[Toxic adenoma and thyroid diseases. Scintigraphic and clinical observations].
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Adenoma↗
Biomedical subjects
N Frisina
Publications and source records attributed to N Frisina.
[Behavior of urinary and blood lactate dehydrogenase in various pathological states].
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Adolescent↗
Wake and sleep cardiovascular reflex tests and GH profiles in diabetic patients.
Fourteen diabetic patients (13 males, 1 female, 7 IDDM and 7 NIDDM) were tested during wakefulness with a battery of tests examining parasympathetic and sympathetic control of the cardiovascular system. Subsequently sleep recordings including EEG, EOG, submental, left and right anterior tibialis EMGs, ECG, nasal airflow, thoracic and abdominal respirograms, nocturnal penile tumescence, were performed in each subject. The assessment of cardiovascular functions during sleep was based on the following parameters: Rbm, R-wake, apnea index, adequate penile tumescence during phase REM. Parasympathetic and sympathetic control of cardiovascular system were both impaired during wakefulness in only one patient, who also showed a low Rbm index indicative of ascertained autonomic neuropathy. Indices Rbm sufficiently low to be considered an evidence of probable autonomic neuropathy were found in 5 patients (3 IDDM and 2 NIDDM); all but one with normal cardiovascular tests during wakefulness. Five patients showed gross deficiency upon nocturnal penile tumescence monitoring. In comparison with a control group the patients showed a significantly lower overall Rbm index (p less than 0.001). IDDM patients showed an increased plasma GH response to insulin-induced hypoglycemia compared to NIDDM and normal subjects. Increased GH secretion was furthermore confirmed by GH values obtained in blood samples drawn during the first REM stage of the night in IDDM patients. The evaluation of the variables taken into consideration during sleep appears to be crucial for the assessment and prevention of autonomic neuropathies and neuroendocrine dysregulation in diabetic patients.
Adolescent↗
Increased indexes of thrombin activation in advanced stages of hypertension.
BACKGROUND: The hemostatic system plays an important role in thrombotic lesions, which can complicate the clinical course of hypertensive patients. The aim of this study was to verify a possible activation of the blood clotting processes, the evaluation of two markers of thrombin activation in 62 hypertensive patients, with and without vascular complications, compared with a control group. METHODS AND RESULTS: In 22 patients with newly diagnosed uncomplicated essential hypertension, in 40 hypertensive patients with clinically evident vascular complications (20 patients with controlled blood pressure and 20 with uncontrolled and high blood pressure) and in 20 normotensive sex- and age-matched subjects, two indexes of thrombin generation and action, namely prothrombin fragment 1 + 2 (F1 + 2) and fibrinopeptide A (FPA) were evaluated. The observed values show an increase of the F1 + 2 levels in patients with overt vascular complications; those with higher blood pressure, moreover, showed FPA levels higher than those with controlled blood pressure. CONCLUSIONS: These results seem to indicate that plasma F1 + 2 levels are significantly elevated, as a marker of a thrombosis-prone status, in patients with organic damage. Successively, with progress of hypertension and increasing blood pressure, the evidence of elevated FPA levels seems to indicate a clear prethrombotic situation which could turn into a thrombotic state.
Adult↗
Hemostasis and fibrinolysis factors in first-degree relatives of patients with Type 2 diabetes without hypertension.
First-degree relatives of type 2 diabetic patients with or without a family history of hypertension are at increased risk for cardiovascular diseases. The aim of this study was to verify some possible hemostatic alterations in first-degree relatives of type 2 diabetic, normotensive and hypertensive patients. In 78 non-diabetic, normotensive first-degree relatives of type 2 diabetic patients (47 without a family history of hypertension and 31 with a family history of hypertension) and in 36 normoglycemic, normotensive subjects with no family history of hypertension, we evaluated plasma levels of fasting glucose and insulin, tissue-type plasminogen activator (t-PA), plasminogen activator-inhibitor (PAI-1), D-dimer (DD) and prothrombin fragment 1 + 2 (F1+2). Insulin resistance, calculated by the HOMA model, and plasma levels of t-PA and PAI-1 were significantly higher in relatives of diabetics compared to controls. As far as the thrombin activation indexes are concerned, we detected a significant increase in DD and F1+2 in relatives of diabetics with hypertension compared to other study subjects. In conclusion, our data indicate that familial predisposition may influence the hemostatic system in first-degree relatives of diabetic and/or hypertensive patients.
Adult↗
Long-term hemostatic effects of cholesterol-lowering therapy with atorvastatin.
This study assessed hemostatic effects of an HMC-CoA reductase inhibitor, atorvastatin, on different parameters in 32 hypercholesterolemic patients of both sexes. In the patients and in 25 control subjects, plasma levels of tissue-type plasminogen activator, plasminogen activator inhibitor (PAI-1), D-dimer, prothrombin fragment 1 + 2 (F1 + 2), total cholesterol, triglycerides and fibrinogen had been measured. All these parameters were evaluated in patients after 6 and 12 months of treatment with atorvastatin at a dosage of 20 mg/day. This treatment significantly lowered the total cholesterol level in all patients. Moreover, after 6 months of atorvastatin treatment, PAI-1 and F1 + 2, which were both increased at baseline, were significantly reduced. This reduction continued after 12 months. The present results show that a reduction of hemostatic abnormalities, which exist in hypercholesterolemia, may be another important effect of the atorvastatin therapy.
Anticholesteremic Agents↗
Haemostatic variables in arterial hypertension.
In 22 untreated patients with uncomplicated essential hypertension and in 10 normotensive subjects the plasma levels of thrombomodulin (TM), beta-thromboglobulin (beta-TG), D-dimer (DD), tissue-type plasminogen activator (t-PA) and plasminogen activator-inhibitor (PAI-1) were evaluated. The observed values show no significant difference in plasma TM, plasma and urine beta-TG concentration and plasma DD among hypertensive patients and controls. On the other hand, the levels of t-PA and PAI-1 in hypertensive patients were significantly higher than the values detected in normotensive control subjects. These data seem to indicate that, at initial stages of essential hypertension, the t-PA and PAI-1 levels increase.
Adult↗
Effects of medium-term antihypertensive therapy on haemostatic parameters in patients with essential hypertension.
This study assessed the effects of the angiotensin-converting enzyme (ACE) inhibitor cilazapril on the main haemostatic variables in 22 patients, of either sex, with newly diagnosed uncomplicated essential hypertension. In the patients and in 10 control subjects, plasma levels of thrombomodulin, beta-thromboglobulin, D-dimer, tissue-type plasminogen activator (t-PA) and plasminogen activator inhibitor (PAI-1) had previously been measured. Only the levels of t-PA and PAI-1 were found to be higher than in controls. All these haemostatic evaluations were carried out after 6 and 12 months of treatment with an ACE inhibitor, cilazapril, 5 mg/day. This treatment significantly lowered the mean arterial pressure in the whole group from 133 to 106 mm Hg (after 6 months) and to 105 mm Hg (after 12 months), p < 0.05. No significant difference in any haemostatic parameters was observed after 6 and 12 months of treatment. The present study confirmed that treatment with cilazapril for 12 months lowers daytime ambulatory mean arterial pressure in patients with essential hypertension, without any significant increase in the tendency of blood to clot.
Adult↗
Is apoptosis cause of pre-eclampsia?
Pre-eclampsia is the main cause of fetal and maternal morbidity and death associated with hypertension during complicating pregnancy. During physiological pregnancy, the immunological system undergoes secondary modifications, with an "exchange" between mother and fetus. Cytokines play an important role in the complex condition of partial fetal "rejection". It has suggested that the condition depend on immunological factors. In line with this hypothesis, apoptosis appear to play a key role in the pathophysiology of placental ischemia and the mechanism underlying this condition may be influenced by substances such as Bcl-2 which inhibits apoptosis. Neither aspirin nor calcium appear to improve maternal hypertension and proteinuria, although late ongoing trials may alter this view. At present, the condition can be resolved only by the end of pregnancy. Further studies are required in order to improve our understanding of these immunological mechanisms underlying hypertension during pregnancy, as the key to effective therapy may be their ability to "manipulate" them in an appropriate way.
Adult↗
[Diverticular disease of the colon in peritoneal dialysis].
Colon diverticular disease is a very common pathology in western countries and represents a risk factor for septic-type complications, especially in peritoneal dialysis patients. We examined both diagnostic procedure and therapeutics options, either pharmacological or surgical. Ultrasonography, which is useful for the diagnosis of diverticulosis and diverticular disease, has been supported in the last few years by new imaging techniques, such as NMR and CT, that also find applications in the treatment of diverticulitis complications like peritoneal abscesses. Our emphasis is on the therapeutic perspective, either dietetic - based on the use of a fibre-rich diet and the infusion of liquids by intravenous injection - or surgical, such as the Hartmann procedure, single anastomosis with stomia conservation and laparoscopic and endoscopic treatment. These therapeutic approaches have reduced both morbidity and mortality rate and have emphasized how the reduction of surgical stress on the mesothelium promotes the recovery of the functional integrity and, consequently, faster resumption of peritoneal dialysis. In conclusion, diverticulosis alone is not a contraindication for peritoneal dialysis, but constitutes a risk factor for the continuation of this alternative treatment.
Anastomosis, Surgical↗
[Growth factors and hematopoiesis. Physiopathology and clinical applications].
Recently biotechnologic progress has, through the technique of the recombinant DNA, allowed a low cost production of large amount of several growth factors. Such a large availability has made possible to either carry out deeper investigations on the physiopathology of the hemopoietic regulation and perform new therapeutic approaches under different pathologic conditions. The most interesting acquisition concerning the biology of hemopoiesis to which such investigations have addressed us is the inadequacy of the protocols adopted till now. Such protocols considered only a simple vision of an elective action of a given growth factor during an exact maturation period of a determined cell colony. On the contrary, it was possible to point out a close network of inter-relationship among the different factors, which sometime impedes a clear distinction for each single factor, between actions of competence and progression in the cell maturation phenomena. However, the present uncertainty pertaining to the regulation of hemopoiesis has not impede the performance of clinical trials with positive findings in several pathologic conditions. The administration of recombinant erythropoietin has for example allowed to intervene in a resolutive way on the anemia in uremic subjects, and seems giving satisfactory results also in subjects with non renal origin anemic conditions. Satisfactory results were also obtained through the use of the Granulocyte-Macrophage CSF and of the Granulocyte-CSF, which by preventing neutropenia have allowed the performance of more adequate chemotherapeutic protocols in neoplastic subjects. New interesting perspectives are now coming for the use of Interleukin-3 in the treatment of the aplastic anaemia.
Colony-Forming Units Assay↗
Changes in plasma concentrations of atrial natriuretic peptide during the first ten days and the second month of life.
Atrial natriuretic peptide (ANP) was assayed on the 1st, 3rd, 7th and 10th day of extrauterine life and the levels of the hormone were checked after the 2nd month in 12 infants. After an initially rapid increase, with a peak of the 3rd day (45.7 +/- 7 pg/ml the 1st day of extrauterine life and 175 +/- 5 pg/ml on the 3rd day), we can recognise a progressive decrease until the measurement made at 2 months (61.5 +/- 5 pg/ml). The reported data show the important role of ANP in adaption of life after birth. This can be considered as a compensatory response because it represents an attempt to maintain the balance of positive sodium which is essential for the growth of the newborn.
Atrial Natriuretic Factor↗
Hypokalemic myopathy in pseudohyperaldosteronism induced by fluoroprednisolone-containing nasal spray.
A man who was using 9-alpha-fluoroprednisolone-containing nasal spray preparation for allergic rhinitis developed a pseudohyperaldosteronism and an acute hypokalemic myopathy. Muscle biopsy changes included variation in fiber size with preserved type 2a fibers, necrosis, phagocytosis and regeneration. This factitious mineralocorticoid excess syndrome, induced by uncontrolled use of intranasally administered steroid, should be considered among the various causes of hypokalemic myopathy.
Administration, Intranasal↗
[A new guanabenz-mefruside drug in the treatment of arterial hypertension].
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Adult↗
The influence of prostaglandins on renin-aldosterone release. In vivo and in vitro experiments.
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Aldosterone↗
[Amylasemia in uremics: a complex interpretation].
Plasmatic amylase increases quite often in uremia. Hyperparathyroidism is also present in uremic patients and it is thought to be the main factor of an increased of amylase; its effect is mediated by an increase of cytosolic calcium. The authors measured the plasmatic level of amylase, lipase, calcium phosphates and parathormone before and after administration of Ca-antagonists (Verapamil and Diltiazem). The results did not shown any correlation. Hyperparathyroidism increased the pancreatic secretion but don't influences the amount of enzymes.
Adult↗
Effects of the evening i.v. administration of erythropoietin in haemodialyzed patients.
The authors evaluated the possibility that the time of the administration of erythropoietin (rHuEPO) may play any effect on the therapeutic outcome of the treatment. The study was carried out on 26 uremic subjects submitted to hemodialysis in the morning or in the evening. At the end of the dialytic treatment every patient was administered rHuEPO IV. The amount of erythropoietin needed to reach an Ht value of 32% was evaluated. The subjects whose rHuEPO had been administered in the first evening hours showed that they needed a less quantity of rHuEPO (885 +/- 50 vs 1550 +/- 75 IU/Kg; p < 0.01), and showed a more rapid improvement of the anemia. According to the lans of a physiologic circadian rhythm, the evening i.v. administration of rHuEPO seems to insure a quicker therapeutic success.
Aged↗
[Rapid, progressive deterioration of renal function following erroneous administration of high doses of subcutaneous recombinant erythropoietin].
It's reported a case of progressive and rapid deterioration of the renal function, following to a wrong administration of high doses of recombinant erythropoietin. After the administration of 10,000 U of rHuEPO three times a week for at least five times instead of the 1000 U ordered, the patient showed a progressive increase of the plasmatic creatinine values from 2.2 to 3.3 mg/dl. In the same period we pointed out an increase of hematocrit (from 29% to 35%) and of the Hb (from 9.3 to 11.2 g/dl). The patient, suffering from a slightly high blood pressure, furthermore showed important pressure increases. The suspension of the treatment by erythropoietin permitted the restoration of the creatinine values to levels similar to the ones pointed out before the treatment and a reduction of the blood pressure values. The AA. think that a too rapid regression of the anaemia achieved by a rHuEPO treatment can condition a worsening of the renal function in the pre uraemic patient.
Aged↗