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Biomedical subjects

L Pasqualini

Publications and source records attributed to L Pasqualini.

At least 37 records · Page 2Linked to original sources

Lipoprotein (a) in peripheral arterial occlusive disease.

Recent studies have shown high levels of lipoprotein (a),--Lp(a)-, an atherogenic and thrombogenic lipoprotein, are considered a risk factor for coronary heart disease. This study evaluated Lp(a) levels, as well as other lipid factors, in a group of 45 patients affected by stage II peripheral arterial occlusive disease (PAOD). An age-, sex- and Body Mass Index-matched group of healthy controls was also recruited. Exclusion criteria were diseases or drugs which could alter Lp(a) levels. Alterations in lipid profiles, which are often associated with PAOD, were observed in the patients. Lp(a) levels did not differ significantly in the two groups (median 16.4 mg/dl, range 10-104, in PAOD and 9.9 mg/dl, range 7.4-66.7, in controls and means 21.7 +/- 17.5 mg/dl and 21.2 +/- 16.8 mg/dl respectively) but in 51% of the controls Lp(a) levels were < 10 mg/dl compared with 20% of the PAOD patients (p < 0.05).

Aged↗

Treating peripheral arterial occlusive disease: pentoxifylline vs exercise.

The effects of three months therapy with Pentoxifylline (800 mg three times daily) and physical training were compared in two age- and sex-matched groups of Stage II PAOD patients. Before therapy and after 12 and 13 weeks each patient underwent a standard treadmill test. The maximum walking time, TcPO2 half recovery time to basal values after the induced ischaemia, granulocyte production of free radicals (by the superoxide dismutase-inhibitable reduction of ferricytochrome) and surface expression of the CD11/CD18 complex of adhesion molecules (by using specific monoclonal antibodies) were determined. Pentoxifylline inhibited free radical production and reduced the percentage of granulocytes expressing adhesion receptors while exercise had no significant effect on these parameters. These changes, which reflect improved microcirculatory functioning, were associated with a greater walking capacity and shorter half recovery time (+14% vs exercise group, p < 0.01; -39% vs exercise group, p < 0.01 respectively).

Aged↗

Are leucocyte-derived free radicals involved in ischaemia in human legs?

Leucocyte-derived free radicals were monitored in 30 stage II peripheral vascular disease (PVD) patients in an open placebo-controlled study. Linked to a transcutaneous oxygen pressure (TcPO2) monitor, they performed two consecutive standard treadmill tests (5 min, 2 km h-1, 12% slope) before and after 15-days treatment with placebo or a leucocyte-derived free radical scavenger (Piroxicam, 20 mg day-1), the second test being carried out at the TcPO2 half-recovery time. Blood samples were collected at baseline, at the maximum walking times and the TcPO2 half recovery times. The total and differential leucocyte counts, the percentage of cells with pseudopodia or cytoplasmatic irregularities, the filterability rates (using a positive pressure Nuclepore filter system) of the main leucocyte subfractions and plasma oxidant activity were monitored. Compared with values before treatment and with the placebo-treated group Piroxicam therapy significantly (P less than 0.001) reduced the final half-recovery time, the percentage of cells with pseudopodia and the level of plasma oxidant activity (P less than 0.01) and kept the granulocyte filterability rate stable, showing leucocyte-derived free radicals are involved in peripheral ischaemia.

Exercise↗

Efficacy of low-molecular-weight heparin in the management of intermittent claudication.

Treating chronic arterial occlusive disease with heparin is controversial because of the risks associated with long-term anticoagulant therapy. Low molecular weight (LMW) heparin (mw about 5000 Dalton), which selectively inhibits the Xa factor with minimal risk of hemorrhage, seems to offer new possibilities in the prevention and treatment of both venous and acute arterial thromboembolism. Therefore, 44 patients with intermittent claudication were recruited to a randomized, double-blind, controlled study. Twenty-two were treated for six months with a single daily subcutaneous dose (15,000 UaXa) of LMW heparin and 22 with placebo administered in the same way over the same period of time. After six months, LMW heparin treatment not only improved walking capacity (by lengthening the pain-free walking time by 25%) but also significantly modified the hemorrheologic pattern (by reducing fibrinogen concentrations and whole blood viscosity at low shear rates). LMW heparin also exerted an antithrombotic and profibrinolytic effect by significantly increasing both the anti-Xa factor and plasminogen activity without markedly modifying activated partial thromboplastin time (+20%). No LMW heparin-treated patient hemorrhaged or reported other noteworthy side effects. These results suggest LMW heparin might be a useful drug in the long-term treatment of chronic arterial occlusive disease of the limbs.

Aged↗

Bacterial infection and peripheral vascular disease.

Whole blood filterability was monitored in 16 nondiabetic peripheral vascular disease (PVD) patients within forty-eight hours of onset of bacterial infection, after ten to seventeen days antibiotic therapy and again, ten days later, after convalescence. The whole blood filterability rate was constantly disturbed before infection in these patients; the impairment worsened significantly (as was expected during infection), but after convalescence the whole blood filterability rate did not return to preinfection levels. This further significant impairment in whole blood filterability was inversely correlated with a reduction in the patients' pain-free walking time as determined by a standard treadmell test performed after convalescence and compared with their average times before infection.

Bacterial Infections↗

Physical training and antiplatelet treatment in stage II peripheral arterial occlusive disease: alone or combined?

The efficacy of physical training alone or combined with antiplatelet therapy (dipyridamole and aspirin) was studied in 30 patients with stage II peripheral arterial occlusive disease (PAOD). Patients were randomly allocated to one of the following groups: Group A--dipyridamole 75 mg three times daily and aspirin 330 mg once daily: Group B--physical exercise; Group C--physical exercise and dipyridamole 75 mg three time daily and aspirin 330 mg once daily. After six months' treatment the pain-free walking time (PFWT) and the maximum walking time (MWT) improved significantly (p less than 0.05) in all three groups. In group A the PFWT lengthened by 35% (from 101.00 +/- 34.56 to 137.32 +/- 40.50 s) and the MWT by 38% (from 150.34 +/- 55.60 to 207.26 +/- 60.67 s); in group B the PFWT lengthened by 90% (from 90.65 +/- 40.54 to 171.45 +/- 55.60 s) and the MWT by 86% (from 145.39 +/- 60.50 to 270.63 +/- 63.61 s). When physical exercise was associated with drugs as in group C, the PFWT lengthened by 120% (from 89.51 +/- 43.89 to 196.72 +/- 51.73 s) and the MWT by 105% (from 160.43 +/- 59.84 to 329.05 +/- 63.96 s). No significant variations were observed at any stage of the study in the ankle/arm pressure ratio at rest and after standard treadmill exercise, in the plethysmographic rest and peak flows, or in the transcutaneous oxygen pressure in basal conditions and in its half recovery time after an induced ischemia. The results confirm the benefits of regular exercise in stage II PAOD patients but suggest they may be enhanced by antiplatelet therapy.

Aspirin↗

Reactive oxygen metabolites in peripheral arterial occlusive disease.

Plasma oxidant activity (marker of reactive oxygen metabolites) and the unfractionated leucocyte filterability rate (determined through 5 micron pore diameter Nuclepore filters, using a positive pressure system) were monitored in 15 stage II peripheral vascular disease (PVD) patients before and after ischaemia was induced by treadmill exercise (12 degrees slope/2 km/hour). Plasma oxidant activity increased (+ 115%) significantly (p less than 0.001) at the maximum walking time, correlating (r = 0.79) with a significant (p less than 0.001) impairment (+23%) in the unfractionated leucocyte filterability rate. At the transcutaneous oxygen pressure (tcPO2) half recovery time the plasma oxidant activity approached basal values but the unfractionated leucocyte filterability rate remained significantly (p less than 0.001) impaired (+16%). It returned to basal values at the full tcPO2 recovery time. These results show reactive oxygen metabolites are released during ischaemia of the lower limbs and are correlated with a significant impairment in the flow properties of leucocytes.

Arterial Occlusive Diseases↗

Effects of physical training on peripheral vascular disease: a controlled study.

The effects of physical exercise on 8 stage II peripheral vascular disease (PVD) patients were observed after a six-month training program. Doppler velocimetry (including the treadmill test), strain gauge plethysmography, and transcutaneous oxygen pressure were used to quantify the results, which were compared with those obtained in a control group of another 8 stage II PVD patients, under placebo therapy for six months. The results show physical exercise increased the walking capacity, both the pain-free walking time and the maximum walking time. No significant difference was observed in the other parameters studied, in either the exercise patients or the control group.

Aged↗

Effect of buflomedil chlorhydrate on local oxygen delivery in peripheral vascular disease.

Modifications in transcutaneous oxygen pressure (TcPO2), induced by the administration of 3 mg/kg/day buflomedil chlorhydrate for seven days were evaluated in 12 subjects suffering from peripheral vascular disease (PVD). After the treatment a significant increase in TcPO2 basal values was observed in Stage III and Stage IV PVD patients (+32.2%) while a significant reduction of 12% in the half-recovery time to basal values after an induced ischemia was recorded in Stage II PVD patients by the seventh day. Buflomedil did not, however, cause any significant variations in the ankle/arm pressure ratio or in the plethysmographic peak flow.

Aged↗

Effects of 3-glucosaminoglycan sulfate on hemorheologic parameters in hyperlipidemic peripheral vascular disease (PVD) patients: a preliminary double-blind crossover study.

The effects of 3-glucosaminoglycan sulfate on lipids and the hemorheologic parameters were observed in a preliminary double-blind crossover study in 30 hyperlipidemic peripheral vascular disease (PVD) patients. Parenteral administration of the test drug was associated with a reduction in serum lipids, especially in triglyceride levels, and a lowering of fibrinogen, plasma viscosity, and whole blood viscosity levels. These effects justify the drug's use in the treatment of PVD, especially when associated with hypertriglyceridemia and hemorheologic disturbances.

Adult↗

Peripheral vascular disease: role of leucocyte rheology and activation during controlled ischemia.

Leucocytes have been implicated in the development of tissue ischaemia. No studies on leucocyte rheology and activation in the earliest stages of controlled ischaemia in Peripheral Vascular Disease (PVD) exist. Blood samples were taken from 15 PVD patients and 15 matched controls before and after treadmill exercise (5 mins/2 km/hr/12% slope). Leucocytes were separated by density and adherence into their granulocyte, lymphocyte and monocyte sub-populations and their filterability rates through 5 micron diameter pore filters were measured. Leucocyte activation as observed under a light microscopy was monitored. Compared to controls, calf pain in the PVD patients was associated with a significant (p less than 0.001) increase (+22%) in monocyte filterability but not in leucocyte activation.

Arterial Occlusive Diseases↗

The apoprotein pattern in normolipemic peripheral vascular disease.

The relationship between peripheral vascular disease (PVD) and plasma apoproteins has still not been well defined. The lipid and apoprotein pattern of a group of 20 normolipemic patients affected by peripheral vascular disease has been compared with 20 healthy normolipemic subjects. Mean triglyceride plasma levels were higher in normolipemic patients than in the healthy controls (107.8 +/- 31.5 mg% vs 73.3 +/- 28.6 mg%; p less than 0.03) while mean HDL-cholesterol values were significantly lower (36.5 +/- 5.4 mg% vs 44.4 +/- 7.1 mg%; p less than 0.003). No significant difference was observed between the two groups in the mean values of the apoproteins AI (112.1 +/- 41.2 mg% in PVD vs 117.2 +/- 17.7 mg% in controls), AII (45.1 +/- 12.2 mg% vs 50.1 +/- 11.1 mg%), B (93.7 +/- 23.5 mg% vs 91.3 +/- 21.6 mg%), CII (3.9 +/- 2.6 mg% vs 2.6 +/- 1.7 mg%), CIII (6.7 +/- 1.5 vs 5.9 +/- 1.4 mg%) and E (3.09 +/- 1.4 mg% vs 3.3 +/- 0.9 mg%). On the contrary the mean triglyceride/Apo-E ratio was higher in PVD patients than in the controls (52.3 +/- 42 vs 23.3 +/- +/- 10; p less than 0.03).

Aged↗

Transcutaneous oxygen tension behavior in the different stages of peripheral vascular disease and its correlation with ankle/arm pressure ratio and calf blood flow.

The practical utility of transcutaneous oxygen tension (TcPO2) has been evaluated in 22 normal subjects and in 54 patients suffering from peripheral vascular disease (PVD) at various stages (II, III, IV), to define its clinical use in the diagnosis of PVD. Basal TcPO2 values can distinguish normal subjects only from stages III and IV PVD patients. In the case of stage II PVD patients the evaluation of the half-recovery time of TcPO2 basal values after an induced ischemia of the limb is mandatory. The study also showed that there are no significant statistical correlations among the TcPO2 values, Doppler, and plethysmographic parameters.

Aged↗

Free radical production in peripheral vascular disease. A risk for critical ischaemia?

Malondialdehyde (MDA) plasma concentrations (marker of lipid free radical peroxidation) and the unfractionated leucocyte and erythrocyte filterability rates (through 5 micron Nuclepore filters in a positive pressure filtration system) were determined during a partial ischaemia induced by two consecutive treadmill tests in 64 stage II peripheral vascular disease (PVD) patients and in 32 matched controls. Transcutaneous oxygen pressure (tcPO2) was monitored constantly throughout the walking tests and recovery periods. In the PVD patients impairments in the flow properties of leucocytes and erythrocytes were associated with increases in MDA plasma concentrations which correlated significantly with a lengthening of the tcPO2 half recovery times--index of the worsening of ischaemia. Patients could be divided into two sub-groups on the basis of these impairments and their half recovery times, suggesting this experimental model may provide a means to identify those stage II PVD patients most likely to develop critical limb ischaemia.

Aged↗