Search PubMed⌕ Search

Biomedical subjects

A Coppola

Publications and source records attributed to A Coppola.

At least 73 records · Page 4Linked to original sources
PubMed1994

Niacin-induced hepatotoxicity: unusual presentations.

We report four cases of niacin-induced hepatotoxicity. All four patients were using sustained-release niacin preparations. When they stopped taking niacin, symptoms and laboratory abnormalities resolved. Two of the patients had focal fatty infiltration of the liver on imaging studies, a presentation of niacin hepatotoxicity not previously described. One patient had a coagulopathy even though aminotransferase levels were only mildly elevated. We recommend that patients using sustained-release preparations of niacin have periodic monitoring of liver enzymes and that the preparation be discontinued if any abnormalities develop.

Adult↗
PubMed1994

Breast feeding and acute lower respiratory infection.

The association between breast feeding and acute lower respiratory infection (ALRI) was studied in a case-control study in southern Italy. Two groups of children were studied: the first group comprised 73 infants, aged 0-6 months, whose diagnosis was pneumonia or bronchiolitis; the second group included 88 infants less than 12 months of age with a diagnosis of pertussis-like illness. Control infants were two groups of infants admitted to the same ward. Compared with controls, infants in the first group were less likely to have been breast fed (odds ratio 0.42, 95% CI 0.19-0.90). The protection conferred by breast feeding was stronger among infants who were receiving human milk at the time of admission (odds ratio 0.22, 95% CI 0.09-0.55) and was absent among those infants who had stopped breast feeding for two or more weeks before admission. Among infants who were severely ill, breast feeding was less likely than among those with milder illnesses. There was evidence in the stratified analysis of effect modification by the presence of other children in the family. Among the infants with pertussis-like illness, the incidence and duration of breast feeding were not different compared with controls. The results suggest that breast feeding has a strong protective effect against ALRI in industrialized countries also. No protection seems to be conferred by human milk against pertussis-like illness.

Acute Disease↗
PubMed1993

Blood pressure 24-hour pattern in two industrialized countries (Italy and Japan) with a different culture in salt intake.

This study investigates the blood pressure (BP) 24-hour pattern in representative samples of 2 industrialized countries, Italy and Japan, showing different cultures in salt intake. BP was monitored by means of a noninvasive ambulatory device whose readings were analyzed by means of chronobiometric procedures. The results show that the 24-hour BP pattern is not substantially different in Italian and Japanese subjects. In particular, the expected lower BP in the Italians was not detected despite their lower salt intake. Because the 24-hour mean BP value was seen not to be proportional to salt intake, the hypothesis is formulated that maintenance of the pressure regimen within a given range of variability is a principle of human physiology. To comply with this rule the Japanese people are supposed to have ethnically developed a certain resistance to dietary salt for which their cardiovascular apparatus is protected (phyletic escape to dietary sodium excess).

Adult↗
PubMed1993

Increasing prevalence of juvenile onset type 1 (insulin-dependent) diabetes mellitus in Sardinia: the military service approach.

In order to obtain new and more detailed information about temporal trends and geographic distribution of Type 1 (insulin-dependent) diabetes mellitus in Sardinia, we screened a series of birth cohorts (1936-1973) of all male army conscripts aged 18-19 years, filed in the Sardinian Conscript Register where Type 1 diabetes is a cause of rejection. A total of 678 diabetic subjects, born and permanently residing in Sardinia, was identified. The point prevalence (x 1000) at the age of 20 years in the birth cohorts ranged from values close to zero for the first ten cohorts (1936-1945) up to a maximum of 3.08 (95% confidence limits 2.28-4.08) for the 1966 cohort and continued high thereafter although an apparent decrease was observed from the early 1970s birth cohorts. Type 1 diabetes was distributed throughout the four provinces of Sardinia with no particularly significant heterogeneity; however, in accordance with the geographical distribution of diabetes cases of the Eurodiab Ace survey (1989-1990), the highest prevalence of the disease was observed in the Cagliari and Oristano provinces, followed by Nuoro and Sassari. These data suggest a gradually increasing trend of male Type 1 diabetes prevalence in Sardinia with a 29-fold increase between the late 1930s and the late 1960s birth cohorts. This seems to confirm the high incidence of Type 1 diabetes in the 0-14 and 0-29 year age groups recently reported among Sardinians during the Eurodiab Ace collaborative multicentre study.

Adolescent↗
PubMed1993

A chronobiological approach to circulating levels of renin, angiotensin-converting enzyme, aldosterone, ACTH, and cortisol in Addison's disease.

This study deals with a chronobiological approach to the circadian rhythm of the renin-angiotensin-aldosterone system (RAAS) and the ACTH-cortisol axis (ACA) in patients with Addison's disease (PAD). The aim is to explore the mechanism(s) for which the circadian rhythmicity of the RAAS and ACA takes place. The study has shown that both the RAAS and ACA are devoid of a circadian rhythm in PAD. The lack of rhythmicity for renin and ACTH provides indirect evidence that their rhythmic secretion is in some way related to the circadian oscillation of aldosterone and cortisol. This implies a new concept: a positive feedback may be included among the mechanisms which chronoregulate the RAAS and ACA.

Addison Disease↗
PubMed1993

Circadian rhythm of cardiac output, peripheral vascular resistance, and related variables by a beat-to-beat monitoring.

This study aimed to explore the 24-h patterns of stroke volume, cardiac output, and peripheral vascular resistance along with other correlated variables, such as left ventricular ejection time, ejection velocity index, thoracic fluid index, heart rate, and blood pressure. The study was performed on 12 clinically healthy subjects by means of a noninvasive beat-to-beat monitoring using the thoracic electric bioimpedance technique associated with the automated sphygmomanometric recording. Time data series were analyzed by means of chronobiological procedures. The results documented the occurrence of a circadian rhythm for all the variables investigated, giving relevance to the beat-to-beat bioperiodicity of cardiac output and peripheral vascular resistance. Temporal quantification of the investigated variables may be useful for a better insight of the chronophysiology of the cardiovascular apparatus.

Adult↗
PubMed1992

Pre-Cushing's syndrome: a case report.

A 67-year-old man affected by prostate cancer was incidentally found to have a nodular enlargement of the left adrenal gland without apparent changes in hormonal status. The adrenal mass was found to be scintigraphically active, the radiolabelled compound being concentrated in its context with a consensual suppression of the contralateral uptake. The patient underwent a resection of the adrenal tumor. Histologically and biochemically, the adrenal mass was found to be a non-functioning adenoma. The radioisotopic uptake along with the non-hormonal activity prompted us to call this tumor "Pre-Cushing's syndrome" of the adrenal cortex.

Adrenal Cortex Neoplasms↗
PubMed1991

Perinatal mortality in southern Italy.

Perinatal deaths occurring in the Campania region of southern Italy in 1982 were analysed. The perinatal mortality rate was 17.6 per thousand (stillbirth rate 8.3, early neonatal mortality rate 9.3). Compared with Swedish data, our deaths excess does not seem attributable to an unfavourable birthweight distribution, but to high birthweight mortality rates in every birthweight category and particularly in the normal birthweight group (greater than 2500 g). This group of newborns, representing about 94% of the births, contributes 45.4% of perinatal deaths; this situation is not common in developed countries, where the normal birthweight newborns form a much smaller proportion of perinatal deaths. The analysis of the causes of perinatal mortality, even though autopsies are rarely executed in Campania, shows a high prevalence of events which should be prevented by good antenatal and perinatal care.

Cause of Death↗
PubMed1991

Antenatal and perinatal care in southern Italy. I. The mothers' reports.

A population-based cross-sectional study of antenatal and perinatal care was performed in Campania, a region of southern Italy. One thousand three hundred women who had given birth in 1982 were interviewed. The number of antenatal visits was very low, less than 1% of the mothers having attended more than three times during pregnancy. The women at high obstetric risk did not attend more than those at low risk and certain aspects of their antenatal care were unsatisfactory. The place of birth was similar for high risk and low risk mothers, with 40% delivering in small private facilities (with few neonatal resuscitation facilities and often with inadequate infant transport services). The labour was induced or accelerated in 60% of the mothers. The organisation of perinatal care did not take into account many of the needs of the mothers such as presence of a relative at delivery, ambulation during labour, early relationship with the newborn, rooming-in, or encouragement to breastfeed.

Cross-Sectional Studies↗
PubMed1991

Antenatal and perinatal care in southern Italy. II. The clinicians' reactions.

One hundred obstetricians and 50 paediatricians engaged in public antenatal and perinatal care in southern Italy were interviewed about the provision of care in their facilities: 93% of the obstetricians judged the coverage of the target population to be insufficient and 53% of them considered the use of the risk approach to be unsatisfactory in public clinics. For example, no initiative was taken by 60% of public clinics when a woman at high risk failed to attend a booked antenatal visit. Bed rest during labour was prescribed by 72% of the obstetricians, a supporting relative was admitted to only 18% of the births and routine episiotomy was performed in 77% of primigravidae. Only 56% of the paediatricians interviewed allowed early contact between mother and baby. In public hospitals, 80% of paediatricians were present in the delivery room for the births. Screening for congenital hypothyroidism and phenylketonuria was executed in only 37% of the public hospitals. Newborn transport system adequate to national standards was available in only 33% of the hospitals. Antenatal and perinatal care need to be rapidly improved to meet population needs in southern Italy.

Attitude of Health Personnel↗
PubMed1991

In vitro inhibition by defibrotide of monocyte superoxide anion generation: a possible mechanism for the antithrombotic effect of a polydeoxyribonucleotide-derived drug.

In an attempt to elucidate the antithrombotic potential of defibrotide (D) we have evaluated several functions of monocytes from 7 healthy subjects before and after in vitro incubation of the cells with increasing concentrations of this drug. At concentrations as high as 40 micrograms/ml, D hardly affected the expression of both the procoagulant activity of monocytes and the formation of superoxide anion in response to 1 mg/ml zymosan (STZ). In contrast, at concentrations that may be achieved in vivo following the administration of the drug (5-20 micrograms/ml), D impaired in a dose-dependent manner (p less than 0.05) the generation of O-2 in response to N-formyl-L-methionyl-L-leucyl-L-phenylalanine (FMLP, 1 microM) or calcium ionophore A23187 (10 microM). Regardless of the agonist employed, at concentrations between 1 and 5 mM, extracellular Ca2+ had little effect on the impairment of superoxide anion generation by D. In contrast, the inhibitory effect was time-dependent, the maximum impairment (greater than 30%) being observed when the cells were preincubated with the drug for 20 h. These data support the concept that the antithrombotic potential of D involves the ability of the drug to affect the generation of free radicals by leukocytes and suggest that future in vivo studies for the evaluation of the activity of D should take into account the role of monocytes in hemostasis and thrombosis.

Adult↗
PubMed1991

Snorting benzodiazepines.

Two cases of intranasal benzodiazepine use are presented. The methods of preparation and administration of the powder and accounts of the pharmacological effects of the drugs used are described. The pattern of development and progress of the habit and its associated features are delineated. Snorting benzodiazepines appears to be more common than is currently appreciated, and the clinical complications and implications of this habit are discussed.

Administration, Intranasal↗
PubMed1991

[24-hour blood pressure: effects of sports in aged subjects].

The present study deals with the blood pressure (BP) and heart rate (HR) 24-h pattern in aged people of both sexes ranging in age from 66 to 75 years. 20 subjects were active in agonistic sports (running and swimming), 20 others had sedentary habits. BP and HR were studied by non-invasive monitoring along with chronobiometric analysis. The BP and HR 24-h pattern was seen to preserve its circadian rhythm in both aged athletes and sedentary elderly. The analysis reveals that the aged athletes show a higher mesor for systolic BP and a lower mesor for diastolic BP and HR. The daily pressure load, as the integral of the BP 24-h values multiplied by the HR mesor, is lower in aged people practising sport as compared to age-matched individuals with sedentary habits. The spectral analysis reveals that physical exercise acts to change the time structure of BP and HR 24-h patterns. The conclusion is drawn that active sport plays beneficial effects in aged people because of a lower pressure load.

Aged↗
PubMed1991

[Bidimensional echocardiographic images of extracardiac tumors. Detection of mediastinal masses by the bidimensional echocardiographic Doppler technique].

A mediastinal tumor might mimic tricuspid stenosis, pulmonary stenosis, constrictive pericarditis, producing symptoms and signs of a cardiologic illness. We report 2 cases of mediastinal masses (1 lymphoma and 1 pulmonary cancer) localized in the anterior mediastinum and compressing the cardiac silhouette. Bidimensional echocardiography and Doppler were used to differentiate masses of cardiac origin from extracardiac origin and to study the hemodynamic alterations; moreover these techniques allow to evaluate the efficacy of therapy.

Adult↗