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Biomedical subjects

G M Puddu

Publications and source records attributed to G M Puddu.

28 records · Page 2Linked to original sources

[ACE inhibitors and heart failure].

ACE-inhibitors have been shown to have considerable therapeutic effectiveness in the treatment of heart failure and to be able to significantly prolong the survival of treated patients. The benefits of these drugs when used in the treatment of heart failure are due to their vasodilator action on both arterial and venous vessels. An even more relevant mechanism might be the modulation of some neuro-endocrine responses induced by heart failure, such as angiotensin-aldosterone production, which are sometimes excessive or harmful. The molecules presently available in Italy are four (captopril, enalapril, lisinopril, quinapril), endowed with considerably different pharmacological characteristics, but substantially similar as far as effectiveness and tolerability are concerned. Although general guidelines cannot be suggested on the basis of the pharmacological profile alone, the choice of the drug to be used in every single patient with heart failure should be made taking into account the adequacy of the pharmacological properties for the specific situation.

Angiotensin-Converting Enzyme Inhibitors↗

Correlations between serum lipids and complement components in adults without demonstrated atherosclerotic disease.

The variability due to age and sex and the reciprocal relations of serum IgG, IgA, IgM, C3, C4, total cholesterol (TC), HDL-cholesterol (HDL-C) and triglycerides (TG) were studied in 87 subjects (46 men and 41 women, aged 20-75 years) selected for the absence of significant atherosclerotic lesions. Serum IgA and C3 were higher in men than in women (P less than 0.05) mainly in the age group 41-60, while IgM and HDL-C were higher in women than in men (P less than 0.05 and P less than 0.01, respectively), especially in the age group 20-40. Direct univariate correlations with age were found for serum TC (P less than 0.0001), IgA (P less than 0.001), and C4 (P less than 0.01) but the latter correlations was confirmed only in women by multivariate analysis. These 3 variables had the major increment in the age group 41-60 in men, while in women the increase associated with age was more progressive or late. Univariate analysis showed a 'ring' of highly significant correlations (P less than 0.0001) involving serum lipids and complement components (TC-C4-C3-TG-TC). The correlation between TC and C4 was present only in men in multivariate analysis and improved with increasing age. These findings might represent a clue to explain the previously reported association between serum C4 and atherosclerosis.

Adult↗

Antibody patterns against cytomegalovirus and Epstein-Barr virus in human atherosclerosis.

The immune response against Cytomegalovirus (CMV) and Epstein-Barr virus (EBV)-induced antigens has been determined in teh sera of 36 patients with angiographically assessed atherosclerosis and compared with that of 36 matched control subjects. Significantly higher titres of antibody against CMV and EBV - induced antigens and a significant increase in CMV- and EBV- reactivated infections were found in atherosclerotic patients as compared to control subjects. Moreover serological signs of concomitant EBV and CMV infections occurred more frequently in atherosclerotic patients than in controls. One atherosclerotic patient, however, completely lacked antibody to CMV while CMV- and EBV- reactivated infections were also noted in control subjects, probably connected with their old age. Our data suggest that multiple reactivations of latent viruses may represent a consequence rather than a causal factor of atherosclerosis.

Antibodies, Viral↗

Association of serum IgA antibodies to milk antigens with severe atherosclerosis.

The presence of antibodies of the IgA class against dietary antigens (bovine IgG (BGG), beta-lactoglobulin, casein, alpha-lactalbumin and xanthine oxidase, chicken ovalbumin and crude gliadin) was checked in the sera of 23 severely atherosclerotic subjects (ATS) and 20 highly selected controls (C). In these subjects an association between serum IgA levels and atherosclerosis had previously been shown. Determinations were performed by a micro-ELISA method and results were expressed as absorbances at 405 nm x 1000. Higher levels of IgA antibodies were found in ATS with respect to C against beta-lactoglobulin (respectively, 113.4 +/- 152.4 (1 SD) vs. 40.0 +/- 34.2; P less than 0.005) and casein (69.8 +/- 35.5 vs. 52.4 +/- 27.5; P less than 0.05). There was no difference in IgG and IgM against these 2 proteins between the 2 groups. Significant differences of prevalence of IgA antibodies were found for the following antigens: beta-lactoglobulin (4 C and 16 ATS over the limit value of 51; P less than 0.002), xanthine oxidase (1 C and 9 ATS over 289; P less than 0.01), BGG (7 C and 17 ATS over 87; P less than 0.02) and casein (5 C and 14 ATS over 60; P less than 0.02). These data suggest an association between anti-milk IgA antibodies and atherosclerosis. Its relevance and significance deserves further investigation.

Aged↗

Coronary and cerebrovascular atherosclerosis: two aspects of the same disease or two different pathologies?

Cerebrovascular and coronary disease are characterized by some common aspects. Indeed the same risk factors relate to coronary heart disease and to cerebrovascular disease. However, there may be differences in the pathogenesis of atherosclerotic lesions in coronary and cerebral arteries. In fact some populations are characterized by a high incidence of ischaemic stroke and a low incidence of myocardial infarction, while in other populations there is an opposite trend. These differences could be explained on the basis of: genetic risk factors; a different prevalence of risk factors; a different reactivity of the coronary and cerebral arteries to risk factors; anatomical differences concerning coronary and extracranial cerebral arteries with respect to intracranial cerebral arteries. Atherosclerosis is undoubtedly a systemic disorder and its genetic and environmental causal factors are only partly known. The variable incidence of cerebrovascular and coronary heart disease in the same population or in different populations as well as the different nature of atherosclerotic plaques are probably related to the different prevalence of the causal factors, even though these may not always be identified.

Journal Article↗

[Beta blockers and cardiac decompensation].

It has been demonstrated that beta blockers are able to modify the course of the disease, through the reduction of hemodynamic in stabilization and mortality cases. The success of these drugs in the treatment of chronic heart failure is related to the sympathoadrenergic activation and to renin-angiothensin-aldosteron system. Various molecules are available at the moment. Recent research has been done on third generation beta blockers (carvedilol, nebivolol, bucindolol). These drugs have shown to possess some peculiar characteristics, in particular the ability of reducing the number of side effects which may be seen while using beta blockers of the first generations. Although it is currently difficult to give general informations based only on the pharmacologic profile, the choice of the type of drug to use in the single patient with chronic heart failure should be made considering the adequacy of the pharmacologic characteristics in each specific situation.

Adrenergic beta-Antagonists↗

Serum IgA antibodies to apoproteins and milk-proteins in severe atherosclerosis.

Total serum IgA and IgA antibodies to some milk antigens are often associated with severe atherosclerosis. In the present study we examined the same serum samples to evaluate the possible involvement of serum IgA antibodies to apoproteins and lipoproteins and their relationship to IgA antibodies to milk antigens. We studied 23 subjects with angiographically assessed atherosclerotic lesions (ATS group) and 20 healthy control subjects with a similar age range (59-69 years) and sex distribution. Anti-ApoB, Apo A-I, Apo A-II and anti-LDL, VLDL and HDL antibodies were measured with the ELISA method. All antibodies tested except those to anti-Apo A-I were significantly higher in the ATS group with respect to controls with a maximum significance for anti-Apo B IgA (p = 0.0018). When, for each antibody, a threshold of positivity was set to the mean + 2 SD of values in the control group, 12 ATS subjects (52%) and 1 control (5%) were found to be positive for either anti-Apo B or anti-Apo A-II IgA. Most of the correlations of anti-apoprotein and anti-lipoprotein IgA with anti-milk protein IgA and total IgA were significant. The association of these antibodies with atherosclerosis might either be specific or represent part of a polyclonal IgA response. Whether this association is a cause or an effect of atherosclerotic disease is presently unknown.

Apoproteins↗

[Cardiac tamponade and rheumatoid arthritis: medical approach or pericardiectomy?].

The authors report the case of a sixty-seven-year-old man with seronegative rheumatoid arthritis since 1967. After the treatment was discontinued, a symptomatic pericardial effusion developed during an exacerbation of rheumatoid arthritis. Histological findings suggested a rheumatoid origin. Consecutive pericardiocentesis and a concomitant adequate treatment resolved cardiac tamponade, at least during short-term follow-up. However, a long term observation will be necessary to exclude recurrent effusion or evolutive constrictive pericarditis.

Aged↗