Search PubMed⌕ Search

Biomedical subjects

S Ghione

Publications and source records attributed to S Ghione.

At least 37 records · Page 2Linked to original sources
PubMed1995

Exposure to oscillating magnetic fields influences sensitivity to electrical stimuli. II. Experiments on humans.

To assess the effect of a magnetic treatment on pain perception, we compared the sensory threshold in 18 healthy volunteers. We determined the threshold by noninvasive electrical stimulation of the tooth pulp and skin before and after exposure to an altered magnetic field of low intensity and to a sham treatment. Five different parameters were recorded: the sensory and pain thresholds for the tooth and the sensory, pain, and tolerance thresholds for the skin. Two hours of exposure to a weak, oscillating magnetic fields induced a significant decrease in three parameters (dental sensory and cutaneous pain and tolerance thresholds), whereas the other two parameters showed a similar tendency. When the same subjects were exposed to a sham treatment, only marginal, nonsignificant variations in all parameters were observed. These results represent the first piece of evidence that weak alterations of the magnetic field may induce hyperalgesia in humans.

Adult↗
PubMed1995

Evidence for an endogenous ouabain-like immunoreactive factor in human newborn plasma coeluted with ouabain on HPLC.

The identification in human plasma of ouabain as an endogenous digitalis-like factor (EDLF) claimed by Hamlyn et al. has recently been contradicted by two studies which failed to demonstrate endogenous ouabain-like immunoreactivity in HPLC fractions in which exogenous ouabain was eluted. In this paper we report the results obtained on the cross-reactivity with antiouabain antibodies of an EDLF purified by us from human newborn cord plasma. We found that this EDLF coeluted with ouabain on HPLC and cross-reacted both with rabbit anti-ouabain antiserum and with the purified antibodies, which excluded possible interferences due to antibodies directed against non-ouabain portions of the immunogen. Similar but not identical slopes of the ouabain and EDLF displacements curves were observed in all competition ELISA experiments. The inhibitory effect of EDLF on erythrocyte 86Rb uptake was reversed by antiouabain antiserum and antibodies. The concentration of EDLF in newborn plasma, in the four different purifications studied ranged from 30 to 380 pM ouabain equivalents (o.e.) by ELISA and from 100 to 300 pM o.e. by 86Rb uptake. Our data thus support the existence, in human newborn plasma, of a factor with both biological and immunological ouabain-like properties, although not necessarily identical to ouabain.

Chromatography, High Pressure Liquid↗
PubMed1995

The stimulatory effect on human erythrocyte rubidium-86 uptake by anti-cardiac-glycoside antibodies.

Considerable, but as yet still controversial evidence indicates the presence, in mammalian tissues of endogenous digitalis-like factors (EDLFs) which inhibit cell membrane Na+, K(+)-adenosine triphosphatase (Na+, K(+)-ATPase) and which may cross-react with anti-digitalis antibodies. The aim of this study was to evaluate the effect of antibodies against cardiac glycosides on Na+, K(+)-ATPase in human erythrocytes. For this purpose, we measured the effect of antibodies against two different cardiac glycosides (anti-ouabain rabbit antiserum and anti-digoxin Fab fragments) on the activity of the Na+, K(+)-ATPase, as measured by erythrocyte rubidium-86 (86Rb) uptake, in subjects who had never come into contact with exogenous cardiac glycosides, and compared these results with the effect of two control rabbit sera: a normal serum and an antiserum to a non-related antigen. Anti-ouabain rabbit antiserum and anti-digoxin Fab fragments induced a significantly greater percentage change in 86Rb uptake in the erythrocytes than the two control sera (ANOVA followed by multiple comparison by the Games-Howell test). The average percentage change was +11.8 +/- 16.3% (n = 19) (mean +/- SD) for anti-ouabain antiserum +10.8 +/- 15.6% (n = 23) for anti-digoxin Fab fragments, -1.68 +/- 11.2% (n = 11) for anti-rhGM-CSF antiserum, and -5.8 +/- 11.7 (n = 10) for normal control serum. In a subgroup of ten subjects in whom the 3 antisera were tested simultaneously, the stimulation of erythrocyte 86Rb uptake induced by the two antidigitalis antibodies correlated significantly (r = 0.906, p = 0.001, n = 10).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Diastolic function in the different patterns of left ventricular adaptation to essential hypertension.

Recent reports have shown that four distinct left ventricular anatomical patterns, with different hypertension severity and hemodynamic features, are associated with sustained arterial hypertension (normal anatomy, concentric remodeling, concentric hypertrophy and eccentric hypertrophy). The aim of this study was to evaluate left ventricular diastolic function in these different left ventricular anatomic patterns. To achieve this aim, 94 borderline-to-severe essential hypertensive patients (60 never treated before, 34 off treatment for at least 3 weeks before the study) underwent an echo-Doppler study; left ventricular thickness, dimension and mass index were obtained. Early (E) and late (A) transmitral flow velocity, their ratio (A/E) and the early filling fraction (EFF) were obtained by pulsed-wave Doppler and used as left ventricular diastolic function indexes. Differences between groups were evaluated by one-way ANOVA followed by Scheffe F-test. A normal left ventricular anatomy was found in 41 (44%), concentric remodeling in 17 (18%), concentric hypertrophy in 21 (22%) and eccentric hypertrophy in 15 (16%) patients. Early filling fraction and A/E ratio which resulted were significantly different for the groups (P < 0.001 and P < 0.002, respectively). As compared with the group with normal left ventricle, patients with concentric hypertrophy had significantly EFF and those with eccentric hypertrophy had significantly lower EFF and higher A/E ratio. Our results thus confirm the presence of distinct anatomical left ventricular adaptation patterns in arterial hypertension.(ABSTRACT TRUNCATED AT 250 WORDS)

Adaptation, Physiological↗
PubMed1994

Echo Doppler diastolic function and exercise tolerance.

OBJECTIVE: To investigate the possible association between Doppler left ventricular filling pattern and exercise capacity in a group of normotensives to severe hypertensive patients. BACKGROUND: Invasive left ventricular filling indexes evaluated at rest are reported to be related to exercise capacity in heart failure. Whether exercise capacity is limited by abnormalities of left ventricular filling also in other less severe conditions is however unclear. METHODS: Fifty-one subjects with normal to severely elevated blood pressure underwent a standard exercise test on cycle ergometer, negative for myocardial ischemia, and a complete echo Doppler evaluation showing a basal systolic function within normal limits. RESULTS: Basal systolic function indexes were not significantly related to exercise duration. On the contrary, exercise duration was highly significantly correlated to the relative atrial contribution to left ventricular filling (0.001 < P < 0.05), in both the overall group and the two subgroups in whom exercise was interrupted because of fatigue (n = 30) or because of attaining target heart rate (n = 21). Significant correlations were also observed between exercise time and resting blood pressure, whereas no association with resting heart rate, age and body surface area was found. Exercise time also correlated to left ventricular mass and mass index but not to left ventricular volume. Multiple regression analysis showed that exercise tolerance was significantly related to diastolic blood pressure and left ventricular filling. Echo Doppler indexes of left ventricular filling are associated with exercise duration; left ventricular diastole could thus influence effort tolerance, not only in patients with cardiac insufficiency, but also in subjects with normal to elevated blood pressure levels and normal systolic function at rest.

Blood Pressure↗
PubMed1994

Insulin resistance and vasodilation in essential hypertension. Studies with adenosine.

Insulin-mediated vasodilation has been proposed as a determinant of in vivo insulin sensitivity. We tested whether sustained vasodilation with adenosine could overcome the muscle insulin resistance present in mildly overweight patients with essential hypertension. Using the forearm technique, we measured the response to a 40-min local intraarterial infusion of adenosine given under fasting conditions (n = 6) or superimposed on a euglycemic insulin clamp (n = 8). In the fasting state, adenosine-induced vasodilation (forearm blood flow from 2.6 +/- 0.6 to 6.0 +/- 1.2 ml min-1dl-1, P < 0.001) was associated with a 45% rise in muscle oxygen consumption (5.9 +/- 1.0 vs 8.6 +/- 1.7 mumol min-1dl-1, P < 0.05), and a doubling of forearm glucose uptake (0.47 +/- 0.15 to 1.01 +/- 0.28 mumol min-1dl-1, P < 0.05). The latter effect remained significant also when expressed as a ratio to concomitant oxygen balance (0.08 +/- 0.03 vs 0.13 +/- 0.04 mumol mumol-1, P < 0.05), whereas for all other metabolites (lactate, pyruvate, FFA, glycerol, citrate, and beta-hydroxybutyrate) this ratio remained unchanged. During euglycemic hyperinsulinemia, whole-body glucose disposal was stimulated (to 19 +/- 3 mumol min-1kg-1), but forearm blood flow did not increase significantly above baseline (2.9 +/- 0.2 vs 3.1 +/- 0.2 ml min-1dl-1, P = NS). Forearm oxygen balance increased (by 30%, P < 0.05) and forearm glucose uptake rose fourfold (from 0.5 to 2.3 mumol min-1dl-1, P < 0.05). Superimposing an adenosine infusion into one forearm resulted in a 100% increase in blood flow (from 2.9 +/- 0.2 to 6.1 +/- 0.9 ml min-1dl-1, P < 0.001); there was, however, no further stimulation of oxygen or glucose uptake compared with the control forearm. During the clamp, the ratio of glucose to oxygen uptake was similar in the control and in the infused forearms (0.27 +/- 0.11 and 0.23 +/- 0.09, respectively), and was not altered by adenosine (0.31 +/- 0.9 and 0.29 +/- 0.10). We conclude that in insulin-re15-76sistant patients with hypertension, adenosine-induced vasodilation recruits oxidative muscle tissues and exerts a modest, direct metabolic effect to promote muscle glucose uptake in the fasting state. Despite these effects, however, adenosine does not overcome muscle insulin resistance.

Adenosine↗
PubMed1994

Cardiac morphology and function in arterial hypertension. The effects of a new multifactorial hypotensive agent: urapidil.

It has been recognized as increasingly important to determine whether antihypertensive agents, while satisfactorily lowering the blood pressure, at the same time adversely or positively affect the cardiac hemodynamic profile. On theoretical grounds, one would expect that an ideal hypotensive drug should decrease blood pressure by decreasing total peripheral resistances, without affecting cardiac output, and should normalize left ventricular hypertrophy without deteriorating systolic or diastolic left ventricular function. We here briefly review the effects of urapidil on these variables in patients under chronic treatment investigated in a series of studies employing echocardiography. The results of the studies are in fair agreement and indicate a blood pressure decrease already after one month of treatment, due to a decrease of peripheral resistances, without changes in heart rate. A clear trend towards a reduction of cardiac hypertrophy during the treatment is suggested by the significant decrements of the indices measured. One study also suggests that right ventricular wall thickness may be reduced. Left ventricular dimensions remained unchanged in all except one study. Systolic and diastolic function indices were also unchanged during the first 6 months of treatment and, in one study, improvement was found after 12 months of treatment. Taken together these results suggest that urapidil lowers blood pressure favorably, affecting cardiac morphology and function.

Antihypertensive Agents↗
PubMed1994

Relationship between increased blood pressure and hypoalgesia: additional evidence for the existence of an abnormality of pain perception in arterial hypertension in humans.

An association between hypertension and decreased pain perception (hypoalgesia) has been shown in experimental hypertension and confirmed in humans by electrical tooth pulp stimulation. The aim of this study was to confirm, using two other techniques, whether hypertension is associated with hypoalgesia in humans. In 77 untreated essential hypertensive outpatients, 37 normotensive outpatients and 27 normotensive volunteers subjective cutaneous sensitivity was assessed by an electrical stimulator. Thirty-three measurements were repeated after one month. In addition, in eight normotensive volunteers and eight hypertensives the thresholds of the polysynaptic components R2 and R3 of the blink reflex to electrical stimulation of the supraorbitalis nerve were evaluated. Tooth pulp stimulation was done in 85 of the subjects who measured cutaneous sensitivity and in all of the blink reflex study. Cutaneous perceptive, pain and tolerance thresholds were significantly higher in the hypertensives compared with both normotensive groups, with no significant difference between these two. The results were identical when age and sex-matched subgroups were compared and a high reproducibility was found for all three parameters. Similar findings were obtained for the tooth pulp thresholds and highly statistically significant correlations were found between cutaneous and tooth pulp sensitivity and between these indices and blood pressure. The thresholds of R2 and R3 were also significantly higher in the hypertensives and a significant correlation was found between R3 threshold and diastolic pressure. These results confirm that hypertension is associated to hypoalgesia in humans.

Adult↗
PubMed1993

Captopril radionuclide test in renovascular hypertension: a European multicentre study. European Multicentre Study Group.

The diagnostic work-up of renovascular hypertension is still controversial. The efficacy of renal scintigraphy with technetium-99m diethylene triamine pentaacetate (DTPA) before and after captopril (scintigraphic captopril test) was evaluated in a multicentre study. All 380 hypertensive patients in the study underwent renal arteriography; 125 had renal arterial stenosis > or = 70%, and 54 had a technically successful intervention to correct the stenosis. The post-captopril study had a sensitivity of 93% and a specificity of 100% for predicting blood pressure response to intervention, if renal function was normal and a combination of quantitative parameters was applied (individual kidney uptake index < 40%, time to peak activity < 2 min or > 10 min). In the entire population renal artery stenosis > or = 70% was detected with a sensitivity of 83% and a specificity of 93% if renal function was normal. In patients with abnormal renal function the performance of the test was worse, owing to a lower specificity which could be increased by using only time parameters. The performance of the test was optimal when the post-captopril findings were examined; no improvement was achieved by evaluation of the changes induced by captopril from the baseline. The test can thus be simplified by performing only a post-captopril study for routine use: a negative test would exclude a curable form of renovascular hypertension in > 80% and a positive test would predict it in > 90% of the patients selected for suspicion of the disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Endogenous digitalis-like activity in the newborn.

Elevated levels of endogenous digoxin-like immunoreactivity have been reported in the body fluids of premature and full-term infants as well as in term pregnancy, in the amniotic fluid, and in human milk. Several lines of evidence suggest that these factors could also have biological properties in common with digitalis: i.e., they could represent truly endogenous digitalis-like factor(s). In recent years we succeeded in partially purifying this factor from umbilical cord blood, which represents an easily available source of this factor. The inhibitory activity of this factor on 86Rb uptake could be neutralized by antidigoxin antibodies (Fab fragments) and provided, for the first time, direct evidence of an association between digoxin-like immunoreactivity and biological digitalis-like activity. In addition, these antibodies could be used for immunoaffine chromatography as a purification step before separation by high-performance liquid chromatography. Preliminary experiments suggest that this endogenous compound has both a tissue and an isoenzyme selectivity and is not a well-known steroid (testosterone, progesterone, 17-OH progesterone, cortisol, dehydroepiandrosterone sulfate, and estradiol).

Animals↗
PubMed1993

Evidence of marked digoxin-like immunoreactivity in the human adrenal cortex: results of an immunohistochemical study.

Several lines of evidence suggest the existence, in mammalian body fluids and tissue extracts, of an as yet unidentified endogenous digitalis-like factor with potential cross-immunoreactivity with digitalis. Using anti-digoxin antibodies, we found preliminary immunohistochemical evidence of digoxin-like immunoreactivity in several human tissues. Strong reactivity was found in the adrenal cortex, which may thus represent a site of production of this endogenous factor.

Adrenal Cortex↗
PubMed1992

Effects of chronic angiotensin converting enzyme inhibition on glucose tolerance and insulin sensitivity in essential hypertension.

The relation between the renin-angiotensin-aldosterone (RAA) system and carbohydrate metabolism and insulin sensitivity in essential hypertension has not been investigated systematically. Twenty nondiabetic patients (age, 49 +/- 1 years; body mass index (BMI), 26.1 +/- 0.4 kg/m2) with essential hypertension (blood pressure, 155 +/- 3/105 +/- 1 mm Hg) received an oral glucose tolerance test (OGTT) at the end of a 1-month placebo period and again monthly during 3 months of angiotensin converting enzyme (ACE) inhibition (cilazapril, 5 mg/day). Furthermore, a two-step euglycemic insulin clamp was performed after placebo and again at the end of treatment. Blood pressure fell by 7 +/- 4/10 +/- 3 mm Hg (p less than 0.001), while BMI remained stable. On the euglycemic clamp, insulin-mediated (plasma insulin, 470 pM) whole body glucose use averaged 42.5 +/- 1.6 mumol.min-1.kg-1 before and 43.6 +/- 1.9 after ACE inhibition (p = NS). Substrate concentrations and oxidative rates and energy expenditure (as estimated by indirect calorimetry) were not altered by ACE inhibition, either in the fasting state or in response to insulin. In contrast, oral glucose tolerance was significantly (p less than 0.05) improved after treatment (area under OGTT curve (AUC), 240 +/- 24 versus 282 +/- 23 mmol 2 hr.l-1). The latter change was associated with enhanced (+16%, p less than 0.05) insulin responsiveness to glucose (estimated as the insulin AUC divided by the glucose AUC) throughout the 3 months of ACE inhibition. At baseline, both the OGTT and the clamp had a marked hypokalemic effect (mean decrements in plasma potassium of 0.75 +/- 0.05 and 0.92 +/- 0.05 mmol/l, respectively) in association with plasma aldosterone reductions of 30% and 50%. Chronic ACE inhibition caused a further 20% (p less than 0.03) lowering of plasma aldosterone concentrations but attenuated insulin-induced hypokalemia. Plasma sodium, which was unaltered by the pretreatment tests, fell during the posttreatment tests (by 3 mmol/l, p less than 0.001). In the urine, the ratio of the fractional excretion of potassium to that of sodium was decreased by both oral glucose (-22%, p less than 0.01) and ACE inhibition (-21%, p less than 0.001). Higher plasma potassium levels before treatment predicted a better blood pressure response to ACE inhibition (r = 0.60, p less than 0.005).(ABSTRACT TRUNCATED AT 400 WORDS)

Administration, Oral↗
PubMed1992

[Relationship of Doppler indexes of left ventricular filling and exertion tolerance].

The aim of this study was to evaluate if Doppler indexes of left ventricular filling are related to exercise capacity. Since a correlation between left ventricular filling pattern and causal blood pressure has been recently reported along a wide range of pressure values, a group of subjects with blood pressure ranging from normal to severely elevated values was studied. Twenty-four subjects (11 normotensives, 13 mild to severe hypertensive patients) underwent an echo-Doppler study and a maximal multistage cycloergometric exercise test. Since the cycloergometric test was limited by fatigue or dyspnea in all subjects, exercise duration was used as an effort tolerance index. Echocardiographic indexes of systolic function resulted normal in all subjects. Significant relationships with exercise duration were found for several indexes of left ventricular filling (A peak: r = -.743, p < .0001; A/E ratio: r = -.606, p < .005; early filling fraction: r = .639, p < .001). Exercise time was also significantly related to casual blood pressure, both systolic and diastolic. The relationships between transmitral blood flow and exercise capacity seem to indicate that an impairment of ventricular relaxation (as indicated by the progressive increase of atrial contribution) is associated with a decreased exercise tolerance, possibly because a progressively lower activation of Frank-Starling mechanism. Diastolic function thus seems to be able to affect exercise tolerance even in subjects with normal systolic function and blood pressure ranging from normal to severely elevated values.

Adult↗
PubMed1992

[The structural aspects of the pharmacological activity of calcium antagonists. A general profile and the results of a pilot study of nicardipine].

The authors examine the most recent findings on arterial hypertension with particular emphasis to morphological changes of the arterial wall and to the results of nicardipine treatment in spontaneous hypertensive rats (SHR). According to these assumptions the authors evaluate the effects of nicardipine on the microvascular network by means of a funduscopic examination in 8 hypertensive patients. The preliminary data suggest that nicardipine has a positive structural and morphological effect on the vessel network.

Delayed-Action Preparations↗