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Biomedical subjects

M Mancini

Publications and source records attributed to M Mancini.

At least 379 records · Page 21Linked to original sources

Increased retraction of fibrin clots by endothelial cells of infants of diabetic mothers.

Cultured endothelial cells (EC) from the umbilical veins of infants of non-diabetic mothers induced retraction of fibrin clots formed by addition of thrombin to cell-free plasma. Fibrin clot retraction activity increased with time, reaching a maximum within 24 hours and was inhibited at 4 degrees C or in the presence of EDTA. This retraction had many characteristics in common with that induced by platelets. EC obtained from the umbilical veins of infants of poorly controlled insulin dependent diabetic mothers (IDDM) showed similar patterns of retraction. However, compared to normals, these cells induced greater retraction. Since the retraction of fibrin clots is thought to promote the exposure of sub-endothelial layers and since such an exposure plays a major role in thrombogenesis, we suggest that retraction of fibrin clot by EC should be taken into account in evaluating pre-thrombotic states.

Cells, Cultured↗

[Tracking of blood cholesterol and arterial pressure in adolescence].

Early identification of atherosclerosis precursors and assessment of secular trends are key factors in organizing primary prevention programs. Tracking phenomenon for serum cholesterol and blood pressure has been evaluated at two years' interval in a group of students of both sexes, aged 11-15 years, in the municipality of Mugnano, near Naples. Serum cholesterol has been followed in 77 students and blood pressure--systolic and diastolic--in 160. Forty-three % serum cholesterol levels, 44% of systolic blood pressure measurements, and 25% of diastolic blood pressure values, that were in the upper quintile at the first visit, were found in the upper quintile again at the second visit. Our results point out that: there is a chance to identify "high" values, that may persist over time, especially for serum cholesterol and systolic blood pressure; great caution must be exercised in taking isolated measurements of serum cholesterol, systolic and particularly diastolic blood pressure at a young age as indicators in implementing prevention programs.

Adolescent↗

Peripheral circulation in hypertensive patients: findings by digital pulse plethysmography.

Sixty one non diabetic, asymptomatic patients with untreated primary hypertension and 122 age and sex matched non diabetic controls have been investigated in the peripheral circulation of the lower limbs by digital pulse plethysmography. The inclination time of the ascending ramp has been chosen as index of arterial wall elasticity. Inclination time was prolonged in the hypertensive group as compared to the control one (123 +/- 29 vs 107 +/- 13 msec; p less than .001). In addition, by using a cut-off point of 120 msec (X +/- 1SD of controls) 23/61 hypertensives and 26/122 controls presented an inclination time above this value (p less than .05 by chi square test). Since no other difference was observed in the main cardiovascular risk factors, we conclude that high blood pressure may produce early structural lesions of the vessel wall.

Adult↗

Separate influence of dietary carbohydrate and fibre on the metabolic control in diabetes.

To clarify the separate influences of digestible carbohydrate and of dietary fibre on blood glucose control and serum lipoproteins, 14 diabetic patients (six Type 1 and eight Type 2) were submitted to three weight-maintaining diets for 10 days each: (1) low carbohydrate/low fibre diet with 42% carbohydrate and 20 g fibre; (2) high carbohydrate/low fibre diet (carbohydrate 53%, fibre 16 g); (3) high carbohydrate/ high fibre diet (carbohydrate 53%, fibre 54 g). In comparison with the low carbohydrate/low fibre diet, the 2-h post-prandial blood glucose and the daily blood glucose profile decreased significantly on the high carbohydrate/high fibre diet, without significant changes during the high carbohydrate/low fibre diet. The diet-induced modifications of blood glucose control were similar in both types of diabetic patients (two-way analysis of variance: F = 5.86, p less than 0.02 for dietary treatment and F = 2.09, NS for type of diabetes). Total and low-density lipoprotein cholesterol were also decreased after the high carbohydrate/high fibre diet in comparison with the low carbohydrate/low fibre diet (p less than 0.001 for both), while they were not significantly modified after the high carbohydrate/low fibre diet. Again the modifications of low density lipoprotein cholesterol induced by diet were similar in both types of diabetic patients (F = 10.02, p less than 0.005 for dietary treatment and F = 0.14 for type of diabetes, NS). High-density lipoprotein cholesterol was lower after the two test diets than after the low carbohydrate/low fibre diet.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Effect of oxprenolol and metoprolol on serum lipid concentration.

The aim of the present study was to evaluate whether a reduction in HDL-cholesterol is peculiar to non cardioselective beta blockers or whether it is also produced by cardioselective beta 1-blockers. 16 patients with primary arterial hypertension on a balanced isocaloric diet were given oxprenolol 120 to 240 mg/day or metoprolol 100 to 200 mg/day in a random cross-over study. No significant change was observed after either treatment in fasting blood glucose, serum total cholesterol and triglycerides. HDL-cholesterol concentration was significantly decreased on metoprolol, from 41 to 36 mg/dl (p less than 0.05), while oxprenolol did not affect it at all. The difference might depend on intrinsic sympathomimetic activity which is possessed by oxprenolol and which metoprolol lacks.

Adult↗

Changes in left ventricular mass during a double-blind study with chlorthalidone and slow-release nifedipine.

The presence of a possible correlation between changes in left ventricular mass of hypertensive patients and the degree of blood pressure reduction with different antihypertensive drugs has been investigated in 40 outpatients by M-mode echocardiography. Ten of these, with blood pressure in normal limits with different antihypertensive treatment had their therapy changed in chlorthalidone 25 mg/day without any run-in (Group A); other 30 patients, with a previously uncontrolled blood pressure, after a 14 day run-in, were randomly allocated to chlorthalidone 25 mg/day (Group B), slow release nifedipine 20 mg/day (Group C) or placebo (Group D). At the end of the eight week treatment period a further decrease in systolic blood pressure was observed in Group A without changes in ventricular mass; an highly significant decrease in both systolic and diastolic blood pressure was observed in B and C but only patients on chlorthalidone changed their ventricular mass; no change in both blood pressure and ventricular mass was observed on placebo. As changes in ventricular mass are not correlated with blood pressure reduction, we conclude that other, not well defined factors, apart from the decrease in duration and degree of left ventricular systolic wall tension, may be responsible for reversal of left ventricular hypertrophy.

Adult↗

Changing the Mediterranean diet: effects on blood lipids.

A study was carried out on 48 healthy middle-age men and women habitually subsisting on a "Mediterranean type" diet in a rural area of southern Italy. Their freely chosen natural diet was modified for a period of 42 days by partially substituting animal fats for olive oil. Currently available foods were used, and the subjects maintained their habitual lifestyle. Dietary fat content changed from 33 to 37% of total energy and the polyunsaturated to saturated fatty acid ratio changed from 0.48 to 0.22. The base-line serum total cholesterol of men increased during the dietary intervention period from 214 +/- 30 mg/dl (mean and SD) to 245 +/- 33 mg (+15%). Low-density lipoprotein cholesterol increased 19%, while high-density lipoprotein cholesterol remained unmodified. Women, while exhibiting a similar trend in serum total cholesterol (+16%), showed also a 19% increase in their high-density lipoprotein cholesterol (p less than 0.001). Apoprotein B increased in parallel with low-density lipoprotein cholesterol in both sexes. The results of the study confirm the impact of the dietary factor on blood lipids. They also provide additional evidence on the response of high-density lipoprotein cholesterol to diet in free-living populations.

Adult↗

Hypocholesterolaemic activity of suloctidil: double-blind, crossover short-term and long-term treatment trial.

Two studies were carried out in patients with primary hyperlipidaemia to investigate the effect of suloctidil (200 mg 3-times daily) on serum cholesterol levels and other lipidaemic variables. The first study was a double-blind, crossover comparison of suloctidil and placebo in 23 patients. Patients were allocated at random to receive one or other treatment for 4 weeks, after a wash-out period of 4 weeks on placebo, and were then crossed over to the alternative medication for the following 4 weeks. Patients were kept on a controlled diet throughout the trial. In the second, long-term study, 28 patients were treated, after an initial washout period of 8 weeks on placebo, with suloctidil for periods of up to 1 year. As in the short-term trial, patients were maintained on a controlled diet. The results showed that suloctidil produced a statistically significant reduction in total serum cholesterol and serum triglycerides in the short-term and this reduction was maintained over the longer period of the second study. In addition, there was a concomitant and approximately proportional increase in HDL-cholesterol. Suloctidil was well tolerated and no serious side-effects were reported.

Body Weight↗

Altered kinetics of an intravenous calcium load in hypertensive patients.

Essential hypertensive (EH) patients have a higher rate of urinary calcium excretion and, according to some reports, somewhat lower levels of serum ionized calcium. The aim of this study was to investigate the kinetics of an i.v. calcium load in EH patients and in normotensive controls. Fifteen EH patients and twelve sex-and weight-matched controls received a constant ionized rate i.v. calcium infusion (0.1 mmol Ca2+/kg body weight/h) for 2 h. Serum ionized calcium and urinary calcium excretion were determined at regular intervals during the infusion and, in two subgroups of seven hypertensives and seven controls, for up to 4 hours later. EH patients had significantly higher excretion rates (P less than (P less than 0.001) and slightly, but not significantly, lower serum ionized calcium compared to controls. The serum ionized calcium concentration attained at 60 and 120 min of the Ca2+ infusion was significantly lower in EH (P less than 0.01) and it remained appreciably lower for up to 220 min from the beginning of the test. The area under the curve of serum ionized calcium calculated at different time points was significantly reduced in the hypertensives. The mean renal calcium clearance of the patients during the infusion and the elimination phase was somewhat higher, but the difference from controls did not reach statistical significance. These data indicate an abnormal handling of a calcium load by patients with EH and raise the possibility that such abnormality may not be due simply to a renal defect but perhaps to an altered calcium distribution among different compartments in the body.

Adult↗

Serum lipid and lipoprotein profiles in childhood.

Serum lipids and lipoproteins as well as other factors have been shown to be predictive of future symptomatic coronary heart disease in adult populations. Many epidemiologic data are available on serum lipids in adults in different populations; similar data in children indicate a large geographic variability between different populations and even among individuals of the same population, suggesting that both genetic and environmental factors are determinants of serum lipid concentrations. Serum cholesterol at birth and during childhood is carried predominantly by low-density lipoprotein (LDL) and high-density lipoprotein (HDL) whereas very low-density lipoprotein (VLDL) remains very low during the same period. Longitudinal studies show that serum cholesterol level decreases slightly with age in boys but not in girls; the decreasing trend is most evident between 10 and 14 years of age. LDL cholesterol follows the same trend. A continuous slight increase in serum total and VLDL triglyceride has been shown with age. HDL cholesterol seems to maintain a constant level with only slight variation with age. Moreover, LDL cholesterol has great consistency with future levels. Measurements made in children confirm that high levels of cholesterol may be present at early ages, suggesting the need for follow-up studies in young populations in order to evaluate whether hypercholesterolemia in childhood is predictive of future coronary events.

Adolescent↗

Evaluation of the hypocholesterolemic effect of vegetable proteins.

The hypocholesterolemic effect of dietary vegetable proteins was studied by comparing egg-white protein and fava bean protein concentrate in one normal and seven hypercholesterolemic (six type II A, one II B) persons; five completed the crossover design. To maintain stable body weight, subjects were kept on an isocaloric diet (20% protein, 48% carbohydrate (CH), 32% fat, P/S = 2) for 1 month and then hospitalized for two consecutive 18-day periods while receiving an isocaloric diet of different composition (15% protein, 50% CH, 26% fat, P/S = 2). Women were provided 50 g and men 70 g daily of egg-white or fava bean protein concentrate during the two crossover periods. Hematocrit and fasting plasma or serum were analyzed every 3 days for glucose, insulin, uric acid, creatinine, total and low-density lipoprotein (LDL), very low-density lipoprotein (VLDL), and high-density lipoprotein (HDL) cholesterols, and for total and VLDL triglyceride. Dietary adequacy of both proteins was evaluated by measuring plasma concentration of prealbumin, transferrin, and retinol-binding globulin. Insulin and hematocrit did not show any change, nor did any other biochemical variables show significant differences when results were compared at the end of each crossover period. Compared with baseline, fasting plasma glucose significantly decreased on the fava bean diet. Serum total and LDL cholesterol decreased during both diets but were statistically significant only on the egg-white diet. Serum HDL cholesterol significantly decreased only on the fava bean diet. Serum total and VLDL triglyceride did not show any significant change. Labile plasma protein concentration was significantly reduced only on the fava bean diet. In conclusion, the fava bean diet did not show a significant effect on lowering serum total and LDL cholesterol. Such an effect was mild but significant on the egg-white diet, compared with baseline.

Adult↗

Abnormalities of calcium metabolism in essential hypertension.

Calcium metabolism has been investigated in patients with essential hypertension and normal renal function to evaluate the renal calcium handling and the reported increase in renal calcium loss. In 55 hypertensive and 55 sex- and age-matched healthy normotensive subjects creatinine clearance, serum total and ionized calcium, plasma parathyroid hormone and 24 h urinary excretion of calcium, sodium and cAMP were measured. In a subgroup of 20 hypertensive patients and 20 controls the fasting calcium excretion rate was also measured. Both 24 h and fasting calcium excretion rates were higher in the hypertensive group; so also were plasma parathyroid hormone and urinary cAMP. Serum total and ionized calcium levels were not different in the two groups. After intravenous calcium infusion (15 mg 3 h-1 kg-1) in seven hypertensive patients and controls, the hypertensive patients excreted more calcium at all serum calcium concentrations. These results support the hypothesis of primary renal calcium leak in essential hypertension. Enhanced urinary calcium excretion rate may cause compensatory parathyroid overactivity.

Adult↗

Characteristics of the association between salt intake and blood pressure in a sample of male working population in southern Italy.

A possible association between dietary salt intake and blood pressure was investigated in an unselected sample of 188 healthy Neapolitan men. In univariate analysis diastolic pressure was positively correlated with age, body mass index and 24-h excretion of sodium, potassium and creatinine, but not with urine volume or sodium: potassium ratio. Systolic pressure was also related to age, body mass index and 24-h sodium, but to a lesser degree. As a high level of intercorrelation was apparent, multivariate analysis was also carried out. Body mass index was shown to be the variable having the largest influence on diastolic pressure variability: nevertheless a significant independent role was still found for 24-h urinary sodium when the latter was included in a regression along with body mass index, age, urine volume and potassium excretion. These results seem to support the possibility that dietary salt has a substantial influence on blood pressure levels.

Adult↗

Once a day indapamide therapy in hypertension. Effects on the heart and peripheral arterial circulation.

Indapamide, a sulphonamide derivative, was prescribed for 8 weeks at low dose (2.5 mg once a day) to 14 hypertensive patients in order to investigate its effects on systolic and diastolic blood pressure (SBP, DBP), cardiac function and peripheral arterial resistance (PAR). During treatment we observed decreases in both SBP and DBP without any change in HR in the supine and standing positions and on exercise. As a result cardiac work was significantly reduced. Slight changes in pre-ejection period (PEP) and left ventricular ejection time (LVET) along with a more significant decrease in rate of rise of left ventricular pressure (DBP to PEP ratio) were observed during treatment. An increase in RBF and a decrease in PAR were also detected in the peripheral circulation. These findings may indicate that indapamide antagonizes the cardiovascular effects of catecholamines.

Adult↗

[Hemorrheological anomalies: an element of additional risk in arterial diseases].

Arterial blood flow to different tissues and organs is influenced by blood viscosity. The main determinants of blood viscosity are hematocrit and plasma protein concentration. Venesection and consequent reduction of hematocrit are very useful in various pathological conditions. Plasma-exchange removes proteins in excess (such as LDL in familial hypercholesterolemia) from plasma and thereby improves plasma viscosity, erythrocyte deformability and blood flow to the body tissues.

Arterial Occlusive Diseases↗