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Biomedical subjects

G Giuliano

Publications and source records attributed to G Giuliano.

At least 73 records · Page 4Linked to original sources
PubMed1987

Long-term hypotensive treatment with nitrendipine in mild to moderate essential hypertension: preliminary results of a placebo-controlled study versus atenolol.

Nitrendipine is a dihydropyridine calcium antagonist suggested to be a new drug for first-line antihypertensive therapy, possibly active in once-daily administration. In the present study the acute and long-term hypotensive effects of nitrendipine have been evaluated in comparison with those of atenolol in a randomized, double-blind, clinical trial. Twenty-four patients have been studied, and the effects of treatment have been evaluated both at rest and during psychological and physiological stresses. Hemodynamic noninvasive parameters have also been obtained, at rest and during mental arithmetic tests, by a continuous-wave Doppler technique. Preliminary results about the first 13 consecutive patients are reported here. Nitrendipine induced a highly significant acute hypotensive effect (2 h after drug administration), whereas no effect was observed for atenolol except for heart rate. During chronic treatment (5 weeks), nitrendipine showed less hypotensive effect than atenolol when BP values 24 h after the last administration were analyzed, but significantly more effect when values obtained 2 h after drug administration were evaluated. These findings confirm that nitrendipine is effective in decreasing blood pressure, but the once-daily administration may not bring about the maximum effect in all patients. Interesting aspects of this drug, which make the clinical use of this compound safe, are represented by apparent lack in tolerance and rebound, and by the moderate increase in cardiac output associated with the treatment.

Adult↗
PubMed1986

The gene crtI mediates the conversion of phytoene into colored carotenoids in Rhodopseudomonas capsulata.

Carotenoids are membrane pigments present in all photosynthetic organisms, providing essential photoprotective functions. The first carotenoid formed in the pathway is phytoene, a colorless compound which is then converted into colored carotenoids by a series of dehydrogenation reactions. In the photosynthetic bacterium Rhodopseudomonas capsulata mutations that affect carotenoid biosynthesis before colored carotenoids are formed have a "blue-green" phenotype as opposed to the "red" of wild type cells. We have extracted carotenoids from several blue-green mutants and found that two strains (BPY69 and BPY102) accumulate phytoene and no colored carotenoids. These mutants failed to dehydrogenate phytoene in an in vitro assay. However, dehydrogenation of this compound can be achieved in vitro by adding a cell-free extract from another blue-green mutant blocked earlier in the pathway. Genetic complementation and deletion mapping indicate that the gene crtI is responsible for the conversion of phytoene into colored carotenoids in these mutants.

Carotenoids↗
PubMed1986

Comparison of pain perception in normotensives and borderline hypertensives by means of a tooth pulp-stimulation test.

Recent studies indicate a reduced sensitivity to pain in genetically and experimentally hypertensive rats. A similar finding is also reported for human established hypertension. However, to our knowledge, no data have been reported in borderline hypertension. The aim of this study was to assess in subjects with borderline hypertension the sensory and pain thresholds by a noninvasive pulp-stimulation test performed with a commercial pulp tester that delivered stepwise increased electrical stimuli to four healthy teeth. The data reported are the means of measurements. In order to assess the possible importance of differences in the selection of the controls, two distinct groups of normotensives were chosen, one of volunteers and the other of outpatients. Significantly higher values for the pain and sensory thresholds were observed in borderline hypertensives compared with pooled normotensives. No significant effect on pain perception could be observed for sex, whereas a significant tendency toward higher threshold levels was found for younger subjects. In two normotensive groups, the sensory and pain thresholds were significantly higher in volunteers than in patients. These results suggest that changes in pain perception are present not only in established hypertension but also in borderline hypertension and, moreover, that differences in the selection of normotensive controls can have important influences on the results.

Adult↗
PubMed1986

Effects of one year of physical training on borderline hypertension: an evaluation by bicycle ergometer exercise testing.

Previous observations have suggested the possibility of separating the borderline hypertensive population into two groups on the basis of blood pressure responses to maximal exercise testing. In order to evaluate the effects of 1 year of physical training on hypertensive subjects, 14 men with resting borderline hypertension and with a normal pressure response to exercise (group I) and 12 with resting borderline hypertension but with an abnormal pressure response to exercise (group II) underwent a maximal bicycle ergometer stress test in a sitting position before and after the training period. In group I, systolic and diastolic blood pressure levels both at rest and during submaximal exercise were significantly reduced after the training period. In group II, resting systolic blood pressure was unchanged, whereas resting diastolic pressure was significantly increased. During submaximal exercise, systolic and diastolic blood pressure showed only mild, nonsignificant differences when compared before and after training. No differences were found during maximal exercise. Blood pressure response to stress testing is useful to identify early stages of the disease and to plan preventive measures consisting of regular physical training either alone or associated with dietary and/or pharmacological treatment.

Adult↗
PubMed1986

Vasculitic purpura in vinyl chloride disease: a case report.

Vinyl chloride (VC), a volatile substance mostly used for polyvinyl chloride (PVC) synthesis, is a systemic toxicant particularly noxious to endothelium. Angiosarcoma of the liver, Raynaud's phenomenon, scleroderma-like lesions, acroosteolysis and neuritis are known to be typical vinyl chloride-associated manifestations (VC disease). A so far unknown feature of the disease is purpura. This was first observed by the authors in a worker of a PVC-producing plant. The skin eruption was characterized by small purpuric maculae with tiny, palpable spots and papulae, mostly concentrated on the lower part of the legs, changing into bullae, pustules and crusts and tending to spontaneous regression after withdrawal from VC exposure. A skin biopsy revealed marked inflammatory reaction with a mostly lymphocytic and histiocytic infiltration around and in the walls of dermal arterioles. The finding of increased circulating immune complexes and anti-smooth muscle autoantibodies strengthens the hypothesis that immunologic changes play a role in the appearance of "vinylic purpura."

Adult↗
PubMed1986

Ischemic heart disease: clinical and pathological mismatch.

Disagreements between dynamic and postmortem morphology arise mainly from different imaging and selection of study population. The high frequency of severe and multivessel atherosclerotic stenosis in non cardiac patients and healthy subjects dying accidentally questions the direct cause-effect relationship between stenosis and ischemic heart disease; supports the view the dramatically enlarged collaterals always found in this condition may have an adequate compensatory role; and suggests the ineffectiveness of occlusion at the site of severe stenosis already bypassed by collaterals. The degree and number of severe stenoses in ischemic heart disease do not predict onset, course, complications, infarct size or death. On the other hand, the presence in this disease of three different types of morpho-functional myocardial damage indicate that different pathogenic mechanisms exist. Complications and death appear related more to metabolic disorders linked with adrenergic unbalance than to ischemia and subsequent expansion of primary infarct necrosis. Finally, postmortem findings show that lympho-plasmacellular inflammation of coronary atherosclerotic plaques is significantly more frequent (100% acute infarct, 88% chronic ischemia, 83% sudden coronary death, 64% healthy controls), severe and diffuse in all plaques in single patients compared to controls. Its preferential location around pericoronary nerves suggests the working hypothesis that it may be the cause of spasm and/or regional alterations of cardiac contractility with extravascular compression of the intramyocardial vasculature. These functional mechanisms could explain the cineangio imaging of coronary cut off rather than thrombus.

Angina Pectoris↗
PubMed1985

Comparison of sensory and pain threshold in tooth pulp stimulation in normotensive man and essential hypertension.

Recent studies indicate a diminished responsiveness to noxious stimuli in arterial hypertension in the experimental animal. A similar finding is also reported in the only study published to our knowledge on this subject in man. The aim of the study was to assess in humans the sensory and pain threshold by a non-invasive tooth pulp stimulation test (stepwise increased electrical stimuli delivered by a commercial pulp tester). Subjects had to report when they started to feel pulp stimulation and when this became painful. The data reported are the means of the measurements on four healthy teeth in each subject. Significantly higher values (expressed as relative units [RU]) were found in 28 non-treated essential hypertensives compared with 33 normotensive controls for sensory threshold (40.64 +/- 8.07 versus 29.96 +/- 6.82 RU, P < 0.0001) and for pain threshold (55.67 +/- 12.74 versus 42.08 +/- 12.58 RU, P < 0.001). Multivariate analysis of variance showed that this difference was apparently not related to age and sex. These data lend further support to the view that pain modulation may be altered in the hypertensive state in man.

Adolescent↗
PubMed1985

[Respiratory function in chemical workers].

The authors have evaluated the trend of the forced expiratory flows at low lung volumes and of the diffusing capacity for CO in a group of chemical workers of a dye factory, exposed to mineral dusts, organic pigments and solvents. Prevalences of chronic bronchitis and dyspnea, as evaluated by CNR questionnaire, were 15 and 32%. FEF25-75, MEF50 and MEF75 showed statistically significant differences with reference values. The reduction of KCO% was almost completely accounted for by smoking habit. During exercise, DLCOSS2 did not reach the expected values. 71% of the subjects with a diagnosis of COLD had worked more than 15 years in the dye factory. These results suggest a negative effect of the working environment, together with cigarette smoking, on lung function of subjects with a medium-long-term exposure.

Carbon Monoxide↗
PubMed1984

A study of the semeiological reliability of dorsalis pedis artery and posterior tibial artery in the diagnosis of lower limb arterial occlusive disease.

Routine diagnosis of suspected occlusive arterial disease of the lower limbs are often based on the pulse absence at the dorsalis pedis artery. However many of these diagnoses are not confirmed after more thorough tests, and this fact arises the problem of the semeiological reliability of the above mentioned artery. Researches carried out by several authors in normal individuals on the dorsalis pedis artery yielded controversial results. Three hundred-sixty subjects free of occlusive arterial disease were then examined by means of clinical and Doppler investigation in order to assess the semeiological reliability of the dorsalis pedis artery in the diagnosis of occlusive arteriopathy of lower limbs, when compared to the posterior tibial one. The conclusion is drawn that a greater semeiological reliability must be attributed to the latter, due to its lesser "absence" incidence.

Adolescent↗
PubMed1984

1-alpha-OH-cholecalciferol (1-alpha-OHD3) and low phosphate diet in predialysis chronic renal failure: effects on renal function and on secondary hyperparathyroidism.

The effect of 1-alpha-OHD3 on the rate of decline of renal function was studied in 18 patients with predialytic chronic renal failure. 9 patients with serum creatinine 4.19 +/- 1.63 mg/dl, were treated with 1-alpha-OHD3 0.4 +/- 0.11 micrograms/day and a low phosphate diet and 9 patients, with serum creatinine 3.69 +/- 1.24 mg/dl, received the low phosphate diet alone. In the first group retrospectively in 8 patients up to 3-44 months and prospectively in all patients reciprocal values of serum creatinine levels fell linearly with time. Comparison of the slopes of the regression lines before and following the start of treatment did not show statistical differences in 6 cases, in 1 case the decline of renal function improved significantly and in 1 case it became positive. Serum calcium increased significantly (p less than 0.025), alkaline phosphatase decreased (p less than 0.005) and serum iPTH decreased in 6 of 8 cases. In the low phosphate diet group, serum calcium, alkaline phosphatase did not change while iPTH increased in 8 of 9 cases. The rate of decline of renal function before treatment in 3 cases did not improve after the institution of the diet. In conclusion improvement or prevention of secondary hyperparathyroidism in predialytic chronic renal failure can be achieved with daily doses of less than or equal to 0.5 micrograms 1-alpha OHD and a low phosphate diet. The small increment in serum calcium levels induced by the treatment did not accelerate the deterioration of renal function while showing a better control of alkaline phosphatase and serum iPTH than the low phosphate diet alone.

Adult↗
PubMed1980

[General anesthesia with continuous-infusion ketamine].

The importance of Ketamine in continuous perfusion is described on the basis of a studied carried out in 30 patients. The clinical data are compared with results predicted by the mathematical model. Special study was made of the behaviour of the cardiocirculatory apparatus, particularly in reference to myocardial contractility and electroencephalographic activity. It is concluded that the drug can be advantageously used in continuous perfusion.

Akathisia, Drug-Induced↗
PubMed1980

[The genetic influence on the labile pseudo-ischemic T-wave (author's transl)].

After the demonstrated familial incidence of the "labile pseudo-ischemic T-wave" patterns, a research has been carried on in order to ascertain the possible genetic conditioning of the anomaly. The analysis of the pattern of the families, formed starting from the subjects carrier of the above-mentioned pattern, carried on with the Haldane sibships method corrected with that proposed by Lejeune, leads to affirm that the models of hereditary transmission able of explaining the found out distributions are of a not simple recessive type. The distribution of frequence of the subjects by "aplotype HLA" does not permit to settle a reliable correlation between the considerated electrocardiographic anomaly and the aplotype, at least as far as the number of the examined cases is concerned.

Adult↗
PubMed1980

[The genetic incidence on QT interval values in ECG (author's transl)].

On the grounds of the well-known finding of the familial incidence of the elongated QT interval in various conditions, a research has been carried on in order to point out the possible genetic conditioning of this electrocardiographic pattern. From the analysis of the QTc values in the components of 28 families of carriers of "labile pseudo-ischemic T wave" it comes out that the QTc phenomenon is conditioned by the heredity. The distribution of the aplotypes HLA does not permit to settle any correlation with these genetic markers on account of the restricted number of the examined cases.

Adult↗
PubMed1978

[A specific anomalies of ventricular repolarization. Dysgenetic syndromes caused by functional asymmetry of the cardiac sympathetic nerves].

The following is a personal study of the case histories of 3 patients, spontaneous carriers of "labile pseudo-ischemic T wave" and of their direct consanguineous, a total of 25 subjects. In these three families the family incidence on electrocardiographic anomalies is confirmed. In these same subjects as well as in others belonging to families examined in a previous study, a total of 90 subjects, the duration of the QT interval was measured, showing values which tended to be above the average and, in some cases, above the accepted maximum. The analogy among the anomalies of the ventricular repolarization to be found during the course of neurological diseases and under experimental conditions of unilateral lesions of the sympathetic cardiac innervation and the "labile T wave" syndrome, sometimes coexisting in the same family with a report of elongated QT interval, suggests the hypothesis that this may be placed within the ambit of disgenetic syndromes from alterations of the functional balance between right and left component of the sympathetic heart innervation.

Adult↗