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Biomedical subjects

S Ghione

Publications and source records attributed to S Ghione.

16 recordsLinked to original sources
PubMed1992

Effects of chronic angiotensin converting enzyme inhibition on glucose tolerance and insulin sensitivity in essential hypertension.

The relation between the renin-angiotensin-aldosterone (RAA) system and carbohydrate metabolism and insulin sensitivity in essential hypertension has not been investigated systematically. Twenty nondiabetic patients (age, 49 +/- 1 years; body mass index (BMI), 26.1 +/- 0.4 kg/m2) with essential hypertension (blood pressure, 155 +/- 3/105 +/- 1 mm Hg) received an oral glucose tolerance test (OGTT) at the end of a 1-month placebo period and again monthly during 3 months of angiotensin converting enzyme (ACE) inhibition (cilazapril, 5 mg/day). Furthermore, a two-step euglycemic insulin clamp was performed after placebo and again at the end of treatment. Blood pressure fell by 7 +/- 4/10 +/- 3 mm Hg (p less than 0.001), while BMI remained stable. On the euglycemic clamp, insulin-mediated (plasma insulin, 470 pM) whole body glucose use averaged 42.5 +/- 1.6 mumol.min-1.kg-1 before and 43.6 +/- 1.9 after ACE inhibition (p = NS). Substrate concentrations and oxidative rates and energy expenditure (as estimated by indirect calorimetry) were not altered by ACE inhibition, either in the fasting state or in response to insulin. In contrast, oral glucose tolerance was significantly (p less than 0.05) improved after treatment (area under OGTT curve (AUC), 240 +/- 24 versus 282 +/- 23 mmol 2 hr.l-1). The latter change was associated with enhanced (+16%, p less than 0.05) insulin responsiveness to glucose (estimated as the insulin AUC divided by the glucose AUC) throughout the 3 months of ACE inhibition. At baseline, both the OGTT and the clamp had a marked hypokalemic effect (mean decrements in plasma potassium of 0.75 +/- 0.05 and 0.92 +/- 0.05 mmol/l, respectively) in association with plasma aldosterone reductions of 30% and 50%. Chronic ACE inhibition caused a further 20% (p less than 0.03) lowering of plasma aldosterone concentrations but attenuated insulin-induced hypokalemia. Plasma sodium, which was unaltered by the pretreatment tests, fell during the posttreatment tests (by 3 mmol/l, p less than 0.001). In the urine, the ratio of the fractional excretion of potassium to that of sodium was decreased by both oral glucose (-22%, p less than 0.01) and ACE inhibition (-21%, p less than 0.001). Higher plasma potassium levels before treatment predicted a better blood pressure response to ACE inhibition (r = 0.60, p less than 0.005).(ABSTRACT TRUNCATED AT 400 WORDS)

Administration, Oral↗
PubMed1992

[Relationship of Doppler indexes of left ventricular filling and exertion tolerance].

The aim of this study was to evaluate if Doppler indexes of left ventricular filling are related to exercise capacity. Since a correlation between left ventricular filling pattern and causal blood pressure has been recently reported along a wide range of pressure values, a group of subjects with blood pressure ranging from normal to severely elevated values was studied. Twenty-four subjects (11 normotensives, 13 mild to severe hypertensive patients) underwent an echo-Doppler study and a maximal multistage cycloergometric exercise test. Since the cycloergometric test was limited by fatigue or dyspnea in all subjects, exercise duration was used as an effort tolerance index. Echocardiographic indexes of systolic function resulted normal in all subjects. Significant relationships with exercise duration were found for several indexes of left ventricular filling (A peak: r = -.743, p < .0001; A/E ratio: r = -.606, p < .005; early filling fraction: r = .639, p < .001). Exercise time was also significantly related to casual blood pressure, both systolic and diastolic. The relationships between transmitral blood flow and exercise capacity seem to indicate that an impairment of ventricular relaxation (as indicated by the progressive increase of atrial contribution) is associated with a decreased exercise tolerance, possibly because a progressively lower activation of Frank-Starling mechanism. Diastolic function thus seems to be able to affect exercise tolerance even in subjects with normal systolic function and blood pressure ranging from normal to severely elevated values.

Adult↗
PubMed1992

[The structural aspects of the pharmacological activity of calcium antagonists. A general profile and the results of a pilot study of nicardipine].

The authors examine the most recent findings on arterial hypertension with particular emphasis to morphological changes of the arterial wall and to the results of nicardipine treatment in spontaneous hypertensive rats (SHR). According to these assumptions the authors evaluate the effects of nicardipine on the microvascular network by means of a funduscopic examination in 8 hypertensive patients. The preliminary data suggest that nicardipine has a positive structural and morphological effect on the vessel network.

Delayed-Action Preparations↗
PubMed1991

Left ventricular filling: relationship with arterial blood pressure, left ventricular mass, age, heart rate and body build.

The relationships of age, heart rate, body build and, in particular, of arterial blood pressure and left ventricular mass to several Doppler indexes of diastolic function were evaluated in a series of 80 subjects with a wide range of blood pressure levels (106-217/68-144 mmHg). Body build and age results were inversely correlated to the indexes, reflecting the early contribution to left ventricular filling, whereas the increase in heart rate was associated with an increase in late diastolic contribution. Strong correlations (in most instances, P less than 0.0001) were observed with arterial blood pressure and left ventricular mass: the increase of these parameters was associated with a decrease of early transmitral peak velocity (E peak) and of early filling fraction, with an increase of late diastolic transmitral peak velocity (A peak) and of A:E ratio and, finally, with an increase of both deceleration time of E peak and acceleration time to A peak. Blood pressure or left ventricular mass were also confirmed as strong predictors of nearly all the Doppler-derived diastolic indexes by stepwise multiple regression analysis. When the subjects were subdivided into quintiles according to diastolic blood pressure and the average values of the five subgroups were compared, age, heart rate and body build results were similar in the quintiles while diastolic blood pressure increased stepwise by 10 mmHg. Analysis of variance showed significant differences for all the indexes of left ventricular filling except deceleration time of and acceleration time to E peak (P less than 0.05 to P less than 0.0001) and almost all the echo-Doppler indexes showed a linear trend with diastolic blood pressure and left ventricular mass.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1978

[Unusual case of urogenital anomaly].

A case of associated malformation of the urogenital apparatus, right renal aplasia associated with uterus unicornis with the second uterine duct being independent of the first and located in the corner of the right iliac vessels, in reported in a woman of 41. Three pregnancies had all terminated regularly with live foetus born from eutocic delivery. The unusual nature of the case is insisted on and it would not seem possible to include it in any of the five classes established by Musset et al.

Adult↗
PubMed1978

[Intraoperative peritoneal lavage in generalized acute peritonitis. Experience with 61 cases].

After wide preface about peritoneal anatomy, pathological, physiology and physiopatology and about the physiopatology of general acute peritonitis, a case records of 61 patients is produced. All the patients were shocked and urgently operated for general acute septic peritonitis and were abundantly washed with a polisaline solution during the operation. That washing technique is described and the authors remark its abundancy (at least 10-12 litres) and its systematicity. They also remark that the washing is the true and main moment of the reanimation and it is the most important salvage action in the general acute peritonitis. The antibiotical therapy, especially the topical one, and the drainage are only complementary elements in the treatment. Among 61 patients, with an average of 54 years, there were eight deaths (13%) in old patients, with an average of 71 years and they were all caused by cardiac and circulatory disease. No patient died for peritonitis or for toxic-infections causes. The postoperative morbility (eight patients-13%) was mainly caused by the infection of the laparotomy and it only prolonged some days the stay in hospital.

Adolescent↗
PubMed1978

The kinetics of plasma noradrenaline in normal and hypertensive subjects.

1. The kinetics of plasma noradrenaline have been determined in normal and essential hypertensive patients by intravenous injection of tritiated noradrenaline and serial mixed venous sampling. 2. The metabolic clearance rate of plasma noradrenaline in normal subjects was approximately 1 1 min-1 m-2, whereas in essential hypertensive patients it was significantly reduced to approximately 0.6 1 min-1 m-2. 3. Metabolic clearance rate was negatively correlated to mean arterial blood pressure and total peripheral resistances. 4. Particularly low values of metabolic clearance rate were found in two patients with congestive heart failure and one with phaeochromocytoma. 5. We propose that the access of plasma noradrenaline to the main removal mechanisms takes place in competition with the flow of unlabelled endogenous noradrenaline directly released by nerve endings. The slower removal of plasma noradrenaline in essential hypertension could then express a larger release of endogenous noradrenaline in this condition.

Adrenal Gland Neoplasms↗
PubMedDate not supplied

Antidigoxin antibodies neutralize the effect of newborn endogenous digitalis-like factor on erythrocyte 86Rb uptake.

Increasing evidence indicates the existence of endogenous digitalis like factor(s) (EDLF). We recently reported on the partial purification of an EDLF from newborn (cord) blood which possesses both digoxin-like immunoreactivity and the ability to inhibit the cell membrane sodium pump measured as the inhibitory activity on erythrocyte 86Rb uptake. We here report that high affinity digoxin-binding antibodies (Fab fragments; Digibind, Burroughs Wellcome Co.) are capable of neutralizing the inhibitory activity on erythrocyte Rb uptake not only of digoxin but also of ouabain and of partially purified newborn EDLF. These results provide, to our knowledge for the first time, direct evidence that antidigitalis antibodies may cross-react with one or more circulating substances which share antigenic determinants with digoxin and ouabain and possess endogenous digitalis-like properties, strongly suggesting that these antibodies may be useful tools both for the assay of EDLF and for the study of its biological effects.

Antibodies↗
PubMedDate not supplied

[Carcinoma of the ileo-cecal appendix].

A structurally impaired appendix observed during laparotomy in a woman of 62, suffering from gall stones with stenosis of the papilla, was removed. Histological examination showed carcinoma. Right hemicolectomy was performed later.

Adenocarcinoma, Mucinous↗
PubMedDate not supplied

[Surgery in the prevention and treatment of intestinal occlusion caused by adhesions. Reymond's method of enteropexy. (Experience with 69 cases)].

The state of the art with regard to surgical management in the prevention and treatment of intestinal occlusion caused by adhesions is described and the various operations proposed are examined. Noble's operation (folding and overcast suture of the intestinal loops)-the first to be proposed requires too much time for its execution. In addition, it restricts loop mobility and thus predisposes to recurrences and complications. The operation of Childs & Philips (folding of the intestine by accordion attachment of the mesentery with transfixing, looped wires) is quicker, but its wires result in a certain degree of vascular and enteric affection. Folding via intubation of the whole of the small intestine with a long catheter, using a nasogastric, gastrostomic or jejunostomic route, is both simple and rapid. It is particularly advisable in non-peritonitic obstruction in children and as a prophylactic measure. Reymond's operation (enteropexy with two simple and fundamental, lateral "virage" sutures) may be segmentary or total, or confined to a few loops. It is very simple and quick. It can always be used and is adaptable to the objective situation in each case. Personal experience with this operation in 69 cases (54 "therapeutic" and 15 "prophylactic") is presented. Two instances of recurrence due to poor technique were noted. It is felt that the operation is extremely satisfactory.

Adolescent↗