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Biomedical subjects

C Benedetto

Publications and source records attributed to C Benedetto.

At least 55 records · Page 3Linked to original sources
PubMed1997

24-hour blood pressure monitoring to evaluate the effects of nifedipine in pre-eclampsia and in chronic hypertension in pregnancy.

OBJECTIVE: To investigate the effect of 7 to 14 days of therapy with nifedipine (sustained-release preparation) on the 24-hour blood pressure patterns of pregnant women with pre-eclampsia or chronic hypertension, and to test the utility of blood pressure monitoring in modulating the timing and dosage of the drug. DESIGN: 24-hour automatic blood pressure monitoring of pregnant women with pre-eclampsia or chronic hypertension before and after nifedipine treatment. SETTING: Centre for Prevention, Diagnosis and Treatment of Hypertension in Pregnancy, University of Turin, Italy. POPULATION: Sixteen pregnant women with pre-eclampsia and 17 with chronic hypertension. METHODS: 24-hour blood pressure monitoring was performed before the beginning of the therapy and after 7 to 14 days of treatment with sustained-release nifedipine. MAIN OUTCOME MEASURES: Chronobiological analysis of systolic and diastolic blood pressure values was performed; MESOR, amplitude, acrophase, hyperbaric index, percent time elevation and significance of rhythm were calculated before and after treatment. RESULTS: 6336 blood pressure measurements were analysed. Systolic and diastolic MESOR values were significantly decreased after nifedipine treatment both in pre-eclampsia and in chronic hypertension. However, the antihypertensive effect of nifedipine in pre-eclampsia was especially pronounced during evening and night, while in chronic hypertension it was more constant during the 24-hour period. 24-hour blood pressure monitoring allowed adjustment, when necessary, to the timing and dosage of nifedipine in accordance with the blood pressure patterns of each patient, using the hyperbaric index and percent time elevation as objective parameters for the evaluation of treatment efficacy. CONCLUSIONS: 24-hour blood pressure monitoring is a good method to optimise treatment, and confirms that nifedipine is useful for the control of maternal blood pressure in pregnancy.

Adult↗
PubMed1997

Pathophysiological aspects of menstrual migraine.

We review the role of several biochemical and hormonal factors in menstrual migraine pathogenesis: ovarian hormones, aldosterone circadian rhythm, nocturnal urinary melatonin excretion, sympathetic autonomic system, prolactin levels and dopaminergic function, endogenous opioid tonus, platelet activity and arachidonic acid metabolites. In particular, we focus on certain aspects of platelet function and prostaglandin metabolism, taking into consideration the different behavior of platelet sensitivity to prostacyclin, intraplatelet 5HT, peripheral plasma concentrations of 6-keto-PGF1alpha and PGE2 in menstrual migraine sufferers and in control subjects during the menstrual cycle. A comprehensive view of the data suggests that a complex impairment of PG and 5HT metabolism, and of platelet function, may play a significant role in the pathogenesis of menstrual migraine. However, it is not yet clear whether these alterations are primary or secondary to neuroendocrine disorders.

Blood Platelets↗
PubMed1997

Patterns of platelet aggregation in menstrual migraine.

We investigated the threshold of the platelet release reaction during the luteal phase of the cycle in 46 patients suffering from menstrual migraine (MM) and 27 healthy normal women. The distribution in both groups of the three types of aggregometric curves (types 1, 2 or 3) obtained in response to ADP 1 microM as aggregating agent was evaluated. Among MM sufferers, 19 (41%) showed a type 1 curve, while 14 (31%) had a type 2 curve and 13 (28%) showed an irreversible aggregation with a type 3 pattern. Curve distribution in controls was 18 (67%) for type 1, 8 (30%) for type 2 and 1 (3%) for type 3. A significantly (p < 0.05) different distribution of the three curve types between MM and controls was present, suggesting that a secondary wave of aggregation is more frequent in MM; the highest difference was due to the observed frequencies of type 3 curves.

Adult↗
PubMed1997

Changes of dimeric inhibin B levels in maternal serum throughout healthy gestation and in women with gestational diseases.

Human placenta expresses subunit messenger RNAs for synthesizing inhibin A and B. Experimental studies have shown an effect of inhibins on placental hormone secretion, but an endocrine function is suggested by the high levels in maternal circulation. Although information is available on the changes of inhibin A in serum of healthy pregnant women, data on inhibin B levels are limited to early gestation. The aim of the present study was to investigate the changes of inhibin B levels in maternal circulation in healthy pregnant women throughout gestation, and to evaluate whether early pregnancy disturbances or gestational diseases are characterized by abnormal inhibin B levels. The protocol included various groups of pregnant women. A longitudinal evaluation of serum inhibin B levels was done at specific intervals (8-12, 13-18, 19-24, 25-28, 29-33, and 34-40 weeks) in the following groups: 1) healthy pregnant women (n = 13); 2) women at risk of hypertension who did not develop hypertension (n = 8); and 3) women with chronic hypertension (n = 13). In women in group 1, a blood sample was also obtained in the postpartum period (12, 24, and 48 h after delivery). Other pregnant women with abnormal bleeding in the first trimester were studied; they were subdivided into women with ongoing pregnancy (n = 12); and women with miscarriage (n = 22); a control group of healthy pregnant women at the same gestational age was also included (n = 18). A final group of women with gestational diseases (n = 34) was included in the study and included women with: 1) pregnancy-induced hypertension (n = 10); 2) preeclampsia (n = 17); and 3) intrauterine fetal growth retardation (n = 7). A group of healthy nonpregnant women (n = 9) was used as controls, and a blood specimen was collected during both the early- to midfollicular and midluteal phases of the menstrual cycle. Serum dimeric inhibin B levels were measured by using a double-antibody enzyme-linked immunoadsorbent assay. Early gestation inhibin B levels were similar to those of nonpregnant controls and showed a significant rise during the third trimester (P < 0.01). The highest maternal serum inhibin B levels were found at term (P < 0.01). Values significantly returned to control levels within 12-48 h (P < 0.01) after placental delivery. Women at risk of hypertension showed a similar gestational-related increase of inhibin B levels during the third trimester, without any significant difference when compared with healthy women. Women with chronic hypertension showed significantly lower levels at term (P < 0.01). Women with pregnancy-induced hypertension or preeclampsia, or who were carrying a fetus with intrauterine growth retardation showed serum inhibin B levels during the third trimester of gestation consistently lower than in control healthy women at the same gestational age (P < 0.001, mean +/- SEM). Maternal serum inhibin B levels in women with early pregnancy bleeding or miscarriage were similar to those of healthy pregnant women at the same gestational age, independent from the outcome of gestation. The present study showed that maternal serum inhibin B levels increase in the last trimester of normal pregnancy, with low levels in women with hypertensive disturbances or intrauterine growth retardation.

Adult↗
PubMed1997

[Prosthetic repair of inguino-crural hernia using Rives technique].

The authors report their experience with Rives procedure, a prosthetic repair of groin hernias using preperitoneal sutured mesh by parainguinal access. This operation is not technically easy to perform and is usually done out of necessity in cases with higher risk of recurrence because of systemic factors of chronic abdominal high pressure and/or of local factors of risk, when there are contraindications to operations like Stoppa procedure. Our series report 38 patients operated upon on 5 years, with incidence of 5.8% overall hernias repaired in the same period. 33 are males, 5 females, with average age of 60.5 years. Mean time required for the operation is 94 minutes (range 55'-130'). About postoperative complications we complain of one testicular atrophy, but none infections. Follow-up range is 9-50 months (average 23.2 months) for 30 patients operated more than one year ago. All but one were revisited after almost 12 months. No recurrences were detected.

Adult↗
PubMed1997

[Stoppa's intervention. The complications nd results].

The authors report their experience with the giant prosthetic reinforcement of the visceral sac (Stoppa procedure), developed in the last 6 years operating 126 cases. Postoperative period was regular for two third of the patients, but only in 4 cases we can consider complication severe: 2 cases of preperitoneal haemorrhage with haematoma formation and subsequent recurrence; one sepsis of the preperitoneal space around the prosthesis, cured with drainage and conservative measures without recurrence, and then one peritonitis in a morbid obese individual. There was no mortality. 93.3% of the patients has been clinically controlled after over 6 months (average 27 months; range 6-67 months): 8 recurrences have been observed (3.6% of the hernias operated). 7 required reintervention. Therefore it is possible to affirm that 91% of the operated patients had good results.

Adult↗
PubMed1997

[Squamous carcinoma of the gallbladder. Anatomo-clinical study of a case with reference to oncogene expression].

Squamous cell carcinoma of the gallbladder is a rare tumor with an ill-defined clinical course. We report a case of pure squamous carcinoma of the gallbladder with a rapidly fatal outcome. The tumor cells were positive for oncogenes P53, c-Erb B2 and Ki 67. This feature has no comparison with other reported cases of squamous carcinoma of the gallbladder but it is in accordance with oncogene expression in adenocarcinomas.

Carcinoma, Squamous Cell↗
PubMed1996

Glucocorticoid receptors immunoreactivity in tissue of human embryos.

The exact period when glucocorticoid receptors (GR) appear in human embryos is unknown, however their presence is acknowledged in target tissues before the fetal adrenal cortex secretes cortisol. Determining when GR develop could serve as an index of the importance of glucocorticoids in the morphological and functional development of tissues. The aim of this study was to determine time of onset of GR in human tissues using an immunohistochemical method. Results indicate GR are present in tissues of 8-10-week-old human embryos: in most tissues, the immune reaction was only or predominantly nuclear.

Embryo, Mammalian↗
PubMed1996

Blood pressure patterns in normal pregnancy and in pregnancy-induced hypertension, preeclampsia, and chronic hypertension.

OBJECTIVE: To compare the 24-hour blood pressure (BP) pattern in physiologic pregnancy, pregnancy-induced hypertension, preeclampsia, and chronic hypertension. METHODS: We investigated four groups of women with singleton pregnancy: 73 controls, 48 patients with pregnancy-induced hypertension, 38 with preeclampsia, and 53 with mild to moderate chronic hypertension. The 24-hour BP monitoring was performed longitudinally in controls and in patients with chronic hypertension, and at the time of diagnosis in those with pregnancy-induced hypertension or preeclampsia. RESULTS: Nineteen thousand eight hundred seventy-two BP measurements were analyzed. In controls, the mean values of BP indices were lower than those first reported in nonpregnant women, and the acrophase was always localized in the first part of the afternoon. In pregnancy-induced hypertension and especially in preeclampsia, besides the obvious quantitative increase in BP, circadian BP oscillations were less pronounced than in controls, and the severity of hypertension seemed to favor the loss of diurnal rhythm. Conversely, in chronic hypertension, circadian oscillations were the same as in controls. CONCLUSION: Standardized 24-hour BP monitoring during pregnancy allows quantitative and qualitative evaluations of the hypertensive status. However, if such a technique is used routinely in every clinical setting, we should establish specific thresholds of normality for pregnancy.

Adult↗
PubMed1996

Risk factors for pregnancy-induced hypertension in women at high risk for the condition. Italian Study of Aspirin in Pregnancy Group.

To analyze determinants of the risk of pregnancy-induced hypertension (PIH) with or without proteinuria, we compared characteristics of women enrolled in the Italian Study of Aspirin in Pregnancy who developed PIH and those who did not. A total of 756 women were included in the present analysis; of these, 132 women (17%) developed PIH during the trial. The risk of developing PIH tended to increase with maternal age: in comparison with women age 20-25 years, the odds ratio (OR) estimates of risk ratio were 3.5 [95% confidence interval (CI) = 1.6-7.1] in women age 26-30 years and 4.2 (95% CI = 1.9-8.8) in those age > 30 years. There was little relation between development of PIH and education. PIH risk increased according to nonpregnant body mass index; in comparison with women with Quetelet's index (kg per m2) < 25, the OR estimates were 1.7 (95% CI = 1.1-2.7) and 2.1 (95% CI = 1.3-3.6), respectively, for women with a value for Quetelet's index of > 25-30 and > 30. Parous women were at decreased risk of PIH: in comparison with nulliparas, the ORs were 0.7 (95% CI = 0.4-1.0) and 0.5 (95% CI = 0.3-0.9), respectively, in women reporting 1 or > or = 2 births. There was no important relation between previous spontaneous or induced abortion and PIH risk.

Adult↗
PubMed1996

High levels of corticotropin-releasing factor (CRF) are inversely correlated with low levels of maternal CRF-binding protein in pregnant women with pregnancy-induced hypertension.

Corticotropin-releasing factor-binding protein (CRF-BP) is suggested to play a role in modulating the activity of the hypothalamus-pituitary-adrenal axis during pregnancy, counteracting the actions of circulating or locally acting CRF. The aim of the present study was to evaluate whether maternal levels of CRF-BP and CRF are modified in pregnant women with a high risk of developing pregnancy-induced hypertension (n = 21). A group of nine patients developed the disease between 25-35 weeks gestation, and sequential blood samples were taken every 5 weeks throughout the pregnancy. As a control group, healthy pregnant women were studied (n = 9) using the same protocol; a group of women with pregnancy-induced hypertension (n = 5) was studied starting from the time of diagnosis. In a subgroup of patients (n = 10), CRF-BP and CRF levels were studied after 5 weeks of antihypertensive treatment. Levels of CRF-BP were determined using a specific RIA, whereas CRF was evaluated by a two-site immunoradiometric assay. In patients at risk, circulating levels of CRF-BP followed the same pattern as that in healthy controls, showing a significant decrease at term (36-40 weeks; P < 0.05). A significant and progressive increase in plasma CRF levels was observed in both groups of pregnant women; the highest values were found at term (P < 0.01). In the nine patients who developed pregnancy-induced hypertension, maternal levels of CRF-BP at the onset of signs and symptoms were lower than control values, and CRF levels were significantly higher at the onset of the disease (P < 0.01). Similarly, in these hypertensive patients studied at the time of hospitalization, CRF-BP levels were lower whereas those of CRF were higher than levels in healthy patients (P < 0.01). No effect of antihypertensive therapy on either CRF-BP or CRF levels was observed. The present study shows an inverse correlation between reduced plasma CRF-BP levels and increased CRF levels in the maternal circulation of patients with pregnancy-induced hypertension, and indicates that these hormonal changes do not occur before the onset of disease, suggesting that the measurement of these polypeptides in maternal plasma does not predict the development of hypertension.

Carrier Proteins↗
PubMed1996

Is pregnancy-related acute renal failure a disappearing clinical entity?

The actual disappearance of pregnancy-related acute renal failure (PR-ARF) is a common "feeling" for nephrologists. The aim of this study was to exactly quantify this event by evaluating epidemiology and the extent of renal damage in PR-ARF. From 1958 to 1994, 84 cases of PR-ARF were observed (5.8% of total number of ARF needing dialysis). In four successive periods (1956-67, 1968-77, 1978-87, 1988-94), the incidence of PR-ARF fell from 43% to 0.5% with respect to the total number of ARF, and from 1/3000 to 1/18,000 with respect to the total number of pregnancies. Maternal mortality in the past was high (31%), but no cases of death in the last period were seen. Irreversible renal damage was recorded in 11.1% of PR-ARF, and, in particular, in 18.7% of cases of preeclampsia-eclampsia (PE-E). The worst maternal and renal prognosis occurred in PE-E that was complicated by abruptio placentae (AP). Neither disseminated intravascular coagulation (DIC), microangiopathic hemolytic anemia, nor prostacyclin imbalance were significantly related to the severity of renal damage. Heparin therapy did not modify DIC evolution and renal outcome and was aggravated by severe hemorragic complications. Support therapy with plasma infusion, antithrombin III, and antiplatelet agents seems to be helpful. In conclusion, PR-ARF has become a rare occurrence and, in our experience, no cases of death or irreversible renal damage were observed in the last 7 years. The most important reasons for this favorable evolution seem to be an improved medical care and more effective measures of careful prevention, mainly regarding tempestive delivery.

Abruptio Placentae↗
PubMed1995

Climacteric symptoms and control of the cycle in women aged 35 years or older taking an oral contraceptive with 0.150 mg desogestrel and 0.020 mg ethinylestradiol.

In a multicenter prospective trial, 58 healthy women aged between 35 and 49 years were studied for one year (639 cycles) while taking an oral contraceptive (OC) containing desogestrel 0.150 mg and ethinylestradiol (EE) 0.020 mg. Efficacy, control of the cycle, side effects, complaints, and climacteric symptoms were monitored after 3, 6, 9 and 12 cycles. No pregnancies occurred during the study period. Spotting gradually decreased from 29.3% in cycle 1 to 4.2% in cycle 12, while breakthrough bleeding (BTB) disappeared after cycle 7. One case of superficial thrombophlebitis and 3 cases of minor side effects were registered. With regard to the complaints, breast tenderness, headache, and depression gradually decreased during the study (basal vs. 12-month data: 50.9% vs. 31.2%, 48.3% vs. 18.7%, 39.6% vs. 20.8%, respectively), while nausea disappeared after three months. A significant treatment-dependent reduction of climacteric symptoms was obtained after cycle 3 and this tendency was maintained up to cycle 12. No changes were registered in body mass index (BMI) or blood pressure.

Adult↗
PubMed1995

Hypertension in pregnancy: changes in activin A maternal serum concentration.

Human placenta is the major source of activin A in maternal circulation. The aim of the present study was to evaluate maternal activin A serum concentration in pregnant women with chronic hypertension (n = 14), pregnancy-induced hypertension (n = 10) or pre-eclampsia (n = 16). In the group of pregnant women with chronic hypertension and of healthy pregnant women (n = 10) activin A was measured in samples collected longitudinally throughout gestation. Using a specific two-site enzyme-linked immunosorbent assay, it has been possible to measure maternal serum activin A concentration. In addition, the effect of recombinant human activin A administration on mean arterial pressure and heart rate in female rats have been also investigated. Mean +/- SEM of maternal serum activin A concentration in pre-eclamptic women (57.4 +/- 28.3 ng/ml), was significantly higher than in women with pregnancy-induced hypertension (14.8 +/- 10.5 ng/ml), chronic hypertension (10.3 +/- 5.4 ng/ml) or healthy control women (9.2 +/- 9.4 ng/ml) (P < 0.01). Serum activin A levels evaluated 2 weeks after anti-hypertensive treatment were not significantly different in pre-eclamptic women. Moreover, when exogenous recombinant human activin A was administered in female rats arterial pressure or frequency of heart rate did not change. The present study showed that maternal serum activin A concentration is abnormally high in patients with pre-eclampsia. Thus, since the patients with chronic hypertension or pregnancy-induced hypertension have activin A concentration in the normal range of values, activin A may be a prognostic marker of hypertension in pregnancy.

Activins↗
PubMed1995

Effect of corticotropin-releasing factor-binding protein on prostaglandin release from cultured maternal decidua and on contractile activity of human myometrium in vitro.

Human placenta and uterine tissues are sites of production and local action of corticotropin-releasing factor (CRF). The recent evidence that CRF-binding protein (CRF-BP), a protein that blocks CRF-induced pituitary ACTH release, is produced by placental tissues suggested the present study to investigate the effects of CRF-BP on prostaglandin release and contractile activity of myometrial strips. Primary cultures of decidual cells were prepared using tissue collected from healthy women undergoing cesarean delivery at term. Mechanical and enzymatic cell dispersions were carried out, and experiments were performed 24-28 h after cell plating. The prostaglandin E2 (PGE2) concentration in cultured medium was measured by RIA. Myometrial strips were obtained from the upper edge of the uterine incision during elective cesarean section at term. Dissected free of connective tissue, strips were mounted in a 30-mL two-chamber organ bath containing oxygenated Tyrode's buffer (37 C) and connected to a two-channel isometric smooth muscle transducer. Cultured decidual cells collected at term significantly increased the release of PGE2 in the presence of CRF (P < 0.01). The addition of CRF-BP did not significantly modify PGE2 release, but completely reversed the effect of CRF. When human myometrial strips were incubated in the presence of CRF and PGF2 alpha, a significant increase in contractile activity was observed (P < 0.01); preincubation with CRF-BP prevented the increased contractile activity induced by CRF. The present data show that CRF-BP is able to counteract the biological effect of CRF on human pregnancy endometrium and myometrium and suggest that CRF-BP may be a regulatory protein that plays a role in the local function of uterine tissues during pregnancy.

Animals↗
PubMed1995

[Parapapillary leiomyoma of the second duodenal portion: anatomo-clinical considerations].

The authors describe a rare case of leiomyoma situated in the second duodenal portion near the Vater papillary diagnosed for over eight years. The preoperative investigation isn't able to explain certainly the characteristics and the anatomo-topographic relations of the lesion besides the anatomo-pathologic dates have left a border of uncertainty about the benignity of the lesion. These considerations, as agreed with the greater part of authors, show the necessity of early surgical treatment.

Duodenal Neoplasms↗