Low-grade systemic inflammation impairs arterial stiffness in newly diagnosed hypercholesterolaemia.

BACKGROUND: Excess of cardiovascular risk among patients with chronic inflammatory diseases has been attributed to increased arterial stiffness. Hypercholesterolaemia has been demonstrated to promote a low-grade inflammatory status. The objective of the present study was to define, in hypercholesterolaemia, the influence of plasma lipids, low-grade inflammation, and indices of adiposity on aortic pulse wave velocity, a measure of arterial stiffness and cardiovascular risk. MATERIALS AND METHODS: Anthropometric characteristics, plasma lipids, C-reactive protein and aortic pulse wave velocity were measured in 85 subjects (60 patients with newly diagnosed never-treated hypercholesterolaemia and 25 age- and sex-matched normocholesterolaemic controls). RESULTS: Plasma C-reactive protein and aortic pulse wave velocity were significantly higher among hypercholesterolaemic patients than in controls (P < 0.05 for both). Aortic pulse wave velocity was associated with age (r = 0.24, P = 0.04), body mass index (r = 0.33, P = 0.006), waist (r = 0.42, P < 0.001) and hip (r = 0.32, P = 0.007) circumferences, as well as with systolic (r = 0.34, P = 0.003) and diastolic (r = 0.30, P = 0.01) blood pressures, plasma C-reactive protein (r = 0.51, P < 0.001), total cholesterol (r = 0.45, P < 0.001), and low-density lipoprotein cholesterol (r = 0.46, P < 0.001). In the multivariate analysis, waist circumference and C-reactive protein levels predicted increased aortic stiffness, independently of traditional cardiovascular risk factors. The degree of independent association between cholesterol, systolic blood pressure and aortic stiffness increased when indices of adiposity and inflammation were excluded from the multivariate analysis. Comparable results were obtained when the analyses were restricted to hypercholesterolaemic patients. CONCLUSIONS: Low-grade systemic inflammation and abdominal fat, more than traditional risk factors, are major determinants of reduced arterial distensibility in hypercholesterolaemia.

[Simplified prognostic test in the early detection of acute pancreatitis]. / Valutazione della pancreatite acuta in urgenza con un sistema prognostico semplificato. Possibilità e limiti.

BACKGROUND: Even though the diagnosis of acute pancreatitis has become easier by the measurement of specific pancreatic enzymes, early assessment of the prognosis still remains a clinical challenge at an early stage of the disease. The imaging procedures and the elevated mediators, are not widely available at the beginning. The aim of this study is to analyze the blood concentration of lipase, glucose, calcium and leucocytes (Simplified Prognostic Test). The values of these markers in the prognostic evaluation of acute pancreatitis are described. METHODS: A total of 45 patients with acute pancreatitis were evaluated; 38 patients developed a mild acute pancreatitis and 7 patients developed a severe acute pancreatitis. The values of serum markers at cut-offs of 160 mg/100 ml for glucose, 10.000 U/L for lipase, 13.000 leucocytes/100 ml and 8.5 mg/ml for calcium were monitored. RESULTS: On admission to hospital, concentration of glucose, lipase, calcium and leucocytes were significantly higher in the second group (severe acute pancreatitis) than in the first one (p<0.01 for glucose, leucocytes and calcium; p<0.05 for lipase). The test was considered positive if 3 out of 4 markers were significant. CONCLUSIONS: At an early stage the SPT was positive in patients who developed severe disease. SPT had sensitivity of 71.4% and specificity of 75.5%. The preliminary results indicate that there is no significant difference between the Ranson score and SPT in evaluating acute pancreatitis. SPT is simple and quick to perform and unlike the recently introduced laboratory markers can easily be adopted in emergency clinical practice. Definite proof may however only be obtained by a prospective, randomized clinical trial.

[Mitral valve prolapse. Age and sex incidence, echocardiographic diagnosis and clinical and electrocardiographic correlations]. / Prolasso della mitrale. Incidenza per età e sesso, diagnosi ecocardiografica e correlazioni cliniche ed elettrocardiografiche.

The paper reports an electrocardiographic and M and B-mode echocardiographical study in 3682 non-selected patients among which a total of 241 were identified with mitral valve prolapse. In males the highest frequency was found during the second decade of life with a tendency to decrease with increasing age. In females, who were found to be the most severely affected (2:1 in relation to males), two peaks of incidence were observed during the third and fifth decade, with a greater frequency in the latter and a marked absence of cases in the fourth decade. Many echocardiographically diagnosed mitral prolapses were both clinically and electrocardiographically silent; moreover it was observed that the risks of this complication increased in parallel to the thinness and redundance of the mitralic flap affected by prolapse and the dilation of the valvular ring.

Circadian rhythm of sinoatrial conduction time assessed by 24 hours ECG monitoring.

SACT was evaluated in 50 subjects during 24 hours ECG monitoring. All of these subjects presented frequent atrial beats with no evidence of bradyarrhythmias. SACT was measured in accordance with Strauss' formula (SACT = P2P3 - P1P1/2). Twenty-four hours recording were divided in to 4 time intervals, 6 hour each, starting 7 o'clock. The SACT is higher during nighttime than during daytime. The phenomenon is, presumably, attributable to predominance of the para-sympathetic tone during the night.

Experimental study on the correlation between cardiac function and ovarian hormones.

Results of the study of cardiac function carried out on young women during various phases of the menstrual cycle were correlated to those obtained after acute administration of progesterone. In all cases systolic time intervals reveals a reduction of mechanical systole and of preejection. Direct action progesterone on cardiac function by an unknown mechanism was confirmed.

[Experimental research on the effect of electro-acupuncture on reparative processes]. / Ricerche sperimentali sull'azione dell'elettroagopuntura nei processi riparativi.

With a view to clarifying the mechanism whereby electroacupuncture aids teh repair of trophic ulcers, including inveterate forms resistant to ordinary treatments, reference is made to histochemical findings and histological findings in periulcerous tissues and experimental research into wound healing. Preliminary work showed that electroacupuncture improves the blood supply to ulcerous tissue and the local biochemistry, and accelerates the repair process. Experimental work also made it clear that the method, when use on alternate days with the modalities employed in clinical practice, accelerates the healing of wounds in the experimental animal.