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G Cataldo

Publications and source records attributed to G Cataldo.

At least 19 recordsLinked to original sources

Organizational manipulation of gonadal hormones and systemic morphine analgesia in female rats: effects of adult ovariectomy and estradiol replacement.

Previous research has indicated the importance of sex in mediating the larger magnitude of mu-opioid receptor agonist-induced analgesia in male relative to female rodents. Whereas manipulations involving the adult activational effects of gonadal hormones minimally alter these analgesic sex differences, manipulations involving neonatal organizational effects of gonadal hormones have previously been shown to profoundly affect morphine analgesia. Thus, adult male rats neonatally castrated on the first day after birth displayed reductions in morphine analgesia relative to sham-operated males, and adult female rats neonatally treated with testosterone propionate on the first day after birth displayed enhancements in morphine analgesia relative to vehicle-treated females. Because neonatal androgenization in female rats produces an anovulatory syndrome that could change their adult hormonal milieu, the present study examined whether adult ovariectomy altered the magnitude of systemic morphine analgesia (1-5 mg/kg) in neonatal androgenized female rats relative to neonatal vehicle-treated female rats as well as gonadal steroid hormone replacement with estradiol benzoate. Intact male rats displayed significantly greater magnitudes and potencies (2- to 2.3-fold leftward shift) of systemic morphine analgesia than female rats treated neonatally with either vehicle (1-5 mg/kg) or testosterone (1.7-5 mg/kg). In turn, neonatal androgenized female rats displayed significantly greater magnitudes of systemic morphine (1, 5 mg/kg) analgesia than vehicle-treated female rats accompanied by a smaller 20% leftward shift in potency. Adult ovariectomy minimally affected morphine analgesia in neonatal vehicle-treated females, while significantly reducing the magnitude (1 mg/kg), but not the potency of morphine analgesia in neonatal androgenized female rats. Estradiol replacement therapy significantly increased the magnitude of morphine analgesia in both groups at some doses, but only changed the potency (20-30%) in females treated neonatally with vehicle. Taken together, these data suggest a limited organizational-activational gonadal hormone interaction in the mediation of systemic morphine analgesia in female rats.

Analgesics, Opioid↗

Indobufen compared with aspirin and dipyridamole on graft patency after coronary artery bypass surgery: results of a combined analysis.

BACKGROUND: Two prospective, randomized, double-blind clinical trials, performed in the UK and Italy, showed that indobufen, a reversible cyclo-oxygenase inhibitor, is as effective as, and safer than, a combination of aspirin with dipyridamole in preventing occlusion of saphenous vein coronary artery bypass grafts (CABG) 1 year after surgery. OBJECTIVE: To obtain, in a larger patient population, a more precise estimate of the possible differences in efficacy and safety between the two treatments. METHODS: We performed a combined analysis of the results of the two studies, based on the 1-year angiography data, on a total of 934 patients with 2258 saphenous vein distal anastomoses. RESULTS: Patients in the UK and Italy had similar baseline clinical characteristics. The analysis confirmed that there were no significant differences between the two treatment groups in the proportion of patients with one or more occluded grafts and in the proportion of occluded distal anastomoses. The combined analysis showed that the difference in response frequency (indobufen compared with aspirin and dipyridamole) was close to 0: 2.0% (95% confidence interval (CI) -4.2 to 8.2) in terms of patients, and 0.8% (95% CI -2.5 to 4.2) in terms of distal anastomoses. The 1-year incidence of postoperative major cardiovascular events was not statistically different between the treatment groups (19/694 indobufen compared with 25/678 aspirin and dipyridamole). CONCLUSIONS: Two multicentre CABG studies performed in different countries in patients with similar characteristics showed similar results in terms of graft patency. On the basis of the combined analysis, the two treatments can reasonably be considered to be equally effective in the prevention of graft occlusion.

Aspirin↗

Indobufen versus warfarin in the secondary prevention of major vascular events in nonrheumatic atrial fibrillation. SIFA (Studio Italiano Fibrillazione Atriale) Investigators.

BACKGROUND AND PURPOSE: The results of a large prospective randomized trial have shown the efficacy of oral anticoagulation in the secondary prevention of major vascular events in patients with nonrheumatic atrial fibrillation (NRAF); less well established is the role of antiplatelet agents. The present study compared the effects of indobufen, a reversible inhibitor of platelet cyclooxygenase, with those of warfarin in this setting. METHODS: A total of 916 patients with NRAF and a recent (< or = 15 days) cerebral ischemic episode were admitted to this multicenter, randomized study, during which they were treated with either indobufen (100 or 200 mg BID) or warfarin (to obtain an international normalized ratio of 2.0 to 3.5) for 12 months. The two groups (462 on indobufen and 454 on warfarin) were well balanced in terms of their main baseline characteristics. The primary outcome of the study was the combined incidence of nonfatal stroke (including intracerebral bleeding), pulmonary or systemic embolism, nonfatal myocardial infarction, and vascular death. RESULTS: At the end of follow-up, the incidence of primary outcome events was 10.6% in the indobufen group (95% confidence interval, 7.7% to 13.5%) and 9.0% in the warfarin group (95% confidence interval, 6.3% to 11.8%), with no statistically significant difference between treatments. The frequency of noncerebral major bleeding complications was low: only four cases (0.9%) of gastrointestinal bleeding were observed, all of them in the warfarin group. CONCLUSIONS: We conclude that, within the limitations of its design, this study may help the medical community in devising appropriate antithrombotic strategies for NRAF patients for whom oral anticoagulants are contraindicated or do not represent a feasible approach to treatment.

Adult↗

Baseline transition sleep and associated sleep episodes are related to the learning ability of rats.

The EEGs of 18 adult male Wistar rats were recorded during a baseline session lasting 7 h (day 1). The following day, rats were trained for a 2-way active avoidance task in an automated shuttle-box. A retention test was scheduled on the third day. On the basis of the number of avoidances scored during the training and retention sessions, rats were assigned to a fast-learning group (FL; achieving criterion during the training session), a slow-learning group (SL; achieving criterion in the retention test session), and a nonlearning group (NL; failing to achieve criterion). Vigilance states were determined by analyzing EEG data in 5-s epochs and calculating EEG power spectra of consecutive time intervals as short as 1 s. This high-resolution method led to the identification of transition sleep episodes that followed slow-wave sleep (SS) and were followed by waking (TS-->W) or by paradoxical sleep (TS-->PS). Comparison of the baseline sleep variables of the 3 behavioral groups revealed the presence of several significant differences. These observations were confirmed by the results of correlative analyses between baseline sleep variables and number of avoidances scored during the training and retention sessions. The most reliable indices of the capacity to learn the avoidance task were the amounts of SS preceding the TS-->W or the TS-->PS sequence, and the amounts of either component of the latter sequence. These variables displayed markedly higher values in FL rats. In addition, the amount of SS preceding TS-->W and the amount of TS-->(W) were significantly correlated with the number of avoidances scored during the training session. On the other hand, 1' SS-->(PS) and (SS)-->PS episodes were longer in NL rats than in SL or FL rats, respectively; and 2, the duration of SS-->(PS) episodes was inversely correlated with the number of avoidances of the first training period. The data are interpreted to suggest that TS and associated sleep episodes may predict the acquisition of the avoidance task, and the episodes of SS-->PS not associated with TS may predict the retention of innate responses, such as freezings or escapes.

Animals↗

Coronary angiography and aorto-coronary bypass surgery in type 2 diabetic patients.

Diabetic and non-diabetic subjects with angina who underwent angiography and were subsequently treated surgically or medically and followed up for 5 years were analysed in order to assess coronary angiographic findings, efficacy of coronary artery bypass grafting and prognostic criteria in Type 2 diabetic patients with angina as compared to non-diabetic subjects. A total of 1853 of non-diabetic and 145 diabetic subjects underwent angiography, including respectively 857 and 68 who had surgery. Perioperative mortality, survival, reinfarction and asymptomaticity rates were measured. Multivariate analysis of risk factors and clinical features was performed. Diabetic patients had a higher frequency of multi-vessel stenoses (p < 0.001), a greater diffusion of stenoses (p < 0.005) and worse left ventricular motion (p < 0.005). No differences were found in perioperative infarction and mortality. Operated diabetic patients had a higher survival rate (p < 0.001) and a longer symptom-free period (p < 0.05) than unoperated diabetic patients. Operated diabetic patients had similar survival and more frequent recurrence of angina (p < 0.05) than operated non-diabetic patients. Survival rate was lower for unoperated diabetic patients than unoperated non-diabetic patients (p < 0.05). Recurrence of angina was similar. Multivariate analysis did not indicate diabetes as a factor affecting survival. It is concluded that surgery for Type 2 diabetic patients with coronary artery disease is a suitable therapeutic option conferring a reduction in mortality regardless of the presence of diabetes.

Adult↗

Coronary artery disease after heart transplantation: non-invasive evaluation with exercise thallium scintigraphy.

In order to assess the value of exercise thallium scintigraphy for the detection and prognosis of graft coronary artery disease, 50 heart transplant patients (mean age 46.7 +/- 11.5 years) were studied within 48 h of their scheduled yearly coronary angiography and subsequently followed up for a mean of 13 +/- 3 months. Angiography revealed normal coronary arteries in 35 patients, and coronary artery disease in 15 (two with type A lesions, seven with type B lesions and six with both). Seven patients had one or more stenoses > or = 50%. Exercise thallium scintigraphy was negative in all patients with normal coronary arteries (100% specificity), and abnormal in 10 of 15 patients with coronary artery disease (67% sensitivity). Fixed defects were seen in six cases, transient defects in two and both in two; the results of the test were abnormal in all seven patients with > or = 50% lesions. During follow-up, none of the patients with a normal exercise thallium scintigraphy experienced any cardiac event; in the group with abnormal results, four cardiac events occurred. Although further studies are needed to confirm these results, exercise thallium scintigraphy seems to be useful in evaluating post-transplant coronary artery disease: it is accurate in detecting the most severe stenoses and provides some prognostic information.

Adult↗

Factors influencing 1-year patency of coronary artery saphenous vein grafts. Studio Indobufene nel Bypass Aortocoronarico (SINBA).

BACKGROUND: To evaluate the possible influence of a series of clinical angiographic and surgical variables on the 1-year patency of saphenous vein (SV) coronary graft, data collected prospectively in a multicenter randomized clinical trial were analyzed. METHODS AND RESULTS: The study group included 349 patients--847 SV distal anastomoses--who underwent angiography at a median time of 374 days after surgery. By logistic binomial regression analysis, age, sex, smoking habits, hypertension, high cholesterol, previous myocardial infarction, and angina were not found to be significant factors leading to graft occlusion. Among the angiographic and surgical variables, the following were retained as predictive of higher occlusion risk: (1) vessel diameter (< or = 1.5 mm versus > 1.5 mm, odds ratio (OR) = 2.46); (2) the location of the grafted vessel, namely, the right coronary artery versus the left anterior descending (OR = 2.15); and (3) the wall motion of the vessel-dependent myocardial region (altered versus normal: OR = 2.12). The presence of two or three risk factors multiplied the occlusion risk up to 11-fold. CONCLUSIONS: The study suggests that vessel diameter, wall motion of the vessel-dependent myocardial region, and location of the grafted vessel are the main determinants of SV coronary graft patency during the first postoperative year. Knowledge of these artery-specific factors may provide a basis for estimating the risk of graft occlusion, thereby modifying surgical strategy and postoperative surveillance.

Aspirin↗

A linear model suitable for assessing graft patency in controlled clinical trials. SINBA Group.

In clinical trials carried out to assess the efficacy of different drugs in reducing the frequency of occlusion after coronary artery bypass, the ratio of the number of patients with at least one occluded anastomosis to the number of patients catheterized up to a given day is a widely adopted statistic. In the early evaluation (at 1 or 2 months after surgery), this is affected by the distribution of timing of angiography and it tends to underestimate the cumulative probability of occlusion because patients whose anastomoses are all patent at angiography and occlude between angiography and the day at which the ratio is estimated do not contribute their events to the numerator of the ratio. One may sensibly assume that this underestimate does not affect the evaluation of the efficacy of treatments tested "within" the trial. In contrast, since the distributions of the timing of angiography vary substantially from trial to trial, it can make comparisons "between" trials unclear and possibly biased. The aim of this article is to suggest an alternative approach of statistical analysis in terms of logistic regression. By modeling the dichotomous response given by each patient in function of time at angiography, type of treatment, and other possible covariates, asymptotically unbiased estimates of the cumulative probability of occlusion are attained. Furthermore, the pertinent hazard function can be estimated. The main features of the model are discussed and the results obtained by fitting early data collected in the Studio Indobufen Nel Bypass Aortocoronarico (SINBA) are given.

Anastomosis, Surgical↗

[Angina pectoris induced by oral administration of dipyridamole].

Five cases scheduled for myocardial elective coronary artery bypass (CAB), who developed angina and ischemic electrocardiographic changes, after oral administration of dipyridamole (100 mg) are reported. Dipyridamole induced myocardial ischemia has been demonstrated in subjects with coronary artery disease, if this drug is administered intravenously. To our knowledge, only one study reported this side effect, after oral route, in four patients awaiting urgent CAB, for unstable angina. Based on our and other Authors experience, preoperative dipyridamole should be used with caution, especially in patients with unstable angina.

Administration, Oral↗

Echocardiographic assessment of cardiac allograft rejection.

Twenty-one patients surviving orthotopic cardiac transplantation were studied by serial M-Mode and cross-sectional echocardiography on the same day as endomyocardial biopsy (EBS) (n = 205) during a mean follow-up period of 7.7 +/- 6 months. Results of EBS and the corresponding echocardiograms were divided into three groups: (1) no rejection (62 patients); (2) onset of mild rejection (11 patients); (3) onset of moderate rejection (17 patients). Groups 1 and 3 differed significantly in interventricular septum plus posterior wall thickness (IVS + PWth) (P less than 0.001), LV mass (P less than 0.001), LV ejection fraction (LVEF) (P less than 0.001), increased myocardial echogenicity (ME) (P less than 0.01), impaired RV wall motion (P less than 0.001). Groups 1 and 2 differed significantly only in increased ME (P less than 0.01). Groups 2 and 3 differed significantly in IVS + PWth (P less than 0.05), LV mass (P less than 0.01), LVEF (P less than 0.01), and impaired RV wall motion (P less than 0.01). With acute rejection we observed (1) increase of greater than 4 mm in IVS + PWth (55%), (2) increase of greater than 30% in LV mass (34%), (3) reduction of greater than 10 points in LVEF (27%), (4) RV dilatation and wall motion impairment (31%), (5) appearance or marked increase of pericardial effusion (34%), (6) increased ME (58%). Specificity of the individual criteria ranged from 95.6% to 100%.(ABSTRACT TRUNCATED AT 250 WORDS)

Biopsy↗

[Cardiac transplantation: role of echocardiography in the diagnosis of rejection].

Sixteen patients surviving orthotopic cardiac transplantation were studied by M-Mode and two dimensional echocardiography (ECHO) on the same day of cardiac biopsy during (n = 138) a mean follow-up of 6.2 +/- 4 months (range 1-4 months). The following parameters were measured: right ventricular end diastolic internal diameter (RVdD) left ventricular end diastolic internal diameter (LVdD), interventricular septum (IVS) and posterior wall (PW) diastolic thickness, myocardial mass (MM); LV cross sectional area (CSA) and ejection fraction (EF). LV and RV wall motion, pericardial effusion and myocardial echogenicity (brightness) were evaluated by inspection. Every ECHO was compared with the previous one for qualitative and quantitative changes. In the absence of rejection, analysis of the data during the first postoperative week showed the following results: mean EF = 51 +/- 6.8%, dilated overloaded RV (30.4 +/- 4.8 mm), various amount of pericardial effusion; FE increased significantly (55.3 +/- 4%; p less than 0.001) and RVdD decreased (26.6 +/- 5mm; p less than 0.001) after the 2nd week and remained stable thereafter, while pericardial effusion decreased or disappeared. The mean values of the remaining ECHO parameters did not very significantly during the follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Indications for surgical treatment in post-infarction angina.

In order to evaluate whether or not criteria for surgical revascularization in patients with early post-infarction angina (EPIA) should be different from those commonly used for patients with angina, the incidence and prognostic implications of EPIA were analysed in 188 AMI patients in Killip's class I or II on admission. Sixty-two patients (33%) complained of EPIA (Group I) and 126 patients were symptom-free (Group II). There were no differences between the two groups in in-hospital and late mortality and reinfarction. On the contrary, severity of angina was significantly associated with the occurrence of in-hospital and late cardiac death, reinfarction and revascularization procedures. EPIA patients underwent revascularization procedures significantly more frequently than group II patients, both during hospitalization (29% versus 1%; P less than 0.001) and follow up (10% versus 1%; P less than 0.01). Coronary artery involvement was significantly more severe in group I than in group II and in the operated patients compared with the non-operated ones. Our data suggest that the severity of angina should be the leading criterion for surgery, as it is able to identify most of the patients with severe coronary artery disease and poor prognosis.

Aged↗

[Long-term clinical results after intervention using aorto-coronary bypass].

The survival and symptoms of 294 consecutive patients discharged from the hospital after isolated coronary artery bypass grafting from 1970 to 1975 were evaluated 6 to 10 years after surgery. The actuarial 10 years expectancy of cardiac death as 10.0 +/- 2.4% the non fatal myocardial infarction one was 11.2 +/- 2.8; the yearly probability of severe ischemic event therefore was 2.1%. One year after surgery, 56% patients were free from angina, 31% improved and only 7% symptomatically unchanged. These percentages became 45%, 26% and 13% respectively at the end of the follow-up, thus showing a definite though slight deterioration. Clinical status one year after operation was predictive of further evolution: only 6.2% of the symptom-free patients developed severe ischemic events, as opposed to 20% of the highly symptomatic ones. The actuarially determined curve of recurrence of angina in the patients asymptomatic at the first control shows, after 2 years of steady state, a progressive upslope which reaches 40% by the 7th year and 90% at the 10th year of follow-up. Subgroup analysis indicated that long term prognosis is influenced by the presence of left main stenosis and by perioperative myocardial damage. Clinical results at one year are influenced by completeness of revascularization, graft patency and perioperative myocardial infarction. The tendency of symptoms to recur in patients who are free from angina one year after intervention, is similar in the various subgroups and is adversely influenced only by perioperative myocardial damage. These results show that coronary artery bypass grafting has a true clinical impact, although symptomatic improvement is somewhat temporary.

Actuarial Analysis↗

Effects of nifedipine, acebutolol, and their association on exercise tolerance in patients with effort angina.

The action of nifedipine (N), acebutolol (A), and their association (A+N) was studied in 16 patients suffering from effort angina with documented coronary artery disease. The therapeutic action was valued by bicycle effort stress test after oral administration of medications in comparison with placebo (P), following a double-blind random sequence of treatments. Working capacity significantly increased after A (507 +/- 450 mkp, p less than 0.05), after N (1,140 +/- 767 mkp, p less than 0.001), and after A+N (1,198 +/- 644 mkp, p less than 0.01). The increments of work after P administration were not significant. Moreover, fatigue instead of angina appeared as a stopping criterion in 8 patients after A+N, and in only 1 patient after P, A, and N.

Acebutolol↗