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Biomedical subjects

G Del Rosso

Publications and source records attributed to G Del Rosso.

33 records · Page 2Linked to original sources
PubMed1981

EMG changes in chronically dialyzed uraemic subjects undergoing d, 1-Carnitine treatment.

The deficiency of muscle Carnitine secondary to chronic dialysis frequently induces lipid storage in striated muscles associated with progressive myocardial involvement. Serial EMG recordings disclose the presence of several motor unit potential families in tibialis anterior muscle related to damage of peripheral nervous fibres and muscular districts due to the storage of lipid vacuoles. The administration of d,1-Carnitine to twenty chronically dialyzed uraemic patients significantly improved distal latency of the M response of the external peroneal nerve at the EDB muscle and the MUP properties suggesting a Carnitine-dependent amelioration of fatty acid oxidative processes both in muscle and Schwann cells. The main side effects following d,1-Carnitine oral administration (3 g/daily) is a myasthenia-like symptom complex that is promptly reversed on drug interruption.

Action Potentials↗
PubMed1981

Neurophysiological abnormalities in uraemic encephalopathy.

Sophisticated electrophysiological assessments have been employed to display cortical alterations in uraemia and to follow the influence of haemodialysis treatment (RDT). Flash-Visual Evoked Responses (VERs); Pattern Reversal Visual Evoked Potentials (VEPs); Brain-stem Auditory Evoked Responses (BAERs); Electroencephalogram (EEG) with Berg's analysis of frequencies were recorded in 15 uraemic patients, 10 of whom subsequently started RDT. VER latency was delayed compared with controls and unmodified after RDT. VEP latency was similarly delayed returning to normal range with RDT. BAER, preliminarily recorded only in 10 patients, showed increased latency of waves I, III, V. EEG showed 7 to 10 and 10 to 13 Hz to be reduced, and after eight months of haemodialysis the 13 to 20 Hz band increased.

Adult↗
PubMedDate not supplied

[On-line HFR and removal of uremic toxins inducing the loss of phospholipidic asymmetry of the erythrocyte membrane].

The phospholipids of the erythrocyte membrane are normally distributed asymmetrically in the double layer with the aminophospholipid phosphatidylserine (PS) present only on the inside of the membrane, since its exposure on the outside has numerous physiopathological consequences. In previous studies we have observed that solutes retained in uremia cause increased exposure of PS on the outer surfaces of the erythrocyte membrane and that this phenomenon may be involved in the uremic physiopathology, reducing erythrocyte survival and encouraging abnormal erythrocyte-endothelium interactions. The capability of the extracorporeal blood clearance treatment in removing the circulating uremic factors, responsible for the increased exposure of PS in red blood cells (RBC), was evaluated in 6 chronic uremic patients treated with haemodialysis (HD) or with on-line HFR in a random cross-over perspective study. The PS removal was evaluated indirectly by measuring the expression of PS in normal RBC incubated with uremic plasma obtained at various moments of the clearance session. The capability of the uremic plasma to expose PS on the RBC of healthy subjects (n-times increase compared to incubation of normal RBC with autologous plasma) was essentially unmodified during HD (3.3 +/- 0.2 pre HD; 3.3 +/- 0.1 after 2 hours; 3.1 +/- 0.2 at the end of the session) but was reduced during HFR (3.1 +/- 0.2 pre HD; 2.3 +/- 0.1 after 2 hours; 1.6 +/- 0.1 at the end of dialysis; p<0.001 at the end of dialysis vs pre and after 2 hours and p<0.001 vs HD at 2 hours and at the end of the session). The reduced capability of the uremic plasma obtained during the HFR session to expose PS in normal RBC, proves removal of the plasmatic uremic factors able to externalize the PS. To assess whether this removal effect is linked to the cartridge containing styrene resin used in the treatment with HFR, samples of ultrafiltrate were taken before and after the cartridge and its capability to express PS on normal RBC was measured. The absolute RBC values expressing PS (%) were (pre-cartridge vs post-cartridge) 8.6 +/- 0.3 vs 3.8 +/- 0.2 after 5 minutes from the start of the session; 3.9 +0.1 vs 1.6 +0.2 halfway through the session; 3.1 +/- 0.1 vs 1.3 +/- 0.66 at the end of the session (p<0.005 pre vs post at all times). Our results show that uremic compounds able to cause increased exposure of PS in RBC can be removed during on-line HFR, mainly thanks to the adsorption properties of the cartridge containing resin. This removal might be of benefit to uremic patients, improving the anaemic condition and reducing abnormal RBC-endothelium interactions which may contribute to endothelial disorder during uremia.

Erythrocyte Membrane↗
PubMedDate not supplied

Clinical effects of recombinant human erythropoietin in hemodialysis patients. Results of the "Abruzzo" Multicenter Trial.

Anemia in regular dialysis treatment (RDT) patients is primarily due to a deficiency in renal-derived recombinant human erythropoietin (EPO). The aim of this study was to evaluate the results of a multicenter trial in 81 end-stage renal disease (ESRD) patients on RDT. An "open" study was conducted over 2 years; starting dose of r-HuEPO was 50 IU/kg/three times weekly i.v. and eventually was increased in steps of 25 Ul/kg/dialysis until 300 Ul/kg/week. Mean weekly dose per patient was 15 Ul/kg, with mean Hb increase of 27.5%. Mean hematocrit (Hct) levels increased in these patients from 22.9 +/- 2.5 to 31.7 +/- 2.8 (p less than 0.001) after 2 years of therapy. Both spontaneous and evoked potentials improved. The response to r-HuEPO is dose dependent; hypertension and hyperkalemia are the most common side effects, but they are easily controlled. Central nervous system function before and after treatment is improved, and seems consistent with an enhancement of patients' quality of life.

Adult↗
PubMedDate not supplied

Therapeutic effects of simvastatin on hyperlipidemia in CAPD patients.

A causal link between hypercholesterolemia due to elevated plasma concentrations of LDL and VLDL remnants of CAPD patients has been established. The effects of 24 weeks of treatment with Simvastatin, a new HMG coenzyme A-reductase inhibitor (at 20 and 40 mg/day) on serum lipid, lipoprotein, and apolipoprotein A-I and B concentrations, as well as safety parameters and subjective side effects, were evaluated in eight patients (mean duration CAPD 24.80 +/- 7.50 months, age 54.50 +/- 13.70 years). Maximal effects on plasma lipoprotein and apolipoprotein concentrations were achieved after 4 weeks, and remained stable thereafter during the study. Mean fasting plasma cholesterol concentrations decreased from 280.5 +/- 60.2 mg% to 190.2 +/- 40.4 mg/dl (p less than 0.005) (-47%); mean plasma LDL-cholesterol concentrations also decreased from 257.6 +/- 13.4 mg% to 190.5 +/- 15.4 mg/dl (p less than 0.001) (-35%). Apolipoprotein A and B concentrations decreased significantly from 1.78 +/- 0.19 to 1.40 +/- 0.22 g/L (p less than .005) and 1.81 +/- 0.26 to 1.38 +/- 0.20 g/L (p less than .005). These data substantiate the view that Simvastatin is well tolerated and that no serious clinical or adverse laboratory effects have been observed. It appears to be a promising drug for the effective control of hyperlipemia in a large proportion of hypercholesterolemic patients, reducing their cardiovascular morbidity while on CAPD.

Adult↗
PubMedDate not supplied

[Blood pressure changes induced by physical exercise and tyramine infusion in hypertensive and normotensive subjects].

The aim of our investigation was to assess blood pressure (BP) and heart rate (HR) variations in 20 essential hypertensive male inpatients (WHO class I and II) and in 20 normotensive healthy volunteers submitted to three provocation tests: isometric handgrip (IHG), bicycle ergometric exercise (BEE) and tyramine infusion (TI) given as i.v. boluses with saline in a single-blind manner. According to our data, IHG induced a comparable rise of systolic blood pressure (SBP), diastolic blood pressure (DBP) and heart rate in both hypertensive and normotensive subjects. BEE, compared with IHG, caused a more significant (p less than 0.01) rise in SBP and heart rate in both groups. By contrast, DBP during BEE increased significantly in hypertensive (p less than 0.01), but decreased slightly in normotensive subjects (p = n.s.). TI caused a dose dependent SBP rise in both groups studied, while DBP and HR were unaffected. BP elevation was, however, more marked in hypertensive subjects. Confirming this finding, significantly lower tyramine doses were required to produce the same SBP increase in hypertensive patients than in the normotensive volunteers. In short, an SBP rise during TI, and a DBP rise during BEE may be the markers of enhanced cardiovascular reactivity on the part of hypertensive subjects. Our study suggests that BP reactivity to stress may be different according to the laboratory stress employed and also that BEE and TI are more useful than IHG for the assessment of enhanced cardiovascular response to stress in hypertensive subjects.

Adult↗
PubMedDate not supplied

Plasma renin activity (PRA) in type I diabetes mellitus: PRA and metabolic control in diabetes.

Plasma renin activity (PRA) and aldosterone were evaluated in 39 diabetic children and adolescents and in 39 healthy subjects. The mean values of PRA in the diabetics were higher than in controls not only basal (means +/- SD: 2.7 +/- 1.1 vs. 1.3 +/- 0.6 ng/ml/h) but also after physical exercise (5.2 +/- 3.84 vs. 2.8 +/- 0.7 ng/ml/h). Aldosterone was similar in diabetics and controls (basal: 18.1 +/- 6.6 vs. 16.9 +/- 5.1 pmol/l; after physical exercise: 5.3 +/- 14.1 vs. 39.9 +/- 7.1 pmol/l). There was a significant correlation between HbA1c and PRA after exercise (p less than 0.01). The diabetic children were subdivided into 3 groups according to their stable HbA1c values (group A: less than 8.5%; group B: 8.5-10.9%; group C: greater than 11.0%). A group of diabetics (group C) were re-evaluated after a long period of a good metabolic control. The values of PRA were decreased and similar to the controls (PRA basal values: 1.7 +/- 1.9 ng/ml/h; after exercise: 3.2 +/- 2.9 ng/ml/h). Our study suggests that PRA abnormalities present in diabetic patients can be reversible if a good metabolic control is achieved.

Adolescent↗