PubMed Health⌕ Search

Biomedical subjects

P Pancera

Publications and source records attributed to P Pancera.

At least 37 records · Page 2Linked to original sources

Haemodynamic parameters in hypertensive patients: changes induced by lacidipine and nifedipine.

We conducted a randomly allocated, double-blind study in 16 essential hypertensive patients, eight of whom were treated with nifedipine and eight with lacidipine. The antihypertensive efficacy was evaluated and any modifications to peripheral haemodynamic parameters were observed in the brachial artery by a mechanographic method and B-mode scanner with a 10-MHz probe. Statistically significant reductions in blood pressure from basal values were observed after 1 and 6 months' treatment. Enhanced compliance (P less than 0.005), reduced characteristic impedance (P less than 0.001) and lower peripheral resistances (P less than 0.01) were also noted. Variations in pulse wave velocity and mean blood pressure showed a statistically significant correlation as early as the first month of treatment (P less than 0.01). Our results suggest that therapy with nifedipine and lacidipine allows an improvement in peripheral haemodynamics in hypertensive patients. This response is maintained in chronic treatment, even just before the next dose administration at the end of the longest dose interval.

Adult↗

[Usefulness of several laboratory tests on prethrombotic status in arterial vascular pathology].

The Authors analyze the clinical and biological meanings of some markers of coagulative activity (beta thromboglobulin, PF4, fibrinogen, fibrinopeptide A) and their changes in some arterial diseases. The role of main atherosclerosis risk factors (dyslipidaemia, hypertension, smoking and diabetes) in promoting a thrombophylic state in these pathological conditions is also considered. Finally the Authors evaluate the usefulness of the markers of coagulative activity from both a diagnostic and a preventive point of view in the arteriopathies of atherosclerotic etiology.

Arteriosclerosis↗

Defibrotide and peripheral obliterative arterial disease: preliminary data.

In a pilot study, defibrotide was administered to 22 patients with arterial occlusive disease of the lower limbs (mean age 59 years; range 48-71 years), of whom 12 were Fontaine 2nd stage and 10 Fontaine 3rd stage. In the first group, treatment enabled significant improvement in the walking distance (580 +/- 95 vs 220 +/- 65 m; M +/- SD; p less than 0.001), even 15 days after discontinuation of therapy (445 +/- 110 m; p less than 0.05). In 3rd stage patients, treatment caused reasonable reduction of pain, with elimination of resting pain in 4 patients. Both groups underwent no modification of Doppler velocimetry and Winsor index, while photoplethysmography in 8 patients at 2nd- and in 3 patients at 3rd-stage showed improvement at the end of treatment. There were no modifications of hepatic, renal, hemopoietic and hemocoagulative functions. Beta-thromboglobulin showed a statistically significant reduction (62 +/- 10 vs 116 +/- 18 ng/ml; M +/- SEM; p less than 0.001), from 2 weeks after the first dose until 15 days after discontinuation of therapy. Defibrotide proved particularly efficacious in Fontaine 2nd-stage patients, showing its suitability for treating the stages of occlusive atherosclerotic disease at which collateral circulation can still be activated.

Aged↗

Ketoconazole: clinical evaluation in severe fungal infections.

Ketoconazole, a new imidazole-derivative antifungal agent, has been studied in sixteen patients with systemic fungal infections. Seven patients had deep localized infections (three cases with pneumonia and one case each with urinary infection, osteomyelitis, endophthalmitis and peritonitis); three patients suffered from granulomatous or acute mucocutaneous infections and six patients had fungal septicemia. All patients suffered from severe underlying diseases and/or predisposing factors such as antibiotic treatment, immunosuppressive therapy or indwelling catheters. Candida albicans was isolated in 13 cases, C. parapsilosis (septicemia), Aspergillus (ophthalmitis) and Mucor (pneumonia) in the other three cases. Ketoconazole was administered orally at daily dosages of 400-800 mg; 5-fluorocytosine was associated in four cases. Out of the ten patients with localized infections, seven were cured and three improved. Two of the six septic patients were cured, one improved who subsequently died from Pseudomonas septic shock and three patients showed no improvement. Two relapses were recorded, both followed by further eradication. The tolerance of the drug was always excellent. Ketoconazole proved a very effective and well-tolerated drug in systemic infections, caused by opportunistic fungi in high-risk patients.

Adolescent↗

Pseudomonas septicaemia. A review of 60 cases observed in a university hospital.

Epidemiological, clinical features and the pathogenesis of 60 cases of pseudomonas septicaemia, observed over a period of 7 years from 1975 to 1981, are described. The mean frequency of occurrence was 0.40 episodes per 1000 admissions and an incidence of 66 per cent was observed in patients with serious underlying diseases, such as haematological malignancies and neoplasia. Thirty-seven patients had received cytotoxic and immunosuppressive therapy and showed a marked leukopenia, and whenever the leukocyte count fell below 2000/mm3, the prognosis was significantly worse. The most common portals of entry were the respiratory and gastrointestinal tracts. The overall mortality was very high (75 per cent) and mainly related to septic shock. Apart from the very high frequency of this complication (24 patients, 40 per cent of all cases), a typical clinical picture, distinguishing pseudomonas from other Gram-negative septicaemias, did not emerge.

Adolescent↗

Contribution of four markers of tubular proteinuria in detecting upper urinary tract infections. A multivariate analysis.

The presence of tubular involvement, as a marker for the detection of urinary tract infection (UTI) site, was examined in 19 patients with pyelonephritis and in 15 patients with cystitis or asymptomatic bacteriuria. The urinary excretion of four markers of tubular proteinuria, beta 2-microglobulin (beta 2M), lysozyme (LZ), lactic dehydrogenase isoenzyme V (LAD-5) and N-acetyl-beta D-glucosaminidase (NAG), was investigated. LAD-5 appeared particularly valuable for the early detection of upper UTI. However, the overall diagnostic accuracy appeared to be further strengthened using, besides LAD-5, one additional variable. A set of simple and noninvasive biochemical tests on urine samples can reliably help to identify the site of UTI.

Acetylglucosaminidase↗

Diagnostic value and biological significance of antibody-coated bacteria in urine.

The incidence of antibody-coated bacteria (ACB) in the urinary sediments as an indication of the site of urinary tract infections (UTI) was investigated in 103 adult subjects with persistent bacteriuria by means of a direct immunofluorescence technique.ACB were found in 49 of 58 (84.5%) subjects with long-standing upper urinary tract obstruction and in 5 of 45 (11.1%) with lower UTI; this difference was statistically significant (X(2) = 51.79; P<0.001). The group with upper UTI was further subdivided according to renal function (patients with renal insufficiency had both bilateral obstruction and bilateral renal damage); 21 positive results were obtained in 27 (77.8%) patients with normal renal function, whereas 28 positive cases were observed among 31 (90.3%) patients with chronic renal insufficiency. Thus the degree of renal involvement also seemed to influence the outcome of the test. Within the group of lower UTI, a higher rate of ;false-positive' results was obtained in 14 patients with symptomatic long-standing infection (21.4%) than in 31 subjects with asymptomatic bacteriuria (6.4%). The three major immunoglobulin classes and the secretory component were studied in 42 cases. Of these, 29 were found to be positive for ACB. The constant presence of IgA and secretory component on the surface of ACB suggests that the secretory immune system plays an important role in UTI.

Antibody-Coated Bacteria Test, Urinary↗

[Incidence and antibiotic-sensitivity of gram-negative bacteria in the urinary infections (author's transl)].

Urinary tract infections due to low-grade pathogenic Gram-negative bacteria show an increasing prevalence. The frequency of isolation from urinary samples of some of these pathogens (Alcaligenes, Citrobacter, Acinetobacter, Providencia, Serratia) was detected in a group of adult patients. The role of local and systemic predisposing factors was investigated. These bacterial agents accounted for 21% of 1,354 isolated strains. Systemic predisposing factors were found in most patients. Moreover, a high proportion of the isolates was found in the urinary samples of patients receiving prolonged antibacterial therapy. Sensitivity to several antibacterial drugs was examined for each strain. A high degree of drug resistance was commonly found.

Anti-Bacterial Agents↗

Evolution of carotid atheromatous lesions in endarterectomized patients.

A noninvasive follow-up using duplex ultrasonography was conducted in 128 patients who had undergone carotid endarterectomy from January 1987 to December 1988. Repeated scans of the operated area revealed a distinct increase in thickened ultrasonographic features (32% vs 8%), and a stenosing lesion was detected in 8 patients. There was also a parallel increase in the number of subjects with thicknesses of the intima adjacent to the endarterectomy area exceeding 2.5 mm. In 7% of cases, dilatation was detected in the operated area and in 27% the margin of the area was raised. The study also dealt with the contralateral carotid artery, where a progression of atheromatous involvement was observed with an increased number of cases of hemodynamically significant stenosis and 3 cases of occlusion. Periodic duplex ultrasonography in endarterectomized patients proves useful for the early detection of hemodynamically significant stenoses or of structural features potentially capable of generating emboli.

Aged↗

[Septicaemia caused by fungus: technical data and cases (author's transl)].

The Authors describe a technique suitable for isolating fungus from haemocultures. Although it is not frequent to find a description of septicaemia caused by fungus in hospital practice besides the Candida type, many kinds of yeasts and filamentous fungus have been occasionally isolated from the blood. It is the Author's opinion that if suitable techniques were always used, the evidence of fungus in haemocultures would be more frequent and above all one could also isolate filamentous fungus.

Blood↗

Effects of sustained-release isradipine on blood pressure and peripheral hemodynamics in hypertensive patients.

In a double-blind crossover study, 16 hypertensive patients (mean age, 41 years) were randomly assigned to receive placebo or 5 mg of an extended-release formulation of isradipine for 30 days. Blood pressure and heart rate were recorded by an automatic device and hemodynamics measured by a duplex scanner and plethysmography. After the first dose and after 30 days' treatment with isradipine, blood pressure was significantly reduced (mean arterial pressure 4 hours after the first dose, 106 +/- 3 vs 120 +/- 4 mmHg, P < 0.01; 22 hours after the last dose, 108 +/- 3 mmHg, P < 0.01) with no significant changes in heart rate. The compliance of the brachial artery was significantly increased (2.823 +/- 0.358 vs 1.204 +/- 0.156 dyn-1.cm4.10(-7), P < 0.002) and the characteristic impedence decreased (49 +/- 6 vs 91 +/- 12 dyn.s.cm-5.10(2), P < 0.05) as well as local resistances (71 +/- 5.6 vs 198 +/- 18 mmHg.ml-1.s, P < 0.001). After 30 days of isradipine treatment, 22 hours after the last dose, compliance was still increased (2.575 +/- 0.453 dyn-1.cm4.10(-7), P < 0.01) whereas impedance and forearm vascular resistances were reduced (59 +/- 8 dyn.s.cm-5.10(2), P < 0.05, and 97 +/- 14 mmHg.ml-1.s, P < 0.001, respectively). The results indicate that sustained-release isradipine ensures good blood pressure control up to the time of the following dose and restores the large artery dumping function against cyclic variations in intraluminal pressure.

Adult↗