Clinical-anamnestic and instrumental data in outpatients suffering from venous disease

The authors studied 200 consecutive outpatients with symptoms due to venous disease of the lower limbs. All the patients underwent anamnestic, clinical and instrumental evaluation (c.w. Doppler velocimetry and strain-gauge plethysmography). The results of this study showed that some anamnestic and clinical data are significantly related to venous disease detected by instrumental techniques. The superficial and deep vein hypertension were, instead, correlated to oral contraceptive use.

Tolerability and efficacy of high-dose furosemide and small-volume hypertonic saline solution in refractory congestive heart failure

Thirty patients aged 65-85 years, with refractory New York Heart Association (NYHA) class IV congestive heart failure (CHF) were treated with an intravenous infusion of furosemide (250-2000 mg/d) and small-volume hypertonic saline solution (150 mL of 1.4-4.6% NaCl) twice a day for 6 to 12 days. A daily fluid oral intake of 1000 mL and previous cardiac therapy were maintained. Clinical signs and symptoms of CHF, such as dyspnea, edema and weakness, improved, as did severity of illness as defined by NYHA class. The infusion was well tolerated. After a 12-month follow-up, 24 patients (80%) were alive and in the NYHA class assigned on discharge from the hospital. This therapeutic combination is…

Attivazione immunoinfiammatoria della fase acuta e diatesi trombofilica in soggetti con ictus ischemico acuto. Studio prospettico di confronto tra diabetici e non diabetici. ;

Left ventricular diastolic and systolic function in normotensive obese subjects: influence of degree and duration of obesity.

The present study was carried out to evaluate systolic and diastolic parameters in overweight and moderately obese, but otherwise healthy subjects, and in a lean control group, to determine whether degree and duration of obesity can influence left ventricular function. A total of 27 subjects, 17 overweight or with moderate obesity and 10 lean, healthy subjects were included. Patients were divided into three groups according to their body mass index (BMI) and to Garrow's criteria as follows: lean control group (BMI less than 25 kg.m-2); overweight subjects (BMI from 25 to 30 kg.m-2); moderately obese subjects (BMI greater than 30 less than 40 kg.m-2). Systolic and diastolic parameters were m…

Diabete mellito ed ictus ischemico: studio caso-controllo di confronto tra soggetti diabetici e non diabetici

Transforming growth factor ß1 ed effetto nefroprotettivo dell’associazione ACE-inibitore/ AT1 antagonista in soggetti ipertesi con iniziale danno renale.

DESCRIPTION OF THE FOURTH CASE OF ACERULOPLASMINEMIA FOUND IN ITALY

Is there a link between liver steatosis, carotid atherosclerosis and C-reactive protein in metabolic and non-metabolic patients?

L'ictus ischemico

Use of QT intervals for a more accurate diagnose of syncope and evaluation of syncope severity.

Abstract BACKGROUND: This study aimed to evaluate the use of QT intervals, their diagnostic predictive value in patients with syncope and their relationship with syncope severity. METHODS: One hundred and forty nine patients with a diagnosis of syncope were admitted to Internal Medicine departments at the University of Palermo, Italy, between 2006 and 2012, and 140 control subjects hospitalised for other causes were enrolled. QT maximum, QT minimum, QTpeak, QT corrected, QT dispersion and Tpeak-to-Tend interval were compared between two groups. The paper medical records were used for scoring with San Francisco Syncope Rule (SFSR), Evaluation of Guidelines in SYncope Study (EGSYS) score and …

IL28B and PNPLA3 Polymorphisms Affect Histological Liver Damage in Patients with Non-alcoholic Fatty Liver Disease.

Background & Aims: Genetic background may affect liver damage in patients with non-alcoholic fatty liver disease (NAFLD). The main outcomes of the study were to assess whether IL28B rs12979860 and rs8099917 polymorphisms, together with PNPLA3 rs738409 C>G polymorphism, are associated with lobular inflammation and fibrosis, in NAFLD patients. Methods: One hundred sixty consecutive NAFLD patients were assessed by liver biopsy (Kleiner score); anthropometric, and biochemical and metabolic features were included. IL28B rs12979860 C>T, IL28B rs8099917 G>C, and PNPLA3 rs738409 C>G single nucleotide polymorphisms were tested. Results: Seventy-four (46.2%) patients had IL28B rs12979860 CC polymorph…

Effects of Physical Exercise on Inflammatory Markers of Atherosclerosis

It is well established that physically fit individuals have a reduced risk of developing CVD (cardiovascular disease) and other age-related chronic disorders. Regular exercise is an established therapeutic intervention with an enormous range of benefits. Chronic low-grade systemic inflammation may be involved in atherosclerosis, diabetes and in pathogenesis of several chronic pathological conditions; recent findings confirm that physical activity induces an increase in the systemic levels of a number of cytokines and chemokines with anti-inflammatory properties. The possibility that regular physical exercise exerts anti-inflammation activity, being the interaction between contracting muscle…

ELECTROCARDIOGRAPHIC FINDINGS IN PATIENTS WITH DEMENTIA.

Methodological matters on an Alzheimer's dementia trial: is a double-blind randomized controlled study design sufficient to draw strong conclusions on treatment? Reply to Dr Mazza and colleagues.

Necessità di nuove terapie sintomatiche nel trattamento delle malattie reumatiche

Micro-albuminuria in obese subjects: relationship among body fat distribution, blood pressure and left ventricular structure and function.

OBJECTIVE: To evaluate the relationships among micro-albuminuria, blood pressure and measurements of left ventricular structure and function in centrally and peripherally obese subjects compared with members of a lean control group. METHODS: Centrally obese subjects were subdivided according to whether they had levels of micro-albuminuria higher than 30 mg/24 h (micro-albuminuric group) or lower than or equal to 30 mg/24 h (normo-albuminuric group). For all the subjects we measured heart rate, casual mean blood pressure (MBP), 24 h MBP, total cholesterol level, high-density lipoprotein cholesterol, lipoprotein (a) level, fasting immunoreactive insulin level, plasma renin activity, plasma al…

Outcomes of patients hospitalized with community-acquired, health care-associated, and hospital-acquired pneumonia

Background: Traditionally, pneumonia has been classified as either community- or hospital-acquired. Although only limited data are available, health care-associated pneumonia has been recently proposed as a new category of respiratory infection. ``Health care associated pneumonia{'' refers to pneumonia in patients who have recently been hospitalized, had hemodialysis, or received intravenous chemotherapy or reside in a nursing home or long-term care facility. Objective: To ascertain the epidemiology and outcome of community-acquired, health care-associated, and hospital-acquired pneumonia in adults hospitalized in internal medicine wards. Design: Multicenter, prospective observational study…

Changes in Natriuretic Peptides, Cytokines, Selectins and Adhesion Molecules Plasma Levels in Patients with Heart Failure, After Treatment with High Dose of Furosemide Plus Small Volume Saline Solutions (HSS) and After an Acute Saline Loading

TVP e neoplasie: modello predittivo delle variabili associate

Cardiovascular Effects of I/D angiotension converting enzyme gene polymorphism in heathy subjects

Risk Factors profile and clinical outcome of ischemic stroke patients admitted in a department of Internal Medicine and classified by TOAST classification

Valore predittivo delle variabili immunoinfiammatorie nell’ictus ischemico acuto.

Piede diabetico e morbilità cardiovascolare. Studio prospettico di controllo. ;

Gemcitabine plus vinorelbine in stage IIIB or IV non-small cell lung cancer (NSCLC): A multicentre phase II clinical trial

Abstract A phase II study in patients with stage IIIB/IV non-small cell lung cancer (NSCLC) was carried out to evaluate the clinical activity and toxicity of the chemotherapeutic combination of gemcitabine+vinorelbine (GEM/VNR). Forty-five patients (40 male, 5 female) with a median age of 67 years (range 37–73) and a median ECOG performance status of 1 (range 0–2) were enrolled into the trial. Twenty patients had stage IIIB (two positive supraclavicular nodes and 20 cytologically positive pleural effusion), and 25 had stage IV NSCLC. GEM 1000 mg/m 2 diluted in 250 cc 3 of normal saline was administered iv on days 1, 8, and 15, while VNR was given 30 mg/m 2 on days 1 and 8 every 4 weeks. The…

Disoleatori statici per il trattamento delle acque di piccole e medie utenze

Per rimuovere gli olii dalle acque reflue di piccole e medie utenze si utilizzano molto i disoleatori prefabbricati. Le verifiche di tre disoleatori commerciali di tipo statico hanno suggerito il limite inferiore per il tempo di detenzione idraulica, e quello superiore per il carico superficiale. Le vasche bi-stadio non hanno dimostrato vantaggi sulle mono-stadio.

Is losartan able to improve renal haemodynamics in hypertensives? a long term study

Salvage treatment with ganciclovir in a splenectomized, polytransfused patient affected by systemic inflammatory response syndrome

A 23-year-old man was admitted to hospital with a 12-day history of daily fever. A clinical history revealed that 10 months previously, the patient had been splenectomized and polytransfused for a severe blunt trauma. On admission, laboratory data revealed significant leukocytosis (33,230/ul). The patient's general clinical conditions rapidly worsened into a severe systemic inflammatory response syndrome in four days. After 10 days of broad-spectrum antibiotic treatment, the temperature curve was unmodified and severe leukocytosis persisted (44,300 ul) with absolute lymphocytosis. Laboratory tests ruled out hematological diseases, pneumonia, abscesses and endocarditis. In the light of IgM …

Effects of clinical and laboratory variables at admission and of in-hospital treatment with cardiovascular drugs on short term prognosis of ischemic stroke. The GIFA study.

Abstract Introduction No information exists, to our knowledge, about the possible role of cardiovascular drug administration in the acute phase of ischemic stroke and possible effects on stroke outcome. The aim of our study was to evaluate the relationship between in-hospital treatment with cardiovascular drugs in patients with acute ischemic stroke and some outcome indicators. Methods and Results 1096 subjects enrolled in the GIFA study, who had a main discharge diagnosis of ischemic stroke represent the final sample. Drugs considered for the analysis were the following: ACE-inhibitors (ACEI), angiotensin II receptor blockers (ARBs), statins, calcium-channel-blockers (CCBs), antiplatelet (…

Impact of atorvastatin plus n-3 PUFA on metabolic, inflammatory and coagulative parameters in metabolic syndrome without and with type 2 diabetes mellitus

Evaluation of regional haemodynamic and alterations of vascular wall of the lower limbs in hypertensive subjects.

Quando la diagnosi è già fatta: anemia e lombalgia in un paziente con recente diagnosi di brucellosi acuta

Profilo di rischio per neoplasia occulta in pazienti con TVP idiopatica.

Obesity and cardiovascular diseases.

Obesity and overweight have great clinical and social significance and are associated with a number of medical and surgical complications. We attempt here to summarize current knowledge on the subject and describe the research we are presently carrying out in this field. After a brief introduction, definition, and discussion of etiopathogenesis, the indexes of ponderal excess and epidemiology are illustrated. The cardiovascular adjustments and the relationships between obesity and hypertension, ischemic heart disease and congestive heart failure are then treated. One aim of our investigation was to study the modifications of an entire set of biological and clinical parameters which could co…

Insufficienza renale acuta da necrosi tubulare acuta iatrogena

Immunoinflammatory and thrombotic/ fybrinolytic markers as a diagnostic panel of acute ischemic stroke

Clinical Trial: High-dose furosemide plus small-volume hypertonic saline solutions vs. repeated paracentesis as treatment of refractory ascites.

Summary Background  In patients with cirrhosis, ascites is defined as refractory when it cannot be mobilized or recurs early in standard diuretic therapy. Aim  To compare the safety and efficacy of intravenous high-dose furosemide + hypertonic saline solutions (HSS) with repeated paracentesis in patients with cirrhosis and refractory ascites. Patients and methods  Eighty-four subjects (59/25 M/F) with cirrhosis, mostly of viral aetiology, admitted for refractory ascites, were randomly assigned to receive furosemide (250–1000 mg/bid i.v.) plus HSS (150 mL H2O with NaCl 1.4–4.6% or 239–187 mEq/L) (60 patients, Group A) or to repeated paracentesis and a standard diuretic schedule (24 patients,…

Predictors of outcome in acute ischemic cerebrovascular syndromes: The GIFA Study

Agenesis of the renal segment of inferior vena cava associated with venous stasis.

Congenital anomalies of the inferior vena cava is an extremely rare vascular anomaly with controversial pathogenesis. Anomalies of the inferior vena cava (IVC) are present in 0.3% to 0.5% of otherwise healthy individual and in 0.6% to 2% of patients with other cardiovascular defects. The phenomenon of absence of the IVC has been described in a variety of ways such as absence, agenesis, anomalous, and interruption of a particular segment ([infra] hepatic, pre-renal, renal, or infrarenal) of the IVC. We describe a 42-year-old man with chronic venous insufficiency, without DVT, caused by congenital absence of renal segment of the IVC

Cardiovascular risk profile and morbidity in subjects affected by type 2 diabetes with and without diabetic foot. ;

La terapia dietetica nell’insufficienza renale cronica.

La claudicatio intermittens

Associazione tra elevate livelli circolanti di Transforming growth factor ß1 (TGF ß1) ed alterato riempimento ventricolare sinistro in una popolazione di soggetti ipertesi.

Obesity: A main factor of metabolic syndrome?

The metabolic syndrome (MS) is a common metabolic disorder that has been recently related to the increasing prevalence of obesity. The disorder is defined in various ways, but in the near future a new definition(s) will be applicable worldwide. The pathophysiology has been largely attributed, in the past years, to insulin-resistance, even if several epidemiological and pathophysiological data are attractive to indicate visceral obesity as a main factor in the occurrence of the MS, promoting new definitions and re-valuation of the pathogenesis of this syndrome. In this review, we have analyzed the role of visceral obesity in the new definition of the MS such as the pathophysiological role of…

Successful salvage therapy of intravenous cyclophosphamide for refractory polymyositis in an elderly patient: a case report.

Dermatomyositis and polymyositis may affect children and adults and are now widely recognized as major causes of disability which, thanks to the introduction of immunosuppressive drugs, is often treatable, at least to some extent. Few data exist regarding polymyositis in elderly patients. We describe a case of refractory life-threatening polymyositis in an elderly patient, successfully treated with intravenous cyclophosphamide

Cytokines, Selectins and Adhesion Molecules Plasma Levels in Acute Ischaemic Stroke: Relationship with Stroke Subtype, Ischaemic Lesion Site and Clinical Outcome

Relationship between transforming growth factor beta1 and progression of hypertensive renal disease.

In this study the role of circulating transforming growth factor beta1 (TGFbeta1) on progression of renal hypertensive disease has been investigated. Fifty consecutive outpatients with essential hypertension were enrolled and divided into three groups, according to their urinary albumin excretion (UAE). Group A comprised 10 hypertensives with UAEor=20 mg/24 h (normoalbuminuric group); Group B included 21 hypertensives with UAE20300 mg/24 h (microalbuminuric group); Group C encompassed 19 hypertensives with UAEor= 300 mg/24 h (proteinuric group). In all patients UAE by immunonephelometric assay, circulating TGFbeta1 by a solid phase specific sandwich ELISA technique, BUN and creatinine by ro…

Methodological matters on an Alzheimer's dementia trial: is a double-blind randomized controlled study design sufficient to draw strong conclusions on treatment?

Letter to Editor

Exercise performance in hypertensives: felodipine vs cilazapril cross-over study

Therapeutic management of elderly hypertensives with concomitant ischaemic heart disease.

CHARACTERISTICS OF ELDERLY HYPERTENSIVES: Hypertension is most prevalent in older patients and is associated with increasing morbidity and mortality with age. Elderly hypertensives often suffer from concomitant diseases, such as ischaemic heart disease, caused by age-induced modifications to the cardiovascular system, haemodynamic function and neurohormone activity. THERAPEUTIC MANAGEMENT: Therapeutic management of elderly hypertensives with concomitant ischaemic heart disease must take account of the pharmacodynamic and pharmacokinetic changes that occur in older subjects and drugs should be selected for their efficacy in both diseases. Since elderly subjects often metabolize drugs more sl…

Low vitamin D serum level is related to severe fibrosis and low responsiveness to interferon-based therapy in genotype 1 chronic hepatitis C

UNLABELLED 25-Hydroxyvitamin D (25[OH]D) can potentially interfere with inflammatory response and fibrogenesis. Its role in disease progression in chronic hepatitis C (CHC) and its relation with histological and sustained virological response (SVR) to therapy are unknown. One hundred ninety-seven patients with biopsy-proven genotype 1 (G1) CHC and 49 healthy subjects matched by age and sex were consecutively evaluated. One hundred sixty-seven patients underwent antiviral therapy with pegylated interferon plus ribavirin. The 25(OH)D serum levels were measured by high-pressure liquid chromatography. Tissue expression of cytochrome (CY) P27A1 and CYP2R1, liver 25-hydroxylating enzymes, were as…

Athersoclerosis in females patients with rheumatoid arthritis: a two years follow-up

Analysis of 24-h noninvasive ambulatory blood pressure profiles by a third-degree polynomial approach

Extensive experience of the circadian variation of blood pressure (BP) has been reported. But some problems exist concerning the correct and satisfactory evaluation of 24-h BP profiles. A well-known approach is the Halberg's 'cosinor' method. But it could be considered inadequate for blood pressure recordings because it is based on a rigid model that does not practically fit empirical data. We suggest an approach based on a cubic function as a suitable method for such an analysis. Our investigation studied the behavior of 24-h blood pressure by a model where the function f(t) is a third-degree polynomial. We recruited 52 untreated patients affected by essential hypertension. Ambulatory BP r…

Antihypertensive and cardiovascular effects of combined blockade of renin-angiotensin system with ACE inhibitor and angiotensin II type 1 receptor blocker in hypertensive patients: a 24 week randomized controlled double-dummy trial.

Background: In this study the effects of 24 weeks losartan and ramipril treatment, both alone and in combination, on blood pressure and left ventricular mass (LVM) and function,have been evaluated in hypertensives. Methods. 57 hypertensives with stage 1 and 2 essential hypertension were included. After 4 weeks run in, a randomized double-blind, 3 arm, double dummy, independent trial was used. All patients were randomly allocated to 3 treatment arms consisting of losartan (50 mg/daily), ramipril (5 mg/daily), and combined (losartan 50 mg/ramipril 5 mg/daily) for 24 weeks. LVM, LVM/h and other echocardiographic measurements, BUN, creatinine and clearance and potassium were determined after ru…

Predictors of outcome in acute ischemic cerebrovascular syndromes:

Evaluation of BNP levels and bioelectrical impedance measurements after a novel therapy of refractory congestive heart failure

Mortality rate and risk factors for gastrointestinal bleeding in elderly patients

Abstract Background Gastrointestinal bleeding (GIB) is burdened by high mortality rate that increases with aging. Elderly patients may be exposed to multiple risk factors for GIB. We aimed at defining the impact of GIB in elderly patients. Methods Since 2008, samples of elderly patients (age ≥ 65 years) with multimorbidity admitted to 101 internal medicine wards across Italy have been prospectively enrolled and followed-up (REPOSI registry). Diagnoses of GIB, length of stay (LOS), mortality rate, and possible risk factors, including drugs, index of comorbidity (Cumulative Illness Rating Scale [CIRS]), polypharmacy, and chronic diseases were assessed. Adjusted multivariate logistic regressio…

Prevalence of obesity and ischaemic heart disease in hypertensive subjects

In the present study the prevalence of obesity and its association with ischemic heart disease, recognized according to clinical criteria (chest pain or previous infarction) and/or instrumental data, were described in 8,847 normotensive subjects and in 867 hypertensive subjects, hospitalized during a ten years period (1983-1992), through a cross-sectional study. In view of this all the subjects were considered as lean or obese according to their body mass index (BMI) and to sex specific cut-off values reported in the Italian Consensus Conference on Obesity. In particular, according to BMI values, the subjects were grouped as lean, overweight, moderate and severe obese subjects. Our results …

Metabolic and anti-inflammatory effects of a home-based programme of aerobic physical exercise

Summary Aims Regular exercise demonstrated the ability to provide enormous benefits to many diseases, atherosclerotic-based, degenerative and neoplastic, but also to grant anti-inflammatory actions, assessed by various authors in different populations. Despite of these clear benefits, many patients are unable to attain long-term results through chronic physical activity for different causes. On this basis, the aim of our study was to assess the metabolic and anti-inflammatory effects of a home-based programme of fast walking in patients affected by metabolic syndrome (MS). Materials and methods We enrolled 176 subjects with MS as stated by ATP III criteria. Patients were invited to walk for…

Descrizione del quarto caso di aceruloplasminemia familiare diagnosticato in Italia.

41 SERUM FETUIN A/ALPHA2HS-GLYCOPROTEIN AND CD40 L IN TOAST STROKE SUBTYPES: CORRELATION WITH LABORATORY, CLINICAL VARIABLES AND PROGNOSIS

Fetuin-A and CD40L plasma levels in acute ischemic stroke: differences in relation to TOAST subtype and correlation with clinical and laboratory variables

Abstract Introduction Accumulating evidence suggests that inflammation plays an important role in the acute phase of ischemic stroke. CD40 L is a well recognized atherosclerotic inflammatory marker, whereas recent evidence suggests a pro-inflammatory role of Fetuin-A. To analyze the role of an inflammatory marker such as CD40 L and of a candidate pro-inflammatory marker such as Fetuin-A in acute stroke we evaluated their serum levels in subjects with acute ischemic stroke and their possible association with other laboratory and clinical variables. Materials and methods We enrolled 107 consecutive patients with a diagnosis of acute ischemic stroke admitted to the Internal Medicine Department…

Intavenous high dose furosemide plus small volume of hypertonic saline solutions (HSS) versus seriated paracentesis in treatment of refractory ascites: a pilot study

Citokines, Selectins and adhesion molecules plasma levels in acute ischemic stroke: relationship with stroke, subtype, ischemic lesion site and clinical outcome

Heredity and obesity-associated hypertension: impact of hormonal characteristics and left ventricular mass. J Hypertens

OBJECTIVES: To investigate the influence of heredity on obesity-associated hypertension, we evaluated casual and 24-h blood pressure, left ventricular mass and some metabolic and hormonal measurements in normotensive obese subjects. DESIGN: Healthy, normotensive obese subjects (n = 81) with positive or negative family history of hypertension were studied. Both groups were also subdivided according to a positive or a negative family history of obesity. Accordingly, 45 obese subjects had a positive family history of hypertension, 25 of these having a positive (subgroup A) and 20 having a negative family history of obesity (subgroup B). The other 36 obese subjects had a negative family history…

Prophylaxis of venous thromboembolism in elderly patients with multimorbidity

none 327 si Pharmacological thromboprophylaxis (TP) is known to reduce venous thromboembolism (VTE) in medical inpatients, but the criteria for risk-driven prescription, safety and impact on mortality are still debated. We analyze data on elderly patients with multimorbidities admitted in the year 2010 to the Italian internal medicine wards participating in the REPOSI registry to investigate the rate of TP during the hospital stay, and analyze the factors that are related to its prescription. Multivariate logistic regression, area under the ROC curve and CART analysis were performed to look for independent predictors of TP prescription. Association between TP and VTE, bleeding and death in …

Effetti cardioprotettivi del Blocco del Sistema Renina-Angiotensina-Aldosterone tramite l’associazione ACE-inibitore – Sartani: Relazione con i livelli circolanti di Transforming Growth Factor ß1.

Polypharmacy, length of hospital stay, and in-hospital mortality among elderly patients in internal medicine wards. The REPOSI study

PURPOSES: We evaluated the prevalence and factors associated with polypharmacy and investigated the role of polypharmacy as a predictor of length of hospital stay and in-hospital mortality. METHODS: Thirty-eight internal medicine wards in Italy participated in the Registro Politerapie SIMI (REPOSI) study during 2008. One thousand three hundred and thirty-two in-patients aged ≥65 years were enrolled. Polypharmacy was defined as the concomitant use of five or more medications. Linear regression analyses were used to evaluate predictors of length of hospital stay and logistic regression models for predictors of in-hospital mortality. Age, sex, Charlson comorbidity index, polypharmacy, and numb…

No evidence-based practice by biased information from systematic reviews: the case of etanercept and infliximab for the treatment of psoriatic arthritis.

Outcomes of Patients Hospitalized with Community-Acquired, Health Care-Associated, and Hospital-Acquired Pneumonia

Background Traditionally, pneumonia has been classified as either community- or hospital-acquired. Although only limited data are available, health care-associated pneumonia has been recently proposed as a new category of respiratory infection. "Health care-associated pneumonia" refers to pneumonia in patients who have recently been hospitalized, had hemodialysis, or received intravenous chemotherapy or reside in a nursing home or long-term care facility. Objective To ascertain the epidemiology and outcome of community-acquired, health care-associated, and hospital-acquired pneumonia in adults hospitalized in internal medicine wards. Design Multicenter, prospective observational study. Sett…

Variazione dei livelli sierici di peptidi natriuretici e citochine dopo terapia con alte dosi di furosemide e soluzioni saline ipertoniche (SSI) e dopo carico salino in soggetti con disfunzione ventricolare sinistra e/o scompenso cardiaco congestizio

Obesità e rischio cardiovascolare.

L’obesità rappresenta attualmente la più diffusa patologia da malnutrizione delle Società occidentali industrializzate e si associa spesso a svariate complicanze invalidanti sia mediche che chirurgiche. Essa è, inoltre, una condizione ad elevata prevalenza ed in continuo e costante incremento, al punto da essere etichettata come una “Epidemia globale”. Nella presente review sono stati analizzati i risultati degli studi più recenti che hanno individuato nella patologia del tessuto adiposo uno dei meccanismi più importanti nello sviluppo dell’aterosclerosi e delle manifestazioni cliniche ad essa connesse. Particolare riguardo è stato dato, oltre che alle evidenze epidemiologiche riguardanti i…

803 Effects of high dose furosemide and small-volume hypertonic saline solution infusion in comparison with a high dose of furosemide as bolus, in refractory congestive heart failure. Long term effects

Association between reduced lymphocyte beta-adrenergic receptors and left ventricular dysfunction in young obese subjects

This study was designed to evaluate total (t) and surface (s) beta-adrenergic receptors (BAR) density and their relationships with left ventricular function in young obese subjects. BAR density, plasma insulin, catecholamines and left ventricular function were evaluated in 27 young obese subjects (BMI30.5 kg/m2 for males and27.3 kg/m2 for females) without other risk factors for cardiovascular diseases (smoking, hypertension, diabetes and lipid abnormalities) and in 20 lean controls (BMI25 kg/m2 for males and24.7 kg/m2 for females). Both groups were matched for gender, age and body height. BAR density was evaluated according to Böyum and De Blasi methods. Plasma catecholamines by high perfus…

Terapia antiaggregante ed arteriopatia obliterante cronica degli arti inferiori

Left ventricular diastolic filling alterations in subjects with mitral valve prolapse: A Doppler echocardiographic study

To assess left ventricular diastolic filling in mitral valve prolapse (MVP), we studied 22 patients with idiopathic MVP and 22 healthy controls matched for sex, age, body surface area and heart rate. A two-dimensional, M-mode and Doppler echocardiographic examination was performed to exclude any cardiac abnormalities. The two groups had similar diastolic and systolic left ventricular volumes, left ventricle mass and ejection fraction. Doppler measurements of mitral inflow were: E and A areas (the components of the total flow velocity-time integral in the early passive period of ventricular filling, E; and the late active period of atrial emptying, A), the peak E and A velocities (cm.s-1), a…

CD40 ligand and MCP-1 as predictors of cardiovascular events in diabetic patients with stroke.

Aim: Up-regulation of soluble CD40 ligand (sCD40L) and of monocyte chemoattractant protein-1 (MCP-1) has been found in diabetes and in patients with acute cerebral ischemia. We asked whether (i) the two molecules are similarly upregulated among non-lacunar and lacunar diabetic strokes and (ii) sCD40L and/or MCP-1 predict the risk of cardiovascular events in this setting.Methods: Ninety patients with type 2 diabetes mellitus presenting with an acute ischemic stroke (compared with 45 control subjects) were evaluated on admission and up to 36 months (median 24 months) after the event.Results: Diabetic patients with acute stroke had higher plasma CD40L and MCP-1 than controls (p<0.0001), wit…

Central obesity and hypertension: Pathophysiologic role of renal haemodynamics and function

OBJECTIVE: To investigate the role of alterations in renal haemodynamics and function and in plasma renin activity on obesity-induced hypertension. DESIGN: Renal haemodynamics and function, salt-regulating hormones and structural cardiac parameters were evaluated in 20 lean normotensives and in 64 obese subjects with central or peripheral fat distribution, 43 of them were normotensives and 21 of them were hypertensives. Obesity and central fat distribution were defined according to sex-specific 85th percentile respectively of Body Mass Index (BMI) and Waist to Hip Ratio (WHR). MEASUREMENTS: Serum immunoreactive insulin (IRI), plasma renin activity (PRA), plasma aldosterone (PA), microalbumi…

Association between diabetes and stroke subtype on survival and functional outcome 3 months after stroke: data from the European BIOMED Stroke Project.

Ischemic stroke in patients with diabetic foot

Effect of obesity on left ventricular function studied by radionuclide angiocardiography

Several studies have shown a significant association of obesity with cardiovascular morbidity and mortality. The present study was carried out to investigate central and systemic haemodynamics in overweight and moderate obese, but otherwise healthy subjects, and in a lean control group to determine whether obesity can influence left ventricular performance per se. In this study an attempt has been made to eliminate misleading factors, such as diabetes, lipid abnormalities and hypertension. A total of 67 subjects, 44 with overweight or moderate obesity and 23 lean healthy subjects, were included. Patients were divided into three groups according to BMI levels and Garrow's criteria as follows…

Insulin resistance is a risk factor for esophageal varices in hepatitis C virus cirrhosis

Indirect methods to predict the presence of esophageal varices (EV) in patients with cirrhosis are not sensitive enough to be used as a surrogate for endoscopy. We tested the effectiveness of liver stiffness measurement (LSM) by transient elastography and the presence of insulin resistance (IR), a marker associated with fibrosis progression, in the noninvasive prediction of portal hypertension. One hundred four consecutive patients with newly diagnosed Child A hepatitis C virus (HCV) cirrhosis underwent upper gastrointestinal endoscopy to search for EV. Clinical, anthropometric, biochemical, ultrasonographic, and metabolic features, including IR by the homeostasis model assessment (HOMA), a…

Hemodynamic Changes in Patients with Essential Hypertension after Therapy with Muzolimine

Muzolimine is a new nonsulfonamide diuretic belonging to the pyrazolinone group (1).It is a potent high-ceiling diuretic agent like furosemide and bumetanide with long duration of action like thiazides (1, 2).

42 PROGNOSIS OF ACUTE ISCHEMIC STROKE RELATED WITH CARDIOVASCULAR DRUGS TREATMENT DURING HOSPITAL STAY

158: Is Bioelectrical Impedance Analysis Helpful for Heart Failure Management in the Emergency Department?

Carotid atherosclerosis in hypercholesterolemic patients: Relationship with cardiovascular events

Background and Aim: Extracranial cerebrovascular atherosclerosis is a common feature of hypercholesterolemia and carotid lesions are good predictors of cardiovascular events in the general population. Factors associated with the carotid damage of hypercholesterolemic patients and their relationships with the occurrence of clinical events are investigated in this study. Methods and Results: One hundred and seventeen cardiovascular event-free hypercholesterolemic subjects underwent a complete clinical examination to look for additional risk factors. A blood sample was collected for lipoprotein determination and an ultrasound high resolution B-mode imaging examination of the common carotid art…

Need for Deprescribing in Hospital Elderly Patients Discharged with a Limited Life Expectancy: The REPOSI Study

<b><i>Objective:</i></b> Older people approaching the end of life are at a high risk for adverse drug reactions. Approaching the end of life should change the therapeutic aims, triggering a reduction in the number of drugs.<b><i></i></b>The main aim of this study is to describe the preventive and symptomatic drug treatments prescribed to patients discharged with a limited life expectancy from internal medicine and geriatric wards. The secondary aim was to describe the potentially severe drug-drug interactions (DDI). <b><i>Materials and Methods:</i></b> We analyzed Registry of Polytherapies Societa Italiana di Medicina I…

Left ventricular function response to exercise in normotensive obese subjects: influence of degree and duration of obesity

This study has been designed to evaluate whether duration and severity of obesity can influence left ventricular function response to exercise in obese subjects without other known cardiovascular risk factors such as hypertension, diabetes or hyperlipoproteinemia. A total of 29 obese subjects were included and they were divided, according to their body mass index and to Garrow's criteria as follows: Overweight or mildly obese subjects: body mass index from 25 to 30 kg/m2; moderately obese subjects: body mass index30 and40 kg/m2. Both obese groups were further subdivided according to their duration of obesity evaluated by accurate anamnesis in subgroup A (duration of obesity less than 120 mo…

Approccio terapeutico alla claudicatio intermittens e all'ischemia critica.

Effects of a short-term hypoenergetic diet on morphofunctional left ventricular parameters in centrally obese subjects

BACKGROUND: We aimed to study centrally obese subjects without other diseases, to establish whether a short-term hypoenergetic balanced regimen is able to positively modify left ventricular (LV) patterns. METHODS: We studied 32 obese subjects (out of 52 recruited for this study) with central fat distribution and without associated diseases. Each subject had undergone a moderately hypoenergetic diet for a four-month follow-up period and had a regular loss in weight. Some relevant clinical and echocardiographic parameters were evaluated. Baseline data and those evaluated at the end of the follow-up period were used for outcome analysis. RESULTS: We found a considerable reduction in LV mass an…

Valutazione mediante monitoraggio ambulatoriale della pressione arteriosa (ABPM) dell’effetto di un programma di attività fisica centrata sul “fast walking” sui livelli pressori in soggetti ipertesi. ; .

Hyperhomocysteinemia in patients with cognitive impairment

Cognitive impairment is common in elderly people and represents clinical feature of neurodegenerative diseases. Not all of patients with Mild Cognitive Impairment (MCI) finally develop dementia and it is interesting to investigate the role of possible markers for early diagnosis. Hyperhomocysteinemia is associated to several pathologies including cognitive impairment; aim of this study is to evaluate the correlation between cognitive performance assessment and homocysteine plasma levels. Total 74 patients and 75 healthy controls were enrolled and MCI were defined by a MMSE score lower than 26 after adjustment for years of schooling. Homocysteine plasma levels were determined. Homocysteine l…

Decreasing incidence of lacunar vs other types of cerebral infarction in a Japanese population

Cytokines, adhesion molecules and Selectins plasma levels and laboratory parameters in patients with different subtypes of ischemic stroke.

Immunoinflammatory activation of the acute phase as a possibile marker of acute ischemic stroke. is .

ELECTROCARDIOGRAPHIC FINDINGS IN PATIENTS WITH AMYOTROPHIC LATERAL SCLEROSIS.

Central obesity and hypertension: the role of plasma endothelin. Am J Hypertens

Hypertension and central obesity are two conditions closely linked, but the mechanisms responsible for obesity-associated hypertension are still unclear. In the last few years, several studies addressed the role of endothelin-1 (ET-1) in the development and maintenance of hypertension. This study was designed to evaluate plasma ET-1 in normotensive and hypertensive central obese subjects compared with a lean healthy group. Our final goal was to analyze the relationship between plasma ET-1, blood pressure, and left ventricular structure and function in central obese subjects (both normotensives and hypertensives). ET-levels have been assessed by the radioimmunoassay method in 20 lean normote…

The Maifinito phenomenon. Confession, Forgiveness, and Healing: “condoni” and“sanatoria”, Isabella Fera in Conversation with Arno Brandlhuber

The book Maifinito featured essays, projects, and a selection of “international artistic, social and architectural experiences,” all of which centered around the “fenomeno del maifinito,”1 the maifinito phenomenon—in other words, the enormous number of unfinished buildings in southern Italy, and especially on the island of Sicily. Many of these buildings, so-called maifiniti, have been constructed entirely outside the legislative framework—a phenomenon that perfectly encapsulates the relationship in Italy between construction, the public vs. private realm, the state, and legislation. In December 2015, Arno Brandlhuber met Isabella Fera in Palermo for a wide-ranging discussion.

Stroke patterns, etiology, and prognosis in patients with diabetes mellitus.

Prospective study of type 1 and type 2 diabetes and risk of stroke subtypes: the Nurses' Health Study: response to Janghorbani et al

Evaluation of regional haemodynamics and alterations of vascular wall of the lower limbs in hypertensive subjects

This study was designed to analyse the relationship between arterial hypertension and changes in arterial blood flow and vascular wall damage of the lower limbs in hypertensive patients with various degrees of hypertension. Six hundred and fifty-four hypertensive patients (421 males and 233 females) aged 35 to 70 years and 88 healthy subjects (63 males and 25 females) aged 39 to 60 years were studied. Strain-gauge plethysmography of the lower limbs was used to calculate arterial calf blood flow (RF), arterial calf blood flow after post-ischaemic hyperaemia (PF), basal and minimal vascular resistances (BVR and MVR), time to reach peak flow (tPF), time until 50% reduction of peak flow (tT1/2)…

Recurrent venous thromboembolism complicated by heparin-induced thrombocytopenia as a first manifestation of an occult cancer: a case report.

Heparin-Induced Trombocytopenia (HIT) is a serious and potentially fatal complication of patients on heparins. Its management is difficult and it can be more complicated in patients with cancer because of the hemorrhagic risk carried out by direct inhibitor of thrombin, the currently approved drug for HIT. At present, it is not clear whether cancer patients also have an increased risk of HIT. We describe the case of a patient with occult cancer at the moment of the index venous thrombosis, who developed Deep Vein Thrombosis (DVT) and concomitant HIT with thrombotic complications (recurrent contralateral venous thrombosis). The management of HIT was efficaciously based on the combined use o…

[Prevalence of pericardial effusion in subjects with rheumatoid arthritis: an echocardiographic study].

We used echocardiography to determine the prevalence of pericardial effusion in rheumatoid arthritis (RA) patients without cardiac systems and compared our results to those obtained in a control group of age-matched subjects. Thirty-six patients with RA (6 men, 30 women; mean age 51 +/- 11 years) were selected from a patient population in treatment at our outpatient Rheumatology Clinic. None of the patients had any symptoms of cardiac disease, and all patients with signs and/or systems of extracardiac disease were excluded from the study. The control group consisted of 60 volunteers (mean age 51 +/- 12 years) randomly selected from a larger group of subjects with neither symptoms, signs and…

Angiotensin-converting enzyme gene deletion polymorphism determines an increase in frequency of migraine attacks in patients suffering from migraine without aura.

Many authors have reported an association between the angiotensin-converting enzyme (ACE)-D allele and coronary heart disease and other cardiovascular diseases. The mechanism underlying the positive associations between the ACE-D alleles and diseases are not yet clear. Previous reports showed an association between migraine without aura and ACE-D allele polymorphism. The study is aimed to evaluate if the DD genotype could also be associated with the frequency and duration of migraine without aura. In 302 patients suffering from migraine without aura (at least for 1 year), with no history of cardiovascular diseases and major risk factors for ischemic events, the genotypes of the ACE gene, pl…

Immunoinflammatory activation of the acute phase as a possibile marker of acute ischemic stroke.

Long-term evaluation of quinapril in mild to moderate hypertension: assessment of renal haemodynamics and function.

Effect of dual blockade of renin–angiotensin system on TGFβ1 and left ventricular structure and function in hypertensive patients

The effects of 24 weeks losartan and ramipril treatment, both alone and in combination, on left ventricular mass (LVM), circulating transforming growth factor beta1 (TGFbeta1), procollagen type I (PIP) and III (PIIIP), have been evaluated in hypertensive (HT) patients. A total of 57 HT with stage 1 and 2 essential hypertension were included. After 4 weeks run in, a randomized double-blind, three arms, double dummy, independent trial was used. All HT patients were randomly allocated to three treatment arms consisting of losartan (50 mg/daily), ramipril (5 mg/ daily) and combined (losartan 50 mg/daily + ramipril 5 mg/daily) for 24 weeks. TGFbeta1, PIP and PIIIP, LVM, LVM/h(2.7) and other echo…

CLINICAL COURSE OF NIMESULIDE-INDUCED LIVER INJURY

[Deciding in conditions of uncertainty: the Delphi method and its use in the formulation of guidelines].

The purpose of this paper is to analyze one of the most powerful tools in the decision-making under conditions of uncertainty, the Delphi method, and to verify the related interest of scientific world, particularly, for formulation of guidelines. The method combines the expert opinion preventing biases due to institutional role, status or dominant personality. In the text we explain the methodology and the steps through which it is possible to realize the consensus; we schematized in a didactic manner all the phases for an operational approach of the reader. The search by the most diffused biomedical database (Medline) individualized 623 citations, 7 of which are guidelines (3 of remarkable…

Una presentazione clinica atipica di appendicite acuta in un giovane con malposizione intestinale

Effect of dual blockade of renin-angiotensin system on TGF beta 1 and left ventricular structure and function in hypertensive patients

The effects of 24 weeks losartan and ramipril treatment,both alone and in combination, on left ventricular mass (LVM), circulating transforming growth factor b1(TGFb1), procollagen type I (PIP) and III (PIIIP), havebeen evaluated in hypertensive (HT) patients. A total of 57 HT with stage 1 and 2 essential hypertension were included. After 4 weeks run in, a randomized double blind, three arms, double dummy, independent trial was used. All HT patients were randomly allocated to three treatment arms consisting of losartan (50 mg/daily),ramipril (5 mg/ daily) and combined (losartan 50 mg/daily plus ramipril 5 mg/daily) for 24 weeks. TGFb1, PIP and PIIIP, LVM, LVM/h 2.7 and other echocardiograph…

Clinical impact of broad-spectrum empirical antibiotic therapy in patients with healthcare-associated pneumonia: a multicenter interventional study

Healthcare-associated pneumonia (HCAP) has been proposed as a new category of pneumonia distinct from community-acquired pneumonia (CAP). A multicenter observational study in 2008 finds that patients with HCAP have a mortality rate significantly higher than patients with CAP, and a worse outcome is associated at logistic regression analysis with a low adherence to empirical antibiotic therapy recommended by ATS/IDSA guidelines. We designed a prospective interventional study to establish whether administration of a broad-spectrum antibiotic therapy consistent with the 2005 ATS/IDSA guidelines has an effect on the clinical outcome of hospitalized patients with HCAP. All patients with HCAP pro…

Fibrospleen: Measuring spleen stiffness by transient elastography increases accuracy of staging of liver fibrosis and of portal hypertension in chronic viral hepatitis

851 Role of segmental and whole body bioelectrical impedance analysis (BIA) in acute heart failure diagnosis

Transforming growth factor beta1 T29C gene polymorphism and hypertension: relationship with cardiovascular and renal damage.

Distribution of T29C TGFb1 gene polymorphism was analysed in 260 hypertensive and 134 normotensive subjects. Circulating TGFb1 and procollagen type III levels, microalbuminuria, left ventricular geometry and function were evaluated in all the hypertensives subgrouped according to T29C TGFb1 gene polymorphism. Circulating TGFb1by ELISA technique, procollagen type III by a specific radioimmunoassay, microalbuminuria by radioimmunoassay, left ventricular geometry and function by echocardiography were determined. All groups were comparable for gender, age and sex. Regarding T29C TGFb1 gene polymorphism, prevalence of TC or CC genotypes was significantly (pv0.05) higher in hypertensives than nor…

A case control study between diabetic and non-diabetic subjects with ischemic stroke

Immunoinflammatory activation of the acute phase of ischemic stroke in relation to time of symptom onset, diabetic state and diagnostic subtype.

Obesità, Diabete e Rischio Cardiovascolare.

Il crescente interesse del mondo scientifico e delle organizzazioni sanitarie nei riguardi dell’obesità deriva dalla diffusione epidemica di questa condizione osservata negli ultimi decenni non solo nel mondo occidentale industrializzato, ma anche nei paesi in via di sviluppo (1). Nelle società più ricche, l'eccesso di peso è maggiore negli strati socio-economici più bassi e nelle fasce d'età più avanzate (2), e la percentuale di soggetti in sovrappeso (BMI>25) e con obesità franca (BMI>30) ha superato negli Stati Uniti d'America il 60% dei maschi adulti ed il 30 % delle donne tra i 50 ed i 60 anni (3). L'aspetto epidemiologico che colpisce e preoccupa di più è il trend secolare, per cui ne…

Immunoinflammatory activation of the acute phase of ischemic stroke in relation to time of symptoms onset, diabetic state and diagnostic subtype.

Immunoinflammatory and thrombotic/ fibrinolytic markers as a diagnostic panel of caute ischemic stroke

redictors of outcome in acute ischemic cerebrovascular syndromes: The GIFA Study

Livelli sierici di citochine infiammatorie, selectine e molecole di adesione nella fase acuta dell’ictus lacunare e non lacunare: relazione con il tempo di comparsa dei sintomi e con il diabete.

Un caso complesso di tromboembolismo venoso. ;

Heredity and obesity-associated hypertension:impact on hormonal characteristics and left ventricular mass.

Fattori predittivi della prognosi nelle sindromi cerebrovascolari acute: lo studio GIFA

Changes in natriuretic peptides and cytokines plasma levels in patients with heart failure, after high dose of furosemide plus small volume saline solution (HSS) and after an acute saline loading

Obesity, hypertension and atherosclerosis

Hypertension and obesity are associated with an increased risk of clinical cardiovascular complications due to atherosclerosis. Moreover has been reported that hypertension may predispose to atheroma development. In the present review some common aspects to hypertension and atherosclerosis including smooth muscle cell proliferation, endothelial damage and intervention of growth factors have been analyzed. Additional data have to be provided to explain if the connections between hypertension and atherosclerosis could be considered two effects with one unknown cause. In addition some aspects related to obesity and atherosclerosis have been dissected. In particular we have reported our results…

Immunoinflammatory predictors of stroke in patients with chronic non valvular atrial fibrillation (NVAF).