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Biomedical subjects

G Pagano

Publications and source records attributed to G Pagano.

At least 163 records · Page 9Linked to original sources
PubMed1991

Lipoprotein-apolipoprotein changes in renal transplant recipients: a 2-year follow-up.

Renal transplantation modifies the dyslipidemia characteristic of chronic renal failure (CRF). The change in lipoprotein and lipid values of 51 transplant recipients, on cyclosporine and corticosteroid treatment, was studied during 2 years after transplantation to examine the short- and medium-term variations of lipid metabolism. Compared with control values of (all in mg/dL) triglycerides (Tg) 111 +/- 44, very-low-density lipoprotein (VLDL) Tg 69 +/- 18, total cholesterol (Chol) 201 +/- 32, VLDL-Chol 32 +/- 9, low-density lipoprotein (LDL) Chol 118 +/- 28, and high-density lipoprotein (HDL) Chol 50 +/- 10, uremic patients pretransplantation exhibited values of Tg 200 +/- 82 (P less than .001), VLDL-Tg 133 +/- 70 (P less than .001), Chol 193 +/- 51 (NS), VLDL-Chol 52 +/- 16 (P less than .001), LDL-Chol 100 +/- 37 (P less than .007), HDL-Chol 40 +/- 16 (P less than .001), which changed to Tg 118 +/- 18 (P less than .001), VLDL-Tg 64 +/- 45 (P less than .001), Chol 223 +/- 48 (P less than .006), VLDL-Chol 26 +/- 33 (P less than .001), LDL-Chol 134 +/- 43 (P less than .001), at HDL-Chol 63 +/- 21 (P less than .001) at 3 months and Tg 135 +/- 76, VLDL-Tg 81 +/- 62, Chol 218 +/- 55, VLDL-Chol 22 +/- 20, LDL-Chol 139 +/- 46, and HDL-Chol 58 +/- 18 at 24 months without evidence of a significative variations in the 3- to 24-month posttransplant period.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[The role of plasma lipids and of coagulation factors in atherosclerosis. Clinical trials and new prospects].

The relevance that lipids have in the pathogenesis and progression of atherosclerotic lesions is well-known. In these last years further insight has come about the role of hemostatic factors in these processes. Plasma fibrinogen seems directly involved in the genesis of atherosclerotic plaque and in the modulation of endothelium/circulating-cells microenvironment. Epidemiological data show that fibrinogen is a major risk factor for cardiovascular death and ischemic heart, brain and peripheral vessels disease. In this review we considered current data about pathogenetic mechanisms of atherosclerosis and its complication in which hemostatic/hemorheological factors (plasma fibrinogen, factor VIIc, platelets and leucocytes) are involved as well as the prognostic relevance of these components in human vascular pathology. Current knowledge suggests the need for intervention both on altered plasma lipids and on altered hemostatic parameters. At present, the actual possibilities of pharmacological intervention in the second case, apart from antiplatelet agents, are really poor. Among the drugs till now employed, fibrates are considered with interest as they seem to ameliorate both pathogenetic mechanisms: bezafibrate lowers plasma total- and LDL-cholesterol, triglycerides as well as plasma fibrinogen and other hemocoagulative parameters. This drug might be proposed in at risk populations in order to reduce the incidence and prevalence of atherosclerotic complications: at present, unfortunately, longitudinal studies to confirm this therapeutic rationale are not available.

Arteriosclerosis↗
PubMed1990

Lymphocyte Na,K-ATPase is reduced in aged people.

Na,K-ATPase-dependent 86Rb uptake, maximum velocity (Vmax), Michaelis constant (Km) of the uptake, and [3H]-ouabain binding were investigated in the lymphocytes of 10 elderly subjects (age greater than 60 years), and in 10 middle-aged (41 to 60 years) and 10 young controls (age less than or equal to 40 years). 86Rb uptake was reduced in elderly versus both middle-aged and young subjects (20.14 +/- 3.30 v 35.60 +/- 2.67, P = .002, and v 36.53 +/- 4.49 nmol, P = .012), as was the number of [3H]-ouabain binding sites per cell (32,662 +/- 2,215 v 40,420 +/- 1,184, P = .011, and v 40,596 +/- 1,349, P = .014). Vmax was reduced in elderly v young subjects (1.20 +/- 0.10 v 1.64 +/- 0.13, P = .034), but not versus the middle-age group (1.20 +/- 0.10 v 1.54 +/- 0.12 nmol.min-1, NS). Km was no different among the three groups. No differences were found between middle-aged and young subjects. Significant correlations were observed between age and Na,K-ATPase-dependent 86Rb uptake (r = -.620, P = .00009), Vmax (r = -.439, P = .024), and [3H]-ouabain binding sites (r = -.648, P = .002). Moreover, the site number was positively correlated with both uptake (r = .635, P = .002) and Vmax (r = .554, P = .011). These differences were observed both in women and men. We conclude that there is an age-dependent reduction in lymphocyte Na,K-ATPase activity, which is fully manifested over 60 years, and that this alteration is probably due to the reduced number of functional units of Na,K-ATPase in advancing age.

Adult↗
PubMed1990

Insulin supplement in type 2 diabetic patients with secondary failure to oral agents ameliorates hepatic and peripheral insulin sensitivity but not insulin secretion.

In order to investigate the mechanism of amelioration of metabolic abnormalities with supplementary doses of insulin, islet B-cell function and insulin sensitivity were measured in 10 patients with Type 2 diabetes in secondary failure to oral agents. A small dose of ultralente insulin (0.26 +/- 0.07 U kg-ideal-body-weight-1) was added in the morning before breakfast. After 3 months insulin therapy and progressive improvement of metabolic control (HbA1 from 10.5 +/- 0.4 to 9.0 +/- 0.3% at the end of insulin treatment, p less than 0.001), basal C-peptide and incremental area during an oral glucose tolerance test were unchanged. In vivo peripheral insulin sensitivity (euglycaemic clamp with insulin infusion of 40, 160, and 600 mU m-2 min-1, respectively) was significantly improved (glucose requirement: to 4.7 +/- 1.0 from 3.0 +/- 0.6 mg kg-1 min-1, p less than 0.05 at first insulin level; to 10.8 +/- 0.5 from 9.3 +/- 0.7 mg kg-1 min-1, p less than 0.01 at second level; to 13.3 +/- 0.6 from 11.8 +/- 0.8 mg kg-1 min-1, p less than 0.025 at third level). Basal hepatic glucose production was also significantly reduced (from 4.3 +/- 0.4 to 3.3 +/- 0.3 mg kg-1 min-1, p less than 0.05), and residual glucose production further suppressed after insulin supplement (from 1.1 +/- 0.4 to 0.3 +/- 0.2 mg kg-1 min-1 after 120 min at 100 mU l-1 plasma insulin, p less than 0.05). Specific insulin binding to mononuclear leucocytes was unchanged (from 3.1 +/- 0.3 to 3.5 +/- 0.3%, NS).

C-Peptide↗
PubMed1990

Incidence of IDDM during 1984-1986 in population aged less than 30 yr. Residents of Turin, Italy.

The goal of this study was to measure the incidence of insulin-dependent diabetes mellitus (IDDM) during 1984-1986 in residents of Turin, Italy, aged less than 30 yr. The primary data source was the list of all subjects diagnosed with IDDM who attended diabetes clinics in Turin. Other data sources were the general register of death certificates, the list of hospital discharges, and the computerized data base of insulin prescriptions. Eighty incident cases of IDDM were identified during the study in 1,130,284 person-yr for those less than 30 yr of age. Age-adjusted (world standard) incidence rates were 8.05, 8.10, and 6.96/100,000 in the age-groups 0-14, 0-19, and 0-29 yr, respectively. Estimated completeness of the primary data source compared with all other data sources was 91%, whereas the estimated completeness of ascertainment of the registry was 99%. Incidence rates of IDDM in northern Italy compare with those of European countries with low-medium incidence. A population-based register is being established for the province of Turin (951,445 inhabitants aged 0-29 yr) for the collection of incident cases since 1984.

Adolescent↗
PubMed1990

Neurological complications in HIV infection. Personal experience.

The personal experience on neurological disturbances associated with early HIV infection and AIDS is reported. Central nervous system (CNS) involvement occurred during the early stages in 3 cases: 2 patients with HIV-seroconversion (CDC category III) and one patient with persistent generalized lymphadenopathy (PGL, III group CDC, 1986). The patients had HIV acute meningitis. The neurological manifestations in AIDS had high incidence (49 of 83 cases), often with multiple aetiology in single patients. We remark the necessity of an early aetiological diagnosis to address the treatment.

Acquired Immunodeficiency Syndrome↗
PubMed1990

Role of diagnostic lymphnode biopsies in 56 anti-HIV positive patients.

The authors have examined two separate series of samples from 33 and 23 anti-HIV positive patients with persistent generalized lymphadenopathy (PGL) undergoing lymphnode biopsy. For the first group of patients, the aim was to evaluate the diagnostic and prognostic correlation between clinical and laboratory features and histologic findings. For the second group, an assessment was made of the indications for lymphnode biopsy as determined by the rate of positive histopathologic findings. Histologic alterations were classified into four types according to Ràcz, without knowledge of clinical and laboratory data. At the time of biopsy, the first sample (n = 33) included 21 lymphadenopathy associated syndrome (LAS) (64%), 6 ARC (18%), and 6 AIDS (18%) patients; a significant prevalence of type 1 histologic features was evident in LAS/ARC patients, while type 4 was exclusively present in the AIDS group. These preliminary results suggested that only symptomatic anti-HIV positive patients (ARC/AIDS) should have been selected for lymphnode biopsy, because of the expected high rate of opportunistic infections, malignant lymphoma, or Kaposi's sarcoma (KS) in this specific subset of patients. Actually, in the second sample of 23 patients (ARC = 8: AIDS = 15) the detection rate of AIDS-related neoplasms included ten Kaposi's sarcoma and three Hodgkin's disease. These findings suggest that diagnostic lymphnode biopsies should be limited to selected anti-HIV positive patients with evidence of AIDS-related neoplasms or treatable opportunistic infections, or for the purpose of detecting histopathologic features of prognostic significance.

AIDS-Related Complex↗
PubMed1989

Glucose intolerance after short-term administration of corticosteroids in healthy subjects. Prednisone, deflazacort, and betamethasone.

Glucocorticoid-induced glucose intolerance has been related to the dose, duration of treatment, and steroid compound. However, a clear demonstration of this phenomenon is still lacking for fluorinated corticosteroids. We performed an oral glucose tolerance test in six healthy volunteers after the short-term administration of deflazacort (18 + 18 mg), prednisone (15 + 15 mg), and betamethasone disodium phosphate (1.5 + 1.5 mg) at equivalent anti-inflammatory doses, in random sequence, and in a triple crossover design. Fasting plasma glucose levels were not modified by deflazacort, whereas fasting plasma glucose levels together with insulin and C-peptide values were progressively and significantly increased by prednisone and betamethasone. During oral glucose tolerance testing a significant increase in the plasma glucose and insulin peaks was recorded after betamethasone and, to a lesser extent, after prednisone and deflazacort. These results suggest that betamethasone induces greater glucose intolerance and insulin resistance than prednisone and deflazacort.

Adult↗
PubMed1989

[Role of the ultrasonic examination in the diagnosis of pelvic pathology].

The diagnostic accuracy of sonography in pelvic pathology is assessed in the case in which the operator is aware of the clinical report. Results attribute in absolute terms more effectiveness to sonography than to the clinical examination but it must, in any case, be considered as an extension of the gynaecological examination and not a replacement of the anamnestic history and physical examination.

Diagnostic Errors↗
PubMed1989

Lipoprotein and apoprotein levels in different types of dialysis.

Cardiovascular disease is common in chronic renal failure and its progression during dialysis has been described. We evaluated lipoprotein and apoprotein profiles in 30 male and 28 female uremic patients on dialysis in order to compare the results with 30 male and 19 female non-uremic controls and to detect any differences in lipemic pattern due to different types of dialysis. The dyslipidemic picture typical of uremia was observed in both sexes, coupled with significant hypertriglyceridemia and an increase in the lipid components of the very low density lipoprotein (VLDL). There was also a significant reduction in high density lipoproteins (HDL) cholesterol and HDL2 cholesterol. Apo C levels were increased, whereas Apo AI and AII were diminished. Apo B levels were unchanged. We also evaluated their lipid profile in relation to three types of dialysis: hemodialysis, hemofiltration and continuous ambulatory peritoneal dialysis. Analysis of variance of three different types of dialysis performed for comparable periods of time showed that the parameters typically altered in uremia (Tg, VLDL, ApoC, ApoE) were uniform, whereas differences were observed in the variables indicative of cholesterol and phospholipid metabolism. The alterations of cholesterol metabolism in some subjects, in addition to the specific alterations of Tg metabolism, help explain the elevated prevalence of atherosclerotic complications in dialysed uremic patient.

Apolipoproteins↗
PubMed1989

The hyperlactatemic effect of biguanides: a comparison between phenformin and metformin during a 6-month treatment.

To compare the chronic hyperlactatemic effect of phenformin and metformin, we performed a double-blind study in 10 non insulin-dependent diabetics without any other known hyperlactatemic condition. After a pre-study period, each patient was allocated to a 6-month treatment with phenformin (50 mg bid) or metformin (850 mg bid) in random sequence. Body weight values were not significantly different between phenformin and metformin. Diabetic control was significantly (p less than 0.001) improved by both biguanides versus pre-study, but was the same during metformin and phenformin: HbAI = 13.8 +/- 0.3 SEM% during pre-study 9.7 +/- 0.2% during phenformin, 10.2 +/- 0.2% during metformin. Mean values of plasma lactate during metformin were significantly lower versus phenformin (1.30 +/- 0.05 vs 1.64 +/- 0.05 mmol/l, p less than 0.001). Mean values of plasma lactate/pyruvate ratio during metformin were significantly lower versus phenformin (16.92 +/- 0.59 vs 22.65 +/- 0.87, p less than 0.001), but not versus pre-study (16.19 +/- 0.51). These results indicate that: 1) during a 6-month treatment with a diabetic control of similar degree phenformin produces a significantly higher hyperlactatemic effect vs metformin; 2) metformin treatment is associated with less impairment of intracellular redox state versus phenformin, and therefore should be considered advantageous in the long-term treatment of non insulin-dependent diabetics.

Acidosis, Lactic↗
PubMed1989

Lymph node biopsy in the diagnostic and prognostic assessment of patients with HIV infection.

Thirty-three anti-HIV positive patients with persistent generalized lymphadenopathy (PGL) who underwent lymph-node biopsy were studied to assess the diagnostic and prognostic relations existing between clinical, histological and laboratory findings. Patients were also examined for known risk factors, laboratory and bacteriological tests, and mononuclear cell surface marker analysis. 4 histological types were identified according to Ràcz's classification. At biopsy, there were 21 cases of LAS (64%), 6 cases of ARC (18%) and 6 cases of AIDS (18%); a clear prevalence of type 1 was evidenced in LAS/ARC patients, while only type 4 was present in the AIDS group. An ARC type 3 patient developed manifest AIDS within 13 months from biopsy. These results suggest that anti-HIV positive asymptomatic patients with PGL apparently do not require lymph node biopsy, as none of them showed histologic findings suggestive of opportunistic infections, malignant lymphoma or Kaposi's sarcoma. On the contrary, lymph node biopsy can play a diagnostic and prognostic role in anti-HIV negative subjects with PGL, and in ARC and AIDS patients.

AIDS-Related Complex↗
PubMed1988

A combined glucagonoma and VIPoma syndrome. First pathologic and clinical report.

We report a case of pancreatic tumour metastatic to the liver in a patient with insulin-treated diabetes, anaemia, cheilitis, necrolytic migratory erythema, hypokalemia and chronic watery diarrhea, a picture suggesting combined glucagonoma and VIPoma syndromes. Immunocytochemistry of a biopsied hepatic metastatic nodule revealed both glucagon and vasoactive intestinal peptide (VIP) positive cells. Increased plasma glucagon and VIP levels were detected (values of 900 pmol/l and 277 pmol/l respectively). This is the first reported case showing not only immunocytochemical, but also clinical evidence of the combined secretion of these hormones.

Adenoma, Islet Cell↗
PubMed1988

Effects of sodium azide on sea urchin embryos and gametes.

Sodium azide (SA) was tested on sea urchin embryos and gametes (Paracentrotus lividus). Developing embryos were exposed to SA (10(-6) to 10(-3) M) up to pluteus larval stage, or for shorter intervals before or after hatching. Developmental defects in SA-exposed embryos consisted mainly of gut abnormalities, without any detectable differences between pre- or post-hatch-exposed embryos. SA-induced damage to gut was exerted during gastrulation, as evident by lectin binding of extracellular matrix. No mitotic damage was observed in SA-exposed embryos, nor could pH-related variations be detected in SA-induced embryotoxicity at pH's ranging from 8 to 6. Concurrently, no effect ensued in the exposure of unfertilized eggs to SA (10(-5) to 10(-2) M) both in terms of fertilization success and of offspring quality. When sperm were suspended in filtered seawater at pH's ranging from 8 to 6, and SA levels ranging from 10(-5) to 10(-2) M, fertilization success of SA-exposed sperm appeared to be modulated by pH, by displaying three distinct dose-response trends at pH 8, 7, or 6. The consequences of sperm pretreatment on offspring quality failed to show any significant SA-induced changes on larval malformations or mortality, while confirming the previously reported pH-induced increase of developmental defects in the offspring of acid-exposed sperm (Pagano et al.: Teratogenesis Carcinogen Mutagen 5:113-121, 1985).

Animals↗