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Biomedical subjects

S Sensi

Publications and source records attributed to S Sensi.

At least 109 records · Page 6Linked to original sources
PubMedDate not supplied

Hyperinsulinaemia in hypertension and diabetes mellitus: a chronobiological approach.

Blood pressure was continuously recorded for 24 h in 31 non-insulin-dependent diabetic men with borderline, mild, or moderate systolic and/or diastolic hypertension. A 2-h oral glucose tolerance test was also performed with blood glucose, serum insulin and C-peptide determination at 30-min intervals. Significant correlations were found between fasting and post-glucose integrated area of blood glucose, insulin and C-peptide concentrations versus blood pressure measures. Total insulin area appeared to correlate significantly with diastolic measures [casual, daytime, night-time, mean computational (mesor), hyperbaric impact and percent time elevation], mean blood pressure, and mesor and hyperbaric impact systolic measures. It is concluded that the more accurate assessment of the circadian pattern of blood pressure by a chronobiological procedure allowed the existence of close correlations between metabolic and blood pressure measures to be established, confirming the importance of hyperinsulinaemia in the pathophysiology of arterial hypertension.

Blood Glucose↗
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Morning sudden cardiac death.

A circadian variation of cardiac function with peak in the early morning was documented about twenty years ago. A circadian rhythm of platelet aggregability, in the same time of the day, was demonstrated in healthy young male subjects. The morning hours were also reported as crucial for sympathetic nervous system activity, for heart rate variability, and for the abrupt rise in blood pressure. Altogether, these trigger factors may explain the high incidence of sudden cardiac death during the morning. In the primary prevention of sudden death in patients with high cardiovascular risk, many strategies were proposed, such as implantable cardioverter-defibrillators, antiarrhythmic and antihypertensive therapies, particularly beta-blockers and more recently, aspirin. Also in subjects without cardiovascular risk factors, it is predictable that early and continuous administration of low-dose aspirin, by inhibiting platelet aggregation and thrombin formation, particularly in morning hours, may represent an effective therapy for the prevention of myocardial infarction and morning sudden cardiac death.

Journal Article↗
PubMedDate not supplied

Chronic fatigue syndrome: circadian rhythm and hypothalamic-pituitary-adrenal (HPA) axis impairment.

Chronic Fatigue Syndrome (CFS) is a clinical condition characterized by a persistent or relapsing debilitating fatigue at rest, lasting more than 6 months, and made worse by exercise. At the present moment, there are three potential etiopathogenic factors: immunologic, viral and neuroendocrine. The purpose of our study was to evaluate possible alterations of the hypothalamic-pituitary-adrenal (HPA) axis in our CFS patients by studying the circadian rhythms of prolactin (PRL), thyrotropic hormone (TSH), adrenocorticotropic hormone (ACTH), and cortisol (CS). A total of 36 patients were enrolled according to the Centers for Disease Control and Prevention case-definition criteria. Twenty healthy subjects were included as controls. Blood samples were taken every 4 hours during a single 24-hour period. We performed a fluorometric enzyme immunoassay with serum PRL, cortisol and TSH, and an immunoradiometric assay with plasma ACTH. The circadian rhythms of PRL, TSH, ACTH and CS were statistically significant in both CFS and control groups. At 24:00 and 04:00 hrs the CFS patients showed lower ACTH levels than healthy subjects (p < 0.001); the PRL levels were higher at 04.00 h in CFS patients than in healthy subjects.

Journal Article↗
PubMedDate not supplied

Non insulin-dependent diabetes mellitus (type 2) secondary failure. Metformin-glibenclamide treatment.

The goal of sulphonylurea (S) treatment in Non-Insulin-Dependent Diabetes Mellitus (NIDDM - type 2 diabetes) subjects should be to obtain a satisfactory glycemic control (fasting glycemic levels < 140 mg%). The loss of an adequate blood glucose control after an initial variable period of S is known as secondary failure (SF). The number of SF are extremely variable among different trials for many reasons, some of which are patient-related: increased food intake, weight gain, non-compliance, poor physical activity, stress, diseases and÷or impaired pancreatic beta cell function, desensitization after S chronic therapy, reduced absorption, concomitant therapies. Many therapeutic strategies have been proposed to achieve an adequate metabolic control in type 2 diabetes patients: switch to intensive insulin therapy and subsequent return to S therapy; association with insulin; association with sulphonylureas plus biguanides. The association biguanides and S, in particular glibenclamide plus metformin, is now widely used by diabetologists in SF since glibenclamide improves insulin secretion while metformin exerts its antidiabetic.

Journal Article↗
PubMedDate not supplied

Zafirlukast versus budesonide on bronchial reactivity in subjects with mild-persistent asthma.

Asthma is one of the most common chronic diseases in children and adults. Recent studies have shown that in asthmatic patients treated with inhaled corticosteroids there is a better disease’s control when adding a second drug, than increasing the corticosteroid’s dose. The aim of this study has been to evaluate the effectiveness and tolerance of zafirlukast, a leukotriene receptor antagonist, versus budesonide in clinically steady patients with mild persistent bronchial asthma. We have enrolled 36 subjects non smokers, with mild persistent bronchial asthma and 12 healthy subjects as control group. At the beginning of this study and at the end of the treatment (8 weeks), all patients underwent complete clinical work-up, pulmonary function testing (FEV1, PEF and FVC) and methacholine challenge test. The patients were divided into 3 groups: group A) 20 mg of zafirlukast twice a day; group B) 400 mg of budesonide twice a day; group C) 20 mg of zafirlukast twice a day and 400 mg of budesonide twice a day. Basal FEV1 and PEF presented no significant statistical differences between control subjects and patients of group A, B and C. After eight weeks there were no significant changes for FEV1 and PEF among the three groups. After therapy a strong significant increase of PD20 was documented in group A (p<0.005), group B (p<0.001) and group C (p<0.005), respect to baseline values. The antileukotriene drugs could be taken as an alternative drug, or in association with low-dose inhaled corticosteroids, in patients with mild persistent asthma, both for their clinical effectiveness and their easy ingestion, which is confirmed in compliance studies on inhaled steroids.

Journal Article↗
PubMedDate not supplied

[Teaching assessment in recruitment of university teaching staff].

When a university teacher is recruited, should his capacity for teaching as well as his scientific maturity be evaluated? If this is the case, how must this assessment be carried out? With regard to the first question, despite the fact that present-day official requirements seem unclear and confusing, for some years now declarations from the Consensus Conference of the World Federation for Medical Education (WFME) leave no doubt that assessment of teaching capacity should constitute a basic requisite for the appointment of teachers and their future career. The fifth declaration of WFME is quite clear about the need to train teachers to be educators and not only experts in their various disciplines, to ratify teaching capacities on par with capacities shown in biomedical research and medical practice. The WFME's recommendations, on the other hand, provide no useful elements for formulating the criteria by which to assess candidates' teaching capacities. The tables given therefore refer not to official documents, but to studies worked out by experts. In the first table regarding criteria for global assessment of candidates, it is easy to observe that teaching capacity is strongly penalized with respect to professional maturity. In the second grid, which is specific for teaching capacities, more precise criteria are suggested to characterize a teaching profile in various ways, such as finishing and updating experience in ateliers, familiarity with teaching instruments, use of articulated teaching methods and the possibility of assessment by students through questionnaires.

Evaluation Studies as Topic↗
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[Relationship between eating behavior and distribution of body fat].

In these recent few years the study of the pathogenesis of obesity include the observation of the difference in eating behaviour between obese and non obese subjects. Therefore, current therapies now take into account, among others, also a program of behavioural therapy. On the other hand, recent studies have revealed the role of different body fat distribution on the obesity prognosis, especially considering cardiovascular risk factors. To this purpose much attention has been focused on the measurement of waist and hips circumferences and their ratio (WHR) considered important predictors of risk associated with obesity. Aim of this study was the observation of some differences in eating habits and psychological status during a 24-hr period in relationship with the android or gynecoid type of obesity. 102 outpatients were divided in two groups: 1) with WHR less than 0.85; 2) with WHR greater than or equal to 0.85. All subjects were given a questionnaire in which by a scale from 0 to 3 they expressed their appetite sensation during different hours of the day. In addition, they indicated their motivation to loose body weight. Our results demonstrated that subjects with WHR greater than or equal to 0.85 showed higher appetite sensation, during the whole day, with a peak at lunch, in comparison with subjects with WHR less than 0.85. Subjects with gynecoid type of obesity seemed to pay much attention to their body image than subjects with android type of obesity and complained less physical disorders than subjects of the second group. These preliminary data seem to suggest a non-secondary role of behavioural pattern in obesity also by affecting the different regional fat distribution.

Adipose Tissue↗
PubMedDate not supplied

Circadian rhythm of albumin excretion rate in healthy subjects.

Many studies have reported the predictive role of unphysiological levels of microalbuminuria for the development of diabetic nephropathy. It is known that physiological levels of 24-h microalbuminuria do not exceed 20 micrograms/min (28.8 mg/day), but a few data are available for shorter periods. Since an accurate 24-h urine collection is difficult to obtain in screening programs, it seems important to study whether a circadian oscillation exists and, if so, to find more precise reference values. Eleven healthy subjects (mean age 30.6 +/- 2.46 years) with normal glucose tolerance and no family history of diabetes mellitus or nephropathy were studied during the usual routine activity. Urines were collected 6 times at 4-h intervals. It was possible to document the existence of a statistically significant circadian rhythm with the following parameters: MESOR 6.95 +/- 0.49 micrograms/min; amplitude 1.96 +/- 0.37 micrograms/min; acrophase 15(06); 95% CL 13(01)-17(45). These data show that reference values are higher during daytime as compared with nighttime and suggest that the time of urine collection must be taken into consideration in order to define the upper physiological limits more precisely.

Adult↗
PubMedDate not supplied

Circadian rhythm of the PRL response to TRH in healthy subjects.

The PRL response to TRH constitutes an important clinical tool for diagnosing forms of hyperprolactinemic syndrome. Hence it is important to establish the characteristics of the circadian variation in the response of PRL to TRH to improve the diagnostic value of the test. Six male subjects, ranging in age from 23 to 24 years, participated in this study. All were considered healthy on the basis of clinical examination, biochemical and hormonal tests. Six TRH tests were performed on each subject, one test every other day during a total span of 12 days. Each test was performed at a different clock hour: 0000, 0400, 0800, 1200, 1600, 2000. For the test, subjects received 200 microgram TRH intravenously. Blood samples were drawn from a catheterized arm vein before the TRH injection (basal value) and 20, 30, 60 and 120 min after injection. At each timepoint 5 endpoints were determined for PRL on each subject. The population mean cosinor, according to Halberg, was used to investigate the circadian rhythm in each of the endpoints. All the 5 endpoints for PRL are consistent on showing p values near 0.5 and acrophase estimates before midnight (while basal value displays acrophase at 0400). Further investigations are necessary to clarify these circadian rhythms and the shift of the acrophases.

Adult↗