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Biomedical subjects

M Mancini

Publications and source records attributed to M Mancini.

At least 397 records · Page 22Linked to original sources

Increased blood flow to lower limbs after plasma exchange in two patients with familial hypercholesterolemia.

Leg blood flow was measured before and 1 and 7 days after plasma exchange by venous occlusion plethysmography in a 9-year-old girl with homozygous familial hypercholesterolemia and in a 41-year-old man with heterozygous familial hypercholesterolemia. In the first patient the plasma cholesterol level was reduced from 890 mg/dl to 532 mg/dl and 666 mg/dl 1 and 7 days after plasma exchange. In the second patient plasma cholesterol decreased from 596 mg/dl to 342 mg/dl and 480 mg/dl, respectively. Leg arterial flow increased from 8.5 ml/min/l of leg volume to 19.1 and 19.5 ml/min/l in the first patient and from 6.6 ml/min/l to 18.0 and 21.8 ml/min/l in the second. No change was observed in haematocrit and total globulin concentration, which are known to play an important role in blood viscosity and flow. It is concluded that plasma exchange, possibly by decreasing plasma cholesterol concentration in patients with familial hypercholesterolemia, is associated with improved arterial flow to lower limbs and it is suggested therefore that some beneficial effect might be found also in other vascular beds.

Adult↗

Nitrogen loss and urinary creatinine excretion during fasting in massive obesity.

Six (5 f, 1 m) massively obese, otherwise healthy subjects, were submitted for 4 weeks to a very-low-calorie diet (VLCD): 80 kcal, 335 kJ = 2.6 g N/day (17 g protein, 0 CHO and fat). Daily urinary creatinine excretion (UCE) and weekly nitrogen loss (NL) were determined during the whole period of treatment. Both NL and UCE decreased from the second week of treatment indicating a progressive sparing effect on lean body mass (LBM). A positive correlation (r = 0.991, P less than 0.001) was observed between mean daily UCE and NL, indicating that NL during prolonged fasting in obesity is possibly influenced by the lean body mass of the individual.

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Risk factors for peripheral atherosclerosis in non insulin dependent diabetes.

Peripheral Atherosclerosis (PA) is a frequent complication of longstanding diabetes. Nevertheless uncertainty exists on defining risk factors (RF) for PA in diabetics. In order to elucidate this matter, at an early stage of the vascular complication, 54 non insulin dependent diabetic (NIDDM) patients, males, age range 40-59 years, without clinical signs of PA, were investigated by digital pulse plethysmography, measuring the inclination time (IT) of the pulse wave. A significant correlation was found between systolic blood pressure (BP) or fasting serum cholesterol (FSC) and IT (r = .28 p less than .05 and r = .34 p less than .05). IT was significantly higher in insulin treated patients compared with those on oral hypoglycemic treatment (154 +/- 41 msec; 122 +/- 25 msec; p less than .05) (M +/- SD). No significant effect on IT was induced by body weight, diastolic BP, serum triglycerides. A positive correlation was found between the number of RF (FSC greater than or equal to 220 mg/dl; systolic BP greater than or equal to 160 mmHg; insulin treatment) in each patient and IT (r = .55 p less than .001). In the absence of RF, IT was similar to that in non diabetic, normocholesterolemic, normotensive men of the same age (119 +/- 27; 116 +/- 15). FSC, systolic BP and insulin treatment are major RF for PA in male NIDDM patients. The condition is worsened by the simultaneous presence of two or more RF together.

Adult↗

Analytical fractionation of human liver microsomal fractions: localization of cholesterol and of the enzymes relevant to its metabolism.

1. The submicrosomal distribution of three enzymes concerned in cholesterol metabolism, and of free and esterified cholesterol, was determined in human liver by analytical isopycnic centrifugation on sucrose gradients. 2. The distribution profile and median density of acyl-CoA:cholesterol O-acyltransferase was similar to that of RNA, showing that this enzyme is confined largely to the ribosome-rich membranes of the endoplasmic reticulum. The distribution profiles and median densities of 3-hydroxy-3-methylglutaryl-CoA reductase and cholesterol 7 alpha-mono-oxygenase showed that both enzymes are confined to the smooth, ribosome-poor, endoplasmic reticulum. 3. Most of the free cholesterol in the microsomal preparations was present in smooth membranes from the Golgi apparatus and in vesicles from plasma-membrane fragments. The distribution of esterified cholesterol was multimodal and extended throughout the whole gradient.

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Obesity and cardiac function.

We studied 10 obese volunteers, mean age 36.5 +/- 10.3 years, who weighed 123.56 +/- 28.7 g and were 69.96 +/- 22.5 kg overweight. The subjects did not have diabetes, arterial hypertension or signs of cardiac and respiratory failure or disease and all underwent right- and left-heart catheterization. cardiac output and stroke volume were high, according to increased oxygen consumption and to the degree of obesity. Ventricular end-diastolic and atrial pressures ranged from normal to high and correlated with body weight, signs of volume overloading and reduced left ventricular (LV) compliance. The mean pulmonary artery pressure was elevated and correlated well with weight, pulmonary resistance being normal; mean aortic pressure did not correlate with weight, and systemic arterial resistance tended to have a negative correlation. The LV function curve showed impaired ventricular function, particularly for the heaviest subjects, in whom Vmax and the ratio of the stroke work index to LV end-diastolic pressure were reduced. These indexes correlated well with each other and both correlated negatively with the degree of obesity. In contrast, maximal dP/dt was normal and did not correlate with excess weight. These observations show that depressed LV function is already present in relatively young obese people, even if they are free from signs of cardiopathy and other associate diseases. The degree of impairment of heart function seems to parallel the degree of obesity.

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Evaluation of the safety of very-low-calorie diets in the treatment of severely obese patients in a metabolic ward.

UNLABELLED: Nitrogen balance has been measured in 25 (18 f, 7m) obese non-diabetic patients submitted for four weeks to different versions of very-low-calorie diets (VLCD). Patients were divided into four groups and treated as follows: Gp 1 (6f, 4m) by 80 kcal (0.34 MJ) VLCD (17 g protein [= 2.6 g N], tr CHO and fat); Gp 2 (4f, 1m) by 180 kcal (0.76 MJ) VLCD (40 g protein [= 6.4 g N], 2 fat, tr CHO); Gp 3 (4f, 1m) by 80/180 kcal (0.34/0.76 MJ) VLCD (80 kcal during the 1st and 2nd week and 180 kcal during the 3rd and 4th week with the same nutrients as Gps and 1 and 2, respectively). Gps 1-3 received VLCD which essentially contained only protein. Gp 4 (4f, 1m) was treated by a 'mixed' VLCD containing protein and CHO (80 kcal, as in Gp 1 during the 1st and 2nd week; and 180 kcal, 17 g protein + 25.5 g CHO during the 3rd and 4th week of treatment). Weight loss was similar in Gps 1, 3 and 4 (-11 kg) and lower (-8 kg) in Gp 3. Mean daily nitrogen loss was lower in Gp 2 and 3 (-3.2 and -2.9 g N/day respectively). From the 3rd week of treatment nitrogen loss was reduced in Gps 1 and 2 and virtually absent in Gp 3. In Gp 4 nitrogen loss was persistently high (4.3-5.8 g N/day) during the whole period of observation. IN CONCLUSION: at a very low energy intake of below 200 kcal (0.84 MJ)/day dietary substitution of protein with carbohydrates does not ameliorate the nitrogen balance.

Adult↗

Effect of dietary fibre on glucose control and serum lipoproteins in diabetic patients.

To evaluate the effects of a fibre-rich diet on blood glucose and serum lipoproteins, eight diabetic patients, four on insulin and four on oral hypoglycaemic drugs, were put on three different diets, a different one for each consecutive 10-day period: diet A (carbohydrate 53%, fibre 16 g), diet B (carbohydrate 53%, fibre 54 g), and diet C (carbohydrate 42%, fibre 20 g). All diets had identical polyunsaturated/saturated fat ratios. Both 2 h post-prandial glucose and mean daily glucose levels were significantly lower after diet B than after either of the two other diets, as were total and LDL cholesterol levels. Total and VLDL triglyceride levels after diet B were significantly lower than those after diet A but almost identical to those after diet C. HDL cholesterol concentration was not affected by dietary fibre but was significantly increased by the low-carbohydrate diet. A high-fibre, normal-carbohydrate diet (the fibre coming exclusively from foodstuffs with a naturally high content of fibre) improves blood glucose control and decreases the concentration of atherogenic lipoproteins in diabetic patients. This effect is independent of the amount of available carbohydrates in the diet.

Adult↗

Plasma high density lipoprotein in severe obesity after stable weight loss.

Changes in plasma lipoprotein pattern, with particular attention to high density lipoprotein cholesterol (HDL-C) concentration, were evaluated in 7 (5 female, 2 male) obese patients before and 15 +/- 1 months after they had lost weight (mean 20.7 +/- 3.1 kg), when the patients' food intake had been ad libitum for at least 6 months, and they had been maintaining their weight loss. Plasma low density lipoprotein cholesterol (LDL-C) and very low density lipoprotein triglyceride (VLDL-TG) concentrations were lower than baseline values: on the other hand, plasma HDL-C concentration, which was below normal values before weight reduction, was found to be significantly increased (P < 0.05). These data indicate that, among the favourable changes in plasma lipoprotein pattern, an increase in HDL-C may be achieved after remarkable and stable weight loss in severe obesity.

Adult↗

Plasma lipoproteins in maturity onset diabetes.

Plasma lipoprotein abnormalities in maturity onset diabetes (MOD) reflect both enhanced production and impaired removal of triglyceride-rich lipoproteins. Hyperglycemia and hyperinsulinemia lead to overproduction of very-low density lipoproteins by the liver. Fat tolerance is reduced in MOD patients: this might be due to low lipoprotein lipase activity (LLA) and/or to low incorporation of LLA-released fatty acids into adipose tissue glyceride. This finding of abnormal low-density lipoprotein composition, with relative enrichment in triglyceride, suggests remnant particle accumulation.

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