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Biomedical subjects

C Gennari

Publications and source records attributed to C Gennari.

At least 163 records · Page 9Linked to original sources
PubMed1990

[Incidence of the most frequent complications in hypertensive patients].

The incidence of district (cardiac, cerebral, renal) and systemic vascular complications was studied in a population of 3992 hypertensive in-patients during the period from 1984 to 1988. The total number of male hypertensive patients was always higher (2355) than that of female hypertensive patients (1637). From the analysis of results it appears that 11.01% of male hypertensive patients and 15.85% of female hypertensive patients were diagnosed as being affected by uncomplicated essential arterial hypertension, whereas 88.97% of male and 84.12% of female hypertensive patients suffered from arterial hypertension with varying percentages of cardiac, cerebral, renal or systemic-type atheroarteriosclerotic complications. The prevalence of the male sex was particularly evident in the case of cardiac complications. Given the peak incidence of the various types of complications when analysed by decade of age, an earlier incidence of cardiac and renal complications was found in male hypertensive patients which anticipates the complications found in female hypertensive patients by approximately one decade. Lastly, the paper underlines the social importance of essential arterial hypertension and the need to develop efficacious primary and secondary prevention in order to reduce the incidence of complications which today represent the most severe aspect of hypertension.

Adolescent↗
PubMed1989

Calcium-channel blockade (nitrendipine) in combination with ACE inhibition (captopril) in the treatment of mild to moderate hypertension.

The antihypertensive efficacy of a combination of calcium-channel blockers and angiotensin-converting-enzyme (ACE) inhibitors in severe primary hypertension is well known, but a synergistic action of this drug combination in mild to moderate primary hypertension is still not established. Therefore, the aim of the present study was to evaluate the efficacy and tolerability of monotherapy with nitrendipine (20 mg) or captopril (100 mg), and of their combination (nitrendipine 10 mg plus captopril 50 mg), in patients suffering from mild to moderate primary hypertension, according to a single-blind, randomized, placebo-controlled design. After the first 4-week monotherapy period, both nitrendipine and captopril induced a significant decrease in systolic and diastolic blood pressure (BP) (p less than 0.001). Furthermore, nitrendipine caused a significant increase in heart rate (HR), while no change in HR was observed in patients treated with captopril. Several side effects were observed, both in the nitrendipine-treated patients (facial flushing, headache, malleolar edema) and in the captopril-treated patients (initial hypotension, dizziness, gastrointestinal disorders). However, these side effects were mild and were well tolerated. In the second combined 4-week therapy period, systolic and diastolic BP of patients treated with 10 mg nitrendipine combined with 50 mg captopril continued to decrease to a degree significantly lower (p less than 0.001) than that observed at the end of the monotherapy period. Simultaneously, no change in HR values occurred when compared to basal values. Furthermore, the incidence and intensity of some side effects observed during the combined therapy period were lower than those of the monotherapy period.(ABSTRACT TRUNCATED AT 250 WORDS)

Captopril↗
PubMed1989

Salmon calcitonin (Miacalcic) nasal spray in prevention and treatment of osteoporosis.

Calcitonin (CT) constitutes one of the major choices for the pharmacologic treatment of postmenopausal and senile osteoporosis. In postmenopausal osteoporosis, CT, analogous to estrogens, determines increase of bone mass, improvement of intestinal calcium absorption and a positivization of calcium balance. Patients treated with CT can also benefit from the analgesic effect of the hormone. Unlike estrogens, these beneficial effects of CT occur with minimal risk and require no routine gynecological monitoring. In addition, CT is completely devoid of toxicity. The only limitations to the use of CT are linked to the frequent parenteral injections and the occurrence of side effects. These limitations can now be overcome by the availability of the new nasal spray preparation, which has been developed for synthetic salmon calcitonin (sCT). The introduction of this new form increases the patients' compliance, and the different pharmacokinetic curtails the side effects, compared to the parenteral administration. At present, one-year controlled studies have been reported, showing a beneficial effect of sCT on bone mass in patients with established osteoporosis. Also, shorter studies demonstrate the analgesic activity of sCT treatment in patients with vertebral crush fractures and bone pain. The improvement in the patients' compliance and the reduction of side effects allow this new CT preparation to be used in the prevention of postmenopausal osteoporosis.

Administration, Intranasal↗
PubMed1989

Effect of L-lysine on cytosolic calcium homeostasis in cultured human normal fibroblasts.

L-lysine, a cationic essential amino acid, has been reported to affect calcium transport in both intestine and kidney. In order to investigate whether this effect is associated with changes in cytosolic calcium homeostasis, we studied the effect of L-lysine deprivation on intracellular calcium concentration ([Ca2+]i), as well as 45Ca efflux and accumulation in normal human fibroblasts. Steady state [Ca2+]i, measured using fura-2 fluorescence in cells cultured for 18 hours in a L-lysine-free medium, was significantly higher than in cells grown in the presence of as little as 4 microM L-lysine. L-lysine deprivation also led to a significant decrease of 45Ca fractional efflux compared with cells grown in complete medium. This effect was paralleled by a significant decrease in 45Ca accumulation. Lack of L-arginine from the growth medium for the same time period had no effect on either [Ca2+]i, 45Ca efflux, or 45Ca accumulation rate. Presumably, the lack of L-lysine for a significant amount of time impairs the active mechanisms of calcium extrusion, which is only partially compensated by a reduction of calcium accumulation rate. This leads to an increased steady state [Ca2+]i. It is concluded that L-lysine is an important modulator of cytosolic calcium homeostasis.

Calcium↗
PubMed1989

Effects of nandrolone decanoate therapy on bone mass and calcium metabolism in women with established post-menopausal osteoporosis: a double-blind placebo-controlled study.

In many patients with involutional osteoporosis anabolic steroids may produce a rapid subjective improvement and a pronounced reduction in the frequency of complaints. Animal experiments have demonstrated that anabolic steroids can also have an objective effect on bone tissue. Twenty (20) post-menopausal osteoporotic patients were randomly assigned to 2 different treatment regimens; 10 patients were treated with 50 mg i.m. of nandrolone decanoate (ND) every 3 wk for 12 mth and 10 patients were treated with a placebo. Both groups also received an oral calcium supplement (1 g/day). Bone mineral content (BMC) was measured by dual photon absorptiometry before and after 1, 3, 6 and 12 mth of treatment. Plasma alkaline phosphatase (ALP) and urinary hydroxyproline excretion were measured at the same time. Intestinal calcium absorption was measured by the 47Ca oral test before and after treatment. A transiliac bone biopsy was performed before and after treatment in 4 patients in each group. After 1 yr there was a significant increase in lumbar spine BMC in the group receiving calcium plus ND. A progressive increase in plasma ALP was also observed in the group treated with ND but this was not significant, whereas radiocalcium absorption did increase significantly in this group. Histomorphometric study of bone samples demonstrated a significant increase in trabecular bone volume (TBV) and in active osteoid surface area in the patients treated with ND. Because plasma ALP tends to increase when a small decrease in bone resorption occurs (as measured by urinary hydroxyproline excretion) and the active osteoid surfaces also significant augment, we concluded that ND therapy increases the bone formation rate through inhibition of bone resorption. This interpretation could explain the considerable increase in lumbar spine BMC and the significant increase in TBV observed in patients treated with ND.

Alkaline Phosphatase↗
PubMed1989

Acute cardiovascular and renal effects of human calcitonin gene-related peptide.

Acute cardiovascular and renal effects of 25 micrograms IV human calcitonin gene-related peptide (hCGRP) have been studied in four normotensive and untreated subjects, in the absence and the presence of indomethacin, a prostaglandin synthesis-blocking agent. Intravenous infusion of hCGRP, alone, caused a transient but significant increase in heart rate (HR), hypotension, and facial flushing. Along with these effects, a positive inotropic action of hCGRP was documented by a noninvasive poligraphy. Furthermore, a significant increase in the catecholamines (norepinephrine and epinephrine), in the cyclic nucleotide (cyclic AMP and cyclic GMP) plasma levels, and a small decrease in total calcium with no change in inorganic phosphorus serum levels, occurred. Also acute renal hCGRP induced effects were observed, as a significant increase in urinary volume and in the urinary calcium, sodium, potassium, and chloride excretion. Indomethacin did not affect all the cardiovascular, metabolic, and renal hCGRP-induced effects. These results are in agreement with the hypothesis that hCGRP acts on the heart, vessels, and kidney, directly or indirectly, by the mediation of other vasodilating agents or systems excluding the prostaglandin system.

Adult↗
PubMed1989

Metabolic and clinical effects of ipriflavone in established post-menopausal osteoporosis.

Twenty patients with post-menopausal osteoporosis were randomly divided into two groups of ten patients and treated under double-blind conditions with ipriflavone (Osteofix) or placebo. The dosage was 600 mg/day given in three doses and treatment lasted 6 months. All the patients received an oral calcium supply (1 g per day). At baseline and then after 3 and 6 months, the following parameters were controlled: bone mineral content at the lumbar spine, distal radius and femoral shaft; parameters of bone metabolism (alkaline phosphatase, PTH, osteocalcin, calcitonin, calciuria and hydroxyprolinuria); clinical conditions (pain at rest and on movement, motility). Ipriflavone facilitated the conservation of bone mass, that increased in one of the tested areas (distal radius). On the contrary, a bone mineral loss was found in the group treated with placebo, which was significant in the spine. Pain and motility significantly improved in the group treated with ipriflavone; there was an initial improvement in the control group, followed by a sharp worsening. The parameters investigated showed a significant reduction of osteocalcin in the ipriflavone group that indicates a modulation on bone turnover. The drug was well tolerated and compliance to oral treatment was excellent.

Bone and Bones↗
PubMed1989

[Serum ionized calcium, parathormone and plasma renin activity in essential arterial hypertension].

Given the significance of the calcium ion in the pathogenesis of essential arterial hypertension, blood levels of total and ionised calcium, phosphorus, parathormone, blood renin activity as well as urinary calcium and phosphorus were assayed in a group of hypertensives and a comparable control group with normal blood pressure. The results showed reduced ionised calcium in the blood of the hypertensives together with hyperparathyroidism and increased calciuria. In addition, the link between parathormone and mean blood pressure levels suggests that parathormone itself play a primary role in the genesis of high blood pressure. Finally the connection between renin activity in the plasma and ionised calcium in the serum suggests that the two hormone systems are closely linked and may interact via the calcium ion.

Calcium↗
PubMed1988

Effects of one-year treatment with estrogens on bone mass, intestinal calcium absorption, and 25-hydroxyvitamin D-1 alpha-hydroxylase reserve in postmenopausal osteoporosis.

A double-blind, placebo-controlled study on 21 postmenopausal osteoporotic women was performed in order to assess the effects of 1 year estrogen therapy (Premarin, 1.25 mg/day) on bone mass, intestinal calcium absorption, and mineral metabolism. Bone mineral content (BMC), measured by dual photon absorptiometry on the vertebral bodies and the femoral shaft, increased in both areas, but the changes were more evident at the former site, which is predominantly trabecular (+8.3%, P less than 0.05), than at the latter, which is mainly cortical (+2.6%, P less than 0.05). An improvement of intestinal calcium absorption was also detected at the end of the study (P less than 0.05) in the estrogen-treated group. Parameters of bone metabolism showed a decrease in hydroxyproline/creatinine ratio and osteocalcin, an increase in calcitonin, and no significant changes in parathyroid hormone (PTH) and alkaline phosphatase. Serum 1,25-dihydroxycholecalciferol (1,25(OH)2D3) levels increased after estrogen therapy, whereas 25-hydroxycholecalciferol (25OHD3) remained stable during the study period. Renal 25-hydroxyvitamin D 1 alpha-hydroxylase reserve, assessed by the PTH-stimulation test, showed a more rapid response in producing a 1,25(OH)2D3 peak in the estrogen-treated patients compared with the control subjects. However, estrogens did not induce an absolute improvement in the secretory reserve. This study demonstrates that 1 year treatment with estrogens improves both intestinal calcium absorption and BMC in postmenopausal osteoporotic women. The latter effect appears to be induced by an inhibition of bone resorption, associated to an increased secretion of calcitonin, whereas vitamin D metabolites do not seem to contribute substantially to the mediation of estrogen action on bone.

25-Hydroxyvitamin D3 1-alpha-Hydroxylase↗
PubMed1988

Serum osteocalcin concentration in patients with prostatic cancer.

Fifty-four subjects were studied: 36 advanced prostatic adenocarcinoma patients in stage D and 18 normal age-matched male controls. Serum alkaline phosphatase, serum acid phosphatase, plasma osteocalcin, 24-h urinary hydroxyproline excretion, and 24-h whole-body retention of [99mTc]-methylene diphosphonate were measured in all subjects before and 3, 6, and 9 weeks after the start of treatment. Skeletal metastases were identified by radiography and/or [99mTc]-methylene diphosphonate bone scan. The results confirm that acid phosphatase is a significant marker in prostatic cancer; serum alkaline phosphatase may be useful in the evaluation and monitoring of bone metastases but it is not always specific; urinary excretion of hydroxyproline is an index of osteoclastic activity; serum osteocalcin may be considered more specific in the evaluation and monitoring of osteoblastic bone metastases in prostatic cancer.

1-Carboxyglutamic Acid↗
PubMed1988

Bone turnover in postmenopausal osteoporosis. Effect of calcitonin treatment.

UNLABELLED: To investigate the effectiveness of calcitonin treatment of postmenopausal osteoporosis in relation to bone turnover, we examined 53 postmenopausal osteoporotic women before and after one year of therapy with salmon calcitonin (sCT), at the dose of 50 IU every other day. Baseline evaluation revealed that 17 (32%) patients had high turnover (HTOP), and 36 (68%) normal turnover osteoporosis (NTOP) as assessed by measurement of whole body retention (WBR) of 99mTc-methylene diphosphonate. The two groups did not differ in terms of bone mineral content (BMC) measured by dual photon absorptiometry at both lumbar spine and femoral diaphysis. However, HTOP patients had higher levels of serum osteocalcin (OC) and urinary hydroxyproline excretion (HOP/Cr). Multivariate regression analysis showed no correlation between parameters of bone turnover (WBR, OC, HOP/Cr) and both femoral and vertebral bone density; the latter being negatively correlated only with the years elapsed since menopause (R2 = 0.406). Treatment with sCT resulted in a significant increase of vertebral BMC in the 53 patients taken as a whole group (+/- 7%, P less than 0.001). When the results obtained in HTOP and NTOP were analyzed separately, only those with HTOP showed a marked increment of spinal BMC (+22%, P less than 0.001), NTOP subjects neither gained nor lost bone mineral during the study. Femoral BMC decreased in the whole group after sCT therapy (-3%, P less than 0.003). However, HTOP patients maintained initial BMC values, whereas those with NTOP lost a significant amount of bone during the study period (-5%, P less than 0.001). The increase of vertebral bone mass was associated with a marked depression of bone turnover detectable in both subsets of patients and in the whole group. IN CONCLUSION: (a) assessment of bone turnover cannot help predict the severity of bone loss in postmenopausal osteoporosis; (b) calcitonin therapy appears to be particularly indicated for patients with high-turnover osteoporosis, resulting in a net gain of bone mineral in the axial skeleton and a slowing of bone loss in the appendicular bones.

Aging↗
PubMed1988

[Treatment of essential mild-to-moderate arterial hypertension with once-daily penbutolol. Controlled clinical study vs atenolol].

The anti-hypertensive and tolerance of penbutolol, a non-selective beta-blocker of long duration and endowed with an ISA effect were compared with those of atenolol, a cardioselective beta-blocker without ISA effect, in two groups of 20 patients each suffering from slight-to-moderate essential primary hypertension selected on the basis of a clinico-experimental design of open randomised type. The two drugs presented a similar anti-hypertensive effect which attained its peak expression in the second week of treatment. As for side-effects, penbutolol during treatment presented better tolerance than atenolol. Further, both penbutolol administered once daily at a dose of 40 mg/die, and atenolol, administered once daily at a dose of 100 mg/die proved to possess satisfactory anti-hypertensive activity justifying its use in a single daily dose.

Adult↗
PubMed1988

[Evaluation of the adrenergic and pressor response to the hand-grip test in young athletes].

Numerous factors may influence the sympathetic and pressure response to physical exercise, age, sex, type of activity carried on and training for example. Training, in particular is considered to reduce both adrenergic and pressure response. Plasma catecholamine levels and the haemodynamic response to the hand-grip test have therefore been evaluated in a group of young athletes, compared with a group of non-trained youths. The results confirmed that young athletes have a lower sympathetic and haemodynamic response to the isometric exercise and this is accompanied by improved cardiac performance. The value of the hand-grip test is underlined as a method of investigation able to evaluate the training level attained by the athlete.

Adult↗
PubMed1987

Cardiovascular effects of calcitonin gene-related peptides I and II in man.

Calcitonin gene-related peptide (CGRP) is present in sensory nerve fibers in the heart and around peripheral arteries. On interaction with specific CGRP binding sites and activation of adenylate cyclase, CGRP causes vasodilation and has positive inotropic and chronotropic effects on the heart. In the present study, human CGRP I and II exerted positive inotropic effects on isolated human right auricles and relaxed small arteries from human skeletal muscle precontracted with norepinephrine (EC50 for CGRP I 0.59 nM and for CGRP II 0.37 nM). CGRP I and II (3.2 nmol) administered i.v. to 6 normal subjects exerted positive inotropic actions on the human heart concomitant with positive chronotropic effects, hypotension, and vasodilation. CGRP may, therefore, be of importance for cardiovascular control in man.

Blood Pressure↗