Search PubMed⌕ Search

Biomedical subjects

M Martinelli

Publications and source records attributed to M Martinelli.

At least 73 records · Page 4Linked to original sources
PubMed1993

[Role of aldosterone in essential arterial hypertension complicated by chronic renal insufficiency].

The following parameters were studied in a group of patients suffering from essential arterial hypertension complicated by chronic renal insufficiency (CRI), mean age = 64.31 +/- 1.84, with creatinine clearance (CrC) ranging between 30 and 60 ml/min: blood pressure (systolic and diastolic arterial pressure), heart rate, plasmatic renin activity (PRA), plasma levels of aldosterone (ALDO) both in clino- and orthostatism, as well as some metabolic parameters. All parameters were compared with those in a group of age- and sex-matched patients with slight or moderate essential arterial hypertension. Before starting the study all patients completed a wash-out period of one week to annual the effects of other drugs which might interfere with the RAA system. PRA levels were within the norm, whereas plasma levels of ALDO were high both in clino- and orthostatism. ALDO levels were also found to be inversely correlated with those of CrC. From these data it emerges that hyperaldosteronism, as observed in these patients with CRI, is a relatively reliable marker of the extent of CRI and may occur independently of the activation of the RAA system, given that other factors, such as orthostatic stimulation, alterations in the acid-base equilibrium, and the degree of aldosterone hepatic and urinary clearance, contribute to its pathogenesis.

Adrenocorticotropic Hormone↗
PubMed1993

[Age-related changes in the renin-angiotensin-aldosterone system and the sympathetic nervous system in patients with essential hypertension].

The aim of this study was to evaluate age, plasmatic renin activity (PRA), plasma aldosterone levels and the total quantity of urinary catecholamines (TOT. UR. CAT.) in a large population of out-patients suffering from essential arterial hypertension (EAH). A total of 986 patients were examined (540 women and 426 men aged between 15 and 87 years) suffering form slight or moderate EAH (WHO stage 1-2). After a wash-out period of two weeks, systolic and diastolic arterial pressure was measured together with heart rate in clino- and orthostatism. Blood samples were collected to determine PRA and plasma aldosterone, and lastly a 24-hour urine collection was made to measure the total quantity of catecholamines. It emerged that there was a significant increase in systolic pressure, whereas heart rate and PRA diminished significantly when correlated with age; diastolic pressure was also considerably lower, but did not reach statistical significance. Moreover, it was found that there was a significant positive correlation between PRA and TOT. UR. CAT., whereas no correlation was found between age and plasma aldosterone and between blood pressure and the various endocrine parameters examined. These data confirm the changes in the biological, hemodynamic and endocrine profiles observed in elderly hypertensive patients in comparison to young hypertensive patients, and suggests that age may be an important predictive factor of the activity of both the renin-angiotensin and sympathetic nervous system which appear to be closely connected and gradually attenuated by age.

Adolescent↗
PubMed1993

[Long-term therapy with gold salts in rheumatoid arthritis. Review of the literature and personal contribution].

The present study concerns the controversial subject of rheumatoid arthritis (RA) therapy and particularly use of orally administered gold salts (auric triethylphosphine-Auranofin). It contains the results of a study conducted on 10 patients affected with RA who were treated with auric triethylphosphine associated with conventional therapy for a period varying from 4 to 8 years. The efficacy of this therapy in these patients was comparable to that observed in a survey of other studies. The authors conclude that there are advantages offered to RA patients utilizing chrysotherapy and particularly Auranofin can be administered for an extended period without the development of collateral effects in other organs or systems.

Adult↗
PubMed1992

Autosomal recessive microcephaly with early onset seizures and spasticity.

We describe two siblings, a male and a female pair, born of consanguineous parents, affected with a rare genetic form of congenital microcephaly. The clinical syndrome is characterized by early onset myoclonic seizures, spasticity, and profound psychomotor retardation without detectable brain malformations. To date, only two kindreds and one sporadic case with a similar clinical picture have been observed and reported (Tolmie et al. 1987, Bundey & Griffiths 1977). The severity of the neurological features and their perinatal onset differentiate the syndrome from the more common autosomal recessive microcephaly with spasticity/seizures.

Child, Preschool↗
PubMed1992

[Effects of long-term iloprost therapy on Raynaud's phenomenon in progressive systemic sclerosis].

One of the most appealing current pathogenetic concepts is that progressive systemic sclerosis (PSS) is a reaction to repeated episodes of endothelial cell injury. Injury of small arteries and capillary endothelium initiates reactions which involve increased permeability of the vessels, platelet adherence, myointimal cell proliferation, luminal narrowing and heightened sensitivity of the vessel wall. Clinical evidence of the vessel damage is Raynaud's phenomenon, involving both skin and viscera. The Authors evaluated the effects of iloprost on Raynaud's phenomenon in patients with PSS. This drug provides prolonged vasodilation, reduces platelet aggregation and promotes endothelial lining function repair. This last pattern is of primary importance because it may stop the vicious circle: endothelial injury-platelet hyperaggregation-microangiospasm. Five females were recruited, aged 41-66 years, suffering from well-documented (ARA criteria) PSS, associated with typical Raynaud's phenomenon. The trial provided for intravenous infusion of iloprost at a rate of 1-2 ng/kg/min. First treatment consisted of six-hour infusions on six successive days. After this first treatment, weekly infusions during the winter months were carried on. Drug effectiveness was considered through subjective and objective parameters. All patients showed prominent reduction of number, duration and severity of attacks of Raynaud's phenomenon, improvement of prehensile strength, healing of finger ulcerations and improvement or normalization of digital photoplethysmography. So far, the treatment has been prolonged for years in our patients and still goes on. The side effects of iloprost (headache, flushing, nausea) have been very poor. Therefore, iloprost proved to be a valid drug in the management of Raynaud's phenomenon in patients with PSS, but the inconvenience of intravenous administration may limit its routine use.

Adult↗
PubMed1992

[The late results of fulguration of the atrioventricular node using high-energy shocks in patients with supraventricular tachycardias].

PURPOSE: To evaluate the long-term efficacy and safety at long term after atrioventricular junction fulguration (complete AV block induction, using high energy shocks, to control drug-resistant supraventricular tachyarrhythmias. METHODS: Twenty-eight patients, 17 (60.7%) men, with mean age 48.1 years, were submitted to one up to six ablation sessions with high energy shocks. The total delivered energy per patient was 1304 +/- 868 J. Each shock ranged from 100 to 400 J. RESULTS: After 12 months, at least, 60.6% of patients were in complete atrioventricular block; three (10.8%) were asymptomatic without complete AV block, and in five (17.8%) the ablation was unsuccessful. CONCLUSION: AV junction ablation with high energy shocks is safe and efficient in long-term follow-up.

Adult↗
PubMed1992

[Evaluation of the hereditary component in patients with essential arterial hypertension].

As is well known, genetic factors play a decisive role in the pathogenesis of essential hypertension (EH), even if they are closely related to environmental factors; it is therefore not possible to quantify with any degree of certainty the role and importance of each in the onset of hypertensive disease. The aim of the present study was to ascertain the presence of hypertensive 1st and 2nd degree ascendant, collaterals and descendants in a group of 355 out-patients with EH (167 males, 188 females; mean age: 52.9 +/- 0.7 years) using an anamnestic analysis. The results of this study confirmed the high prevalence of the hereditary component in EH: familial hypertension was found in 60.6% of the group. From a detailed analysis of the group, with regard to hypertensive ascendant, the hereditary transmission of EH by the mother was significantly higher than that by the father, both the parents and the forefathers, even if it is worth pointing out that the penetration of the genetic character was not always sex-related and was equally distributed between male and female descendents. In addition, it was observed that patients with a familial pattern of hypertension in common with collateral relatives showed significantly enhanced levels of systolic and diastolic pressure in relation to those with another hereditary component. These findings serve to underline the importance of evaluating the effective incidence of EH with regard to an entire family nucleus and not only in individual terms, in order to identify the various means of genetic transmission and possible interactions with environmental factors.

Female↗
PubMed1992

[Metabolic changes in the patient with essential hypertension].

The aim of the present study was to evaluate a number of parameters in a group of patients with essential hypertension and then compare the results with those in a group of healthy normotensive subjects. One hundred and fifty-six patients with essential hypertension (EH) in the non-complicated form (73 males, 83) females; mean age: 54.8 +/- 0.9 years) were selected and compared with 150 normotensive subjects matched for age and sex. After a 2-week period of wash-out during which patients followed a diet with normal sodium and calorie content, body mass index, systolic and diastolic arterial pressure (AP), mean arterial pressure (MAP), heart rate in clino- and orthostatism were measured and blood was collected to assay glycemia, total cholesterolemia, LDL and HDL cholesterolemia and triglycerides. In the group of patients suffering from EH all the above parameters were found to be significantly higher than in normotensive control subjects. In particular, in the hypertensive population the prevalence of obesity was 21.3%, hyperglycemia 26.9%, hypercholesterolemia 65.1% and smoking 36.4%. When the possible relation between one or more risk factors and AP values was assessed, it was found that in hypertensive patients the presence of hyperglycemia alone or in association with other metabolic disorders led to the highest MAP findings. Moreover, having studied the correlation rate of the various parameters, it was seen that in both the hypertensive and normotensive populations systolic AP measured in clinostatism positively correlated with glycemia, total cholesterolemia, and age, whereas correlations were not found between clinostatic diastolic AP and the above parameters.(ABSTRACT TRUNCATED AT 250 WORDS)

Analysis of Variance↗
PubMed1990

Muscle lipofuscin content and satellite cell volume is increased after high altitude exposure in humans.

Muscle ultrastructural changes during a typical expedition to the Himalayas were analyzed by taking muscle biopsies from seven climbers before and after their sojourn at high altitude (over 5000 m for 8 weeks). M. vastus lateralis samples were analyzed morphometrically from electron micrographs. A quantitative evaluation was made of lipofuscin, satellite cells and myonuclei. Significant increases of the volume densities of lipofuscin (+ 235%) and satellite cells (+ 215%) were observed.

Altitude↗
PubMed1990

[Incidence of the most frequent complications in hypertensive patients].

The incidence of district (cardiac, cerebral, renal) and systemic vascular complications was studied in a population of 3992 hypertensive in-patients during the period from 1984 to 1988. The total number of male hypertensive patients was always higher (2355) than that of female hypertensive patients (1637). From the analysis of results it appears that 11.01% of male hypertensive patients and 15.85% of female hypertensive patients were diagnosed as being affected by uncomplicated essential arterial hypertension, whereas 88.97% of male and 84.12% of female hypertensive patients suffered from arterial hypertension with varying percentages of cardiac, cerebral, renal or systemic-type atheroarteriosclerotic complications. The prevalence of the male sex was particularly evident in the case of cardiac complications. Given the peak incidence of the various types of complications when analysed by decade of age, an earlier incidence of cardiac and renal complications was found in male hypertensive patients which anticipates the complications found in female hypertensive patients by approximately one decade. Lastly, the paper underlines the social importance of essential arterial hypertension and the need to develop efficacious primary and secondary prevention in order to reduce the incidence of complications which today represent the most severe aspect of hypertension.

Adolescent↗
PubMed1989

Antinuclear antibodies in psoriatic arthritis and its subgroups.

We tested serum samples from 48 patients with Psoriatic Arthritis (PA) for Antinuclear Antibodies (ANA) using a highly sensitive substrate (Hep-2 cells). We obtained the following results: 1) in PA patients ANA positivity (16.6%) was significantly higher than in age-and sex-matched groups of healthy controls (4.1%; p less than 0.05) and uncomplicated psoriasis (2%; p less than 0.025). 2) ANA were more common in Symmetrical Polyarthritis (37.5%) and Arthritis Mutilans (25%) than in Asymmetrical Oligoarthritis and Spondarthritis (11.8%) and 'Classical' PA (0%). 3) We did not find any positivity for anti-DNA and anti-ENA antibodies among PA patients.

Adult↗
PubMed1989

[Serum ionized calcium, parathormone and plasma renin activity in essential arterial hypertension].

Given the significance of the calcium ion in the pathogenesis of essential arterial hypertension, blood levels of total and ionised calcium, phosphorus, parathormone, blood renin activity as well as urinary calcium and phosphorus were assayed in a group of hypertensives and a comparable control group with normal blood pressure. The results showed reduced ionised calcium in the blood of the hypertensives together with hyperparathyroidism and increased calciuria. In addition, the link between parathormone and mean blood pressure levels suggests that parathormone itself play a primary role in the genesis of high blood pressure. Finally the connection between renin activity in the plasma and ionised calcium in the serum suggests that the two hormone systems are closely linked and may interact via the calcium ion.

Calcium↗