[Increase in absolute atmospheric pressure in hyperbaric chamber in cirrhosis with ascites: lack of natriuretic response and increase of atrial natriuretic peptide]. / Aumento della pressione atmosferica assoluta in camera iperbarica nella cirrosi con ascite: mancata risposta natriuretica e incremento del peptide natriuretico atriale.

In normal subjects increasing atmospheres of absolute pressure (ATA) on the cardiopulmonary system, in a hyperbaric chamber, results in a marked diuresis and an increase of circulating concentration of atrial natriuretic peptide (ANP). The present investigation was designed to determine the effect of ATA in a group of 5 sodium-retaining cirrhotic patients on hydro-saline balance, renin-angiotensin-aldosterone system and ANP. After seven days on a 10 mEq sodium intake, each patient was studied on both a control and experimental (4-hour stay at 2-ATA in hyperbaric chamber) day. On each day, measurement of the following were obtained: plasma ANP, plasma renin activity (PRA) and aldosterone, electrolytes, creatinine clearance, volume and sodium and potassium urinary excretion. The increasing ATA lacked to induce both diuresis, natriuresis and increase in ANP plasma concentration. In these patients baseline, pre-hyperbaric, mean levels of PRA, aldosterone and ANP were 15.5 +/- 11.5 ng/ml/h, 808.4 +/- 360 pg/ml, 86 +/- 10.1 pg/ml, respectively, and were significantly elevated compared with normal range for control subjects without sodium restriction. In conclusion, increasing pressure at 2-ATA, in a hyperbaric chamber is unable to elicit both diuresis and natriuresis as well as modification on ANP and renin-angiotensin-aldo-sterone system in sodium-retaining cirrhotic patients.

[Observations on a case of arterial hypertension associated with primary hyperparathyroidism and renal artery thrombosis]. / Osservazioni su un caso di ipertensione arteriosa, associata ad iperparatiroidismo primario ed a trombosi di arteria renale.

A patient with hypertension (female: aged 48 years) associated with primary hyperparathyroidism and left renal artery thrombosis is described. Taking into account that the patient was treated on the left side by lithotripsy about two years before the development of hypertension while assuming an oral dose of an estro-progestinic compound, a possible role of these two conditions is discussed in the genesis of renal artery thrombosis and development of renal hypertension.

[Primary hyperparathyroidism with prevalent neuro-muscular manifestations]. / Iperparatiroidismo primario con prevalenti manifestazioni neuro-muscolari.

A case of primary hyperparathyroidism with prevalent neuromuscular symptoms is described. Clinical, diagnostic and therapeutic implications are emphasized. Particular attention must involve a full clinical examination, electromyographic data and neuromuscular biopsy to make differentiation from primary myopathy or denervation pathology. Some similarity of electromyographic data with those observed in botulism and myastenia gravis should also be taken in mind. Hypercalcemia could play a pathological role in conditioning abnormalities of nervous impulse conduction at the level of neuromuscular junction. Another possible interference might be related to a direct effect of parathormone and hypophosphataemia on nervous impulse conduction. "Glandular hyperplasia", as observed in this case at istologic examination, rises some problems as far as the prognosis is concerned.

[Transluminal percutaneous angioplasty in renovascular hypertension caused by monolateral fibromuscular dysplasia]. / Angioplastica percutanea transluminale nell'ipertensione renovascolare da displasia fibromuscolare monolaterale.

The authors, following recent observation of two cases of renovascular hypertension, one related to single right renal artery stenosis and the other to fibromuscular dysplasia of the left renal artery, examine the value of the Captopril-Test and treatment with Percutaneous Transluminal Angioplasty (PTA), in the diagnosis and therapy of this form of hypertension. According to the latest experience, reported in the literature, the Captopril-Test yields valid information as regards the dependence of hypertension on the renin-angiotensin system, while PTA represents the primary procedure in the treatment of renovascular hypertension when some conditions are satisfied as in our cases.

[Effects of ketanserin on arterial pressure at rest and during physical exercise in essential arterial hypertension]. / Effetti della ketanserina sulla pressione arteriosa a riposo e durante esercizio fisico nell'ipertensione arteriosa essenziale.

The antihypertensive effect of ketanserin, a recent 5-hydroxytryptamine (5-HT) antagonist, which acts on the 5-HT2-subtype receptor, was evaluated in 10 patients of both sexes (age range 35-69 years) with mild to moderate essential hypertension. Blood pressure and heart rate were measured at rest, in supine and standing position at the end of two weeks of placebo washout and after 2, 4 and 8 weeks of treatment with ketanserin 20 mg twice daily as monotherapy, while the changes of blood pressure and heart rate during static (hand-grip) and dynamic (bicycle ergometer) exercise were evaluated at the end of placebo and of the fourth week of therapy. The treatment induced a highly significant reduction of supine and standing systolic and diastolic blood pressure during rest, without any significant change in heart rate. During dynamic exercise, the increase in systolic and diastolic blood pressure and heart rate was not blunted by ketanserin, while the drug reduced systolic blood pressure and heart rate increase, during static exercise, with no change of diastolic blood pressure. From these data it may be concluded that ketanserin lowers blood pressure in essential hypertension without any interference with cardiovascular reflexes related to standing or dynamic exercise, and reduces the increase of systolic blood pressure and heart rate during static exercise with favourable interference on myocardial oxygen consumption. This sparing effect on myocardial oxygen demand is particularly relevant in hypertensive patients with asymptomatic coronary disease engaged in normal daily physical activity which includes many forms of static exercise.

[Effects of calcium antagonists on pancreatic endocrine secretion]. / Influenza dei farmaci calcio-antagonisti sulla secrezione endocrina pancreatica.

The influence of Verapamil, a calcium antagonist, on circulating levels of glucose, insulin and glucagon has been evaluated in 5 normal subjects and in 5 patients with non insulin-dependent diabetes (NIDDM). An oral glucose tolerance test was performed both in basal conditions and during intravenous infusion of the drug (5 mg/h). Administration of Verapamil didn't induce any significant change on the three parameters. The small decrease of glycemia in patients affected by NIDDM and treated with Verapamil was not related to reduction of glucagonemia.

[Clinical evaluation of the therapeutic effectiveness of a new drug with anti-inflammatory-balsamic action, guacetisal, in respiratory tract diseases]. / Valutazione clinica dell'efficacia terapeutica di un nuovo farmaco ad azione antiflogistico-balsamica, il guacetisal, nelle affezioni delle vie respiratorie.

In 40 patients with bronchopulmonary diseases, in prevalence of chronic type, the therapeutic value of a new antiphlogistic-balsamic compound was evaluated. The favourable results obtained, particularly as far as the rapidity of regression of signs and symptoms is concerned, showed that this drug may have a significant role in a combined scheme of treatment.