Investigating feedforward neural regulation of circulation from analysis of spontaneous arterial pressure and heart rate fluctuations in conscious rats.

Investigating feedforward neural regulation of circulation from analysis of spontaneous arterial pressure and heart rate fluctuations in conscious rats. Am J Physiol Heart Circ Physiol 296: H202–H210, 2009. First published November 14, 2008; doi:10.1152/ajpheart.00358.2008.—It has been suggested in anesthetized animals that the occurrence of sequences of consecutive beats characterized by systolic arterial pressure (SAP) and RR or pulse interval (PI) changing in the opposite direction (SAP /RR and SAP /RR , nonbaroreflex sequences) might represent the expression of neural cardiovascular regulatory mechanisms operating with feedforward characteristics. The aim of the present study was to study nonbaroreflex sequences in a more physiological experimental model, i.e., in conscious freely moving rats. We studied conscious rats before and after 1) complete autonomic blockade (n 12), 2) sympathetic blockade (n 10), 3) (n 7)- and (n 8)-adrenergic blockade, and 4) parasympathetic blockade (n 10). Nonbaroreflex sequences were defined as three or more beats in which SAP and PI of the following beat changed in the opposite direction. Complete autonomic blockade reduced the number of nonbaroreflex sequences (95.6 9.0 vs. 45.2 4.1, P 0.001), as did sympathetic blockade (80.9 12.6 vs. 30.9 6.1, P 0.001). The selective -receptor blockade did not induce significant changes (80.9 12.5 in baseline vs. 79.0 14.7 after prazosin), whereas -receptor blockade significantly reduced nonbaroreflex sequence occurrence (80.9 12.5 in baseline vs. 48.9 15.3 after propranolol). Parasympathetic blockade produced a significant increase of nonbaroreflex sequences (95.1 6.9 vs. 136.0 12.4, P 0.01). These results demonstrate the physiological role of the nonbaroreflex sequences as an expression of a feedforward type of short-term cardiovascular regulation able to interact dynamically with the feedback mechanisms of baroreflex origin in the neural control of the sinus node

How to improve the management of patients and the compliance to lipid lowering drug treatment

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Association between histological diagnosis of helicobacter pylory and coronary disease: results of a retrospective study

OBJECTIVE: Several epidemiological and clinical reports have investigated the relationship between Helicobacter pylori (H. pylori) infection and ischemic heart disease (IHD). All studies utilized for the diagnosis of H. pylori infection the antibody titre that is unable to distinguish an actual from a previous H. pylori infection. PATIENTS AND METHODS: We report a retrospective analysis on 149 subjects, who underwent an esophago-gastro-duodenoscopy, in whom the search for H. pylori was histologically performed. RESULTS: The prevalence of IHD is not significantly different from that observed in H. pylori free patients (26% vs 21%, p = 0.527). CONCLUSIONS: The mechanism underlying the possible role of H. pylori needs further investigation and prospective studies to further analyze the relationship between "active" H. pylori infection and ischemic heart disease were necessary

Frequent use of emergency departments by the elderly population when continuing care is not well established

The elderly, who suffer from multiple chronic diseases, represent a substantial proportion of Emergency Department (ED) frequent users, thus contributing to ED overcrowding, although they could benefit from other health care facilities, if those were available. The aim of this study was to evaluate and characterize hospital visits of older patients (age 65 or greater) to the ED of a university teaching hospital in Rome from the 1st of January to the 31st of December 2014, in order to identify clinical and social characteristics potentially associated with "elderly frequent users"