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Biomedical subjects

P Rubba

Publications and source records attributed to P Rubba.

At least 73 records · Page 4Linked to original sources
PubMed1989

Different localization of early arterial lesions in insulin-dependent diabetes mellitus and in familial hypercholesterolemia.

Ultrasound methods have been used for the vascular examination of middle-aged patients with insulin-dependent diabetes mellitus (IDDM, n = 44) or heterozygous familial hypercholesterolemia (FH, n = 37); they were compared with 50 healthy controls. To define the localization of the early arterial lesions in these two conditions, the determination of ankle pressure by Doppler ultrasound and the detection of flow disturbances in the iliac arteries by echo-Doppler technique have been combined in a single vascular investigation. There were no major differences in mean age, degree of overweight, sex distribution, blood pressure, or smoking habits among the three groups. Total serum cholesterol in patients with FH was almost double compared with diabetics and controls. Triglyceride, HDL cholesterol, and blood pressure values did not differ. Nine of 88 limbs of patients with IDDM had an abnormally low ankle-arm pressure ratio (less than 0.97), and there were three cases of low ratio of 100 limbs in the control subjects (P less than .02). The corresponding figure for heterozygous FH was of three of 74 limbs (not different from controls). Echo-Doppler abnormalities suggesting lesions in the iliac arteries were significantly increased (P less than .01) in FH patients (13 limbs with lesions of 74) compared with controls (four of 100 limbs). The proportion of echo-Doppler abnormalities in IDDM (four of 88 limbs) was practically the same as compared to the controls.

Adult↗
PubMed1989

Reproducibility of non-invasive vascular diagnosis in patients with diabetes mellitus.

Reproducibility of noninvasive ultrasound methods for vascular diagnosis was studied in 36 patients with Insulin Dependent Diabetes Mellitus. The vascular examination included a) the measurement of ankle systolic arterial pressure and ankle/arm pressure index (c.w. Doppler), b) Echo-Doppler examination of iliac arteries with measurement of maximum systolic frequency, systolic spectrum width and diastolic reverse flow component. A grading of iliac artery stenosis was also performed. The examination was repeated after one month according to a blind protocol. The coefficients of variation were as follows: 8% for ankle pressure; 8% for ankle/arm pressure index; 9% for the maximum systolic frequency; 18% for the spectrum width and 15% for the reverse flow component. The reproducibility of the grading of iliac artery stenosis based on the combined use of the three Echo-Doppler parametres was measured by the Kendall coefficient (W = 0.865). These results confirm that non invasive methods are suitable and reliable for investigating vascular disease in diabetic patients. Accurate estimates of reproducibility are essential pre-requisites for the planning of studies on the natural history of vascular disease and on progression-regression of arterial lesions.

Aged↗
PubMed1989

Enhancement of exogenous triglyceride removal following calcium channel blockade.

Adrenergic regulation of lipid metabolism is mediated by various intracellular messengers, including calcium ions. Little is known about the role of calcium in the catabolism of triglyceride-rich lipoproteins. Aim of this study was to investigate whether blockade of calcium influx across the cell membrane influences lipid metabolism in man. The calcium entry blocker nitrendipine was administered to 10 hypertensive, normolipidemic subjects for eight weeks at the dose of 10 mg b.i.d. An enhancement in plasma clearance of triglyceride was observed after nitrendipine administration: fractional removal rate of the triglyceride emulsion Intralipid increased by 22% (from 3.13 +/- 1.1 after placebo to 3.81 +/- 1.4% min after nitrendipine, p less than 0.03). Fasting serum triglyceride was not shifted (83 +/- 57 vs 84 +/- 37 mg/dl). Total serum cholesterol and cholesterol in high density lipoproteins were also unchanged during the study. No evidence of change in insulin response was detected. It is hypothesized that calcium plays a role in the modulation of lipoprotein lipase, the enzyme mainly responsible of the removal of exogenous triglyceride from plasma. Alternatively, the increase in the clearance rate of the triglyceride emulsion might be explained by the vasodilating activity of nitrendipine.

Adult↗
PubMed1988

Abnormalities in serum lipoprotein composition in patients with premature coronary heart disease compared to serum lipid matched controls.

Serum lipoprotein composition was examined in 18 male patients (mean age 44 +/- 0.9 years) who had undergone coronary artery by-pass surgery because of premature coronary heart disease (PCHD) and in 18 control subjects, matched with patients for sex, age, body mass index and serum cholesterol and triglyceride. Cholesterol, triglyceride and apolipoprotein B (apo B) concentrations in very low density lipoprotein (VLDL) and in low density lipoprotein (LDL) did not differ in the two groups, but high density lipoprotein (HDL)-cholesterol was significantly lower in PCHD patients (P less than 0.02). Cholesterol/apo B, triglyceride/apo B and phospholipid/apo B ratios in VLDL were significantly higher in patients than in controls (P less than 0.05, P less than 0.01 and P less than 0.001, respectively). The relative VLDL enrichment in cholesterol was mainly due to the non-esterified moiety (P less than 0.01). These VLDL abnormalities as well as the low HDL-cholesterol suggest an impairment of VLDL catabolism in PCHD patients.

Adult↗
PubMed1988

Extracoronary atherosclerosis in familial hypercholesterolemia.

Sixty-two patients (31 males, 31 females) with familial hypercholesterolemia (FH) underwent a vascular examination by Doppler ultrasound. The ankle/arm systolic pressure index was determined, and serum lipoproteins were analyzed. Eight of 124 legs examined (6.5%) showed an ankle/arm pressure index less than 0.95, suggesting flow reducing stenosis. Common carotid, internal carotid, and iliac arteries were evaluated by echo Doppler examination with spectral analysis. Forty-five of the 372 arteries examined (12.1%) had detectable abnormalities at echo Doppler examination. Iliac and internal carotid artery lesions were significantly (P less than 0.01) more frequent among FH patients than in a control group (30 men, 20 women) comparable for sex and age. The mean age of the patients with heterozygous FH and detectable arterial lesions was 45.3 years and that of those without lesions 30.7 years (P less than 0.05). When 14 patients with heterozygous FH and arterial lesions were compared to another 14 without lesions and matched for age and gender, it was found that patients with lesions had on average lower concentrations of HDL-cholesterol, and that 10 of 14 cases were actual smokers.

Adolescent↗
PubMed1988

Serum apolipoproteins, lipoproteins and fatty acids in relation to ischaemic heart disease in northern and southern European males.

Serum apolipoprotein and lipoprotein concentrations, fatty acid spectra of various lipids, dietary habits and common risk factors for ischaemic heart disease were studied in 73 and 77 randomly selected, 50-year-old healthy men in Naples and Stockholm, respectively. Mean serum cholesterol concentration was higher in Stockholm than in Naples men (6.23 vs. 5.47 mmol/l, p less than 0.001) as were low (LDL) (4.08 vs. 3.57 mmol/l, p less than 0.001) and high (HDL) (1.40 vs. 1.25 mmol/l, p less than 0.001) density lipoprotein fractions. Mean serum triglyceride concentrations did not differ. Mean apolipoprotein B and C-I concentrations were higher in Stockholm men (1,116 vs. 1,020 mg/l, p less than 0.05 and 96 vs. 79 mg/l, p less than 0.01, respectively). Stockholm men derived significantly more of their calories from fat (38 vs. 28%, p less than 0.001) and the dietary fat had significantly lower polyunsaturated-to-saturated fatty acid ratio (P/S-ratio 0.29 vs. 0.51, p less than 0.001), and less from carbohydrate (44 vs. 49%, p less than 0.001) than Naples men, respectively. Mean caloric intake and mean weight/height index did not differ. Stockholm men had higher blood pressures, but there were more smokers among Naples men. The higher fat intake in Stockholm men may offer an explanation of the differences seen in lipoprotein and apoprotein concentrations and compositions but other factors, such as genetic influences cannot be excluded. A greater cholesterol flux through the plasma compartment in Stockholm men may be one important factor contributing to the higher incidence of ischaemic heart disease in this population.

Adult↗
PubMed1988

Very low density lipoprotein. Qualitative abnormalities in patients with premature coronary heart disease and in patients with insulin dependent diabetes.

VLDL composition has been investigated in two groups of patients: one with Premature Coronary Heart Disease (PCHD) and another one with Insulin Dependent Diabetes Mellitus. Both groups showed abnormal VLDL composition. PCHD patients had VLDL significantly enriched in free cholesterol and triglycerides in comparison with a group of controls matched with patients for sex, age, BMI, serum cholesterol and TG. This VLDL composition indicates a prevalence of big particles, which can be found at the beginning of the lipolytic cascade. On the other hand VLDL of diabetic patients were enriched in cholesterol, especially esterified cholesterol, and apo B in comparison with the respective control group suggesting an increase of smaller VLDL, considered more atherogenic. In conclusion these two studies demonstrate that VLDL compositional abnormalities can be found in two different groups of patients even in the absence of hyperlipidemia.

Adult↗
PubMed1987

Adipose tissue fatty acids and blood pressure in middle-aged men from southern Italy.

Adipose tissue (AT) biopsies were performed in a random population sample of 74 clinically healthy middle-aged men (40-49 years) from southern Italy. The percentage of saturated fatty acids (FA) in AT was directly correlated with systolic (SBP) and diastolic (DBP) blood pressure (p less than 0.01). This relationship was independent of smoking habit and body weight. AT of men in the upper DBP quintile (range 90-102 mmHg) was significantly richer in palmitic acid (p less than 0.01) compared to that of men in the lowest DBP quintile. Dietary history demonstrated that the overall intake of saturated fat (% energy) was similar in the two extreme DBP quintiles. There was a relatively higher consumption of fish by those in the lowest DBP quintile (p less than 0.05). The amount of monounsaturated fat consumed (% energy) was also higher (p less than 0.05) in men with low blood pressure. Men in the upper quintile of DBP consumed more eggs (p less than 0.05).

Adipose Tissue↗
PubMed1987

Calcium antagonists and thiazide diuretics in the treatment of hypertension.

The usefulness of the combination of nifedipine and chlorthalidone has been investigated in mild to moderate hypertensive patients (seven men, seven women; age range 39-62 years) by adding the diuretic to nifedipine monotherapy. After a 2 week washout, slow-release nifedipine 20 mg b.i.d. was given for 6 weeks, followed by addition of either chlorthalidone 25 mg (group A) or placebo (group B) q.d. for a further 6-week period. Blood pressure, heart rate, plasma renin activity, and 24-h urinary Na and K excretion were measured at baseline and at the end of each treatment period. Nifedipine decreased blood pressure in the two groups. A further significant fall was observed after chlorthalidone was added. No further change was detected after placebo in group B. Plasma renin activity after 1 h standardized walk significantly increased after combined treatment compared with baseline (3.3 +/- 1.2 to 9.4 +/- 5.3 ng/ml/h; p less than .05). No change was observed in 24 h urinary Na and K in the two groups. Venous distensibility measured by strain gauge plethysmography was slightly reduced during nifedipine monotherapy. Our data therefore suggest that chlorthalidone potentiates the antihypertensive effect of nifedipine despite an increase of renin activity.

Adult↗
PubMed1986

Effects of alpha-adrenergic and beta-adrenergic receptor blockade on lipid metabolism.

The role of lipoprotein lipase in the pathophysiology of lipid changes during alpha-receptor or beta-receptor blockade was evaluated in this clinical trial. Thirty hypertensive patients were given 2 mg of prazosin twice daily or 100 mg of metoprolol twice daily for 10 weeks, according to an open, randomized protocol. Both drugs were effective in reducing arterial blood pressure (from 153 +/- 16/102 +/- 6 mm Hg to 146 +/- 12/92 +/- 8 mm Hg with prazosin and from 158 +/- 17/103 +/- 8 to 144 +/- 14/94 +/- 10 mm Hg with metoprolol). Prazosin significantly reduced total plasma cholesterol from 202 +/- 39 to 188 +/- 36 mg/dl and increased high-density lipoprotein cholesterol from 36 +/- 8 to 40.5 +/- 11 mg/dl. Prazosin did not affect plasma triglycerides levels, whereas patients taking metoprolol had a slight rise in these levels, from 122 +/- 42 to 142 +/- 57 mg/dl, along with a decrease in high-density lipoprotein cholesterol from 37 +/- 10 to 31 +/- 8 mg/dl. The concentration of apoprotein B did not change significantly with either treatment. Lipoprotein lipase activity increased in the prazosin group from 28.4 +/- 16 to 37.7 +/- 14 mumol/liter per minute (p less than 0.01), but did not change significantly (29.9 +/- 12 versus 32.8 +/- 8 mumol/liter per minute) in patients treated with the beta blocker. These data, which confirm previous reports of serum lipid changes during antihypertensive therapy, suggest that alpha1 blockers may interfere with lipoprotein lipase, possibly by reducing its catecholamine-mediated inactivation.

Adolescent↗
PubMed1986

A case of association between type I hyperlipoproteinemia and systemic lupus erythematosus (SLE). Effects of steroid treatment.

The case of a girl aged 19 yr with hypertriglyceridemia and systemic lupus erythematosus (SLE) is described. The girl had been admitted to a Lipid Outpatient Clinic in 1981 and diagnosed as having a Type I hyperlipidemia pattern. In November 1984 the patient acutely developed a SLE syndrome. Steroid treatment led to a dramatic fall of serum triglycerides from a starting value of 2100 mg/dl to 95 mg/dl. The role of steroids in completely correcting genetically deficient Lipoprotein Lipase Activity (LLA) is discussed.

Adult↗
PubMed1986

Dose dependence of nicotinic acid-induced hyperbilirubinemia and its dissociation from hemolysis in Gilbert's syndrome.

The serum increments in unconjugated bilirubin and total iron were determined after intravenous administration of 5.90 mumol/kg body weight of nicotinic acid (NA) in 26 patients with Gilbert's syndrome (GS), seven patients with hemolytic anemia, and 13 healthy volunteers. The hyperbilirubinemic response, expressed as the area under time concentration curve of unconjugated bilirubin (AUCBR, milligrams per deciliter per 240 minutes) was significantly higher (P less than 0.01) in patients with GS than in controls and patients with hemolytic anemia, in whom no difference was observed. In contrast, comparable values of the hypersideremic effect (AUCFe, milligrams per deciliter per 240 minutes) were noticed among the three groups. In seven consecutive patients with GS, seven with hemolytic anemia, and four healthy volunteers, AUCBR, AUCFe, and the NA plasma half-life of the first fast slope of the curve were determined at three different doses of the drug (1.18, 2.95, and 5.90 mumol NA per kilogram body weight). A significant, dose-dependent increase in AUCBR was present in patients with GS, whereas it remained constant both in controls and in patients with hemolytic anemia. The NA plasma half-life was also significantly prolonged in GS with each of the three doses, but remained unchanged in the other two groups. In patients with GS, a linear correlation (r = 0.891, P less than 0.001) was present between AUCBR and NA plasma half-life. In contrast, the AUCFe value remained constant at the different doses used in the three groups.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1985

Cardiovascular effects of ketanserin, a new antiserotonergic agent in the treatment of arterial hypertension.

Ketanserin, an investigational, antiserotonergic agent, at a dose of 40 mg bid was given to 18 patients with mild to moderate primary hypertension in a randomized, double-blind, crossover study, with 100-mg metoprolol bid for four weeks each. The following parameters were evaluated: blood pressure, heart rate, cardiac workload (product of systolic blood pressure and heart rate during bicycle exercise), systolic time intervals, and peripheral blood flow (by strain-gauge plethysmography). Significant reductions in diastolic and concomitant slight decreases in systolic blood pressure without changes in heart rate were observed during ketanserin treatment; cardiac oxygen demands during exercise test did not change, however. Pre-ejection period and left ventricular ejection time were unchanged, while significant increase in rest flow to the lower limbs and decrease in peripheral resistance were demonstrated by strain-gauge plethysmography. The results indicate that ketanserin has vasodilating properties and hypotensive activity that may be useful in the management of patients with essential hypertension.

Adult↗
PubMed1985

Plasma lipoproteins and lipoprotein lipase in young diabetics with and without ketonuria.

Plasma lipoprotein and lipoprotein lipase activity have been evaluated in young diabetics with and without ketonuria and in healthy controls of the same age. Fifteen (age range 7-23 years) newly detected diabetics (8 with ketonuria, 7 non ketonuric) have been examined before starting the treatment. Five healthy medical students (age range 19-21 years) have also been studied. Both ketotic and non ketotic patients showed an impaired insulin and C-peptide response to the glucose load in comparison to controls. Ketotic patients had low lipoprotein lipase activity (p less than 0.01) and high density lipoprotein (p less than 0.01); total plasma Triglycerides and VLDL Triglyceride and Cholesterol were higher than in controls. Plasma Triglyceride and VLDL Triglyceride and Cholesterol were inversely related to lipoprotein lipase activity. Low lipoprotein lipase activity, from adipose tissue and muscle, has been found to be associated with hypertriglyceridemia and reduced HDL Cholesterol in young diabetic patients with ketonuria.

Adolescent↗
PubMed1985

Improved reactive hyperemia test after plasma exchange in familial hypercholesterolemia.

By using a non-invasive methodology of vascular diagnosis, ECG-triggered strain-gauge plethysmography, 5 patients with familial hypercholesterolemia (FH) (3 homozygous, 2 heterozygous) were evaluated before and during the 1st and 2nd week after plasma exchange (PE). In order to obtain data on the responsiveness to vasodilating stimuli in FH patients undergoing PE, reactive hyperemia test and peak flow determination were also performed. Resting arterial flow over the calf was found to be significantly enhanced after PE. Reactive hyperemia test demonstrated persistent improvement of peak flow following exchange. This study demonstrates useful hemodynamic effects of PE in patients with FH.

Adult↗
PubMed1985

Study with the competitive 5-HT2-serotonergic antagonist ketanserin.

In 10 patients with primary arterial hypertension of mild or moderate degree, ketanserin, a competitive antagonist of serotonin receptors, was given for a period of 4 weeks, 40 mg twice daily. In a control group, patients were given 100 mg twice daily of metoprolol for 4 weeks for each treatment. A randomized double-blind crossover model was used. Blood pressure and heart rate were measured at rest and during exercise testing on a bicycle; peripheral blood flow was measured by strain-gauge plethysmography. A slight reduction in resting systolic and diastolic blood pressure without change in heart rate was observed during treatment with ketanserin. Cardiac workload during exercise test did not change over the observation period. A slight increase in resting blood flow to the lower limbs, with a decrease in peripheral resistance was demonstrated by strain-gauge plethysmography.

Adult↗