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Biomedical subjects

P Perini

Publications and source records attributed to P Perini.

26 records · Page 2Linked to original sources
PubMed1993

Body composition study in the elderly: comparison between tritium dilution method and dual photon absorptiometry.

BACKGROUND: The methods commonly employed in body composition study in elderly persons derive fat-free mass (FFM) by measures of total body water (TBW); these methods assume FFM hydration constant (TBW/FFM = 0.732). The aim of our study was to verify the accuracy of the TBW method in FFM estimation and to study the variability of fat-free mass hydration (TBW/FFM) in healthy elderly subjects. METHODS: We assessed FFM in 27 healthy old subjects (76 +/- 7 yrs) by dual photon absorptiometry (DPA) and by TBW measured by 3H2O. Furthermore, to verify the accuracy in FFM estimation by our methods, we measured resting metabolic rate (RMR) by indirect calorimetry. RESULTS: FFM hydration was 71.9 +/- 4.9 (range 63.6-80.4%), a range larger than that reported by direct chemical analysis in adults. The FFM hydration measured in our subjects was not different from the 73.2 value currently used in healthy adults. FFM values derived by TBW (assuming TBW/FFM = 0.732) were not significantly different from FFM measured by DPA. We correlated FFM with resting metabolic rate and found a similar correlation between RMR and FFM-DPA (r = .89, p < .001) and FFM-TBW (r = .85, p < .001). CONCLUSIONS: Both methods employed in our study have proved to be accurate in estimating FFM in elderly persons; particularly, the value of 0.732 assigned to FFM hydration to derive fat-free mass in adults can be employed also in body composition study of the elderly.

Absorptiometry, Photon↗
PubMed1992

Hepatitis C viraemia rebound after "successful" interferon therapy in patients with chronic non-A, non-B hepatitis.

A quantitative polymerase chain reaction (PCR) assay for hepatitis C viral RNA (HCV-RNA) was used to monitor viraemia levels in six patients at multiple time points before, during, and after interferon therapy for chronic non-A, non-B hepatitis (NANBH). Prior to therapy, serum HCV-RNA was detected in all patients at approximately 10(4)-10(5) HCV genomes/ml. HCV viraemia became undetectable within 1 month of commencing interferon in three of the five patients whose alanine aminotransferase (ALT) levels decreased to normal on therapy. In the remaining two responder patients, viraemia levels declined more slowly, becoming undetectable after a period of several months. Recurrence of viraemia during therapy was observed in two cases. The one patient whose serum ALT levels remained elevated throughout therapy showed no decline in viraemia. On stopping interferon after a 6 months course, HCV genome titres climbed rapidly in all patients, reaching higher levels than had been observed prior to therapy. Biochemical relapse occurred within 7 months of ending interferon treatment in all but one of the patients who demonstrated this viraemia "rebound" phenomenon.

Adult↗
PubMed1980

[Echocardiographic patterns in discrete subvalvular aortic stenosis (author's transl)].

Ten patients with angiocardiographic and hemodynamic evidence of discrete subvalvular aortic stenosis were examined by M-mode-echocardiography. Different echocardiographic patterns were identified: the most frequent appeared an abnormal systolic movement of aortic valve leaflets, less frequently a discrete linear echo was observed in the outflow tract of the left ventricle; in one case the echocardiogram showed no abnormality of the left ventricular outflow tract or aortic valve morphology. In half of the cases the left ventricular outflow tract was narrowed. No correlation was found between echocardiographic measurements and severity of the subaortic lesion, as expressed by peak systolic pressure difference between the left ventricle and the aorta. It is concluded that M-mode-echocardiography: - may furnish helpful criteria in the diagnosis of discrete subaortic stenosis, but the absence of such criteria does not allow to exclude the existence of the malformation; - is not quantitatively useful in the assessment of subaortic stenosis.

Adolescent↗
PubMedDate not supplied

Heart rate and metabolic response to burn injury in humans.

BACKGROUND: Although frequently done, estimating the energy requirements of individual burn patients without measuring their resting metabolic rate is a less than satisfactory method of evaluation. METHODS: We tested whether heart rate, which relates to the energy expenditure during physical activity, is also associated with postburn hypermetabolism (calculated as percentage increase of resting metabolic rate above the predicted normal fasting resting metabolic rate). Twenty-three patients [12 men and 11 women, aged 38 +/- 13 years (mean +/- SD); weight, 71.6 +/- 14.8 kg; body mass index, 25.4 +/- 3.6; total burn surface area, 35.3 +/- 17.8% (percentage of body surface)] were studied weekly for 3 weeks after an overnight fast. RESULTS: Measured resting metabolic rates and heart rates were 2016 +/- 497 kcal/d, 101 +/- 13 bpm (n = 19); 2231 +/- 485 kcal/d, 107 +/- 13 bpm (n = 18); and 1903 +/- 598 kcal/d, 99 +/- 14 bpm (n = 11) for weeks 1, 2, and 3, respectively. Postburn hypermetabolism was +36% +/- 19%, +55% +/- 27%, and +36% +/- 35% in the first, second, and third week, respectively. In each week postburn hypermetabolism correlated with heart rate (r = 0.65, p = .003; r = 0.69, p = .001; and r = 0.80, p = .002, respectively). Only in the second week did postburn hypermetabolism correlate with total burn surface area (r = 0.52, p = .02); there was no correlation with body temperature. In a multiple regression analysis, predicted resting metabolic rate, heart rate, and total burn surface area together explained 77% of all of the variance observed in the 48 fasting resting metabolic rates that were measured in the study (r2 = 0.77, p < .0001), and each of these variables also had a significant partial correlation with fasting resting metabolic rates (r2 = 0.45, p < .0001; r2 = 0.29, p < .0001; and r2 = 0.03, p < .03, respectively). CONCLUSIONS: In burn patients, variability in heart rate is associated with a significant part of postburn hypermetabolism variability. Therefore, heart rate may be considered a useful variable to be used for the evaluation of the energy requirements of severely burned patients.

Adolescent↗
PubMedDate not supplied

Hyperthyroidism and concurrent thyroid cancer.

AIMS AND BACKGROUND: The aim of this study was to analyze the frequency of coexisting hyperthyroidism and thyroid malignancy in endemic goiter areas and review the current literature on the subject. METHODS: During the period January 1984 to June 1998, 1853 patients were examined for hyperthyroidism at the Spedali Civili Hospital of Brescia, Italy; 512 (27.6%) subjects underwent surgery. Of these patients 108 (21%) had Graves' disease, 251 (49%) multinodular toxic goiter (MTG) and 153 (30%) uninodular toxic goiter (UTG). RESULTS: Malignancy was found in 24 (4.7%) patients: 19 females and 5 males with a mean age of 52.2 years (range, 21-76 years). The frequency of cancer in Graves' disease was 6.4%, 5 females and 2 males; in MTG 3.9%, 2 females and 8 males, and in UTG 4.4%, 7 females and 1 male. CONCLUSIONS: Our data confirm previous reports on the frequency of thyroid cancer in hyperthyroidism. This association is more relevant than previously suspected. The frequent coexistence of hyperthyroidism and neoplasia, demonstrated by our study and the most recent literature, underlines the importance of studying and excluding the possibility of neoplastic degeneration by means of a systematic approach.

Adult↗
PubMedDate not supplied

Combined hemodynamic echocardiographic Doppler evaluation of prostaglandin E1 effects in patients with severe dilated cardiomyopathy undergoing evaluation for heart transplantation.

BACKGROUND: Prostaglandin E1 has been used in patients undergoing evaluation for heart transplantation. Because of high lung metabolism, the drug has been used to test pulmonary vasoreactivity, although a systemic effect is also present. The purpose of this study is a more thorough assessment of the drug. METHODS: Prostaglandin E1 was infused with progressive steps in 14 patients in New York Heart Association class III to IV with severe dilated cardiomyopathy. The patients were studied through a combined hemodynamic and Doppler echocardiographic evaluation. RESULTS: With prostaglandin E1, mean aortic and pulmonary arterial pressure decreased by 7% (p < 0.01) and 24% (p < 0.001), respectively with a 23% (p < 0.001) increase in stroke volume index. Systemic vascular resistance decreased by 22% (p < 0.001), and pulmonary vascular resistance decreased by 33% (p < 0.001), with a 15% decrease in the pulmonary/systemic vascular resistance ratio. Heart rate was unaffected. Minimum and end-diastolic left ventricular pressure decreased by 35% (p < 0.001) and 21% (p < 0.001), respectively. The logarithmic time constant of left ventricular isovolumetric relaxation and maximum rate of isovolumic pressure decline were not modified. Early and late left ventricle diastolic filling were not significantly modified if considered separately, but there was a 27% (p < 0.01) decrease in the early/late filling ratio, suggesting a redistribution of diastolic filling to later in diastole. The 34% (p < 0.01) decrease in right atrial pressure suggests a reduction in intrapericardial pressure which mirrors the significant change in the early/late ratio toward a less restrictive filling pattern. CONCLUSIONS: It is possible that the end-stage ventricles of these patients respond to the reduction in pulmonary and systemic resistances secondary to prostaglandin E1 infusion by increasing stroke volume, with a redistribution of diastolic filling to later in diastole.

Alprostadil↗