24-h blood pressure (BP) and heart rate (HR) values in clinically healthy subjects adapted to living in Antarctica, as compared to their coeval subjects living in their home country. Its aim is to detect how cardiovascular rhythms behave in those environmental conditions and occupational cues. The 24-h BP and HR values were measured via a noninvasive ambulatory monitor, and statistically analyzed via conventional and chronobiological procedures. The normotensive subjects living in Antarctica were seen to show significant changes in the daily mean level of systolic BP (increase) and HR (decrease) as compared to their controls. In addition, they were seen to show the BP and HR circadian rhythms to be perfectly synchronized to the 24-h cycle, despite the permanent solar light, as an effect imposed by the routines of their local lifestyle. The observed changes reflect a tonic modulation of the BP and HR circadian rhythms which allows the cardiovascular apparatus to adapt itself without imposing an extra load on its function.

Adaptation, Physiological↗
PubMed1997

[The role and chronobiometric study of ambulatory arterial pressure monitoring in hypertensive patients with a recent cerebral ischemia episode].

Essential hypertensive patients with a history of recent TIA syndrome were investigated by ambulatory blood pressure monitoring (ABPM). The aim of this trial was to verify the presence of false normotensive patients in order to optimize the secondary prevention of hypertensive cerebrovascular damage (ischemic or hemorrhagic stroke). This study was carried out on 51 patients (26 M and 25 F, mean age = 58 +/- 14 yrs) and 225 clinically healthy control subjects (113 M and 112 F, mean age = 55 +/- 12 yrs), who underwent an ABPM. The BP time series were analyzed by chronobiometric procedures. The comparison of the individual BP within-day values to the reference limit revealed a highly significant proportion of these patients (90%) whose hypertension was not well controlled. Their BP series showed supranormal values ranging from 39% to 56% of all the readings, with a pressure excess ranging from 8.35 h to 11.34 h. The high incidence of not adequately treated patients with a history of recent TIA syndrome confirms that their hypertension should be controlled by means of the ABPM. These results suggest that the chronomodulation of the antihypertensive treatment might be the better management of BP regimen in these patients for the secondary prevention of cerebrovascular damage.

Aged↗
PubMed1997

[Compliance and the chronotherapy of refractory arterial hypertension].

The compliance to pharmacological treatment is strongly compromised whether the disease is refractory to therapy. In addition to the generic reasons for the non-compliance, there are some other aspects, i.e. the heaviness and complexity of the treatment, the frustation for the inefficacy of the therapy. The physician is disarmed because of the limits in the available pharmacological possibilities. In fact, the refractory arterial hypertension is defined as "hypertensive state which is resistant at least to 3-4 antihypertensive drugs, each having a different mechanism of action". In order to define a disease to be refractory to treatment, it needs that all the available therapeutical strategies have been accomplished. Among the techniques for treating arterial hypertension, there is the chronotherapy which is based on the modulation of pharmacological doses and the administration of drugs as a function of the moment of highest necessity. A recent research of our group demonstrated the inconsistency of the refractoriness whether the conventionally classified resistant hypertensive patients were treated via the chronotherapeutic technique of administering the antihypertensive drugs two hours before the highest hypertensive value of the morning, afternoon and/or night. These patients were seen to be no more prone for the non-compliance. Therefore, it is proposed the reformulation of the definition for refractory arterial hypertension as "hypertensive state which is resistant at least to 3-4 antihypertensive drugs, each having a different mechanism of action, administered even with chronotherapeutic criteria".

Antihypertensive Agents↗