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Biomedical subjects

G Gamba

Publications and source records attributed to G Gamba.

185 records · Page 11Linked to original sources
PubMedDate not supplied

Activation of the hemostatic process in patients with unruptured aortic aneurysm before and in the first week after surgical repair.

BACKGROUND AND OBJECTIVE: It has been previously suggested that activation of coagulation and fibrinolysis may sometime occur in patients with unruptured aortic aneurysm. However, the incidence of this complication and the effect of surgical repair are unknown. The objective of our study was to gain further information on this topic. METHODS: We investigated activation of the hemostatic process in 20 consecutive patients with unruptured abdominal aortic aneurysm. We then evaluated the effect of surgical repair of the vascular abnormalities. RESULTS: Both before and in the first week after surgery, the large majority of patients showed clear signs of activation of coagulation (increased plasma levels of prothrombin fragment 1 + 2 and fibrin peptide A), and many had low levels of the natural anticoagulant antithrombin III. Platelets were activated in all cases (high levels of plasma beta-thromboglobulin), and signs of platelet consumption (thrombocytopenia and/or increased mean platelet volume) were present in most of them. INTERPRETATION AND CONCLUSIONS: Activation of the hemostatic process occurs in nearly all patients with abdominal aortic aneurysm and could play a role in the hemorrhagic and thrombotic events that can complicate the clinical development of these subjects.

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[Role of renal interstitial pressure on chronic control of arterial blood pressure].

Several lines of evidence support the hypothesis that the kidney is involved in the generation and maintenance of arterial hypertension. The evidence comes from: 1) experimental models of hypertension showing that induction of all secondary forms of hypertension require some maneuvers to reduce the renal sodium and water excretion; 2) the existence of several rat models with genetic hypertension exhibiting a shift of the pressure-natriuresis relationship toward higher pressures; 3) renal transplantation experiments between normal and genetically hypertensive rats showing that hypertension follows the kidney; and 4) human genetic disease with chronic changes in arterial blood pressure levels in which all identified genes so far are part of a common pathway for renal sodium reabsorption. It is well known that pressure-natriuresis is the mechanisms by which any changes in arterial pressures are followed by changes in renal sodium excretion. However, it has been recognized now that the interstitial pressure in renal medulla is the linkage between arterial pressure levels and the amount of sodium reabsorption. Thus, the medullary interstitial pressure might be involved in the long-term control of systemic arterial pressure. Part of these new lines of evidence associating the renal medullary interstitial pressure in the control of arterial pressure are due to the availability of new methods such as laser-doppler flowmetry and videomicroscopy, that allows the measurement of blood flow in renal cortex and medulla separately. Several studies with this methodology show that medullary, but not cortical pressure and blood flow correlate positively with natriuresis. What still remains unsolved is the mechanism by which renal sodium reabsorption increases or decreases after changes in the medullary interstitial pressure occur.

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