PubMed Health⌕ Search

Biomedical subjects

R Ferrari

Publications and source records attributed to R Ferrari.

At least 91 records · Page 5Linked to original sources
PubMed2000

New insights on myocardial pyridine nucleotides and thiol redox state in ischemia and reperfusion damage.

OBJECTIVE: to investigate the changes of pyridine nucleotides and thiol redox state in cardiac tissue following ischemia and reperfusion. NADH/NAD and NADPH/NADP redox couples were specifically studied and the influence of NADPH availability on cellular thiol redox was also investigated. METHODS: isolated rabbit hearts were Langendorff perfused and subjected to a protocol of ischemia and reperfusion. An improved technique for extraction and selective quantitation of pyridine nucleotides was applied. RESULTS: ischemia and reperfusion induced an increase in diastolic pressure, limited recovery in developed pressure and loss of creatine phosphokinase. Creatine phosphate and ATP were decreased by ischemia and only partially recovered during reperfusion. NADH was increased (from 0. 36+/-0.04 to 1.96+/-0.15 micromol/g dry wt. in ischemia, P<0.001), whereas NADPH decreased during ischemia (from 0.78+/-0.04 to 0. 50+/-0.06 micromol/g dry wt., P<0.01) and reperfusion (0.45+/-0.03 micromol/g dry wt.). Furthermore, we observed: (a) release of reduced (GSH) and oxidised glutathione (GSSG) during reperfusion; (b) decreased content of reduced sulfhydryl groups during ischemia and reperfusion (GSH: from 10.02+/-0.76 to 7.11+/-0.81 nmol/mg protein, P<0.05, and to 5.48+/-0.57 nmol/mg protein; protein-SH: from 280.42+/-12.16 to 135.11+/-17.00 nmol/mg protein, P<0.001, and to 190.21+/-11.98 nmol/mg protein); (c) increased content in GSSG during reperfusion (from 0.17+/-0.02 to 0.36+/-0.02 nmol/mg protein, P<0.001); (d) increased content in mixed disulphides during ischemia (from 6.14+/-0.13 to 8.31+/-0.44 nmol/mg protein, P<0.01) and reperfusion (to 9.87+/-0.82 nmol/mg protein, P<0.01). CONCLUSIONS: under severe low-flow ischemia, myocardial NADPH levels can decrease despite the accumulation of NADH. The reduced myocardial capacity to maintain NADPH/NADP redox potential can result in thiol redox state changes. These abnormalities may have important consequences on cellular function and viability.

Adenosine Triphosphate↗
PubMed2000

Cardiac remodeling--concepts and clinical implications: a consensus paper from an international forum on cardiac remodeling. Behalf of an International Forum on Cardiac Remodeling.

Cardiac remodeling is generally accepted as a determinant of the clinical course of heart failure (HF). Defined as genome expression resulting in molecular, cellular and interstitial changes and manifested clinically as changes in size, shape and function of the heart resulting from cardiac load or injury, cardiac remodeling is influenced by hemodynamic load, neurohormonal activation and other factors still under investigation. Although patients with major remodeling demonstrate progressive worsening of cardiac function, slowing or reversing remodeling has only recently become a goal of HF therapy. Mechanisms other than remodeling can also influence the course of heart disease, and disease progression may occur in other ways in the absence of cardiac remodeling. Left ventricular end-diastolic and end-systolic volume and ejection fraction data provide support for the beneficial effects of therapeutic agents such as angiotensin-converting enzyme (ACE) inhibitors and beta-adrenergic blocking agents on the remodeling process. These agents also provide benefits in terms of morbidity and mortality. Although measurement of ejection fraction can reliably guide initiation of treatment in HF, opinions differ regarding the value of ejection fraction data in guiding ongoing therapy. The role of echocardiography or radionuclide imaging in the management and monitoring of HF is as yet unclear. To fully appreciate the potential benefits of HF therapies, clinicians should understand the relationship between remodeling and HF progression. Their patients may then, in turn, acquire an improved understanding of their disease and the treatments they are given.

Adrenergic beta-Antagonists↗
PubMed2000

Internal structure and validity of the multidimensional pain inventory, Italian language version.

OBJECTIVE: The aim of the study is an investigation of the psychometric characteristics of the Italian translation of the Multidimensional Pain Inventory and a comparison with the American, German, Swedish and Dutch versions of the MPI. METHOD: The Italian translation of the MPI was administered together with Melzack McGill Pain Inventory, Beck Depression Inventory, Spielberger State-Trait Anxiety Inventory, and Visual Analog Scales. Confirmatory factor analyses were accomplished on the MPI scores. Furthermore, reliability, intercorrelations, and convergent validity of MPI were evaluated. PATIENTS: Participants were 220 patients suffering from a variety of chronic pain syndromes (cephalalgia 45.8%; low-back pain 30.5%). RESULTS: Confirmatory factor analyses suggest changes to all 3 sections of the MPI-IV. Factor structure, after having excluded several items sorted according to the 3 sections of the questionnaire, is basically the same as in other versions of the MPI. Internal consistency analyses yielded acceptable reliability (Cronbach alpha coefficients) for 11 out of 13 scales. CONCLUSIONS: After making appropriate changes in all 3 sections of the inventory, the MPI is substantially suitable for use in cross-cultural and international research.

Journal Article↗
PubMed2000

The biopsychosocial model--a tool for rheumatologists.

Rheumatologists grapple in daily practice with many controversial syndromes including fibromyalgia, late whiplash syndrome, chronic fatigue syndrome, Gulf War syndrome, the adverse outcomes of silicon breast implants and so on. For decades, much of the debate surrounding, and the approach to these controversial syndromes has centred on a model creating two camps-organic versus non-organic. While each camp has its support, this model seems to have failed in achieving the desired understanding of these syndromes, most particularly in offering the rheumatologist a practical and coherent approach to effective treatment. This chapter will thus introduce the biopsychosocial model, its elements, its advantages over the traditional model and the practical application of this model. Examples will be given of how rheumatologists can approach the treatment of these syndromes through patient education and the implementation of a change in illness behaviour.

Fatigue Syndrome, Chronic↗
PubMed2000

Sensitivity, specificity, and predictive accuracies of non-invasive tests, singly and in combination, for diagnosis of hibernating myocardium.

OBJECTIVE: To determine the best test(s) for predicting functional recovery of hibernating myocardium after reperfusion. METHODS: A prospective study to compare echocardiographic left ventricular diastolic wall thickness (> or =5 mm), low-dose dobutamine echocardiography and rest-redistribution thallium-201 scintigraphy, alone and in combination, for predicting recovery of left ventricular akinesis after surgical revascularization. RESULTS: Twenty-eight consecutive patients aged 58+/-9 years were studied. Of the 448 left ventricular segments, 263 were akinetic at rest; 230/263 (87%) had wall thickness > or =5 mm, 135 (51%) had a positive response and 175 (66.5%) were graded viable on thallium. Of akinetic segments 61% improved after surgery. Left ventricular score decreased from 2.3+/-0.4 to 1.8+/-0.4 (P<0.01) and ejection fraction increased from 27+/-10 to 37+/-14% (P<0.01). For predicting results at 1 year, diastolic wall thickness had a sensitivity and a predictive accuracy of a negative test of 100% but a specificity of 28% and predictive accuracy of a positive test of 61%. The addition of dobutamine echocardiography or thallium-201 improved the predictive accuracy of a positive test to 76% and 69%, respectively; the addition of both tests was not of greater benefit than that of a single test. CONCLUSIONS: Diastolic wall thickness <5 mm on echocardiography was the best simple and single predictor of non-recovery of left ventricular dysfunction. The addition of dobutamine echocardiography or thallium-201, but not both, was the best solution for predicting recovery of left ventricular dysfunction. In times of limited resources, these findings are important from a clinical point of view.

Adult↗
PubMed2000

A reply

Explore the source record for details and available documents.

Journal Article↗
PubMed2000

Apoptosis in the skeletal muscle of patients with heart failure: investigation of clinical and biochemical changes.

OBJECTIVE: To investigate the contribution of apoptosis in the development of the skeletal myopathy in chronic heart failure. DESIGN: The electrophoretic pattern of myosin heavy chains (MHC), fibre cross sectional area, number of in situ nick end labelling (TUNEL) positive apoptotic myocyte nuclei, and the tissue levels of caspase-3, Bcl-2, and ubiquitin were determined in biopsies taken from the vastus lateralis muscle. The study involved nine patients with severe chronic heart failure caused by ischaemic heart disease and hibernating myocardium and five controls. RESULTS: In chronic heart failure patients the vastus lateralis showed a significant increase of MHC(2a) and MHC(2b) and a greater degree of fibre atrophy, as demonstrated by the decreased cross sectional area. There was also an increased number of TUNEL positive apoptotic myocyte nuclei. Tissue concentrations of Bcl-2 were decreased, while those of caspase-3 and ubiquitin were increased. Peak oxygen consumption (VO(2)) was negatively correlated with the number of TUNEL positive nuclei and the fibre cross sectional area. There was a correlation between the number of apoptotic nuclei and the fibre cross sectional area, but no correlation between myosin heavy chains and number of apoptotic nuclei. CONCLUSIONS: Myocyte apoptosis occurs in the skeletal muscle of patients with chronic heart failure, and its magnitude is associated with the severity of exercise capacity limitation and the degree of muscle atrophy. Muscle atrophy contributes to the limitation of exercise capacity, together with the increased synthesis of fast, more fatiguable myosin heavy chains.

Adult↗
PubMed2000

[Rheumatology expertise].

Requests for expert appraisals in cases of osteoarthritic diseases increases continually, especially those addressed by the "Office de I'Assurance Invalidité (OAI)" or private insurances (PRIV). In this series of 413 cases, the mean age of the applicants was significantly lower than that of 10 years ago. There were more men than women, foreigners than Swiss natives and couples than people living alone but not significantly. 85% of complaints were for vertebral pain; fibromyalgia and depression were noted in 8% and 27% of cases respectively. Only 42% of those demanding time off work had heavy work; 66% did not continue their schooling beyond the minimum requirement. Less than 1/3 of work interruption for OAI and 1/6 for PRIV were confirmed; more than 1/2 of the patients for PRIV could not justify a work disability higher than 20%. 19% of our appraisals were disputed; 3% succeeded and 3% are still in progress. Chronic rheumatological complaints do not necessarily result in insurance compensations. Practitioners can contribute to chronification of rheumatological complaints by perpetuating work interruption for non medical reasons.

Adult↗
PubMed2000

Pain in the neck for a rheumatologist.

Rheumatologists are frequently asked to see whiplash patients for an independent medical examination. There are many diagnostic and other assessment issues which arise in the setting of an independent assessment, and which do not usually arise in the usual physician-patient relationship. This article thus reviews aspects of the history, physical examination, radiological evaluation, and causation by way of the accident that are of importance to the rheumatologist as independent examiner. We address questions such as Was a physical injury likely to have occurred in the accident? What are the pertinent psychosocial aspects in the history? What are useful diagnostic signs on examination? and What is the significance of radiological findings? These are important and sometimes troublesome questions to answer in the setting of the independent medical examination, but rheumatologists can look to recent literature and research findings to assist in answering these questions.

Expert Testimony↗