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Biomedical subjects

A Giunta

Publications and source records attributed to A Giunta.

121 records · Page 7Linked to original sources
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Cardiac hypertrophy in the absence of pressure overload: an experimental and clinical report.

A stimulated altitude of 7000 m was applied in rats chronically exposed to hypoxia in a hypobaric chamber. In these experimental conditions the contralateral ventricle not exposed to pressure overload (that is, the left) showed a significant degree of hypertrophy. The hypoxic stimulus did not affect systemic artery pressure or the heart rate. Chronic adrenergic stimulation performed in the rat treated with low doses of isoprenaline (a direct stimulating adrenergic drug) or with tyramine (primarily a releaser of endogenous catecholamines) induced hypertrophy of the right ventricle, left ventricle, and interventricular septum without modifying the haemodynamic parameters mentioned above. The development of ventricular hypertrophy in the absence of pressure overload is stressed. A role for neurohumoral factors (that is, adrenergic stimulation and catecholamines) in the development of ventricular hypertrophy is suggested.

Animals↗
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Failure of ursodeoxycholic acid to dissolve radiolucent gallstones in patients with cystic fibrosis.

Ursodeoxycholic acid has been used widely to dissolve cholesterol gallstones and more recently was shown to improve clinical symptoms and biochemical indices in different chronic liver diseases, including that associated with cystic fibrosis. We treated 10 cystic fibrosis patients (5 males, 5 females, age range 2-22 years) with pancreatic insufficiency and normal liver function with ursodeoxycholic acid 15-20 mg/kg/day. Seven patients had radiolucent gallstones (in 3 cases associated with biliary sludge) and 3 had sludge; all were asymptomatic. Before treatment, the gallbladder was well opacified in oral cholecystogram. The gallbladder was scanned by ultrasound in similar conditions and by the same operator before administration of ursodeoxycholic acid and after a median period of treatment of 16 months (range 11-32 months). During treatment, all patients remained asymptomatic and the relative proportion of ursodeoxycholic acid in duodenal bile increased from 4.7 +/- 3.2% at baseline to 34.7 +/- 8.6%. Complete or partial dissolution of gallstones was never observed and the maximum diameter of stones increased from a mean of 6.1 +/- 3.4 to 8.0 +/- 5.3 mm; in one case the development of biliary sludge occurred during bile acid therapy. Sludge disappeared in 1 of the 6 patients who initially had it, while in 2 cases its volume increased. We conclude that ursodeoxycholic acid is not effective in most CF patients with gallstones, probably because cholesterol is not the main component of stone or sludge.

Adolescent↗
PubMedDate not supplied

[Italian Cystic Fibrosis Registry: 10 years of activity].

Cystic Fibrosis (CF) is a recessive autosomic genetic disease with an incidence in mediterranean countries of about 1:3500 born alive. In Italy the considerable genetic variability makes it difficult to identify all the homozygous subjects and, consequently, to estimate the incidence of the disease in healthy carriers. The disease is evolutive and affects various systems, most of all the respiratory and gastrointestinal systems. Not many years ago, when the clinical definition of CF was first introduced, average survival did not exceed the pediatric age. Nowadays with ever advancing diagnostic and therapeutical techniques many CF patients survive until an adult age. It is therefore necessary to plan adequate health service interventions so as to satisfy as much as possible the needs of both the patients and their families. To this end data collected since 1.1.1988 by the Italian registry for CF (year of birth, sex, region of birth and residence, diagnosis procedures, results of sweat test, pancreatic insufficiency, DNA analysis, status: alive, dead, lost to follow up) of all the patients, diagnosed in the 18 Reference Centres and the 3 local Centres for CF, have proved to be extremely useful. Since the birth of the Registry on 31.12.1997, data relating to 2458 patients alive on 1.1.1988 and 1159 born during the last ten years, for a total of 3617 subjects (1756 females and 1861 males), have been recorded. As already mentioned a considerable increase in life expectancy of CF patients (from 1988 to 1990 the average age of death was 14 years, from 1994 to 1997 it was 19) and a consequent increase in the percentage of adult patients have been observed.

Adolescent↗
PubMedDate not supplied

The steatocrit: a simple method for monitoring fat malabsorption in patients with cystic fibrosis.

Steatocrit was determined through microcentrifugation of fecal homogenate from 110 pediatric controls and 107 patients with cystic fibrosis (CF). For 74 CF patients, steatocrit was determined in the same fecal material collected to determine a fat balance. In controls, steatocrit value was 0.7 +/- 1.0%, which was significantly lower than values found in CF patients with a coefficient of fat excretion less than 10% of intake (1.7 +/- 1.2%). Significantly increased values were found in CF patients with a coefficient of fat excretion ranging between 10 and 25% of intake (4.7 +/- 1.7%) and in those whose coefficient of fat excretion was greater than 25% of intake (11.3 +/- 4.3%). In the 74 CF patients, steatocrit was directly correlated to the coefficient of fat excretion (r = 0.93; P less than 0.001). We performed steatocrit several times in the course of the 1st year of life in 33 infants with CF diagnosed by means of CF screening. Values obtained at the time of diagnosis, before starting enzymatic therapy, were relatively high; they showed a progressive decrease when, using steatocrit as a guide, the dose of pancreatic enzymes had been increased. The normalization of steatocrit values was accompanied by a better growth rate in the majority of these infants, confirming the importance of an optimal early correction of pancreatic insufficiency. We propose that this simple semiquantitative test can be usefully performed for the frequent monitoring of fat absorption and for checking the response to enzymatic therapy in patients with CF.

Adolescent↗
PubMedDate not supplied

Renal function in cystic fibrosis.

The effect of saline extracellular volume expansion (4 ml/min/10 kg b.w. X 60 min) on renal function has been studied in patients with cystic fibrosis (CF) and in normal age-matched controls. Basal values for glomerular filtration rate (GFR), renal plasma flow (RPF), tubular sodium and chloride (Na, Cl) handling were similar in both groups. Saline expansion resulted in an increase in GFR and RPF in the CF patients: 127 +/- 18 ml/min/1.73 sqm BSA to 166 +/- 5; p less than 0.001, but not in the control group: 112 +/- 10 to 120 +/- 20. These hemodynamic changes were associated with increased proximal tubular reabsorption of NaCl in the CF patients whereas controls had reduced NaCl reabsorption. Renin and aldosterone levels suggested that increased NaCl reabsorption in CF patients was not secondary to chronic extracellular volume contraction or salt loss. These results support the hypothesis that the renal tubule is involved in the generalised electrolyte transport disorder exhibited in other epithelial structures. This study also indicated that the regulation of renal hemodynamics is altered in CF. The relationship between the disorder of proximal tubular salt handling and changes in renal hemodynamics is not known, but the observed changes imply a tubulo-glomerular feedback mechanism.

Absorption↗