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Biomedical subjects

R Castello

Publications and source records attributed to R Castello.

At least 73 records · Page 4Linked to original sources
PubMed1990

The value of exercise testing in patients with coronary artery spasm.

To analyze the usefulness of a single exercise test to predict the presence of fixed obstructive coronary artery disease in patients with active coronary spasm, 91 consecutive patients with angiographically proven symptomatic coronary artery spasm who had performed a symptom-limited exercise test within the week before diagnostic coronary angiography were studied. Coronary angiography revealed significant coronary obstructions in 61 patients (67%). According to the type of angina, the prevalence of significant coronary stenosis was 53% for patients with angina at rest, 68% for those with effort angina, and 92% for those with mixed angina. Exercise-induced ST segment elevation was present in eight patients (9%), ST segment depression was seen in 37 patients (41%), and no ST abnormalities in 46 (50%). There was not a significant relationship between the ST segment response to exercise and the clinical variables assessed except for coronary anatomy. Abnormal exercise test results were significantly more frequent in patients with significant coronary obstructions than in those without significant coronary occlusions (62% versus 23%; p less than 0.01). ST elevation was not useful to predict the presence of fixed coronary lesions. However, ST depression strongly suggested the presence of underlying coronary lesions with a sensitivity of 54%, a specificity of 87%, and a positive predictive value of 89%. Using this criterion, 65% of the patients were correctly classified. The results indicate that despite the functional component of ischemia in patients with coronary spasm, ST segment depression with exercise is still a highly specific sign with a high positive predictive value for the presence of significant coronary artery disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

Safety and utility of transesophageal echocardiography in the critically ill patient.

We studied the safety and utility of transesophageal echocardiography in the evaluation of critically ill patients in the intensive care unit setting. Sixty-two studies were performed in four different intensive care units on 61 patients with a mean age of 58 +/- 14 years (range 25 to 78 years). Indications for the study included suspected aortic pathologic conditions (18 patients), cardiac source of embolus (16 patients), postmyocardial infarction complications (6 patients), and suspected infective endocarditis (5 patients). Studies were performed at bedside with the use of small amounts of intravenous sedatives. The probe was passed successfully in 61 of 62 attempts. Diagnoses that were missed by surface echocardiography, including aortic dissection, left atrial thrombus, ruptured papillary muscle, and prosthetic valve vegetation were clearly identified by transesophageal echocardiography, which facilitated appropriate management in these cases. In cases in which no pathologic condition was identified, transesophageal echocardiography was useful in ruling out intracardiac shunt, in assessing left ventricular function, and in excluding significant valvular pathologic conditions. No serious complications were recorded, and the procedure was, in general, very well tolerated.

Adult↗
PubMed1989

[Clinical and hemodynamic effects of medium-term ketanserin treatment in 2 compared groups of obese and non-obese hypertensive patients].

We evaluated systemic and central hemodynamics in 10 lean hypertensives and in 10 obese hypertensives (WHO stage I-II) after 8 weeks treatment regimen with a serotoninergic antagonist such as ketanserin. At the beginning and at the end of the study, body weight, BMI, blood pressure and heart rate were measured and a first pass radionuclide angiocardiography was performed to determine cardiac output, cardiac index and ejection fraction of left ventricle. Total peripheral resistances were also calculated. In both hypertensive groups ketanserin significantly reduced diastolic (p less than 0.05) and mean (p less than 0.005) blood pressure. No significant change in systolic blood pressure, cardiac output, cardiac index and ejection fraction of left ventricle has been observed in lean and obese hypertensives. Total peripheral resistance values significantly (p less than 0.05) decreased in lean hypertensives; in obese hypertensives total peripheral resistance moderately reduced. Our results indicated that monotherapy with ketanserin is effective in treating mild to moderate hypertension both in lean and in obese hypertensives and did not interfere with left ventricular performance. At last the effectiveness of ketanserin treatment appears moderately higher in lean than in obese hypertensives.

Adult↗
PubMed1986

Synthesis and antiulcer activity of (E)-5-[2-(3-pyridyl)ethenyl]-1H,7H-pyrazolo [1,5-a]pyrimidine-7-ones.

A series of (E)-5-[2-(3-pyridyl)ethenyl]-1H,7H-pyrazolo-[1,5-a]pyrimidine-7-ones were synthesized and evaluated for the inhibition of stress-induced gastric ulcers in the rat after oral administration. Several molecules were found to be very active. The particularly interesting compound (E)-1-(3-chlorophenyl)-5-[2-(3-pyridyl)ethenyl]-1H,7H-pyrazolo[1,5-a]- pyrimidine-7-one was chosen for wider pharmacological investigation.

Animals↗
PubMed1985

Glomerular monocyte infiltration in human nephropathies: prevalence and correlation with clinical and morphological variables.

Glomerular monocyte infiltration was evaluated by histochemical means (nonspecific esterase) and/or electron microscopy in 305 renal biopsies belonging to a wide variety of human renal diseases. Significant monocyte infiltration was never observed in a first group of nepropathies (minimal change disease, nephrotic syndrome with IgM deposits, focal segmental glomerulosclerosis, membranous GN, Berger's GN, healed GN, dense deposit disease, chronic non specific GN, benign familial haematuria, Alport's disease, renal amyloidosis, arteriosclerotic kidney, light chain GN). Conversely, it was present at varying frequency in a second group of nephropathies including: acute GN (58.3%), persistent GN (10%), membranoproliferative GN (25.2%), eryoglobulinaemic GN (82.6%), lupus GN (36%), extracapillary proliferative GN (50%) and Schoenlein-Henoch GN (40%). The results indicate: 1) there is an evident association between monocyte infiltration and the subendothelial site of deposits; 2) the presence of monocytes is not affected by the size and extension of subendothelial deposits; 3) monocytes were more frequently observed when IgG, IgM and fibrinogen were present in the subendothelial deposits, Conversely, complement fractions do not seem to affect monocytic activity; 4) polymorphonuclear leukocyte exudation is less frequently found and mostly associated with monocyte infiltration; 5) in some GNs (persistent GN, cryoglobulinaemic GN and membranoproliferative GN), proteinuria was significantly higher in patients with than in those without monocyte infiltration, giving support to the hypothesis that in human beings as in experimental animals monocytes play a role in the pathogenesis of proteinuria.

Biopsy↗
PubMed1985

Bicyclic compounds with potential antiulcer and/or antisecretory activity. I. 4,5,6,7-Tetrahydrobenzimidazoles.

The remarkable antiulcer and antisecretory activity of some previously described 4,5,6,7-tetrahydroimidazo[4,5-c]pyridine derivatives prompted us to further investigate related bicyclic systems. Accordingly, a series of 5-amino- and 5-aminomethyl-4,5,6,7-tetrahydrobenzimidazoles, regiospecifically alkylated in position 1, were synthesized and tested. Only a few 1-ethyl-5-amino derivatives displayed a reasonable antiulcer activity in comparison with our former class of compounds.

Animals↗
PubMed1985

Essential mixed cryoglobulinemic glomerulonephritis associated with diabetic glomerulosclerosis. Light, immunofluorescence, and ultrastructural study of two cases.

The association of cryoglobulinemic glomerulonephritis with diabetic glomerulosclerosis is reported in two patients. Renal pathology was investigated by light and electron microscopy and by immunofluorescence on biopsy material from both patients and on autopsy material (obtained a few hours after death) from one patient. Glomerular involvement due to cryoglobulins preceded the development of diabetic glomerulosclerosis in one patient. This contrasts with what has been reported in the literature, where various types of glomerular lesions are reported to be superimposed on overt and often long-lasting diabetic glomerulopathy. Though the association may be coincidental, the immune complexes (cryoglobulins) may have accelerated the formation of the nodular hyaline diabetic lesions in the mesangium through a mesangiolytic process.

Cryoglobulinemia↗
PubMed1985

In vivo localization of C3 on the brush border of proximal tubules of kidneys from nephrotic patients.

Deposits of C3 but not of C1q and C4 were detected on the proximal tubules of kidneys from nephrotic patients with non-selective proteinuria. The incidence of tubular C3 deposits was significantly higher in patients with membranous glomerulonephritis, focal glomerulosclerosis, membrano-proliferative glomerulonephritis and non-selective proteinuria than in patients with minimal change disease, nephrotic syndrome and selective proteinuria or in patients with glomerular disease, but without nephrotic syndrome. The occurrence of tubular C3 deposits was positively correlated with the amount of urinary C3 excretion. In vitro studies showed that the human normal kidney as well as pathologic specimens negative for in vivo tubular C3 deposits were able to bind C3 on the brush border of proximal tubules when incubated with fresh heterologous serum. In contrast, in patients with non-selective proteinuria and in vivo tubular C3 deposits, the binding of heterologous C3 to the brush border of proximal tubules was markedly reduced. The positive correlation between the occurrence of tubular C3 deposits and the urinary complement excretion, together with the detection of the C3 breakdown products in the urines further supported the hypothesis that complement components, once filtrated through the glomerular barrier, might be activated by the brush border of the proximal tubule.

Adolescent↗
PubMed1984

New derivatives of pyrrolo and pyrido[2,1-b] quinazoline as antiulcer agents.

A series of 3-benzylidene-1,2,3,9-tetrahydro-9-oxopyrrolo-[2,1-b] quinazolinecarboxylic acids and 6-benzylidene-6,7,8,9-tetrahydro-11-oxo-11H-pyrido[2,1-b] quinazolinecarboxylic acid was synthesized and evaluated for their antiulcer activity by the test of inhibition of restraint ulcers in the rat, and for gastric antisecretory activity using the technique of Shay. Some compounds appear potentially useful for therapeutic application.

Animals↗
PubMed1984

Detection of monocytes and evaluation of their role in human glomerular pathology: the contribution of electron microscopy.

The potentialities of electron microscopy in detecting monocytes in human glomeruli are discussed and its reliability is compared with that of other techniques (such as enzyme histochemistry and immunohistochemistry) having the same purposes. The major advantages of electron microscopy are: the same material can be used for both monocyte detection and conventional diagnostic purposes; its high resolution power allows for information on the site of monocyte infiltration and clarification of some functions of the latter (such as the phagocytic activity on immune complexes or their participation to the basement membrane damage). Nevertheless, the suggested technique also has some disadvantages, in particular it permits to investigate only a small number of glomeruli and it creates difficulties in the identification of nonstimulated monocytes.

Glomerulonephritis↗
PubMedDate not supplied

In vivo and in vitro studies on the mechanism and clinical significance of spontaneous echocardiographic contrast in patients with atrial dysrhythmias.

The pathogenesis of spontaneous echocardiographic contrast (SEC) is complex and multifactorial. Although originally described in low-flow state situations such as in the left atrium of patients with mitral stenosis or in the false lumen of patients with aortic dissection, its detection is highly dependent on technical factors such as the frequency of the transducer used. Multiple blood components have been implicated in SEC formation and erythrocyte aggregation currently appears to be the most likely mechanism. SEC is related to atrial fibrillation and is commonly found in patients with thrombus or prior history of thromboembolism. In addition, it may represent a prognostic marker for patients with atrial fibrillation because patients with SEC have a higher incidence of subsequent thromboembolic events. Therapeutic options include anticoagulation and, perhaps, antiplatelet therapy. Further prospective studies are necessary to better define SEC pathogenesis and treatment.

Arrhythmias, Cardiac↗
PubMedDate not supplied

How does QIP (quality improvement process) work with the JCAHO monitoring and evaluation process?

In summary, the Joint Commission is in the process of adopting the concept of continuous quality improvement as the basis of operation, both internally and externally. This will translate into a mandatory shift by hospitals from using traditional Joint Commission guidelines to the incorporation of the QIP model of continuous quality improvement. Proof of this direction is found in the Joint Commission's Beta Testing program.

Data Collection↗
PubMedDate not supplied

Immunohistochemical localization of 11-hydroxysteroid dehydrogenase in rat kidney with monoclonal antibody.

Monoclonal antibody (MAb) against 11-hydroxysteroid dehydrogenase (11-HSD) has been raised by immunization of female balb/c mice. 11-HSD from solubilized rat renal microsomal protein could be bound in a modified ELISA using antimouse IgG and MAb against 11-HSD. On Western blots of solubilized rat renal microsomes the MAb recognized a single protein band of an approximate molecular weight of 35 kD. Immunohistochemical staining of rat renal tissue with the above MAb and the APAAP staining technique displayed a heterogenous reginal and subcellular distribution: glomeruli and arterioles were practically devoid of specific staining, as were epithelial cells in inner and outer medulla. Intense immunostaining was observed in PCT and particularly in PST, appearing granular with highest density around the nuclei. Here the enzyme bound to intracellular membranes may exert an autocrine function such as signal inactivation. In contrast to cortex, staining of interstitial cells was observed in renal medulla. The latter localization is compatible with the concept of a paracrine function of 11-HSD which might prevent corticosterone from gaining access to collecting duct cells.

11-beta-Hydroxysteroid Dehydrogenases↗