[Changes in colloid-osmotic pressure in subjects with venous circulation disorders before and after exertion].
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Blood Proteins↗
Biomedical subjects
R Pieri
Publications and source records attributed to R Pieri.
Management of antihypertensive treatment with Lisinopril: a chronotherapeutic approach.
Risk for cardiovascular events seems to be higher in the early morning, also as consequence of a rise in blood pressure (BP) values due to the characteristic circadian pattern of BP variability. Therefore, a suitable therapeutic BP control should be tightest during the early morning. On the basis of the ambulatory blood pressure monitoring (ABPM) studies, it has been previously demonstrated that the antihypertensive effect of once daily drug, generally administrated in the morning, decreases at the end of the dosing period. A chronotherapeutic approach to the management of hypertension (this field has been pourly investigated so far) would allow the assessment of the optimum timing of drug dosing, according to the circadian BP rhythm and to the chronorisk maps, in hypertensive patients affected by associated vascular pathologies. This would increase the therapeutic effects. The aim of this study was to assess BP changes due to ACE-inhibitor (Lisinopril 20 mg/die) once daily administration at three different times (8.00 AM, 4.00 PM, 10.00 PM), in order to optimise the dosing time. 40 subjects (mean age +/- SD: 45 +/- 10) affected by primary mild to moderate hypertension were submitted to ABPM for 24 hours, by means of Spacelabs 90207, before and after pharmacological treatment. Patients were randomised to take the drug at 8.00 AM, 4.00 PM or 10.00 PM, and they repeated ABPM every two months, by changing the dosing time. The chronobiological analysis showed: 1) a sensible decrease both in Systolic (S)BP and Diastolic (D)BP without affecting the circadian rhythm, in all evaluations; 2) a greater reduction of SBP and DBP from 6.00 AM to 11.00 AM, period in which cardiovascular risk is higher, after 10.00 PM dosing; 3) no other sensible reduction in SBP and DBP occurred after night administration as compared to that caused by other dosing times. Lisinopril administration at 10.00 PM. has been shown to be much more useful since, although BP circadian rhythm was unmodified, it protects hypertensive patients from both vascular chronorisk and Cruickshank effect (J-curve). Therefore, a chronobiologist antihypertensive treatment in order to increase the therapeutic effect already obtained with the traditional statistic methods.
Adult↗
[Injuries in childhood: a study on emergency department admissions of pediatric population in an Emilia-Romagna USL].
A study of childhood injuries of 0-14 year-olds children based on emergency room records of the five hospitals was conducted in USL 39 of Emilia-Romagna during 1988. The incidence of visits was 164, 14/1000 child-years with 95% confidence intervals (CI = 163, 28-165). The rate was 198, 93/1000 child-years (CI = 195, 36-202, 51) among the 0-4 year-olds, 140, 65/1000 child-years (CI = 139, 17-142, 13) in the 5-9 age group and 170, 86/1000 child-years (CI = 169, 77-171, 95) among 10-14 year-olds. The male to female ratio was 1.4 for the 0-4 year-olds, 1.7 for the 5-9 year-olds and for the 10-14 year-olds. The most frequent causes of injuries were falls (49.52%), being road accidents (22.1%) and bites-stings (17.4%); 4.8% of the injured children were admitted to hospital and 0.044% dead.
Accidents, Home↗
Efficacy of biofeedback treatment compared with drug therapy in hypertensive patients.
To assess the ability of biofeedback (BFB) in controlling hypertension a study was made of 40 hypertensive patients selected by means of the cardiovascular response to an arithmetic test. The patients were divided into four treatment groups: 10 patients were treated with diuretic therapy (D-T), 10 with beta-blocker therapy (Bb-T), 10 with BFB treatment, while 10 had no treatment at all (N-T). The BFB treatment consisted of 36 sittings where patients were requested to control muscular contraction, peripheric temperature and heart rate (HR) by means of a correlated acoustic signal. The results for blood pressure and HR reductions were compared during a 12-month follow-up period. The results for systolic blood pressure, diastolic blood pressure and HR indicate the efficacy of BFB for selected patients and suggest the possibility of using BFB treatment in the first stages of suspected neurogenic hypertension.
Adult↗