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Biomedical subjects

G Martines

Publications and source records attributed to G Martines.

At least 19 recordsLinked to original sources
PubMed2001

Carotid and femoral ultrasound morphology screening and cardiovascular events in low risk subjects: a 10-year follow-up study (the CAFES-CAVE study(1)).

BACKGROUND: Subclinical arteriosclerotic lesions at the carotid and femoral bifurcations may be related to the occurrence of future cardiovascular events and of occult arteriosclerotic coronary disease. B-mode ultrasound of carotid and femoral arteriosclerotic bifurcation lesions may provide a simple screening method to select asymptomatic subjects at risk of future events. METHODS AND RESULTS: 13221 low-risk, healthy, asymptomatic individuals were included in a 10-year, prospective, follow-up based on carotid and femoral bifurcation morphology defined by B-mode ultrasound. Four classes were considered at inclusion (I: normal wall, II: wall thickening, III: non-stenosing plaques, IV: stenosing plaques). When 10000 subjects (75.6% of included subjects; 6055 males, 3945 females) completed the 10-year follow-up the study was concluded. At 10 years there were 10 events (out of 7989 subjects) in class I and 81 events in II (930 subjects; incidence=8.6%); 239 events were observed in class III (611 subjects; 39.28%) and 381 events (470 subjects; 81.06%) in IV; 61 deaths occurred in classes III+IV (1081 subjects) producing a death rate within these two classes of 5.5% (51 out of 61=81.5% in class IV). The increased event rates in classes III and IV were significant (log rank; P<0.02) in comparison with I and II. CONCLUSIONS: Carotid and femoral morphology identified 2011 subjects (20.1% of the population) in classes II,III,IV including 98.6% of cardiovascular events and deaths in the following 10 years. A higher (P<0.05) rate of progression in classes III and IV in comparison with I and II was also observed. The ultrasound carotid and femoral classification was useful in selecting subjects at very low risk of cardiovascular events (class I), those at limited risk (class II) and a group at moderate risk (class III). A subpopulation at high risk of cardiovascular events (IV) was identified.

Adult↗
PubMed2001

Oxygen-free radical decrease in hypertensive patients treated with lercanidipine.

BACKGROUND: The relationship between oxidative stress, lipoproteins, cardiovascular risk factors and vascular disease progression has recently attracted fresh attention due to the possibility of measuring free radicals (FRs). The aim of this study was to evaluate blood plasma variations in oxygen FRs in hypertensive patients treated with lercanidipine, a drug acting on blood pressure and microcirculation. METHODS: Twenty-two patients with moderate hypertension (M:F=12:10; age=52) and no vascular disease (evaluated by high-resolution ultrasound) were treated for 24 weeks with Lercanidipine (10 mg/day or 20 mg/day if BP values did not decrease at least 15 percent after four weeks of treatment). BP was measured at inclusion and after 4, 8, 12 and 24 weeks of treatment. FRs measurements (using the D-Roms test) were made at inclusion, at the 8th, 12th and 24th week. RESULTS: All patients completed the treatment which was well tolerated and without side effects. Systolic and diastolic BP decreased after 8, 12 (p<0.05) and 24 weeks (at 24 weeks systolic pressure was decreased by 21.1 percent, and diastolic by 11.1 percent; p<0.02). FRs levels progressively decreased from 541 Carr Units (SD 54) at inclusion to 411 (SD 56) at eight weeks (p<0.05), to 401 (SD 35) (p<0.05) at 12 weeks and finally to 398 (SD 33), (p<0.02) at 24 weeks of treatment (72.2 percent of the initial value). CONCLUSIONS: The possibility of measuring FRs in vivo with a simple, inexpensive test allows the identification of subjects with a high level of oxidative stress, and the monitoring of the effects of treatments. Lercanidipine, acting on blood pressure, on the microcirculation and decreasing oxidative stress and Frs plasma levels may effectively decrease the rate of progression of cardiovascular diseases offering the advantage of an increased level of protection in patients with high levels of oxidative stress.

Adult↗
PubMed2000

PGE(1) treatment of severe intermittent claudication (short-term versus long-term, associated with exercise)--efficacy and costs in a 20-week, randomized trial.

The efficacy, safety, and cost of prostaglandin E1 (PGE1) in the treatment of severe intermittent claudication was studied comparing a long-term treatment protocol (LTP) with a short-term treatment protocol (STP) in a randomized 20-week study. The study included 980 patients (883 completed the study) with an average total walking distance of 85.5 +/-10 m (range 22-119). Phase 1 was a 2-week run-in phase (no treatment) for both protocols. In LTP, phase 2 was the main treatment phase. In the LTP, treatment was performed with 2-hour infusions (60 microg PGE1, 5 days each week for 4 weeks. In phase 3 (4-week interval period) PGE1 was administered twice a week (same dosage). In phase 4 (monitoring lasting 3 months, from week 9 to 20) no drugs were used. In STP phase 2 treatment was performed in 2 days by a 2-hour infusion (first day: morning 20 microg, afternoon 40 microg; second day morning and afternoon 60 microg). The reduced dosage was used only at the first cycle (week 0) to evaluate tolerability or side effects. Full dosage (60 microg bid) was used for all other cycles. The same cycle was repeated at the beginning of weeks 4, 8, and 12. The observation period was between weeks 12 and 20. A treadmill test was performed at inclusion, at the beginning of each phase, and at the end of 20th week. A similar progressive physical training plan (based on walking) and a reduction in risk factors levels plan was used in both groups. Intention-to-treat analysis indicated an increase in walking distance, which improved at 4 weeks and at 20 weeks in the STP more than in the LTP group. At 4 weeks the variation (increase) in pain-free walking (PFWD) was 167.8% (of the initial value) in the LTP group and 185% in the STP group (p<0.05). At 4 weeks the variation (increase) in total walking distance (TWD) was 227.6% of the initial value in the LTP group and 289% in the STP group (p<0.05). At 20 weeks the increase in PFWD was 496% of the initial value in the LTP group vs 643% in the STP group (147% difference; p<0.02). The increase in TWD was 368% in the LTP group and 529% in the STP group (161% difference; p<0.02). In both groups there was a significant increase in PFWD and TWD at 4 and 20 weeks, but results obtained with STP are better considering both walking distances. No serious drug-related side effects were observed. Local, mild adverse reactions were seen in 6.3% of the treated subjects in the LTP and 3% in the STP. Average cost of LTP was 6,664 Euro; for STP the average costs was approximately 1,820 E. The cost to achieve an improvement in walking distance of 1 m was 45.8 E with the LTP and 8.5 E with the STP (18% of the LTP cost; p<0.02). For an average 100% increase in walking distance the LTP cost was 1,989 E vs. 421 E with STP (p<0.02). Between-group analysis favors STP considering walking distance and costs. Results indicate good efficacy and tolerability of PGE, treatment. With STP less time is spent in infusion and more in the exercise program. STP reduces costs, speeds rehabilitation, and may be easily used in a larger number of nonspecialized units.

Aged↗
PubMed2000

[NMR cholangiography in the diagnostic algorithm of candidates to video laparocholecystectomy].

BACKGROUND: High resolution magnetic resonance cholangiopancreatography (MRCP) is a non invasive imaging modality for depicting the pancreatobiliary tree. It can demonstrate dilation, stenosis and intraductal filling defects of both the biliary and the pancreatic duct. The imaging quality of high resolution MRCP is excellent. MRCP appears to be more effective and less invasive than endoscopic retrograde cholangiopancreatography (ERCP) to evaluate many pancreatic and biliary diseases as choledocholithiasis, malignant obstruction, incomplete or failed ERCP, postsurgical alterations of the biliary tract (as biliary-enteric anastomoses), sclerosing cholangitis, chronic pancreatitis, and congenital anomalies of the biliary and pancreatic duct. METHODS: MRCP was performed in 21 non selected patients with suspected choledocholithiasis and demonstrated the presence of stones in the biliary tract in 5 of them. In these 5 patients sequential endoscopic-laparoscopic treatment was performed and confirmed in all cases the presence of stones in the biliary tree. Laparoscopic cholecystectomy (VLC) and transcystic cholangiography was attempted in the restant 16 patients. RESULTS: Laparoscopic transcystic cholangiography confirmed in all cases the response of MRCP. CONCLUSIONS: MRCP has the potential to replace ERCP in the management of patients candidate to VLC with suspected choledocholithiasis.

Algorithms↗
PubMed1996

[Functional aspects of the fetal urinary apparatus in relation to growth].

The normal and regular development of the fetal renal function is related to fetal growth and to the correct development of the fetal lung. Besides, the fetal kidneys plays an important role in the regulation of the hydro-electrolytic balance and in the modulation of the fetal arterial pressure. The postnatal renal failure is one of the most dangerous factors which may occur in the very small preterm babies (birth weight below 1000 g) and their therapeutical answer depends on the degree of kidney maturation. The knowledge of the kidney maturation process is one of the actual controversies in perinatal medicine. The development of the renal nephron and of the excretory system continues until 32-36 weeks of gestation, their maturation process ends only some months after birth. At 9 weeks of gestation the embryonic kidney may be seen in a transvaginal ultrasonographic scanning; the calico-pelvic system is visible from the 11th week of gestation and the bladder may be seen by ultrasound from the 12 weeks' gestation. The fetal glomerular ultrafiltration process starts at the 10-11 week of gestation and the most important factors that improve the volume of glomerular ultrafiltrate is the total renal mass which is related to the number of functional nephron units. The Doppler velocimetry performed on the fetal renal artery has shown that the fetal renal blood flow increases with the increase of the renal volume and gestational age and it depends on the cardiac output. In the renal artery the resistance to blood flow decreases with gestational age. During fetal hypoxia there is a reduction of the amniotic fluid production; this phenomenon is related to the redistribution of the fetal blood flow with a decrease of the perfusion of peripheric organs (as the kidney) and an increase of the perfusion of brain, heart, liver and adrenals. The hypoxic fetal kidney is ischemic; moreover, the urine production rate is diminished and the humoral response of the kidney increase the fetal arterial pressure which maintains the haemodynamic compensation to hypoxia. When this situation is prolonged, there is possibly renal failure. The fetal renal ultrasonographic examination can give important information about the maturity degree of the fetal kidney and the evaluation of Doppler velocimetry on renal artery and the evaluation of the amniotic fluid allow the monitoring of fetal hypoxia. In future the Doppler velocimetry of intrarenal arteries and the biochemical evaluation of the amniotic fluid may a real evaluation of the fetal renal function.

Adult↗
PubMed1993

[Is it possible to obtain a reduction of body weight exclusively via a loss in fat mass? Experience with d-fenfluramine].

Aim of the study was to observe if the administration of an anorectic drug, d-fenfluramine, in addition to hypocaloric diet, could influence the body composition and adipose mass distribution during a weight decrease programme in 17 obese women. Drug's effects plus diet on body weight changes were compared with those of a "only-diet programme" in another group of 18 obese subjects, sex and age matched. Both groups were observed for a 6-month period. All subjects were selected on the base of Index Body Weight % within 120-200 and without any therapy for other diseases. Blood samples were drawn before, during (3rd month) and after the period of observation for the measurement of OGTT, serum lipids, liver and kidney function parameters, blood cells count. Body weight and height, body composition, waist-to-hip ratio were also evaluated. Results documented: 1) significant reduction of body weight in the group kept on the combined therapy; 2) significant variation of body composition with increment of fat free mass and adipose mass decrease; 3) significant improvement of glucose tolerance, liver and kidney function parameters. In conclusion, our data show beneficial effects of d-fenfluramine on appetite reduction, influencing the carbohydrates assumption and the consequent fat mass loss with a good tolerability of the drug.

Adipose Tissue↗
PubMed1988

Hepatic alterations in indomethacin-treated rabbits.

Indomethacin was parenterally administered (6 mg/Kg/day) for 30 days to rabbits, to evaluate changes in serum biochemical parameters and any ultrastructural alterations induced by the drug at the hepatic level. An analysis of the results demonstrated that when the group of rabbits, a statistically significant increase in the serum ALT was found in the treated rabbits. Ultrastructural observations showed the following hepatocyte alterations: 1) minimum mitochondrial alterations 2) mild signs of cholestasis (pericanalicular osmophilic bodies) 3) Smooth endoplasmic reticulum hyperplasia. These findings suggest that indomethacin has the capacity to induce hepatic lesions in the rabbit and this is probably due to the surfactant mechanism.

Alanine Transaminase↗
PubMed1982

[Observations and significance of extrasystole in very young athletes].

80 very young football players (from 8 to 12) have been examined for three months by some clinical and instrumental cardiologic tests (starting E.C.G. and after graduated stresses on a football court). The starting E.C.G. showed variable extresystolic arrhythmias in 8 subjects, without any sure signs of a cardiopathy, to point out by deeper tests (such as polygraphic, echocardiographic test and rx heart teleradiography). The above-mentioned arrhythmias felt the effects of training variably, since they regressed in 6 cases, however two subjects needed a pharmacological intervention. They are still talking over the meaning to give to extrasystolic arrhythmias in very young people in evaluation of attitude to agonism and in programming training.

Age Factors↗
PubMed1982

[Initial observations in a cardiovascular poly-instrumental study of a homogeneous sample of young football players].

A group of 20 football players (from 12 to 15 aged) has been taken for a boodless test of cardiology (such as polygraphic and echocardiographic test) at the beginning of a longitudinal study in order to give the exact meaning, as much as possible, to the fitness for an agonistic training. One of the subjects examined was not for that test because of his cardiomegaly, another one had an anomalous mitral valve, in both the subjects the clinic and instrumental side resulted within normal ranges only if searched by E.C.G. About the other athletes the starting parameters will be controlled again, after they will have been in that football team for 1-2 years more. The authors think the point that came out is very important and they hope everybody to execute those studies either to avoid some cardiopathies pass unnoticed to routine tests or to value the effects of training of heart sizes and performances.

Adolescent↗
PubMed1980

[Nosology of contraceptives: hematological and ultrastructural observations after experimental administration of low dosage contraceptives (author's transl)].

A further experimental study on changes produced in rabbits by low dosage contraceptives is presented. The administration has been continued for six months. Serum biochemical and hepatic ultrastructural findings are in agreements with literature data. On the contrary the early changes of cardiac microcirculation and chiefly renal glomerular tuft seem to be rather unusual. The weight to be attached to the knowledges descending from the presented data in assessing allowance of contraceptive treatments in human subjects and aiming preventive medicine purposes is emphasized.

Animals↗
PubMed1980

[Effects of clofibrate on rabbit kidneys].

The Authors have investigated the effect on the kidney of experimental administration of 250 mg of clofibrate in rabbits. After 36 days of treatment the animals are sacrificed and histological and ultrastructural examination are made. The seriographies an alteration of the glomerular membrane and a mild fragmentation of endothelial lamina. Swelling of the proximal tubular cell is also revealed. It is concluded that this early injury of the nephron is reversible and more severe manifestation in man can occur. This drug must be strongly avoided.

Animals↗
PubMed1979

[Biochemicals and ultrastructural aspects of cardiac microcirculation after experimental treatment of SAM (author's transl)].

The Authors in an experimental model have studied the SAM'S pharmacodynamic process. Various group fo rabbit treated for a pathophysiological screening have been monitored. After discussion of data they conclude that the absence of injury of SAM is revealed by ultramicroscopic screening of morphometabolic areas. A pathologic deviation of biochemical data is also demonstrated.

Animals↗