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Biomedical subjects

G Magnati

Publications and source records attributed to G Magnati.

At least 19 recordsLinked to original sources

Energy homeostasis and body weight in obesity: new physiopathological and therapeutic considerations.

This paper reviews recent developments and findings regarding the role of the hypothalamus as the main site in the central nervous system (CNS) for regulating appetite. It contains a specific neural network consisting of the main central monoaminergic neurotransmitters (adrenaline, noradrenaline, dopamine, serotonin) and many neuropeptides with orexigenic and anorexigenic functions. The crucial relationship between CNS and obesity and the complex interconnections of CNS and peripheral peptides are becoming clearer. The mechanisms by which these hormones affect energy homeostasis through long and short-term anabolic and catabolic pathways are described. New anti-obesity therapeutic strategies based on drugs or molecules with new mechanisms of action, some not yet available in Italy but will soon be on the market, are considered.

Appetite Depressants↗

Isolated and preclinical impairment of left ventricular filling in insulin-dependent and non-insulin-dependent diabetic patients.

BACKGROUND: Diabetes mellitus can induce a pattern of myocardial pathology known as specific diabetic cardiomyopathy, even if this is not clearly specified. HYPOTHESIS: The aim of our study was to evaluate the presence of preclinical myocardial damage in insulin- and non-insulin-dependent diabetic patients and controls by assessment with Doppler echocardiography. METHODS: Twenty insulin-dependent diabetic (IDDM) patients, 10 non-insulin-dependent diabetic (NIDDM) patients, and 12 healthy individuals (C) as controls, matched for age, gender, and without overt cardiovascular disease, were assessed in this study. RESULTS: Systolic function parameters presented normal values in the three groups, with the exception of a slight reduction in ventricular volume indices in the NIDDM group. Diastolic function was clearly impaired in both groups of patients versus that in healthy controls. In particular, ventricular filling was impaired in the NIDDM compared with the IDDM patients, especially the peak early filling rate E (p < 0.001). Moreover, in the IDDM group, the duration of diabetes (p < 0.01) and glycosilated hemoglobin value (HbA1C, p < 0.02) were higher than in the NIDDM group. Multiple regression analysis showed a significant inverse correlation between HbA1C and peak late filling rate A (R2 = 0.28) in both groups of patients and a direct correlation between velocity time integral E and age, duration of diabetes, and HbA1C (R2 = 0.46). The two groups presented a small, homogeneous number of cases with initial microangiopathy and borderline autonomic neuropathy, associated with microalbuminuria. Doppler echocardiography showed an early impairment of left ventricular filling, as well as an early preclinical alteration of myocardial function in diabetic patients, especially in the NIDDM group. CONCLUSION: These early signs of cardiomyopathy could constitute a predisposing condition toward the high cardiac morbidity and mortality rate in diabetic patients.

Adult↗

[Nutritional principles for the pregnant diabetic].

After a short account on alimentation in pregnant women, the authors examine in detail the correct alimentation in pregnant women affected by different types of diabetes. As general lines for a correct nutritional approach, a total caloric intake of 2200-2500 kcal daily (9196-10450 Kj) (which enclose 35-40 kcal/pro/kg ideal weight and a caloric surplus for pregnancy) is recommended. In over-weight women the caloric intake will be reduced till 1500 kcal (6270 Kj) checking constantly metabolic situation (increase of weight should be for the first ten weeks of 100 g weekly, than of 300 g weekly). Altogether weight increase should be from 9 to 12 kg. 15-20% of caloric intake should be represented for proteins, very important for pregnancy and good growth of fetus. Carbohydrate intake should be 55-60% of caloric intake represented for 75-80% by complex glucides and for 20-25% simple glucides to support a suitable amount of dietary fibres (25-30%). The lipid intake recommended should be 25-30% of the daily calories with a third of monounsaturated fat acids, a third of polyunsaturated fat acids and a third of saturated fat acids, with a cholesterol amount under 300 mg/die. In additional the nutritional plan should consist of a adequate amount of "non energetic nutrients" (minerals and vitamins), particularly the calcium intake must be 1200 mg/die and 18 mg/die that of iron and folic acid, vitamin A, D and B intake must be increased. Finally, the authors advise against alcoholic beverages and recommend a regular subdivision of the meals.(ABSTRACT TRUNCATED AT 250 WORDS)

Diet, Diabetic↗

[Comparison of HbA1c, fructosamine and the main metabolic parameters in a non-insulin-dependent diabetic population].

Our objective was the checking of clinical data obtainable from the assay of some parameters in NID diabetic individuals. To this end, we studied 133 patients--57 males and 76 females, average age 74.36 +/- 1.01 years, 72.6% of which were above 65 years of age. The control population was subdivided as follows: 50 subjects, 26 F and 24 M; average age 71.25 +/- 1.32 years, with normal glucidic tolerance as assessed by OGTT. Current glycemia, average glycemia, fructosamine, glycosylated hemoglobin, triglycerides, LDL-cholesterol and apolipoprotein B were obviously much higher than normal in the individuals admitted to the study. A statistically significant correlation was found between average glycemia, glycosylated hemoglobin, LDL-cholesterol and blood triglycerides (p less than 0.05). No correlation was found between current glycemia, fructosamine and glycosylated hemoglobin. Similarly, serum fructosamine was unrelated to the parameters studied. In our study, fructosamine, glycosylated hemoglobin and current glycemia offered unrelatable data. Hence, in our opinion it is necessary to assay these three parameters contemporaneously for a reliable assessment of metabolic compensation.

Aged↗

[Etiopathogenetic role of metabolic, circulatory, sex factors and type and duration of diabetes in diabetic retinopathy. Investigation with vitreofluorophotometry].

We have studied metabolic, circulatory and vascular parameters in a group of 57 diabetics (37 affected by IDDM, 20 affected by NIDDM; 35 were males, 22 were females). Goals of present study were: 1) quantitative evaluation of the blood retinal barrier; 2) influence of the metabolic state, blood pressure, sex, type and duration of the diabetes on the ocular conditions; 3) relationship between ophthalmoscopic appearance of the retina and vitreous fluorophotometric recordings. We concluded that: a) ocular alterations depend by lipidic metabolism, blood pressure, sex, type and duration of the diabetes; b) vitreous fluorophotometry has proved a good device for early detection of retinal damages in the diabetic retinopathy.

Blood Pressure↗

[The dietary problem in cholelithiasis and patients at risk].

Gallstone disease has been recognized to be linked to others metabolic disorders such as obesity, atherosclerosis, hyperlipidemia and diabetes. Previous studies demonstrated a close relationship between abnormal eating habits and gallstone disease. The total caloric intake should be calculated on each individual energy requirement and should be restricted in over-weight patients. The diet should contain approximately 15-20% of the daily calories from proteins, 30-35% from fat (mainly vegetable fat for the higher content in polyunsaturated fat) and 40-55% from carbohydrate (especially complex carbohydrate). In addition the nutritional plan should consist of adequate amount of minerals and vitamins and the fiber consumption should be increased to 30-40 g/day. Finally, at last the Authors recommends (6279-8372 Kj- a regular subdivision of the meals (small and frequent) dressed in the very natural wag.

Cholelithiasis↗

[Clinical study of a new preparation from plantago seeds and senna pods].

The lack of fiber in the western diet may contribute to the development of several diseases including gastrointestinal disorders; the clinical effects of a new substance (AGIOLAX) made from plantago seeds and senna pods were studied. 100 patients of both sexes, aged from 40 to 60 years (30 with diabetes mellitus, 40 with obesity and 30 with hyperlipidemia) were treated; everyone complained a slowness, of different degree, of normal intestinal transit time or chronic constipation. The experiment was carried out without the use of a control group. Aim of the present study was to investigate the efficacy and tolerability of the product. In addition to the clinical evaluation of the symptoms, laboratory tests were performed. The patients were treated for 3 months with a daily dose of 2 teaspoons every evening. In the majority of the subjects a good clinical response was obtained; 88% of the patients presented a normalization of the gastrointestinal transit time; only 12% of them did not respond satisfactorily to the substance. Further the drug was well tolerated by 86% of the patients. In conclusion the authors report a good efficacy and tolerability of the product; thus they recommend its use in those disorders characterized by slow intestinal transit time and/or constipation.

Adult↗

Effectiveness of long-term treatment with pantethine in patients with dyslipidemia.

A one-year clinical trial with pantethine was conducted in 24 patients with established dyslipidemia of Fredrickson's types II A, II B, and IV, alone or associated with diabetes mellitus. The treatment was well tolerated by all patients with no subjective complaints or detectable side effects. Blood lipid assays repeated after 1, 3, 6, 9, and 12 months of treatment revealed consistent and statistically significant reductions of all atherogenic lipid fractions (total cholesterol, low-density lipoprotein cholesterol, and apolipoprotein B) with parallel increases of high-density lipoprotein cholesterol and apolipoprotein A. The results were equally good in patients with uncomplicated dyslipidemia and in those with associated diabetes mellitus. The authors conclude that pantethine (a drug entity related to the natural compound, pantetheine) represents a valid therapeutic support for patients with dyslipidemia not amenable to satisfactory correction of blood lipids by diet alone.

Cholesterol↗

[Hyperlipidemia, diabetes and atherosclerosis: efficacy of treatment with pantethine].

The hypolipidemizing effects of Pantethine were investigated by the Authors in 37 hypercholesterolemic and/or hypertriglyceridemic patients. Of these, 21 were also diabetic, in a satisfying glucidic compensation, in order to verify the action of this drug also in this metabolic condition. The study was carried out for three months and during this period the patients were given Pantethine at the dose of 600 mg/die orally. At the 30th, the 60th, the 90th day of treatment the following parameters were controlled: cholesterolemia, HDL cholesterol, apolipoproteins A and B, triglyceridemia, systolic and diastolic arterial pressure, uricemia, body weight. Thirty days after suspending the treatment, the parameters were controlled again to detect a possible "rebound" effect. The results were analyzed on the whole case-record, subdividing the patients in dislipidemic and diabetic-dislipidemic, and on the basis of the Fredrickson's classification. Pantethine induced in all groups a quick and progressive decrease of cholesterolemia, triglyceridemia, LDL cholesterol and Apolipoproteins B with increased HDL cholesterol and Apolipoproteins A. After suspending the treatment, there is a clear inversion of the state of these parameters. The Authors conclude that the present work shows that Pantethine, a natural and atoxic substance, an important component of Coenzyme A, is efficacious in determining a clear tendency towards normalization of the lipidic values.

Adolescent↗

[Serial determination of HbA1 or the oral glucose test in the adequate evaluation of fetal growth?].

The authors compared sequential HbA1 levels with the results obtained by oral glucose tolerance test (O.G.T.T.) with the purpose of detecting the confidence limit of each test regarding the glucose control in pregnant women. HbA1 detection showed more sensitivity than O.G.T.T. in detecting maternal impaired glucose control and in distinguishing between a metabolic or a genetic feto-neonatal macrosomia.

Embryonic and Fetal Development↗

[Dietary fiber and OGTT: blood sugar variations after administration of a new purified glucomannane].

After having stressed the importance of fibres in the nutritional field, pointing out the inverse relationship between vegetal fibres consumption in various populations and diffusion of many diseases of the so-called "industrialized" societies (such as obesity, diabetes, dyslipidemias, atherosclerosis, cholelithiasis, cancer of the colon, etc.), the Authors report their experiment on a new experimental product based on glucomannane purified (PRL). The present study was carried out on 24 obese subjects (5 males and 19 females). The patients, normoglycemics in their basic condition, were submitted to OGTT with 75 g of glucose in the morning before eating and were subdivided into two groups, the first (Group A) characterized by the sequence OGTT + placebo; after a few days, by another OGTT + experimental product; the second characterized by the inverse sequence. Four tablets (glucomannane purified 5,2 g) and four tablets of placebo was the posology employed. The evaluation of the possible action of the product in reducing or slowing down the intestinal absorption of glucose was the aim of the research. The results obtained show that the administration of the product under study has led to a sharp decrease of the average glycemic values with variations per cent ranging from 13% to 16% in Group A, from 10% to 11% in Group B and from 7% to 12% in the two groups considered on the whole. In conclusion, the Authors wish an increased diffusion of dietary fibres and particularly of the glucomannanes in all those dysmetabolic forms having at their bases an unbalanced, hypercaloric alimentation, rich in refined aliments and poor in fibres.

Blood Glucose↗

[Clinical study of the use of a deproteinized guar flour in the treatment of obesity].

The Authors have studied an experimental product (L. G. 140/S), based on GUAR GUM, to establish its effectiveness and tolerability as a dietetic support in the treatment of obesity. The clinical research work has been conducted on 21 obese subjects (18 females and 3 males) aged 17 to 58 and treated with a hypocaloric and hypoglycemic diet. This preparation has proved useful in helping the patients to conform to the dietary restrictions and/or in normalizing their intestinal transit. No objective or subjective symptoms certainly referable to this preparation have been observed. The administration of the product has been interrupted for precautionary reasons in some cases, since it was not indispensable. Considering the good results they have obtained in terms of tolerability and agreeableness of this product, the Authors conclude that it can be considered a useful support to the restrictive dietary regimen, which is still considered - together with physical activity - the only sound and effective remedy in the treatment of obesity.

Adolescent↗

[Clinical experience on a new substance with high fibre content (author's transl)].

After a brief reference on the so-called diseases of "civilisation" and on their correlations with a diet rich in refined high caloric carbohydrate having poor gastric filling capacity and therefore lacking in fibre, the authors present their experience on a new product, MF/D/80, which is an association of cereal and acid fruit fibres. 25 patients (3 men and 22 women) were treated, 22 of them suffered from chronic constipation and 3 from colitis. The experiment was carried out without the use of control drugs. The aim of the research was that of verifying the efficacy and tolerability of the product. The efficacy was optimal in 88%, good in 4% and modest in 2 cases (8%) of the entire number of cases while the tolerability has been optimal in all the cases. The Authors conclude the retaining that MF/D/80 is a product that can be used with enormous advantages in chronic constipation for its efficacy, optimal tolerability and for its mechanism of action. The Authors finally underline its usefullness as an "alimentary integrator" in all those diseases (obesity, diabetes, atherosclerosis etc.) which among the various etiopathogenetic moments, also count in refined alimentation.

Adolescent↗