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C Stefanutti

Publications and source records attributed to C Stefanutti.

23 records · Page 2Linked to original sources

[Some historical considerations on the inflammatory theory of atherosclerosis].

In the past 20 years several clinical and experimental observations have led to the hypothesis that an inflammatory response can trigger some key processes during the development of atherosclerosis. Here we briefly review, from the historical viewpoint, the inflammatory theory of atherosclerosis, as proposed by the Berliner pathologist Rudolf Virchow in the XIX century. Contrary to this hypothesis, in the same period the Viennese Karl von Rokitansky recognized blood dyscrasia (particularly fibrin-induced alterations) as the promoting factor in the process of atherogenesis. Moreover, we outline the relationship between atherosclerosis and arthritis, by reporting some passages from two scientific works published in the late XIX century, the former by the Italian Achille De Giovanni ("Sull'arterite. Sue forme cliniche e sua patogenesi", 1882) and the latter by the French Theophile Guyot ("L'arthritis. Maladie Constitutionnelle", 1890).

Arteriosclerosis↗

[LDL-apheresis: current status].

PURPOSE: State of the art of LDL-apheresis and treatment of severe familiar hypercholesterolemia. PATIENTS AND METHODS: Clinical experience of treatment with LDL-apheresis of pediatric and adult patients with familial hypercholesterolemia using the following techniques: D.A.L.I., H.E.L.P., D.S.C. RESULTS: The outcome of treatment with LDL-apheresis in young patients, using the most recently introduced techniques, is reported. We have submitted to LDL-apheresis 11 pediatric patients. The youngest is aged 3.5. LDL-apheresis is able at improving the metabolic impairment and halting the natural evolution of atherosclerotic disease and atherosclerotic complications. CONCLUSIONS: At present, LDL-apheresis is the most effective and safe therapeutic approach to the treatment of homozygous, heterozygous and double heterozygous familial hypercholesterolemia.

Blood Component Removal↗

Effect of oral and transdermal hormone replacement therapy on lipid profile and Lp(a) level in menopausal women with hypercholesterolemia.

OBJECTIVE: The aim of this randomized clinical study was to evaluate the hormonal replacement therapy (HRT) effect on plasma lipoproteins and Lp(a) profile in 42 menopausal women with primary hypercholesterolemia (total cholesterol > 240 mg/dL). SETTING: University clinic. PATIENTS AND METHODS: 42 hypercholesterolemic menopausal women were randomly assigned to the following groups; (1) transdermal estradiol, 50 micrograms + medroxyprogesterone 10 mg/day for days; (2) conjugated equine estrogens, 0.625 mg/day + medroxyprogesterone acetate 10 mg/day for 12 days; (3) no treatment. At baseline and after 3 and 6 months two blood samples were collected with a 24-hour interval in order to reduce intraindividual and laboratory variability. Serum total cholesterol, HDL cholesterol, triglycerides, LDL cholesterol, and Lp(a) were determined. RESULTS: Total cholesterol and LDL cholesterol significantly decreased after 6 months in both treated groups in comparison to untreated women; HDL cholesterol and triglycerides showed only minimal changes. HRT at the dosage utilized in the study did not seem influence the Lp(a) concentrations after 3 and 6 months. CONCLUSIONS: Both transdermal and oral estrogens at medium dosage have a favorable influence on total cholesterol and LDL-cholesterol level of hypercholesterolemic menopausal women, but Lp(a) remains resistant to manipulation.

Administration, Cutaneous↗

Effect of L-carnitine on plasma lipoprotein fatty acids pattern in patients with primary hyperlipoproteinemia.

PURPOSE: To investigate the effect of L-carnitine (L-C) administration on plasma lipoprotein fatty acids pattern in patients with primary hyperlipoprotinemia. PATIENTS AND METHODS: The effect of L-C on plasma lipoprotein fatty acids pattern was investigated in 24 male and female hyperlipoproteinemic patients, aged 51.3 +/- 7.8 years (lipoprotein phenotypes: IIb and IV, WHO, 1970). After hypolipidemic diet (P, 22%; C, 48%; L, 30%; S, 10%; M, 10%; PV, 10%, cholesterol < 300 mg/d) lasting 30 days, L-C was given at a daily dosage of 1 g t.i.d. for 90 days. RESULTS: Plasma total polyunsaturated to saturated fatty acids ratio (8/5) showed a statistically significant increase after L-C (baseline: 0.74 +/- 0.2, vs 120 days: 0.84 +/- 0.2; p < or = 0.03). A statistically significant decrease of HDLs 16:0 (baseline: 28.1 +/- 4.2 vs 120 days: 26.4 +/- 3.7; p < or = 0.002), HDL3s 16:0 (baseline: 28.6 +/- 4.5 vs 120 days: 26.9 +/- 3.6; p < or = 0.001) and VLDLs 14:0 (baseline: 2.0 +/- 0.8 vs 120 days: 1.6 +/- 0.6; p < or = 0.02), specular to a statistically significant increase of VLDL's 18:2 (baseline: 21.9 +/- 5.1 vs 120 days: 24.3 +/- 4.9; p < or = 0.01), was also observed. Plasma levels of total cholesterol and LDL-cholesterol were reduced after one month. Plasma apolipoprotein AI and B levels were significantly increased after 30 and 60 days of treatment with L-C. CONCLUSIONS: A less atherogenic plasma lipoprotein fatty acids profile was observed after 120 days of combined treatment with diet and L-C.

Carnitine↗

Pattern of red blood cells and platelets cholesterol and fatty acids in homozygous familial hypercholesterolemic patients treated with LDL-apheresis.

Two homozygous familial hypercholesterolemic patients were treated with dextran-sulfate cellulose LDL-apheresis (DSC-LDL/A). We evaluated qualitatively and quantitatively, red cell and platelets membrane cholesterol and fatty acids, before and after LDL-apheresis. Fatty acids and cholesterol of red blood cells and platelets were determined by gas-chromatographic technique. We failed to observe any quantitative or qualitative modification, as far as the youngest patient (MD) is concerned. Only in the oldest patient (SM), docosaesanoic acid (22:6) values, were significantly reduced by LDL-A on quantitative basis. In the same patient, also mirystic acid (14:0) values, were significantly decreased as determined by qualitative method. The above mentioned fatty acids were significantly changed in platelets on treatment with LDL-apheresis performed on weekly basis.

Adult↗