Effect of felodipine on arterial blood flow and venous function at rest in patients with mild essential hypertension.

Felodipine is a second-generation dihydropyridine calcium antagonist used to treat mild to moderate arterial hypertension. The authors used venous occlusion plethysmography to study the effect of this drug on lower limb arterial inflow and venous outflow in 10 at rest patients with mild essential hypertension. They also sought correlations between changes in district blood flow and blood pressure. Plethysmography was carried out at 8 AM and 4, 8, and 24 hours later at baseline (after washout), on the first day of treatment with a single daily administration of 10 mg felodipine ER, and after 7 and 30 days of treatment. The drug was given after the 8 AM evaluation. The authors determined rest flow, maximal venous incremental volume (MVIV) at 40 mmHg and 60 mmHg, and gradient of venous volume between 60 and 40 mmHg divided by the pressure difference (DV/DP) as index of venous distensibility. On the days of plethysmographic evaluation, arterial blood pressure and heart rate were measured continuously over 24 hours by the ABPM (Ambulatory Blood Pressure Monitoring). The results were analyzed by ANOVA. Rest flow, MVIV, and DV/DP were stable at the baseline evaluation. On days 1, 7, and 30 of treatment the rest flow after 4 and 8 hours was significantly greater than at 8 AM but had always returned to normal after 24 hours. No other plethysmographic parameters changed significantly; in particular venous outflow remained unchanged. Mean arterial, systolic, and diastolic blood pressure were significantly reduced, compared with baseline, following treatment on the first day and after 7 and 30 days' treatment. There was no effect on heart rate. The authors conclude that felodipine is useful for the treatment of mild essential hypertension, since it reduces arterial resistance without altering venous capacitance or distensibility.

Carbocalcitonin treatment in Sudeck's atrophy.

The efficacy of new calcitonin, the amino analog of eel calcitonin (carboCT) on Sudeck's atrophy of the foot was investigated in 14 patients. CarboCT was administered at the dose of 40 Medical Research Council (MRC) units per day, and the duration of treatment was two to ten months. No adverse effects were noted. Bone pain and local edema decreased associated with improvement of motility. CarboCT induced a slight decrease in plasma calcium, plasma phosphate, and 24-hour urinary calcium excretion. An increase in cAMP/Cr ratio, an index of parathyroid function, was also observed (probably a manifestation of the hypocalcemic effect of calcitonin and secondary parathyroid stimulation). The whole body retention of 99mTc-MDP represents a valuable index of bone turnover, it decreased progressively and significantly on treatment. A dynamic study of local bone uptake of 99mTC-MDP was performed in eight patients. After carboCT therapy, statistically significant decreases in local blood flow, early uptake, and delayed uptake were appreciated in the involved foot. These findings lead to the conclusion that carboCT is effective in the treatment of Sudeck's atrophy.

Effect of a long-term treatment with 1,25-dihydroxyvitamin D3 on osteocalcin in postmenopausal osteoporosis.

Serum bone Gla-protein (BGP or osteocalcin) was measured in 25 women with histologically confirmed postmenopausal osteoporosis before and during long-term treatment with 1 microgram/day of 1,25-dihydroxyvitamin D3(1,25(OH)2D3). Basal serum BGP was significantly lower in osteoporotic women (3.8 +/- 1.4 ng/ml) than in age-matched controls (6.8 +/- 2.0 ng/ml). During 1,25(OH)2D3 therapy serum BGP increased so that the mean of the values observed on treatment (4.8 +/- 1.5) was significantly higher than the mean basal value. It is known that BGP synthesis is stimulated by 1,25(OH)2D3 and that serum BGP is a specific marker of bone formation; therefore, it is possible that the low basal levels of osteocalcin we observed were related to the low serum 1,25(OH)2D concentrations reported in osteoporotic women and that the increase in BGP levels observed under 1,25(OH)2D3 treatment was a consequence of osteoblast stimulation.

[Evaluation of the antihypertensive effect and tolerability of nadolol administered alone or in association with bendroflumethiazide]. / Valutazione dell'efficacia anti-ipertensiva e della tollerabilità del nadololo somministrato da solo o in associazione a bendroflumetiazide.

The anti-hypertensive action and tolerability of single daily doses of 80 mg nadolol, or 80 mg nadolol and 5 mg bendroflumethiazide were assessed in 30 subjects with mild or moderate hypertension. In both experiments a significant reduction in arterial pressure was observed, while no undesirable effects were noted. The association of nadolol and bendroflumethiaxide not merely proved to have a greater anti-hypertensive effect than treatment with the beta-blocking agent alone, but also led to the normalisation of blood pressure values in a higher percentage of hypertensive subjects than when nadolol alone was administered. This particular drug combination is thus the treatment of choice for most patients with hypertension. The fact that the beta-blocking agent and the diuretic can be administered in a single daily dose clearly enhances the patient's compliance with the prescribed treatment.

[Effects of nandrolone decanoate on bone mineral content and intestinal absorption of calcium]. / Effetti del nandrolone decanoato sul contenuto minerale osseo e sull'assorbimento intestinale del calcio.

To evaluate the effects of a long-term treatment with nandrolone decanoate on metabolism of the skeleton, a double-blind randomized study was carried out in women with joint diseases without metabolic bone derangement. Ten patients were treated with 50 mg of nandrolone decanoate every three weeks for two years; in six subjects a treatment with placebo was performed. As it concerns plasma calcium and phosphate, serum alkaline phosphatase, urinary excretion of calcium, phosphate, hydroxyproline and cAMP, as parathyroid index, it was not observed significant differences in the two examined groups. While in placebo group at the end of the study the intestinal radiocalcium remained unchanged and bone mineral content showed a slight decrease, on the contrary nandrolone decanoate treatment promoted a significant improvement in intestinal calcium absorption and an increase in bone mineral content.

[Treatment of Sudeck's syndrome with human calcitonin]. / Behandlung des Sudeck-Syndroms mit Human-Calcitonin.

Human calcitonin (Cibacalcin), at a dose of 0.5 mg daily for 15 days followed by 0.5 mg every other day for 4-6 months, was administered to 11 patients (eight men and three women, aged 36-74 years) with posttraumatic reflex sympathetic dystrophy of the lower limbs (stage I-II). Within one month there was significant lessening of pain, improved mobility and less oedema. Biochemical tests were within normal limits before and after treatment, while the pre-treatment raised bone retention of 99mTc-methylene-diphosphonate and increased blood flow in the affected area became normal during treatment. In nine patients healing occurred in the course of four to six months on treatment, in two patients after more than six months. There were no serious side-effects requiring interruption of treatment. These results indicate that human calcitonin should be tried in the treatment of this condition.

[Behavior of urinary excretion of cyclic AMP in post-menopausal osteoporosis during therapy with salmon calcitonin]. / Comportamento dell'escrezione urinaria di AMP ciclico nella osteoporosi post-menopausale in corso di terapia con calcitonina di salmone.

Salmon calcitonin has been administered at a dose of 100 U.M.R.C. for 6 months in 10 patients suffering from post-menopausal osteoporosis. During treatment, calcium plasma levels fluctuated but tended to fall, while urinary excretion of cyclic AMP rose, this pointing to an enhancement of parathyroid function. After 6 months an increase in intestinal calcium absorption and a decrease in bone turnover were also observed, the bone mineral content evaluated by bone densitometry showed a slight quantitative increase but proved to be substantially unchanged. Salmon calcitonin thus proved capable of interfering with bone turnover by reducing the bone resorption. By fostering an increase in parathyroid hormone production, it also made it possible to exploit that anabolic effect which, in low doses, the parathormone exerts on the bone tissue.