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Biomedical subjects

P Verdecchia

Publications and source records attributed to P Verdecchia.

155 records · Page 9Linked to original sources
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Echocardiographic left ventricular hypertrophy as related to arterial pressure and plasma norepinephrine concentration in arterial hypertension. Reversal by atenolol treatment.

We tried to assess relationships between echocardiographic left ventricular hypertrophy (LVH), arterial pressure levels, and plasma norepinephrine concentration (NE) in 20 previously untreated stable hypertensive patients with LVH, and in 11 healthy normotensive control subjects. Interventricular septal (IVS) thickness, posterior wall (PW) thickness, and left ventricular mass index (LVMI) were related to arterial pressure levels and to NE by univariate and multivariate regression analyses. In addition, after 18 months of monotherapy with atenolol (carried out in nine of 20 patients), the relationship between echocardiographic changes and degree of pressure reduction was tested. Before treatment, PW thickness weakly correlated with systolic (r = 0.55; p less than 0.01) and mean (r = 0.50; p less than 0.05) arterial pressure. IVS thickness weakly correlated with NE (r = 0.53; p less than 0.05). On this relatively small sample, multivariate regression analysis showed an association of both IVS thickness (R = 0.57; p less than 0.05) and PW thickness (R = 0.58; p less than 0.05) with mean arterial pressure (MAP) and NE. After atenolol, there was a reduction in IVS thickness (1.15 to 1.02 cm; p less than 0.01), PW thickness (1.08 to 0.99 cm; p less than 0.01), and LVMI (136.3 to 113.8 g/m2; p less than 0.01), besides a significant reduction in blood pressure and heart rate. The degree of pressure reduction induced by treatment did not correlate the change in IVS or PW thickness. In contrast, the change in diastolic and mean arterial pressure positively correlated the change in LVMI (r = 0.72 and r = 0.75, respectively; both p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

White-coat hypertension in adults and children.

The measurement of blood pressure in the clinic triggers an altering reaction and a rise in blood pressure in the patient. Such a reaction is usually defined as a 'white-coat effect' or 'white-coat phenomenon', while the coexistence of persistently high office blood pressure with normal blood pressure outside the medical setting is referred to as 'white-coat' or 'office' hypertension. The white-coat effect can be estimated on a beat-to-beat basis using invasive (intra-arterial) or non-invasive methods, or, more commonly, by measuring the difference between office blood pressure and average daytime ambulatory blood pressure. The white-coat effect has little clinical importance because it is not associated with the target-organ damage and prognosis. We found that cardiovascular morbidities of healthy normotensive controls and subjects with white-coat hypertension did not differ. Results of a prospective study with intra-arterial blood pressure monitoring and preliminary prospective data from another group confirm our findings. A recent analysis of our database suggests that we should use a restrictive definition of white-coat hypertension (for example, average daytime blood pressure <130/80 mmHg) in order to identify the minority of subjects with low probabilities of developing a major cardiovascular event in the subsequent years. Also a recent document by the American Society of Hypertension suggests that one should use restrictive upper normal limits of ambulatory blood pressure (i.e., average daytime blood pressure <135 mmHg systolic and 85 mmHg diastolic). We have found that, over a follow-up period of 0.5-6.5 years, 37% of subjects with white-coat hypertension spontaneously evolve into ambulatory hypertension, with accompanying increase in left ventricular mass. The probability of developing ambulatory hypertension increased with the baseline values of ambulatory blood pressure, not of clinic blood pressure. A final answer on the clinical significance of white-coat hypertension will come from very large surveys of the natural history of this condition in the long term. Authors of these longitudinal studies should also compare the response to drug treatment of these subjects with that to life-style-modification measures.

Adult↗
PubMedDate not supplied

Sleep disorders.

Sleep disorders occupay an important position among the pathologies which may precede the appearance of headache. Some authors consider sleep disorders an expression of a functional, biochemical and/or neurotransmission alteration at central nervous system level. Sleep disorders may be distinguished, according to the Association Sleep Disorders classification in: alteration of the sleep-awake cycle, hypersomnia, parasomnia, insomnia. We observed 1876 normal children ranging from 3 to 14 years of age, 1073 (60.4%) of whom presented sleep disorders. Few studies have been carried out on the incidence of sleep disorders on casistics of healthy children. Date reported in literature state that sleep disorders do not exceed 25% of cases that is not more than one child out of four presents sleep disorders. This percentage is much lower than the 60.4% rate observed by us in children suffering from primary headache. Our results stress the importance of sleep disorders as a cephalalgic risk factor.

Child↗
PubMedDate not supplied

Evaluation of anxiety and depression in childhood migraine.

Childhood migraine can be the expression of an unconscious attempt of the small patient to show a discomfort which is denied through the defence of somatization. We considered a sample of 73 children, 39 males and 34 females suffering from migraine. We evaluated the presence of emotional disorders through diagnostic interviews consisting of one by one submission of the Anxiety Scale Questionnaire for Evolutive Age and the Children Depression Scale Test. Within our sample we are able to distinguish three groups: a first group negative for both anxiety and depressive disorders, thus defined as control group; a second group presenting anxiety depressive disorders and a third one presenting a mostly depressive symptomatology. We found a significantly higher incidence of migraine in male firstborn children belonging to the group with a condition associated to anxiety and depression.

Adolescent↗
PubMedDate not supplied

Migraine with visual aura in developing age: visual disorders.

Visual disorders are an important symptom in the migraine of developing age. Different kinds of visual disturbances can precede, accompany or follow a migraine attack. These visual disturbances can be grouped into negative (hemianopsia, quadrantopsia, scotoma) and positive (phosphene, teicopsia, metamorphopsia, macropsia, micropsia, teleopsia, diplopia, dischromatopsia, hallucination disturbances) disorders. The pathogenetic mechanism of the visual phenomena of migraine has not yet been clarified. Various hypotheses have been proposed: vasospasm with consequent ischemia of some cerebral areas, the opening of arteriovenous shunts between the intra and extra cerebral circulation, the formation of microthrombi in arterioles and dopaminergic hypersensitivity of some nervous centers. We have studied 1787 children, affected by migraine with (13%) or without (87%) aura. Among the patients, 211 (12%) referred visual disorders, especially scotoma and phosphene. These data let us hypothesize that a relationship between migraine and visual disorders is present also in pediatric age. However this relationship is less important than in adults.

Adolescent↗
PubMedDate not supplied

Fever: a novelty among the symptoms accompanying migraine attacks in children.

Our casistic of 1787 children with headache, is made up of 943 males (53%) and 844 females (47%) aged 3-14 years. 1724 had primary headache. To make a precise diagnosis of primary headache, all the children have been subjected to a rigorous anamnesis, physical and diagnostic examination (blood, urine test, head x-rays-scans, sight test with cat's eyes). Symptoms that frequently accompany headache are: phono-photophobia, (47%), pallor (43%) nausea (41%) vomit (31%) intolerance to movement (40%) and fever (9%). We especially focused on fever which presented together with migraine in 156 (9%) of the 1724 subjects examined. Headache is an important syndrome and frequent in early childhood. Actually the hypothesis used to explain the etiopathogenetic mechanism is based on a disregulation of the neurotransmitters like serotonin, catecholamine and the prostaglandins.

Adolescent↗
PubMedDate not supplied

[Acute renal failure, hemolysis and thrombocytopenia].

A 41-year-old male was admitted because of severe systemic hypertension and acute renal failure (ARF) that required hemodialysis (HD). Also present were hemolytic anemia, thrombocytopenia and increased plasmatic levels of aldosterone and reninic activity. The diagnostic tests performed during the recovery led to the conclusion of malignant hypertension. This case dealt with a cause of ARF, which is not currently so common; physicians should be aware of this condition especially when it is present with hemolytic anemia and thrombocytopenia, which are the microangiopathy markers.

Acute Kidney Injury↗
PubMedDate not supplied

Electromicroscopic observations on small vessels in animals treated with sulfinpyrazone and placebo following vascular microsurgery.

To evaluate the antithrombotic effect of sulfinpyrazone on blood vessels (1-2 mm diameter) injured by microsurgical procedures, twenty male rabbits were chosen at random to receive sulfinpyrazone (10 mg/kg/die) or placebo three days prior to and on the morning of vascular microsurgery, which consisted of a complete transverse section, or a longitudinal section 1 cm long, of the femoral artery and vein, followed by interrupted suture. Scanning electron microscopy revealed consistently less fibrin and blood cell adhesion to the endothelial areas adjacent to the surgical trauma in the animals treated with sulfinpyrazone than in those treated with placebo. Our results agree with those reported in the literature, demonstrating the antithrombotic effects of sulfinpyrazone at the level of the vascular endothelium injured by various kinds of trauma and are sufficiently encouraging to justify testing this drug in the prevention of vascular thrombosis following microsurgical procedures in man.

Animals↗
PubMedDate not supplied

[Postpartum depression].

From a review of the literature it emerges that postnatal depression is present in 10-15% of women during the first year after birth. Some studies have showed that a higher percentage of women with problems of depression commit infanticide compared to non-depressed women. A number of studies have been performed to identify the risk factors which may be used to predict postnatal depression during pregnancy; it is important that gynecologists recognise these factors in order to prevent the onset of this pathology during the postnatal period. Another aspect which emerges from the literature is that the absence of social rituals surrounding birth in the industrialised society, in which the transition role of the new mother is not always recognised, may be an important factor in the etiology of postnatal depression.

Depression↗
PubMedDate not supplied

Familial hemiplegic migraine in developmental age: report of two cases.

The authors report two cases of a particular type of migraine with aura, known as familial hemiplegic migraine (FHM). According to the International Headache Society (IHS) diagnostic criteria, the FHM can be diagnosed with the exception of organic causes, in a patient with migraine with aura including emiparesis of anything severity and with an end occurring a member of the family with similarity in the attach pattern. The two clinical cases reported clearly show these features and they can be considered exemplary for this type of pathology. This rare type of migraine has an unknown etiology, it seems to depend on a decreases of cerebral blood flow originative on the occipital lobe, over the subsequentially spreading anteriory region temporal and parietal lobe. The hypoperfusion with the next following neural ischemia is related to the variation of blood flow and/or "the spreading depression" supported by Leao and Olesen recently. We wanted to show these two cases so that the psychiatrist, the pediatrician, and the neurologist can be able to refer parents to the right approach, considering possibility of a pathology rare but benign; this is the FHM.

Adolescent↗