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Biomedical subjects

M Bernardi

Publications and source records attributed to M Bernardi.

At least 289 records · Page 16Linked to original sources
PubMedDate not supplied

Effects of a new loop diuretic (muzolimine) in cirrhosis with ascites: comparison with furosemide.

Muzolimine is a loop diuretic with both the dose-dependent increasing effectiveness of loop diuretics and the long-lasting effect of thiazides. This is a potential advantage in the treatment of ascites in advanced cirrhosis since these patients have a low tolerance to sudden reductions of blood volume. Equivalent single, oral doses of furosemide (40 mg) and muzolimine (30 mg) were given to 10 cirrhotic patients with ascites and reduced renal perfusion (glomerular filtration rate = 30 to 75 ml per min). The study was preceded by 4 days of equilibration (dietary sodium 40 mmoles per day), and the drugs were alternated via a single-blind, cross-over protocol after a wash-out period of 3 days. Renal function was monitored under basal conditions and after diuretic administration through 4-hr clearance periods for 24 hr. The renin-aldosterone axis was evaluated before diuretic administration and after 8 and 24 hr. Muzolimine led to a 12-hr cumulative diuresis [AUC0-12 = 2.52 +/- 0.42 (S.E.) ml per min] and natriuresis (5.14 +/- 1.05 mmoles per hr), which were comparable to those of furosemide (2.85 +/- 0.29 ml per min and 6.75 +/- 1.63 mmoles per hr). Its effect, however, was distributed over a longer period (8 hr) than furosemide (4 hr). Muzolimine activity mainly differed from furosemide because of: significantly lower 12-hr potassium excretion (AUC0-12 = 0.28 +/- 0.82 vs. 2.69 +/- 0.46 mmoles per hr; p less than 0.005); greater sodium/chloride excretion ratio (0.45 +/- 0.08 vs. 0.26 +/- 0.06; p less than 0.025), and absence of rebound phenomena.(ABSTRACT TRUNCATED AT 250 WORDS)

Aldosterone↗
PubMedDate not supplied

Peripheral arterial vasodilation hypothesis: a proposal for the initiation of renal sodium and water retention in cirrhosis.

Renal sodium and water retention and plasma volume expansion have been shown to precede ascites formation in experimental cirrhosis. The classical "underfilling" theory, in which ascites formation causes hypovolemia and initiates secondary renal sodium and water retention, thus seems unlikely. While the occurrence of primary renal sodium and water retention and plasma volume expansion prior to ascites formation favors the "overflow" hypothesis, the stimulation of the renin-angiotensin-aldosterone system, vasopressin release and sympathetic nervous system associated with cirrhosis is not consonant with primary volume expansion. In this present article, the "Peripheral Arterial Vasodilation Hypothesis" is proposed as the initiator of sodium and water retention in cirrhosis. Peripheral arterial vasodilation is one of the earliest observations in the cirrhotic patient and experimental animals with cirrhosis. Arterial vasodilators and arteriovenous fistula are other examples in which renal sodium and water retention occur secondary to a decreased filling of the arterial vascular tree. An increase in cardiac output and hormonal stimulation are common features of cirrhosis, arteriovenous fistula and drug-induced peripheral arterial vasodilation. However, a predilection for the retained sodium and water to transudate into the abdominal cavity occurs with cirrhosis because of the presence of portal hypertension. The Peripheral Arterial Vasodilation Hypothesis also explains the continuum from compensated to decompensated cirrhosis to the hepatorenal syndrome.

Animals↗
PubMedDate not supplied

ACTH(1-24) stimulates the migration of human monocytes in vitro.

In view of the increasing evidence that a variety of stresses can influence immune responses, the direct effect of adrenocorticotropic hormone on the migration of human monocytes was studied in vitro. ACTH(1-24) significantly increased the number of migrating cells when placed in the same or the opposite compartment of the chemotaxis chamber, maximum activity being obtained at 10(-14) and 10(-8) M. The results indicate that ACTH(1-24) directly and potently stimulates the migration of human monocytes by means of a chemokinetic effect.

Adrenocorticotropic Hormone↗
PubMedDate not supplied

Some approaches to the pharmacology of multisubstrate enzyme systems.

Analytical and exploratory in vitro, in situ and in vivo, physio-pharmacotoxicology, from enzymology to population epidemiology, now embraces those approaches that correlate complex dynamic multisubstrate kinetics through conventional and more recent non-invasive quantitative methodologies. Basically, substrates may be classed as pertaining to fundamental energy turnovers (first-order cellular metabolic pathways or networks) and to iso- vs allosteric modulator systems (second-order metabolic control network). Pairs of substrates and cofactors set-up the third-order multienzyme-receptor patterns, which in intact, native in vivo structures establish and maintain the compartmentalized, dynamically superimposed overall coordination of local redox and phosphate potentials. Perturbations of the various levels of the metabolic hierarchy induced by drugs, as well their relaxations, can be readily submitted to non-invasive kinetic analysis. Both indirect and direct titrations of substrate levels, their modelling and statistical ad hoc evaluations of their interrelations can lead to the identification of the multiple sites involved in drug effects as structured at the different orders/levels of concomitant functional variations. Fractal geometries contribute towards defining the space- and time-related events.

Animals↗