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Biomedical subjects

S Turco

Publications and source records attributed to S Turco.

48 records · Page 3Linked to original sources

Left ventricular systolic and diastolic function in severe obesity: a radionuclide study.

To verify the impact of sever obesity (defined as body mass index > 31 kg/m2) on left ventricular (LV) function, 32 asymptomatic obese but otherwise healthy subjects (16 men; age 38 +/- 11 years) voluntarily underwent first-pass and equilibrium 99mTc radionuclide angiography at rest and, in 22 of them, during bicycle supine exercise. Data were compared to those obtained from 10 normal volunteers (age 48 +/- 13; p < 0.05, vs. obeses). End-diastolic and stroke volumes did not differ between the two groups, whereas end-systolic volume was significantly higher in obese subjects (67 +/- 20 vs. 49 +/- 20 ml; p < 0.05), and, as a consequence, LV ejection fraction at rest was decreased in obese subjects (59 +/- 7%) compared to normals (65 +/- 6%; p < 0.05). Due to the higher heart rate in obese subjects (81 +/- 13 vs. 69 +/- 10 pbm, respectively; p < 0.05) cardiac output was significantly greater compared to normals (7.1 +/- 0.8 vs. 6.2 +/- 0.2 liters/min, respectively; p < 0.01). During exercise, ejection fraction normally increased in normals (70 +/- 7%; p < 0.001, vs. baseline) but not in obese subjects (60 +/- 9%; p = nonsignificant vs. baseline). In addition, systolic blood pressure/end-systolic volume ratio was significantly decreased in obese subjects (23 +/- 1.3) compared to normals (2.8 +/- 1.6; p < 0.05). Peak filling rate, normalized to end-diastolic counts per second, was significantly lower in obese subjects (2.2 +/- 1.3) compared to normals (2.8 +/- 1.6; P < 0.05). This difference was also true when peak filling rate was computed in stroke counts per second (3.8 +/- 0.8 in obeses vs. 4.4 +/- 0.4 in normals; p < 0.05). Repeat analysis in a subgroup of 10 young obese subjects (age < or = 30 years) confirmed decreased ejection fraction at rest (60 +/- 4%; p < 0.05) and peak filling rate (2.4 +/- 0.4 end-diastolic counts/s; p < 0.05), as well as the lack of ejection fraction increase during exercise (59 +/- 9%). Thus, these data indicate a subclinical impairement of LV systolic and diastolic function at rest and during exercise in asymptomatic severely obese but otherwise healthy subjects.

Adult↗

[Non-insulin-dependent diabetes mellitus associated with nonalcoholic liver cirrhosis: an evaluation of treatment with the intestinal alpha-glucosidase inhibitor acarbose].

Non-insulin-dependent diabetes mellitus not responding to diet only in patients with non-alcoholic liver cirrhosis is characterized by high post-prandial hyperglycemia. The aim of this study was to evaluate the safety and efficacy of 24 weeks of treatment with 300 mg acarbose per day in 76 consecutive outpatients affected by type 2 diabetes and well-compensated liver cirrhosis. The study design was double-blind cross-over vs placebo. All patients tolerated both treatments well, and no significant variations in liver function tests were observed (< 5% vs pre-treatment). A significant reduction of several parameters was observed only after acarbose: fasting glycemia (19 +/- 6 vs 2 +/- 0.5%; p < 0.01), post-prandial glycemia (41 +/- 9 vs 3 +/- 0.6%; p < 0.01), mean glycemia (30 +/- 8 vs 14 +/- 5%; p < 0.01), daily glycemic variation (52 +/- 8 vs 8 +/- 1%; p < 0.01), HbA1c (16 +/- 1 vs 2 +/- 0.5; p < 0.05), incremental area of C-peptide after a standard meal (80 +/- 19 vs 200 +/- 36 ng/mL/300 min; p < 0.01). After acarbose a significant increase of intestinal voiding/week (98 vs 28%; p < 0.01) and a parallel reduction of blood ammonia levels (52 +/- 9 vs 9 +/- 5%; p < 0.01) were observed. Results clearly document the good tolerability and the absence of toxic effects of acarbose on the liver, due to a theoretic absence of both absorption by the gut and hepatic metabolism of the drug. In fact, acarbose increases peristaltic movement of the gut, stimulates the proliferation of saccharolytic bacteria and simultaneously reduces proteolytic bacterial proliferation, thus actively reducing blood ammonia levels. These unexpected effects of acarbose may be used to advantage for the treatment of type 2 diabetes mellitus in patients with well-compensated liver cirrhosis.

Acarbose↗

The influence of manufacturing parameters on the formation and growth on autoclaving of a 40% V/V Bis-Perfluorobutylethene emulsion.

The influence of different process variables on the number of large particles before and after autoclaving of a 40% V/V Bis-Perfluorobutylethene emulsion stabilized by egg yolk lecithin, made isotonic with blood, was examined. The concentration of emulsifier, emulsification and autoclaving time and temperature, fill volume and the cooling gradient applied to the emulsion after autoclaving all affect the number of large droplets and hence the stability and acceptability of the finished product. This work suggests that validation of equipment and process to very exacting specifications and strict adherence to specified manufacturing protocol is essential for the reproducible production of fluorocarbon emulsions acceptable for intravenous administration.

Emulsions↗

[Cardiovascular response to the cold test in obese subjects. Effect of a hypocaloric, normal sodium diet].

Loss of weight in obese patients, both hypertensive and normotensive, causes a fall in blood pressure (BP) through a mechanism which is still not fully understood. The effects of a low-sodium low-energy diet on BP were assessed in 20 obese subjects (15 M and 5 F; age 26-65 years), 11 of whom were normotensive and 9 hypertensive. Following a period of normocaloric diet, a diet of 600 kcal was prescribed for 6 months. BP and heart rate (HR) were measured at the start and end of hypocaloric diet in resting conditions and during stimulation of the adrenergic nervous system (ANS) obtained by exposure to cold (immersion of the hand in water and ice). A reduction of resting BP (from 137/81 +/- 5/4 to 122/74 +/- 4/4 mmHg, p less than 0.05) was observed in 8 patients who lost at least 30% of excess weight (from kg 107 +/- 6 to 91 +/- 4, p less than 0.001) together with an increase in BP during exposure to cold (from 140/82 +/- 3/3 to 156/95 +/- 7/4 mmHg before and from 120/78 +/- 3/4 to 140/88 +/- 3/3 after the diet, p less than 0.05). No changes were found in the daily urinary excretion of Na during the course of diet therapy. These results demonstrate that a hypocaloric diet, independent of saline restriction, is able to reduce resting BP and pressure peaks during adrenergic stimulation.

Adult↗

[Cardioscintigraphic evaluation of obese subjects with or without arterial hypertension].

A group of normotensive obese subjects (group A), a group of hypertensive obese subjects (group B) and a group of control subjects (group C) were submitted to radionuclide ventriculography using 99mTc to investigate cardiac function and haemodynamic situation in the presence of an increased preload (group A), preload and afterload (group B). Results show a significant reduction in ejection fraction and systolic blood pressure/end systolic volume in group A. Group B shows better cardiac function probably for the presence of cardiac concentric hypertrophy. Left ventricle work either in a minute and for each beat is greatest in patients of group B. Thus the simultaneous presence of obesity and hypertension can cause a worse prognosis in such patients for cardiac ischaemia and/or sudden death.

Adult↗