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Biomedical subjects

M Milani

Publications and source records attributed to M Milani.

At least 73 records · Page 4Linked to original sources
PubMed1996

Effects of isradipine sustained release on platelet function and fibrinolysis in essential hypertensives with or without other risk factors.

The aim of this study was to assess the chronic effects of a highly selective dihydropiridine calcium channel blocker, israpidine, in its sustained release form (I-SRO), on platelet functions and fibrinolytic parameters in subjects with essential hypertension (EH) combined or not with other well-known cardiovascular risk factors, such as cigarette smoking (EH+S) and type II diabetes mellitus (EH+DM). Thirty-six patients with essential hypertension with sitting diastolic blood pressures of 96-104 mmHg without (EH, n = 12) or with other risk factors (EH+S, n = 12, EH+DM, n = 12) were enrolled. After a 4-week, single-blind, placebo run-in period, the subjects received I-SRO 5 mg once daily for 18 weeks. After both placebo and 6 and 18 weeks of I-SRO treatment, the following parameters were measured: sitting blood pressure by mercury sphygmomanometer; platelet aggregation, plasma beta-thromboglobulin (BTG), platelet factor-4 (PF4), and plasminogen activator inhibitor 1 (PAI-1) by means of ELISA methods; and euglobulin lysis time before (ELT) and after standardized (10 min) venous occlusion (ELT-VO). In the group of patients as a whole compared with placebo, I-SRO significantly reduced SBP/DBP platelet aggregation, BTG, PF4, ELT, and ELT-VO. Significant reductions in these parameters were also observed in each group. In addition to the antihypertensive effect, I-SRO chronic treatment may favorably affect the platelet function and fibrinolytic system in essential hypertension with or without other cardiovascular risk factors.

Antihypertensive Agents↗
PubMed1996

Effects of two different HMG-CoA reductase inhibitors on thromboxane production in type IIA hypercholesterolemia.

Many studies have found that familial hypercholesterolemia, a hyperlipoproteinemia associated with premature atherosclerosis, is characterized by enhanced platelet aggregation. This study was undertaken to measure the urinary excretion of the two main urinary thromboxane B2 (TXB2) metabolites (2, 3-dinor-TXB2 and 11-dehydro-TXB2) in 20 patients affected by familial hypercholesterolemia treated for one month with 40 mg/day of pravastatin (10 patients) in comparison to 10 normocholesterolemic subjects. After a run-in period, the type II A patients showed total cholesterol levels (296 +/- 32 mg/dL) significantly higher (P < 0.001) than those of control subjects (155 +/- 46 mg/dL). The urinary concentrations of 11-dehydro-TXB2 and 2,3-dinor-TXB2 also significantly differed (P < 0.001) between control group (1,463 +/- 1,440 and 386 +/- 447 pg/mg urinary creatinine) and treated patients (3,536 +/- 2,112 and 914 +/- 572 pg/mg urinary creatinine). At baseline there was a positive correlation between total cholesterol (TC) levels and urinary TXB2 metabolite concentrations (2,3-dinor-TXB2 r = 0.61, P < 0.02; 11-dehydro-TXB2, r = 48, P < 0.05), but not between low-density-lipoprotein cholesterol (LDL-C) and the urinary compounds. At the end of a four-week treatment. TC and LDL-C had decreased significantly from the baseline levels, by 27% and 30% in the fluvastatin group (P < 0.01) and by 23% and 31% in the pravastatin group (P < 0.01), with no significant difference between the two groups. After the two treatments with HMG-CoA reductase inhibitors, there was no statistically significant reduction of the urinary metabolite levels. In addition, the positive correlation seen at baseline between TC and TXB2 metabolites was no longer present. In accord with previous studies, we found a significant correlation between TC levels and TXB2 metabolites concentrations in type II A hypercholesterolemic patients. Although, short-term treatment with two statins reduced TC levels, it did not change the thromboxane metabolite excretion.

Anticholesteremic Agents↗
PubMed1996

Effects of picotamide, an antiplatelet agent, on cardiovascular, events in 438 claudicant patients with diabetes: a retrospective analysis of the ADEP study.

Picotamide is an antiplatelet drug which inhibits thromboxane A2 (TxA2) synthase and antagonizes TxA2 receptors. In the ADEP (Atherosclerotic Disease Evolution by Picotamide) trial, 2304 patients with peripheral obstructive arterial disease (POAD) were studied in a double-blind, placebo-controlled, 18-month, multicentre trial. In this study, 151 events (13.1%) occurred on placebo and 122 (10.6%) on picotamide (900 mg day-1). The relative risk reduction was 19%, (P = 0.056). This paper reports a post-hoc analysis in a subgroup of 438 diabetic patients (picotamide = 230; placebo = 208). There were 32 vascular events on placebo (15%) and 18 on picotamide (8%) (relative risk reduction: 48%; 95% CI = 26, 76; P = 0.022). The results of this retrospective analysis suggest that a prospective study to investigate events in claudicant patients with diabetes mellitus is warranted.

Arterial Occlusive Diseases↗
PubMed1996

[Thymoma: diagnosis and surgical treatment].

Thymoma is the most common primary neoplasm of the tymus. The majority of thymomas are encapsulated masses and exhibit benign behavior. Less frequently they may be invasive, or rarely they may metastasize to distant sites. The usual clinical presentation is that of an anterior mediastinal mass found accidentally in an asymptomatic patient. Computed tomography and magnetic resonance may be helpful in the evaluation of adjacent structures. The histologic classification proposed by Muller-Hermelink is useful in predicting and defining the risk of invasiveness of thymomas showing a significant correlation between tumor cell type and stage. The treatment of choice is complete surgical excision; radiation therapy may be used adjunctively to surgery in the treatment of invasive tumors. The choice of surgical approach is conditioned by site and grading of thymoma. The prognosis of encapsulated thymoma is generally favorable; invasive tumors are associated with a worse prognosis but may respond to radical resection.

Aged↗
PubMed1996

[Incidence of lymphoproliferative diseases in Northern Italy].

INTRODUCTION: In the last 6 years we have observed an increasing number of cases of lymphoma, extranodal cases being the majority over nodal ones. This fact induced us to investigate the incidence of NHL and HD in the population served by the Lecco Hospital, Department of Pathology, as well as the temporal trend from 1990 to 1995. MATERIALS AND METHODS AND DATA: All hospitals and dispensaries located in the surrounding areas of Lecco including the district of Menaggio and Morbegno are dependent on the Department of Pathology of Lecco Hospital. In fact, the surgical pathology of this area with its 272144 inhabitants converges in our department. We investigated the incidence of nodal and extranodal lymphomas in this population in the period between january 1990 and december 1995 while isolating the number of new cases reported in our files. The incidence per age, population over three-years period has been epressed as the number of cases per million population per year (cases per pmp/y). RESULTS: 285 patients aged 20 to 90 years old (mean 62.5) were selected (51% males, 49% females): they presented 141 nodal lymphomas (36 HD and 105 NHL) and 144 extranodal lymphomas of which 57 primary gastric lesions (22 males and 35 females, mean-age 63.5 in the male group (range 38-85) and 59.0 in the female group (range 31-91)). In nodal as in extranodal lymphomas the diffuse large B-cell lymphomas were the most frequent entity diagnosed, furthermore we noted an increase of incidence in all age groups in the last six years for NHL, mostly NHL HG, in contrast to decrease for HD. About gastric lymphomas, 2/3 were diffuse large B-cell lymphoma with or without low grade component, while the remaining were low grade B-cell lymphoma and only three cases were gastric peripheral T-cell lymphoma. Gastric lymphomas show a higher incidence than in other countries. CONCLUSION: These results show an increase of the incidence of non-Hodgkin lymphomas, mainly of high grade, during six years and in all age groups. On the contrary we observe a tendency in reduction for Hodgkin Disease. Primary gastric lymphomas show a greater increase and their incidence has been estimated in 17.5 cases per 100,000 per 5 years.

Adult↗
PubMed1995

Effects of fluvastatin and pravastatin on lipid profiles and thromboxane production in type IIa hypercholesterolemia.

The aim of this study was to assess the effects of fluvastatin and pravastatin on lipid profiles and urinary thromboxane (TX) A2 metabolites (11-dehydro TXB2 and 2,3-dinor TXB2) in patients with type IIa hypercholesterolemia. A total of 20 patients (13 men, 7 women; mean age 53 +/- 9 years) with primary type IIa hypercholesterolemia (Fredrickson's classification) in a 4-week, double-blind, parallel-group study were randomized to fluvastatin or pravastatin, both at 40 mg once daily (at bedtime), after a single-blind, 4-week, placebo run-in period. Total cholesterol, low density lipoprotein cholesterol (LDL-C), high density lipoprotein cholesterol (HDL-C), and triglycerides were measured after placebo (baseline) and after 4 weeks of double-blind treatment. Thromboxane metabolites were measured at the same time points, using an enzyme immunoassay kit, in 12 hr urine samples. At baseline, the mean +/- SD levels of total cholesterol, LDL-C, triglycerides, and HDL-C were: 292 +/- 23, 213 +/- 47, 186 +/- 119 and 41 +/- 17 mg/dL with fluvastatin; and 301 +/- 40, 212 +/- 40, 150 +/- 124 and 43 +/- 10 mg/dL with pravastatin, respectively. Baseline thromboxane-metabolite levels were positively and significantly (p < 0.04) correlated with levels of total cholesterol, but not LDL-C. Compared with baseline, total cholesterol and LDL-C were significantly (p < 0.01) decreased by 27% and 30% with fluvastatin, and by 23% and 31% with pravastatin, respectively. HDL-C increased from 41 +/- 17 to 59 +/- 25 mg/dL with fluvastatin, and from 43 +/- 10 to 46 +/- 12 mg/dL with pravastatin.(ABSTRACT TRUNCATED AT 250 WORDS)

Anticholesteremic Agents↗
PubMed1995

Effects of picotamide, an antithromboxane agent, on carotid atherosclerotic evolution. A two-year, double-blind, placebo-controlled study in diabetic patients.

BACKGROUND AND PURPOSE: We assessed the effects of long-term treatment with picotamide, an antiplatelet agent with dual antithromboxane activity, on the evolution of early asymptomatic carotid atherosclerotic lesions in diabetic patients. METHODS: In a double-blind, placebo-controlled, 2-year study, 50 type II normotensive diabetic patients (35 men; mean age, 66 +/- 5 years) with asymptomatic mild or moderate nonstenotic (< 50%) carotid atherosclerotic lesions and negative history of cerebrovascular ischemic events were enrolled and randomly given picotamide (300 mg TID) or the corresponding placebo. A high-resolution, real-time B-scan echographic assessment of carotid arteries was performed at baseline and after 1, 3, 6, 12, 18, and 24 months of double-blind treatment. Prevalence and evolutionary trends of carotid atherosclerotic lesions (number per patient and mean stenosis expressed as percent) were considered as efficacy primary end points. RESULTS: At baseline, mean +/- SD numbers of carotid atherosclerotic lesions per patient were 2.7 +/- 1.8 and 2.2 +/- 1.2 in the picotamide and placebo groups, respectively. Mean +/- SD percent stenosis was 25.3 +/- 7% in the picotamide group and 27.3 +/- 6% in the placebo group. Forty-nine patients completed the study. At month 24, the placebo group (n = 24) showed a significant progression in number of carotid atherosclerotic lesions (3.04 +/- 1.8; P < .02 versus baseline) and in mean percent stenosis (35 +/- 17%; 95% confidence interval, 33% to 37%; P < .01 versus baseline). In the picotamide group (n = 25), mean number of carotid atherosclerotic lesions (2.7 +/- 1.6) and percent stenosis (26 +/- 9%; 95% confidence interval, 24.8% to 27.2%) remained unchanged. At month 24, compared with randomized placebo, lesion numbers (P < .03) and percent stenosis (P < .01) in the picotamide group were significantly lower. During the study, 12 patients experienced major or minor ischemic vascular events (9 in the placebo group and 3 in the picotamide group; P = .07). CONCLUSIONS: In diabetic patients compared with patients receiving placebo, long-term treatment with picotamide can slow the evolution of early carotid atherosclerotic lesions, inhibiting progression of plaque number and growth.

Administration, Oral↗
PubMed1995

[Our experience with the orthotopic continent colonic neobladder].

In the last years particular surgery operations became refined for the techniques and therapeutics progresses also developed in this field. This has allowed with major security to accomplish engagemently reconstruction operations after removal of the bladder, especially for cases of neoplastic pathology, to offer the patients a more normal quality of life avoiding urinary derivations that should change the performance of "EGO". After the operations of radical cystoprostatovesciculectomy different methods have been presented for the construction of heterotopical and orthotopical neobladder; among these the continent colic orthotopical neovesica of Goldwassern which uses the detubulization right colon, in our opinion could offer best functional and clinic results in virtue of easier execution and to use of minor number of intestinal segments. Moreover, for the peculiar characteristics of colic segment, allow to make a wide tank at low pression with perfect diurnal and nocturnal continence. We have, therefore, presenting the results of our experience regarding 12 cases of continent colic orthotopical neovesica, by Goldwasser, with a follow-up of 1-6 years which have comforted us with the results predicted. Although other techniques may offer similar results we believe that the Goldwasser method is still valid for all the above reasons.

Aged↗
PubMed1995

Gene mapping of Usher syndrome type IIa: localization of the gene to a 2.1-cM segment on chromosome 1q41.

Usher syndrome type II is associated with hearing loss and retinitis pigmentosa but not with any vestibular problems. It is known to be genetically heterogeneous, and one locus (termed USH2A) has been linked to chromosome 1q41. In an effort to refine the localization of USH2A, the genetic map of the region between and adjacent to the marker loci previously recognized as flanking USH2A (D1S70 and PPOL) is updated. Analysis of marker data on 68 Usher II families places the USH2A gene into a 2.1-cM region between the markers D1S237 and D1S229. The gene for transforming growth factor beta 2 (TGFB2) and the gene for the homeodomain box (HLX1) are both eliminated as candidates for USH2A, by virtue of their localization outside these flanking markers. The earlier finding of genetic heterogeneity was confirmed in six new families, and the proportion of unlinked Usher II families is estimated at 12.5%. The placement of the USH2A gene into this region will aid in the physical mapping and isolation of the gene itself.

Chromosome Mapping↗
PubMed1995

[Merkel cell tumor. A clinical case].

Merkel's tumor cells represent a rare neuroendocrine neoplasia type which belong to an apudomi group but it's different due to the absence of the biogen amine and hormone polypeptide production. The authors report a rare case of Merkel's tumor cells clinically evident with a great neoformation under the left axilla but already represents at the moment of discovery a notable diffusion with repetition as in hepatic and suprarenal gland. Pointing out not only clinic case having arrived at their observance but also it's important to take note of this particular neoplasia and to suspect it in case of doubt interpretation of clinical tumor.

Aged↗
PubMed1994

Efficacy and safety of fluvastatin, a new HMG CoA reductase inhibitor, in elderly hypercholesterolaemic women.

This multicentre open 6-week study evaluated the efficacy, safety and tolerability of fluvastatin, the first fully synthetic 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase inhibitor, in elderly women with type IIa hypercholesterolaemia. After a 4-week single-blind placebo period, 22 elderly women (mean age 68 +/- 5 years) with primary hypercholesterolaemia [low density lipoprotein (LDL) cholesterol > 160 mg/dl] were enrolled in the trial. Fluvastatin 40 mg was administered once in the evening. At baseline, and after 3 and 6 weeks of treatment, total cholesterol, LDL cholesterol, high density lipoprotein (HDL) cholesterol, triglycerides, apolipoproteins B (apo B) and A-I (apo A-I) were measured. Safety and tolerability were assessed by monitoring routine laboratory parameters and by recording spontaneously reported side effects. The mean (+/- SD) baseline total cholesterol, LDL cholesterol, triglyceride, HDL cholesterol, apo B and apo A-I levels were 325 +/- 43, 236 +/- 43, 128 +/- 56, 61 +/- 16, 221 +/- 60 and 164 +/- 28 mg/dl, respectively. After 6 weeks, fluvastatin significantly (p < 0.001, ANOVA test) reduced total cholesterol, LDL cholesterol and apo B levels by 22%, 29% and 23%, respectively. These significant reductions were already reached at week 3 (total cholesterol, -21%; LDL cholesterol, -27%). The total cholesterol: HDL cholesterol ratio was reduced by 22% at week 3 and by 21% at week 6 (from 5.3 to 4.2). 78% of the patients showed a reduction > or = 20% for LDL cholesterol. Triglycerides were reduced by 16% (not significant).(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗
PubMed1994

[Assessment of the effects of alfuzosin on miction with dynamic echography].

Alfuzosina has a specific antagonist effect on the alfa-1-adrenergic post-junctional receptor posed at urethral laeve musculature, prostatic capsule and vesical trgonum. It's and ideal drug the symptoms of the difficult urinary flow typical of the benign prostatic hypertrophia (IPB) and of some patologies of vesical collum to attenuate. With this work we want to demonstrate the anatomic alterations of vesical collum and prostatic urethra by means of dynamic recording mictional phase with transrectal scan carried out before and after treatment. In this study, 30 patients were divided into three groups of 10 in relation to the pathology: overtone of vesical collum, little benign prostatic ipertrophia and great benign prostatic ipertrophia have included. The patients of each group have also been divided in undergroups of five (selected with the method of double-blind) of which the first treated with alfuzosina 7.5 mg/die for 30 days and the second with placebo. Considering the limits of this study, the analysis of the results have permitted to conclude that the drug has determined a subjective improvement in all patients except those with great IPB, while the objective valuation, reached comparing scan dynamic pictures before and after treatment, has made it possible to visualize an improvement on the opening of the vesical collum and the prostatic urethra after therapy with great variations of the size of che mictional funnel and same prostatic urethra. The alfuzosina is efficacious, in the cases under examination, except the third group were the compression on the urethra was of an elevated degree.

Adrenergic alpha-Antagonists↗
PubMed1994

Endothelin in mild to moderate essential hypertension: relationship between ambulatory and clinic blood pressure values.

We investigated in a post hoc analysis the relationship between plasma endothelin (ET-1) levels (immunoreactive ET-1-like material: ir-ET-1) with both casual and noninvasive 24h ambulatory blood pressure monitoring (24h ABPM) values in EH. Fifteen uncomplicated EH patients (casual supine DBP > or = 100 mmHg), 10 males, age 54 +/- 6 years, 13 previously treated, enrolled in an antihypertensive drug trial (casual DBP > or = 100 mmHg), were evaluated. After a four week single-blind placebo wash-out period, measurements of supine casual SBP and DBP (three consecutive readings) and a 24h ABPM (Spacelabs 90207; automatic reading every 15 minutes) were carried out. Plasma ir-ET-1 was measured by radioimmunoassay kit (Amersham, UK). Pearson correlation coefficient tests were used for statistical evaluations. Mean (SD) casual SBP/DBP values were 166(5)/104(2) mmHg. The 24h ABPM mean values were 148(7)/87(3) mmHg. Daytime (07.00-23.00h) and nighttime (23.00-07.00h) SBP/DBP were 153(7)/91(3) and 137(10)/78(5) mmHg, respectively. Plasma ir-ET-1 levels were 0.9(0.5) pmol/l (range 0.3-2.1 pmol/l). Plasma ir-ET-1 was not correlated with casual SBP and DBP, age, serum creatinine and duration of EH. Positive and significant correlations were observed with 24h SBP (r = 0.59), daytime SBP (r = 0.58), nighttime SBP (r = 0.53) and DBP (r = 0.60). Unlike casual BP, ABPM mean values correlate positively with plasma ir-ET-1 in mild to moderate EH.

Blood Pressure↗
PubMed1993

Evening vs morning isradipine sustained release in essential hypertension: a double-blind study with 24 h ambulatory monitoring.

A randomized, double-blind, placebo controlled study evaluated the effects on 24 h ambulatory blood pressure (ABP) of isradipine sustained release (I-SRO) administered once daily, in the morning (AM) or in the evening (PM). Eighteen uncomplicated essential hypertensives (10 men, mean age 55 +/- 6 years) with casual sitting DBP 96-110 mm Hg received, according to a triple-way crossover design, I-SRO 5 mg AM, or 5 mg PM, or placebo for 4 weeks. A 24 h ABP monitoring (Spacelabs 90207) was carried out at the end of each treatment. Twenty-four hour BP was 145.3/89.8 mm Hg after randomized placebo. AM and PM I-SRO significantly reduced 24 h BP, by 13.7/8.7 and 12.9/8.2 mm Hg respectively. Daytime (07.00 h-23.00 h) BP significantly decreased by 15.0/9.7 mm Hg with AM and 13.2/8.7 mm Hg with PM regimen; night-time BP (23.00 h-07.00 h) significantly decreased by 11.6/7.1 and 12.3/7.4 mm Hg, respectively. Nocturnal nadir BP values were 132.6/78.1 after randomized placebo, 120.9/71.4 after AM I-SRO and 121.0/72.4 mm Hg after PM I-SRO. Morning peak BP values were 154.6/96.9, 139.5/87.6 and 137.5/85.5 mm Hg, respectively. Mean BP values in the early morning hours (i.e. between 03.00 h and 08.00 h) were significantly decreased by 12.1/7.3 mm Hg after AM and 14.3/7.9 mm Hg after PM intake. No significant differences were detected in the BP lowering effect of the two I-SRO regimens.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Isradipine in the treatment of peripheral occlusive vascular disease of the lower limbs: a pilot study.

The long-term effects of isradipine on peripheral occlusive vascular disease of the lower limbs were investigated in 23 normotensive patients with stable Fontaine stage IIa disease and with an absolute pain-free interval (treadmill speed 4 km/h, no incline) of 300 - 700 m, and Doppler ankle - arm arterial pressure index of less than 0.80 in at least one leg. Using a double-blind, parallel-group design, patients received either 2.5 mg isradipine twice daily or placebo for 12 months. Both isradipine (n = 11) and placebo (n = 12) increased the absolute pain-free interval mean values; the increases were not significantly different. Similar trends were observed in the mean values for relative pain-free interval and ankle--arm arterial pressure index. In a subgroup of patients with a baseline absolute pain-free interval of greater than 500 m, isradipine (n = 6) significantly (P less than 0.001) increased both the absolute and the relative pain-free intervals and increased the ankle--arm arterial pressure index compared with placebo (n = 7). The favourable effects of long-term isradipine treatment suggest that isradipine could positively interfere with factors involved in the progression of atherosclerotic lesions or improve collateral vessel flow.

Antihypertensive Agents↗