Paolo T. Scarpelli

Simultaneous and sequential same-arm measurements in the validation studies of automated blood pressure measuring devices

The oscillometric ambulatory blood pressure recorder Daypress 500 was validated according to the British Hypertension Society protocol. Both sequential and simultaneous measurements were used. Multiple regression analysis demonstrated a significant influence of subject pulse pressure and arm circumference on device-observer systolic pressure differences. Differences between observer consecutive readings were inversely related to heart rate. Device and observer blood pressure readings were closer at simultaneous than at sequential measurements. However, both kinds of measurement led to the same final evaluation (A for diastolic and B for systolic blood pressure), provided that the appropriate grading criteria were applied for each method.

Age effects upon the harmonic structure of human blood pressure in clinical health

Ambulatory blood pressure monitoring of 180 clinically healthy adults of both genders is used to investigate and compare ultradian aspects of systolic and diastolic blood pressure as a function of age. Three age categories are considered: 20-40, 40-60, and over 60 years of age. results from least-squares spectra of each data series are further examined by analysis of variance. Gender and age effects are found to characterize the waveform of human blood pressure. These effects can be quantified by spectral analysis and may represent gauges of aging.<<ETX>>

Instrumentation for Human Blood Pressure Rhythm Assessment by Self-Measurement

Herein, we wish to document the need for instrumentation for autorhythmometry, notably of blood pressure (BP). Autorhythmometry has been introduced by us in schools, in the home and in the clinic. Despite obvious limitations of the existing instrumentation, the merits of autorhythmometry pertain to (early) diagnosis, (optimal) treatment and, first and foremost, to prevention, as illustrated by the following results.

Cigarette-smoking effects on circadian rhythm parameters of blood pressure

Ambulatory monitoring of blood pressure (BP) and heart rate in a multicentric Italian study is used to investigate effects of smoking and of a family history of high blood pressure and cardiovascular disease in clinically healthy adults of both genders between 40 and 59 years of age. A higher 24-h rhythm-adjusted mean of systolic blood pressure is found in smokers having a positive family history of high blood pressure. The results of this chronobiologic investigation are reviewed in the context of relations between smoking and cardiovascular morbidity. It appears that the effect of smoking depends in part on interacting factors. The major factor in this context may well be the family history of BP insofar as the results of the study based on a considerable number of observations are considered.<<ETX>>

Blood pressure self-measurement in schools for chronobiologic discriminant analysis between two groups of children with and without family history of hypertension

The purpose of this study is to verify the possibility and to quantify the degree of discrimination between two groups of primary school children, one of which is at risk of developing a high blood pressure (BP) as far as family history of hypertension is concerned. A self-measurement approach was considered of more practical use for an epidemiologic study as compared to the more reliable but more cumbersome automatic invasive or even indirect monitoring with currently available heavy instrumentation in 9-year-olds.

A Modified Bladder Washout Test to Improve Diagnostic Results in Chronic Urinary Tract Infections

Bladder washout (BWO) and antibody-coated bacteria (ACB) tests were performed on 25 patients with radiological and/or clinical evidence of chronic upper urinary tract infection (UTI) and 12 patients with asymptomatic bacteriuria. Using a traditional single-washout procedure, the BWO test gave equivocal results in many cases of chronic pyelonephritis; this seemed mainly due to the lack of complete bladder sterilization. A modified procedure, including double sterilization and irrigation, biochemical typing of isolated bacteria, and evaluation of temporal pattern of bacteriuria recurrence, was then introduced. Although preliminary results of the modified BWO test demonstrated a general improvement in the diagnosis of the infection site, it seemed rather difficult, at least in chronic UTI, to establish localizing criteria based on definite numeric changes in bacterial counts after washout.

Peripheral small vessel involvement in chronic nephritides

Small cutaneous vessels, obtained by ear lobe biopsies were studied in 14 patients with various chronic nephritides and in 10 normal controls. The capillaries in the group of patients with nephritis were found to undergo two main changes: thickening of the adventitia reticularis and perivascular cellular infiltration in an inverse ratio. This infiltration was seen to be made up on mononuclear cells and an increased number of mast cells in various stages of degranulation. Changes in the basement membrane as seen by electron microscopy are not constant. All of the above changes were absent in the controls and are similar to what has been described in previous studies in both experimental and spontaneous pathologic conditions, such as experimental hypertension, diabetes mellitus, scleroderma, rheumatoid arthritis, etc.Small vessel involvement in chronic nephritides could be part of a process of diffuse microvascular damage that includes the kidneys or it may be related to hypertension or to the biochemical changes which follow uremic and pre-uremic states.

Nefronoftisi familiare: Revisione della letteratura e presentazione di 4 casi della stessa famiglia

SummaryNephronophthisis (N) and medullary cystic disease (MCD) can occur in the same family group. In a single family of 11 children, 4 were affected by hereditary nephropathy. 2 of them died before the disease was well known and no histological diagnosis was made. Of the other 2 members, the first, at the time of observation, was in periodical dialysis and died during our study; autopsy showed a typical MCD. The second one is still living and renal biopsy showed a typical N. The other unaffected members, including the father, have no signs of kidney involvement. The clinical and histological findings are discussed and the conclusion drawn is that MCD and N may be considered a same disease.RiassuntoLa nefronoftisi (N) e la malattia cistica midollare (MCM) possono verificarsi nello stesso nucleo familiare. In una famiglia di 11 figli, 4 erano affetti da nefropatia ereditaria. 2 di essi morirono prima che la malattia fosse ben nota e non fu fatta la diagnosi istologica. Degli altri 2 membri, il primo, al momento dell’osservazione, era in dialisi periodica e morì durante il nostro studio; l’autopsia ha dimostrato una tipica MCM. Nel secondo, vivente, la biopsia renale ha messo in evidenza una tipica N. I rimanenti membri sani della famiglia, compreso il padre, non mostrano segni di malattia renale. Viene discusso il quadro clinico ed istologico, giungendo alla conclusione che la MCM e la N possono essere considerate la stessa malattia.