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Biomedical subjects

P Pasqualetti

Publications and source records attributed to P Pasqualetti.

At least 127 records · Page 7Linked to original sources
PubMed1991

Impaired pulmonary function in schoolchildren exposed to passive smoking. Detection by questionnaire and urinary cotinine levels.

Pulmonary function was evaluated by FEV1, FVC, PEF, MEF50%FVC, MEF25%FVC and MMEF in relation with passive smoking exposure in 143 children aged 6-11 years (mean age = 8.5 +/- 1.6). Passive smoking exposure was evaluated by a questionnaire and by measurement of urinary cotinine levels. Children were divided into different groups: no exposure, low exposure and high exposure. The mean values of each pulmonary function test were compared between the groups and between the different evaluations by Student's test. The evaluation of passive smoking exposure by questionnaire and by urinary cotinine levels separated homogeneous groups of children. The urinary cotinine levels were significantly lower in the non-exposed children than in the other groups (p less than 0.001). Pulmonary function tests, especially MEF50%FVC, MEF25%FVC and MMEF were significantly reduced in exposed subjects (p less than 0.05). These alterations are an index of early involvement of the small airways also in passive smokers. The greater the exposure to passive smoking, the lower the values of the pulmonary function tests.

Child↗
PubMed1991

Isolated atrial myocardial infarction: pathological and clinical features in 10 cases.

Isolated myocardial infarction of the atria is a relatively understudied and underestimated entity, rarely diagnosed in life. The pathological and clinical features in 10 cases of acute isolated atrial myocardial infarction are reported. They represent 3.5% of all myocardial necrosis out of a series of 2,704 consecutive autopsies in adults. The right atrium is more frequently involved than the left atrium (9:1). Pulmonary hypertension, with or without coronary arterial narrowing, is the major condition leading to isolated atrial infarction. Congestive heart failure, thromboembolic phenomena, and supraventricular arrhythmias are the most frequent complications of atrial infarction. The electrocardiographic findings are often non-specific and elusive and are not useful to a correct diagnosis. These observations suggest that isolated atrial myocardial infarction is a well-distinct entity with respect to ventricular myocardial infarction, since there are several differences between the 2 diseases in pathogenesis, diagnosis, clinical picture, and prognosis.

Electrocardiography↗
PubMed1991

[Basal and postprandial blood gastrin in peptic ulcer. The physiopathological aspects in relation to different sites of the lesion].

A different pathophysiological mechanism is widely accepted for gastric and duodenal ulcer. In particular, the exact role of gastrin in the determinism of non hormono-dependent peptic ulcer disease is not completely clarified. Therefore, the aim of present study was to analyse fasting and post-prandial serum gastrin levels in 99 duodenal ulcer patients, 17 gastric ulcer patients and 11 subjects presenting an association of gastric and duodenal ulcer. The possible correlation between post-prandial gastrin concentrations and basal and maximal acid output in the 3 fasting serum gastrin levels appear not different among the 3 classes of patients, while post-prandial gastrin concentrations are statistically higher at 15 minutes in duodenal ulcer patients and in subjects with the association of gastric and duodenal ulcer as compared to gastric ulcer patients. Mean fasting and stimulated gastrin levels are higher in gastric ulcer females than in males during the entire test and with statistically difference at 30 minutes. The concentrations of the hormone are not different in males of the 3 groups of patients at basal time, while are statistically lower at 15 and 30 minutes in gastric ulcer males compared to the males with duodenal ulcer and the association of the localization. Finally, positive correlation has been observed between BAO and MAO and post-prandial gastric concentrations in the 3 groups of patients, while there is an inverse correlation between the previous parameters as regards sex, both in gastric and duodenal ulcer.

Adult↗
PubMed1991

[Epidemiologic chronorisk of acute cardio-cerebrovascular diseases].

This review summarizes the accumulated data demonstrating that several cardio-cerebrovascular diseases do not occur with casual periodicity, but present a predictable critical time of ultradian, circadian, or infradian recurrence in their onset. In fact, during the last years, it has been clearly established that there is a prominent increase in a definite period of the day, of the week, and of the year in the frequency of onset of acute myocardial infarction, sudden cardiac death, stroke, and fatal pulmonary thromboembolism. Morning hours, week-end, and winter seem to be the periods at higher risk, since a number of physiological processes that could contribute to the onset of the disease are intensified. Also environmental and behavioural conditions could contribute to these peaks. Consequently, the periodicity in the occurrence of these diseases may be due to the relationships between the exogenous factor rhythms, the endogenous biological rhythms, and the disease. These epidemiological and chronopathological observations suggest the introduction of time as a measurable structure for the clinical risk, and the term "chronorisk" as a predictable condition of temporally periodic or permanent risk for human health, which is generated by a temporal-quantitative disorder in the physiological course of the biological oscillating functions. The temporal recurrences in the onset of the acute diseases are not only epidemiological data, but, since the reasons for these rhythm changes in pathology are likely multifactorial, the study of such rhythms will probably help in the understanding of the pathogenesis and the triggering mechanisms. Moreover, further investigations of these rhythmicities may help the planning of more effective preventive therapy.

Adult↗
PubMed1990

Multiple myeloma: relationship between survival and cellular morphology.

Myeloma cells in bone marrow aspirates from 121 patients with multiple myeloma at time of diagnosis were evaluated, by assigning them into morphological categories. Cox's model was used to calculate the coefficients for total myeloma cells and "plasmablasts" in respect to survival. Applying these coefficients, the Multiple Myeloma Cellular Score (MMCS) was calculated. MMCS significantly divides the patients into three stages. In fact, there are significant differences both between mean survivals (P less than .001) and between survival curves (P less than .00001). There is also a significant correlation (P less than .00001) between the calculated MMCS and survival in the whole patient group.

Adult↗
PubMed1990

Epidemiological chronorisk of stroke.

A retrospective study was undertaken on onset of symptoms in 667 cases of stroke. All strokes occurred out of hospital. There were 382 males and 285 females, observed from 1971-1988. The 667 cases of stroke consisted of 508 cases of cerebral infarction and 159 cases of cerebral hemorrhage. The data, analyzed by the single cosinor method, demonstrate a significant circadian, circaseptan, and circannual rhythmicity in the occurrence of stroke. The peaks occur in the morning hours, in the weekend, and in winter. Cerebral hemorrhages do not have a circadian rhythmicity in their occurrence, while they do present circaseptan and circannual rhythmicity. Cerebral infarctions present circadian, circaseptan, and circannual rhythms. No difference was found between males and females. The possible factors involved in temporal distribution of stroke are discussed. These observations could be useful for a better understanding of the pathogenesis and treatment of stroke.

Adult↗
PubMed1990

Circadian pattern of circulating plasma ACTH, cortisol, and aldosterone in patients with beta-thalassemia.

Plasma levels of ACTH, cortisol, and aldosterone were measured for an entire day every 2 h, starting from midnight, in 4 healthy subjects, and in 4 patients with beta-thalassemia, without evidence for any endocrine disease. The subjects, after synchronized standard life conditions for 10 days, were held in constant supine position during the study. The data were analysed by the "cosinor" method. The results show significant circadian rhythms for the three biological variables in healthy subjects. In the thalassemic patients a significant circadian rhythm was detected only for cortisol and aldosterone. No rhythm was demonstrated for ACTH in the patient group. While no differences were found in mesors and acrophases for the three hormones between the two groups, a significant difference was observed regarding amplitudes. These data suggest that in beta-thalassemia, the secretion rhythmicity of ACTH is modified, whereas the adrenal cortex maintains its own physiologic rhythmicity in hormone secretion.

Adolescent↗
PubMed1990

Long-term treatment for gastric and duodenal ulcer.

The histamine H2-receptor antagonists, cimetidine, ranitidine, famotidine and nizatidine are effective in promoting the healing of both gastric and duodenal ulcer. Unfortunately the recurrence rate after withdrawal of the therapy does not appear modified and many studies indicate an increased rate of relapse after antisecretory treatment. The difference between various H2-blockers in terms of duration of acid inhibition and then increasing in gastrin levels may play a role in explaining the phenomenon, the exception represented by the last H2-blocker, nizatidine. It is reasonable, therefore, to analyze the different therapeutical approaches proposed for ulcer relapse prevention, such as continuous maintenance therapy, seasonal on demand, intermittent, week-end therapy, association of drugs with different mechanisms of action, etc. Four categories of patients can be characterized both for gastric and duodenal localization: 1. Subjects with low rate of relapses, i.e. less than one each fifteen months; 2. Subjects with episodic relapses, i.e.; one or two per year; 3. Subjects with frequent relapses, i.e. more than three per year; 4. Subjects with complications (bleeding, perforation).

Duodenal Ulcer↗
PubMed1990

[Simultaneous presentation of multiple myeloma and acute myelomonocytic leukemia in the absence of previous chemotherapy. Description of a case and review of the literature].

A case of simultaneous occurrence of multiple myeloma and acute myelomonocytic leukaemia without previous chemotherapy is reported. A careful search of the literature disclosed 16 other cases of the same association. The possible relationships between these two haematopoietic neoplasms are discussed. On the literature and personal data, it is concluded that in course of multiple myeloma the association with an acute myeloblastic leukaemia is due to two possibilities: the first, more frequent, is the long-term effect of chemotherapy, while the second, rare, is that, by still unknown causes, a simultaneous neoplastic development of a plasma cell and myeloblastic clone occurs.

Aged↗
PubMed1990

[Socioeconomic status and survival in multiple myeloma].

In order to investigate the relationship between socioeconomic status and survival in multiple myeloma, a group of 121 patients, followed from first diagnosis to their demise, was subdivided into three social classes: high, medium, and low. Social class subdivision was performed taking into account the degree of education, occupation, and income. Significant differences (p less than 0.05) exist regarding mean survivals, survival curves, clinical stages, and responses to therapy between the three considered classes. A low socioeconomic status is associated with shorter survival, higher frequence in poor clinical stage, and less percentage of positive responses to chemotherapy. In conclusion, the socioeconomic status is an important prognostic factor in patients with multiple myeloma, to be considered with other clinical and laboratory data.

Adult↗
PubMed1990

[Differentiated circadian chrono-risk of acute myocardial infarct].

In order to determine whether acute myocardial infarction (AMI) presents a circadian periodicity in its occurrence, the onset of AMI, evaluated by onset of clinical symptoms and pain, has been analysed in 520 patients with AMI. The definitive criteria of AMI were: typical chest pain, electrocardiographic findings, and plasma CPK-MB elevation. All cases of AMI were divided into subgroups according to sex (males = 369, females = 151), age (less than 60 years old = 254, more than 60 years old = 266), type of AMI (Q wave AMI = 407, non Q wave AMI = 113), previous pharmacological treatment (no treated = 373, treated = 147), history of arterial blood hypertension (normotensive = 403, hypertensive = 117). Cases of Q and non Q wave AMI were also subdivided according to treatment and hypertensive conditions. All AMI occurred outside hospital; silent AMI and reinfarctions were excluded by analyses. The data have been analysed by chronograms and by means of "single cosinor" method, both for total cases, and for each subgroup of AMI. The results show a diurnal variation in AMI occurrence regarding the whole group, with a peak from 4:00 am to noon and with a secondary small no-significant peak in the late evening, and the minimum in the afternoon. Rhythmometric analysis demonstrates a significant circadian rhythm (p less than 0.001) with acrophase at 7:52 am (from 6:08 am to 9:36 am). A statistically-significant circadian rhythm is demonstrated in each subgroup, except in hypertensive patients. Acrophases of males and females, and of patients aged over or under 60 years do not differ from that of the whole group, and between them (p greater than 0.05). The peak of non Q wave AMI occurs at 4:44 am, while the peak of Q wave AMI at 10:08 am: this difference is significant (p less than 0.001). There is also a significant difference between the acrophases of AMI in the treated and untreated groups (p less than 0.01), as well as between normotensive and hypertensive subjects (p less than 0.001). The previous treatment seems able to anticipate the maximum occurrence of AMI in the whole group and in the group of Q wave AMI. These results are very similar to previous observations and confirm the greater morning occurrence of AMI. The present data are discussed in respect with the literature observations, and the possible pathophysiological mechanisms that contribute and conditionate the morning increase and the different peaks in subgroups of AMI patients are discussed.(ABSTRACT TRUNCATED AT 400 WORDS)

Circadian Rhythm↗
PubMed1990

[Chrono-risks in the episodes of fatal pulmonary thromboembolism].

A study on circadian and circannual rhythmicity in the episodes of fatal pulmonary thromboembolism has been conducted in 152 cases. The data demonstrate that the incidence in the episodes of pulmonary thromboembolism, evaluated as hour and day of onset in the clinical symptoms, presents a temporal, both circadian, and circannual distribution. The greater incidence occurs in the morning hours and in the winter season. The rhythmometric analysis by "cosinor" method showed a significant circadian and circannual rhythms in incidence of episodes of fatal pulmonary thromboembolism. The temporal distribution does not seem to be casual, but the effect of interrelationship between exogenous rhythms, such as those in the haemostatic system, endogenous rhythms, such as the cold temperature, and disease. These results demonstrate that the pulmonary thromboembolism is a disease with an high "chrono-risk", i.e. it is an expectable disease in its temporal recurrence.

Adult↗
PubMed1990

[Prognostic value of the ratio of bone marrow plasma cells in multiple myeloma].

The relationship between initial percentage of bone marrow plasma cells and survival was studied in a group of 70 patients affected with multiple myeloma. All patients had a complete follow-up. The initial percentage of plasma cells shows a highly significant correlation with survival. Moreover, the percentage of bone marrow plasma cells is also correlated with the levels of hemoglobinemia and serum or urinary monoclonal component. The patients were divided in three groups according to the percentage of bone marrow plasma cells: group A: less than 20%; group B: 21-40%; group C: greater than 41%. The mean survival times of these three groups are significantly different, as well as their survival curves. The initial percentage of plasma cells in bone marrow is an useful parameter for estimating survival and predicting prognosis, and it can be an additional factor in the clinical staging of multiple myeloma, while the effectiveness of therapy can be monitored by sequential bone marrow aspirates.

Aged↗
PubMed1990

[Bleeding of gastric ulcers. Epidemiologic, clinical and functional characteristics].

The frequency of gastrointestinal haemorrhage due to gastric ulcer has been assessed in 254 personally observed patients suffering from this endoscopically verified pathology. 56 patients, namely 22% of the cases, presented haematemesis and/or melena of the ulcerative lesion. This subgroup was compared with 65 patients with endoscopically verified gastric ulcer without previous bleeding episodes from the lesion in their clinical history, in respect of certain epidemiological, clinical and biohumoral features. The purpose of the study was to check the possible existence of clinical and/or physiopathological differences between subjects with bleeding gastric ulcer and the population of non-bleeding ulcer patients. In 80% of patients studied, the gastric ulcerous disease started with digestive haemorrhage and it was not accompanied by dyspeptic-painful symptomatology in 20% of cases. The pain symptomatology does not appear to be influenced by the intake of non-steroid anti-phlogistic drugs. No significant difference emerges between the two groups considered as regards epidemiological features and biohumoral data (PG I, gastrin, B.A.O. and M.A.O.).

Adult↗