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Biomedical subjects

G Leone

Publications and source records attributed to G Leone.

At least 523 records · Page 29Linked to original sources
PubMedDate not supplied

Who are the non-dippers? A better definition via the blood pressure circadian rhythm.

OBJECTIVE: The non-dipping phenomenon (NDP) can be better interpreted when considering that blood pressure (BP) shows a within-day variability which is the expression of a circadian rhythm (CR). PATIENTS AND METHODS: The NDP was investigated at the light of the BP CR by analysing the ambulatory BP monitoring of 298 essential hypertensive patients (EHP), 84 secondary hypertensive patients (SHP), as well as 93 normotensive subjects (NS). According to the rhythmometric validation, the investigated subjects were defined "rhythmic" (R) or "non-rhythmic" (NR). RESULTS: The non-dippers (ND) were found among not only the EHP (14%) and SHP (27%) but also the NS (16%). The percentages of R ND were 9%, 4% and 20%, respectively in EHP, SHP and NS. The R ND were characterized by a nocturnal phase-shift (100% in NS), associated with an amplitude increase (50% in EHP) or a mesor increase (50% in EHP; 100% in SHP) in BP CR. The NR ND were characterized by an amplitude almost negligible (100% in NS) associated with a mesor increase (100% in EHP; 100% in SHP). CONCLUSIONS: The detection of a NDP associated with a rhythmicity suggests that the criterion with which the ND are identified cannot be used for making inferences on the BP CR in HP or NS. The rhythmic characteristics in ND suggest that the rhythmometric analysis is fundamental for identifying the abnormal time structure of BP 24-h values in the presence of the NDP.

Adult↗
PubMedDate not supplied

Lower 24-h blood pressure regimen in subjects with a familial genealogy of longevity.

OBJECTIVE: This study investigates the 24-h blood pressure (BP) pattern in longevous subjects and their progeny, in order to validate the hypothesis that the human beings who live beyond their longest expectancy of life should be protected from developing hypertension. Such a characteristic feature is supposed to be a biological aspect of human longevity which can be transmitted to the progeny. MATERIALS AND METHODS: The study was carried out on 92 elderly subjects, (45 M, 47 W, 76-102 years), and 28 firstborn descendants of the first (7 M, 7 W, 36-55 years) and second (7 M, 7 W, 16-26 years) generation, in clinical health. The control subjects were 308 clinically healthy individuals (154 M, 154 F, 16-75 years) of the common population, stratified by age. RESULTS: The longevous subjects were found to show a diastolic daily mean level less pronounced than expected, according to the BP age-related trend in the common population. Both the children and grandchildren of the longevous subjects were seen to show a systolic and diastolic daily mean level significantly less pronounced than in their coeval subjects of the common population. CONCLUSIONS: Because of the unexpected lower diastolic BP daily mean level in the very old subjects, the hypothesis that the longevous subjects might be protected from developing hypertension via the arteriolar vasoconstriction seems to be confirmed. Because of the lower systolic and diastolic BP in young and adult subjects with a positive familiarity for longevity, the hypothesis that the hemodynamic protection from senile hypertension might be an inheritable biological feature of the longevity seems to be acceptable.

Adolescent↗
PubMedDate not supplied

Age-related changes in blood pressure twenty-four-hour pattern in normotensive subjects of two populations.

OBJECTIVES: This study investigates the systolic (S) and diastolic (D) blood pressure (BP) 24-h pattern in normotensive healthy subjects belonging to two populations characterized respectively by a "non-salt culture" (Italian subjects) and a "salt culture" (Japanese subjects) in their dietary salt intake (4-6 g/day in Italians vs 10-12 g/day in Japanese). The comparison was performed by taking into consideration the within-day variability (WDV) and circadian rhythmicity (CR) of BP with respect to age. MATERIALS AND METHODS: Subjects investigated were 862 normotensive healthy subjects (308 Italians and 554 Japanese), stratified by age from 16 to 75 years, who volunteered for a noninvasive BP monitoring in an ordinary day of their life. The SBP and DBP time series were analyzed via conventional parametric statistics as well as chronobiological procedures. RESULTS: The biometric estimates demonstrate that BP changes in its WDV and CR as a function of age in both populations. Despite the difference in their habitual salt intake, the age-related changes in BP WDV and CR result to be almost comparable at the cross-sectional contrasts, giving origin to age-related trends for SBP and DBP which are significantly parallel. CONCLUSIONS: The comparability of BP WDV and CR in the two populations with a substantial difference in salt intake suggests that the normotensive status in human races is realized despite the difference in their habitual salt intake. This implies the ancestral development of mechanism(s) of adaptation to the possible "sodium luxus consumption". Although the adaptive mechanisms which provide a normotensive regimen under different conditions of sodium intake are almost unexplored, the racial adaptation to dietary salt constitutes, however, the initial condition for the cause-effect nexus between dietary salt intake and hypertension in human populations.

Adolescent↗
PubMedDate not supplied

Age-related trend for blood pressure circadian rhythm in normotensive healthy subjects: estimates provided by the clinospectror method.

The present study investigates how blood pressure (BP) circadian rhythm (CR) changes in its rhythmic properties as a function of chronological age in normotensive healthy subjects (NHS). The age-related trend for BP CR was investigated via the Clinospectror method, a periodic-linear analysis of regression for rhythmic parameters. The study was performed on 437 NHS (219 males and 218 females, ranging in age from 1 year to 102 years), who were monitored in their 24-h BP via a noninvasive automated recorder. An age-related trend was detected for the three properties of BP CR, i.e., mesor (M), amplitude (A) and acrophase (cent). Such a trend was positive for M and A, and negative for cent. According to the clinospectrometric formula, the BP CR can be classified as a "dianaclinous rhythm", i.e., a rhythm which increases in its oscillatory level and extent with advancing years. The documented age-related trend for the rhythmic properties suggests that the biological clock which regulates the BP CR in human beings undergoes a resetting of its mechanisms of tonic, amplitude and phasic modulation as a function of chronological age. The readjustment of the pressure clock may be regarded as one of the physiological features which characterize the aging process in human beings.

Adolescent↗
PubMedDate not supplied

The ambulatory monitoring documents a more elevated blood pressure regimen (pre-hypertension) in normotensives with endothelial dysfunction.

PURPOSE: The present study investigates the blood pressure (BP) 24-h values in normotensives with and without endothelial dysfunction (ED). The scope is to detect differences in BP regimen supporting the hypothesis that the ED is associated with vasopressant effects that can cause a condition of "pre-hypertension". MATERIALS AND METHODS: Thirty-eight normotensives were investigated in their endothelial function by mean of the non-invasive post-ischemic brachial artery vasodilation test (endothelium-dependent vasomotricity). Their were also automatically and non-invasively monitored in their systolic (S) and diastolic (D) BP over the 24-h period in order to confirm that they were not hypertensive. RESULTS: Eight of the investigated normotensives were found to show an ED. A significantly higher daily mean level as well as a more prominent nychtohemeral variability in SBP and DBP 24-h values were observed in the normotensives with ED as compared to the normotensives without ED. The higher BP regimen in the normotensives with ED was found to maintain a circadian rhythm. However, a significant amplification the second harmonic component, with a 12-h period, was observed. The different structure of the BP 24-h pattern in the normotensives with ED was confirmed by the detection of additional ultradian components at the linear-in-period spectral analysis. CONCLUSIONS: The present study documented a significant elevation of BP 24-h values in normotensives with ED that is the reflex of consistent changes in the frequency organization of the BP circadian pattern. The elevation of BP regimen suggests that the ED is associated with vasopressant effects even in normotensives. Such a condition of higher BP in normotensives with ED can be regarded as a status of "pre-hypertension".

Adult↗
PubMedDate not supplied

Lymph node blast crisis in chronic myeloid leukemia mimicking T-immunoblastic lymphoma.

BACKGROUND: Chronic myeloid leukemia arises from a somatic mutation in a pluripotent stem cell. It generally terminates with a blastic crisis (BC). One third of BC are lymphoid, and most have a pre-B phenotype. Few cases of T-lymphoid BC have been reported. Here we describe a lymph node blast crisis mimicking T-immunoblastic lymphoma. METHODS: Bone marrow and lymph nodes were histologically examined by standard methods and by an immunoperoxidase technique. Cytogenetic studies were also performed on lymph node and blood cells. Analysis of T-cell receptor genes and BCR rearrangements were performed on DNA extracted from both frozen bone marrow and lymph-node cells. RESULTS: Lymph-node histology showed an infiltration by large lymphoid blasts, consistent with a diagnosis of immunoblastic lymphoma. Blast cells were CD2, CD7, TDT positive, and negative for myeloid and mature lymphoid antigens. The Ph1 chromosome was found in both bone marrow and lymph-node cells. BCR rearrangement was found in the DNA from both bone marrow and lymph-node cells. TCR genes were not rearranged. DISCUSSION: The present study provides strong evidence that the lymph-node blast crisis of CML can assume the morphological appearance of immunoblastic lymphoma and may retain the immunological phenotype and genetic features of early T cells with BCR rearrangements.

Antigens, Neoplasm↗
PubMedDate not supplied

[Colonic perforations after self-expandable metallic stenting: two case reports].

The use of self-expandable metallic stents in colorectal stenoses, both benign and malignant, is a recently born treatment, quickly widespread because of its simplicity and therapeutic efficacy. It is particulary useful, like emergency temporany treatment, in malignant colonic obstruction; in these cases the temporary endoprosthesis positioning allows the intestinal transit and to overcame the emergengy phase. After patient conditions improvement, he can be operated and the endoprosthesis removed within operating specimen. In some particularly serious cases, when only a derivative intervention is mandatory because of the general conditions of the patient or the advanced stadium of the illness, stenting can also represent definitive palliative treatment. In fact, it allows contemporary resolution of the occlusion and of the physiopathologic alterations, with hospital cost reduction and a quality life imprevement for the patient thanks to the colestomy absence. In benign pathologies, self-expandable stents are used for a long time in the superior gastrointestinal and biliary tract; now stents have found employment also for the treatment of the post-operative fistula, intestinal diverticular occlusion and for the treatment of post-anastomotic or radiotherapy strictures. The Authors report two cases observed in emergency with complication determinated by positioning of colonic endoprosthesis for previous occlusive episode. The first case, a 56 year-old woman with a decubitus perforation occurred by stent, previously positioned with only palliative intent for a sigma-rectal metastatic cancer: in the second case, a 75 year-old man, the endoprosthesis had been positioned for a postoperative benign stricture of colorectal anastomosis for neoplasm: in this case the stent had determined a vescico-rectal fistula and after a new intestinal occlusion.

Aged↗
PubMedDate not supplied

[Rectal stenosis after stapler hemorrhoidopexy].

We report a case of a 52-year-old woman with hemorrhoids submitted to Procedure for Prolapse and Hemorrhoids (PPH), i.e. stapled hemorrhoidopexy, using a modified Longo's technique (double purse string) to treat an associated rectocele and rectal prolapse; the STARR technique (Stapled Trans Anal Rectal Resection) was not yet codified. The post-operative course was uneventful and the patient is discharged in II p.o. day. In fifth post-operative day the patient came back with an unusual rectal stenosis due to the superior purse string. The stricture was easily resolved by 'opening' the purse string with a transanal approach in outpatient setting.

Constriction, Pathologic↗
PubMedDate not supplied

Oral idarubicin plus cytosine arabinoside in the treatment of acute non lymphoblastic leukemia in elderly patients.

Eighteen acute nonlymphoblastic leukemia patients greater than 60 yr., 12 at diagnosis and 6 in first relapse, were treated with the association of oral Idarubicin and subcutaneous Aracytin. One patient was not evaluable. Eight out of 17 patients achieved complete remission (47%), 4 patients died in induction and 5 proved resistant to treatments. Mucocutaneous and gastrointestinal toxicity was mild. The most frequent extra-hematological complications were infections. We observed an important hepatic toxicity in 1 case.

Administration, Oral↗
PubMedDate not supplied

Autologous peripheral blood stem cell transplantation in hematological malignancies.

Three patients (2 with high malignant non Hodgkin's lymphomas in partial remission and 1 with acute myeloblastic leukemia in 2nd complete remission) underwent autologous peripheral blood stem cell transplantation (APBSCT). The minimal number of mononuclear cells and CFU-GM collected was 6.18 x 10e8 and 19.77 x 10e4/kg b.w., respectively. Conditioning chemotherapy consisted in BEAM and CVB protocols in non Hodgkin's lymphoma (NHL) patients and busulphan and cyclophosphamide in acute myeloblastic leukemia (AML) patients. All patients achieved complete remission. Bone marrow biopsy performed on day 14 showed complete engraftment. The time to reach 1 x 10e9/l WBC, 0.5 x 10e9/l neutrophil granulocytes and 50 x 10e9/l platelets was no longer than 11, 15 and 8 days, respectively. No major infectious episodes were evident during aplastic phase; fever greater than 38 degrees C was observed in two patients not lasting longer than 2 days. All patients are still in complete remission and continue to have normal hematological values (follow-up lasting 8+ and 3+ months for NHL patients and 4+ months for AML patient).

Adult↗
PubMedDate not supplied

Preoperative selection for curable renovascular hypertension.

Clinical research has defined the criteria for identifying "curable" renovascular hypertension. The prediction is based on the measurement of plasma renin activity in peripheral veins, renal veins, and the aorta. Renin profiles can be examined with the method of Laragh and coworkers (the so-called incremental method), in which values for plasma renin activity are incorporated into formulas to compute indexed parameters. A score is attributed to each index and the prediction is based on the final score. Because the identification of curable renovascular hypertension is made according to numerical rules, the method is easily transformed into a computer-assisted process. The program is written in BASIC, and it is short enough to run on a personal computer.

Diagnosis, Computer-Assisted↗
PubMedDate not supplied

Collection of peripheral blood stem cells using an automated discontinuous flow blood cell separator.

Twenty collections of peripheral blood stem cells were performed in 3 patients (2 NHL, 1 AML) using the Haemonetics V50S discontinuous flow blood cell separator. A modified lymphocyte collection protocol (Nebraska Surge) was used in all instances. Leukapheresis were performed after 1 or 2 courses of chemotherapy and started when peripheral blood leukocytes count reached 1 x 10e9/l and platelets count 80 x 10e9/l. A mean blood volume of 5.9 +/- 0.6 litres was processed per procedure and the mean yields for mononuclear cells, nucleated cells and CFU-GM were respectively 5.4 +/- 1.4 x 10e9, 4.9 +/- 1.6 x 10e9 and 128.5 +/- 182.3 x 10e4 per procedure. Haemonetics V50S had showed a mean collection efficiency for mononuclear cells of 67.5 +/- 5.0% per procedure. Results obtained are not significantly different from the ones obtained with an automated continuous flow separator even if extracorporeal circulation is consistently high in patients with a low hematocrit when the 250 ml Latham Bowl is used.

Cell Separation↗
PubMedDate not supplied

Idarubicin combined with intermediate-dose cytosine arabinoside in the treatment of refractory acute leukemia.

From December, 1985 to October, 1987, 16 patients aged from 14 to 62 (median 34) with acute leukemia in relapse (10 affected by ANLL and 6 by ALL) were treated with the following regimen: Idarubicin 12 mg/m2/day on days 1-2-3, Ara-C 600 mg/m2 twice a day from day 1 to 6. Twelve patients (75%) achieved complete remission (C.R.). Two (12%) died during the induction phase from alveolar pneumonitis. One patient was resistant. The median duration of C.R. and survival was respectively 12 (range 6 to 100 +) and 23 weeks (4 to 108 +). The median duration of granulocytopenia was 16 days (range 10 to 24 days). The most frequent non-hematological complications consisted of nausea, vomiting, diarrhea and mucositis. Four patients had hepatic and splenic microabscesses of suspected mycotic etiology, and one showed a transient cardiac arrhythmia. The C.R. rate obtained in this series may be considered satisfaying since all but 3 patients were on treatment at the time of relapse. Yet the short duration of C.R. suggests the opportunity of performing consolidation cycles or suprelethal therapy followed by bone marrow transplantation.

Adolescent↗
PubMedDate not supplied

Day-time changes for pituitary-thyroid hormones denote a rhythmic structure not detectable in elderly subjects.

The day-time concentrations of TSH, T3, T4, FT3 and FT4 were investigated in clinically healthy volunteers, 20 young individuals, aged from 20 to 27 years, and 12 elderly subjects, aged from 70 to 81 years. Nocturnal sampling was purposely avoided in order to eliminate the interindividual differences in sleep patterns. The day-time series were analysed by means of cosinor analysis to interpolate the best-fitting sinusoidal wave that covers the day-night period. The reconstruction of the circadian sinusoidal wave was validated for TSH, T3, T4, FT3 and FT4 in young subjects, and, with limitation, for T4 in elderly individuals. The findings suggest that the day time patterns of TSH, T3, FT4 and FT3 in elderly subjects are characterized by a dyschronism that is not detectable in young subjects. The investigation of the day-time concentrations is suggested as a cost-effective tool for exploring the circadian cycle of the pituitary-thyroid hormones in aged people.

Adult↗
PubMedDate not supplied

Cardiovascular effects induced by progesterone administration.

The Authors have studied cardiovascular effects induced by progesterone administration. The results obtained in the present investigation reveal a significant reduction in O-S2 and PEP in the absence of modifications in the values of the other parameters of systolic time intervals. The results confirm the hypothesis that progesterone exerts an adrenergic effect upon cardiac function.

Adolescent↗