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Biomedical subjects

M Mancini

Publications and source records attributed to M Mancini.

At least 235 records · Page 13Linked to original sources
PubMed1992

Coping and blood pressure.

The relationship between psychological coping strategies and BP was analysed in a group of 158 southern Italian men and women aged 20-59, randomly selected from an epidemiological study on coronary heart disease risk factors. Coping strategies were evaluated by use of a self-administered questionnaire (Jalowiec Coping Scale) listing 40 frequently used strategies. Factor analysis revealed the reported use of 5 different coping strategies. Males, on average, reported seeking less external support than females. In both sexes, increased years of education were associated with increased use of solution-oriented coping strategies and decreased use of resignation and sympathy seeking. After adjustment for age, alcohol use, body mass index, education and smoking, increased use of resignation was associated with lowered BP in both sexes. Emotional coping was inversely related to BP in males, but not in females. The search for external support was associated with a higher BP only in males. These data provide some evidence to suggest that psychological coping modalities are related to blood pressure.

Adaptation, Psychological↗
PubMed1992

Captopril therapy in severe hypertension: effects of intravenous administration.

In 10 severe hypertensives the effects of intravenous administration of scalar doses of captopril were evaluated. The behaviour of blood pressure, heart rate, electrocardiographic pattern and left ventricular (LV) diastolic function, in basal condition (T0) and after 60 min of captopril infusion (T60), were analysed. Diastolic performance was assessed by pulsed wave Doppler echocardiography, evaluating transmitral peak flow velocities in early diastole (PEDV), late diastole (PLDV) and the PEDV/PLDV ratio. All patients showed an increase in LV mass (assessed by M-mode echocardiography) and altered diastolic performance, documented by high PLDV and low PLDV/PEDV ratio values. Clinical, haematological, urinary and biochemical data were also assessed for possible side effects. Captopril significantly reduced BP in 7 out of the 10 patients. Supine BP decreased from 212 +/- 15.3/126 +/- 5.6 to 171 +/- 17.7/98 +/- 11.8 mmHg (T0 vs. T60 P less than 0.0001). No electrocardiographic abnormality was observed during the study. The goal of antihypertensive effect was reached at 40-50 min after the onset of captopril therapy. Heart rate showed a small but constant decrease (from 76 +/- 7.7 to 72.8 +/- 5.7 beats/min, T0 vs. T60, P less than 0.05). Side effects of intravenous captopril were always mild and transient; no severe hypotension as 'first dose effect' was observed in our study. The echocardiographic data showed a significant decrease in LV end-systolic dimension after captopril infusion, while left atrial, LV diastolic dimension and fractional shortening remained unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Evaluation of the therapeutic efficacy and tolerability of levocarnitine propionyl in the treatment of chronic obstructive arteriopathies of the lower extremities: a multicentre controlled study vs. placebo.

The treatment of symptomatic chronic obstructive peripheral arteriopathies is a difficult task since it requires the prolonged administration of drugs which are often unable to correct the various pathogenetic factors reponsible for the disability. The authors, on the basis of recent studies demonstrating the rheological and vasoactive as well as metabolic activities of levocarnitine propionyl, have decided to use this substance in the treatment of arteriopathics affected by intermittent claudication. Levocarnitine propionyl administered orally to 142 arteriopathics affected by intermittent claudication was responsible for a marked increase in initial as well as absolute walking distances. It is particularly important to note that these clinical results were obtained primarily due to the metabolic activities of levocarnitine propionyl.

Administration, Oral↗
PubMed1991

Increasing the dietary potassium intake reduces the need for antihypertensive medication.

OBJECTIVE: To determine whether an increase in dietary potassium intake from natural foods reduces the need for antihypertensive medication in patients with essential hypertension. DESIGN: Randomized, controlled trial with 1-year follow-up. SETTING: Hypertension outpatient clinic of a university hospital. PATIENTS: Fifty-four patients with well-controlled hypertension, 47 of whom completed 1 year of follow-up. INTERVENTION: Patients were randomly assigned to one of two groups and were given dietary advice aimed at selectively increasing potassium intake (group 1) or at keeping their customary diet unchanged (group 2). During a 1-year follow-up period, drug therapy was reduced in stepwise fashion, according to a fixed protocol, provided that blood pressure remained below 160/95 mm Hg. MAIN RESULTS: Potassium intake was checked monthly by referring to 3-day food records and by measuring 24-hour urinary potassium excretion. Potassium intake increased in group 1 but did not change in group 2 (P less than 0.001). No change was observed in either urinary sodium excretion or in body weight. After 1 year, the average drug consumption (number of pills per day) relative to that at baseline was 24% in group 1 (95% Cl, 15% to 32%) and 60% in group 2 (Cl, 44% to 76%) (P less than 0.001). By the end of the study, blood pressure could be controlled using less than 50% of the initial therapy in 81% of the patients in group 1 (Cl, 66% to 96%) compared with 29% of the patients in group 2 (Cl, 10% to 48%) (P = 0.001). Patients in group 1 ended the study with a lower number of reported symptoms compared with patients in the control group (P less than 0.001). CONCLUSION: Increasing the dietary potassium intake from natural foods is a feasible and effective measure to reduce antihypertensive drug treatment.

Adult↗
PubMed1991

Decreased density of beta-adrenergic and muscarinic cholinergic receptor sites in the vasa nervorum of aged rats.

The pharmacological profile and the anatomical localization of beta-adrenergic and muscarinic cholinergic receptors of the vasa nervorum were studied in sections of sciatic nerve using radioreceptor binding and light microscope autoradiography techniques. Sprague-Dawley rats of 4 and 24 months of age were used. [3H]Dihydroalprenolol (DHA) and [3H]quinuclidinyl benzilate (QNB) were used to label beta-adrenergic and muscarinic cholinergic receptors, respectively. The ligands were bound to sections of rat sciatic nerve in a manner consistent with the labelling of beta-adrenergic or muscarinic cholinergic receptors in the 2 age groups investigated. The dissociation constant (Kd) values (about 1.37 nM for [3H]DHA and 0.75 nM for [3H]QNB) did not significantly change between 4- and 24-month-old rats. The maximum concentration of binding sites (Bmax) for [3H]DHA was decreased by about 35% in 24 in comparison with 4-month-old rats. The Bmax value for [3H]QNB was reduced by about 50% in the aged rats. Light microscope autoradiography revealed the development of specific silver grains in the medial layer of epineurial and perineurial arteries in sections of sciatic nerve exposed either to [3H]DHA or [3H]QNB. The number of silver grains developed in epineurial and perineurial arteries of rats of 24 months is significantly lower than in animals of 4 months. The above results suggest the occurrence of an age-dependent loss in the density of beta-adrenergic and muscarinic cholinergic receptors of vasa nervorum. Vasa nervorum are the blood vessels which supply peripheral nerve trunks. They are constituted by outer (epineurial) and inner (perineurial) arteries and veins as well as by a capillary (endoneurial) plexus. Vasa nervorum are innervated by both sympathetic and non-sympathetic nerves which probably play a role in the pathogenesis of some neuropathies. Several different neurotransmitter containing nerve fibres have been identified in the vasa nervorum perivascular plexuses. However, no information is so far available concerning the neurotransmitter receptors of vasa nervorum. Moreover, although the occurrence of age-dependent changes in peripheral nerve morphology and function is well documented, very few reports were centered on the age-dependent changes of the vasa nervorum. The aims of the present study were to characterize pharmacologically and to localize anatomically the beta-adrenergic and muscarinic cholinergic receptors in the rat vasa nervorum. Moreover, the effect of ageing on the density and pattern of these receptors was investigated.

Aging↗
PubMed1991

Specific release of granulocyte-macrophage colony-stimulating factor, tumor necrosis factor-alpha, and IFN-gamma by human tumor-infiltrating lymphocytes after autologous tumor stimulation.

Tumor-infiltrating lymphocytes (TIL) have been cultured from a variety of human tumors, and some melanoma TIL have demonstrated specific, MHC-restricted recognition of autologous tumor in short term lysis assays. The current study investigates cytokine release by TIL as an indicator of specific tumor recognition. We have identified two of four melanoma and one of seven breast carcinoma TIL cultures that specifically release granulocyte-macrophage-CSF, TNF-alpha, and IFN-gamma after autologous tumor stimulation. The other cultures either do not secrete cytokine or secrete cytokine in a nonspecific fashion. The amount of specific cytokine released is directly related to the number of TIL and stimulating tumor cells. Studies of TIL, from two melanoma patients, separated into CD4+ and CD8+ populations revealed that CD8+ cells were responsible for virtually all of the specific cytokine secretion, although both populations released cytokines when activated by immobilized anti-CD3 antibody. Specific cytokine release by CD8+ TIL was inhibited by anti-MHC class I mAb. Specific cytokine release was also detected from a CD4+ breast cancer TIL culture, and this was inhibited by anti-MHC class II mAb. The clinical significance of this specific mode of immune antitumor reactivity is currently under investigation.

Antibodies, Monoclonal↗
PubMed1991

Correlates of high-density lipoprotein cholesterol in a sample of healthy workers.

METHODS: Correlates of high-density lipoprotein cholesterol are analyzed in a sample of 797 male workers in southern Italy participating in the Olivetti Heart Study. At the univariate level high-density lipoprotein cholesterol concentrations are positively related to alcohol consumption (r = 0.127; P less than or equal to 0.001) and sport activity (r = 0.074; P less than or equal to 0.05) and inversely related to body mass index (r = -0.160; P less than or equal to 0.001), serum triglycerides (r = -0.349; P less than or equal to 0.001), cigarette smoking (r = -0.227; P less than or equal to 0.001), and coffee consumption (r = -0.153; P less than or equal to 0.001). RESULTS: In the group as a whole, body mass index, alcohol consumption, cigarette smoking, and serum triglycerides remain significantly related to high-density lipoprotein cholesterol in the multivariate model, while the association with coffee intake and sport activity loses statistical significance. A significant negative interaction is reported between physical activity and cigarette smoking, and a positive significant linear trend between high-density lipoprotein cholesterol and sport activity is observed only in nonsmokers. CONCLUSION: These findings suggest that body mass index, alcohol consumption, cigarette smoking, serum triglycerides, and sport activity are important correlates of high-density lipoprotein cholesterol but that the positive significant association between sport activity and high-density lipoprotein cholesterol is absent in smokers.

Adult↗
PubMed1991

Responses of serum insulin and blood pressure to cold and handgrip in obese patients.

A close correlation between body weight and blood pressure has been frequently observed in both clinical and epidemiological studies. The aim of this clinical trial was to evaluate whether, in obese patients, there is any relationship between blood pressure, at rest or during sympathetic stimulation, and blood glucose and serum insulin, both while fasting and during an oral glucose challenge. Twenty obese patients (age 26-65 years, body weight 97 +/- 16 kg, 11 normotensive and 9 hypertensive) entered the study. After a 4-week run-in period on an isocaloric diet with normal intake of sodium, blood pressure and heart rate were measured at rest and during sympathetic stimulation induced by cold and isometric testing. Responses of glucose and insulin to a standardized 75 g oral glucose tolerance test were also evaluated. The responses of glucose and insulin to glucose challenge were not statistically different in normotensive and hypertensive obese patients. Levels of insulin in the serum in the serum in the fasting state and during glucose load were significantly correlated with the response of blood pressure to cold and isometric exercise, but not to blood pressure at rest. The response of heart rate to cold was closely related to insulin only in the subgroup of normotensives. The present findings support the hypothesis that the sympathetic nervous system, which influences secretion of insulin and regulation of blood pressure, is involved in the pathophysiology of the association of obesity and hypertension.

Adult↗
PubMed1991

Evolving modalities of treatment with interferon alfa-2b for Ph1-positive chronic myelogenous leukaemia.

We have administered interferon alfa-2b, alone or in combination with chemotherapy, to 126 Ph1-positive chronic myelogenous leukaemia patients. Of 71 early chronic phase (CP) patients (less than 12 months from diagnosis), 41 (58%) obtained a complete haematological response (CHR). Daily interferon was more effective than intermittent administration. In previously untreated patients, the response was significantly influenced by risk status at diagnosis. Thirty-four out of 71 (48%) patients improved cytogenetically, the median of Ph1+ mitoses declining from 100% to 66% with complete Ph1-suppression in one case. Of 46 late CP patients (greater than 12 months from diagnosis), 32 (70%) achieved CHR with interferon alone or combined with chemotherapy. All 10 patients with disease well controlled by chemotherapy obtained stable CHR with interferon alone. Of 36 partial responders to conventional chemotherapy, 22 (61%) obtained CHR on interferon plus low-dose hydroxyurea. Ph1 mosaicism was reached by 16 (35%) late CP patients (median Ph1+ cells 75%). Of nine accelerated phase patients on interferon plus chemotherapy, one attained CHR, and two responded partially. At a median follow up of 36 months, of 41 CHR patients in early CP, 15 are controlled on interferon, 12 have had autologous bone marrow transplantation (BMT), and two allogeneic BMT. Blastic transformation (BT) has occurred in eight of 41 CHR patients (19%) versus 17 of 30 (57%) non-responders and partial responders to interferon. At a median follow up of 22 months, of 32 late CP patients obtaining CHR, 26 remain on interferon, one had allogeneic BMT, one had autologous BMT, and one developed BT (versus five out of 14 with less than CHR). These studies confirm the haematological and cytogenetic efficacy of interferon in CML and indicate that the disease status at the start of treatment is critical in determining the success of therapy.

Combined Modality Therapy↗
PubMed1991

Prevalence and correlates of angina pectoris in the Italian nine communities study. Research Group ATS-RF2 of the Italian National Research Council.

We investigated the prevalence and correlates of angina pectoris in 6573 men and women aged 20-59 participating in the Italian National Multicenter Study on Risk Factors for Arteriosclerosis. In both sexes, the prevalence of angina pectoris, as assessed by the Rose questionnaire, increased sharply with age (from 0.8% to 5.1% for men and from 1.7% to 6.9% for women). In all age groups, there was a higher prevalence of angina pectoris for women than for men. In men, a strong positive association was found between angina pectoris and myocardial infarction (both by self-report and electrocardiographic documentation) and self-reported dyspnea. In women, myocardial infarction (self-reported), electrocardiographic-documented myocardial ischemia, intermittent claudication, and dyspnea were all associated with angina pectoris. In both sexes, angina pectoris was positively associated with body mass index. Males with diabetes had two times the prevalence of angina pectoris as males without diabetes; in females, diabetes was only weakly associated with angina pectoris. None of other major ischemic heart disease risk factors (blood pressure, serum lipids, or smoking) was associated with angina pectoris.

Adult↗
PubMed1991

Comparative effects on blood pressure and regional hemodynamics of nicardipine and captopril.

This randomized, double-blind, crossover study was aimed at detecting efficacy differences in blood pressure control and peripheral circulation in cerebral aortic and femoral districts of slow-release nicardipine, 40 mg, and captopril, 50 mg, given twice daily to 20 primary hypertensive patients (9 male, 11 female; age range 33-60 years) for a period of 4 weeks for each treatment. Blood flow velocities in the aorta, common carotid artery, internal carotid artery, middle cerebral artery, and common femoral artery were noninvasively measured using a 2.0- or 5-MHz Doppler probe. Systolic blood pressure fall was similar with nicardipine (from 156 +/- 12 to 139 +/- 8 mm Hg, p less than 0.001) and captopril (from 158 +/- 13 to 146 +/- 13 mm Hg, p less than 0.001) while significant efficacy difference (p less than 0.005) in diastolic pressure control was detected (from 104 +/- 6 to 91 +/- 8 mm Hg, p less than 0.001 with nicardipine and from 102 +/- 6 to 98 +/- 7 mm Hg with captopril). Regarding regional hemodynamics, nicardipine increased (from 119 +/- 24 to 133 +/- 27 cm/s), and captopril did not affect systolic velocity in the aorta (difference between final data, p less than 0.03). In the common carotid artery systolic velocity was increased solely by nicardipine. No significant changes were detected in the other vessels explored.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Renal tubular sodium handling and plasma atrial natriuretic peptide, renin activity and aldosterone in untreated men under normal living conditions.

The associations between renal tubular sodium handling and plasma levels of atrial natriuretic peptide, renin activity and aldosterone were studied in 295 untreated men under normal living conditions. The renal clearance of ingested lithium was used as a marker of proximal tubular sodium handling. Plasma atrial natriuretic peptide was inversely related to creatinine clearance (r = -0.148, P less than 0.01) and directly and significantly related to the overall fractional excretion of sodium (r = 0.213, P less than 0.001) and to distal (r = 0.151, P less than 0.01) fractional sodium excretion. Plasma renin activity was inversely related to sodium excretion at both proximal (r = -0.145, P less than 0.05) and distal (r = -0.236, P less than 0.001) tubular site, whereas plasma aldosterone was significantly and inversely related to distal sodium excretion only (r = -0.305, P less than 0.001). The association between plasma atrial natriuretic peptide and distal sodium excretion in a large sample of men under normal living conditions supports the view of a possible tubular effect of the hormone of the overall control of sodium excretion in man.

Adult↗
PubMed1991

Recurrent kidney stones: causes and diagnostic criteria in patients from Campania (southern Italy).

A study was carried out on 180 recurrent kidney stone formers from the Campania region of southern Italy. The data showed that this hypercalciuric population was similar to that in previous studies; however, there was no difference in terms of parathyroid activity when compared with normal controls. The slightly depressed serum levels of vitamin D in hypercalciurics indicate that gut calcium absorption is not directly related to vitamin D levels. We found no difference in the prevalence of metabolic abnormalities associated with stone formation between the patients in this series and those in previous studies.

Acidosis, Renal Tubular↗
PubMed1991

Resolution of high initial epicardial patch defibrillation thresholds following chronic implantation.

To determine what effect chronic implantation of automatic implantable cardioverter defibrillator epicardial patch electrodes had on initial high defibrillation thresholds at implant, six patients were studied. There were five men, one woman, mean age 61 years. Three had coronary artery disease and three had dilated cardiomyopathies. Mean ejection fraction was 20%. Two patients underwent concomitant coronary artery revascularization and one underwent mitral valve replacement. No patient was on antiarrhythmic drugs. At the time of initial implant, adequate defibrillating thresholds could not be obtained in any patch configuration despite the use of up to 40 joules. Further testing was precluded in each patient due to the development of profound hypotension (less than or equal to 70 mmHg systolic) that was poorly responsive to pressors. The patch electrodes were then implanted in an arbitrary anterior-posterior position and the leads were tunneled to an abdominal pocket. After 10-15 days (mean 11), the lead ends were exposed and defibrillation testing was performed again. In all six patients, adequate defibrillation thresholds were obtained (mean 18 joules). We conclude that if adequate defibrillation thresholds cannot be obtained at implant and if further testing cannot be performed without jeopardizing the life of the patient, the patch electrodes should be implanted and retesting performed at 10-15 days.

Aged↗
PubMed1991

Lipid intake and atherosclerosis.

The importance of diet in the prevention and treatment of atherosclerosis is well known. Among the different nutrients, lipids certainly have a primary role. Dietary cholesterol can influence the progression of atherosclerosis by increasing cholesterol levels or by modifying the composition of lipoproteins. Epidemiological and clinical studies have clearly demonstrated a relationship between the intake of saturated fatty acids and atherosclerosis. Among these fatty acids, stearic acid has the smallest effect on cholesterol levels. Until a few years ago it was though that monounsaturated fatty acids (MUFA) did not affect lipoprotein metabolism. However, very recently it has been shown that MUFA have the same hypocholesterolemic effect as polyunsaturated fatty acids; moreover they do not induce a decrease in high-density lipoprotein cholesterol. Therefore the overall metabolic effect of MUFA seems to be beneficial.

Arteriosclerosis↗