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Biomedical subjects

C Ferri

Publications and source records attributed to C Ferri.

At least 199 records · Page 11Linked to original sources
PubMed1992

Insulin resistance and essential hypertension: pathophysiologic and therapeutic implications.

PURPOSE: Essential hypertension is often accompanied by metabolic abnormalities, which commonly include insulin resistance. In this paper we review data on the effects of different antihypertensive drugs on insulin resistance. DATA ANALYSIS: A number of reports have described a frequent association between hyperinsulinemia, hypertension and obesity. In epidemiological surveys, increased insulin concentrations have been seen in hypertensives and have been correlated with cardiovascular risk. Although the impact of antihypertensive therapy on glucose and lipid metabolism has been widely studied, few researchers have investigated the effects of different antihypertensive drugs on insulin resistance. An analysis of available data from controlled studies has shown that the use of thiazides is correlated with a decrease in insulin sensitivity. Pollare and co-workers tested insulin sensitivity by using the glucose-clamp technique in hypertensive patients, and found a 21% decrease in insulin sensitivity during atenolol treatment. Similar findings have been described with metoprolol. In contrast, calcium antagonists do not alter insulin resistance and/or sensitivity. At present, angiotensin converting enzyme (ACE) inhibitors seem to be the only drugs able to improve insulin sensitivity. CONCLUSIONS: ACE inhibitors may improve insulin-dependent glucose uptake, thus leading to a reduction in insulin concentrations. Calcium antagonists appear to preserve insulin sensitivity. Since insulin resistance may be an additional risk factor for cerebral and vascular disease, these drugs may be particularly useful in insulin-resistant hypertensives.

Antihypertensive Agents↗
PubMed1992

[Behavior of the lithium excretion fraction in hypertensive patients during variations of sodium intake].

Fractional excretion of lithium (FeLi) is a marker of proximal tubular sodium reabsorption. During different sodium intakes (normal = 120 mEq/day, low = 40 mEq/day and high = 240 mEq/day) fractional lithium excretion was evaluated in essential hypertensive patients (n. 19) and control subjects (n. 5). Our data showed that FeLi was higher in hypertensives than in controls. Dividing hypertensives on the basis of blood-pressure sensitivity, salt resistant patients showed lower FeLi levels as compared to salt sensitive ones. Our findings indicate that proximal tubular sodium reabsorption is decreased in essential hypertension; this behavior is particularly evident in salt sensitive patients, suggesting that factors affecting proximal tubular function are activated in these patients in order to reduce the impairment of renal excretory capability.

Adult↗
PubMed1991

Antibodies to hepatitis C virus in patients with mixed cryoglobulinemia.

The prevalence of antibodies to hepatitis C virus (HCVAb) was investigated in 52 unselected patients with mixed cryoglobulinemia and in 84 patients with other systemic immunologic diseases. HCVAb were detected by an enzyme-linked immunosorbent assay, and their specificity was evaluated by a recombinant-based immunoblot assay. The presence of HBV-related markers was investigated in the same samples. HCVAb were found in 54% of mixed cryoglobulinemia patients, and the finding was confirmed by recombinant-based immunoblot assay in all cases. HCVAb and/or HBV markers were present in 70% of the patients. HCVAb seropositivity was significantly more frequent in mixed cryoglobulinemia patients with biopsy-proven liver involvement (P less than 0.01) and with increased serum transaminase levels (P less than 0.01). HCVAb were virtually absent in control patients with other immunologic diseases. These results support the notion that viral agents, i.e., HCV and possibly HBV, have a role in the pathogenesis of mixed cryoglobulinemia patients.

Adult↗
PubMed1991

Transitional cell carcinoma of the upper urinary tract: evaluation of prognostic factors by histopathology and flow cytometric analysis.

Prognostic factors in transitional cell carcinoma of the upper urinary tract were assessed with histopathological examination and flow cytometric analysis in a series of 127 patients operated upon between 1976 and 1988. In particular, we evaluated the usefulness of flow cytometry to identify patients who require adjuvant treatment among those with low grade and low stage disease (51% in this series). A multivariate analysis was done on 92 cases, considering patient age and sex, stage, grade and number of lesions (unifocal versus multifocal), site (renal pelvis versus ureter), presence of vesical tumors, recurrences along the urinary tract or in the bladder, type of operation and nuclear deoxyribonucleic acid (DNA) ploidy (diploid versus tetraploid/aneuploid tumors). Only the stage (p = 0.001), grade (p = 0.001) and, to a lesser extent, the DNA pattern (p = 0.031), as well as the number of lesions (p = 0.061) were determinant for prognosis. In regard to the subgroup of 41 patients with grade 2 or less, stage P1 or less tumors, no significant difference in survival was demonstrated between diploid and nondiploid tumor patients. However, 7 of 10 patients from the latter group are still under observation. Therefore, our conclusions may have to be modified in the future.

Adult↗
PubMed1991

Does mild autonomic neuropathy affect atrial natriuretic factor regulation in diabetic hypertensive patients?

The effect of postural changes on plasma atrial natriuretic factor (ANF) levels was investigated in 16 diabetic hypertensives (eight with and eight without mild autonomic neuropathy) and in 10 hypertensives. The presence of renal damage or secondary hypertension was excluded. All diabetic patients were in good metabolic control. In upright position, the mean levels of plasma ANF were of 23.1 +/- 7.6 pg/mL in neuropathic diabetic hypertensives, 24.2 +/- 8.3 pg/mL in diabetic hypertensives, and 21.6 +/- 6.7 in essential hypertensives. Percentage decrease observed after the assumption of supine position was 47 +/- 18, 50 +/- 10, and 46 +/- 13, respectively. No significant difference was found between hypertensives and diabetic hypertensives, even in the presence of mild autonomic neuropathy. Plasma ANF response to postural changes was similar in all groups.

Adult↗
PubMed1991

Plasma insulin levels do not change during atrial natriuretic factor infusion in human essential hypertensives.

In order to evaluate the effects of atrial natriuretic factor (ANF) infusion on plasma insulin (IRI) in hypertension, 32 essential hypertensives (aged 40 to 62 years) were studied. After 1 week of pharmacologic washout under normal sodium intake (120 mEq of Na+/day), patients were randomly assigned to receive either ANF (0.04 micrograms/kg/min) or its vehicle (50 mL of isotonic saline) over a 60-min period in supine position. Plasma IRI and glucose were measured at -60, 0, 20, 40, 60, 120, 180, and 240 min (infusion time: from 0 to 60 min). Plasma levels of IRI and glucose did not change significantly during ANF infusion. On the contrary, after ANF discontinuation plasma IRI rose from levels of 13.5 +/- 6.4 microU/mL at 60 min to values of 20.1 +/- 11.3 microU/mL at 240 min (P less than .0001 v time 0). Plasma glucose showed a similar behavior, increasing from values of 100.4 +/- 5.0 mg/dL at 60 min to values of 120.0 +/- 5.1 mg/dL at 240 min (P less than .02 v time 0). Our findings suggest that ANF did not influence insulin release in hypertensives. The increase of plasma glucose and IRI observed after ANF discontinuation could be due to the relapse of sympathetic activity, suppressed during ANF infusion.

Adult↗
PubMed1991

Blood-brain-barrier in a geriatric population: barrier function in degenerative and vascular dementias.

Albumin and IgG were determined in serum and cerebrospinal fluid (CSF) of patients with early-onset Alzheimer's disease (AD, n. 13), senile dementia of Alzheimer type (SDAT, n. 33), vascular dementia divided into multi-infarct (MID, n. 9) and probable vascular (PVD, n. 11) dementia. Albumin and IgG ratio and IgG index were calculated. CSF albumin and albumin ratio were significantly higher in MID patients indicating an increased BBB permeability. IgG ratio and IgG index did not show any significant difference among groups. These results do not provide evidence for BBB damage in AD/SDAT, while in MID the increase of CSF albumin and albumin ratio is suggestive of BBB dysfunction.

Aged↗
PubMed1991

Cutaneous and serologic subsets of systemic sclerosis.

The relevance of the extent of skin sclerosis and of other clinicoserological features in diagnosis, severity and prognosis of disease was studied in a large number of unselected patients with systemic sclerosis (SSc). One hundred and fifty-one patients with SSc (126 F and 25 M, mean age 48 +/- 14 SD) followed for 5.3 +/- 3.2 years were included. Patients were divided into 3 cutaneous subsets: limited (68), intermediate (46) and diffuse SSc (37). Serological markers were detected in 288 patients with Raynaud's phenomenon and other connective tissue diseases (CTD). Limited and intermediate SSC prevailed in female patients while the diffuse subset was more frequent in males (p less than 0.0001). Duration of Raynaud's phenomenon before disease onset was shorter in the diffuse variant (p less than 0.0001). A wider cutaneous involvement was associated with more severe forms of SSc. Diffuse subset showed the poorest prognosis at 10 years of followup compared with intermediate (p less than 0.05) and limited variant (p less than 0.001). Intermediate SSc seems a distinct variant of SSc on the basis of clinical manifestations and survival. Among serological markers, anticentromere, anti-Scl-70 and antinucleolar antibodies were found in 21, 40 and 27% of the cases, respectively; these were statistically less frequent (p less than 0.0001) in other CTD. In 83.5% of patients with SSc at least one of these specific markers was recorded. Anticentromere antibodies were correlated to sex (female), limited SSc, calcinosis and telangiectasia. On the contrary anti-Scl-70 was associated with diffuse and intermediate subsets and with more severe SSc manifestations.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Effects of nicardipine in hypertensive patients with chronic kidney insufficiency].

There has been a increasing awareness that calcium antagonists may have beneficial effects on the kidney. Therefore we evaluated the renal and antihypertensive effects of nicardipine treatment in 12 hypertensive patients with chronic renal failure. The drug was given at a dose of 20 mg three times a day. Blood pressure was normalized in almost all cases while the indexes of renal function were improved. A transient deterioration of renal function, probably due to reduction of glomerular capillary pressure was observed in some cases. In conclusion, our data showed a beneficial effect on renal function during nicardipine therapy. This effect could be absent in the most advanced degree of renal damage.

Adult↗
PubMed1990

Plasma atrial natriuretic peptide in young normotensive subjects with a family history of hypertension and in young hypertensive patients.

Plasma atrial natriuretic peptide (ANP) behavior was evaluated in 26 untreated essential hypertensives, 21 normotensives, and 20 normotensives with hypertensive heredity under normal sodium intake (120 mEq of Na+/day). All subjects were men, mean age 22.1 +/- 1.9 years. Plasma ANP was evaluated by radioimmunoassay on samples collected in supine position upon waking and again after 1 h of orthostatism. Resulting data showed that ANP in hypertensives (supine = 44.5 +/- 19.4 pg/mL, orthostatism = 24.1 +/- 11.6 pg/mL) was at higher levels than in controls (supine = 38.3 +/- 19.4 pg/mL, orthostatism = 19.9 +/- 10.6 pg/mL) or in normotensives with hypertensive heredity (supine = 42.1 +/- 16.8 pg/mL, orthostatism = 23.2 +/- 10.8 pg/mL). Mean ANP level was higher in the latter group than in the control group (supine = +9%; orthostatism = +14.2%). In conclusion, plasma ANP is raised in young essential hypertensives, resulting in slightly elevated levels in normotensives with hypertensive heredity.

Adult↗
PubMed1990

[Nitrendipine: evaluation of the duration of the antihypertensive effect at different doses using the conventional method and ambulatory monitoring of arterial pressure].

To evaluate the effect-duration of nitrendipine in 20 moderate essential hypertensives (aged from 42 to 66, mean +/- SD: 55 +/- 7) when treated with 20 mg once or twice a day, we utilized the blood pressure standard method of measurement and the ambulatory monitoring. Blood pressure determinations were made during the follow-up at 2- week intervals for 3 months, each measurement being made with a mercury sphygmomanometer, 24 +/- 3 hours after the last dose; laboratory parameters, 2 24-hour blood pressure monitoring (ICR 5200, Spacelabs) and standard ECG were performed at baseline and after 3 months. Following a 2-week run-in period with placebo bid (at 10.00 am and 10.00 pm) a 20 mg morning dose of nitrendipine was started continuing the administration of the placebo tablet at 10.00 pm. The dosage was changed to a twice active daily regimen, with an increase in the daily dose (20 mg twice a day) in those patients whose diastolic blood pressure remained greater than 90 mmHg after a 4-week control. After the twelfth week, another 2-week placebo run-in followed the active treatment. Supine blood pressure recorded after 3-month therapy, showed a significant (p less than 0.0001) reduction in both systolic and diastolic mean values (22/15 mmHg) at the end of active treatment in the 16 patients who ended the trial. In particular, the responders to 20 mg (5 patients) showed a blood pressure reduction of 18 mmHg in comparison with the run-in period; in the other group of responders to increasing dosage of 40 mg (11 patients), we observed a 8 mmHg diastolic blood pressure reduction at 28 days and a successive 7 mmHg at the end of the treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

[Atrial natriuretic factor: an epidemiological study. Preliminary results].

We performed an epidemiological study on the atrial natriuretic factor pattern in a young population. Subjects were recruited in the Ospedale Militare Principale of Rome among young men liable to conscription, whose hospitalization was due either to essential hypertension or to other pathologies (not influencing our study, such as headache etc.). The recruitment lead to the formation of three different groups: normotensives, normotensives with family history of hypertension (mother and/or father) and hypertensives. On the morning of the study (after 7 days of pharmacological wash-out, under a diet containing 120 mEq of Na+/die), blood samples were taken. Plasma atrial natriuretic factor, renin activity and aldosterone were assayed by RIA. Digoxin-like immunoreactive substance was assayed by a solid-phase radioimmunoassay, following the extraction of plasma. Serum creatinine, sodium, potassium and urinary sodium and potassium (24 h before the study) were assayed by standard methods. Urinary kallikrein was assayed by chromogenic substrate S-2266. So far, we have studied 60 subjects (26 hypertensives, 21 normotensives and 13 normotensives with family history) and we wish to discuss in this article the preliminary results concerning the atrial natriuretic factor and its relationship with renin activity, aldosterone and blood pressure. Our results show that the mean plasma levels of atrial natriuretic factor in the hypertensive group were higher, although not significantly, than those of the other two groups and that the normotensives with family history had slightly higher levels as compared to normotensives (Delta % = + 7.4).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Lung function in essential mixed cryoglobulinemia: a short-term follow-up.

Lung involvement in essential mixed cryoglobulinemia (EMC) has been recently described. In order to assess whether patients with EMC experience an accelerated deterioration of lung function, nineteen patients (17 females, 2 males; 49.6 +/- 6.6 years) underwent a short-term follow-up of lung function, chest X-ray and serologic investigations. Reduction of forced expiratory flows and presence of roentgenologic signs of interstitial involvement were confirmed in the baseline evaluation. In addition, a decrease of diffusing capacity was shown. After a mean interval of 15 months, no significant change in lung function was found, with the exception of decrease in maximal expiratory flow at 50% of forced vital capacity, total lung capacity, functional residual capacity, coefficient of transfer of CO. A slight decrease of hemolitic complement (CH50) and of complement fraction (C3) was also observed. This study suggests that patients with EMC tend to have an involvement of pulmonary interstitial space, possibly related to immune complex deposition, but they do not show a severe decline of lung function. Periodical assessment of lung function and chest X-ray is, however, worthwhile.

Adult↗
PubMed1989

Low-antigen-content diet in the treatment of patients with mixed cryoglobulinemia.

PURPOSE: The effects of a low-antigen-content diet (LAC diet) versus a standard normocaloric diet on the signs and symptoms of mixed cryoglobulinemia (MC) were compared in a crossover randomized study. PATIENTS AND METHODS: The study consisted of 24 outpatients with MC, and was carried out in a 48-week period. After 18 weeks of either the LAC or the placebo diet, patients returned to a totally unrestricted diet for 12 weeks (washout period) and crossed over to the second half of the study for the other 18 weeks. RESULTS: After three weeks of the restricted LAC diet, the cryocrit decreased from 3.5 +/- 3.4% (mean +/- SD) to 2.3 +/- 2.0% (p less than 0.01), and the circulating immune complex levels decreased from 48 +/- 30% to 39 +/- 34% (p less than 0.01). At the same time, the purpura score (p less than 0.05), glutamic pyruvic transaminase level (p less than 0.01), and gamma glutamyl transferase level (p less than 0.001) significantly improved. Splenic reticuloendothelial function, measured as the half-life of heat-damaged autologous red cells, decreased from 41 +/- 21 minutes to 21 +/- 10 minutes (p less than 0.005). In contrast, no significant parallel clinical, biochemical, and immunologic changes occurred in the same patients during the placebo (standard normocaloric) diet. CONCLUSION: These data show that an LAC diet decreases the amount of circulating immune complexes in MC and can modify certain signs and symptoms of the disease. These effects of the LAC diet may be explained by postulating a functional restoration of the mononuclear phagocytic system.

Adult↗