DISTRIBUTION OF CATECHOLAMINERGIC NEUROTRANSMITTERS AND RELATED RECEPTORS IN HUMAN BRONCHUS-ASSOCIATED LYMPHOID TISSUE

Background: The functions of the bronchus-associated lymphoid tissue (BALT) are under the control of the autonomic nervous system ( sympathetic and parasympathetic nerve fibers). Objectives: The relationships between the adrenergic nerve fibers and beta-adrenergic receptors were studied in the human BALT with the aim to demonstrate a probable neuromodulation. Methods: Morphological observations ( staining with hematoxylineosin and scanning electron microscopy images) were carried out on samples of human BALT harvested during autopsies. Moreover, histochemical staining for norepinephrine ( adrenaline = adrenergic nerve fibers) as well as for other catecholamines was performed. Finally, beta-adrenergic receptors were stained by means of a beta-blocking, radiolabeled drug ( pindolol I-125). All our data were submitted to morphometric analysis ( quantitative analysis of images and statistical analysis of data). Results: Our results provide direct evidence of the presence and distribution of catecholaminergic nerve fibers and related beta-adrenergic receptors in BALT. beta-Adrenergic receptors are present above all in the most richly innervated part of the BALT, and are, therefore, in close relationship with their related adrenergic nerve fibers. Conclusions: Studies on the distribution of adrenergic neurotransmitters and related beta-adrenergic receptors in the human BALT are the first step for the demonstration of a probable neuromodulation of BALT. Copyright (C) 2004 S. Karger AG, Basel

The prevalence of resistant arterial hypertension and secondary causes in a cohort of hypertensive patients: a single center experience

The prevalence of resistant hypertension (RHT) still remains unknown. Aim of the study was to investigate in a large cohort of hypertensive patients the prevalence of RHT, and to identify in these patients the secondary forms of arterial hypertension (SH). We enrolled a series of 3685 consecutive hypertensive patients. All patients underwent complete physical examination, laboratory tests, screening for SH. Ambulatory blood pressure monitoring (ABPM) was performed to exclude white-coat hypertension. Further, we investigated for any obstructive sleep apnea syndrome (OSA). Only 232 (5.8%) hypertensive patients fulfilled criteria for RHT. 91 (39%) had a SH; 56 (61%) hypertensive patients had a primary aldosteronism, 22 (24%) had OSA, 7 (7.7%) had a hypercortisolism, and 5 (5.5%) had a renovascular hypertension (RVH). Only one patient had adrenal pheochromocytoma. An accurate definition and investigation into RHT is needed. We recommend ABPM to all patients at diagnosis. Finally, all patients must be screened for SH, such as adrenal hypertension, OSA and RVH, especially those who are apparently resistant to polypharmacological treatment

Diabete prevenzione e stili di vita

Il Corso ha evidenziato il ruolo degli stili di vita nella prevenzione della malattia diabetic