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Biomedical subjects

C Fersini

Publications and source records attributed to C Fersini.

At least 37 records · Page 2Linked to original sources
PubMed1994

Emergency admissions of opioid drug abusers for overdose: a chronobiological study of enhanced risk.

STUDY OBJECTIVE: To determine whether there is a specific temporal risk for opioid drug overdose. DESIGN: To study patients presenting to the ED in a comatose state from accidental drug opioid overdose. PARTICIPANTS: Two hundred seventy-four patients were admitted to the ED of the Hospital of Ferrara, Italy, from 1988 to 1990, 225 men (82.1%; mean age, 25 +/- 3.4 years) and 49 women (17.9%; mean age, 23.5 +/- 2.8 years). INTERVENTIONS: Month, day, and hour and minute of admissions were recorded, and time-qualified frequency data were analyzed by the single cosinor method. RESULTS: Cosinor analysis demonstrated a significant circadian rhythm for both the total number of observations and the separate male and female subgroups with an early evening peak ("acrophase") at about 7:00 PM. No significant circannual rhythm was evident, but for the total group a significant 6-month rhythm was demonstrable with peaks in late November and late May. CONCLUSION: There is a distinct "chronorisk" of opioid drug overdose in the early evening hours.

Adult↗
PubMed1994

Circadian variation in the occurrence of fatal pulmonary embolism. Differences depending on sex and age.

Published studies have indicated a circadian variation in the occurrence of several acute cardiovascular events, e.g., myocardial ischemia, myocardial infarction, sudden cardiac death and cardiac arrest. The aim of this study was to determine if there is a circadian variation in the occurrence of fatal pulmonary embolism, and to evaluate possible differences in the temporal pattern in relation to sex and age. 230 cases of fatal pulmonary embolism (74 out-of-hospital and 156 hospitalized) observed in a general hospital over a 9-year period were considered. The total sample was stratified both by sex and into four groups by age including, respectively, subjects aged less than 60 years (group A), between 60 and 69 (group B), between 70 and 79 (group C) and 80 years and over (group D). The data were analyzed by the single cosinor method. A significant morning pattern was found for the total population (p = 0.011), females (p = 0.033), and age subgroups C and D (p = 0.015 and 0.008), with respective acrophases at 11.57, 11.23, 10.54 and 13.24. A morning pattern in the onset of fatal pulmonary embolism is confirmed for the total population, although sex and age seem also to play an important role.

Age Factors↗
PubMed1993

Chronobiological aspects of acute cerebrovascular diseases.

The study was aimed at further investigating the circadian and circannual patterns of stroke onset. Study design and type of participants: 977 strokes (475 in men and 502 in women) concerning 926 subjects (457 men and 469 women) admitted to Ferrara Hospital in two calendar years (1990-1991), were prospectively investigated. The strokes were classified as based on cerebral infarction (CI), transient ischemic attack (TIA) and cerebral hemorrhage (CH: subarachnoid and intracerebral hemorrhage). Two statistical models of analysis were used. The assessment of circadian and circannual periodicity was performed utilizing the single cosinor method. A separate analysis was performed after distribution of events into 6-hour intervals, and chi-square test for fit was applied to the number of observed versus expected cases. The majority of strokes occurred in the morning between 7 a.m. and noon (35% of cases) and the hypothesis of a uniform distribution of the time onset was rejected on the basis of the chi-square for all subtypes of stroke. A circadian rhythm was found for CI and TIA with acrophase at the 11.56 and 12.41 respectively. Also a circannual periodicity was found for CI with a prevalent peak in October. The spectral analysis detected a circadian cycle for CH having a period of 4 h, and a circannual cycle for TIA with a period of 4 months. This study confirms that stroke is a high-chrono-risk disease, with specific circadian and circannual rhythms. This is very important for a better understanding and control of the underlying factors and in terms of prevention.

Acute Disease↗
PubMed1993

Sudden death may show a circadian time of risk depending on its anatomo-clinical causes and age.

The aim of this study was to determine whether the time of occurrence of sudden death exhibits a circadian rhythm depending on its different anatomoclinical causes. A longitudinal prospective investigation of 610 nonhospitalized subjects who died suddenly in the Emergency Room of Ferrara Hospital between January 1983 and December 1990 was conducted. All subjects underwent autopsy. Sudden death was classified on the basis of the following pathological causes; acute myocardial infarction, acute myocardial failure, intracerebral hemorrhage, rupture of aortic aneurysm, pulmonary embolism, and clinical causes, i.e., arrhythmia and circulatory failure. The investigated cases were stratified into 2 groups according to age; Group A = age < 70 years (n = 301, 49.3%), and Group B = age > or = to 70 (n = 309, 51.7%). The assessment of circadian rhythmicity was performed utilizing the single cosinor method. The results by cosinor analysis found a circadian rhythmicity for cases of sudden death (peak at 14.04, n = 610, p = 0.036), and in particular for females (peak at 13.12, n = 200, p = 0.004). Spectral analysis detected a statistical ultradian cycle in males having an 8-hour period (p = 0.015). A statistically significant circadian rhythm was found for cases of sudden death due to acute myocardial infarction (peak at 15.28, n = 330, p = 0.013), pulmonary embolism (peak at 11.46, n = 56, p = 0.003) and arrhythmia (peak at 13.08, n = 291, p = 0.04). In Group A no significant circadian rhythm was found, whereas in Group B a significant rhythmicity was found for sudden death from cardiac causes at 13.32 (n = 249, p = 0.015), from myocardial infarction at 15.02 (n = 154, p = 0.018) and from arrhythmia at 13.07 (n = 122, p = 0.014). Different circadian patterns of onset of sudden death may be shown in various subgroups of patients, due not only to different pathophysiologic mechanisms but also to anatomo-clinical aspects.

Age Factors↗
PubMed1993

Chronoepidemiology in human diseases.

Current knowledges about time-dependent variations in onset of several acute medical diseases are briefly reviewed. Moreover, temporal variation in relative risk factors are also discussed. Any clue to the increased likelihood of a given event can heighten suspicion and shorten time of effective action. The predictability of a certain event, due to the periodicity of cyclic changes, can be of a practical interest in everyday medical practice.

Cardiovascular Diseases↗
PubMed1992

Sudden death from pulmonary thromboembolism: chronobiological aspects.

The aim of this study was to determine whether sudden cardiac death from pulmonary embolism exhibits any chronobiological rhythm. Five hundred and seven consecutive subjects dying suddenly outside of hospital and brought into our Emergency Department from January 1983 to December 1989 were studied. The time and date of event were accurately recorded. All subjects underwent autopsy and 48 of them were found to have died of pulmonary embolism (23 males, mean age 73.9 +/- 8 years and 25 females, mean age 76 +/- 12 years). All data were analysed by means of single cosinor[19,20]. In the subjects with pulmonary emboli both a circadian and a circannual rhythmicity were found, with a significant acrophase respectively in the morning (h.min. 11.46, P = 0.003) and in winter (-19.3, P = 0.009).

Aged↗
PubMed1992

Acute and chronic nitrendipine administration in essential hypertension: a chronobiologic study.

To evaluate the chronobiologic pattern of the hypotensive effect of nitrendipine, 10 patients with mild-to-moderate arterial hypertension were studied. They received a randomized single dose (20 mg) of nitrendipine and placebo, and 20 mg of nitrendipine daily for 2 months. Systolic and diastolic blood pressure (SBP and DBP, respectively) and heart rate (HR) were measured for 24 h using an automatic noninvasive device. The data were analyzed by single and mean cosinor methods and by ANOVA and Student's paired t test. Chronic administration of nitrendipine resulted in a more effective lowering of the SBP and DBP mesor, compared with placebo and acute administration, preserving the circadian rhythms. The preservation of the HR circadian rhythm agrees with the lack of interference of the drug with neurohormonal mechanisms.

Adult↗
PubMed1991

Circadian rhythm of blood pressure and calcium entry blockade: a chronobiologic study with nitrendipine in essential hypertension.

In order to evaluate the chronobiologic effect of nitrendipine, 27 patients with mild-to-moderate arterial essential hypertension were studied. After randomized administration of 20 mg of nitrendipine and placebo, systolic and diastolic blood pressure (SBP and DBP, respectively) and heart rate (HR) were measured for 24 h using an automatic noninvasive device. The data of the time series were statistically analyzed by single and mean cosinor methods (obtaining mesor, amplitude, and acrophase) and by ANOVA and Student's paired t test. Nitrendipine significantly reduced the SBP and DBP mesors without affecting the HR mesor, and reduced the SBP and DBP amplitudes while increasing the HR amplitude. After placebo, group circadian rhythms were observed for SBP, DBP, and HR and maintained after nitrendipine. In conclusion, a single-dose administration of nitrendipine is effective in lowering blood pressure. The increased HR amplitude is probably due to a tachycardic reaction. The preservation of the SBP, DBP, and HR group circadian rhythms agrees with the lack of interference of the drug with the neurohormonal mechanisms.

Adult↗
PubMed1989

A mass-spring model hypothesis of the genesis of the physiological third heart sound.

A study on the genesis of the third heart sound (S3) based on the mass-spring model is presented. In such a system the natural frequency of vibration depends on the stiffness constant and the mass according to a physical law. The amplitude versus frequency spectra of S3 of 19 patients were obtained using the FFT algorithm together with mono- and two-dimensional echocardiographic parameters. Each echo parameter was correlated with the relative energy contained in each of the 15 Hz bands in which the normalized average spectrum of S3 of each subject was divided. The relative energy of each band was related to echocardiographic parameters. Significant correlation coefficients were found between the diameter of the left ventricle measured at the end of the rapid filling phase. The thickness of the posterior wall and of the interventricular septum at this moment, and the energy contained in certain frequency bands. The statistical correlations we have revealed are consistent with the model postulated in our hypothesis.

Adult↗
PubMed1988

Does placebo lower blood pressure in hypertensive patients? A noninvasive chronobiological study.

Placebo controlled trials have generally been used in order to evaluate the antihypertensive efficacy of drugs. There is some evidence, though, that blood pressure might not be influenced by placebo. Non-invasive devices for automatic blood pressure monitoring are likely to provide a better assessment of blood pressure response to drugs, as well as to different physiologic and pathologic conditions, than the traditional sphygmomanometric devices. The aim of this study was to investigate the effect of placebo on blood pressure recorded automatically and non-invasively. For this purpose, a chronobiologic approach to the collection, evaluation and interpretation of data seemed most appropriate. A group of 12 patients with a clinical diagnosis of essential hypertension underwent automatic blood pressure monitoring in hospital for 4 days. Measurements were taken every 15 min by an oscillometric instrument with an automatically inflated cuff. After a washout period during which the patients received no treatment, pressure recording was undertaken under basal conditions for 2 days. On the third and fourth days of study, the patients received 2 tablets of placebo, one at 10 a.m. and one at 10 p.m. In each patient a highly significant circadian rhythm was documented for systolic and diastolic pressure, both under basal conditions and during placebo administration. Blood pressure mesors were higher than reference standards and were not significantly affected by placebo. The circadian amplitudes and acrophases did not differ significantly before and during placebo. Our data indicate that automatically recorded blood pressure is not influenced by placebo.

Adult↗
PubMed1987

Chronobiologic aspects of recurrent transient ischemic attack.

An epidemiologic study was conducted from 1979 through 1984 on subjects presenting transitory ischemic attacks (TIA) and admitted into our Institute. We investigated year, season, month, day, and hour of every attack on 80 patients aged between 51 and 88 years. Time-series analysis showed a seasonal pattern of disease onset in early spring. Peaks occurred in March-April, and isolated peaks were also detected in January and October. Concerning TIA-onset day, we observed a peak distribution in the last 10 days of the month. Data on the hour of onset, according to single cosinor (mesor +/- SE = 2.67 + 1.13; amplitude +/- SE = 2.57 + 1.13), yielded a significant (P less than 0.05) acrophase. The acrophase is at -135 degrees (-93 degrees, -245 degrees) for tau = 48 hr.

Aged↗
PubMed1981

[Circadian variations of sinus rate in subjects with normal or pathological sinus node (author's transl)].

Circadian variation of sinus rate (SR) is well described in subjects with normal sinus node (SN). On the other hand there are on data in literature concerning the SR daily variations in patients with SN disfunction. In order to clarify this problem we studied the SR circadian variation in normal subjects (12, and in patients with intermittent bradycardia (11), persistent bradycardia (9) and intermittent 2:1 seno-atrial block (7). SR was recorded utilizing ECG Holter monitoring. By histograms obtained every two hours, modal, maximum and minimum SR were evaluated. Time series were analyzed with a computer program for cosinor method. In the patients with normal SN, circadian periodicity in SR was confirmed with acrophase at 1626 (maximum SR), 1638 (minimum SR) and 1631 (SR mode), respectively. In patients with intermittent bradycardia a circadian rhythm was detected only in minimum SR (acrophase 1651) and in SR mode (acrophase: 1631). No statistically significant circadian variations of the 3 parameters of SR were observed in patients with both persistent bradycardia and sinoatrial block. These data suggest that: - the disappearance of circadian periodicity is proportional to the severity of SN dysfunction; - the patients with intermittent bradycardia show a more normal behavior at low rates than at high ones; - the disappearance of circadian rhythm in patients with marked SN disfunction can be related to SN intrinsic involvement and/or autonomic nervous system disfunction.

Adolescent↗