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Biomedical subjects

V de Leonardis

Publications and source records attributed to V de Leonardis.

At least 19 recordsLinked to original sources
PubMed1996

Adjuvant chemotherapy after gastric resection in node-positive cancer patients: a multicentre randomised study.

After curative resection for gastric adenocarcinoma, 103 patients, all with positive nodes, were randomised so that 48 received adjuvant chemotherapy of epidoxorubicin (EPI) 75 mg m-2 on day 1, leucovorin (LV) 200 mg m-2 on days 1-3 and 5-fluorouracil (5-FU) 450 mg m-2 on days 1-3, every 21 days for 7 months, whereas the remaining 55 did not. During the first year of observation, 21 control patients (38%) and five treated patients had recurrences. After a follow-up period of 36 months, 12 of the treated patients (25%) and only seven controls (13%) were still alive. At that point, the median survival was 13.6 months for the 55 untreated patients and 20.4 months for the 48 treated patients, a significant difference. We found a survival advantage for patients treated with the EPI-LV-5-FU regimen and a consistent delay in the appearance of recurrent or metastatic cancer. Acute toxicity was mild and treatment was well accepted by all patients. There was no long-term toxicity or any cardiac toxicity. We conclude that this particular chemotherapy, administered shortly after gastric resection, improves survival rate in node-positive gastric cancer patients, even although final assessment of this particular adjuvant approach must await completion of the trial.

Adenocarcinoma↗
PubMed1995

Angiopathy affects circulating endothelin-1 levels in type 2 diabetic patients.

To evaluate the role of endothelin-1 (ET-1), a vasoconstrictor and mitogenic peptide synthesized by endothelial cells, on the endothelial dysfunction in non-insulin-dependent diabetic (type 2) patients, we have measured the circulating ET-1 levels in 25 patients with and without clinically evident vascular complications and in a control group. Circulating ET-1 levels were significantly higher in diabetic patients with angiopathy than in diabetics without angiopathy and in controls (7.02 +/- 2.9 pg/ml vs 4.4 +/- 1.1 pg/ml and 3.08 +/- 0.7 pg/ml, respectively; P < 0.001). No difference was demonstrated between diabetic patients without angiopathy and controls. These findings suggest that ET-1 may be a marker for arterial vascular disease only in patients with overt angiopathy. It is unclear whether it participates in the endothelial injury process or it is merely released from damaged endothelial cells.

Biomarkers↗
PubMed1994

Comparison of immuno- and HPLC-assays for the measurement of urinary collagen cross-links.

Pyridinoline (Pyr) and deoxypyridinoline (D-Pyr) are two cross-links of collagen molecules, that are present in the extracellular matrix and released during its degradation. Pyr is present in bone and cartilage, but not in significant amounts in other connective tissues and D-Pyr appears to be specific for bone tissue. Therefore, the urinary excretion of Pyr and D-Pyr might be a sensitive marker of bone matrix degradation. For the determination of urinary Pyr and D-Pyr two methods are available: a chromatographic method (HPLC) by which it is possible to measure separately Pyr and D-Pyr, and a new immunoassay which measures total free and low molecular weight pyridinoline released in the urine. We compared the results obtained by HPLC analysis of 205 urinary samples from normal subjects and patients affected by various bone disorders with those obtained by the immunoassay. The overall correlation coefficient between the results obtained by the two methods was 0.34. When calculated in a range of pyridinoline concentrations from 0 to 30, 30 to 60, and over 60 pmol/mumol creatinine the correlation coefficient was respectively -0.094, 0.38, and 0.12. The two methods yielded variable profiles in the detection of circadian rhythms and these differences did not segregate with normal or pathological conditions. We conclude that the immunoassay proposed for the determination of urinary collagen cross-links is not immediately applicable to clinical use. The improvement of the antibody specificity will probably contribute to replace the HPLC method with the immunoassay.

Adult↗
PubMed1992

Low incidence of cardiac hypertrophy in essential hypertensives with no retinal changes.

120 subjects, 90 hypertensives and 30 age-matched controls, were evaluated by fundoscopy and echocardiography to assess the degree of target organ involvement. The hypertensive patients were divided into 3 groups (mild, moderate, severe hypertension) according to their diastolic blood pressure levels. No significant difference was demonstrated in left ventricular mass among the 3 groups. Moreover, no relationship was demonstrated between the degree of hypertension and the severity of fundoscopic changes. Our findings indicate that patients with no retinal changes show a low probability of left ventricular hypertrophy and that patients with left ventricular hypertrophy show a high probability of retinal involvement. Our data indicate that fundoscopy is more sensitive than echocardiography in the recognition of the hypertensive disease.

Adult↗
PubMed1991

Ventricular late potentials in the assessment of mitoxantrone cardiotoxicity.

Sixteen female patients underwent signal-averaged electrocardiography and radionuclide angiography for the assessment of the resting left ventricular ejection fraction in the course of chemotherapy with mitoxantrone (MTX) for advanced breast cancer. Nine patients had received prior cardiotoxic treatments. Our findings indicate that patients treated with MTX may develop late potentials.

Adult↗
PubMed1989

Does ergometric stress test induce a procoagulative condition in patients with previous myocardial infarction?

A regularly scheduled physical training program seems to have antithrombotic effects. Moreover, the hemostatic changes occurring in patients with coronary artery disease during acute exercise have not been clearly elucidated. Since stress testing is routinely performed in clinical cardiology, it would be helpful to assess whether patients with coronary artery disease are exposed to acute coronary thrombosis during or soon after sustained physical exercise. This study was designed to evaluate the effect of acute physical exercise (stress test by bicycle ergometer) on blood coagulation in a group of patients with previous myocardial infarction, and to determine whether the antithrombotic therapy commonly administered favorably influences hemostatic equilibrium. Our results suggest that exercise testing is not harmful to patients with previous myocardial infarction in regard to hemostasis and fibrinolysis and that antithrombotic therapy reduces postexercise increase in platelets.

Aged↗
PubMed1989

New indices in the evaluation of clonidine transdermal therapy of hypertension.

Since high blood pressure might be more harmful the higher it is and the more it remains above a determined critical value (140/90 mm Hg - 18.7/12.0 k Pa - in the present study), the hyperbaric impact, a measure of the total load exerted on the arterial walls and the total time during the day when blood pressure is elevated above the critical value, have been evaluated. Ten patients with essential hypertension underwent non-invasive automatic 24-h blood pressure monitoring three times (baseline and after three and seven days from the application on the upper chest of a transdermal self-adhesive patch delivering clonidine). The recorder was programmed to measure blood pressure every 30 min during the day and every 60 min during the night. Significantly lower values of blood pressure, hyperbaric impact and duration of elevated blood pressure have been demonstrated from the third day after the beginning of transdermal therapy.

Administration, Cutaneous↗
PubMed1988

Echocardiographic evaluation of children with and without family history of essential hypertension.

A family history of hypertension is considered a risk factor for developing hypertension. We studied two groups of normotensive children (aged 14 years): one comprising 14 subjects with family history of hypertension, the other comprising 15 subjects without family history of hypertension. Children were comparable with respect to age, weight, height, body surface area, heart rate, and arterial blood pressure. M-mode echocardiography demonstrated higher interventricular septum/posterior wall ratio in progeny of hypertensive subjects. Interestingly, all the parameters evaluated were within the normal limits. Our data suggest that a certain degree of cardiac changes is present in children with positive family history of hypertension, though further studies are needed before considering these findings predictive of future essential hypertension.

Adolescent↗
PubMed1987

Circadian variations of heart rate and premature beats in healthy subjects and in patients with previous myocardial infarction.

Chronobiological analysis of the circadian variations of heart rate, ventricular and atrial ectopies, was carried out on 11 patients with previous myocardial infarction matched with 11 controls. Individual circadian rhythms in heart rate were seen in all the control subjects but only in 6 patients with previous myocardial infarction. The behaviour of the individual circadian rhythms of premature beats was not significantly different between the two groups. A significant group rhythm in ectopies was not demonstrated, nevertheless a trend to higher frequency of arrhythmias during the activity span was detected. These results do not allow to postulate a circadian pattern of arrhythmias common to all the subjects examined. Therefore, the individual circadian behaviour of premature atrial and ventricular beats should be recognized for monitoring antiarrhythmic therapy. A significant group rhythm in heart rate was demonstrated for the two populations studied and linear discriminant analysis showed that the amplitude of this rhythm was significantly lower in patients than in controls. Possibly, myocardial infarction may affect the sinus node function producing a "flattened" range of heart rates during the 24 hours.

Activity Cycles↗
PubMed1986

Evidence of no interobserver variability in M-mode echocardiography.

Left ventricular internal dimensions, septal and posterior wall thickness, aortic root diameter, and left atrial dimensions, were independently measured by two experienced interpreters on 50 consecutive routinely performed M-mode echocardiograms. The purpose of this work was to evaluate the reproducibility of these measurements and to assess if a different "diagnostic effect" could be provided by the two readers. The extent of interobserver variability was calculated and expressed as a percent of the mean. No significant interobserver variability was found for all the measured echocardiographic parameters and the two interpreters gave rise to the same "diagnostic effects." Therefore, the authors suggest following well stated guidelines to provide uniformity in the process of determining the boundaries of the structures to be measured and adjusting the actual measurements by multiplying by a conversion factor (representing the ratio between the number of 1 cm markers and the distance in centimeters between the first and the last marker), as opposed to interpolating between the marks on the recording paper.

Echocardiography↗
PubMed1986

Muscular blood flow in patients with heart failure.

We studied reactive hyperemia in a group of patients with heart failure before and after therapy, since changes in the characteristics of muscular blood flow may influence the functional class of these patients. At the same time we evaluated some echocardiographic parameters too. When the patients improved clinically, they showed an increase in muscular blood flow at rest and in percent of fractional shortening and a decrease in peripheral vascular resistance. The reactive hyperemia did not change significantly. This fact probably depends on a maximal response to the postischemic hyperemia and represents the integrity of autoregulatory mechanisms.

Aged↗
PubMed1985

A chronobiologic study on some cardiovascular parameters.

We studied the chronobiologic pattern of heart rate, R and T wave voltage, QT interval, and ST segment displacement. Premature atrial and ventricular beats obtained by dynamic electrocardiography, as well as arterial blood pressure measurements obtained by autometry, have also been studied in 131 untreated subjects (25 with hypertension, 28 with major risk factors for coronary artery disease, 9 with coronary artery disease, 37 presumably healthy and 11 shift workers). Our results show the existence of circadian rhythms in heart rate, in the duration of the QT interval and also in the voltage of R and T waves. Our data for R and T wave voltages do not completely agree with those from other authors. We demonstrated also that smoking may influence the circadian acrophase of the rhythm in R wave voltage while sleeping does not show any relationship with R and T wave voltages although it seems related to the displacement of the ST segment. We could point out only small differences in the chronobiologic behavior of patients with coronary disease and that of normal subjects, unlike the results previously reported by other authors. Our study demonstrated the existence of circadian and ultradian rhythms in premature atrial and ventricular beats as well as circadian and circaseptan rhythms in arterial blood pressure. Further studies are needed to improve our chronobiologic knowledge in order to optimize dosage and time of administration of the drugs used in the long term management of arrhythmias and hypertension.

Adult↗
PubMed1985

Effects of isoproterenol and methoxamine on the electrocardiogram.

The effects of isoproterenal (ISP) and methoxamine (MTX) infusion in 20 asymptomatic subjects with labile T wave were studied. In those treated with ISP the T wave showed an early negative trend and later became clearly positive in 5 subjects. In the majority of the subjects treated with MTX the T wave became positive. T wave changes match variations of both the ventricular gradient and, to a lesser degree, the QRS area. These changes were not related to heart rate or, in the subjects treated with MTX, to the baroreceptorial sensitivity deduced from the slope of the regression equation between R-R internal and systolic arterial pressure. The results of this study confirm the existence of a neurogenic mechanism affecting the electrocardiographic changes in T wave.

Adult↗
PubMed1984

Computerized M-mode echocardiography in the assessment of cardiovascular effects during intravenous administration of amiodarone.

Antianginal and antiarrhythmic long term therapy with amiodarone may be associated with side effects, therefore it should be used mainly in short term treatment of severe arrhythmias and acute coronary insufficiency. It is important to assess if any inotropic effect may be produced after intravenous administration of this drug in commonly accepted therapeutic doses (5 mg/kg body weight). To investigate this possibility we studied the effects of amiodarone on blood pressure (BP), on heart rate (HR) and on the maximal velocity of circumferential fiber shortening (Vcf Max). Simultaneous echocardiogram (UCG), electrocardiogram (lead DII) (ECG) and BP cuff measurement were performed on 12 subjects without cardiomegaly and clinical evidence of heart failure, immediately before a 30 second intravenous injection of amiodarone and every 30 seconds over a period of 6 minutes after drug administration. Amiodarone administration markedly raised HR within the first 30 seconds from the beginning of the injection and concomitantly decreased diastolic BP. No significant lowering of systolic BP was observed. Vcf Max (circ/sec) raised during the test concomitantly with HR increase, showing a significant relationship between left ventricular performance and HR. The same was also true during atrial pacing performed on one subject. No significant changes in any of the parameters studied were demonstrated after placebo (saline solution) administration to two presumable healthy subjects. Amiodarone does not seem to have any positive or negative intrinsic inotropic effect when administered intravenously at a dose of 5 mg/kg body weight.

Adolescent↗
PubMed1983

Circadian rhythms in dynamic electrocardiography.

A group of ten healthy subjects aged 32-58 years was studied by dynamic electrocardiography. An electrocardiogram (ECG) was recorded on CM 5 lead for 14 seconds every 15 minutes during the 24 hours. All the subjects were under a similar nyctohemeral schedule, sleeping between 23.30 and 06.45, and all followed their spontaneous diet without any restriction. "Mean Cosinor" analysis of the data revealed statistically significant circadian rhythms of heart rate (HR), R and T-wave voltages, duration of the QT interval and ST segment displacement, but not of the duration of the corrected QT (QTc).

Adult↗
PubMedDate not supplied

Response of some haemocoagulatory and haemorheological variables to maximal exercise in sedentary and active subjects.

The purpose of this study was to evaluate how physical conditioning is associated with haemostatic and rheological responses to strenuous exercise. A total of 25 males, divided into two groups differing in exercise fitness (14 sedentary and 11 active), underwent exercise testing on a bicycle ergometer with an initial 25 W workload increasing by the same amount every 3 min. The following variables were evaluated before and after the test: platelet count and aggregability, plasma fibrinogen, fibrinolytic degradation products, viscometry and micro-haematocrit. Significant differences in baseline values between the two groups were found only for blood viscosity. Irrespective of the group, significantly increased values were demonstrated for all the variables, except platelet aggregability and fibrinogen levels, in response to strenuous exercise. It is concluded that the possible protective effect of exercise against cardiovascular disease does not seem to be related to changes in the haemorheological and haemostatic measures evaluated.

Adult↗
PubMedDate not supplied

Circadian rhythms of arterial blood pressure.

We measured variations of blood pressure during the day in 46 untreated outpatients (25 hypertensives and 21 normotensives) to assess their circadian patterns. The self-measured blood pressures (autorhythmometry), determined at 08:00, 12:00, 16:00, 20:00 and 23:00 for 40 consecutive days were evaluated chronobiologically from single and population mean cosinors. On the basis of the results, we conclude that it is impossible to propose a common schedule of temporal therapy that will be effective for all hypertensive patients because of the unpredictable circadian behavior of blood pressure in this kind of subjects. Therefore, we suggest that individual circadian patterns of arterial pressure be studied when therapy is being established, so that the best therapeutic results can be achieved.

Blood Pressure↗