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Biomedical subjects

V Palmieri

Publications and source records attributed to V Palmieri.

At least 19 recordsLinked to original sources

Acute ethanol administration induces oxidative changes in rat pancreatic tissue.

BACKGROUND: There is mounting clinical evidence that ethanol toxicity to the pancreas is linked with glutathione depletion from oxidative stress but there is not experimental proof that this occurs. AIMS AND METHODS: The effect of acute ethanol ingestion (4 g/kg) on the pancreatic content of reduced (GSH) and oxidised (GSSG) glutathione, malondialdehyde (MDA), and carbonyl proteins were therefore studied in the rat. RESULTS: Ethanol caused a significant reduction in GSH (p < 0.02) and an increase in GSSG (p < 0.005), MDA (p < 0.05), and carbonyl proteins (p < 0.05) in the rat pancreas. The GSH/GSSG ratios were significantly decreased after ethanol, especially in rats pretreated with diethylmaleate (DEM), a GSH blocker. Administration of ethanol after DEM further increased the rate of lipid and protein oxidation. Pretreatment with cyanamide (an inhibitor of aldehyde dehydrogenase) but not with 4-methylpyrazole (an alcohol dehydrogenase inhibitor) caused higher production of GSSG and MDA. CONCLUSIONS: These findings indicate that acute ethanol reduces the pancreatic content of GSH, which seems to be protective against ethanol toxicity, since its depletion is accompanied by increased oxidative damage to cell structures. The further increase of lipid peroxidation and GSSG production in the presence of cyanamide suggests that acetaldehyde might be responsible for the oxidative changes that occur in pancreatic cells after ethanol administration.

Animals

Early abnormalities of cardiac function in non-insulin-dependent diabetes mellitus and impaired glucose tolerance.

The aim of this study was to evaluate the role of diabetes and minor abnormalities of glucose homeostasis, such as impaired glucose tolerance, as determinants of cardiac function and structure in a working population. We studied a population-based sample of 64 telephone company employees (both sexes, mean age 58 years): 25 with normoglycemia, 15 with impaired glucose tolerance, and 24 with non-insulin-dependent diabetes mellitus (NIDDM) diagnosed by oral glucose tolerance test according to the recommendations of the World Health Organization. Subjects with myocardial ischemia were excluded. Left ventricular end-systolic dimension, indexed to body surface area, was greater in those with NIDDM (p < 0.05) and in those with impaired glucose tolerance (p < 0.05) with respect to normoglycemic persons. The ratio of the peak early diastolic velocity wave to the late diastolic wave was lower in those with NIDDM (p < 0.05) and in those with impaired glucose tolerance (p < 0.05) than in participants with normoglycemia. Body mass index and blood pressure were similar in the 3 groups. These results clearly indicate that early abnormalities of cardiac structure and function are observed not only in patients with NIDDM, but also in those with impaired glucose tolerance, independent of the confounding role of myocardial ischemia, body weight, and blood pressure.

Adult

Echocardiographic size of conductance vessels in athletes and sedentary people.

The purpose of the present study was to assess the size of great and medium caliber arterial and venous vessels (conductance vessels) in athletes of different sports and sedentary people. Vessel size was measured by two-dimensional echocardiography in 15 professional cyclists, 15 highly-trained long-distance runners, 15 professional volley-ball players, 10 wheelchair basketball players, 11 wheelchair distance runners and 20 sedentary controls. The following vessels were imaged and measured: aortic arch, left carotid and left subclavian artery, right pulmonary artery, abdominal aorta and mesenteric artery, superior and inferior vena cava. Vessel size was considered in absolute value and normalized for body surface area (BSA). Among the able-bodied athletes, both cyclists and long-distance runners showed a generalized increase in vessels size in respect to controls, either absolute or normalized for BSA. The increase was highly significant for normalized inferior vena cava: cyclists, mean 15.1 mm, 95% confidence intervals 14.2 to 15.8 mm; long-distance runners, 15.8 mm, 15.3 to 16.4; controls, 10.5 mm, 9.8 to 11.3. Volleyball players also showed larger vessels than controls, but this feature was clearly related to their greater body size because statistical differences were attenuated or abolished by normalization for BSA. Wheelchair athletes exhibited significantly larger upper-body vessels but significantly smaller lower-body vessels than controls when normalized for BSA. In addition, wheelchair distance runners, who trained more intensively, had larger abdominal aorta and inferior vena cava than wheelchair basket players. Long-term endurance training leads to a generalized increase in arterial and venous conductance vessels size.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent

Prolonged consumption of moderate doses of alcohol and in vitro gastro-duodenal and ileal contractility in the rat.

The effects of chronic feeding with moderate doses of ethanol (3% vol/vol in drinking water for 8 weeks), which do not induce tolerance, dependence and withdrawal, on the contractility of gastric, duodenal and ileal strips from rats were investigated. Only 50% of ethanol-treated specimens (as compared to 100% of saccharose-fed controls) exhibited antral phasic contractions (frequency decreased by 31% and 27% in the antrum and duodenum, respectively; P < 0.03 vs. controls). The depolarizing agent potassium chloride (KCl, 80 mM) produced less peak active tension in the fundus of ethanol-fed rats (P < 0.01). In alcoholic rats the sensitivity of the antrum to acetylcholine was fourfold less than that of control specimens. It is concluded that, in the rat, moderate doses of ethanol given chronically impair both spontaneous and tonic contractility of the stomach and duodenal muscle without affecting ileal contraction. It is possible that motility defects in the gut exposed to ethanol concentrations which do not cause tolerance, dependence or withdrawal in the rat may be due to a local rather than a systemic effect on the smooth muscle.

Acetylcholine

Effects of cholestyramine on gallbladder and gastric emptying in obese and lean subjects.

Gallbladder stasis is frequent in obese subjects and may contribute to their increased risk for gallstone formation. The bile salt sequestrant cholestyramine acutely enhances postprandial gallbladder emptying in lean subjects, through disinhibition of a negative feedback between intraluminal bile salts and CCK release. In this study the effect of cholestyramine on both gallbladder and gastric antrum dynamics were studied by real-time ultrasonography in 12 obese and 15 lean subjects. For the acute study, on different days, subjects ingested a liquid meal (two egg yolks plus water 200 mL, 50 kJ) or a meal with 4 g cholestyramine. Gallbladder emptying was impaired in obese patients who had significantly larger fasting gallbladder volume (39.4 +/- 6.9 vs. 21.6 +/- 1.7 mL, P < 0.02), larger residual volume (12.3 +/- 1.8 vs. 4.0 +/- 0.5 ml, P < 0.0006) and slower emptying time (T/2: 33 +/- 2 vs. 21 +/- 2 min, P < 0.05) than lean subjects. Integrated antral emptying was also less in obese than lean subjects (5521 +/- 578 vs. 7908 +/- 491 %120 min-1, P < 0.02). Cholestyramine enhanced postprandial gallbladder emptying in both obese and lean subjects. Gastric emptying was delayed with cholestyramine in lean but not obese subjects. For the chronic study, after 1 month therapy with cholestyramine (4 g every 2 days), the motility tests were repeated in nine obese subjects. Gallbladder and gastric responses to a test meal, with or without cholestyramine, were preserved. We conclude that both gallbladder and antral emptying of a liquid test meal are impaired in obese subjects. Gallbladder emptying improves after acute administration of a low dose cholestyramine with test meal. This effect is sustained after 1 month treatment with a low dose of cholestyramine and does not interfere with gastric emptying of obese patients. Cholestyramine may improve gallbladder hypomotility in obese people.

Adolescent

Diagnostic work-up for food-dependent, exercise-induced anaphylaxis.

Fourteen patients with suspected food-dependent, exercise-induced anaphylaxis (EIAn) were subjected to prick tests with commercial food extracts and common airborne allergens, prick + prick tests with fresh foods, determination of total IgE levels, and specific IgE for 31 foods (CAP System FEIA RAST). All were positive for two or more foods; 10 presented hypersensitivity to 11 or more foods. On the basis of these findings, history data, and responses to food-exercise challenges (treadmill stress tests 90 min after meals containing none of the suspected foods and none associated with skin-test and/or RAST positivity) and suspected food-exercise challenges (SFECs - administered after meals containing the suspected food), three patients were diagnosed as having specific food-dependent EIAn (for wheat in two cases, tomato in one). In nine others, the presence of specific IgE for numerous foods (including those suspected on the basis of histories and utilized in the SFECs) suggests involvement of specific food hypersensitivity, although SFEC confirmation could not be obtained. Avoidance of all foods associated with test positivity 4 h before exercise has prevented all further EIAn episodes in these 12 patients. In two others, the reactions did not appear to be related to IgE directed against specific food allergens, and these subjects have eliminated further reactions by avoiding all meals for the 4 h preceding exercise. These findings emphasize the importance of allergologic testing with a wide panel of food allergens (including foods used for seasoning, such as garlic or parsley) in all patients with suspected food-dependent EIAn. Prick + prick tests with fresh foods and the CAP System RAST disclosed numerous hypersensitivities.

Adolescent

[The SINTESI Project: software in cardiovascular prevention].

Coronary heart disease is the most important cause of mortality in adults. New approaches may reduce the cardiovascular risk in population. "SINTESI" is an original data base designed in collaboration with the Italian Group for the Study of Metabolism Disease and Atherosclerosis to improve the evaluation of the major risk factors in the population and to create a data bank for medical research. It runs in Windows. The software includes the following electronics archives: Demographics; History; Follow-up; ECG; Laboratory; Doppler-echocardiography; Stress test-ECT; Ambulatory blood pressure monitoring; Holter-ECG; Nuclear imaging; Vascular echo-Doppler; Hemodynamics; Radiology. We named the most important file "Main Working Area" (MWA). This displays all the most important information on the clinical status of the patients and represents the "console" for using the software. In fact, in MWA "buttons" are displayed to enter all the electronic archives. The software displays graphics and the flow-chart of clinical history. We implemented "routines" for automatic evaluation of several variables. We also simplify the statistical use of the data implementing functions for "query" that permit the management of data bank. The use of this software may facilitate the correct evaluation and stratification of the cardiovascular risk. In conclusion, "Progetto SINTESI" is an easy, synthetic organization of patient's clinical data and a complete data bank. It is our opinion that the use of this software may promote a standard way of collecting a large number of data to improve the stratification of cardiovascular risk.

Adult

Gallbladder motor function in gallstone patients: sonographic and in vitro studies on the role of gallstones, smooth muscle function and gallbladder wall inflammation.

Gallbladder motility was studied by ultrasound in 100 healthy adult volunteers and 150 gallstone patients, in a subgroup of whom gallstone burden, type and number, gallbladder histology and tensiometric responses of gallbladder strips to cholecystokinin octapeptide were evaluated. Patients were divided into contractors (n = 108) and hypocontractors (n = 42), according to their gallbladder motility pattern in vivo. Contractors showed slower gallbladder emptying and increased fasting and postprandial residual volumes, although the ejected amount of bile was greater than that of controls (20.2 +/- SEM 1.1 vs 16.0 +/- 0.7 ml; p < 0.001). In contrast, hypocontractors exhibited slower and less complete gallbladder emptying than controls with a reduction in the absolute amount of ejected bile. Although gallbladder wall inflammation was mild and comparable in specimens from both groups of patients, the thickness of the muscular layer was greater in hypocontractors than in contractors (1073 +/- 76 vs 745 +/- 75 microns, p < 0.01) and related inversely to postprandial ejected volume (r = -0.42; p < 0.03; n = 32) but positively to gallstone volume (r = 0.40; p < 0.03; n = 32). Compared to contractors, gall-bladder muscle strips of hypocontractors exhibited a decrease in frequency and amplitude of spontaneous contraction and in maximal stress and receptor sensitivity to cholecystokinin octapeptide (0.1 nM-1 microM). Postprandial gallbladder evaculation was unaffected by stone number, and by the presence or absence of stone calcification. Gallstone volume was larger in hypocontractors (19.4 +/- 3.0 ml vs 9.6 +/- 0.9 ml, p < 0.001) than contractors. The comparison of in vitro contractility patterns between cholesterol, mixed and pigment stone patients showed a more severe defect in patients with cholesterol and mixed stones than in those with pigment calculi. In conclusion, in gallstone patients: (i) gallbladder motor dysfunction manifests mainly with increased fasting and postprandial residual volumes in contractors and with markedly increased postprandial residual volumes and decreased gallbladder emptying in hypocontractors; (ii) gallbladder kinetics seem to be influenced by stone volume and cholesterol content of calculi but not stone number, calcification or mild chronic cholecystitis; (iii) a form of hypertrophic leiomyopathy is observed in gallstone patients with the most impaired gallbladder motor function.

Adult

Role of myocarditis in athletes with minor arrhythmias and/or echocardiographic abnormalities.

We report the clinical and instrumental data, including the endomyocardial biopsy findings, of six young athletes presenting with minor arrhythmias and/or echocardiographic abnormalities. In one of them, a left ventricular dilation with moderate depression of the systolic function had been attributed to an athlete's heart. A diagnosis of arrhythmogenic right ventricular dysplasia had been made in three others, one with right ventricular dilation and apical hypokinesia, and two with ventricular arrhythmias with QRS morphology of left bundle branch block. A myocarditis could be unequivocally established in four athletes (two with and two without fibrosis). In the remaining two, with a clinical history strongly suggesting a previously acute myocarditis, the endomyocardial biopsy specimen revealed a nonspecific fibrosis compatible but not definitely pathognomonic of a healed myocarditis. Our report suggests that a myocarditis may be a cause of minor rhythm disturbances and/or echocardiographic abnormalities in athletes. A prevalent localization of the inflammatory process in the right ventricle with or without the occurrence of ventricular arrhythmias with left bundle branch block morphology can mimic an arrhythmogenic right ventricular dysplasia. An early diagnosis of myocarditis in athletes is useful to avoid the risk of fatal arrhythmias, also considering that rest still keeps on being one of the most effective strategies in myocarditis management.

Adolescent

Effect of glutathione administration on hepatic biliary and plasmatic glutathione levels in the rat.

BACKGROUND: Since the effect of exogenous glutathione (GSH) on overall hepatic GSH homeostasis is not known, the present study investigated the changes in the hepatic, biliary, and plasmatic GSH levels during GSH administration in intact rats. METHODS: An exteriorized biliary-duodenal fistula was established, and GSH (1 mmol/kg over 2 h) or saline was administered intraperitoneally to rats with or without pretreatment with 5 mmol/kg L-serine borate, an inhibitor of gamma-glutamyltransferase (GGT). RESULTS: Three hours after GSH administration, biliary GSH efflux and bile flow rose from 104.7 +/- 5.6 to 290.6 +/- 8.6 micrograms/ml bile and from 20.2 +/- 1.3 to 30.2 +/- 2.1 microliters/min, respectively; GSH-treated rats also showed increased liver (35%) and posthepatic vein plasma (68%) GSH concentrations compared with controls. By contrast, in rats pretreated with the GGT inhibitor GSH administration appeared to be devoid of any effect, except for a modest biliary GSH increase. CONCLUSIONS: This study indicates that significant changes occur in the hepatic GSH homeostasis after intraperitoneal GSH administration. The activity of hepatic GGT, most likely through degradation of circulating GSH, followed by an increase in cysteine availability, seems to account, at least partially, for the reported effects.

Animals

Sonographic evaluation of gallstone burden in humans.

A prospective blind study was performed to compare sonographic with postoperative findings of gallstone burden in 34 patients (10 males, 24 females; mean age 52 years). Gallstone size was assessed in single calculi (n = 15) by measuring the largest diameter by ultrasonography (US). The ellipsoid algorithm was used to estimate US volume for both single and multiple gallstones. After cholecystectomy, diameters were measured in single stones; stone volume was assessed by the ellipsoid formula (single stones) and fluid displacement (single and multiple stones). Stone volumes assessed by the ellipsoid formula and fluid displacement correlated closely (r = 0.98; p < 0.0001, n = 15). In the case of single gallstones, the mean length assessed by US was 25.3 +/- 3.2 mm and compared well with the value measured "in vitro" (24.8 +/- 3.1 mm). A highly significant and positive relationship existed between the sonographic size and the true stone size (r = 0.93; p < 0.0001, n = 15). Stone volumes assessed "in vivo" and by fluid displacement were comparable and correlated for both single (US: 6.6 +/- 1.3 vs fluid displacement: 5.8 +/- 1.4 ml; r = 0.79; p < 0.0005, n = 15) and multiple stones (US: 3.8 +/- 0.8 vs fluid displacement: 3.7 +/- 0.8 ml; r = 0.85; p < 0.0001, n = 19).(ABSTRACT TRUNCATED AT 250 WORDS)

Algorithms

Food-dependent exercise-induced anaphylaxis: report of two cases.

Exercise-induced anaphylaxis (EIAn) is a rare condition characterized by giant urticaria, angioedema and acute gastrointestinal symptoms that develops on exertion. In the most severe forms it may be associated with acute cardiorespiratory symptoms (laringeal stridor, wheezing), profound hypotension or syncope. In some individuals, EIAn characteristically occurs after a meal suggesting that the anaphylactic reaction is provoked by both exercise and ingestion of a foodstuff to which the patient has become sensitized. Two representative cases of severe food-dependent EIAn are described, which emphasize the need of performing a careful allergological evaluation in sportsmen with unexplained cardiovascular and/or respiratory symptoms during effort, especially when associated with other allergic manifestations and/or occurring in the post-prandial period.

Adult

Gallbladder volume in adults, and relationship to age, sex, body mass index, and gallstones: a sonographic population study.

The influence of gender, age, body size, cholelithiasis, and obesity on fasting gallbladder volume (GBV) was investigated by real-time ultrasonography in a general population cohort of subjects whose ages were between 30 and 69 yr, living in Bari, a Southeastern Italian city. Of the 2076 subjects analyzed, 1246 (60%) were males and 830 (40%) were females (mean age 50 yr). Among them, 1703 subjects were healthy, 108 had gallstones, and 265 were obese. Fasting GBV in healthy individuals was larger in males (M) than in females (F) [M, 18.7 +/- 0.3 (SEM) ml vs. F, 17.0 +/- 0.3 ml; p less than 0.001] and obese (M, 23.4 +/- 1.5 ml vs. 19.7 +/- 0.9 ml; p less than 0.05). The trend was similar in gallstone patients, but it was not statistically significant (M, 23.0 +/- 2.0 ml vs. F, 18.8 +/- 1.5 ml; t = 1.64). Gallbladder size correlated positively with body size in the lean healthy population (p less than 0.01), increased with age in healthy nonobese males (p less than 0.01), and was smaller in healthy males than in males with gallstones (0.01 less than p less than 0.02) and obese, in both sexes (p less than 0.01). We conclude that fasting GBV 1) is larger in lean healthy and obese males than females, 2) increases with age in lean males and with body size in healthy lean females, and 3) is greater in patients with gallstones and in obese subjects, and this might partially account for the defective gallbladder motor function reported in these patients.

Adult

Coronary arteries and athlete's heart.

An increase of coronary artery size after endurance training has been suggested by experimental data on animals and anecdotal autopsy reports in men. However, systematic studies on in vivo coronary anatomy of athletes have been lacking so far. We utilized two-dimensional echocardiography (2DE) to explore non-invasively the coronary anatomy of endurance athletes. Twenty long-distance runners (LDR) and 20 matched sedentary controls (SC) were studied initially. Visualization of the ostia and main trunks of-right (RCA) and left coronary artery (LCA) was obtained in 90-100 p. 100 of LDR and 70-75 p, 100 of SC. Collateral branches of LCA (anterior descending artery and circumflex branch) and RCA were visualized respectively in 60-70 p. 100 and 30-40 p, 100 of cases. The very good quality of images made possible the measurement of LCA and RCA size. LDR as a group had significantly larger coronary arteries than SC: this was associated with significant left and right ventricular enlargement and hypertrophy. These results have been further confirmed in a large survey of triathletes, swimmers, water-polo players, young LDR and prepubescent football players. Increase of coronary artery size is a well-documented effect of endurance training which can be easily investigated with 2DE, However, the large interindividual variability and the observation of very large coronary arteries in adolescent subjects suggest that genetic factors may also play a role in determining the final size of the coronary vessels.

Cardiomegaly

[Echocardiographic visualization of the coronary arteries in endurance athletes].

Visualization of left (LCA) and right coronary artery (RCA) by two-dimensional echocardiography (2-DE) was tried in 20 highly-trained endurance athletes and 20 normal sedentary controls using multiple echo planes. On the standard parasternal short axis aortic root view, the ostium of LCA was successfully visualized in all 20 athletes (100 percent) and in 18 controls (90 percent), the left main trunk in 19 athletes (95 percent) and 14 controls (70 percent) and a distinct bifurcation of the main trunk in 4 athletes (20 percent) and 2 controls (10 percent). In another 2 athletes, the initial tract of the left anterior descending artery and of the left circumflex branch could also be identified. With the same echo view, both from left or right sternal border, the ostium of RCA was visualized in 19 athletes (95 percent) and 16 controls (80 percent), the right main trunk in 18 athletes (90 percent) and 15 controls (75 percent) and a distinct bifurcation of RCA with one branch in 9 athletes (45 percent) and none of controls (p less than 0.025). Moreover, visualization of the distal tract of RCA was obtained on the parasternal long axis view of right ventricle in 15 athletes (75 percent) and 6 controls (30 percent, p less than 0.025). The very good quality of the 2-DE images allowed to measure the size of the ostia and initial tracts of both coronary arteries and the length for which the vessels could distinctly be followed.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent