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Biomedical subjects

G Martini

Publications and source records attributed to G Martini.

At least 181 records · Page 10Linked to original sources
PubMedDate not supplied

Obesity and autonomic function in adolescence.

Hypertension and obesity are risk factors for coronary heart diseases in adults. In turn, childhood overweight and high blood pressure increase the risk of subsequent obesity and hypertension in adulthood. Human obesity is characterized by profound alterations of hemodynamic and metabolic states. Whether these alterations involve sympathetic nervous system control on cardiac function is controversial. We report the results of our study, conducted in a sample of obese adolescents by using power spectral analysis of heart rate variability. An increase in sympathetic tone coupled with a reduction in vagal tone was found. This allowed us to hypothesize that autonomic nervous system changes depend on the time course of obesity development. It is still unclear if treatment of obesity in adolescence prevents subsequent autonomic imbalance and hypertension.

Adolescent↗
PubMedDate not supplied

Heart rate variability and left ventricular diastolic function in patients with borderline hypertension with and without left ventricular hypertrophy.

The relationships between heart rate variability (HRV), left ventricular mass and diastolic function in borderline hypertensive patients (BHT) were evaluated. 24 h Holter electrocardiogram (ECG) and blood pressure (BP) monitoring, M and 2 D echocardiogram and Doppler analysis in 42 BHT with and without left ventricular hypertrophy (LVH) and in 20 normotensive controls were assessed. From 24-h ECG, time domain indexes of HRV were calculated. Standard Deviation of all Cycles (SDNN) and Standard Deviation of the means of heart periods over five-minute intervals (SDANN) were significantly reduced in BHT with LVH but not in BHT without LVH. No significant differences of short-term variability measures were detectable, although a progressive decrease among control subjects and BHT with and without LVH was observed. Diastolic left ventricular compliance evaluated by early to late transmitral flow velocity ratio (E/A ratio) significantly declined from normotensive subjects to BHT with LVH. There was a significant positive correlation between E/A and SDNN and SDANN throughout all studied groups. This indicates that BHT with LVH has a reduced HRV compared to other groups. This impairment is probably related to left ventricular mass and left ventricular filling abnormalities.

Adult↗
PubMedDate not supplied

Antihypertensive drugs and sympathetic nervous system.

Several studies have demonstrated that essential hypertension is accompanied by sympathetic activation, which contributes to blood pressure elevation. Sympathetic activation also has adverse consequences in hypertensive patients beyond initiating blood pressure elevation. There is evidence that neural vasoconstriction has metabolic effects in skeletal muscle, impairing glucose delivery to muscles. In the liver, retarding of post prandial clearance of lipids contributes to hyperlipidemia. Cardiac sympathetic activation is a probable cause of sudden death in hearth failure. A trophic effect of sympathetic activation on cardiovascular growth is also likely, contributing to the development of left ventricular hypertrophy. Consequently, one of the major aims of antihypertensive therapy should be to attenuate sympathetic tone. It is possible that, among the antihypertensive drugs available, those inhibiting the sympathetic nervous system might best reduce cardiovascular risk.

Adrenergic alpha-Antagonists↗
PubMedDate not supplied

Peripheral blood abnormalities in Alzheimer disease: evidence for early endothelial dysfunction.

Clinical and epidemiologic studies demonstrate that vascular risk factors may be involved in Alzheimer disease (AD). To evaluate whether vascular abnormalities are an early feature of AD, several parameters of coagulation and fibrinolysis were assessed. Thirty patients with mild AD and 30 age-matched control subjects entered the study. All subjects performed a standardized clinical and laboratory protocol. Persons with vascular risk factors and systemic diseases were excluded. AD patients present significant increased levels of thrombomodulin (p < 0.0001) and sE-selectin (p < 0.03). In contrast, no difference was found between the two diagnostic groups in the levels of beta-thromboglobulin, prothrombin fragment 1+2, fibrinogen, and von Willebrand factor. No other association but diagnosis was found with thrombomodulin and sE-selectin. These findings suggest that endothelial dysfunction is an early event in AD patients.

Aged↗
PubMedDate not supplied

DNA haplotypes in the G6PD gene cluster studied in the Chinese Li population and their relationship to G6PDCanton.

In an effort to investigate the subtelomeric region of the X chromosome among Orientals, five DNA sites in the F8C and G6PD genes were analyzed in a sample of 46 chromosomes belonging to the Chinese Li population, an ethnic group characterized by a high prevalence of G6PD deficiency. The DNA sites analyzed, which are highly polymorphic in other populations, have a low degree of heterozygosity in the Li sample and, furthermore, the distribution of the corresponding haplotypes is very different from that previously observed in Italian populations. Interestingly, three unrelated Li G6PD-deficient variants analyzed at the DNA level have the 1376G-->T mutation characteristic of G6PDCanton and they share the same haplotype, including the sites mentioned above, as well as eight DNA polymorphisms in the red/green color vision pigment genes located proximal to G6PD on chromosome X.

Adult↗
PubMedDate not supplied

Kawasaki's disease in northern Italy: a multicenter retrospective study of 250 patients.

OBJECTIVE: To evaluate (i) the clinical course and outcome in a cohort of 250 children affected with Kawasaki disease (KD) in northern Italy; (ii) the prevalence of coronary aneurysms and their correlation with treatment; and (iii) the prevalence of incomplete and atypical KD in the series as a whole. RESULTS: The male to female ratio was 1.8 to 1 and the median age at diagnosis 37 months. The majority of cases occurred in children under five years, with the youngest patient aged 51 days. Median duration offever was 8 days; median erythrocyte sedimentation rate (ESR) and C Reactive protein (CRP) values, performed before any treatment, were 77 mm/1st h and 10.4 mg/dl respectively. Median haemoglobin (Hb) levels was 9.2 g/dl and median platelet (PTL) count 408,000/mm3. Out of 250 patients, 209 (83.6%) fulfilled all criteria for the diagnosis of KD whilst 41/250 (16.4%) had an incomplete disease and 11/250 (4.4%) had an atypical onset. Fifty-four children (21.6%) were treated with aspirin alone (50-80 mg/kg/day, during the acute phase), while 196/250 (78.4%) were given aspirin (50-80 mg/kg day, during the acute phase and then 3-5 mg/Kg/day) and high-dose intravenous gammaglobulin (IVIG, 400 mg/Kg/day or 2 g/Kg/day). Coronary artery abnormalities, including aneurysms and dilatation, were reported in 7/54 patients (5 males and 2 females) who had not received IVIG and 53/196 patients (27 males and 26 females) who were treated with the IVIG in addition to aspirin. Other clinical manifestations included abdominal pain/diarrhoea (11), arthritis (10), hydrops of the gallbladder (8), disseminated intravascular coagulation (3), and hemiparesis (1). All patients except one infant are still alive. In most of the patients coronary alterations normalised, while in 20 patients they persisted for more than one year; in 12/20 patients they were permanent. CONCLUSION: Pediatricians should be aware of the increasing number of children with atypical and incomplete KD, in order to diagnose and treat the disease even in the absence of all typical manifestations and to prevent coronary complications.

Adolescent↗
PubMedDate not supplied

[Heparin-induced thrombocytopenia syndrome and thrombosis in patients undergoing periodic haemodialysis].

Heparin-induced thrombocytopenia (HIT) is the most important immunological drug reaction that patients face today. Being unfractionated heparin the standard anticoagulation used in haemodialysis, acute or chronic uremic patients starting haemodialysis are at risk of developing HIT. Through the accurate description of two patients, one with chronic and the other with acute uraemia, who developed this complication at the start of haemodialysis, we compare the distinct clinical problems of haemodialysis-related HIT with the general clinical features of HIT. We report the occurrence of repeated clotting of both dialysers and catheters, as well as thrombosis of the central veins where the catheters are placed and of the fistulas. We also report an accurate review of the literature on haemodialysis-related HIT. We have observed that HIT seems to be particularly rare in haemodialysis patients. Since newly treated haemodialysis patients are at risk of developing HIT, and most of the studies were made on long-term chronic haemodialysis patients, we assume that the syndrome is poorly documented. Our own experience on 37 haemodialysis patients who developed HIT is reported by focusing on both the clinical presentation of HIT as well as the long-term follow up of the patients. We present some considerations on the treatment options of acute HIT in uremic patients as well as on the problem of heparin re-exposure subsequent to the HIT episode, a very prominent problem in chronic haemodialysis patient.

Anticoagulants↗
PubMedDate not supplied

[Methodological basis and clinical applications of total-body densitometry].

With the advent of dual-energy x-ray absorptiometry (DXA) total body scans can be done in only 10-20 minutes rather than the 60-80 minutes required by dual-photon absorptiometry (DPA). The DXA approach replace the Gd153 radionuclide source of DPA and provides substantially greater output intensity. The higher radiation flux achievable provides several advantages over conventional DPA: this makes total body scans routinely accessible. The measures of the entire skeleton and its major subregions cut down the problems of representativeness and relocation. The short term precision (coefficient of variation) was 0.5% for total body-bone mineral density (BMD) and about 1% for regional-BMD. We studied 885 women; study cohort consisted of 161 healthy postmenopausal women, 357 healthy postmenopausal women and 367 osteoporotic women with one or more vertebral crushes. The results indicate that bone mass begin decreasing during the last period of the premenopausal phase; the advent of menopause brings about a dramatic reduction of both total body and single area BMD: this phenomenon is particularly marked in subjects with osteoporosis. The single most important factor in determining BMD changes, is years since menopause. In order to assess the ability of DXA total body to distinguish women with postmenopausal osteoporosis of variable radiological degress from healthy postmenopausal women, we studied 330 postmenopausal females aged 42-85 years. There were 63 healthy women who were considered controls (Group 1).(ABSTRACT TRUNCATED AT 250 WORDS)

Absorptiometry, Photon↗
PubMedDate not supplied

Localized and systemic forms of scleroderma in adults and children .

Systemic sclerosis (SSc) presents a great deal of variability in the extent and severity of skin and internal organ involvement. The diagnostic and prognostic significance of autoantibodies in SSc is undisputed and the patient's autoantibody profile represents a fundamental tool for clinicians. Scleroderma is a rare condition in children. Unlike adults, localized scleroderma is more frequent than the systemic sclerosis, nevertheless it represents a disabling condition. In both conditions, no validated outcome measures and proven effective treatment is available to date.Raynaud's phenomenon (RP) is one the most common and significant clinical symptoms of SSc and therefore in patients with RP a capillaroscopic analysis should be carried out as soon as possible. The actual and select advantage of the early nailfold videocapillaroscopic (NVC) analysis is to distinguish between the primary RP and the secondary RP and to allow the early detection of SSc.

Adult↗
PubMedDate not supplied

Diagnostic approach to osteoporosis and spondyloarthrosis in post-menopausal women by total body dual-photon absorptiometry.

Dual-photon absorptiometry of total body (153 Gd with photopeaks at 44 and 100 keV) enables bone mineral content of the entire skeleton and its major anatomical areas to be quantitated. Total body bone mineral (TBBM), total body density (TBD), bone mineral content and bone density of spine and lumbar-spine were measured in 97 women with post-menopausal osteoporosis, 33 females with spondyloarthrosis and in 19 females with spondyloarthrosis associated with osteoporosis. Seventy-nine females of similar age made up the normal control group. TBBM and TBD proved to be significantly lower in post-menopausal osteoporotic women compared to age-matched normal females: bone loss was particularly evident in spine measurements. In spondyloarthrosis patients TBBM and TBD fell within the normal range and both spine bone density and spine bone mineral did not differ from normals. TBD, TBBM, spine density and spine mineral in females with disuse osteoporosis associated with spondyloarthrosis were significantly lower in comparison with normals and higher with respect to post-menopausal osteoporotic women. Total body absorptiometry represents a valuable method in the differential diagnosis of post-menopausal osteoporosis, spondyloarthrosis and the disuse osteoporosis associated with spondyloarthrosis.

Bone and Bones↗