[Atenolol-chlorthalidone combination vs placebo: controlled clinical trial in patients with medium-mild arterial hypertension].
Explore the source record for details and available documents.
Adult↗
Biomedical subjects
M Ferrario
Publications and source records attributed to M Ferrario.
[Myocardial ischemia during exertion. Correlations between blood levels of thromboxane B2 and changes in coronary flow and resistance].
Platelet activation, with the subsequent generation of Thromboxane (Tx) A2, has been implied as a possible cause of resting as well as exercise induced myocardial ischemia. To verify the latter hypothesis, we measured the exercise release of TxB2, the stable metabolite of TxA2, in 9 patients with exertional angina and left anterior descending coronary artery disease. Three of the patients also suffered from angina at rest, due to coronary vasospasm. The great cardiac vein flow, venous efflux from the myocardial territory supplied by the left anterior descending, was determined by the thermodilution technique in the basal conditions, at peak exercise when angina and/or significant ST changes occurred, and 20 min after exercise. Simultaneous blood samples were drawn from the great cardiac vein and a peripheral artery for TxB2 measurements. Regional coronary resistances were calculated as the ratio of mean arterial pressure and coronary flow. At peak exercise the great cardiac vein flow increased and regional coronary resistances decreased in all patients, except in one who showed exercise induced coronary spasm. An increase in TxB2 release was found in 3 patients, a decrease in 3, while the remaining 3 patients did not show significant changes. After exercise the great cardiac vein flow and regional coronary resistances returned to control values in all, whereas both great cardiac vein and arterial TxB2 levels were increased in 6 patients. Our data show that no apparent relation exists between exercise-induced changes in coronary resistances and generation of TxB2.(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
[Effects of the cold pressor test and mental stress on coronary flow and resistance in patients with angina pectoris].
We compared the effects of cold pressor test and mental stress on coronary hemodynamics in 16 patients with coronary artery disease. The patients were divided into 2 groups according to the clinical characteristics of chest pain. Group I included 5 patients complaining of angina at rest associated with transient ST-segment changes, while Group II comprised 11 patients with stable exertional angina. In all patients coronary arteriography disclosed a proximal left anterior descending artery disease. Thermodilution measurements of the great cardiac vein flow, the venous efflux from the territory supplied by the left anterior descending artery, were obtained during cold pressor test and, after return to control conditions, during a mental arithmetic stress, consisting of serial subtractions of a two-figure number from a four-figure number. Coronary resistance of the anterior region was calculated as the quotient of mean arterial pressure and the great cardiac vein flow. In both groups of patients heart rate, mean arterial pressure and the great cardiac vein flow increased significantly during cold pressor test as well as during mental stress. During cold pressor test, coronary resistance of the anterior region increased in all patients of Group I (p less than 0.05), but did not change significantly in Group II patients. During mental test, coronary resistance of the anterior region increased in 3 patients and decreased in 2 patients of Group I (p:NS), while a significant decrease in coronary resistance of the anterior region was found in all patients of Group II (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
Adult↗
Effects of nifedipine on coronary hemodynamic findings during exercise in patients with stable exertional angina.
To investigate the mechanism by which nifedipine improves exercise tolerance in patients with coronary artery disease, we studied 14 patients with stable exertional angina and left anterior descending artery disease by measuring great cardiac vein flow (GCVF) and calculating anterior regional coronary resistance (ARCR) during exercise before and after sublingual administration of 20 mg of nifedipine. After nifedipine seven patients (group I) had no increase in exercise capacity and showed a similar magnitude of ST segment depression at peak exercise, while another seven patients (group II) had prolonged exercise duration (p less than .001) with less ST segment depression at peak exercise (p less than .01). Such effects were achieved despite a significant increase in double product, an indirect index of myocardial oxygen consumption. In group I patients no significant change was induced by nifedipine in GCVF or in ARCR either at rest or at peak exercise. In contrast, in group II patients nifedipine significantly increased GCVF at rest (p less than .05) and at peak exercise (p less than .001). Moreover, resting ARCR was decreased (p less than .01) and remained significantly lower at peak exercise (p less than .01) compared with the prenifedipine values. These data show that nifedipine may increase GCVF and decrease ARCR at rest and at peak exercise in patients with left anterior descending artery disease. Such increase in myocardial oxygen supply seems the most likely mechanism by which nifedipine may improve exercise capacity in patients with stable exertional angina.
Adult↗
MEDIC: a language to process clinical data for elementary statistical purposes.
A new language has been developed which is helpful for handling data, already collected and stored on disk, with the aim of producing reports of clinical interest. For each clinical data bank a dictionary is generated, which contains all information needed to fully identify each medical item (e.g., name, type, attributes, indexed/single value). Now the user can write programs in a very easy way using the statements of the MEDIC language which give him the possibility of powerfully filtering data, making calculations and producing reports. Data integrity is achieved by the fact that users can only accede to data from the data bank and cannot alter data or modify them on disk. A special emphasis has been given, when designing MEDIC, to the possibility of counting data which satisfy certain sets of conditions, and to special output functions, as histograms. Programs written in MEDIC language are processed by MEDIC generator, are immediately executable, and have the possibility of tracing/debugging (the tracing option is chosen when program is starting execution). At execution time the user chooses in a very easy way the rules of scanning data bank, for example, the whole data bank and single ranges of records.
Computers↗
[Psychiatric experience in and outside the hospital at the Fatebenefratelli Hospital in Milan].
Explore the source record for details and available documents.
Ambulatory Care↗
Comparative results between two groups of track-and-field athletes with or without the use of Master Amino acid Pattern as protein substitute.
Comparative results of this study have shown that athletes, by taking the Master Amino acid Pattern (MAP) as a dietary protein substitute and performing physical activity, have had (1) increased body muscle mass, strength, and endurance; (2) decreased fat mass; (3) increased basal metabolism rate; (4) greater improvement in performance of the nonprevailing muscles compared to the prevailing ones; and (5) improved muscular and hematologic lactate clearance, which allows for better muscle performance and faster muscle recovery after physical activity. It was concluded that the use of MAP as a dietary protein substitute in conjunction with physical activity can provide a safe and unprecedented way to optimize the body's protein synthesis, thereby improving anthropometric characteristics and physical and physiologic performance.
Adult↗
Results of taking Master Amino acid Pattern as a sole and total substitute of dietary proteins in an athlete during a desert crossing.
Study results show that a 51-year-old female athlete, while taking the Master Amino acid Pattern (MAP) as a sole and total substitute for dietary protein, and performing physical activity, experienced (1) increased body muscle mass, strength, and endurance; (2) decreased body fat mass; (3) greater increase in performance of the nonprevailing muscles compared to the prevailing muscles; (4) improved cardiorespiratory performance; and (5) increased red blood cells, hemoglobin, and hematocrit parameters. It was concluded, confirming previous findings, that use of MAP as a sole and total substitute for dietary protein, in conjunction with physical activity, provides safer, unprecedented optimization of the body's protein synthesis, thereby improving anthropometric characteristics and physical and physiologic performance.
Amino Acids↗
Laparoscopic donor nephrectomy: analysis of donor and recipient outcomes.
Explore the source record for details and available documents.
Humans↗
Effects of cyproterone acetate on the reproductive tract and pituitary-gonadal axis of the golden hamster.
The effects of cyproterone acetate (CA) on the reproductive tract and serum levels of gonadotropins and testosterone in male golden hamsters exposed to long days, were studied. The daily injection of CA at 100 mg kg-1 body weight during 8 weeks reduced sperm count, both in caput and cauda epididymidis. The weight of epididymis and seminal vesicles were also reduced, while testicular weight and histology were not affected. Serum levels of testosterone and LH were increased 3.6 and 1.8 fold, respectively, above controls, while FSH was not affected by the treatment with CA. The absence of an inhibitory action of CA on the testis could be explained through an increase in LH stimulation, thus suggesting that in the golden hamster CA is devoid of progestagenic partial effects.
Animals↗
Heparin infusion facilitates ex vivo spontaneous platelet aggregation in patients with acute myocardial infarction who have undergone thrombolytic therapy.
We investigated ex vivo spontaneous platelet aggregation (SPA) in platelet-rich plasma in 37 patients with acute myocardial infarction. It occurred in about 50% of subjects receiving heparin after streptokinase treatment, while it rarely took place in patients who did not receive either streptokinase or heparin and in those treated with streptokinase alone. The study of patients receiving heparin for deep vein thrombosis suggested that SPA may derived from adenosine diphosphate released from platelets during sample handling. We suggest that heparin infusion may facilitate ex vivo platelet activation and that this mechanism is operative in patients with acute myocardial infarction who have undergone thrombolytic therapy.
Heparin↗
[Occupational aging and cardiovascular diseases].
A short review of occupational aging and cardiovascular disease is presented. Coronary and stroke events are typical diseases of aging, in which rare monogenic disorders and common polymorphisms interact with environmental factors. Among these factors, particular attention has been given to social and occupational organizations. Cardiovascular mortality apparently increases with heavy industrialization processes and lower socioeconomic and educational status. Similar data are now available for incidence and case fatality. Since traditional risk factors--e.g., cholesterol, blood pressure and smoking--follow the same pattern, but with a weaker association than expected, observational and preventive studies are considering risk possibilities beyond such factors. Job demand/job decision latitude is the most widely used paradigm to evaluate specific organizational risk at work. A few cohort or population studied and many cross-sectional studies have shown an independent and inverse relationship between decreasing control of the job, coronary disease and blood pressure levels. While such results need further confirmation, they suggest the need for more accurate research on the adverse or mutually protective influences of long-lasting adaptation processes required by prevailing work organization.
Adult↗
[Stress, socio-occupational factors and cardiovascular risk: Italian experience].
A short overview about the main results obtained in some Italian studies on stress, occupation and cardiovascular disease is presented. Objective occupational discomfort and stress perception are related to biological changes in cathecolamine excretion and blood pressure. The latter, in males, is proposed as a biological index of stress perception. However it is not clear if these changes are a consistent contribution in increasing prevalence of major cardiovascular risk factors, coronary disease severity and incidence, although case fatality seems undoubtedly associated to low socio-occupational status. Consequent directions for future research are proposed.
Cardiovascular Diseases↗
[Differences of mortality risk for all causes and for cardiovascular diseases among occupational classes in men living the Northern Italy].
To assess socio-occupational (SO) class differences in 8-year risk of all-cause and cardiovascular (CVD) death in an North Italian prospective epidemiological study, five cohorts (four population-based and one factory-based) were investigated at baseline from 1986 to 1995. Follow-up procedures allow to sensor 4339 35-74 years old men up to the end of 1998 for all-cause and cardiovascular deaths. Coronary risk factors were measures according to the standardised methods of MONICA Project. Five SO classes were identified according to the method proposed by Erikson, Golthorpe e Portocarero. Results shows an inverse associations between SO classes and death risk for all-cause and cancer. The higher SO classes showed higher risk of cardiovascular death risk. Possible explanations include high level of job stress among employed managers and professionals.
Cardiovascular Diseases↗
[Reliability of the Karasek scale in the assessment of perceived occupational stress and gender-related differences in scores. The SEMM study].
In recent years more attention has been paid to the relationship between work organization and job stress and chronic-degenerative diseases. Aims of this report are the assessment of the reliability and internal consistency of the Karasek's Job Content Questionnaire-JCQ and to assess age-specific distributions of core JCQ scores between the gender groups. The study has been carried out in a large group of employees (n. 7871 subjects, 5270 women and 2601 men) of the Municipality of Milano in the years between 1992 and 1996. Decision Latitude (DL), Psychological Job Demand (PJD) and Social Support at Work (SSW) scores were calculated. Reliability of the JCQ was satisfactory, with Cronback's alpha suitable values for DL and SSW and acceptable for PJD. From the distribution of gender- and age-specific mean scores, women show reduced probabilities of developing a favorable career and of perceiving satisfactorily the support from colleagues and supervisors than men when they get older. This results suggest that the Karasek's JCQ is an effective toll to describe perceived job stress conditions in this Italian work setting.
Adult↗
[Epidemiology of cardiovascular disease among those of working age].
BACKGROUND: Cardiovascular mortality from the second half of 1970's has progressively decreased in Italy, in particular in the northern regions, in relation to the reduction of coronary mortality and cerebral-vascular incidents. OBJECTIVES: To concentrate mainly on Italian epidemiological studies that have explored the status of cardiovascular diseases among working adults. METHODS: A review of epidemiological studies carried out in Italy on these topics was made. RESULTS AND CONCLUSION: The marked reduction in coronary mortality rates observed in the last twenty years does not correspond to a concomitant reduction in the incidence of the disease. Therefore, the prevalence of chronic coronary heart disease, in particular in the less severe forms, is increasing in Italy. The demand for the assessment of residual working capacity for these patients is therefore increasing as well. Differences also exist in the socio-occupational gradient in coronary heart disease, reinforcing the need for cooperation between occupational physicians and cardiologists aimed at cardiovascular prevention and health promotion in work settings. In this perspective work stress should be considered as a relevant factor. The good reliability of the Karasek's questionnaire, as well as the association between job stress and blood pressure observed in work- and population-based Italian samples, indicates that this method of evaluating job stress may be used in health monitoring programmes in work settings.
Adult↗
[Incidence risk of major cardiovascular events among socio-occupational classes. 11-year follow-up of the MONICA Brianza and PAMELA cohorts].
The aim is to assess socio-occupational (SO) class differences in incident coronary and stroke. Methods. In a prospective fixed-cohort study 2959 35-74 year old men free from coronary (CHD) and stroke events were recruited in four population-based cohorts from 1986 to 1994 and followed-up until the end of 2002 to ascertain first CHD and stroke events. At baseline, major cardiovascular risk factors were investigated according to a standardised protocol. SO classes were based on current or last employment. Age-adjusted and multi-factors-adjusted risk ratios (RR) and 95% CI were calculated from Poisson regression models. Results. In 11-year median follow-up, the cohorts accumulated 33,926 person-years and generated 168 first major CHD events and 56 stroke events. Non-manual workers showed the lowest incident rates of both endpoints, and were considered as the reference category. Higher relative risks of CHD events were foundfor lower administrators and professionals, unskilled manual workers (UMW) and self-employed. Higher relative risks of stroke were found for skilled manual workers and UMW. Higher relative risks of CVD (either CHD or stroke) were found for lower administrators and professionals, skilled and unskilled manual workers and self-employed. Adjustments for major risk factors (cholesterol, systolic blood pressure, cigarette smoking, diabetes) did not modify the RRs. Conclusion. The higher risk of major cardiovascular events among lower SO classes is confirmed. Higher relative risks of CHD among lower administrators and professionals, and self-employers were also found. Further studies are needed to assess the etiologic role of job stress conditions.
Adult↗
[Job stress in the service industry. Evaluation of the Italian version of the Job Content Questionnaire].
BACKGROUND: Recent changes in work organization have greatly expanded the service industry, where stress perception appears to be the major factor of discomfort. Job stress remains a critical issue in occupational exposure assessments. OBJECTIVES: To assess the compliance and the consistency of the three major constructs (Psychological Job Demand (PJD); Decision Latitude (DL); and Social Support at Work (SSW)) of the Italian version of the Job Content Questionnaire (JCQ) adopted in the MOPSY and JACE studies and their gender-specific distributions in a large sample of civil servant in northern Italy. METHODS: JCQ was administered to 2601 men and 5761 women employed in six different departments of the Municipality of Milan. Two JCQ versions - short and intermediate which differ by the number of items that assess DL for inclusion of SSW, were used in different sub-samples. Compliance was measured in terms of participation rate and percentage of missing items. A construct-specific Cronbach alpha coefficient was used to assess internal consistency. As a measure of external consistency the correlation coefficients between the three constructs were adopted. RESULTS: The participant rate was very high in the entire sample: 75.3% in men and 76.2% in women. The percentage of missing items was small and acceptable, ranging from 3.61% for DL to 6.33% for SSW. The Cronbach alpha coefficients ranged from 0.72 for PJD to 0.88 for SSW. Assumptions for external validity were satisfied in both gender groups. The percentage of perceived high job stress diminished in older men, but the age trend was inverse among women, indicating gender differences in the possibility of improving work conditions and career. Interferences with the family-related load and responsibilities may play a significant role. In both gender groups, a satisfactory SSW level reduced perceived high job stress. CONCLUSIONS: The adopted versions of the JCQ, originally developed in American and north European socio-cultural contexts, demonstrated satisfactory levels of compliance, and internal and external consistency. The JCQ adequately described perceived job stress in the groups of workers under study.
Adult↗