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  • 1
    Electronic Resource
    Electronic Resource
    Ambulatory blood pressure recording in diabetic patients with abnormal responses to cardiovascular autonomic function tests (1992)
    Springer
    Acta diabetologica 28 (1992), S. 221-228 
    Details
    ISSN: 1432-5233
    Keywords: Blood pressure ; Nycthermal rhythm ; Diabetic autonomic neuropathy
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The aim of our study was to analyse the 24-h periodic pattern of blood pressure (BP) in diabetic patients with abnormal responses to cardiovascular reflexes, in order to evaluate the extent of the initial autonomic damage. We studied 44 patients with diabetes mellitus (14 insulin-dependent, 30 non-insulin-dependent; mean duration of disease 6.5±1.8 years) in good metabolic control (fasting glycaemia 〈140 mg/dl, postprandial glycaemia 〈180 mg/dl, fructosamine 〈285 mg/dl), divided into two subgroups, containing 21 normotensives (13 males and 8 females aged 28–72 years) and 23 hypertensives (13 males and 10 females aged 32–70 years) respectively. All patients showed abnormal responses to at least two out of four tests: deep breathing, lying to standing, Valsalva manœuvre and postural hypotension. Two sex-and age-matched control groups were recruited, comprising 20 normotensive and 20 hypertensive diabetic patients without dysautonomia, respectively. The reference group consisted of 248 normotensives (135 males and 113 females, aged 18–76 years) and 212 mild-moderate hypertensives (130 males and 82 females, aged 27–66 years). Each patient underwent ambulatory BP monitoring for at least 24 h, using an auscultatory automatic device. Data concerning biological rhythms were analysed by means of periodic functions. We limited the Fourier partial sums to the first three harmonics. In the diabetic normotensive groups, we observed that the absolute systolic and diastolic BP minima during the night occurred very rapidly and that the increase to the morning maximum was markedly slowed in patients with abnormal responses to cardiovascular tests in comparison with the controls (nocturnal BP decrease −5.8/−4.7 vs −3.8/−4.0 mm Hg/h; increase 4.7/3.6 vs 5.9/6.1 mm Hg/h). The same phenomenon was observed in both hypertensive groups but the differences were more marked (nocturnal BP decrase −7.7/−7.1 vs −4.3/−3.9 mm Hg/h; increase 3.2/2.1 vs 5.8/4.3 mm Hg/h). Diabetic patients without dysautonomia had similar patterns to those in the normotensive and hypertensive reference groups. Since alterations in circadian rhythm are preceded by an intermediate smoothed BP curve during the early morning, which is well defined by Fourier analysis and related “speeds”, this method makes it possible to quantify the extent of the initial autonomic damage.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00779003
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Salt-sensitivity is associated with a hyperinsulinaemic and hyperglycaemic response to atrial natriuretic peptide infusion in human essential hypertension (1994)
    Springer
    Diabetologia 37 (1994), S. 308-312 
    Details
    ISSN: 1432-0428
    Keywords: Hypertension ; atrial natriuretic peptide ; insulin ; salt-sensitivity ; kidney
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To evaluate the influence of salt-sensitivity on the plasma insulin and glucose response to infusion of ANP, we studied 22 men with essential hypertension, who were between 40 and 60 years old. After 1 month under normal Na+ intake (120 mmol Na+ per day), patients were randomly assigned to receive either ANP (0.04 μg · kg−1 · min−1) (n=15) or vehicle (50 ml saline) (n=7) over a 60-min period, while in the supine position. Plasma insulin and glucose were measured at time −60, 0, 20, 40, 60, 120, 180, 240 min. Ten days after ANP infusion, blood pressure sensitivity to changes in di etary salt intake was assessed according to a randomized double-blind crossover protocol. Patients were classified into two groups either salt-sensitive (n=8) or salt-resistant (n=7). Our results showed that plasma insulin and glucose did not change during ANP infusion in both groups. However, both plasma insulin (from 75.6 ± 45.1 pmol/l at 60 min to 121.2 ± 48.6 pmol/l at 240 min, p 〈0.05 vs time 0) and glucose levels (from 4.86 ± 0.73 mmol/l at 60 min to 6.56 ± 1.03 mmol/l at 240 min, p 〈0.01 vs time 0) rose after discontinuation of ANP in salt-sensitive patients, but did not change at all in salt-resistant patients. In conclusion, this randomized vehicle-controlled study demonstrates that plasma insulin and glucose levels increase in salt-sensitive hypertensive patients after the infusion of ANP. The increase of plasma insulin levels observed after ANP discontinuation, if occurring under physiologic conditions, could influence the blood pressure sensitivity to dietary Na+ intake.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00398059
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Salt-sensitivity is associated with a hyperinsulinaemic and hyperglycaemic response to atrial natriuretic peptide infusion in human essential hypertension (1994)
    Springer
    Diabetologia 37 (1994), S. 308-312 
    Details
    ISSN: 1432-0428
    Keywords: Key words Hypertension, atrial natriuretic peptide, insulin, salt-sensitivity, kidney. [Diabetologia (1994) 37: 308–312]
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary To evaluate the influence of salt-sensitivity on the plasma insulin and glucose response to infusion of ANP, we studied 22 men with essential hypertension, who were between 40 and 60 years old. After 1 month under normal Na+ intake (120 mmol Na+ per day), patients were randomly assigned to receive either ANP (0.04 µg·kg−1·min−1) (n =15) or vehicle (50 ml saline) (n =7) over a 60-min period, while in the supine position. Plasma insulin and glucose were measured at time –60, 0, 20, 40, 60, 120, 180, 240 min. Ten days after ANP infusion, blood pressure sensitivity to changes in dietary salt intake was assessed according to a randomized double-blind crossover protocol. Patients were classified into two groups either salt-sensitive (n =8) or salt-resistant (n =7). Our results showed that plasma insulin and glucose did not change during ANP infusion in both groups. However, both plasma insulin (from 75.6±45.1 pmol/l at 60 min to 121.2±48.6 pmol/l at 240 min, p〈0.05 vs time 0) and glucose levels (from 4.86±0.73 mmol/l at 60 min to 6.56±1.03 mmol/l at 240 min, p〈0.01 vs time 0) rose after discontinuation of ANP in salt-sensitive patients, but did not change at all in salt-resistant patients. In conclusion, this randomized vehicle-controlled study demonstrates that plasma insulin and glucose levels increase in salt-sensitive hypertensive patients after the infusion of ANP. The increase of plasma insulin levels observed after ANP discontinuation, if occurring under physiologic conditions, could influence the blood pressure sensitivity to dietary Na+ intake.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00398059
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
  • 4
    Electronic Resource
    Electronic Resource
    A case of facio-scapulo-humeroperoneal myopathy with inflammatory changes. Preliminary data on distribution of mononuclear cells in muscle tissue (1992)
    Springer
    Neurological sciences 13 (1992), S. 69-73 
    Details
    ISSN: 1590-3478
    Keywords: Facioscapulohumeroperoneal dystrophy ; inflammatory ; histology ; immunohistochemistry ; lymphocytes
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Sommario Una donna di 49 anni presenta reperti clinici, elettrofisiologici ed istochimici indicativi di distrofia facioscapolo-omero-peroneale con importanti alterazioni a carattere infiammatorio. La tipizzazione linfocitaria condotta su frammento di muscolo prelevato biopticamente con le tecniche di immunofluorescenza ed immuno-perossidasi, ha mostrato un elevato numero di T8 nei siti endomisiali. I linfociti non presentano invasione diretta delle fibre sane, per cui non è presumibile una loro azione citotossica primaria verso il tessuto muscolare. I macrofagi parimenti risultano aumentati di numero sia in regione endomisiale che perivascolare. In questo caso un ruolo patogenetico della immunità cellulo-mediata non è significativo, contrariamente ad altri studi della letteratura condotti nelle polimiositi e nelle distrofie facio-scapolo-omerali con reperti infiammatori.
    Notes: Abstract We report the case of a 49 year old woman with clinical, electrophysiological and histochemical signs of facio-scapulohumeroperoneal dystrophy characterized by highly inflammatory changes. Lymphocyte typing by immunofluorescence and immunoperoxidase techniques on a muscle biopsy fragment revealed a large number of T8 cells at endomysial sites. There was no evidence of direct invasion of sound fibers by lymphocytes, which are thus unlikely to have exerted a primary cytotoxic action on the muscle tissue. Another finding was an increased number of macrophages in both endomysial and perivascular regions. Cell-mediated immunity did not play a significant role in the pathogenesis of our case, unlike other reported cases of polymyositis and facioscapulohumeral dystrophy with inflammatory findings.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02222891
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    Paper (German National Licenses)
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  • 5
    Electronic Resource
    Electronic Resource
    Early nocturnal blood pressure changes in diabetic autonomic neuropathy assessed by Fourier series (1993)
    Springer
    Clinical autonomic research 3 (1993), S. 249-254 
    Details
    ISSN: 1619-1560
    Keywords: Blood pressure ; Circadian rhythm ; Fourier series ; Dysautonomia
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The 24 h periodic pattern of blood pressure was studied in 44 patients with diabetes mellitus (14 type 1, 30 type 2; mean duration of disease 6.5 ± 1.8 years) in good metabolic control but with abnormal cardiovascular reflex responses; of these 21 were normotensive and 23 hypertensive. All had abnormal responses to at least two out of four tests: deep breathing, lying to standing, Valsalva manoeuvre and postural hypotension. Two sex- and agematched groups, consisting of 20 normotensive and 20 hypertensive diabetic patients without dysautonomia, were studied as controls. Each patient underwent ambulatory blood pressure monitoring for at least 24 h, using an auscultatory automatic device. Data were analysed using the sum of three periodic functions (Fourier partial sum). In the diabetic normotensive groups, the absolute blood pressure fell to its night-time minimum more rapidly, and increased to its morning maximum more slowly, in those with abnormal cardiovascular reflexes than in the controls (nightly blood pressure decrease −5.8/−4.7 vs. −3.8/−4.0 mmHg/h; increase 4.7/3.6 vs. 5.9/6.1 mmHg/h). The same behaviour was found in both hypertensive groups but the amplitude of the differences was more marked (blood pressure nocturnal decrease −7.7/−7.1 vs. −4.3/−3.9 mmHg/h; increase 3.2/2.1 vs. 5.8/4.3 mmHg/h). This analysis of 24 h ambulatory blood pressure data may be of value in diagnosis and evaluation of autonomic deficits.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF01829014
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    Paper (German National Licenses)
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