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E Peruzzi

Publications and source records attributed to E Peruzzi.

15 recordsLinked to original sources

Determinants of age at menopause in Italy: results from a large cross-sectional study. ICARUS Study Group. Italian Climacteric Research Group Study.

OBJECTIVE: To identify the determinants of age at menopause in an Italian population, using data from the Italian Climacteric Research Group Study (ICARUS). METHODS: ICARUS is a prospective study of the effect of menopause on women's health that has been running in menopause clinics throughout Italy since 1995. A total of 4300 women with spontaneous menopause, aged 55 years or more and observed for the first time at the participating centres are included in the present analysis. RESULTS: The mean age at menopause in the total population was 50.9 years. After taking into account potential covariates, the women reported smoking, had a slightly lower mean age at menopause than non smokers 50.4 versus 50.9 years; P = 0.01. The mean age at menopause in nulliparae was 50.0 years, and, respectively 50.4, 50.6, 50.9, 51.2 and 50.9 years in those reporting 1, 2, 3, 4 and 5 or more births (P < 0.01). A low body mass index and an early age at menarche were associated with early menopause in the crude analysis, but these associations disappeared after taking into account the confounding factors. CONCLUSIONS: This study offers an estimate of the mean age at menopause of women attending menopause clinics in Italy, on the basis of the data obtained from a large sample. It also indicates that smoking and nulliparity are associated with early menopause.

Age Factors↗

Sociodemographic and clinical factors associated with HRT use in women attending menopause clinics in Italy.

OBJECTIVE: The aim of this analysis is to find any association between the use of hormone replacement therapy (HRT) and sociodemographic and clinical factors among women attending 54 menopause clinics in Italy. METHODS: The analysis includes data relating to 17,851 women who attended one of 54 menopause clinics in Italy for general gynecological evaluations and counselling between 1995 and 1997. The characteristics of women reporting ever HRT use were compared with those of never users. The odds ratios (ORs) of HRT use were computed in relation to selected reference categories, together with their 95% confidence intervals (CIs). RESULTS: Of the 17,851 women interviewed, 8539 reported ever HRT use. The mean age of the never and ever HRT users was 52.8 years and 53.7 years, respectively. Higher education was associated with an increased frequency of HRT use: in comparison with women reporting no or primary-/middle-school education, the OR of HRT use of women reporting a high-school diploma or university degree was 1.3 (95% CI 1.1-1.6). HRT use tended to be less frequently reported with increasing body mass index (BMI): in comparison with women whose BMI was < 23.4 kg/m2, the OR of HRT use in those with a BMI of 23.4-26.1 kg/m2 and > or = 26.2 kg/m2 was 0.8 (95% CI 0.8-0.9) and 0.6 (95% CI 0.5-0.7), respectively. Among the postmenopausal women, those who had undergone surgical menopause had an OR of HRT use of 1.3 (95% CI 1.2-1.4). A history of breast cancer was associated with a lower frequency of HRT use (OR 0.3, 95% CI 0.2-0.4). Likewise, a history of thromboembolic disease (OR 0.5, 95% CI 0.4-0.7) or myocardial infarction (OR 0.7, 95% CI 0.6-0.9) was associated with a lower frequency of HRT use. CONCLUSIONS: In our study population, the variable most closely related to HRT use was education/social class, thus underlining the impact of information campaigns on HRT and women's health. Among the medical determinants, our analysis indicates that a history of myocardial infarction, thromboembolic disease or breast cancer is associated with less frequent use of HRT.

Adult↗

Long term efficacy, safety, and tolerabilitity of low daily doses of isosmotic polyethylene glycol electrolyte balanced solution (PMF-100) in the treatment of functional chronic constipation.

AIMS: To assess the long term therapeutic effectiveness, safety, and tolerability of low daily doses of isosmotic PEG electrolyte solutions (PMF-100) administered for a six month period for the treatment of functional constipation, in a double blind, placebo controlled, parallel group study. METHODS: After an initial four week run in period with PMF-100 (250 ml twice daily; PEG 14.6 g twice daily), 70 patients suffering from chronic constipation (58 females, aged 42 (15) years) with normalised bowel frequency (>3 bowel movements (bm)/week) were randomly allocated to receive either PMF-100 or placebo, contained in sachets (one sachet in 250 ml of water twice daily) for 20 weeks. Patients were assessed at four week intervals, and reported frequency and modality of evacuation, laxative use, and relevant symptoms on a diary card. At weeks 1, 12, and 24, a physical examination and laboratory tests were performed. RESULTS: Complete remission of constipation was reported by a significantly (p<0.01) higher number of patients treated with PMF-100 compared with placebo at each four week visit. At the end of the study, 77% of the PMF-100 group and 20% of the placebo group were asymptomatic. Compared with placebo, patients treated with PMF-100 reported hard/pellety stools and straining at defecation less frequently, a significantly higher bowel frequency (week 12: 7. 4 (3.1) v 4.3 (2.5) bm/week, 95% CI 1.64, 4.42; week 24: 7.4 (3.2) v 5.4 (2.1) bm/week, 95% CI 0.13,3.93), reduced consumption of laxative/four weeks (week 12: 0.7 (2.7) v 2.2 (3.3), 95% CI -2.29, 0. 03; week 24: 0.2 (0.8) v 1.4 (2), 95% CI -2.07, -0.023), reduced mean number of sachets used (week 12: 33 (13) v 43 (12), 95% CI -17. 24, 4.56; week 24: 33 (13) v 44 (12), 95% CI -19.68, -2.24), and reduced number of drop outs for therapy failure (16 v 3; p<0.005). Adverse events, physical findings, laboratory values, palatability, and overall tolerance of the solutions did not differ between groups. CONCLUSIONS: Administration of small daily doses of isosmotic PEG electrolyte balanced solutions was effective over a six month period for the treatment of functional constipation. A mean daily dose of approximately 300 ml of PEG solution (PEG 17.52 g) appeared to be safe, well tolerated, and devoid of significant side effects.

Adolescent↗

Cost analysis of an Italian ICU.

BACKGROUND: Cost reduction is an important issue in medicine today, especially when considering ICUs, since they account for a large percentage of all hospital expenditure. Through a retrospective analysis of the data regarding the expenses incurred during the years 1996-97, we have been able to evaluate the total costs of our ICU and the influence that each component had on the final costs, thus gathering the necessary information for the improvement of the unit itself. METHODS: Retrospective analysis of a 5-bedded multidisciplinary ICU activity over a two-year period (1996-1997). Cost-related data have been supplied by the Hospital Administration as to wages, infrastructures, equipment buying and maintenance; by Hospital Pharmacy as to drugs and devices supplies; and by Laboratory and Radiology as to diagnostic investigations. RESULTS: According to our experience, physicians and non-medical staff account for more than 50% of the total expenditure--the latter slightly prevailing. Furthermore, we have assessed that the cost distribution is hardly comparable to that reported by other authors. CONCLUSIONS: It is useful to analyse the total distribution and to evaluate their nature only to gain the necessary data that will lead to a more effective management of the unit. Nevertheless, this methodology is valid within the cost analysis of our ICUs but the ICUs of other countries show great differences in the way they are structured and some of the use more reliable activity-based costing methodology.

Drug Costs↗

The effect of menopause on blood lipid and lipoprotein levels. The Icarus Study Group.

There is increasing evidence from epidemiological studies that exogenous estrogen (hormone replacement therapy) protects against the elevated risk of cardiovascular disease in women after the menopause. However, it is still uncertain whether the postmenopausal decrease in endogenous estrogen in itself contributes significantly to this increase in risk. Most of the studies that have provided evidence linking cardiovascular disease with menopause have involved North American women, who may differ significantly from Europeans in terms of lifestyle and diet. ICARUS (Italian Climacteric Research Group Study) is an observational study that involves Italian Menopause Clinics, with the objective of collecting observational data on menopause and its management. The results of a cross-sectional analysis of 9309 women, free from any hormonal treatment and enrolled up to March 1997, are reported here. Data show that the menopause has a marked effect on the circulating levels of lipids and lipoproteins. From pre- to post-menopause there are significant increases in total cholesterol (6.9% before and 4.4% after adjustment for covariates including chronological age, educational level, center, BMI, smoking habits, hypertension and diabetes, previous contraceptive use, and time since menopause), LDL (7.5% before, 4.0% after), and triglycerides (9.0% before, 3.2% (ns) after). However, there is no significant change in HDL. Among postmenopausal women, no effect on lipid profile of time since menopause was observed.

Cholesterol↗

Diclofenac dispersible provides superior analgesia with faster onset of action compared to naproxen granular in patients with acute, painful, minor sports injuries.

BACKGROUND: To compare the efficacy and tolerability of single doses of diclofenac dispersible and naproxen granular in patients with acute, painful, minor sports injuries. METHODS: Forty-eight adult outpatients with moderate-to-severe pain on movement, following a traumatic event < or = 36 hours previously, participated in this double-blind, between-patient comparative study. Patients were randomised in equal comparative study. Patients were randomised in equal number to receive diclofenac dispersible 50 mg or naproxen granular 500 mg. Pain on movement, pain on pressure, spontaneous pain and pain relief were assessed at 15, 30, 45, 60 minutes and 4 hours after dosing. RESULTS: Both treatments were effective at reducing pain from the 15 minute time point. At 15 minutes there was no significant difference between the treatments for pain on movement (p = 0.4) but diclofenac was significantly superior to naproxen with respect to pain on pressure (p = 0.004), spontaneous pain (p = 0.0022) and pain relief (p = 0.034). In addition, diclofenac was significantly superior to naproxen with respect to AUC0-4 hours for percentage reduction in intensity of pain on movement (p = 0.04) and spontaneous pain (p = 0.0047), and for pain relief scores (p = 0.015). Both treatments were well tolerated. CONCLUSIONS: The study results suggest that diclofenac dispersible 50 mg provides faster and overall better analgesia compared to naproxen granular 500 mg in the acute relief of pain following minor sports injuries.

Acute Disease↗

[Respiratory mechanics and gas exchange in anesthesia for laparoscopic cholecystectomy].

OBJECTIVE: To evaluate the influence of endoabdominal CO2 insufflation during anaesthesia for laparoscopic cholecystectomy on airway pressure, gas exchange and their relationships. DESIGN: Perspective; clinical investigation. SETTING: Operating room at a central general hospital. PATIENTS: 14 patients (3 males and 11 females) ASA 1-2, non smokers, without lung disease, scheduled for elective laparoscopic cholecystectomy. INTERVENTIONS: During balanced anaesthesia (N2O/O2, Fentanyl, Isoflurane), with fixed minute ventilation, endoperitoneal insufflation of CO2 held at constant pressure (21 cm H2O). MEASUREMENTS: Serial measurements of: Airway pressure, near-static compliance, ETCO2, CO2 minute production, blood gas analysis and derived data: P(a-A)O2, P(a-ET)CO2, Vd/Vt. MAIN RESULTS: During insufflation peak and pause pressures increased by 6 cm H2O and mean pressure; by 3 cm H2O; Compliance was reduced by 48%; PaO2 decreased evenly with time (p > 0.05) irrespective of the airway pressure. PaCO2, PECO2, VCO2 and Vd/Vt after a sharp increase stabilized at 30% (mean value) over the baseline. P(a-ET)CO2 and Vd/Vt fluctuate in the physiological range except for two short but significant changes (p > 0.05) at insufflation and desufflation time. CONCLUSIONS: Laparoscopic technique for cholecystectomy, at least in healthy patients, produces relevant changes in airway pressures but only minor modifications of gas exchange, similar to those seen during general anaesthesia. This technique can be safely used for routine operation with standard monitoring equipment.

Adult↗

Beta-adrenergic receptors and reflex tachycardia after single and repeated felodipine administration in essential hypertension.

To verify the possible contribution of beta-adrenergic receptor down-regulation to the reversal of reflex tachycardia during chronic treatment with a dihydropyridine calcium antagonist, 11 hypertensive patients were studied with noninvasive blood pressure (BP) and heart rate (HR) monitoring after a placebo period, and on the first and seventh day of felodipine administration, 5 mg twice daily. Plasma catecholamines and neutrophil beta-adrenergic receptors were measured on the first and seventh day of treatment, immediately before and 2 h after drug administration. The first administration of felodipine was followed by a significant drop in BP (peak reduction in mean BP 24 +/- 7 mm Hg), lasting 6 h and mirrored by reflex tachycardia (peak increase in HR 14 +/- 9 beats/min). On the morning of the seventh day, 12 h after the previous felodipine administration, mean BP (MBP) was 16 mm Hg lower than on the last placebo day, while HR was unchanged. The next administration of felodipine was followed by a smaller drop in BP (MBP - 15 +/- 7 mm Hg; NS vs. placebo), while reflex tachycardia was the same as after acute felodipine (HR 13 +/- 8 beats/min; p less than 0.05 vs. placebo, NS vs. acute administration). Plasma noradrenaline concentration increased after both acute and chronic administration (p less than 0.0001), and preadministration values were highest on day 7 (p less than 0.05). Neutrophil beta-adrenergic receptor density and affinity did not change either acutely or chronically. This study gives both indirect and direct evidence that beta-adrenoceptor down-regulation does not occur during repeated felodipine administration in hypertension. Reflex tachycardia is not abolished, but is reset to lower BP levels.

Adult↗

"In vitro" study of liver slices lipid (1-14C) acetate incorporation in experimental diabetes.

The effect of insulin deficiency on lipid synthesis in the liver of normal rats, diabetic rats by alloxan and pancreatectomized rats was studied in vitro using (1-14C) acetate as lipid precursor. Insulin deficiency induces an increased incorporation of (1-14C) acetate into triglycerides in rat liver. This is particularly evident in pancreatectomized rats with respect to alloxan diabetic rats. It is concluded that in experimental diabetes an atherogenous metabolic pattern is elaborated by the liver.

Acetates↗

Lipid synthesis from the liver in patients with psoriasis.

In psoriatic patients with hyperlipidemia we studied the hepatic lipid synthesis from (1-(14)C)-acetate in human liver biopsy specimens in vitro by a thin-layer radio-chromatography. In psoriatics type IV (according to Fredrickson) a significant increase in (1-(14)C)-acetate hepatic incorporation especially into phospholipids (25%) and triglycerides (52%) was observed; in type IIb increased lipogenesis was phospholipids (24.5%), free cholesterol (44.4%) and triglycerides (29%). Abnormal lipid metabolism often coexists with glucose intolerance in psoriasis; no correlation between hyperinsulinemia and augmented (1-(14)C)-acetate incorporation into hepatic triglycerides was found.

Adult↗

Effects of insulin on hepatic lipid synthesis in alloxan diabetic rats.

In vitro hepatic synthesis of lipids starting from 1-(14)C-acetate was studied in rats made diabetic by subcutaneous alloxan administration (175 mg/kg b.w.). A second group of diabetic rats was treated with lente insulin. In the alloxan-treated rats, a decrese was observed in hepatic incorporation of 1-(14)C-acetate into phospholipids, triglycerides and esterified cholesterol; there was an increased incorporation into nonesterified fatty acids (NEFA) and free cholesterol. Insulin administration restored lipid synthesis values to normal. On histologic examination, an intranuclear glycogenesis was observed in the hepatocytes of the alloxan-treated rats, along with severe hepatic necrosis; the latter however, only in rats sacrified on the 3rd day. Hepatic steatosis with small, medium and large droplets was present in the insulin-treated rats; signs of cellular degeneration were less evident.

Animals↗

[Not Available].

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History, Early Modern 1451-1600↗

[Not Available].

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History, Early Modern 1451-1600↗

[The effect of anesthesiologic technique on the mental state of elderly patients submitted for orthopedic surgery of the lower limbs].

UNLABELLED: Influence of anesthetic technique on mental status in elderly patients submitted to major orthopedic procedures of lower limbs. Mental impairment is a common occurrence in elderly patients after major orthopedic surgery. Few studies have been published so far on this topic in spite of its relevant clinical and economic implications. OBJECTIVE: 1) To verify whether anesthesia has a causative role in postoperative mental confusion in elderly patients; 2) to compare the effects of General Anesthesia (GA) and Spinal Anesthesia (SA) on mental status. DESIGN: Controlled, comparative study. PATIENTS: Sixty patients aged > or = 70, ASA I-II, submitted to femoral neck repair. SETTING: Anesthesia Dept. and Orthopedic Dept. of a District Hospital in Italy. METHOD: The day before surgery the mental status of elected patients was evaluated employing a modified Organic Brain Syndrome (OBS) scale (Gustafsson). The better the mental status, the lesser the OBS score. It was possible therefore to distinguish "oriented" from "confuse" patients (38 vs 22) if they scored < or = 6 or > 6 respectively. Patients from each group were than randomly assigned to receive either GA or selective SA. Neither group was premedicated. GA was induced with propofol 1 mg/kg and maintained with O2/N2O 40/60% and isoflurane; atracurium was employed to facilitate mioresolution. Spinal anesthesia was performed with hyperbaric 1% bupivacaine. All patients were monitored in the Recovery Room (RR) for at least one hour. Occurrence of hypotension and/or hypoxia in the Operating Room (OR) or the RR was immediately treated. Mental status was reassessed on the 1st and 2nd postoperative day and results were compared with the corresponding preoperative OBS scores both in GA patients and in SA patients. RESULTS: No statistically significant differences were found between pre- and postoperative OBS scores in both GA and SA group, whether "oriented" or "confuse". CONCLUSIONS: Mental status of elderly patients submitted to femoral neck repair doesn't seem to be influenced by the anesthetic technique chosen, independent of preoperative psychic conditions.

Aged↗