tag:blogger.com,1999:blog-88144299230039094692024-02-19T00:52:35.703-08:00Semeiotica Biofisica QuantisticaIn questo spazio è illustrata la Semeiotica Biofisica-Quantistica mediante articoli che ne sottolineano i benefici nel campo della Diagnosi Clinica, Monitoraggio Terapeutico, Prevenzione Primaria e nella Ricerca.Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.comBlogger26125tag:blogger.com,1999:blog-8814429923003909469.post-88560903199450235922011-07-07T06:14:00.000-07:002011-07-07T06:15:58.937-07:00Water Memory-Information containing Muscle Extremely High Energy Frequency: Is the Therapeutic Problem of Chronic Fatigue Syndrome solved?Introduction. <br />As I wrote formerly (1), till July 1st, 2011, water memory was an argument of large discussion, really a conjecture.<br />In fact, nobody has ever proved that water is able of retaining a memory (I use also the term INFORMATION) of substances dissolved in it once to arbitrary dilution. In the referred paper, precise information on utilizing Water Memory-Information was provided. <br />While some studies, including Benveniste’s, reported this effect, double-blind replications of the experiments involved have failed to reproduce the results, and the concept is not accepted by the scientific community. <br />On the contrary, I illustrated the CLINICAL, Quantum Biophysical Semeiotic Demonstration of Water Memory-Information, curing my gastroenterocolitis due to Gram-positive bacteria, I had been suffering from for 4 days (1). <br />Importantly, every my experimental evidence can be bedside reproduced easily and quickly, at the condition that scientists, who want reproduce it, know the quantum biophysical semeiotic method! <br /><br />For 4 decades I have been suffering from Chronic Fatigue Syndrome (CFS), an unsolved therapeutic problem till now. Thanks to earlier treatment, based on free-radicals scavenger and anti-inflammatory drugs, I obtained partial and transitory benefit (2-8). <br /><br />Chronic Fatigue Syndrome: State of the Art. <br />Chronic fatigue syndrome, CFS, is a debilitating and complex disorder characterized by profound fatigue that is not improved by bed rest and that may be worsened by physical or mental activity. Persons with CFS most often function at a substantially lower level of activity than they were capable of before the onset of the illness. <br />The fatigue of CFS is accompanied by characteristic symptoms lasting at least 6 months, including self-reported impairment in short-term memory or concentration, severe enough to cause substantial reduction in previous levels of occupational, educational, social, or personal activities; sore throat is frequent or recurring; tender cervical (neck) or axillary lymph nodes; muscle pain; multi-joint pain without swelling or redness; headaches of a new type, pattern, or severity; very common un-refreshing sleep and post-exertional malaise (extreme, prolonged exhaustion and sickness following physical or mental activity) lasting more than 24 hours. <br />However, many CFS patients may experience other symptoms, including irritable bowel, depression or psychological problems, chills and night sweats, visual disturbances, allergies or sensitivities to food, odours, chemicals, medications, or noise, brain fog, difficulty maintaining upright position, dizziness, balance problems or fainting. <br /><br />CFS: the hypothesis 0, I cannot falsify. <br />Quantum Biophysical Semeiotics facilitates CFS diagnosis, as illustrated here after. <br />The hypothesis 0 to falsify was that in CFS skeletal muscles, a part from the possible causes of such a disorder, are altered from the structural and functional view-point: structure and function are two poles of the same equation! <br />As a consequence the relative energy frequency, gathered from skeletal muscles, e.g., biceps and quadriceps, was altered, too, so that after modifying it properly with Cem Tech, and retransmitting it to a glass of mineral water that patients swallow, physicians will ameliorate until normalize their muscle structure and function, especially regarding local mitochondria respiratory activity, altered in CFS. <br />As a matter of fact, such a water, thanks to Cem Tech, contains Information on the muscle physiological structure, conserving it as Memory for a time to prove – two days after the experiment beginning – results are present yet, as I am going to illustrate here after. <br /><br />Quantum Biophysical Semeiotic Methods. <br />Basal QBS evaluation showed that, under “intense” (= such an adjactive is “quantitative”, rather than “qualitative”, indicating that it brings about upper ureteral reflex, typical of Artero-Venous Anastomoses (AVA) type A, group II, according to Bucciante) (19-13) digital pressure, latency time of (biceps and quadriceps) skeletal muscle-gastric aspecific reflex was 9 sec. (NN = 10 sec.); duration pathologically increased to 7 sec. (NN > 3 sec. < 4 sec.; paramount parameter value, paralleling the efficiency of local Microcirculatory Reserve Function); finally, the time of reflex disappearing lowered to 3 sec. (NN > 3 sec. < 4 sec., perfectly identical to fractal Dimension of local microvessel fluctuation, calculated in a really refined, but difficult, way) (9-12). <br />In addition, the Free-Radical QBS evaluation resulted positive, emphasising an high tissue level of oxygen reactive substances (8): at the second assessment, exactly 3 sec. after the basal evaluation, latency time of muscle-gastric aspecific reflex decreased pathologically to 7,5 sec. <br /><br />At this point, I have captured with Cem Tech two devices (crystals) frequency from my right biceps and respectively from my left quadriceps, for 1 minute. <br />Subsequently, after applying the two devices on myself on the same sites, cited above, I assessed for the second time the identical parameter values of skeletal muscle-gastric aspecific reflex. <br />Latency time of the reflex raised to 20 sec. (basal value = 9 sec.), as it happens in QBS physiological preconditioning (11, 12). Reflex duration decreased to 3 sec., showing a perfect muscle vessels Microcirculatory Functional Reserve. Finally, the time of reflex disappearing returned to normal value: > 3 sec. < 4 sec. <br /><br />At this moment, I removed from my body Cem Tech crystals, emitting extremely high energy frequency, and immediately reflex parameters showed identical pathological parameter value, as those observed in basal examination, referred above. <br /><br />At this point, I directed the extremely high frequency energy, contained by Cem Tech devices, towards the water, precisely mineral water, present in a glass, placed on the table 10 cm from my body, by applying the two crystals directly on the base of glass bottom for 10 min. <br />Starting from about 4 minutes, parameter values of the above illustrated reflex progressively ameliorated, and after less than 10 sec. they showed the values, typical of QBS physiological preconditioning.<br />Every observation was possible thank to, and enlightened by, n-DNA and mit-DNA Antenna theory, I demonstrated formerly (14, 15).<br />At this point, I went away from the water in the glass, as well as from Cem Tech devices: the evaluation of reflex parameter values resulted again in pathological ranges, showing the same data, referred above! <br /><br />Soon after I drunk that energized water, I observed identical, significant increasing of all parameter values of muscle-gastric aspecific reflex: Latency time of the reflex raised to 20 sec. (basal value 9 sec.), characteristic of QBS preconditioning (11, 12). Reflex duration lowered to 3 sec., showing a perfect Microcirculatory Functional Reserve of muscle microcirculatory bed. <br />Finally, the time of reflex disappearing returned to normal value: > 3 sec. < 4 sec.; <br />Importantly, the cleaned glass was inactive, i.e., it did not bring about increasing of reflex parameter values! <br />Interestingly, two hours after the experiment beginning, all parameter values, illustrated above, were yet identical. I walked for 45 min. without feeling fatigue, like now while I am writing this Manuscript. Benveniste was right!<br />Interestingly, the above illustrated positive results lasted exactly for 14 hours; then all parameters values slowly decreased in the three subsequent hours until the latency time of skeletal muscle reflex decreased to 12 sec. (NN = 10 sec.); reflex duration lowered to 3 sec. (NN >3 sec.< 4 sec. indicating a perfect Microcirculatory Functional Reserve); finally, reflex disappearing time was 4 sec., showing that fractal Dimension of local microvessels oscillations was at highest value. <br />After two days all parameters showed normal values.<br /> <br />Conclusion: the significant data of this quantum-biophysical-semeiotic experiment, illustrated in details from the technical view-point, aiming to treat Chronic Fatigue Syndrome, allows me to state that a “possible”, really efficacious therapy of CFS has been discovered, if it will be corroborated on a very large scale, of course. <br /><br />References <br />1) Stagnaro Sergio. First Water Memory-Information Demonstration through Quantum Biophysical Semeiotics. 1 July, 2011, http://stagnaro.wordpress.com/ ; http://www.sisbq.org/journal-of-quantum-biophysical-semeiotics1.html; http://www.sisbq.org/uploads/5/6/8/7/5687930/watermemoryinformation.pdf<br />2) Stagnaro-Neri M., Stagnaro S., Carenza di Co Q10 secondaria a terapia ipolipidemizzante diagnosticata con la Percussione Ascoltata. Settimana Italiana di Dietologia, 9-13 Aprile 1991, Merano. Atti, pg. 65. Epat. 37, 17, 1990. <br />2) Stagnaro-Neri M., Stagnaro S., Acidi grassi ώ-3, scavengers dei radicali liberi e attivatori del ciclo Q della sintesi del Co Q10. Gazz. Med. It. – Arch. Sc. Med. 151, 341, 1992. <br />3) Stagnaro-Neri M., Stagnaro S., Auscultatory Percussion Coenzyme Q deficiency Syndrome. VI Int. Symp., Biomedical and clinical aspects of Coenzyme Q. Rome, January 22.24, 1990,Chairmen K. Folkers, G.L. Littarru, T. Yamagani, Abs., pg. 105. <br />4) Stagnaro-Neri M., Stagnaro S., Sindrome clinica percusso-ascoltatoria da carenza di Co Q10. Medic. Geriatr. XXIV, 239. <br />5) Stagnaro-Neri M, Stagnaro S. Co Q10 in the prevention and treatment of primary osteoporosis. Preliminary data. Clin Ter.;146(3):215-9 [MEDLINE] <br />6) Stagnaro-Neri M., Stagnaro S., La sindrome percusso-ascoltatoria da carenza di Carnitina. Clin. Ter. 145, 135, 1994 [Medline] <br />7) Stagnaro-Neri M., Stagnaro S., La sindrome percusso-ascoltatoria da carenza di Carnitina. Clin. Ter. 145, 135, 1992 [Medline] <br />8) Stagnaro-Neri M., Stagnaro S., Ketanserina: antagonista dei recettori 5Ht2-serotoninergici e scavenger dei radicali liberi. Clin. Ter. 141, 465, 1994 [Medline] <br />9) Stagnaro-Neri M., Stagnaro S., Deterministic chaotic biological system: the microcirculatoory bed. Theoretical and practical aspects. Gazz. Med. It. – Arch. Sc. Med. 153, 99 <br />10) Stagnaro-Neri M., Moscatelli G., Biophysical Semeiotics: deterministic Chaos and biological Systems. Gazz. Med. It. – Arch. Sc. Med. 155, 125, 1996. <br />11) Stagnaro-Neri M., Stagnaro S., Deterministic Chaos, Preconditioning and Myocardial Oxygenation evaluated clinically with the aid of Biophysical Semeiotics in the Diagnosis of ischaemic Heart Disease even silent. Acta Med. Medit. 13, 109, 1997. <br />12) Stagnaro Sergio. Role of Coronary Endoarterial Blocking Devices in Myocardial Preconditioning - c007i. Lecture, V Virtual International Congress of Cardiology. 2007. http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php <br />13) Stagnaro-Neri M., Stagnaro S., Auscultatory Percussion Evaluation of Arterio-venous Anastomoses Dysfunction in early Arteriosclerosis. Acta Med. Medit. 5, 141, 1989. <br />14) Sergio Stagnaro. Ruolo del DNA Antenna nella Diagnosi Semeiotica Biofisica Quantistica dei Primi due Stadi del Diabete Mellito tipo 2. http://www.fcenews.it, 19 novembre 2010. http://www.fceonline.it/images/docs/dna_diabete.pdf; http://qbsemeiotics.weebly.com/uploads/5/6/8/7/5687930/dna_t2dm.pdf <br />15) Simone Caramel and Sergio Stagnaro The role of glycocalyx in QBS diagnosis of Di Bella’s Oncological Terrain - http://www.sisbq.org/uploads/5/6/8/7/5687930/oncological_glycocalyx2011.pdfStagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-38429995229963882482011-07-05T04:39:00.001-07:002011-07-05T04:41:19.518-07:00Gentile’s Sign*: Bedside Diagnosing Acute Myocardial Infarction, even initial or silent.Bedside diagnosing Acute Myocardial Infarction (AMI) is sometimes very difficult, particularly if initial or silent. On the other hand, the efficaciousness of therapeutic results, especially regarding mortality rate, depend of early AMI diagnosis (1-7). <br />In following, a Quantum Biophysical Semeiotics simple method, easily and quickly to apply, based on Gentile’s Sign, is fully illustrated. <br />Considering that glucose and lipid metabolism impairment worsens, BUT not brings about coronary artery disease (CAD), as I have demonstrated earlier (3-8), physician has to know CAD Inherited Real Risk, rapidly detected with the Caotino’s Sign (8), representing the condition sine qua non of CAD, especially in individuals involved by hypertension, diabetes mellitus, dyslipidemia, or elevated C-reactive protein.<br />In my long, well-established clinical experience, Gentile’s Sign proved to be really useful also in order to bed-side recognizing AMI, even silent or initial: impending infarction. <br />Importantly, it is known that patients with CAD may have no symptoms at all for many years or decades and that the electrocardiographic features of ischemia may be induced by exercise without accompanying angina (2, 7, 8). As a consequence, physicians need a clinical tool reliable in rapid detecting CAD, even clinically silent, initiating from CAD “inherited real risk. From the practical viewpoint, in order to apply Gentile’s Sign doctor has to know, at least, the auscultatory percussion of the stomach (1). <br />In health, digital pressure of “mean” intensity (= stimulation of both upper and lower ureteral reflex: vasomotility and respectively vasomotion, according to Hammersen), applied upon ventricle heart skin projection area = precordium), brings about the so-called gastric aspecific reflex (= in the stomach, fundus and body are dilated, while antral-pyloric region contracts) after a latency time of 8 sec. exactly; reflex duration is less than 4 sec. (= parameter value of paramount significance since it parallels the efficacy of local coronary microvessel Microcirculatory Functional Reserve). Finally, the reflex disappearing is > 3 sec. < 4 sec. (= parameter value paralleling fractal Dimension of local microcirculatory oscillations) (1-4) (Fig. 1).<br />On the contrary, in impending infarction and obviously in overt AMI, even silent or initial, latency time appears significantly lowered to 3-5 sec, in inverse relation with the seriousness of underlying disorder (NN = 8 sec.). Reflex lasts longer than normal: 4 sec. or more (NN = > 3 sec. < 4 sec.), directly correlated with the AMI severity. <br />Finally, nail-digital pressure on identical heart trigger-points, illustrated above, only in AMI patients bring about gastric aspecific refelex after a reduced latency time: 3-5 sec. (NN = 10 sec. or more)<br />When physicians will be able to apply Gentile’s Sign, and Caotino’s Sign, both morbidity and mortality caused by AMI will lowered significantly, and CAD will not be, as nowadays, a growing epidemics. <br /><br />*Anna Gentile, MD. My Cardiologist, Sestri Levante Hospital, ASL 4, (Genova) Italy<br /><br />References<br /><br />1)Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. Ed. Travel Factory, Roma, 2004. http://www.travelfactory.it/ semeiotica_biofisica.htm <br />2)Stagnaro-Neri M., Stagnaro S., Deterministic Chaos, Preconditioning and Myocardial Oxygenation evaluated clinically with the aid of Biophysical Semeiotics in the Diagnosis of ischaemic Heart Disease even silent. Acta Med. Medit. 13, 109, 1997.<br />3)Stagnaro Sergio. Role of Coronary Endoarterial Blocking Devices in Myocardial Preconditioning - c007i. Lecture, V Virtual International Congress of Cardiology. http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php <br /><br />4)Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico- Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Travel Factory, Roma, 2004<br /><br />5) Stagnaro Sergio. Reale Rischio Semeiotico Biofisico. I Dispositivi Endoarteriolari di Blocco neoformati, patologici, tipo I, sottotipo a) oncologico, e b) aspecifico. Ediz. Travel Factory, www.travelfactory.it, Roma, 2009. <br /><br />6)Stagnaro S. Epidemiological evidence for the non-random clustering of the components of the metabolic syndrome: multicentre study of the Mediterranean Group for the Study of Diabetes. Eur J Clin Nutr. 2007 Feb 7; [MEDLINE]<br /><br />7) Stagnaro Sergio. CAD Inherited Real Risk, Based on Newborn- Pathological, Type I, Subtype B, Aspecific, Coronary Endoarteriolar Blocking Devices. Diagnostic Role of Myocardial Oxygenation and Biophysical-Semeiotic Preconditioning. www.athero.org, 29 April, 2009 http://www.athero.org/commentaries/comm907.asp<br /><br />8) Sergio Stagnaro. Caotino’s Sign in bedside detecting CAD, since its initial Stage of CAD Inherited Real Risk. www.fce.it. 3 giugno 2010. http://www.fceonline.it/images/docs/caotino.pdfStagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-30875255038093023782011-07-04T00:10:00.000-07:002011-07-04T00:26:22.940-07:00Without Diabetic Quantum Biophysical Semeiotic Constituion DM cannot occurs!My 55 year long clinical experience allows me to state that type 1 and 2 DM is based on a mitochondrial cytopathology, I named Congenital Acidosic Enzyme-Metabolic Histangiopathy, i.e., CAEMH (See my website www.semeioticabiofisica.it, Diabetes Mellitus, 6 articles) (!-5). In addition, CAEMH can bring about "all" biophysical semeiotic constitutions, including both the "diabetic and the dyslipidemic" ones: type 2 DM can occur solely in presence of the TWO constitutions, according to Joslin's old, but corroborated, theory (See above-cited 5 articles). Interestingly, if mother is positive for diabetic constitution, but father not, and the child is physically alike the father, in 50% of cases, ther is not predisposition to DM.<br />As mitochondrial cytopathology, ONLY mather can transmit these predispositions, but not father. Therefore, offspring of diabetic father (but NOT mother), were obviously "healthy" individuals!Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-5804927924808207972011-05-14T01:49:00.000-07:002011-05-14T01:51:21.826-07:00Functional Decline in Aging , Brain Inherited Real Risk, and Co Q10 Deficiency Syndrome.Original Message ----- <br />From: "JCI Editors" <ushma.neill@the-jci.org><br />To: <dottsergio@semeioticabiofisica.it><br />Sent: Wednesday, March 30, 2011 10:32 PM<br />Subject: Fwd: Fwd: What do you think?<br />Dear Dr. Stagnaro,<br /> <br /> Thank you for your presubmission inquiry. Unfortunately, the Editors did <br /> not feel that submission of your manuscript to the Journal of Clinical <br />Investigation would be appropriate at this time.<br /> <br /> As we are able to only review a fraction of the manuscripts submitted to <br /> the JCI, we must keep in mind how well your manuscript would compete <br /> with the many others we receive. Your proposal was carefully evaluated, <br /> and we determined that it would not ultimately be successful upon formal <br /> review. In making this decision we do not mean to imply a criticism of <br /> the work, we simply question its appropriateness for the JCI.<br /> <br /> We thank you for giving us the opportunity to read about your work, and <br /> hope you are soon able to interest an alternate journal in your manuscript.<br /> <br /> Sincerely,<br /> Ushma S. Neill, Ph.D.<br /> Executive Editor<br /> <br /><br />In following, I would like emphasise briefly the central role of these quantum-biophysical-semeiotic-Constitution-Dependent, Inherited Real Risk of Brain also in aging people disease occurrence,especially if Co Q10 deficiency is present. <br /> <br />In my opinion, bedside quantum-biophysical-semeiotic diagnosis of Co Q10 deficiency syndrome, I have described earlier (1-5), and the topic of above-cited Letter to Editors, could be very helpful in risk stratification to predict functional decline in Older Adults.<br /> <br /> In fact, I have demonstrated that doctors can clinically recognize with the aid of a stethoscope subjects involved by Ubidecarenone deficiency, even initial and symptomless, causing damage of tissues due to the increase levels of free radical (1-5). <br /> <br />Moreover, in my 55-long clinical experience, such as diagnosis, made clinically for the first time, proved to be really efficacious and reliable in avoiding dangerous administration of statine to individuals without clinical symptomatology, even involved by ubidecarenone deficiency, notoriously worsened by anti-cholesterolemic drugs. <br /> <br />In addition, physicians are able to recognize since birth whatever Constitution-Dependent Inherited quantum-biophysical-semeiotic Real Risk, including oncological, diabetic, and Alzheimer Disease one (5-8), based on microvascular remodelling, characterized by newborn-pathological, type I, subtype a), oncological, and b) aspecific Endoarteriolar Blocking Devices, which predispose to the related disorders.<br /> <br />Finally, only individuals with inherited cerebral quantum-biophysical-semeiotic Inherited Real Risk (5) may be involved by functional decline, like Alzheimer Disease (8), particularly in presence of Co Q10 deficincy syndrome.<br /><br />References<br />1) Stagnaro-Neri M., Stagnaro S., Carenza di Co Q10 secondaria a terapia ipolipidemmizante diagnosticata con la Percussione Ascoltata. Settimana Italiana di Dietologia, 9-13 Aprile 1991, Merano. Atti, pg. 65. Epat. 37, 17, 1990. <br /><br />2)Stagnaro-Neri M., Stagnaro S., Acidi grassi W-3, scavengers dei radicali liberi e attivatori del ciclo Q della sintesi del Co Q10. Gazz. Med. It. – Arch. Sc. Med. 151, 341, 1992. <br /><br />3) Stagnaro-Neri M., Stagnaro S., Auscultatory Percussion Coenzyme Q deficiency Syndrome. VI Int. Symp., Biomedical and clinical aspects of Coenzyme Q. Rome, January 22.24, 1990,Chairmen K. Folkers, G.L. Littarru, T. Yamagani, Abs., pg. 105. <br /><br />4) Stagnaro-Neri M., Stagnaro S., Sindrome clinica percusso-ascoltatoria da carenza di Co Q10. Medic. Geriatr. XXIV, 239. <br /><br />5) Stagnaro Sergio. Reale Rischio Semeiotico Biofisico. I Dispositivi Endoarteriolari di Blocco neoformati, patologici, tipo I, sottotipo a) oncologico, e b) aspecifico. Ediz. Travel Factory, www.travelfactory.it, Roma, 2009.<br /><br />6) Stagnaro S. Bedside diagnosis of osteoporotic constitution, real risk of inheriting ostoporosis, and finally osteoporosis. Theoretical Biology and Medical Modelling 21 June 2007. http://www.tbiomed.com/content/4/1/23/comments#285569 <br /><br />7) Stagnaro S. New bedside way in reducing mortality in diabetic men and women. Ann. Int. Med. . http://www.annals.org/cgi/eletters/0000605-200708070-00167v1<br /><br />8) Stagnaro Sergio. Alzheimer's Disease Byophysical Semeiotics supports the pathophysiology of Koudinov's theory.11 January 2002. Clin. Med. & Health Research http://clinmed.netprints.org/cgi/eletters/2001100005v1#9Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-74469939675123561382011-05-13T22:08:00.000-07:002011-05-13T22:09:59.326-07:00Do NEJM Editors know Oncological Terrain? Vitamine D and Cancer Primary Prevention. Oncological Terrain plays a central Role.Do NEJM Editors know Oncological Terrain?<br />Vitamine D and Cancer Primary Prevention. Oncological Terrain plays a central Role.<br /><br />The following Letter to Editors, date submitted 8 April, 2011 (Manuscript ID: 11-04116. Title:Vitamine D and Cancer. Oncological Terrain plays a central Role. Author: Stagnaro, Sergio. Date Submitted: 08-Apr-2011) has been rejected by NEJM the day 13 May, 2010.<br /> Overlooking the Congenital Acidosic Enzyme-Metabolic Histangiopathy, at base of Oncological Terrain, "conditio sine qua non" of most dangerous human disorders, including malignancy is overlooked, primary preventions are fundamentally biased, and thus no efficacious (1-5). Environmental risk factors and drugs, suggested as cancer risk factors, influence human biological functions, bringing about different disorders, like cancers, exclusively in presence of CAEMH-Dependent Oncological Inherited Real Risk in a biological system. This overlooked functional mitochondrial cytopathology, quantum-biophysical-semeiotic constitutions are based on, is genetic factor of human disorders, including malignancy (1-5). I emphasise pathological negative influence of smoking and Vitamine D deficiency on biological systems (3, 4). This effect varies in prevalence and intensity among individuals in relation to the above-mentioned congenital mitochondrial cytopathology, (2). This "silent" and dangerous action is easy to evaluate at the bed-side with a stethoscope. Physician first investigates the presence of CAEMH in the "enrolled" individuals, and than assesses OT-Dependent Inherited Real Risk, based on above-mentioned congenital cytopathology, characterized by newborn-pathological, type I, subtype a), oncological, Endoarterial Blocking Devices, causing the typical microvascular remodelling (1-5). <br /><br />References<br />1) Stagnaro S., Stagnaro-Neri M. Una patologia mitocondriale ignorata: la Istangiopatia Congenita Acidosica Enzimo-Metabolica. Gazz. Med. It. - Arch. Sci. Med. 1990;149: 67-69. <br /><br />2) Stagnaro S., West PJ., Hu FB., Manson JE., Willett WC. Diet and Risk of Type 2 Diabetes. N Engl J Med. 2002 Jan 24;346(4):297-298. [MEDLINE]<br /> 3) Caramel S., Stagnaro S. The role of mitochondria and mit-DNA in Oncogenesis. http://ilfattorec.altervista.org/mitDNA&oncogenesis_english.pdf; http://www.quantumbiosystems.org/admin/files/QBS 2(1) 250-281.pdf.<br />4) Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. Ed. Travel Factory, Roma, 2004. http://www.travelfactory.it/ <br />5) ) Stagnaro Sergio. Reale Rischio Semeiotico Biofisico. I Dispositivi Endoarteriolari di Blocco neoformati, patologici, tipo I, sottotipo a) oncologico, e b) aspecifico. Ediz. Travel Factory, www.travelfactory.itStagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-28905334995525577982011-05-11T02:04:00.000-07:002011-05-11T02:07:09.995-07:00Right Planum Temporale Dominance, Congenital Acidosic Enzyme-Metabolic Histangiopathy, Quantum Biophysical Semeiotic Constitutions-Dependent InheritedAbstract.<br />In the paper Authors* illustrate briefly the relation between right Planum Temporale dominance, Congenital Acidosic Enzyme-Metabolic Histangiopathy, and Quantum Biophysical Semeiotics Constitutions-Dependent Inherited Real Risks. In addition, Authors emphasise the possibility of bedside recognizing these congenital alterations, starting since birth. Finally, the efficacious Primary Prevention of most common and dangerous disorders is described.<br /><br />* Sergio Stagnaro, and Simone Caramel<br /><br />Editors,<br />in spite of an awful number of papers, one may reading the Literature since 32 years, the right dominant Planum Temporale, typical of Congenital Acidosic Enzyme-Metabolic Histangiopathy, a congenital mitochondrial cytopathy, quantum biohysical semeiotic Constitutions, and thus the relatedInherited Real Risk, bedside recognised with a stethoscope, are based on, is either overlooked or ignored by the majority of physicians, including neurologists. (1-8)<br />Quantum Biophysics Semeiotics,QBS, is a new discipline in medical field, extension of the classical semeiotics with the support of quantum and complexity theories, a scientific approach first described by Stagnaro (1-8) based on the 'Congenital Acidosic Enzyme-Metabolic Histangiopathy , CAEMH (1-4), a unique mitochondrial cytopathy, present at birth and subject to medical therapy.<br />According to the research of Stagnaro, today doctors should be able to evaluate, at the bedside, simply using the stethoscope and auscultatory percussion of the stomach (2), mitochondria functionality, as well as thefunctionality of all biological systems. It is now possible, since the moment of birth, to make adiagnosis in order to detect the presence of the Inherited Real Risk of many diseases linked with QBS Constitutions (3), so that an intelligent prevention strategy can be<br />implemented only on those subjects with Inherited Real Risk. <br />According to Stagnaro (2-5, 8-10), genome's information are transmitted simultaneously both to parenchyma and related micro-vessels, so that mutations in parenchymal cell n-DNA<br />and mit-DNA are the conditio sine qua non of the most common human disorders, like diabetes, CAD, and cancer, today's epidemics.<br />In fact, all these diseases are based on a particular congenital, functional, mitochondrial cytopathy, mostly transmitted through mother, and defined 'Congenital Acidosic Enzyme-<br />Metabolic Histangiopathy' - CAEMH (8-10).<br />Quantum Biophysical Semeiotics, in addition to the most severe disease diagnosis as, for example, many solid and liquid forms of cancer, type 2 diabetes mellitus, heart diseases, hypertension, osteoporosis, is concerned to suggest preventive therapies so that, especially in those at risk for some diseases, the still potential pathology does not manifest itself in practice.<br /> W4 emphasise the importance of taking conjugated-melatonin according tothe recipe of ‘Di Bella-Ferrari’, in conjunction with other appropriate preventive therapies, designed in the etymological sense: i.e., to avoid tobacco smoke, sedentary lifestyle and overweight, and at the same time to favor an healthy lifestyle, using for instance a custom Mediterranean diet, encouraging a daily physical activity and body movement. It needs to be understood that the CAEMH reveals the state of suffering of the cell, particularly with respect to mitochondrial DNA, and thus the mitochondria,responsible for cell oxygenation. In case of alteration of mitochondrial DNA, it is clear that the mitochondrial oxygen becomes deficient. We are able to improve the mitochondrial respiration and functioning of the respiratory chain, i.e., the redox processes, reducing consequently the 'Congenital Real Risk'of cancer, if there was. Improving the mitochondrial respiration, or tissue oxygenation, we render harmless the risk of cancer. To give effect to this outcome over time, however, a continuous preventive therapy is needed. Manuel is the son of two parents both positive for 'OncologicalTerrain', but they agreed, at Stagnaro’s advice, to undergo a preventive therapy consisting ofetymologically speaking diet and in taking conjugated - melatonin 'Di Bella - Ferrari', beforebaby’s conception. After a few months of treatment, Stagnaro personally visited<br />Manuel, and I could see who was born without 'Oncological Terrain', though conceived by<br />both parents positive for TO. This means that Manuel will never become ill with cancer, even<br />in the presence of the several risk factors, and he will never surface in a 'real risk' of cancer.<br /><br />References<br /><br />1) Stagnaro S., West PJ., Hu FB., Manson JE., Willett WC. Diet and Risk of Type 2 Diabetes. N Engl J Med. 2002 Jan 24;346(4):297-298. [MEDLINE] <br />2) Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. Ed. Travel Factory, Roma, 2004. http://www.travelfactory.it/semeiotica_biofisica.htm <br />3) Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico- Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Ed. Travel Factory, Roma, 2004. http://www.travelfactory.it/libro_costituzionisemeiotiche.htm<br /> 4) Stagnaro S., Stagnaro-Neri M. Single Patient Based Medicine.La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. Travel Factory, Roma, 2005. http://www.travelfactory.it/libro_singlepatientbased.htm <br />5) Stagnaro Sergio. Epidemiological evidence for the non-random clustering of the components of the metabolic syndrome: multicentre study of the Mediterranean Group for the Study of Diabetes. Eur J Clin Nutr. 2007 Feb 7; [MEDLINE]<br /> 6) Stagnaro Sergio. Pre-Metabolic Syndrome and Metabolic Syndrome: Biophysical-Semeiotic Viewpoint. www.athero.org, 29 April, 2009. http://www.athero.org/commentaries/comm904.asp<br /> 7) Stagnaro Sergio. CAD Inherited Real Risk, Based on Newborn-Pathological, Type I, Subtype B, Aspecific, Coronary Endoarteriolar Blocking Devices. Diagnostic Role of Myocardial Oxygenation and Biophysical-Semeiotic Preconditioning. www.athero.org, 29 April, 2009 http://www.athero.org/commentaries/comm907.asp<br />8) Simone Caramel and Sergio Stagnaro (2011) Quantum Chaotic Aspects of Biophysical Semeiotics - from JOQBS 1 28-70, 2011, http://www.sisbq.org/uploads/5/6/8/7/5687930/quantumchaotic_qbs.pdf <br />9) Simone Caramel and Sergio Stagnaro (2011) Quantum Biophysical Semeiotics of Oncological Inherited Real Risk of Myelopathy: The diagnostic role of glycocalyx. http://www.sisbq.org/uploads/5/6/8/7/5687930/qbs_myelopathy_glycocalyx_english.pdf <br />10) Simone Caramel and Sergio Stagnaro (2011) Quantum Biophysical Semeiotics and mit-Genome's fractal dimension Journal of Quantum Biophysical Semeiotics, 1 1-27,<br />http://www.sisbq.org/uploads/5/6/8/7/5687930/joqbs_mitgenome.pdf<br />11) Sergio Stagnaro The New War against Five Stages of type 2 Diabetes Mellitus. www.scivox.com, 12 December, 2011, http://www.sci-vox.com/stories/story/2011-01-12the+new+war+against+five+stages++of+type+2+diabetes+mellitus.html ; http://wwwshiphusemeioticscom-stagnaro.blogspot.com/2011/01/new-war-against-five-stages-of-type-2.html <br />12) Sergio Stagnaro. New Renaissance of Medicine. Type 2 Diabetes Mellitus Primary Prevention. http://qbsemeiotics.weebly.com/atti-del-convegno.html, 16 November, 2010; http://qbsemeiotics.weebly.com/uploads/5/6/8/7/5687930/report_stagnaro.pdf ; http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Eng/Nuovo%20Rinascimento%20eng.doc<br />13) Sergio Stagnaro. Il I Stadio Semeiotico-Biofisico-Quantistico del Diabete Mellito:<br />Nosografia e Patogenesi. www.fce.it 17 novembre 2010. http://www.fceonline.it/images/docs/diagnosi%20diabete.pdf; http://qbsemeiotics.weebly.com/uploads/5/6/8/7/5687930/newrenaissance_prevenzionet2dm.pdf <br />14) Sergio Stagnaro. Ruolo del DNA Antenna nella Diagnosi Semeiotica Biofisica Quantistica dei Primi due Stadi del Diabete Mellito tipo 2. www.fce.it, 19 novembre 2010. http://www.fceonline.it/images/docs/dna_diabete.pdf; http://qbsemeiotics.weebly.com/uploads/5/6/8/7/5687930/dna_t2dm.pdf<br />15) Sergio Stagnaro. Siniscalchi's Sign. Bedside Recognizing, in one Second, Diabetic Constitution, its Inherited Real Risk, and Type 2 Diabetes Mellitus. <br />24 December, 2010, www.scivox.com, http://www.sci-vox.com/stories/story/2010-12-25siniscalchi%27signi.bedside++diagnosing+type+2+dm.html; www.sciphu.com; http://wwwshiphusemeioticscom-stagnaro.blogspot.com/Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-58860062931045649642011-01-11T22:41:00.000-08:002011-01-11T22:45:15.108-08:00The New War against Five Stages of type 2 Diabetes MellitusAccording to WHO competent Authorities, there were in 2010 250 milion of diabetics, and they will be 366 milion in 2030, indicating that type 2 DM is today's growing epidemics (1-16).<br />In my opinion, as far as diabetes is concerned, primary prevention, especially when initiated in the first two stages among the five of th natural history of the disease, is far better than therapy, as usually.<br />Unforunately, Diabetic "and" Dislipidemic Constitutions, conditio sine qua non of type 2 DM, are nowadays overlooked by the majority of physicians all around the world (12-14). A long well westablished clinical experience allows me to state that with the aid of Quantum Biophysical Semeiotics, physicians can quickly and easili bedside recognize the "microcirculatory remodelling", based on newborn-pathological, subtype a) oncological , and b), aspecific, type I, Endoarteriolar Blocking Devices in tissue, wherein does really exist the inherited real risk of human common and severe diseases, as diabetes (12-16).<br /> Obviously that happens in individuals with defined Biophysical Semeiotics Constitutions, in our case, Diabetic “and” Dislipidaemic, according to Joslin(1-6, 12-16). <br />To realize on vast scale Diabetes Primary Prevention (PP),enrolling exclusively individuals at Inherited Real Risk, we need new clinical tools, aiming to lower the increasing number of patients, because the present, expensive screening has failed (14). For instance, in the normal Langheran’s islets microcirculatory bed, there are exclusively “normal” type II (= in arterioles, according to Hammersen), but not type I (= in small arterioles) endoarteriolar blocking devices, i.e. EBD, of first and second classes, according to S.B.Curri (See http://www.semeioticabiofisica.it/microangiologia). In health, i.e., not involved by Diabetic Constitution, we cannot observe type I, newborn- pathological, EBD in above-mentioned biological system. On the contrary, in individuals involved by diabetic constitution as well as diabetic "Inherited Real Risk" and overt diabetes, of course, we observe with the aid of Quantum Biophysical Semeiotics also type I, newborn-pathological, subtype b) a-specific , EBD, facilitating the diagnosis and consequently diabetes primary prevention. In addition, the evaluation of Insulin Secretion Acute Pick Renal Test is significantly impaired, corroborating the clinical diagnosis (1-3) (See above cited- website, Practical Applications, and Glossary). Finally, an interesting clinical tool in recognizing diabetic constitution -dependent inherited real risk, as well as in diagnosing diabetes since early stages and diabetic monitoring proved to be bedside Biophysical-Semeiotic Osteocalcin Test and Siniscalchi's Sign (10, 15, 16).<br />As a matter of fact, Pre-hypertension during Young Adulthood may be involved by Coronary Calcium Later in Life exclusively in presence of Inherited Real Risk of CAD, typical for individuals with lithyasic Constitution, present in about 50% OF ALL CASES OF Pre-Metabolic and Metabolic Syndrome (www.semeioticabiofisica.it; Constitutions and Bibliography). Considering the frequent association between hypertension and diabetes, more important, in my opinion based on 53-year-long clinical experience, is bedside recognizing diabetic predisposition, now-a-days possible since birth, utilising a lot of methods, different in difficulty, but all reliable. For the first time, from the clinical view-point, I have recently illustrated an original manoeuvre, based on a singular activity of osteocalcin, and reliable in bedside detecting diabetes in one minute, with the aid of a stethoscope (10). In fact, osteocalcin, a product of osteoblasts, among other action mechanisms, stimulates both insulin secretion and insulin receptor sensitivity. As a consequence, osteocalcin, secreted by above-mentioned bone cells during mean-intense lasting digital pressure – for instance – applied upon lumbar vertebrae, brings about increasing pancreatic diameters, i.e., technically speaking, type I, associated, Langherans’s islet microcirculatory activation, so that doctors assess pancreas size augmentation, which in health, lasts 10 seconds exactly (1-11). After that, pancreas diameters return to basal value for 3 sec. The second pancreas size increasing lasts 20 sec., and finally the third show the highest value: 30 sec. I terme such as clinical investigation. On the contrary, in case of diabetic constitution (3, 4, 11, 13) the first pancreas increasing persists normally (10 sec.), but both the second and the third are less than physiological ones (i.e., less than 20 sec. and respectively 30 sec.). In presence of intense inherited real risk of diabetes (6), such as impairment is greater. Finally, in case of diabetes the alteration is present already in the first evaluation, wherein duration appears less than 10 sec., inversely related with disorder seriousness. Subsequently, I have ascertained that Ronald’s Manoeuvre result pathological already in individuals involved by both Diabetic Constitution and Inherited Diabetic Real Risk (1-11). Interestingly, not only in examining subject, but also in all others, even if kilometers way from him (her), according to Lory’s experiment, based of no local realm in biological systems (12, 15), pancreas show identical modifications, allowing doctors to made clinical diagnosis until now impossible (1-15). <br />1)Stagnaro S., Stagnaro-Neri M. Valutazione percusso-ascoltatoria del Diabete Mellito. Aspetti teorici e pratici. Epat. 32, 131, 1986 <br />2) Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. Travel Factory, Roma, 2004. http://www.travelfactory.it/semeiotica_biofisica.htm <br />3) Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico- Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Travel Factory, Roma, 2004. http://www.travelfactory.it/libro_costituzionisemeiotiche.htm<br /> 4) Stagnaro S., Stagnaro-Neri M. Single Patient Based Medicine.La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. Travel Factory, Roma, 2005. http://www.travelfactory.it/libro_singlepatientbased.htm <br />5) Stagnaro S. Pivotal role of Biophysical Semeiotic Constitutions in Primary Prevention. Cardiovascular Diabetology, 2:1, 2003 http://www.cardiab.com/content/2/1/13/comments#5753<br /> 6) Stagnaro S. Stagnaro Sergio. Newborn-pathological Endoarteriolar Blocking Devices in Diabetic and Dislipidaemic Constitution and Diabetes Primary Prevention. www.fce.it, http://www.fceonline.it/index.php?option=com_content&task=view&id=3736&Itemid=47<br />7) Stagnaro S., West PJ., Hu FB., Manson JE., Willett WC. Diet and Risk of Type 2 Diabetes. N Engl J Med. 2002 Jan 24;346(4):297-298. [Medline] <br />8) Stagnaro Sergio. New bedside way in Reducing mortality in diabetic men and women. Ann. Int. Med.2007. http://www.annals.org/cgi/eletters/0000605- 200708070-00167v1 <br />9) Stagnaro Sergio. Single Patient Based Medicine: its paramount role in Future Medicine. Public Library of Science. http://medicine.plosjournals.org/perlserv/?request=read-response 2005<br />10) Stagnaro Sergio. Teoria Patogenetica Unificata, 2006, Ed. Travel Factory, Roma.<br />11) Stagnaro Sergio. Il test Semeiotico-Biofisico della Osteocalcina nella prevenzione primaria del diabete mellito. www.fce.it, http://www.fcenews.it/index.php?option=com_content&task=view&id=909&Itemid=47 <br />12) Stagnaro Sergio e Paolo Manzelli. L’Esperimento di Lory. Scienza e Conoscenza, N° 23, 13 Marzo 2008. http://www.scienzaeconoscenza.it//articolo.php?id=17775 <br />13) Stagnaro Sergio. Reale Rischio Semeiotico Biofisico. I Dispositivi Endoarteriolari di Blocco neoformati, patologici, tipo I, sottotipo a) oncologico, e b) aspecifico. Ediz. Travel Factory, www.travelfactory.it, Roma, Luglio 2009.<br />14) . Sergio Stagnaro. New Renaissance in Medicina. Prevenzione Primaria del Diabete Mellito tipo 2. Sito del Convegno, http://qbsemeiotics.weebly.com/atti-del-convegno.html, 16 novembre 2010; English version: http://qbsemeiotics.weebly.com/uploads/5/6/8/7/5687930/report_stagnaro.pdf <br />15) Sergio Stagnaro. Siniscalchi's Sign. Bedside Recognizing, in one Second, Diabetic Constitution, its Inherited Real Risk, and Type 2 Diabetes Mellitus. <br />24 December, 2010, www.scivox.com, http://www.sci-vox.com/stories/story/2010-12-25siniscalchi%27signi.bedside++diagnosing+type+2+dm.html; www.sciphu.com; http://wwwshiphusemeioticscom-stagnaro.blogspot.com/ Italian version: http://www.sisbq.org/uploads/5/6/8/7/5687930/segnodisiniscalchi.pdf<br />16) Caramel Simone. Primary Prevention of T2DM and Inherited Real Risk of Type 2 Diabetes Mellitus http://ilfattorec.altervista.org/T2DM.pdfStagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-18952950248955899772010-12-27T23:59:00.000-08:002010-12-28T00:05:39.640-08:00Bedside Diagnosing Ovarian Oncological Inherited Real Risk and Cancer.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgHz09XANSjEiCAJiQK3Mx9no-VGLcKM4NgzuVnGgtWXgdBNT4TmWblBboS-3VDNGFgqnHg7jIXTRWX_au6p14CN28ylWX7BRD4zmJU-DycPdRL6Own6tnxMe-xR_1C_TLeoDmNnxorLJPz/s1600/sergio18.jpg"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 155px; height: 200px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgHz09XANSjEiCAJiQK3Mx9no-VGLcKM4NgzuVnGgtWXgdBNT4TmWblBboS-3VDNGFgqnHg7jIXTRWX_au6p14CN28ylWX7BRD4zmJU-DycPdRL6Own6tnxMe-xR_1C_TLeoDmNnxorLJPz/s200/sergio18.jpg" alt="" id="BLOGGER_PHOTO_ID_5555640305516008930" border="0" /></a>
<br /><!--[if gte mso 9]><xml> <w:worddocument> <w:view>Normal</w:View> <w:zoom>0</w:Zoom> <w:hyphenationzone>14</w:HyphenationZone> <w:punctuationkerning/> <w:validateagainstschemas/> <w:saveifxmlinvalid>false</w:SaveIfXMLInvalid> <w:ignoremixedcontent>false</w:IgnoreMixedContent> <w:alwaysshowplaceholdertext>false</w:AlwaysShowPlaceholderText> <w:compatibility> <w:breakwrappedtables/> <w:snaptogridincell/> <w:wraptextwithpunct/> <w:useasianbreakrules/> <w:dontgrowautofit/> </w:Compatibility> <w:browserlevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:latentstyles deflockedstate="false" latentstylecount="156"> </w:LatentStyles> </xml><![endif]--><!--[if !mso]><object classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id="ieooui"></object> <style> st1\:*{behavior:url(#ieooui) } </style> <![endif]--><!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabella normale"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} </style> <![endif]--> <p class="MsoNormal" style="text-align: right;" align="right"><span style="font-size: 11pt; font-family: "Courier New";">“……<span style=""> </span>questo usa parole al vento. </span></p> <p class="MsoNormal" style="text-align: right;" align="right"><span style="font-size: 11pt; font-family: "Courier New";">Non sa di cosa parla!” </span></p> <p class="MsoNormal" style="text-align: right;" align="right"><span style="font-size: 11pt; font-family: "Courier New";"> </span></p> <p class="MsoNormal" style="text-align: right;" align="right"><span style="font-size: 11pt; font-family: "Courier New";">Silvio Garattini </span></p> <p class="MsoNormal" style="text-align: right;" align="right"><span style="font-size: 11pt; font-family: "Courier New";">mail 9 dicembre, 2010</span></p> <p class="MsoNormal" style="text-align: right;" align="right"><span style="font-size: 11pt; font-family: "Courier New";">______________________________</span></p> <p class="MsoNormal" style="text-align: right;" align="right"><span style="font-size: 11pt; font-family: "Courier New";"> </span></p> <p class="MsoNormal" style="text-align: right;" align="right"><span style="font-size: 11pt; font-family: "Courier New";">“</span>Veritas Filia Temporis.”</p> <p class="MsoNormal" style="text-align: right;" align="right"> </p> <p class="MsoNormal" style="text-align: right;" align="right">A Gellio. <span style="" lang="EN-GB">II sec. after Christ </span></p> <p class="MsoNormal" style="text-align: right;" align="right"><b style=""><span style="font-size: 14pt; font-family: "Courier New";" lang="EN-GB"> </span></b></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 11pt; font-family: "Courier New";" lang="EN-GB"> </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Editor,</span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"> </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">in my 55-year-long well established clinical experience, Quantum Biophysical Semeiotics proved to be a reliable and useful bedside tool in early detecting ovarian cancer, since its first stage, i.e., ovarian Cancer Inherited Real Risk, mainly overlooked – if not mocked<span style=""> </span>– <span style=""> </span>by physicians around the world, in individuals obviously with Oncological Terrain, (1) (website, www.semeioticabiofisica.it , Oncological Terrain) (1-3). </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">There is a general agreement among the Authors, that ovarian cancer I diagnosed to late in 75% of all cases, so that its prognosis is not good at all!</span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In my opinion, what accounts for the reason cancer is a growing health problem in developed as well as in developing countries, as CAD and type 2 Diabetes Mellitus, is that Medicine developments, especially in the field of physical semeiotics,<span style=""> </span>continuously meet difficulties in spreading among General Practitioners all around the world.</span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">As follows, a easy method, quickly to apply, which proved to be reliable in my long CLINICAL experience, is fully escribed.</span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In healthy woman, starting hopefully since birth, involved by Oncological Terrain, of course, lying down on supine position, psycho-physically relaxed, and with open eyes to reduce endogenous melatonin secretion, lasting, mean-intense hand pressure, applied on X thoracic dermatomere (= from the practical viewpoint, <span style=""> </span>at right or left iliac fossa, which represent ovarian trigger-points), brings about aspecific gastric reflex (= stomach fundus and body dilate, while antral-pyloric region contracts), only after a latency time of exactly 8 sec. </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">The reflex lasts physiologically "less" than 4 sec., related to normal Microcirculatory Functional Reserve; it's really a paramount parameter value, since it parallels fractal dimension of related microvessell fluctuations (1-3). Afterwards reflex disappears for > 3 <></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">On the contrary, in ovarian cancer, since its earliest stage of Inherited, Oncological Terrain-dependent, ovarian cancer "Real Risk", latency time could be jet 8<span style=""> </span>sec. (NN = 8 sec.), but reflex duration interestingly lasts 4 sec. or more (NN > 3 <></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Importanly, from differential diagnostic viewpoint, soon thereafter stomach contracts "pathologically": tonic Gastric Contraction (tGC), typical sign of cancer. </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">These parameter values parallell ovarian microcirculatory abnormalities, so-called "microcirculatory remodelling", based on newborn-pathological, type I, subtype a), oncological, Endoarteriolar Blocking Devices, I discovered (1- 2). </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">More precisely speaking, reflex latency time becomes shorter than the normal 8 sec. in inverse relation to the tumour stage. </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In addition, in day-to-day practice, biophysical semeiotic "ovarian preconditioning" is very useful and reliable: exactly 5 sec. after the basal manoeuvre, illustrated above, when ovarian Microcirculatory Functional Reserve is activated, doctor performs the described test a second time: in health, where tGC. is always absent, all parameters values improve in a clear-cut manner, latency time raising to 16 sec., i.e., doubled value.</span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">On the contrary, in patients at inherited real risk of ovarian cancer, they either persist unchanged or increase not significantly in relation to the severity of ovarian, inherited cancer "real risk".</span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Finally latency time worsens significantly in case of <b style="">overt ovarian cancer</b>, even in initial stages of its evolution. Such as sign, easy to perform and reliable at the bed-side, is really useful in both ovarian cancer clinical primary prevention and diagnosis, among a large variety of other remarkable biophysical-semeiotic signs (1-10). </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In addition, as I described previously (1-8), malignancies occur on the base of a genetically transmitted mitochondrial cytopathology, I named Congenital Acidosic Enzyme-Metabolic Histangiopathy, <i style="">conditio sine qua non</i> of Oncological Terrain. Such as inherited abnormalities of psycho-neuro-endocrine-immunological system is mainly transmitted by mother. Therefore, it is a distressing non-sense, or at least uselessly expensive, for instance, to ask if patient's mother is, or was, involved by ovarian cancer, as well as assess oncological biomarkers and newly discovered mutated genes level in women (and men, of course!) without Oncological Terrain and/or whatever Cancer Real Risk. Doing such as clinical research, physician can avoid the overlooked epidemics, I termed Psychological Jatrogenetic Terrorism </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">According to Psychokinetic Diagnostics, in healthy women, since birth, "intense" digital pressure, applied on above-mentioned trigger-point is not "simultaneously" accompanied by gastric aspecific reflex. </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">On the contrary, in women at ovarian cancer inherited real risk, and in those involved by overt cancer, even in initial stage, “simultaneously” appears gastric aspecific reflex, immediately followed by characteristic tonic Gastric Contraction, showing parameter intensity correlated with the seriousness of underlying disorder. </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"> </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"> </span></p> <p class="MsoNormal" style="text-align: justify;"><b style="">References </b></p> <p class="MsoNormal" style="text-align: justify;"> </p> <p class="MsoNormal" style="text-align: justify;">1) Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. Travel Factory, Roma, 2004. www.travelfactory.it </p> <p class="MsoNormal" style="text-align: justify;">2) Stagnaro Sergio. Reale Rischio Semeiotico Biofisico. I Dispositivi Endoarteriolari di Blocco neoformati, patologici, tipo I, sottotipo a) oncologico, e b) aspecifico. Ediz. Travel Factory, www.travelfactory.it , Roma, 2009. </p> <p class="MsoNormal">3) Caramel S., Stagnaro S. The role of mitochondria and mit-DNA in Oncogenesis.<span style="font-family: TT13o00;"> </span><a href="http://ilfattorec.altervista.org/mitDNA&oncogenesis_english.pdf"><span style="">http://ilfattorec.altervista.org/mitDNA&oncogenesis_english.pdf</span></a>; <span style="color: black;"><a href="http://www.quantumbiosystems.org/admin/files/QBS%202%281%29%20250-281.pdf"><span style="">http://www.quantumbiosystems.org/admin/files/QBS%202(1)%20250-281.pdf</span></a></span>.<span style="color: black;"></span></p> <p class="MsoNormal" style="text-align: justify;">4) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica condizione necessaria non sufficiente della oncogenesi. XI Congr. Naz. Soc. It. di Microangiologia e Microcircolaz. Abstracts, pg 38, 28 Settembre-1 Ottobre 198=</p> <p class="MsoNormal" style="text-align: justify;">3, Bellagio. </p> <p class="MsoNormal" style="text-align: justify;">5) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica. X Congr. Naz. Soc. It. di Microangiologia e Microcircolazione. Atti, 61. 6-7 Novembre, 1981, Siena </p> <p class="MsoNormal" style="text-align: justify;">6) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica. Una Patologia Mitocondriale Ignorata. Gazz Med. It. - Arch. Sci. Med. 144, 423, 1985 (Infotrieve). </p> <p class="MsoNormal" style="text-align: justify;">7) Stagnaro-Neri M., Stagnaro S., Cancro della mammella: prevenzione primaria e diagnosi precoce con la percussione ascoltata. <span style="" lang="EN-GB">Gazz. Med. It. - Arch. Sc. Med. 152, 447, 1993. </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">8) Stagnaro Sergio. Bed-Side Prostate Cancer Detecting, even in early stages ("Real Risk" of Cancer): BMC Family Practice, 2005, 6:24 doi:10.1186/1471-2=296-6-24 </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><a href="http://www.biomedcentral.com/1471-2296/6/24/comments#202466">http://www.biomedcentral.com/1471-2296/6/24/comments#202466</a><span style=""> </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">9) Sergio Stagnaro Mitochondrial Bed-Side Evaluation: a new Way in the War against Cancer (21 December 2005). </span>Cancer Cell International </p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><a href="http://www.cance=rci.com/content/5/1/34/comments#218502"><span style="" lang="IT">http://www.cance=rci.com/content/5/1/34/comments#218502</span></a></span><span style=""> </span></p> <p class="MsoNormal" style="text-align: justify;">10) Stagnaro Sergio. Teoria Patogenetica Unificata, 2006, Ed. Travel Factory, Roma </p> <p class="MsoNormal" style="text-align: justify;">11) Sergio Stagnaro.<b style=""> </b><span style=""> </span>Psychokinetic Diagnostics, Quantum Biophysica Semeiotics Evolution. <span style="" lang="EN-GB"><a href="http://www.shiphu/">www.shiphu</a>. , 12 March 2010, <a href="http://sciphu.com/2010/03/psychokinetic-diagnostics-quantum.html">http://sciphu.com/2010/03/psychokinetic-diagnostics-quantum.html</a><span style=""> </span>and<span style=""> </span><a href="http://wwwshiphusemeioticscom-stagnaro.blogspot.com/2010/03/psychokinetic-diagnostics-quantum.html">http://wwwshiphusemeioticscom-stagnaro.blogspot.com/2010/03/psychokinetic-diagnostics-quantum.html</a></span></p> <p class="MsoNormal" style="text-align: justify;">12) Sergio Stagnaro.<span style=""> </span><span style=""> </span><a href="http://www.mysun.co.uk/stagnaro/blog/2010/05/04/_osteocalcin_manouvre_in_diagnosing_diabetes._psychokinetic_diagnostics._">Osteocalcin Manouvre in Diagnosing Diabetes. <span style="" lang="EN-GB">Psychokinetic Diagnostics. </span></a><span style="" lang="EN-GB">My Sun Tue 4 May 2010, <a href="http://www.mysun.co.uk/stagnaro/blog">http://www.mysun.co.uk/stagnaro/blog</a>, <span style=""> </span><span style=""> </span><span style=""> </span><a href="http://www.mysun.co.uk/stagnaro/blog/2010/05/04/_osteocalcin_manouvre_in_diagnosing_diabetes._psychokinetic_diagnostics._">http://www.mysun.co.uk/stagnaro/blog/2010/05/04/_osteocalcin_manouvre_in_diagnosing_diabetes._psychokinetic_diagnostics._</a></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">13) Sergio Stagnaro. <strong><span style="font-weight: normal;"><span style=""> </span><span style=""> </span></span></strong>Caotino’s Sign in bedside detecting CAD, since its initial Stage of CAD Inherited Real Risk. <a href="http://www.fce.it/"><span style="" lang="IT">www.fce.it</span></a></span>. 3 giugno 2010.<span style=""> </span><span style="" lang="EN-GB"><a href="http://www.fceonline.it/images/docs/caotino.pdf"><span style="" lang="IT">http://www.fceonline.it/images/docs/caotino.pdf</span></a></span></p> <p class="MsoNormal"><span style="" lang="EN-GB">14) <b style="">Sergio Stagnaro.<span style=""> </span><span style="color: black;"><span style=""> </span></span></b><span style="color: black;"><span style=""> </span></span>Siniscalchi's Sign.<b style=""> </b>Bedside Recognizing, in one Second, Diabetic Constitution, its Inherited Real Risk, and Type 2 Diabetes Mellitus. </span></p> <p class="MsoNormal"><span style="" lang="EN-GB">24 December, 2010, </span><a href="http://www.scivox.com/"><span style="" lang="EN-GB">www.scivox.com</span></a><span style="" lang="EN-GB">,<span style=""> </span></span><a href="http://www.sci-vox.com/stories/story/2010-12-25siniscalchi%27signi.bedside++diagnosing+type+2+dm.html"><span style="" lang="EN-GB">http://www.sci-vox.com/stories/story/2010-12-25siniscalchi%27signi.bedside++diagnosing+type+2+dm.html</span></a><span style="" lang="EN-GB">;<span style=""> </span><a href="http://www.sciphu.com/">www.sciphu.com</a>; </span><a href="http://wwwshiphusemeioticscom-stagnaro.blogspot.com/"><span style="" lang="EN-GB">http://wwwshiphusemeioticscom-stagnaro.blogspot.com/</span></a><span style="" lang="EN-GB"></span></p> <p class="MsoNormal" style="text-align: justify;">15) Sergio Stagnaro. <span style=""><span style=""> </span><strong><span style=""> </span></strong>New Renaissance in Medicina. Prevenzione Primaria del Diabete Mellito tipo 2. Sito del Convegno, <a href="http://qbsemeiotics.weebly.com/atti-del-convegno.html">http://qbsemeiotics.weebly.com/atti-del-convegno.html</a>, 16 novembre 2010; <a href="http://qbsemeiotics.weebly.com/uploads/5/6/8/7/5687930/newrenaissance_prevenzionet2dm.pdf">http://qbsemeiotics.weebly.com/uploads/5/6/8/7/5687930/newrenaissance_prevenzionet2dm.pdf</a>; english version <a href="http://qbsemeiotics.weebly.com/uploads/5/6/8/7/5687930/report_stagnaro.pdf">http://qbsemeiotics.weebly.com/uploads/5/6/8/7/5687930/report_stagnaro.pdf</a> ; <a href="http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Ita/Nuovo%20Rinascimento%20Medicina%20RELAZIONE%20I%20Congr.doc">http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Ita/Nuovo%20Rinascimento%20Medicina%20RELAZIONE%20I%20Congr.doc</a>; english version <a href="http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Eng/Nuovo%20Rinascimento%20eng.doc">http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Eng/Nuovo%20Rinascimento%20eng.doc</a></span></p> <p class="MsoNormal" style="text-align: justify;"> </p> <p class="MsoNormal" style="text-align: justify;"> </p> <p class="MsoNormal" style="text-align: justify;">Sergio Stagnaro </p> <p class="MsoNormal" style="text-align: justify;">Sergio Stagnaro MD </p> <p class="MsoNormal" style="text-align: justify;">Via Erasmo Piaggio 23/8 </p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">16039 Riva Trigoso (Genoa) Italy </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Founder of Quantum Biophysical Semeiotics </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Who's Who in the World (and America) </span></p> <p class="MsoNormal" style="text-align: justify;">since 1996 to 2010 </p> <p class="MsoNormal" style="text-align: justify;">Presidente Onorario della Società Internazionale di Semeiotica Biofisica Quantistica </p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Ph 0039-0185-42315 </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Cell. 3338631439 </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">www.semeioticabiofisica.it </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">dottsergio@semeioticabiofisica.it </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"> </span></p>
<br />
<br />Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-19804243798211600902010-12-24T23:22:00.001-08:002010-12-24T23:27:46.245-08:00Siniscalchi’s Sign*. Bedside Recognizing, in one Second, Diabetic Constitution, its Inherited Real Risk, and Type 2 Diabetes Mellitus.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgLUWxVp6ci2aajN817ejEkgeAQRlFDwAGSA5JUE-yoM64kZkjZh5W1ZDr5fVvAeiU3NHEnNrXdpFbt8DI54CBESQMrIH3AnewskD9ZBhfiPdpS1ql6RbdAip9uMtp6JwGzKINCPEsSmwwS/s1600/sergio18.jpg"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 155px; height: 200px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgLUWxVp6ci2aajN817ejEkgeAQRlFDwAGSA5JUE-yoM64kZkjZh5W1ZDr5fVvAeiU3NHEnNrXdpFbt8DI54CBESQMrIH3AnewskD9ZBhfiPdpS1ql6RbdAip9uMtp6JwGzKINCPEsSmwwS/s200/sergio18.jpg" alt="" id="BLOGGER_PHOTO_ID_5554517052341041938" border="0" /></a><!--[if !mso]> <style> v\:* {behavior:url(#default#VML);} o\:* {behavior:url(#default#VML);} w\:* {behavior:url(#default#VML);} .shape {behavior:url(#default#VML);} </style> <![endif]--><!--[if gte mso 9]><xml> <w:worddocument> <w:view>Normal</w:View> <w:zoom>0</w:Zoom> <w:hyphenationzone>14</w:HyphenationZone> <w:punctuationkerning/> <w:validateagainstschemas/> <w:saveifxmlinvalid>false</w:SaveIfXMLInvalid> <w:ignoremixedcontent>false</w:IgnoreMixedContent> <w:alwaysshowplaceholdertext>false</w:AlwaysShowPlaceholderText> <w:compatibility> <w:breakwrappedtables/> <w:snaptogridincell/> <w:wraptextwithpunct/> <w:useasianbreakrules/> <w:dontgrowautofit/> </w:Compatibility> <w:browserlevel>MicrosoftInternetExplorer4</w:BrowserLevel> </w:WordDocument> </xml><![endif]--><!--[if gte mso 9]><xml> <w:latentstyles deflockedstate="false" latentstylecount="156"> </w:LatentStyles> </xml><![endif]--><!--[if !mso]><object classid="clsid:38481807-CA0E-42D2-BF39-B33AF135CC4D" id="ieooui"></object> <style> st1\:*{behavior:url(#ieooui) } </style> <![endif]--><!--[if gte mso 10]> <style> /* Style Definitions */ table.MsoNormalTable {mso-style-name:"Tabella normale"; mso-tstyle-rowband-size:0; mso-tstyle-colband-size:0; mso-style-noshow:yes; mso-style-parent:""; mso-padding-alt:0cm 5.4pt 0cm 5.4pt; mso-para-margin:0cm; mso-para-margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:10.0pt; font-family:"Times New Roman"; mso-ansi-language:#0400; mso-fareast-language:#0400; mso-bidi-language:#0400;} </style> <![endif]--> <p class="MsoToc3" style=""><span class="MsoHyperlink"><span style=""><a href="http://www.blogger.com/post-create.g?blogID=8814429923003909469#_Toc280992279"><span style="" lang="EN-GB">Siniscalchi’s Sign*.</span><span style="display: none; text-decoration: none;color:#000000;" ><span style=""> </span></span><span style="display: none; text-decoration: none;color:#000000;" >1</span><span style="display: none; text-decoration: none;color:#000000;" ></span></a></span></span><span style=""></span></p> <p class="MsoToc3" style=""><span class="MsoHyperlink"><span style=""><a href="http://www.blogger.com/post-create.g?blogID=8814429923003909469#_Toc280992280"><span style="" lang="EN-GB">Bedside Recognizing,<span style=""> </span>in one Second, Diabetic Constitution, its Inherited Real Risk, and Type 2 Diabetes Mellitus.</span><span style="display: none; text-decoration: none;color:#000000;" ><span style=""> </span></span><span style="display: none; text-decoration: none;color:#000000;" >1</span><span style="display: none; text-decoration: none;color:#000000;" ></span></a></span></span><span style=""></span></p> <p class="MsoToc3" style=""><span class="MsoHyperlink"><span style=""><a href="http://www.blogger.com/post-create.g?blogID=8814429923003909469#_Toc280992281"><span style="" lang="EN-GB">Introduction</span><span style="display: none; text-decoration: none;color:#000000;" ><span style="">. </span></span><span style="display: none; text-decoration: none;color:#000000;" >1</span><span style="display: none; text-decoration: none;color:#000000;" ></span></a></span></span><span style=""></span></p> <p class="MsoToc3" style=""><span class="MsoHyperlink"><span style=""><a href="http://www.blogger.com/post-create.g?blogID=8814429923003909469#_Toc280992282"><span style="" lang="EN-GB">The war against diabetes: State of the Art.</span><span style="display: none; text-decoration: none;color:#000000;" ><span style=""> </span></span><span style="display: none; text-decoration: none;color:#000000;" >1</span><span style="display: none; text-decoration: none;color:#000000;" ></span></a></span></span><span style=""></span></p> <p class="MsoToc3" style=""><span class="MsoHyperlink"><span style=""><a href="http://www.blogger.com/post-create.g?blogID=8814429923003909469#_Toc280992283"><span style="" lang="EN-GB">The “screening” of Diabetes Mellitus is not synonymous of Primary Prevention</span><span style="display: none; text-decoration: none;color:#000000;" ><span style="">. </span></span><span style="display: none; text-decoration: none;color:#000000;" >3</span><span style="display: none; text-decoration: none;color:#000000;" ></span></a></span></span><span style=""></span></p> <p class="MsoToc3" style=""><span class="MsoHyperlink"><span style=""><a href="http://www.blogger.com/post-create.g?blogID=8814429923003909469#_Toc280992284"><span style="" lang="EN-GB">The five Stages of Type 2 Diabetes Mellitus</span><span style="display: none; text-decoration: none;color:#000000;" ><span style="">. </span></span><span style="display: none; text-decoration: none;color:#000000;" >4</span><span style="display: none; text-decoration: none;color:#000000;" ></span></a></span></span><span style=""></span></p> <p class="MsoToc3" style=""><span class="MsoHyperlink"><span style=""><a href="http://www.blogger.com/post-create.g?blogID=8814429923003909469#_Toc280992285"><span style="" lang="EN-GB">Siniscalchi’s Sign.</span><span style="display: none; text-decoration: none;color:#000000;" ><span style=""> </span></span><span style="display: none; text-decoration: none;color:#000000;" >6</span><span style="display: none; text-decoration: none;color:#000000;" ></span></a></span></span><span style=""></span></p> <p class="MsoToc3" style=""><span class="MsoHyperlink"><span style=""><a href="http://www.blogger.com/post-create.g?blogID=8814429923003909469#_Toc280992286"><span style="" lang="EN-GB">Conclusions.</span><span style="display: none; text-decoration: none;color:#000000;" ><span style=""> </span></span><span style="display: none; text-decoration: none;color:#000000;" >6</span><span style="display: none; text-decoration: none;color:#000000;" ></span></a></span></span><span style=""></span></p> <p class="MsoToc3" style=""><span class="MsoHyperlink"><span style=""><a href="http://www.blogger.com/post-create.g?blogID=8814429923003909469#_Toc280992287"><span style="" lang="EN-GB">References</span><span style="display: none; text-decoration: none;color:#000000;" ><span style="">. </span></span><span style="display: none; text-decoration: none;color:#000000;" >8</span><span style="display: none; text-decoration: none;color:#000000;" ></span></a></span></span><span style=""></span></p> <h3><span style="" lang="EN-GB"> </span></h3> <h3><span style="" lang="EN-GB"> </span></h3> <h3 style="text-align: justify;"><a name="_Toc280992281"><span style="" lang="EN-GB">Introduction</span></a><span style="" lang="EN-GB"><br /><br /></span><span style="" lang="EN-GB"></span></h3> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Despite screening measures adopted in the <i style="">secondary</i> prevention, at the moment there is no primary prevention because the traditional and pedantic Medicine ignores Quantum-Biophysical-Semeiotic Constitutions and the correlated Inherited Real Risks (1-9), such as of the diabetes, CVD and Cancer (Oncologic Terrain), pathologies that all the Authors consider ever-growing epidemics (1-5).</span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Next to Diabetes Mellitus, whose type 2 represents about the 50% of all the cases, arterial hypertension, glaucoma, osteoporosis, CVD, the several forms of dyslipidemia, and cancer (1-10) are generally diagnosed too late, only when the classic clinical and laboratory symptoms set in, “anticipated”<span style=""> </span>and accompanied by harmful complications, often lethal, which notoriously manifest decades after the Congenital Real Risk, dependant of the correlated Constitution, expression of the potential disease (6-12). <span style=""> </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"> </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">These few exemplar FACTS underline the urgency in Medicine to proceed without any further delay towards the New Renaissance of Medicine (1), for the first time with the aid of primary prevention of Diabetes Mellitus, CAD, and cancer, three growing epidemics.</span></p> <p class="MsoNormal"><span style="" lang="EN-GB">Recently, illustrating my Lecture at I National Meeting of International Society of Quantum-Biophysical-Semeiotics, Riva Trigoso (Genoa), <span style=""> </span>I have announced a paramount clinical tool in the war against type 2 DM, Siniscalchis Sign (1). See also website </span><b style=""><a href="http://www.sisbq.org/">http://www.sisbq.org</a></b></p> <p class="MsoNormal" style="text-align: justify;"><span style=""><span style=""> </span><span lang="EN-GB"></span></span></p> <h3 style="text-align: justify;"><a name="_Toc280992282"></a><a name="_Toc277062723"><span style=""><span style="" lang="EN-GB">The war against diabetes: State of the Art.</span></span></a><span style="" lang="EN-GB"></span></h3> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><br /><span class="bodydoc">On the 21st December, 2006 the General Assembly of the United Nations declared that diabetes mellitus is a threat for the whole world, designating the 14<sup>th</sup> November as World Diabetes Day. </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">In fact, this epidemic, ever-growing and unstoppable, is a serious threat to health, on the same level as infectious diseases like Aids, tuberculosis and malaria. The incidence and predominance of diabetes type 2 are growing in underdeveloped and developing countries. </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">For example, today in Italy diagnosed diabetics are two millions, without counting those who haven’t been recognized ill, while the numbers of diabetics in the world is foreseen to rise from 171 millions in 2000 to 366 millions in 2030 (Nature Clinical Practice Endocrinology & Metabolism 2007, 3, 667).</span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">To be carefully considered it is the number of adults with arterial hypertension, which affects the 70% of the diabetics, showing a double incidence compared with non-diabetics subjects, and it is foreseen an increase of the 60%,<span style=""> </span>for a total equal to 1.500 millions in 2025. </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB"> </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">Diabetic pathology is notoriously characterized by the fact that the affected body can’t make use of the sugar present in the blood and it appears only in patients with Quantum-Biophysical-Semeiotic Congenital Real Risk.</span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">Diabetes mellitus, both type I and type II, can damage heart, kidneys, eyes, nerves, peripheral arteries of the patients affected by the congenital real risks in the target organs (11-15).<span style=""> </span>Without this pathological condition, dependant on the related constitution, the environmental risk factors, like diabetes, are “innocent spectators” (32).</span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">In fact a long and successful clinical experience allows me to state that in the absence of this characteristic parenchimal congenital and microvascular alteration, the “micro vascular remodelling”, all the environmental risks factors are not harmful, similarly to what happens in case of CAD (32).</span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">This at last explains why only about the 50% of patients suffering from Metabolic Syndrome (11) is affected by diabetes type 2 as well as by the regional and not systemic vascular damage, and the existence of several diabetics without lesions in the target organs! </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB"> </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">I think that it is no longer possible to delay an honest stance on everyone’s behalf, but especially the Government responsible for Health, Research and University, who must eventually consider the scientific discoveries in diabetology, accepted by Publishers of famous "peer-reviews", aimed to start a new and effective strategy against diabetes mellitus and other serious and common diseases, such as CVD and cancer “clinically” carried out on a large scale in a population “rationally” enrolled (1-22).</span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">Although diabetes keeps being one of the most serious world epidemic, no world authorized Health<span style=""> </span>Authority shows interest in modifying the expensive, obsolete, disastrous management enforced so far, paying the due attention and honest critic to original proposals, that proved effective in a long clinic experience, whose data are by now spread in a wide Literature (1-5, 24).</span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB"> </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">At the beginning of the third millennium no medical or surgical intervention exists, that can give complete recovering from diabetes. About the dangers of present use of stem cells, the day 11November, 2010, the <i style="">Federation Argentina de Cardiologia</i>, FAC, has posted in its Forum my comment, I have sent to the most prestigious peer-reviews of the world (Ask Google.com), wherein I referred to my earlier letter published on Washington Post website in 2007.</span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">Furthermore only a small percentage of diabetics is kept under control in a satisfying way, if evaluated and monitored in the best possible way available today:<span style=""> </span>the biophysical-semeiotic evaluation of hepatic PPARs (1-7).</span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">In a few words, the so-called diabetic complications begin decades before leading to the diabetic syndrome, as allows me to state also Quantum Biophysical Semeiotics, showing that primary prevention is the best therapy ever! </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB"> </span></span></p> <p class="MsoNormal"><span class="bodydoc"><span style="" lang="EN-GB">Unfortunately up to this day primary prevention of diabetes has been realized in an expensive, limited, impractical, reductive, ineffective way, due to completely wrong principles on which it is founded, in the absolute preference for technology and neglecting a Medicine focused on Man, according to the spirit of the "Single Patient Based Medicine" (5, 7, 9).</span></span></p> <h3 style="text-align: justify;"><span style="" lang="EN-GB"><br /><a name="_Toc280992283"></a><a name="_Toc277062724"><span style="">The “screening” of Diabetes Mellitus is not synonymous of Primary Prevention</span></a></span></h3> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In the well-known magazine <span class="bodydoc"><i style="">Diabetologia</i>, considered rightly, in my opinion, <span style=""> </span>the “Bible” for diabetologists, for example in the Volume 50, Number 11, November 2007, there is no article actually clinical, whose data can be cross-examined at the patient’s bedside using a stethoscope.</span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">In other words, the majority of articles published in that magazine, similarly to what happens in the others, report the conclusions of researches based on results from laboratories and sophisticated semeiotic instruments, among them genetic investigations that can only be performed in very few university centres and specialized institutes, and for this reason not applicable on a large scale of the population. </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">In spite of the progress, only apparently astonishing, of technology applied to diabetology, the paradoxical result is that today, during a physical examination, preferably at the patient’s birth, no doctor and no diabetologist is able to clinically recognize and discern, in a quantitative way, the one with diabetic real risk, that is actually predisposed to diabetes mellitus, from the one who surely will never suffer from diabetes, even if he/she will live surrounded by several environmental risk factors. </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">Otherwise stated, the doctor who only knows the orthodox, academic, traditional physic semeiotics, based on the deterministic mechanics in the service of power, even having the use of state-of-the-art laboratories and sophisticated and expensive instrumental semeiotics, cannot “bedside” diagnose the diabetic constitution, the dyslipidemic constitution and the congenital Diabetic Real Risk, which represent the "<i style="">conditio sine qua non</i>" of the onset of diabetes (1-22, 31-35). </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">The consequences of what mentioned above, a striking example of Medieval Medicine, maidservant of Economy (23), are too evident to be only mentioned! </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">On the basis of a successful clinical experience of more than 50 years, without fearing refutations I state that the fight against diabetes mellitus, carried out on a very large scale with clinical methods,<span style=""> </span>must necessarily be realised in ALL the individuals who are positive to diabetic “and” dyslipidemic constitutions, quickly recognizable with the help of a simple phonendoscope, and at the same time positive to the “Congenital Diabetic Real Risk” (1-22) (see also the open letter I sent to the former Minister Prof. G. Sirchia on May 2004!: </span><a href="http://www.clicmedicina.it/pagine-n-30/reale-rischio.htm"><span style="" lang="EN-GB">http://www.clicmedicina.it/pagine-n-30/reale-rischio.htm</span></a></span><span class="bodydoc"><span style="" lang="EN-GB">). </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">In order to predict achievable objectives in a far-reaching enterprise like the primary prevention diabetes mellitus, more than relying on good intentions it is useful to carefully consider the logic held in it, associating the Medicine Based on the Obvious to the more pragmatic, realistic and practical Medicine Based on the Single Patient, which by now is accepted worldwide (5-14). </span></span><span style="" lang="EN-GB"><span style=""> </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">In the useless and expensive campaigns against diabetes so far fought, due to the irrational selection of the subjects to enrol, the term of primary prevention has been constantly, erroneously and silently substituted by <i style="">screening</i> (early recognition of a disease already in existence, but not diagnosed for years or decades, independently from the presence or seriousness of its “complications” already acting and from its well-known development). </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB"> </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">I think that among the several reasons of the failing and wasteful prevention of diabetes carried on until now, the following facts lead a primary role: </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB"> </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">a) The so-called diabetic, kidney, retinic, coronary, etc. “complications” show up decades and decades before the onset of the diabetic symptoms, both haematological (altered glycaemia on an empty stomach and/or post-prandial, high levels of glycosylated haemoglobin, pathologic OGTT, etc.), and clinic, according to the Angiobiopathy theory (31). It follows that the traditional diagnosis of diabetes, even when it seems early, is “always” inevitably late, done when by that time the target organs have already been damaged. </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><br /><span class="bodydoc">b) Stylish and precise enough evaluations of the alterations of the glycidic metabolism of the initials phases (e.g. </span>hyperinsulinemic-<em><span style="font-style: normal;">normoglycemic clamping</span></em><span class="bodydoc">) CANNOT be used on a large scale for obvious economical and organizational reasons, contrary to the quantum-biophysical-semeiotic evaluation of PPARs (alfa) of the liver, the most precise method – to my knowledge – to monitor<span style=""> </span>the gluco-lipidic metabolism (1-5).</span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB"> </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">c) Metabolic Syndrome, constantly anticipated by the Pre-Metabolic Syndrome, classic and variant, described in previous papers (11, 17), can be diagnosed by a phonendoscope since birth, that is when the Pre-Metabolic Syndrome and the so-called diabetic “complications” are present, but “potential” (5-10).</span></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><br /><span class="bodydoc">d) The term "<i style="">screening</i>", used arbitrarily as a synonymous of <i style="">primary prevention</i> by the Health Authorities and Doctors, is not correct at all. In fact, in this case we are not talking about primary prevention, carried out before the onset of a disease in individuals who are apparently healthy, but with congenital real risk, dependant on the relative pathology, but it is secondary prevention, carried out on diabetic patients, perhaps not yet diagnosed, but with the complications of the disease already in action. The tertiary prevention aims to contrast the progression of clinically present and advanced complications. </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB"> </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">The nature of a prediction is scientific when can’t escape, with the help of <i style="">ad hoc</i> theories, to falsification: I foresee that in future Diabetology based on Man, in the scrupulous respect of the "Single Patient Based Medicine" (5, 7-10), and accordingly in agreement with the spirit of the NEW RENAISSANCE of Medicine, the “clinical” diagnosis will play the leading role, quantitative of<span style=""> </span>diabetic “and” dyslipidemic quantum-biophysical-semeiotic constitutions, diabetic congenital real risk, followed by the acknowledgement of Pre-Metabolic Syndrome and consequently of the Metabolic one in diabetic evolution and eventually of diabetes mellitus on a very initial stage (21, 31). </span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB"> </span></span></p> <h3 style="text-align: justify;"><a name="_Toc280992284"><span style="" lang="EN-GB">The five Stages of Type 2 Diabetes Mellitus</span></a><span style="" lang="EN-GB"></span></h3> <p class="MsoNormal"><span style="" lang="EN-GB"> </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Since their births all diabetic individuals show quantum biophysical semeiotic signs typical of dyslipidemic “and” diabetic constitutions, and all the related, ICAEM- dependent, Inherited Real Risks, <span style=""> </span>subsequently evolved first into pre-metabolic syndrome and after into metabolic under the negative influence of well-known environmental factors: sedentary lifestyle, tobacco smoke, overeating, a diet rich in saturated fats and carbohydrates, weight gain (BMI 25 or more), and so on (5, 7, 9-11, 13-15,17, 20).<b><span style="color:red;"><span style=""> </span></span></b><span style="">(Table 1)</span></span></p> <p class="MsoNormal" style="text-align: justify;"><b><u><span lang="EN-GB" style="color:red;"><span style="text-decoration: none;"> </span></span></u></b></p> <div style="border: 1pt solid windowtext; padding: 1pt 4pt;"> <p class="MsoNormal" style="text-align: center; border: medium none; padding: 0cm;" align="center"><b><u><span style="" lang="EN-GB">Natural History of type 2 Diabeyes Mellitus</span></u></b></p> <p class="MsoNormal" style="text-align: center; border: medium none; padding: 0cm;" align="center"><b><u><span style="" lang="EN-GB"><span style="text-decoration: none;"> </span></span></u></b></p> <p class="MsoNormal" style="text-align: justify; border: medium none; padding: 0cm;"><b><u><span style="" lang="EN-GB">Stage 1<span style=""> </span>(individual’s birth)</span></u></b><span style="" lang="EN-GB"></span></p> <p class="MsoNormal" style="text-align: justify; border: medium none; padding: 0cm;"><b><span style="" lang="EN-GB">Diabetic “and ” Dislipidemic Constitutions</span></b></p> <p class="MsoNormal" style="text-align: justify; border: medium none; padding: 0cm;"><b><span style="" lang="EN-GB">Diabetic Inherited Real Risk (e.g. LATENT)</span></b></p> <p class="MsoNormal" style="text-align: justify; border: medium none; padding: 0cm;"><b><span style="" lang="EN-GB"> </span></b></p> <p class="MsoNormal" style="text-align: justify; border: medium none; padding: 0cm;"><b><u><span style="" lang="EN-GB">Stage II</span></u></b><b><span style="" lang="EN-GB"> (under 10 years)</span></b></p> <p class="MsoNormal" style="text-align: justify; border: medium none; padding: 0cm;"><b><span style="" lang="EN-GB">Abnormal<span style=""> </span>synthesis of Perivascular GAGs by<span style=""> </span>fibroblasts, pericytes, mioblasts, megacariocytes, a.s.o.; Amiline in the Interstitial Fundamental Substance, and so on. (Location: Capillaries,<span style=""> </span>Small Arteries, Arterioles, AVA type II,<span style=""> </span>group B, cutaneous, EBD, a.s.o.)</span></b></p> <p class="MsoNormal" style="text-align: justify; border: medium none; padding: 0cm;"><b><span style="" lang="EN-GB"> </span></b></p> <p class="MsoNormal" style="text-align: justify; border: medium none; padding: 0cm;"><b><u><span style="" lang="EN-GB">Stage III</span></u></b><b><span style="" lang="EN-GB"><span style=""> </span>(Second decade of life)</span></b></p> <p class="MsoNormal" style="text-align: justify; border: medium none; padding: 0cm;"><b><span style="" lang="EN-GB">IIR, Microalbuminurie, Initial<span style=""> </span>ATS Plaques , a.s.o.</span></b></p> <p class="MsoNormal" style="text-align: justify; border: medium none; padding: 0cm;"><b><span style="" lang="EN-GB"> </span></b></p> <p class="MsoNormal" style="text-align: justify; border: medium none; padding: 0cm;"><b><u><span style="" lang="EN-GB">Stage IV</span></u></b><b><span style="" lang="EN-GB"><span style=""> </span>( about third decade of life)</span></b></p> <p class="MsoNormal" style="border: medium none; padding: 0cm;"><b><span style="" lang="EN-GB">Prediabetes, overt microbascular Complications.</span></b></p> <p class="MsoNormal" style="border: medium none; padding: 0cm;"><b><span style="" lang="EN-GB">(OGTT, Iper-Insulinemic-Normo-Glicemic Clamping, Insulinemia)</span></b></p> <p class="MsoNormal" style="border: medium none; padding: 0cm;"><b><span style="" lang="EN-GB"> </span></b></p> <p class="MsoNormal" style="text-align: justify; border: medium none; padding: 0cm;"><b><u><span style="" lang="EN-GB">Stadio<span style=""> </span>V</span></u></b></p> <p class="MsoNormal" style="text-align: justify; border: medium none; padding: 0cm;"><b><span style="" lang="EN-GB">Type 2 overt Diabetes<span style=""> </span></span></b></p> <p class="MsoNormal" style="text-align: center; border: medium none; padding: 0cm;" align="center"><span style="" lang="EN-GB"> </span></p> </div> <p class="MsoNormal" style="text-align: center;" align="center"><span style="" lang="EN-GB">Tabella 1</span></p> <p class="MsoNormal" style="text-align: center;" align="center"><span lang="EN-GB" style="color:red;"> </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"> </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In fact, it is evident that not “all” the individuals, even though obese and/or hypertensive, are at diabetes risk with different probabilities, obviously, as instead health authorities, both Ministers of Health and Instruction, university professors and also the General Practitioners<span style=""> </span>keep – so it seems – thinking.</span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"> </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">On the contrary, the individuals with diabetic “real risk” are all those who are positive to dyslipidemic “and” diabetic biophysical-semeiotic constitutions, inherited only from the mother, and associated to the diabetic Congenital Real Risk, measurable only with a simple phonendoscope, <i style="">conditio sine qua non </i>of diabetes type 2<i style="">.</i> </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><br />Quantum Biophysical Semeiotics allows physician, since birth, rationally and clinically to select “all” the individuals affected by dyslipidemic “and” diabetic constitutions, even latent, the only ones to enrol in the primary prevention because carriers of the diabetic congenital real risk (1-33).</span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"> </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Furthermore, for the first time the General Practitioner is able to monitor, clinically and objectively, the course of gluco-lipic congenital metabolic anomalies, recognizing the possible progression, slow and gradual, towards diabetes, favoured, but not caused, by the environmental risk factors: from the genetically directed alterations of lipidic “and” glucidic metabolism towards the Pre-Metabolic Syndrome first and, after, the Metabolic one, both absolutely lacking the traditional clinical symptoms, well recognized instead by Quantum Biophysical Semeiotics (21, 34, 35). (Table1)</span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"> </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">As for the technical aspect, in the easiest way the doctor can recognize diabetic congenital real risk by an “intense” skin pinch at the level of the VI thoracic dermatome, which corresponds to the superior part of the epicondrium (= the area beneath the right and left costal arches).</span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In a healthy patient, “simultaneously” the gastric aspecific reflex is absent, appearing after 24 sec sharp (1-35)</span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">On the contrary, in those patients who are predisposed to diabetes, the reflex appears “simultaneously”, showing an intensity inferior to 1 cm, while in the diabetic patient is 1 cm or more, in relation to the here beneath mentioned pathology.</span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In other words, interesting from the practical viewpoint, reflex intensity parallels the seriousness of the alterations of amorphous fundamental substance as well as glycemic metabolism<span style=""> </span>impairment, which highlights the contemporaneous intense<span style=""> </span>“in toto” ureteral reflex” (1)</span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"> </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Interestingly, from practical view point, the intensity of reflex is directly linked to the seriousness of the glucidic dysmetabolism. </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"> </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Once diabetes has been recognized, potential or overt, the doctor proceeds to the quantum-biophysical-semeiotic evaluation of the glucidic metabolism, using several methods, all reliable but different in style and information (1-35).</span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"> </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">A therapeutic important aspect is played by the war against overweight and obesity, which facilitate diabetes onset, obviously exclusively in individuals at inherited real risk.</span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">As a consequence, doctors have to reach the goal of maintaining the real weight near to ideal weight at the best, i.e., conserving physiological BMI.</span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"> </span></p> <h3 style="text-align: justify;"><a name="_Toc280992285"><span style="" lang="EN-GB">Siniscalchi’s Sign.</span></a><span style="" lang="EN-GB"></span></h3> <p class="MsoNormal"><span style="" lang="EN-GB"> </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In health, lying down psycho-physically relaxed, in supine position with closed eyes to lower melatonin secretion, “intense” (24-28) cutaneous pintchig of VI thoracic dermatomere , i.e., trigger-point of pancreas (= the skin 3 cm. about below costal arch, at right or left),<span style=""> </span>does not bring about “simultaneously” the gastric aspecific reflex, which occurs <span style=""> </span>after exactly 24 sec., as after pancreas preconditioning<span style=""> </span>(5, 12, 14) (Fig. 1).</span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"> </span></p> <p class="MsoNormal" style="text-align: center;" align="center"><span style="" lang="EN-GB"><img src="file:///C:/DOCUME%7E1/Sergio/IMPOST%7E1/Temp/msohtml1/01/clip_image002.jpg" width="182" border="0" height="185" /></span></p> <p class="MsoNormal" style="text-align: center;" align="center"><span style="" lang="EN-GB">Fig. 1</span></p> <p class="MsoNormal" style="text-align: center;" align="center"><i style=""><span style="" lang="EN-GB">The figure shows centripetal lines, along which digital percussion has to be applied, gently and quickly, starting from outer areas and moving towards the bell piece of stethoscope. For further technical information, See <a href="http://www.semeioticabiofisica.it/">www.semeioticabiofisica.it</a>, Technical Page Number 1.</span></i></p> <p class="MsoNormal" style="text-align: center;" align="center"><i style=""><span style="" lang="EN-GB"> </span></i></p> <p class="MsoNormal" style="text-align: justify;"><i style=""><span style="" lang="EN-GB"><span style=""> </span></span></i></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><span style=""> </span>On the contrary, under identical experimental condition, illustrated above, in individuals involved by Diabetic Constitution, Diabetic Constitution-Inherited Real Risk, and overt Diabetes Mellitus, of course, “simultaneously” appears the gastric aspecific reflex (respectively of 0,5 <></span></p> <h3 style="text-align: justify;"><a name="_Toc280992286"></a><a name="_Toc277062727"></a><a name="_Toc277058861"></a><a name="_Toc277057987"></a><a name="_Toc275583226"></a><a name="_Toc274033678"></a><a name="_Toc273896939"><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style="" lang="EN-GB">Conclusion</span></span></span></span></span></span></span></a><span style=""><span style=""><span style=""><span style=""><span style=""><span style="" lang="EN-GB">s.</span></span></span></span></span></span><span style="" lang="EN-GB"></span></h3> <p class="MsoNormal"><span style="" lang="EN-GB"> </span></p> <p class="MsoNormal"><span style="" lang="EN-GB"> </span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span lang="EN-GB" style="font-size:13.5pt;">Based on a sclerotized Physiology, incapable of giving persuasive explanations of the several quantum-biophysical-semeiotic signs and of a Biology that disregards a non-local Reality next to a local one, Western Medicine only considers biological systems which are “static” and with a rigid metabolic balance and, according to Claude Bernard and Walter Cannon, intra-correlated only through nervous and vascular ways, arterial, venous, lymphatic.</span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span lang="EN-GB" style="font-size:13.5pt;">In contrast with the blind ignorance of traditional Medicine, the physiological behaviour of biological systems is indeed that of a dynamic system far away from a fixed balance, where also the single cellular and sub-cellular structures vibrate in a stochastic, unpredictable, uncertain, chaotic way.</span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span lang="EN-GB" style="font-size:13.5pt;">In addition, Western Medicine erroneously considers individuals born equal and “healthy” until the moment of the onset of the disease, according to a platonic-manichean vision, vainly underpinned with "<i style="">ad hoc</i>" hypothesis. Western Medicine is a giant with clay feet (30).</span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span lang="EN-GB" style="font-size:13.5pt;">For all the above mentioned reasons, which surely don’t exhaust my <i style="">J’Accuse</i> against the present Middle Ages of Medicine, maid of Economy, it now time of its Renaissance, on the basis of the discoveries done in the last 50 years and which brought to the foundation of Quantum Biophysical Semeiotics (33).</span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span lang="EN-GB" style="font-size:13.5pt;">Regarding the present war against DM, based on the useless screening, unfortunately until now physician fight such as metabolic, complex disorder exclusively with therapy, however showing to be <span style=""> </span>not able to bring under optimal control metabolic impairment.</span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span lang="EN-GB" style="font-size:13.5pt;">Quantum<span style=""> </span>Biophysical Semeiotic primary prevention of type 2 DM, providing an efficacious, reliable tool,<span style=""> </span>as Siniscalchi’s Sign, here illustrated for the first time, allows, easily and quickly, to recognize individuals at real risk of DM, to be enrolled in the original primary prevention.</span></span></p> <span class="bodydoc"><span style=";font-family:";font-size:13.5pt;" lang="EN-GB" ><br /></span></span> <p class="MsoNormal" style="text-align: justify;"><span class="bodydoc"><span style="" lang="EN-GB">* </span></span><span class="bodydoc"><span lang="EN-GB" style="font-size:14pt;">Mario Siniscalchi, my dearest Friend, Cardiologist in Neaple, skilled in Quantum Biophysical Semeiotics of hearth disorders</span></span><span class="bodydoc"><span style="" lang="EN-GB">.</span></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"> </span></p> <p class="MsoNormal"><span class="bodydoc"><span style="" lang="EN-GB"> </span></span></p> <p class="MsoNormal"><span class="bodydoc">**</span><b style=""><span style=";font-family:Arial;font-size:10pt;" > </span></b>Sergio Stagnaro MD<span style="font-family:Arial;"></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10pt;" >Via Erasmo Piaggio 23/8</span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10pt;" lang="EN-GB" >16039 Riva Trigoso (Genoa) <b style="">Italy</b></span><span style="" lang="EN-GB"></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10pt;" lang="EN-GB" >Founder of Quantum Biophysical Semeiotics</span><span style="" lang="EN-GB"></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10pt;" lang="EN-GB" >Who's Who in the World (and America)</span><span style="" lang="EN-GB"></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10pt;" lang="EN-GB" >since 1996 to 2010</span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10pt;" lang="EN-GB" >Ph 0039-0185-42315</span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10pt;" lang="EN-GB" >Cell. 3338631439</span><span style="" lang="EN-GB"></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10pt;" ><a href="http://www.semeioticabiofisica.it/"><span style="" lang="EN-GB">www.semeioticabiofisica.it</span></a></span><span style=";font-family:Arial;font-size:10pt;" > </span><span style="" lang="EN-GB"></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10pt;" ><a href="mailto:dottsergio@semeioticabiofisica.it"><span style="" lang="EN-GB">dottsergio@semeioticabiofisica.it</span></a></span><span style=";font-family:Arial;font-size:10pt;" > </span><span style="" lang="EN-GB"></span></p> <p class="MsoNormal"><span style="" lang="EN-GB"><a href="http://club.quotidianonet.ilsole24ore.com/blog/sergio_stagnaro">http://club.quotidianonet.ilsole24ore.com/blog/sergio_stagnaro</a><span class="enddoc"> </span></span></p> <p class="MsoNormal"><span style="" lang="EN-GB"> </span></p> <p class="MsoNormal"><span style="" lang="EN-GB"> </span></p> <h3><a name="_Toc280992287"></a><a name="_Toc277062728"><span style=""><span style="" lang="EN-GB">References</span></span></a><span style="" lang="EN-GB"></span></h3> <p class="MsoNormal"><b style=""><span style="" lang="EN-GB"> </span></b></p> <p class="MsoNormal">1) Sergio Stagnaro. <span style=""><span style=""> </span><strong><span style=""> </span></strong>New Renaissance in Medicina. Prevenzione Primaria del Diabete Mellito tipo 2. Sito del Convegno, <a href="http://qbsemeiotics.weebly.com/atti-del-convegno.html">http://qbsemeiotics.weebly.com/atti-del-convegno.html</a>, 16 novembre 2010; <a href="http://qbsemeiotics.weebly.com/uploads/5/6/8/7/5687930/newrenaissance_prevenzionet2dm.pdf">http://qbsemeiotics.weebly.com/uploads/5/6/8/7/5687930/newrenaissance_prevenzionet2dm.pdf</a>; english version <a href="http://qbsemeiotics.weebly.com/uploads/5/6/8/7/5687930/report_stagnaro.pdf">http://qbsemeiotics.weebly.com/uploads/5/6/8/7/5687930/report_stagnaro.pdf</a> ; <a href="http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Ita/Nuovo%20Rinascimento%20Medicina%20RELAZIONE%20I%20Congr.doc">http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Ita/Nuovo%20Rinascimento%20Medicina%20RELAZIONE%20I%20Congr.doc</a>; english version <a href="http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Eng/Nuovo%20Rinascimento%20eng.doc">http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Eng/Nuovo%20Rinascimento%20eng.doc</a></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">2) </span><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" >Stagnaro Sergio</span><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" >. <span style="color:red;"> </span>Pivotal PPARs Activity Bed-side Evaluation in Pre-Metabolic Syndrome and Metabolic Syndrome Primary Prevention. <i>Cardiovascular Diabetology.</i> 2005, <span style="">4:</span>13 doi:10.1186/1475-2840-4-13<span style="color:red;"> </span><span style="color:navy;"></span></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">3) </span><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" >Stagnaro Sergio.</span><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" > <span class="maintextmoduleitalic">Bedside biophysical-semeiotic PPARs evaluation in glucose-lipid metabosism monitoring. </span><i>Annals of Family Medicine</i> <span class="maintextmoduleitalic">2007; 5: 14-20. </span></span><strong><span style="font-weight: normal;font-family:Verdana;" lang="EN-GB"><a href="http://www.annfammed.org/cgi/eletters/5/1/14"><span style="font-size:10pt;">http://www.annfammed.org/cgi/eletters/5/1/14</span></a></span></strong></p> <p class="MsoNormal"><strong><span style="font-weight: normal;" lang="EN-GB">4) </span></strong><span style="" lang="EN-GB"><span style=""> </span></span><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" >Stagnaro Sergio. </span><span style=";font-family:Verdana;font-size:10pt;color:red;" lang="EN-GB" > </span><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" >Pivotal Role of Liver PPARs Activity Bed-side Evaluation in Monitoring glucidic and lipidic Metabolism. <i>Lipids in Healt and Disease</i>. 02 June 2007, </span><span style="font-family:Verdana;"><a href="http://www.lipidworld.com/content/6/1/12/comments#284542"><span lang="EN-GB" style="font-size:10pt;">http://www.lipidworld.com/content/6/1/12/comments#284542</span></a></span><span lang="EN-GB" style="font-family:Verdana;"></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" >5) </span><span style="">Stagnaro Sergio, Stagnaro-Neri Marina.<span style=""> </span>Introduzione alla Semeiotica Biofisica. Il Terreno oncologico”. Travel Factory SRL., Roma, 2004. </span><span style="" lang="EN-GB"><a href="http://www.travelfactory.it/"><span style="" lang="IT">http://www.travelfactory.it</span></a></span><span style=""> </span></p> <p class="MsoNormal"><span style=""><span style=""> </span>6</span>)<span style=""><span style=""> </span></span>Stagnaro S., Stagnaro-Neri M., La Melatonina nella Terapia del Terreno Oncologico e del “Reale Rischio” Oncologico. Ediz. Travel Factory, Roma, 2004.</p> <p class="MsoNormal"><a name="_Toc75255120"><span style="color:red;"><span style=""> </span></span>7) <span style="color:red;"><span style=""> </span></span>Stagnaro S., Stagnaro-Neri M., Le Costituzioni<span style=""> </span>Semeiotico-Biofisiche.</a>Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Ediz. Travel Factory, Roma, 2004. <span style="" lang="EN-GB"><a href="http://www.travelfactory.it/"><span style="" lang="IT">http://www.travelfactory.it</span></a></span><span style=""> </span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" >8) <span style="">Stagnaro Sergio</span>. </span><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" >Single Patient Based Medicine: its paramount role in Future Medicine. Public Library of Science. <a href="http://medicine.plosjournals.org/perlserv/?request=read-response">http://medicine.plosjournals.org/perlserv/?request=read-response</a></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" >9) <span style="">Stagnaro S., Stagnaro-Neri M</span>., Single Patient Based Medicine. La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. Travel Factory, Roma, 2005. </span><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" ><a href="http://www.travelfactory.it/libro_singlepatientbased.htm"><span style="" lang="IT">http://www.travelfactory.it/</span></a></span><span style=";font-family:Verdana;font-size:10pt;" ></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" >10) <span style="">Stagnaro</span> <span style="">Sergio</span></span> Sergio Stagnaro<span style="font-size:10pt;">.</span><span style=";font-family:TT786613C3tCID-WinCharSetFFFF-H;font-size:10pt;color:blue;" > </span><span style=""> </span><span style="" lang="EN-GB">Biophysical-Semeiotic Diabetic Constitution. Cyber Lecture, <a href="http://www.indmedica.com/">www.indmedica.com</a>, 2006,<span style=""> </span><a href="http://cyberlectures.indmedica.com/show/60/1/Diabetic_Constitution">http://cyberlectures.indmedica.com/show/60/1/Diabetic_Constitution</a></span><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" ></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" >11)<span style="color:red;"> </span><span style="">Stagnaro Sergio. </span><span style="color:red;"> </span> Pre-Metabolic Syndrome and Metabolic Syndrome: Biophysical-Semeiotic Viewpoint. </span><span style=";font-family:Verdana;font-size:10pt;" ><a href="http://www.athero.org/" target="_blank"><span style="" lang="EN-GB">www.athero.org</span></a></span><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" >, 29 April, 2009. <a href="http://www.athero.org/commentaries/comm904.asp" target="_blank">http://www.athero.org/commentaries/comm904.asp</a></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" >12) Stagnaro Sergio. </span><span style=";font-family:Verdana;font-size:10pt;color:red;" lang="EN-GB" > </span><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" > CAD Inherited Real Risk, Based on Newborn-Pathological, Type I, Subtype B, Aspecific, Coronary Endoarteriolar Blocking Devices. Diagnostic Role of Myocardial Oxygenation and Biophysical-Semeiotic Preconditioning. <a href="http://www.athero.org/" target="_blank">www.athero.org</a>, 29 April, 2009 <a href="http://www.athero.org/commentaries/comm907.asp" target="_blank">http://www.athero.org/commentaries/comm907.asp</a></span><span style="" lang="EN-GB"></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" >13) <span style="">Stagnaro Sergio.</span> Il “Reale Rischio” Semeiotico-Biofisico. <a href="http://www.piazzettamedici.it/" target="_blank">http://www.piazzettamedici.it/</a>. URL:<a href="http://www.piazzettamedici.it/professione/professione.htm" target="_blank">http://www.piazzettamedici.it/professione/professione.htm</a></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" >14) <span style="">Stagnaro Sergio.</span> Reale Rischio Semeiotico Biofisico. I Dispositivi Endoarteriolari di Blocco neoformati, patologici, tipo I, sottotipo a) oncologico, e b) aspecifico. </span><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" >Ediz. Travel Factory, <a href="http://www.travelfactory.it/" target="_blank">www.travelfactory.it</a>, Roma, 2009.</span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" >15) <span style="">Stagnaro Sergio. </span><strong><span style="font-weight: normal;font-family:Verdana;" >New bedside way in Reducing mortality in diabetic men and women. <i>Ann. Int. Med.</i> </span></strong></span><span lang="EN-GB" style="font-family:Verdana;"><a href="http://www.annals.org/cgi/eletters/0000605-200708070-00167v1"><span style="font-size:10pt;">http://www.annals.org/cgi/eletters/0000605-200708070-00167v1</span></a></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" >16) <span style="">Stagnaro S., West PJ., Hu FB., Manson JE., Willett WC. </span>Diet and Risk of Type 2 Diabetes. N Engl J Med. 2002 Jan 24;346(4):297-298. <span style="">[Medline]</span></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" >17) Stagnaro Sergio.</span><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" > Epidemiological evidence for the non-random clustering of the components of the metabolic syndrome: multicentre study of the Mediterranean Group for the Study of Diabetes. <i>Eur J Clin Nutr</i>. 2007 Feb 7; [Epub ahead of print] <span style="">[Medline]</span></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" >18) Stagnaro Sergio.</span><span style=";font-family:Verdana;font-size:10pt;" > Lettera di un medico in pensione ad un neolaureato, aggiornata e commentata.<a href="http://www.mednat.org/" target="_blank">www.mednat.org</a>, 22 marzo 2009. </span><span style="font-family:Verdana;"><a href="http://www.mednat.org/curriculum_stagnaro.htm" target="_blank"><span style="font-size:10pt;">http://www.mednat.org/curriculum_stagnaro.htm</span></a></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" >19) <span style="">Stagnaro S., Stagnaro-Neri M.</span> Valutazione percusso-ascoltatoria del Diabete Mellito. Aspetti teorici e pratici. Epat. 32, 131, 1986</span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" >20) Sergio Stagnaro.</span><span style=";font-family:TT786613C3tCID-WinCharSetFFFF-H;font-size:10pt;color:blue;" > </span><span style=""> </span>Biophysical-Semeiotic Dyslipidaemic Constitution. <span style="" lang="EN-GB">Cyber Lecture, <a href="http://www.indmedica.com/">www.indmedica.com</a> , 2006,<span style=""> </span><a href="http://cyberlectures.indmedica.com/show/50/1/Biophysical-Semeiotic_Dyslipidaemic_Constitution">http://cyberlectures.indmedica.com/show/50/1/Biophysical-Semeiotic_Dyslipidaemic_Constitution</a> </span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" >21) <span style="">Stagnaro-Neri M., Stagnaro S.</span>, La sindrome percusso-ascoltatoria da carenza di Carnitina. Clin. Ter. 145, 135 <span style="">[Medline]</span></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;color:navy;" >1994.</span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;color:navy;" >22) </span><span style=";font-family:Verdana;font-size:10pt;" >Stagnaro-Neri M., Stagnaro S.</span><span style=";font-family:Verdana;font-size:10pt;" >, Semeiotica Biofisica: valutazione clinica del picco precoce della secrezione insulinica di base e dopo stimolazione tiroidea, surrenalica, con glucagone endogeno e dopo attivazione del sistema renina-angiotesina circolante e tessutale – Acta Med. </span><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" >Medit. 13, 99, 1997.</span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" >23) <span style="">Stagnaro Sergio.</span> Middle Ages of today’s Medicine, Overlooking Quantum-Biophysical-Semeiotic Constitutions and Related Inherited Real Risk. <a href="http://sciphu.com/" target="_blank"><span style="" lang="IT">http://sciphu.com</span></a></span><span style=";font-family:Verdana;font-size:10pt;" > November 4, 2008. <a href="http://sciphu.com/2008/11/meadle-ages-of-todays-medicine.html" target="_blank">http://sciphu.com/2008/11/meadle-ages-of-todays-medicine.html</a></span></p> <p class="MsoNormal">24) <span style=";font-family:Verdana;font-size:10pt;" >Stagnaro Sergio.</span><span style=";font-family:Verdana;font-size:10pt;" > Il test Semeiotico-Biofisico della Osteocalcina nella prevenzione primaria del diabete mellito. <a href="http://www.fce.it/" target="_blank">www.fce.it</a> Febbraio 2008. <a href="http://www.fcenews.it/index.php?option=com_content&task=view&id=909&Itemid=47" target="_blank">http://www.fcenews.it/index.php?option=com_content&task=view&id=909&Itemid=47</a></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" >25) </span><span style=""> </span>Stagnaro S. e Manzelli P. Semeiotica Biofisica: Realtà non-locale in Biologia. Dicembre 2007 <a href="http://www.ilpungolo.com/leggitutto.asp?IDS=13&NWS=NWS5217">http://www.ilpungolo.com/leggitutto.asp?IDS=13&NWS=NWS5217</a> </p> <p class="MsoNormal"><span style="">26) </span>Stagnaro S. e Manzelli P. Semeiotica Biofisica Endocrinologica: Meccanica Quantistica e Meccanismi d'Azione Ormonali. Dicembre 2007, <a href="http://www.fcenews.it/component/content/816.html?task=view">http://www.fcenews.it/index.php?option=com_content&task=view&id=816&Itemid=45</a> </p> <p class="MsoNormal"><span style="">27) </span>Stagnaro S. e Manzelli P. Semeiotica Biofisica Quantistica: Bifasicità della Secrezione Ormonale. www.ilpungolo.com, Dicembre 2007</p> <p class="MsoNormal"><span style="">28) </span>Stagnaro S. e Manzelli P. Natura Quantistica di una Originale Manovra Semeiotico-Biofisica di Epatopatia . Dicembre 2007, <a href="http://www.fcenews.it/component/content/862.html?task=view">http://www.fcenews.it/index.php?option=com_content&task=view&id=862&Itemid=45</a></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" >29) <span style="">Stagnaro Sergio e<i> </i>Paolo Manzelli.</span> L’Esperimento di Lory. Scienza e Conoscenza, N° 23, 13 Marzo 2008. <a href="http://www.scienzaeconoscenza.it/articolo.php?id=17775" target="_blank">http://www.scienzaeconoscenza.it//articolo.php?id=17775</a></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" >30) <span style="">Sergio Stagnaro</span>. La Medicina Occidentale: un Gigante dai Piedi d’Argilla. 4 Gennaio. 2010, <a href="http://www.fcenews.it/" target="_blank">http://www.fcenews.it</a>, <a href="http://www.fceonline.it/images/docs/gigante.pdf" target="_blank">http://www.fceonline.it/images/docs/gigante.pdf</a></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" >31) </span><span class="bodydoc">Stagnaro-Neri M., Stagnaro S., Sindrome di Reaven, classica e variante, in evoluzione diabetica. Il ruolo della Carnitina nella prevenzione del diabete mellito. Il Cuore. </span><span class="bodydoc"><span style="" lang="EN-GB">6, 617, 1993</span></span></p> <p class="MsoNormal"><span class="bodydoc"><b style=""><span style="" lang="EN-GB"><span style=""> </span>[Medline]</span></b></span></p> <p class="MsoNormal"><span class="bodydoc"><span style="" lang="EN-GB">32 ) </span></span><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" >Sergio Stagnaro.</span><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" > <strong><span style="font-weight: normal;font-family:Verdana;" >Without CAD Inherited Real Risk, All Environmental Risk Factors of CAD are innocent Bystanders. <i>Canadian Medical Association Journal.</i></span></strong><span style=""> </span>CMAJ, 14 Dec 2009, <a href="http://www.cmaj.ca/cgi/eletters/181/12/E267#253801" target="_blank">http://www.cmaj.ca/cgi/eletters/181/12/E267#253801</a></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" >33) </span>Sergio Stagnaro.<span class="spnmessagetext"><span style="color:black;"> </span></span>New Renaissance in Medicine. <span style="" lang="EN-GB">01 October 2010, <a href="http://www.scivox.com/">http://www.scivox.com</a>. </span></p> <p class="MsoNormal"><span style="" lang="EN-GB"><span style=""> </span><a href="http://www.sci-vox.com/stories/story/2010-10-01new+renaissance+in+medicine..html">http://www.sci-vox.com/stories/story/2010-10-01new+renaissance+in+medicine..html</a><span class="bodydoc"></span></span></p> <p class="MsoNormal">34) <span style=";font-family:Verdana;font-size:10pt;" >Stagnaro Sergio</span><span style=";font-family:Verdana;font-size:10pt;" >. <a href="http://www.fceonline.it/wikimedicina/semeiotica-biofisica/211/581-valutazione-dell-amiloide-insulare-nel-diabete.html" target="_blank"><span style="">Valutazione dell'amiloide insulare nel diabete mellito</span></a>. </span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" ><a href="http://www.fceonline.it/" target="_blank"><span style="">www.fceonline.it</span></a>, 2008, <a href="http://www.fceonline.it/wikimedicina/semeiotica-biofisica/211/581-valutazione-dell-amiloide-insulare-nel-diabete.html" target="_blank"><span style="">http://www.fceonline.it/wikimedicina/semeiotica-biofisica/211/581-valutazione-dell-amiloide-insulare-nel-diabete.html</span></a>; e <a href="http://xoomer.virgilio.it/piazzetta/professione/amiloide.htm">http://xoomer.virgilio.it/piazzetta/professione/amiloide.htm</a></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" >35) </span><span lang="EN-GB" style="color:black;">Caramel Simone. </span><span style="" lang="EN-US">Primary Prevention of<span style=""> </span></span><span style="" lang="EN">T2DM</span><span style="" lang="EN-US"> and Inherited Real Risk of Type 2 Diabetes Mellitus</span><span lang="EN-US" style="color:black;"> </span><span style="color:black;"><a href="http://ilfattorec.altervista.org/T2DM.pdf"><span style="" lang="EN-GB">http://ilfattorec.altervista.org/T2DM.pdf</span></a></span><span lang="EN-GB" style="color:black;"></span></p> <p class="MsoNormal"><span style="color:black;">36) </span>Sergio Stagnaro.<span style=""> </span><span style=""> </span><strong><span style="font-weight: normal;"><span style=""> </span></span></strong>Primo neonato negativo per il Terreno Oncologico nato da genitori positivi per la Variante RESIDUA in trattamento con Melatonina-Coniugata, secondo Di Bella-Ferrari. <a href="http://www.fce.it/">www.fce.it</a>,<span style=""> </span><span style=""> </span>13 aprile 2010,<span style=""> </span><a href="http://www.fceonline.it/images/docs/neonato.pdf">http://www.fceonline.it/images/docs/neonato.pdf</a>; nel sito<span style=""> </span><a href="http://junior.cybermed.it/index.php?option=com_frontpage&Itemid=36">http://junior.cybermed.it/index.php?option=com_frontpage&Itemid=36</a>,<span style=""> </span>alle URLs <a href="http://junior.cybermed.it/index.php?option=com_content&task=view&id=1073&Itemid=51">http://junior.cybermed.it/index.php?option=com_content&task=view&id=1073&Itemid=51</a><span style=""> </span><a href="http://www.cybermed.it/index.php?option=com_content&task=view&id=24687&Itemid=134">http://www.cybermed.it/index.php?option=com_content&task=view&id=24687&Itemid=134</a>;<span style=""> </span></p> <p class="MsoNormal"><a href="http://www.piazzettamedici.it/professione/professione.htm">http://www.piazzettamedici.it/professione/professione.htm</a> </p> <p class="MsoNormal"><a href="http://www.liquidarea.com/2010/07/manuels-story-la-melatonina-nella-terapia-del-terreno-oncologico/">http://www.liquidarea.com/2010/07/manuels-story-la-melatonina-nella-terapia-del-terreno-oncologico/</a></p> <p class="MsoNormal"><span style="" lang="EN-GB">37) Sergio Stagnaro.<span style="color:black;"> </span></span><a href="http://www.mysun.co.uk/stagnaro/blog/2010/05/02/new_way_in_the_war_against_cancer._oncological_terrain-dependent,_inherited_real_risk_based_primary_prevention:_manuel_story."><span style="" lang="EN-GB">New Way in the War against Cancer. Oncological Terrain-Dependent, Inherited Real Risk based Primary Prevention: Manuel' Story.</span></a><span style=""> <span lang="EN-GB">2 May, 2010.<span style=""> </span></span></span><a href="http://www.mysun.com/"><span style="" lang="EN-GB">www.mysun.com</span></a><span style="" lang="EN-GB">. ,<span style=""> </span><a href="http://www.mysun.co.uk/stagnaro/blog/2010/05/02/new_way_in_the_war_against_cancer._oncological_terrain-dependent,_inherited_real_risk_based_primary_prevention:_manuel_story">http://www.mysun.co.uk/stagnaro/blog/2010/05/02/new_way_in_the_war_against_cancer._oncological_terrain-dependent,_inherited_real_risk_based_primary_prevention:_manuel_story</a>, and </span></p> <p class="MsoNormal"><span style="" lang="EN-GB"><a href="http://www.sci-vox.com/stories/story/2010-07-21manuel%27s+story%3A+a+new+way+in+cancer+primary+prevention.html"><span style="">http://www.sci-vox.com/stories/story/2010-07-21manuel%27s+story%3A+a+new+way+in+cancer+primary+prevention.html</span></a></span></p> <p class="MsoNormal">38) Sergio Stagnaro. <span style=""> </span><strong><span style="font-weight: normal;">Lettera Aperta alle Neo-Spose. La Storia di Manuel, che nessuno racconta. <a href="http://www.masterviaggi.it/">http://www.masterviaggi.it</a> </span></strong><span style=""> </span>Giovedì, 15 Luglio 2010<strong><span style="font-weight: normal;">.<span style=""> </span><a href="http://www.masterviaggi.it/news/categoria_news/40260-lettera_aperta_alle_neo-spose_la_storia_di_manuel_che_nessuno_racconta.php">http://www.masterviaggi.it/news/categoria_news/40260-lettera_aperta_alle_neo-spose_la_storia_di_manuel_che_nessuno_racconta.php</a></span></strong></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" >39) <span style="">Stagnaro Sergio.</span> Oncogenesis is possible exclusively in individuals Oncological Terrain-positive. </span><span style="font-family:Verdana;"><a href="http://www.thescientist.com/"><span style="font-size:10pt;">www.thescientist.com</span></a></span><span style=";font-family:Verdana;font-size:10pt;" > 2007. </span><span lang="EN-GB" style="font-family:Verdana;"><a href="http://www.the-scientist.com/blog/print/53498/"><span lang="IT" style="font-size:10pt;">http://www.the-scientist.com/blog/print/53498/</span></a></span><span style="font-family:Verdana;"></span></p> <p class="MsoNormal"><span style="" lang="EN-GB">40) Sergio Stagnaro.<span style=""> </span><strong><span style="font-weight: normal;"><span style=""> </span></span></strong>There are other, clinical ways in preventing disease transmission through mitochondria intervention.<b style=""> </b></span>15 April, 2010. <span style="" lang="EN-GB"><a href="http://www.thescientist.com/"><span style="" lang="IT">www.thescientist.com</span></a></span>, <span style="" lang="EN-GB"><a href="http://www.the-scientist.com/blog/display/57287/"><span style="" lang="IT">http://www.the-scientist.com/blog/display/57287/</span></a></span></p> <p class="MsoNormal">41) Sergio Stagnaro. Il Terreno Oncologico di Di Bella. <a href="http://www.fce.it/">www.fce.it</a>, 11 ottobre 2010,<span class="spnmessagetext"><span style="color:black;"> </span></span><span style="font-size:14pt;"><span style=""> </span></span><a href="http://www.fceonline.it/images/docs/terreno%20oncologico.pdf">http://www.fceonline.it/images/docs/terreno%20oncologico.pdf</a><span style="font-size:14pt;">; </span></p> <p class="MsoNormal"><a href="http://www.luigidibella.it/cms-web/upl/doc/Documenti-inseriti-dal-2-11%202007/Il%20Terreno%20Oncologico%20di%20Di%20Bella.pdf">http://www.luigidibella.it/cms-web/upl/doc/Documenti-inseriti-dal-2-11 2007/Il%20Terreno%20Oncologico%20di%20Di%20Bella.pdf</a>; <a href="http://www.altrogiornale.org/news.php?extend.6420">http://www.altrogiornale.org/news.php?extend.6420</a></p> <p class="MsoNormal">42) <b><span style=";font-family:Verdana;font-size:10pt;" >Stagnaro Sergio.</span></b><span style=";font-family:Verdana;font-size:10pt;" > <span style="color:black;"> La Diagnostica Psicocinetica migliora l’Esame Obiettivo. </span><a href="http://www.fcenews.it/" target="_blank"><span style="">http://www.fcenews.it</span></a><span style="color:black;">, 15, giugno 2009. <a href="http://www.fcenews.it/docs/diagnostica2.pdf" target="_blank"><span style="">http://www.fcenews.it/docs/diagnostica2.pdf</span></a> ; <a href="http://www.altrogiornale.org/" target="_blank"><span style="">www.altrogiornale.org</span></a>, <a href="http://www.altrogiornale.org/news.php?extend.4889" target="_blank"><span style="">http://www.altrogiornale.org/news.php?extend.4889</span></a>; <a href="http://www.nonapritequelportale.com/?q=la-psicocinesi-esiste-funziona" target="_blank"><span style="">http://www.nonapritequelportale.com/?q=la-psicocinesi-esiste-funziona</span></a>; <a href="http://unlocketor.altervista.org/forum/viewtopic.php?t=1192&start=0&postdays=0&postorder=asc&highlight=&sid=af35aa98b69d6f08d116f65d34b55827" target="_blank"><span style="">http://unlocketor.altervista.org/forum/viewtopic.php?t=1192&start=0&postdays=0&postorder=asc&highlight=&sid=af35aa98b69d6f08d116f65d34b55827</span></a>; </span><a href="http://www.spaziomente.com/articoli/La_semeiotica_biofisica_quantistica_corrobora_la_psicocinesi.pdf" target="_blank"><span style="">http://www.spaziomente.com/articoli/La_semeiotica_biofisica_quantistica_corrobora_la_psicocinesi.pdf</span></a></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" >43) </span>Curri S. B., Le microangiopatie, a cura di Inverni della Beffa, Arte Grafica S.p.A. Verona, 1986</p> <p class="MsoNormal">43) <b><span style=";font-family:Verdana;font-size:10pt;" >Stagnaro S.</span></b><span style=";font-family:Verdana;font-size:10pt;" >, Istangiopatia Congenita Acidosica Enzimo-Metabolica condizione necessaria non sufficiente della oncogenesi. XI Congr. Naz. Soc. It. di Microangiologia e Microcircolaz. Abstracts, pg 38, 28 Settembre-1 Ottobre, Bellagio</span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" >44)<b><span style=""> </span>Stagnaro S.</b></span><span style=";font-family:Verdana;font-size:10pt;" >, Istangiopatia Congenita Acidosica Enzimo-Metabolica. X Congr. Naz. Soc. It. di Microangiologia e Microcircolazione. Atti, 61. 6-7 Novembre, Siena</span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10pt;" >45) <b>Stagnaro S.</b></span><span style=";font-family:Verdana;font-size:10pt;" >, Istangiopatia Congenita Acidosica Enzimo-Metabolica. Gazz Med. It. – Asch. </span><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" >Sci, Med. 144, 423</span><span style="" lang="EN-GB"></span></p> <p class="MsoNormal"><span style="" lang="EN-GB">46) JEQUIER E. Leptin Signaling, Adiposity, and Energy Balance. Ann. N. Y. Acad. Sci. 967: 379-388 (2002)</span></p> <span style=";font-family:";font-size:12pt;" lang="EN-GB" ><br /></span>Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-87993437493381520782010-03-13T02:19:00.002-08:002010-03-13T02:27:00.504-08:00PSYCHOKINETIC DIAGNOSTICS, QUANTUM-BIOPHYSICAL SEMEIOTICS EVOLUTION.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbSn1RZztOcaJhJaTA8KA6fYznYUZaTIlIhAgq2M2ZWDiK9xjxiD0IK_Zm-NV0B2vDGcYoGDZzotaADglZeepwTIhL009yawXgK7GvRpofl326NrHtFxGscqt2FpQBJBBrGhwOja_QmCCA/s1600-h/diagramma_tacogramma.jpg"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 200px; height: 133px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgbSn1RZztOcaJhJaTA8KA6fYznYUZaTIlIhAgq2M2ZWDiK9xjxiD0IK_Zm-NV0B2vDGcYoGDZzotaADglZeepwTIhL009yawXgK7GvRpofl326NrHtFxGscqt2FpQBJBBrGhwOja_QmCCA/s200/diagramma_tacogramma.jpg" alt="" id="BLOGGER_PHOTO_ID_5448061309202389314" border="0" /></a><p style="text-align: justify;" class="MsoNormal"><span class="GramE"><b style=""><span style="" lang="EN-GB">Introduction.</span></b></span><b style=""><span style="" lang="EN-GB"><o:p></o:p></span></b></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">Since November 2007, I’ve been illustrating in numerous articles the bases of Quantum Biophysical Semeiotics (1-10). Then some famous websites have been helping me in spreading these developments of such physical semeiotics, representing a new physical tool, which proved to be reliable in bedside diagnosis, therapeutic monitoring and clinical research. For instance, with the aid of quantum-biophysical semeiotics, it’s possible in a few seconds to bedside recognize every constitution, as well as related inherited real risk, that predisposes positive individuals to the relative disorders (11-13). Starting from May 2009, some <i style="">Commentaries</i> have been posted even in the <i style="">International Atherosclerosis Society </i>website <a href="http://www.athero.org/">www.athero.org</a> (14, 15)<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">At this point, I cannot understand the real reason why the numerous Biophysical-Semeiotic Constitutions, as well as relative inherited real risk, <span class="SpellE"><i style="">conditio</i></span><i style=""> sine qua non</i>, e.g., of diabetes and malignancy, both solid and liquid, bedside recognized quickly with a stethoscope since birth, although such knowledge is accepted and spread among physicians by the majority of famous peer-reviews (See Bibliography in my website <a href="http://www.semeioticabiofisica.it/">www.semeioticabiofisica.it</a>), are not illustrated sufficiently and emphasised by National Health Services. In addition, traditional Medicine cannot highlight a lot of biological events, as <span class="SpellE">Lory's</span> experiment (8), because it knows exclusively local realm in biological systems, which brought about the psychokinetic diagnostics, for the first time described in this article. <o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">As a matter of facts, in all tissues - besides local realm exists also NON-LOCAL Realm, as<span style="color: red;"> </span>my friend Paolo <span class="SpellE">Manzelli</span> and I have demonstrated earlier in a lot of articles (1-10). Recognizing also a 4 Dimension Space/Time Matrix, wherein there are 2 SD and 2 TD, which provides a simultaneous information, not ruled by the old, out-<span class="SpellE">moded</span>-view of the world, deterministic, classic physics, but by quantum physics evolution (entanglement and disentanglement) we are able to understand why the first phase of hormone action is simultaneous with very beginning of whatever stimulation (for instance, intense digital pressure upon a bone, e.g., radius, is simultaneous to pancreas size increasing as response to endogenous <span class="SpellE">osteocalcin</span>!) (16) The second phase of hormone action mechanism, different in nature, is brought about by the contact of <span class="SpellE">osteocalcin</span> with relative receptors on beta-cell outer membrane of <span class="SpellE">Langherans's</span> islets (10, 21, <span class="GramE">22</span>).<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">In conclusion, mankind needs urgently open-minded physicians, Editors, and Reviewers, who <span class="GramE">are<span style=""> </span>unavoidable</span> to Medicine Progresses, as I wrote earlier (7, 24-28).<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><b style=""><span style="" lang="EN-GB">No Local Realm beside Local Realm in Biological Systems.<o:p></o:p></span></b></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">On the website of Harvard University Press, at <a href="http://www.hup.harvard.edu/catalog/LIBMIN.html"><span style="font-size: 10pt;">http://www.hup.harvard.edu/catalog/LIBMIN.html</span></a> <a href="http://www.hup.harvard.edu/catalog/LIBMIN.html"><span style="font-size: 10pt;">http://www.hup.harvard.edu/catalog/LIBMIN.html</span></a>, one may read such as statement: <o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">“</span><span style="font-family: 'Courier New';" lang="EN-GB">Most notably, <span class="SpellE">Libet's</span> experiments reveal a substantial delay--the "mind time" of the title--before any awareness affects how we view our mental activities. If all conscious <span class="SpellE">awarenesses</span> are preceded by unconscious processes, as <span class="SpellE">Libet</span> observes, we are forced to conclude that unconscious processes initiate our conscious experiences”.<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">I have sent the following critical comment to <a href="mailto:Contact_HUP@harvard.edu">Contact_HUP@harvard.edu</a>, without receiving answer, neither for courtesy or good manner!<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">Dear Sirs, in your wonderful website at the URL <a href="http://www.hup.harvard.edu/catalog/LIBMIN.html">http://www.hup.harvard.edu/catalog/LIBMIN.html</a>, I've just read "Most notably, <span class="SpellE">Libet's</span> experiments reveal a substantial delay - the "mind time" of the title - before any awareness affects how we view our mental activities. If any conscious awareness is preceded by unconscious processes, as <span class="SpellE">Libet</span> observes, we are forced to conclude that unconscious processes initiate our conscious experiences". Such as sentence is not right, from Quantum Biophysical Semeiotics view-point, <a href="http://www.semeioticabiofisica.it/">www.semeioticabiofisica.it</a><o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">In fact, first of all, with the aid of this clinical tool, since 30 years I've been demonstrating that it's possible, rapid, and easy to bedside assess in reliable way microcirculatory function and structure of every biological system, including brain (14-23).<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">Secondly, Benjamin <span class="SpellE">Libet</span> did not know Quantum Biophysical Semeiotics, I have founded in 2007, November! Energy-Information, according to my friend Paolo <span class="SpellE">Manzelli</span>, an outstanding chemist, is simultaneous and not transmitted spending time and wasting energy, as it happens throughout biological systems, identical from embryogenesis view-point, both in the same individual and from subject to subject (not necessarily twin, as in <span class="SpellE">Lory’s</span> Experiment), regardless the distance between them (1-13)<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">As regards the future of Medicine, I am allowed to state that it’s already begun, as far as Biology and Physical Semeiotics are concerned. In fact, biological events are more complex, i.e., difficult to understand, than generally admitted today. Fortunately, the presence of no local realm, besides local realm, in Biological Systems (1-21), highlights the <span class="SpellE">patho</span>-physiological mechanisms underlying a lot of above-mentioned events, until now unknown, or erroneously explained, like Benjamin <span class="SpellE">Libet's</span> experiments (8). <o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">Interestingly, the fundamental knowledge, Quantum Biophysical Semeiotics is based on, indicates that in all biological systems, both in human and animal, besides local realm, there is no local realm, wherein space/time matrix is jet quadric-dimensional, but showing 2 S/D and 2 T/D (1-11). <o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">As a consequence, this type of information is “simultaneous” in space and “synchronous” in time, as <span class="SpellE">Lory's</span> Experiment demonstrates (8). In a few words, information appears simultaneously in a human body many kilometres far away from information’s origin, starting when the examiner is “thinking” to give somebody the information to do something. <o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">At this point, I cannot understand the real reason why the numerous predispositions to disorders (i.e., Quantum Biophysical-Semeiotic Constitutions) (11-15), like diabetes and malignancy, both solid and liquid, as well as relative inherited real risks, bedside recognized with a stethoscope already at birth in a few seconds’ time due to Quantum Biophysical Semeiotics, already accepted and spread among physicians by the majority of famous peer-reviews will be tomorrow suggested by National Health Services. In addition, traditional Medicine cannot highlight a lot of biological events, e.g. <span class="SpellE">Lory's</span> experiment (8), because it knows exclusively the Local Realm in biological systems. On the contrary, in all tissues - besides that - really exists also NON-LOCAL Realm, as my co-worker friend Paolo <span class="SpellE">Manzelli</span> and I have demonstrated recently in 6 articles (1-16). Recognizing also a 4 <span class="SpellE">Dimemsion</span> Space/Time Matrix, wherein there are 2 SD and 2 TD, which provides a simultaneous Information, not ruled by the old, out-<span class="SpellE">moded</span> deterministic, classic physics, but by quantum physics evolution (entanglement and disentanglement) we are able to understand why the first phase of hormone action is simultaneous with a very beginning of whatever stimulation. For instance, intense digital pressure upon radius or vertebra bone is simultaneous to pancreas size increasing as response to endogenous <span class="SpellE">osteocalcin</span>! The second phase, different in nature, is brought about by the contact of <span class="SpellE">osteocalcin</span> with relate receptors on beta-cell outer membrane in <span class="SpellE">Langherans's</span> islets (1-14).<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">As a consequence, regarding Benjamin <span class="SpellE">Libet’s</span> theory, illustrate especially in Mind Time: "The Temporal Factor in Consciousness", from the above remarks, in the light of Quantum Biophysical Semeiotics, we must conclude that a new interpretation is unavoidably necessary!<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">As a matter of fact, in individual of experiment, in the parietal cerebral cortex, related to foot digital movement, even if the examiner is exclusively “thinking” to give a signal for muscle movement, e.g., of<span style=""> </span>right big toe the circulation at base line, the circulation at base line simultaneously shows microcirculatory activation type I, associated.<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">When examiner says to the subject to be ready moving right big toe contemporaneously to a conventional signal, AL + PL + DL duration increases immediately to 7 sec. (NN = 6 sec.), paralleling “readiness potentials”. Finally, soon thereafter signal begin, Plateau Line <span class="GramE">intensity <span style=""> </span>raises</span> at highest value, i.e., 9 sec. (11-13,17-20) (Fig. 1). <o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p style="text-align: center;" class="MsoNormal" align="center"><span style="" lang="EN-GB">Fig. 1<o:p></o:p></span></p> <p style="text-align: center;" class="MsoNormal" align="center"><i style=""><span style="" lang="EN-GB">In health, mean-intense digital pressure, applied upon parietal cerebral cortex skin projection area, brings about fluctuation of both upper and lowers <span class="SpellE">ureteral</span> reflex: <span class="SpellE">vasomotion</span> and <span class="SpellE">respectivaly</span> <span class="SpellE">vasomotility</span>. Transferred the parameter values <span class="GramE">of <span style=""> </span>these</span> fluctuations , even mentally, on <span class="SpellE">cartesian</span> axes system, doctor obtain diagram and <span class="SpellE">tachygram</span>, very rich of information.<o:p></o:p></span></i></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span class="SpellE"><span class="GramE"><b><span style="" lang="EN-GB">Psychokinesis</span></b></span></span><span class="GramE"><b><span style="" lang="EN-GB"><span style=""> </span>and</span></b></span><b><span style="" lang="EN-GB"> Quantum-Biophysical Semeiotics.<o:p></o:p></span></b></p> <p style="text-align: justify;" class="MsoNormal"><b style=""><span style="" lang="EN-GB"><o:p> </o:p></span></b></p> <p style="text-align: justify; margin: 0cm 0cm 0pt;"><span style="" lang="EN-GB">The term <span class="SpellE"><span style="">psychokinesis</span></span> (from the </span><a title="Greek Language" href="http://en.wikipedia.org/wiki/Greek_Language"><span style="color: windowtext;" lang="EN-GB">Greek</span></a><span style="" lang="EN-GB"> “psyche” and “kinesis”, literally “movement from the mind”), also known as <span style="">telekinesis</span>, is a term referring to the direct influence of mind on a </span><a title="Physical system" href="http://en.wikipedia.org/wiki/Physical_system"><span style="color: windowtext;" lang="EN-GB">physical system</span></a><span style="" lang="EN-GB"> that cannot be entirely accounted for by the mediation of any known </span><a title="Physical energy" href="http://en.wikipedia.org/wiki/Physical_energy"><span style="color: windowtext;" lang="EN-GB">physical energy</span></a><span style="" lang="EN-GB">. Examples of <span class="SpellE">psychokinesis</span> could include distorting or moving an object. <o:p></o:p></span></p> <p style="text-align: justify; margin: 0cm 0cm 0pt;"><span style="" lang="EN-GB">The study of phenomena said to be psychokinetic is notoriously an aspect of </span><a title="Parapsychology" href="http://en.wikipedia.org/wiki/Parapsychology"><span style="color: windowtext;" lang="EN-GB">parapsychology</span></a><span style="" lang="EN-GB">. <o:p></o:p></span></p> <p style="text-align: justify; margin: 0cm 0cm 0pt;"><span style="" lang="EN-GB">Until now, there was no convincing </span><a title="Scientific method" href="http://en.wikipedia.org/wiki/Scientific_method"><span style="color: windowtext;" lang="EN-GB">scientific</span></a><span style="" lang="EN-GB"> evidence that <span class="SpellE">psychokinesis</span> exists. However, in my opinion, based on strict interpretation of clinical experiments, quantum-biophysical in nature, I refer in <span class="GramE">following,</span> the time has come to change our idea on it.<o:p></o:p></span></p> <p style="text-align: justify; margin: 0cm 0cm 0pt;"><span style="" lang="EN-GB">At the beginning of April, 2009, I started a research considering, as hypothesis 0, to falsify, <span class="GramE">the<span style=""> </span>possibility</span> that quantum entanglement could link distant patient to examining physician in a strict manner, so that trigger-points modifications in the first (patient) would bring about identical modification in the trigger points of second (doctor) and vice versa, according to the results of my earlier researches, initiated with<span style=""> </span><span class="SpellE">Lory’s</span> Experiment (1-11).<o:p></o:p></span></p> <p style="text-align: justify; margin: 0cm 0cm 0pt;"><span style="" lang="EN-GB"><span style=""> </span>For instance, “intense” digital pressure upon patient’s <span class="SpellE">precordium</span>, i.e., heart skin projection area, even far away a lot of kilometres from examining physician, brings about “simultaneously” gastric <span class="SpellE">aspecific</span> reflex also in the later, exclusively when the first is involved by every cardiac disorders, e.g., by CAD (4-6, 15). <o:p></o:p></span></p> <p style="text-align: justify; margin: 0cm 0cm 0pt;"><span style="" lang="EN-GB">As a consequence, I felt myself authorized to consider such as fact, psychokinetic in nature, in the sense that doctor’s heart trigger points were “simultaneously” stimulated in the same way as patient’ ones, causing heart-gastric reflex also in doctor, but showing parameter values identical to those of distant subject: latency time, duration, intensity, and so on. <o:p></o:p></span></p> <p style="text-align: justify; margin: 0cm 0cm 0pt;"><span style="" lang="EN-GB">As a matter of facts, what happens under such as experimental condition is really complex, but completely enlightened by Quantum Biophysical Semeiotics (See later on). Starting from these theoretical bases – hypothesis 0, to confute – I have done a large number of experiments, in order to study what happens in “my” body, when I stimulate different trigger points by thinking, i.e., done by the mind, on a well defined subject, both healthy or ill, even a lot of kilometres far away from me, at the condition that I know him/her, at least <i style="">per image</i>, ignoring completely his (her) health condition. Obviously, I carried out such experiments also on known ill patients, but without knowing on the precise diagnosis. <o:p></o:p></span></p> <p style="text-align: justify; margin: 0cm 0cm 0pt;"><span style="" lang="EN-GB">Interestingly, I have subsequently applied the “mental” stimulation also on exact point of inner part of well-defined biological system, and it proved to be more precise, obviously. For instance, I suffer from outcome of lower myocardial infarct; exclusively when I stimulate “by thinking” the precise site of left ventricle involved by infarct scar<span class="GramE">,<span style=""> </span>gastric</span> <span class="SpellE">aspecific</span> reflex shows a pathological <span class="SpellE">lateny</span> time of 3 sec. Otherwise, latency time of heart-<span class="SpellE">aspecific</span> gastric reflex results normal, i.e., 8 sec., when I mentally apply digital pressure upon all diverse part of my heart. In fact, all other coronaries, both macro- and micro-coronary vessels, are normal, according to <span class="SpellE">coronarographic</span> examination, and, more precise, to quantum-biophysical-semeiotic results, which are the only to give information about coronary micro-circulatory bed (1-15).<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">Despite some human errors and late diagnoses, at least in initial stages of disorders, like those of Colleagues working in famous hospital, the interesting diagnoses, subsequently corroborated by means of direct examination, and then laboratory and image diagnostics, were: flu, <span class="SpellE">pleuritis</span>, <span class="SpellE">pneumonitis</span>, <span class="SpellE">Oncological</span> Terrain, breast cancer, <span class="SpellE">arthrosis</span>, <span class="SpellE"><span class="GramE">a.s.o</span></span>. In other words, I've examined at distance, utilising the psychokinetic diagnostics, 120 subjects, and I made their clinical diagnoses, corroborated subsequently by laboratory and image diagnostics, as the same individuals can confirm with pleasure.<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><b style=""><i style=""><span style="" lang="EN-GB"><o:p> </o:p></span></i></b></p> <p style="text-align: justify;" class="MsoNormal"><b style=""><span style="" lang="EN-GB">Clinical Evidences demonstrate <span style="">Psychokinetic Diagnostics Theory.<o:p></o:p></span></span></b></p> <p style="text-align: justify;" class="MsoNormal"><b><span style="" lang="EN-GB"><o:p> </o:p></span></b></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">Firstly, we have to remember all microcirculatory events at the base of quantum-biophysical-semeiotic preconditioning (6<span class="GramE">,11</span>-15,24-28).<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">In health, latency time of a reflex, e.g., heart-gastric <span class="SpellE">aspecific</span> reflex, paralleling tissue oxygenation level, at first evaluation is exact 8 sec., after 5 sec. interruption from the end of the first evaluation, raises to16 sec., doubling its basal value, due to Microcirculatory Functional Reserve <span style=""> </span>physiological activation, Preconditioning is based on. Moreover, “intense” digital pressure, lasting one second, or more, upon hearth skin projection area (= <span class="SpellE">Precordium</span>), even kilometres away from examining doctor, does not bring about “simultaneously” gastric <span class="SpellE">aspecific</span> reflex, which occurs obviously after 8 sec. precisely, and lasts less than 4 sec., according to <span class="SpellE">Lory’s</span> Experiment (1-10).<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">At this point, if doctor apply really, for the first time, directly, “mean-intense”<span style="color: red;"> </span>digital pressure on his (her) own heart skin projection, after precise 5 sec., namely performing heart preconditioning (6,26-28), the second latency time raises physiologically to16 sec., corroborating former heart<span style=""> </span>distant stimulation, due to psychokinetic event: the <span class="SpellE">psychocinetic</span> diagnostic theory is thus corroborated. <span style=""> </span><o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">To summarize in a few words, stimulating patient’s trigger-points only “by thinking”, i.e., “mentally”, despite the real distance between doctor and individual to be examined, brings about<span style=""> </span>the possibility of physician’s preconditioning of every biological system, demonstrating thus the truth as well as the scientific significance of such<span style=""> </span>diagnostics, made for the first time.<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">I term this original diagnosing method as <b style="">Psychokinetic Diagnostics</b>, which represents the paramount advancement of quantum-biophysical semeiotics: when physician is “thinking” about a well-known subject (analogously, to open radio!), i.e., having the subject on own mind, due to quantum <i style="">entanglement</i>, both peoples become part of a cosmic hologram, and can communicate each other, exchanging information (1-10).<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">Importantly, at this point, if Vibratory Energy (= ATP) is lowering in one or both communicating individuals, any exchange of information immediately stops. In addition, if examining doctor “imagines” the other subject as not lovely, even hateful, communication is not possible, in my opinion, <span class="GramE">demonstrating<span style=""> </span>that</span> Information Energy is LOVE!<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">As a consequence, in spite of the distance between them, when doctor is stimulating “by thinking<span class="GramE">” <span style=""> </span>some</span> trigger points of an individual to be examined, the related visceral reaction, e.g., <span class="SpellE">aspecific</span> gastric reflex, appears also in doctor’s stomach, showing identical value parameters. <o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">Interestingly to understand quantum nature of these events, if either doctor or subject to examine does not breath (= Apnoea test), lowering significantly tissue energy level, subsequently worsening mitochondrial respiratory chain activity, above-illustrated events stop quickly, after only one second, indicating the real nature of these events: reducing body Vibratory Energy (= ATP), according to P. <span class="SpellE">Manzelli</span>, also Information Energy lowers rapidly, so that quantum entanglement interrupt suddenly (= disentanglement), after only one second (1-10).<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p style="text-align: center;" class="MsoNormal" align="center"><b style=""><i style=""><span style="" lang="EN-GB"><o:p> </o:p></span></i></b></p> <p class="MsoNormal"><b style=""><i style=""><span style="" lang="EN-GB"><o:p> </o:p></span></i></b></p> <p class="MsoNormal"><span class="SpellE"><b style="">References</b></span><b style="">.<o:p></o:p></b></p> <p class="MsoNormal"><b style=""><o:p> </o:p></b></p> <p class="MsoNormal">1) <span style="font-size: 11pt;">Stagnaro Sergio e<i style=""> </i>Paolo <span class="SpellE">Manzelli</span>. Semeiotica Biofisica: Realtà non-locale in Biologia. Dicembre 2007</span>, <a href="http://www.ilpungolo.com/">www.ilpungolo.com</a>, <span style="font-size: 11pt;"><a href="http://www.ilpungolo.com/leggi-tutto.asp?IDS=13&NWS=NWS5217">http://www.ilpungolo.com/leggi-tutto.asp?IDS=13&NWS=NWS5217</a><o:p></o:p></span></p> <p class="MsoNormal"><span style="font-size: 11pt;">2) Stagnaro Sergio e<i style=""> </i>Paolo <span class="SpellE">Manzelli</span>. Semeiotica Biofisica Quantistica.</span><span style="color: red;"><span style=""> </span></span><span style="color: red; font-size: 11pt;"><a href="http://www.ilpungolo.com/leggi-tutto.asp?IDS=13&NWS=NWS5243">http://www.ilpungolo.com/leggi-tutto.asp?IDS=13&NWS=NWS5243</a><o:p></o:p></span></p> <p class="MsoNormal"><span style="font-size: 11pt;">3) </span><span style="font-family: Verdana; font-size: 10pt;">Stagnaro Sergio e<i> </i>Paolo <span class="SpellE">Manzelli</span></span><span style="font-family: Verdana; font-size: 10pt;">,<b><span style="color: red;"> </span></b>09-1-2008, Semeiotica Biofisica Quantistica: la manovra di attivazione <span class="SpellE">surrenalica</span> <span class="SpellE">jatrogenetica</span><b> </b><a href="http://www.fcenews.it/index.php?option=com_content&task=view&id=161&Itemid=63">http://www.fcenews.it/index.php?option=com_content&task=view&id=161&Itemid=63</a></span><span style="color: red; font-size: 11pt;"><o:p></o:p></span></p> <p class="MsoNormal"><span style="font-size: 11pt;" lang="EN-GB">4) </span><span class="SpellE"><span style="" lang="EN-GB">Stagnaro</span></span><span style="" lang="EN-GB"> Sergio.<span style=""> </span></span><a href="http://sciphu.com/2009/03/pollios-sign-in-bedside-recognizing.html"><span style="" lang="EN-GB">Pollio’s Sign in bedside Recognizing renal Cancer, since its initial Stage of Inherited, Oncological Real Risk.</span></a><span style=""> </span><span class="SpellE">Sunday</span>, March 22, 2009.<span style=""> </span><span style="" lang="EN-GB"><a href="http://sciphu.com/"><span style="" lang="IT">http://sciphu.com/</span></a></span></p> <p style="text-align: justify;" class="MsoNormal">5) <span style="font-family: Verdana; font-size: 10pt;">Stagnaro Sergio.<b> </b></span><st1:personname st="on" productid="La Diagnosi Clinica"><span class="GramE"><strong><span style="font-family: Verdana; font-size: 10pt; font-weight: normal;">La Diagnosi Clinica</span></strong></span></st1:personname><span class="GramE"><strong><span style="font-family: Verdana; font-size: 10pt; font-weight: normal;"> nella Semeiotica Biofisica Quantistica</span></strong></span><strong><span style="font-family: Verdana; font-size: 10pt; font-weight: normal;">.</span></strong><b><span style="font-family: Verdana; font-size: 10pt;"> <a href="http://www.fce.it/" target="_blank">www.fce.it</a> </span></b><span style="font-family: Verdana; font-size: 10pt;">02-05, 2008<b style="">, <o:p></o:p></b></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="font-family: Verdana; font-size: 10pt;"><a href="http://www.fcenews.it/index.php?option=com_content&task=view&id=1285&Itemid=47" target="_blank">http://www.fcenews.it/index.php?option=com_content&task=view&id=1285&Itemid=47</a><o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="font-family: Verdana; font-size: 10pt;">6) Stagnaro Sergio<b>. </b></span><span style="font-family: Verdana; font-size: 10pt;">Semiotica Biofisica Quantistica: Diagnosi di Cuore sano in un Secondo in paziente distante <st1:metricconverter st="on" productid="200 KM">200 KM</st1:metricconverter>! <b><a href="http://www.fce.it/" target="_blank">www.fce.it</a>, </b>07-05-2008<span class="GramE"> </span><o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="font-family: Verdana; font-size: 10pt;"><a href="http://www.fcenews.it/index.php?option=com_content&task=view&id=1316&Itemid=47" target="_blank">http://www.fcenews.it/index.php?option=com_content&task=view&id=1316&Itemid=47</a><o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="font-family: Verdana; font-size: 10pt;" lang="EN-GB">7) <span class="SpellE"><span style="">Stagnaro</span></span><span style=""> Sergio.<b> </b></span>Role of<span class="GramE"> NON</span>-LOCAL Realm in Primary Prevention with Quantum Biophysical Semeiotics. <a href="http://www.nature.com/" target="_blank">www.nature.com</a>, <st1:date st="on" year="2008" day="1" month="2">01 Feb, 2008-05-17</st1:date><a href="http://www.nature.com/news/2008/080130/full/451511a.html" target="_blank"> http://www.nature.com/news/2008/080130/full/451511a.html</a><o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="font-family: Verdana; font-size: 10pt;">8) <span style="">Stagnaro Sergio e<i> </i>Paolo <span class="SpellE">Manzelli</span>.</span> L’Esperimento di <span class="SpellE">Lory</span>. Scienza e Conoscenza, <span class="SpellE">N°</span> 23, 13 <span class="GramE">Marzo</span> 2008. <a href="http://www.scienzaeconoscenza.it/articolo.php?id=17775" target="_blank">http://www.scienzaeconoscenza.it//articolo.php?id=17775</a></span></p> <p style="text-align: justify;" class="MsoNormal">9)<b><span style="font-family: Verdana; font-size: 10pt;"> </span></b><span style="font-family: Verdana; font-size: 10pt;">Stagnaro Sergio e <span class="SpellE">Manzelli</span> Paolo.<b> </b></span><span class="GramE"><span style="font-family: Verdana; font-size: 10pt;"> </span></span><span style="font-family: Verdana; font-size: 10pt;">Semeiotica Biofisica Quantistica: Livello di Energia libera tessutale e Realtà non locale nei Sistemi biologici. <span style="color: red;"><a href="http://www.fce.it/" target="_blank">www.fce.it</a><span class="GramE"> <span style="color: windowtext;">,</span></span></span> 29 maggio 2008, <a href="http://www.fcenews.it/index.php?option=com_content&task=view&id=1421&Itemid=47" target="_blank">http://www.fcenews.it/index.php?option=com_content&task=view&id=1421&Itemid=47</a><o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="font-family: Verdana; font-size: 10pt;">10) <span style="">Stagnaro Sergio e<i> </i>Paolo <span class="SpellE">Manzelli</span>.</span> <span class="GramE">Semeiotica Biofisica Endocrinologica: Meccanica Quantistica e Meccanismi d’Azione Ormonali</span>. Dicembre 2007, <a href="http://www.fce.it/">www.fce.it</a>,<span class="GramE"> </span></span><span style="font-family: Verdana;"><a href="http://www.fcenews.it/index.php?option=com_content&task=view&id=816&Itemid=45"><span style="font-size: 10pt;">http://www.fcenews.it/index.php?option=com_content&task=view&id=816&Itemid=45</span></a><o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal">11) <span style="font-family: Verdana; color: rgb(51, 51, 51); font-size: 10pt;">Stagnaro-Neri M., Stagnaro S.</span><span style="font-family: Verdana; color: rgb(51, 51, 51); font-size: 10pt;"> Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. <span class="SpellE">Travel</span> <span class="SpellE">Factory</span>, Roma, 2004.</span><span class="GramE"><span style="font-family: Verdana; color: red; font-size: 10pt;"> </span></span><span style="font-family: Verdana; font-size: 10pt;"><a href="http://www.travelfactory.it/">http://www.travelfactory.it/</a><o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="font-family: Verdana; font-size: 10pt;">12) <span style="">Stagnaro S., Stagnaro-Neri M.</span>, Le Costituzioni <span class="SpellE">Semeiotico-Biofisiche</span>.<span class="GramE">Strumento</span> clinico fondamentale per la prevenzione primaria e la definizione della Single <span class="SpellE">Patient</span> <span class="SpellE">Based</span> Medicine. <span class="SpellE">Travel</span> <span class="SpellE">Factory</span>, Roma, 2004. </span><span style="font-family: Verdana; font-size: 10pt;" lang="EN-GB"><a href="http://www.travelfactory.it/libro_costituzionisemeiotiche.htm"><span style="" lang="IT">http://www.travelfactory.it/</span></a></span><span style="font-family: Verdana; font-size: 10pt;"><o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="font-family: Verdana; font-size: 10pt;">13) <span style="">Stagnaro S., Stagnaro-Neri M</span>., Single <span class="SpellE">Patient</span> <span class="SpellE">Based</span> <span class="SpellE">Medicine.<span class="GramE">La</span></span> Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. <span class="SpellE">Travel</span> <span class="SpellE">Factory</span>, Roma, 2005. </span><span style="font-family: Verdana; font-size: 10pt;" lang="EN-GB"><a href="http://www.travelfactory.it/libro_singlepatientbased.htm"><span style="" lang="IT">http://www.travelfactory.it/</span></a></span></p> <p style="text-align: justify;" class="MsoNormal">14) Stagnaro Sergio.<b style=""><span style=""> </span></b>Stagnaro Sergio.<span style=""> </span><span style="" lang="EN-GB">Pre-Metabolic Syndrome and Metabolic Syndrome: Biophysical-Semeiotic Viewpoint. <a href="http://www.athero.org/">www.athero.org</a>, 29 April, 2009. </span><a href="http://www.athero.org/commentaries/comm904.asp" target="_blank"><span style="" lang="EN-GB">http://www.athero.org/commentaries/comm904.asp</span></a><span style="" lang="EN-GB"><o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">15) <span class="SpellE">Stagnaro</span> Sergio.<b style=""><span style=""> </span></b><span class="SpellE">Stagnaro</span> Sergio. CAD Inherited Real Risk, Based on Newborn-Pathological, Type I, Subtype B, <span class="SpellE">Aspecific</span>, Coronary <span class="SpellE">Endoarteriolar</span> Blocking Devices. <span class="GramE">Diagnostic Role of Myocardial <span class="SpellE">Oxigenation</span> and Biophysical-Semeiotic Preconditioning.</span> <a href="http://www.athero.org/">www.athero.org</a>, <st1:date st="on" year="2009" day="29" month="4">29 April, <span class="GramE">2009</span></st1:date><span class="GramE"><span style=""> </span></span></span><a href="http://www.athero.org/commentaries/comm907.asp" target="_blank"><span style="" lang="EN-GB">http://www.athero.org/commentaries/comm907.asp</span></a><span style="" lang="EN-GB"><o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal">16) Stagnaro Sergio. Il test <span class="SpellE">Semeiotico-Biofisico</span> <span class="GramE">della </span><span class="SpellE">Osteocalcina</span> nella prevenzione primaria del diabete mellito. <span class="GramE">www.fce.it</span> Febbraio 2008. </p> <p style="text-align: justify;" class="MsoNormal"><a href="http://www.fcenews.it/index.php?option=com_content&task=view&id=909&Itemid=47">http://www.fcenews.it/index.php?option=com_content&task=view&id=909&Itemid=47</a><b style=""><i style=""> </i></b>e <span class="GramE">alla </span>URL <b style=""><span style=""> </span></b><a href="http://www.clicmedicina.it/pagine-n-32/diabete-semeiotica.htm">http://www.clicmedicina.it/pagine-n-32/diabete-semeiotica.htm <o:p></o:p></a></p> <p style="text-align: justify;" class="MsoNormal">17)Stagnaro S., Valutazione <span class="SpellE">percusso-ascoltatoria</span> della microcircolazione cerebrale globale e regionale. Atti, XII <span class="SpellE">Congr</span>. Naz. Soc. <span class="GramE">It.</span> di Microangiologia e Microcircolazione. <span style="" lang="EN-GB">13-15 <span class="SpellE">Ottobre</span>, <st1:place st="on"><st1:city st="on"><span class="GramE">Salerno</span></st1:city></st1:place><span class="GramE"> ,</span> e <span class="SpellE">Acta</span> Medit. 145, 163, 1986<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">18<span class="GramE">)<span class="SpellE">Stagnaro</span></span><span class="SpellE">-Neri</span> M., <span class="SpellE">Stagnaro</span> S., Deterministic chaotic biological system: the <span class="SpellE">microcirculatoory</span> bed. <span class="GramE">Theoretical and practical aspects.</span> <span class="SpellE"><span class="GramE">Gazz</span></span><span class="GramE">.</span> Med. It. – Arch. Sc. Med. 153, 99, 1994<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">19) <span class="SpellE">Stagnaro-Neri</span> M., <span class="SpellE">Stagnaro</span> S., <span class="SpellE">Auscultatory</span> Percussion Evaluation of <span class="SpellE">Arterio</span>-venous <span class="SpellE">Anastomoses</span> Dysfunction in early Arteriosclerosis. </span><span class="SpellE">Acta</span> <span class="SpellE"><span class="GramE">Med</span></span><span class="GramE">.</span> <span class="SpellE">Medit</span>. 5, 141, 1989.</p> <p style="text-align: justify;" class="MsoNormal">20) Stagnaro-Neri M., Stagnaro S. Indagine clinica <span class="SpellE">percusso-ascoltatoria</span> delle unità <span class="SpellE">microvascolotessutali</span> della <span class="SpellE">plica</span> ungueale. <span class="SpellE">Acta</span> <span class="SpellE"><span class="GramE">Med</span></span><span class="GramE">.</span> <span class="SpellE">Medit</span>. 4, <span class="GramE">91</span>, 1988.</p> <p style="text-align: justify;" class="MsoNormal">21) Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. <span class="SpellE">Travel</span> <span class="SpellE">Factory</span>, Roma, 2004. <a href="http://www.travelfactory.it/semeiotica_biofisica.htm">http://www.travelfactory.it/semeiotica_biofisica.htm</a></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">22) </span><span class="SpellE"><span style="font-family: Verdana; font-size: 10pt;" lang="EN-GB">Stagnaro</span></span><span style="font-family: Verdana; font-size: 10pt;" lang="EN-GB"> Sergio.</span><span style="font-family: Verdana; font-size: 10pt;" lang="EN-GB"> <a name="911"><span class="maintextmodulestrong">Newborn-pathological </span></a><span class="SpellE"><span style=""><span class="maintextmodulestrong">Endoarteriolar</span></span></span><span style=""><span class="maintextmodulestrong"> Blocking Devices in Diabetic and <span class="SpellE">Dislipidaemic</span> Constitution and Diabetes Primary Prevention.</span></span><span class="maintextmodulestrong"> </span><span class="GramE"><span class="maintextmoduleitalic"><i>The Lancet</i>.</span></span><span class="maintextmoduleitalic"> </span><st1:date st="on" year="2007" day="6" month="3"><span class="maintextmodule1">March 06 2007</span></st1:date><span class="maintextmodule1">. </span></span><span style="font-family: Verdana;" lang="EN-GB"><a href="http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?totalcomments=1"><span style="font-size: 10pt;">http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?totalcomments=1</span></a>, </span><span style="" lang="EN-GB">and especially <a href="http://www.fce.it/">www.fce.it</a>, <a href="http://www.fceonline.it/docs/stagnaro.pdf">http://www.fceonline.it/docs/stagnaro.pdf</a><o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">24) </span><span class="SpellE"><span style="font-family: Verdana; font-size: 10pt;" lang="EN-GB">Stagnaro</span></span><span style="font-family: Verdana; font-size: 10pt;" lang="EN-GB"> Sergio.</span><span style="font-family: Verdana; font-size: 10pt;" lang="EN-GB"> <a name="1433"></a><span class="GramE"><span style="">Bedside Biophysical-Semeiotic <span class="SpellE">Osteocalcin</span> Test in Diagnosing and Monitoring Diabetes.</span></span><span style=""></span><span style=""> </span>The Lancet, <st1:date st="on" year="2008" day="28" month="1"><span class="maintextmodule">January 28, 2008</span></st1:date><span class="maintextmodule">.<o:p></o:p></span></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="font-family: Verdana; font-size: 10pt;"><a href="http://www.thelancet.com/journals/lancet/article/PIIS0140673608601014/comments?action=view&totalComments=2" target="_blank"><span style="" lang="EN-GB">http://www.thelancet.com/journals/lancet/article/PIIS0140673608601014/comments?action=view&totalComments=2</span></a></span><span style="font-family: Verdana; font-size: 10pt;" lang="EN-GB">; See <a href="http://www.fceonline.it/docs/stagnaro.pdf">http://www.fceonline.it/docs/stagnaro.pdf</a></span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span style="" lang="EN-GB">25) </span><span class="SpellE"><span style="font-family: Verdana; font-size: 10pt;" lang="EN-GB">Stagnaro</span></span><span style="font-family: Verdana; font-size: 10pt;" lang="EN-GB"> Sergio. Comment to </span><span style="" lang="EN-GB">“Liz Wager: If comment is cheap why is peer review so expensive?<span class="GramE">”.</span> <a href="http://www.bmj.com/"><span style="">www.BMJ.com</span></a>, <st1:date st="on" year="2009" day="17" month="4">April 17th, 2009</st1:date>, </span><span style="font-size: 11pt;" lang="EN-GB"><a href="http://blogs.bmj.com/bmj/2009/04/16/liz-wager-if-comment-is-cheap-why-is-peer-review-so-expensive/#comments"><span style="">http://blogs.bmj.com/bmj/2009/04/16/liz-wager-if-comment-is-cheap-why-is-peer-review-so-expensive/#comments</span></a> <o:p></o:p></span></p> <h4 style="text-align: justify; margin: 0cm 0cm 0pt;"><span style="font-weight: normal;" lang="EN-GB">26) </span><span class="SpellE"><span style="font-family: Verdana; font-size: 10pt; font-weight: normal;" lang="EN-GB">Stagnaro-Neri</span></span><span style="font-family: Verdana; font-size: 10pt; font-weight: normal;" lang="EN-GB"> M., <span class="SpellE">Stagnaro</span> S.</span><span style="font-family: Verdana; font-size: 10pt; font-weight: normal;" lang="EN-GB">, Deterministic Chaos, Preconditioning and Myocardial Oxygenation evaluated clinically with the aid of Biophysical Semeiotics in the Diagnosis of <span class="SpellE">ischaemic</span> Heart Disease even silent. <span class="SpellE"><span class="GramE">Acta</span></span><span class="GramE"> Med. Medit. 13, 109, 1997.</span><o:p></o:p></span></h4> <h4 style="text-align: justify; margin: 0cm 0cm 0pt;"><span style="font-family: Verdana; font-size: 10pt; font-weight: normal;" lang="EN-GB">27) </span><span class="SpellE"><span style="font-family: Verdana; font-size: 10pt; font-weight: normal;" lang="EN-GB">Stagnaro</span></span><span style="font-family: Verdana; font-size: 10pt; font-weight: normal;" lang="EN-GB"> Sergio.</span><span style="font-family: Verdana; font-size: 10pt;" lang="EN-GB"> </span><span class="GramE"><span style="font-family: Verdana; font-size: 10pt; font-weight: normal;" lang="EN-GB">Middle Ages of today’s Medicine, Overlooking Quantum-Biophysical-Semeiotic Constitutions and Related Inherited Real Risk.</span></span><span style="font-family: Verdana; font-size: 10pt; font-weight: normal;" lang="EN-GB"> <a href="http://sciphu.com/" target="_blank"><span style="">http://sciphu.com</span></a> November 4, 2008. </span><span style="font-family: Verdana; font-size: 10pt; font-weight: normal;"><a href="http://sciphu.com/2008/11/meadle-ages-of-todays-medicine.html" target="_blank"><span style="" lang="EN-GB">http://sciphu.com/2008/11/meadle-ages-of-todays-medicine.html</span></a></span><span style="font-family: Verdana; font-size: 10pt; font-weight: normal;" lang="EN-GB"><o:p></o:p></span></h4> <h4 style="text-align: justify; margin: 0cm 0cm 0pt;"><span style="font-family: Verdana; font-size: 10pt; font-weight: normal;" lang="EN-GB">28) </span><span class="SpellE"><span style="font-family: Verdana; font-size: 10pt; font-weight: normal;" lang="EN-GB">Stagnaro</span></span><span style="font-family: Verdana; font-size: 10pt; font-weight: normal;" lang="EN-GB"> Sergio.</span><span style="font-family: Verdana; font-size: 10pt;" lang="EN-GB"> </span><span class="GramE"><span style="font-family: Verdana; font-size: 10pt; font-weight: normal;" lang="EN-GB">Role of Coronary <span class="SpellE">Endoarterial</span> Blocking Devices in Myocardial Preconditioning - c007i.</span></span><span style="font-family: Verdana; font-size: 10pt; font-weight: normal;" lang="EN-GB"> <span class="GramE"><i>Lecture</i>, V Virtual International Congress of Cardiology, 2007.</span> </span><span style="font-family: Verdana; font-weight: normal;" lang="EN-GB"><a href="http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php"><span style="font-size: 10pt;">http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php</span></a></span><span style="font-weight: normal;" lang="EN-GB"><o:p></o:p></span></h4> <p class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal">*<b style=""><span style="font-family: Arial; font-size: 10pt;"> Sergio Stagnaro MD<o:p></o:p></span></b></p> <p class="MsoNormal"><span style="font-family: Arial; font-size: 10pt;">Via Erasmo Piaggio 23/8</span></p> <p class="MsoNormal"><span style="font-family: Arial; font-size: 10pt;" lang="EN-GB">16039 Riva <span class="SpellE">Trigoso</span> (<st1:city st="on">Genoa</st1:city>) <st1:place st="on"><b style="">Europe</b></st1:place></span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span style="font-family: Arial; font-size: 10pt;" lang="EN-GB">Founder of Quantum Biophysical Semeiotics</span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span style="font-family: Arial; font-size: 10pt;" lang="EN-GB">Who's Who in the World (and <st1:place st="on"><st1:country-region st="on"><span class="GramE">America</span></st1:country-region></st1:place>)</span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span class="GramE"><span style="font-family: Arial; font-size: 10pt;" lang="EN-GB">since</span></span><span style="font-family: Arial; font-size: 10pt;" lang="EN-GB"> 1996 to 2009<o:p></o:p></span></p> <p class="MsoNormal"><span style="font-family: Arial; font-size: 10pt;" lang="EN-GB">Ph 0039-0185-42315<o:p></o:p></span></p> <p class="MsoNormal"><span class="GramE"><span style="font-family: Arial; font-size: 10pt;" lang="EN-GB">Cell.</span></span><span style="font-family: Arial; font-size: 10pt;" lang="EN-GB"> 3338631439</span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span style="font-family: Arial; font-size: 10pt;"><a href="http://www.semeioticabiofisica.it/"><span style="" lang="EN-GB">www.semeioticabiofisica.it</span></a></span><span style="font-family: Arial; font-size: 10pt;"> </span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="font-family: Arial; font-size: 10pt;"><a href="mailto:dottsergio@semeioticabiofisica.it"><span style="" lang="EN-GB">dottsergio@semeioticabiofisica.it</span></a></span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><o:p> </o:p></p> <p class="MsoNormal"><o:p> </o:p></p> <p class="MsoNormal"><o:p> </o:p></p><span style="" lang="EN-GB"><o:p></o:p></span> <p class="MsoNormal"><o:p> </o:p></p> <p class="MsoNormal"><o:p> </o:p></p> <p class="MsoNormal"><o:p> </o:p></p>Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-1096627967486032792010-03-11T04:44:00.000-08:002010-03-11T04:50:24.816-08:00CAD Inherited Real Risk: Nosography and Therapy. The Concept of Angiobiopathy<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhC3sLIZovdlsm92lHQQPXVmTsU-6bT_8ZKU9FoNaItjKf3PglOr9RZuT-Y8EiKoJHoMq99_Z77y_FriC88TRSss4CAluBnGYYd341ARZZR0MC-_gq9v80PFCRrq5ZBEHxQarYlMtg8wiRN/s1600-h/sergio18.jpg"><img style="display: block; margin: 0px auto 10px; text-align: center; cursor: pointer; width: 155px; height: 200px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhC3sLIZovdlsm92lHQQPXVmTsU-6bT_8ZKU9FoNaItjKf3PglOr9RZuT-Y8EiKoJHoMq99_Z77y_FriC88TRSss4CAluBnGYYd341ARZZR0MC-_gq9v80PFCRrq5ZBEHxQarYlMtg8wiRN/s200/sergio18.jpg" alt="" id="BLOGGER_PHOTO_ID_5447357682050297426" border="0" /></a><br /><br /><p style="text-align: justify;" class="MsoNormal"><span class="GramE"><b style=""><span style="" lang="EN-GB">Introduction.</span></b></span><b style=""><span style="" lang="EN-GB"><o:p></o:p></span></b></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">Mutations in <span class="SpellE">parenchimal</span> cell n-DNA and <span class="SpellE">mit</span>-DNA are the <span class="SpellE"><i style="">the</i></span><i style=""> <span class="SpellE">conditio</span> sine qua non </i>of the most common human disorders, like diabetes and cancer, today’s <span class="SpellE">epidaemics</span> (1-17). In fact, all these diseases are based on a particular congenital, functional, <span class="SpellE">mithocondrial</span> <span class="SpellE">cytopathy</span>, transmitted through <span class="GramE">mother,</span> I termed Congenital <span class="SpellE">Acidosic</span> Enzyme-Metabolic <span class="SpellE">Histangiopathy</span>, CAEMH (1, 13, 14). In addition, <span class="SpellE">parenchymal</span> gene mutations cause local microcirculatory remodelling, doctor can evaluate at the bedside in a reliable manner, gathering indirect information on relative <span class="SpellE">parenchymal</span> cell inherited modifications, since biological system functional modifications parallel gene mutation , according to <span class="SpellE">Angiobiopathy</span> theory (1,18, 19).<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span class="SpellE"><span class="GramE"><b style=""><span style="" lang="EN-GB">Nosography</span></b></span></span><span class="GramE"><b style=""><span style="" lang="EN-GB"> of CAD Inherited Real Risk.</span></b></span><b style=""><span style="" lang="EN-GB"><o:p></o:p></span></b></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">In presence of intense CAEMH in a well-defined <span class="SpellE">myokardial</span> area, involved by gene mutations in both n-DNA and <span class="SpellE">mit</span>-DNA, can brings about CAD Real Risk, <span class="SpellE">charcaterized</span> by<span style=""> </span>microcirculatory remodelling from biophysical-semeiotic viewpoint, especially intense under environmental risk factors (1, 6, 7, 16). Such as congenital <span class="SpellE">microvascular</span> remodelling, including also <span class="SpellE">vasa</span> <span class="SpellE">vasorum</span> of large coronary arteries, show since birth interesting structures, i.e., newborn-pathological, type I, subtype b), <span class="SpellE">Endoarteriolar</span> Blocking Devices, EBD, localized in <span class="GramE">small<span style=""> </span>arteries</span>, according to <span class="SpellE">Hammersen</span>, I discovered (See also <a href="http://www.semeioticabiofisica.it/microangiologia">www.semeioticabiofisica.it/microangiologia</a>). <o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">Interestingly, CAD Inherited Real Risk is associated to endothelial dysfunction (there are mitochondria also in <span class="SpellE">endothels</span>, although in small amount), doctor can bedside assess in easy and reliable way, at rest as well as under stress tests (1-10, 18, 19).<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">As a consequence of above, briefly referred <span class="SpellE">remaks</span>, physicians are able nowadays to demonstrate the presence of <span class="GramE">typical<span style=""> </span>pathological</span> <span class="SpellE">EBDs</span> in coronary <span class="SpellE">microvessel</span>, which play a central role in CAD Inherited Real Risk.<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB"><span style=""> </span>First of all, in health, due to the non local realm, present in all biological systems beside the local realm<span style=""> </span>(20, 21),<span style=""> </span>as I demonstrated earlier (2-25), “intense” digital pressure on <span class="SpellE">cutaneous</span> projection area of the hearth (<span class="SpellE">precordium</span>) (= activation of the local microcirculatory blood-flow, according to type I) do not provoke “simultaneously” <span class="SpellE">aspecific</span> gastric reflex, which occurs exactly after 16 sec. of latency time (1-5, 20, 21).<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">On the contrary, in case of CAD Real Risk, under the <span class="SpellE">indentical</span> experimental condition, referred above, doctor observes a gastric <span class="SpellE">aspecific</span> reflex “<span class="SpellE">simoultaneous</span> to intense digital pressure”, whose intensity parallels the seriousness of underlying disorder.<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p style="text-align: center;" class="MsoNormal" align="center"><span style="" lang="EN-GB">Fig. 1<o:p></o:p></span></p> <p style="text-align: center;" class="MsoNormal" align="center"><span class="SpellE"><i style=""><span style="" lang="EN-GB">Aspecific</span></i></span><i style=""><span style="" lang="EN-GB"> Gastric <span class="SpellE">Reflex<span class="GramE">:in</span></span> the stomach, both body and <span class="SpellE">fundus</span> are <span class="SpellE">dileted</span>, <o:p></o:p></span></i></p> <p style="text-align: center;" class="MsoNormal" align="center"><span class="GramE"><i style=""><span style="" lang="EN-GB">whereas</span></i></span><i style=""><span style="" lang="EN-GB"> <span class="SpellE">antel</span>-pyloric regions contracts.<o:p></o:p></span></i></p> <p style="text-align: justify;" class="MsoNormal"><i style=""><span style="" lang="EN-GB"><o:p> </o:p></span></i></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">As a matter of facts, the hearth-<span class="SpellE">aspecific</span> reflex, reliable and easy to apply, brought about by “mean-intense” digital stimulation of cardiac trigger-points (<span class="SpellE">precordium</span>), appears after 8 sec. physiological latency time, but lasting 4 sec. (NN = less <span class="SpellE">tha</span> 4 sec.): this is an important parameter value, corresponding to Microcirculatory Functional Reserve (MFR) activity of related coronary <span class="SpellE">microvessel</span>, thus correlated with the function and <span class="SpellE">anathomy</span> of the microcirculatory bed, or more precisely speaking, <span class="SpellE">microvascular</span> <span class="SpellE">tissular</span>-unit.<span style=""> </span><o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">In fact, hearth-<span class="SpellE">aspecific</span> gastric reflex, when pathologically lasting 4 sec. or more (NN less than 4 sec.), indicates local microcirculatory remodelling, and thus MFR impairment due to newborn-pathological, type I, subtype b), <span class="SpellE">aspecific</span>, EBD, which reduce tissue oxygenation, through lowering microcirculatory blood-flow.<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">Reliable and precise information<span style=""> </span>is provided by hearth preconditioning in both its Inherited Real Risk and in<span style=""> </span>very initial stage of CAD (6, 11), not to speak of clinical microcirculatory analysis, which needs a<span style=""> </span>thorough knowledge of the original methods (</span><a href="http://www.semeioticabiofisica.it/microangiologia"><span style="" lang="EN-GB">www.semeioticabiofisica.it/microangiologia</span></a><span style="" lang="EN-GB">).<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span class="GramE"><b style=""><span style="" lang="EN-GB">Discussion.</span></b></span><b style=""><span style="" lang="EN-GB"><o:p></o:p></span></b></p> <p style="text-align: justify;" class="MsoNormal"><b style=""><span style="" lang="EN-GB"><o:p> </o:p></span></b></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">From the above remarks, <span class="SpellE">Angiobiopathy</span> theory results once again corroborated. As a matter of fact, according to this theory, which carries out <span class="SpellE">Tischendorf’s</span> <span class="SpellE">Angiobiotopy</span>, every inherited pathological condition of every parenchyma associates since birth with a subsequent modification of related microcirculatory bed, so that microcirculatory remodelling give reliable information on related <span class="SpellE">parenchymal</span> cells.<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB"><span style=""> </span>First of all, analogously to all other biological systems, appears the <span class="SpellE">finctional</span> alteration of the mitochondrial respiratory chain, i.e., CAEMH), after that, come congenital gene mutations (n-DNA and <span class="SpellE">mit</span>-DNA) in myocardial cells, which cause biological alterations, and thus local microcirculatory remodelling, associated with endothelial dysfunction.<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB"><span style=""> </span>Notoriously, negative environmental risk factors can worsen already present dangerous effects of such as gene inherited modifications (inherited real risk), but cannot independently bring about them directly. <o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span class="SpellE"><span style="" lang="EN-GB">Undoubtadly</span></span><span style="" lang="EN-GB">, metabolic syndrome (MS) is major target in Primary Prevention of today’s <span class="SpellE">epidaemias</span>: diabetes, <span class="SpellE">dyslipidaemias</span>, hypertension, <span class="SpellE">a.s.o</span>. However, we have firstly to remember beside "classic" form of MS also the "variant" one, I described earlier with a clinical method, <span class="SpellE"><i>conditio</i></span><i> sine qua non</i> of <span class="SpellE">lithyasis</span> (1-8) (See </span><span style=""><a href="http://www.semeioticabiofisica.it/"><span style="" lang="EN-GB">http://www.semeioticabiofisica.it</span></a></span><span style="" lang="EN-GB"> and </span><span style=""><a href="http://www.semeioticabiofisica.it/microangiologia.it"><span style="" lang="EN-GB">http://www.semeioticabiofisica.it/microangiologia.it</span></a></span><span style="" lang="EN-GB">). In addition, I described the Pre-Metabolic Syndrome (classic and "variant", of course) that follows biophysical-semeiotic constitutions, and comes for the MS, years or decades long: "Pre-Metabolic Stage" represents the LOCUS of primary prevention (1-6).</span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">Finally, the above remarks account for the reason that only in some cases of MS, but not in ALL, there is diabetes, which is absent in a second subgroup of individuals with MS. Notoriously, patients with MS can be subdivided in two subgroups, as regards glucose metabolism impairment (25).<o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">In fact, besides individuals showing IIR and/or high FPG and/or PPG levels, IGT, and finally diabetes, we observe patients with IIR, who will never suffer from diabetes. My 52 year-long clinical experience allows me to state that “biophysical-semeiotic <span class="SpellE">dyslipidaemic</span> AND diabetic” constitutions account for the reason of such as different outcome. Really, only patients with <span class="GramE">inherited<span style=""> </span>pancreatic</span> islet </span><span lang="EN-GB" style="font-family:Symbol;"><span style="">b</span></span><span style="" lang="EN-GB">-cell insufficiency, can be involved – in life-span – by insulin secretion failure, due to the exhaustion of hormone production (25). </span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB">As a consequence, cigarette smoking, diabetes, <span class="SpellE">dyslipidaemias</span>, hypertension, <span class="SpellE">a.s.o</span>., do not contribute to provoke CAD in ALL individuals, but exclusively in individuals among those involved by inherited CAD real risk (1, 11-13). Therefore, in all researches, aiming to recognize risk factors of human diseases, like cigarette smoking, inappropriate diet, hypertension, diabetes, <span class="SpellE">a.s.o</span>., especially individuals with the congenital real risk have to be enrolled. From the therapeutic viewpoint, in my long well-established clinical experience, diet <span class="SpellE">ethimologically</span> speaking, <span class="SpellE">Coniugated</span>–<span class="SpellE">Melatonine</span>, and NIR-LED application in <span class="SpellE">pesonalized</span> way, proved to be really efficacious against every inherited real risk form, including cancer real risk, due to their positive influence on mitochondrial respiratory function, which results normalized or even increased (26).<span style=""> </span><o:p></o:p></span></p> <p style="text-align: justify;" class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal"><b>*</b><b style=""><span style=";font-family:Arial;font-size:10pt;" > Sergio Stagnaro MD<o:p></o:p></span></b></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10pt;" >Via Erasmo Piaggio 23/8, </span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10pt;" lang="EN-GB" >16039 Riva <span class="SpellE">Trigoso</span> (<st1:city st="on">Genoa</st1:city>) <st1:place st="on"><st1:country-region st="on"><b style="">Italy</b></st1:country-region></st1:place></span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10pt;" lang="EN-GB" >Founder of Quantum Biophysical Semeiotics</span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10pt;" lang="EN-GB" >Who's Who in the World (and <st1:place st="on"><st1:country-region st="on"><span class="GramE">America</span></st1:country-region></st1:place>)</span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span class="GramE"><span style=";font-family:Arial;font-size:10pt;" lang="EN-GB" >since</span></span><span style=";font-family:Arial;font-size:10pt;" lang="EN-GB" > 1996 to 2009<o:p></o:p></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10pt;" lang="EN-GB" >Ph 0039-0185-42315<o:p></o:p></span></p> <p class="MsoNormal"><span class="GramE"><span style=";font-family:Arial;font-size:10pt;" lang="EN-GB" >Cell.</span></span><span style=";font-family:Arial;font-size:10pt;" lang="EN-GB" > 3338631439</span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10pt;" ><a href="http://www.semeioticabiofisica.it/"><span style="" lang="EN-GB">www.semeioticabiofisica.it</span></a></span><span style=";font-family:Arial;font-size:10pt;" > </span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10pt;" ><a href="mailto:dottsergio@semeioticabiofisica.it">dottsergio@semeioticabiofisica.it</a> </span></p> <p class="MsoNormal"><o:p> </o:p></p> <p style="text-align: justify;" class="MsoNormal"><span style=""> </span></p> <p style="text-align: justify;" class="MsoNormal"><o:p> </o:p></p> <p style="text-align: justify;" class="MsoNormal"><span class="SpellE"><b style="">References</b></span><b style="">.<o:p></o:p></b></p> <p style="text-align: justify;" class="MsoNormal"><o:p> </o:p></p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal"><span class="GramE">1.Stagnaro-Neri</span> M., Stagnaro S. Introduzione alla Semeiotica Biofisica. <span class="GramE"><span style="" lang="EN-GB">Il</span></span><span style="" lang="EN-GB"> <span class="SpellE">Terreno</span> <span class="SpellE">Oncologico</span>. Travel Factory, Roma, 2004. <span class="GramE">http://www.travelfactory.it/semeiotica_biofisica.htm<br />2.Stagnaro S., <st1:place st="on">West PJ.</st1:place>, <span class="SpellE">Hu</span> FB., Manson JE., Willett WC.</span> <span class="GramE">Diet and Risk of Type 2 Diabetes.</span> N <span class="SpellE">Engl</span> J Med. 2002 Jan 24<span class="GramE">;346</span>(4):297-298. </span><span class="GramE">[<b style="">MEDLINE</b></span>]. </p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal"><span class="GramE">3.Stagnaro-Neri</span> M., Stagnaro S., Semeiotica Biofisica: valutazione clinica del picco precoce della secrezione insulinica di base e dopo stimolazione tiroidea, <span class="SpellE">surrenalica</span>, con <span class="SpellE">glucagone</span> endogeno e dopo attivazione del sistema <span class="SpellE">renina-angiotesina</span> circolante e tessutale <span class="SpellE">Acta</span> <span class="SpellE">Med</span>. <span class="SpellE">Medit</span>. 13, <span class="GramE">99</span>, 1997. </p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal"><span class="GramE">4.Stagnaro-Neri</span> M., Stagnaro S., Semeiotica Biofisica: la manovra di <span class="SpellE">Ferrero-Marigo</span> nella diagnosi clinica della <span class="SpellE">iperinsulinemia-insulino</span> resistenza. <span class="SpellE"><span class="GramE"><span style="" lang="EN-GB">Acta</span></span></span><span class="GramE"><span style="" lang="EN-GB"> Med. Medit. 13, 125, 1997.</span></span><span style="" lang="EN-GB"><br /><span class="GramE">5.Stagnaro</span> Sergio. Endothelial cell function can ameliorate under safer drugs, such as Melatonin-Adenosine. <span class="GramE">BMC Cardiovascular disorders.</span> <a href="http://www.biomedcentral.com/1471-2261/4/4/comments">http://www.biomedcentral.com/1471-2261/4/4/comments</a><o:p></o:p></span></p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal"><span style="" lang="EN-GB">6.Stagnaro-Neri M., <span class="SpellE">Stagnaro</span> S. Deterministic Chaos, Preconditioning and Myocardial Oxygenation evaluated clinically with the aid of Biophysical Semeiotics in the Diagnosis of <span class="SpellE">Ischaeemic</span> Heart Disease even silent. <span class="SpellE"><span class="GramE">Acta</span></span><span class="GramE"> <span class="SpellE">Medica</span> <span class="SpellE">Mediterranea</span> 13, 109-116, 1997.</span> <o:p></o:p></span></p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal"><span class="GramE"><span style="" lang="EN-GB">7.Stagnaro</span></span><span style="" lang="EN-GB"> S. <span class="GramE">A clinical efficacious <span class="SpellE">maneouvre</span>, reliable in bed-side diagnosing coronary artery disease, even initial or silent, as well as "heart coronary risk".</span> 3rd Virtual International Congress of Cardiology, FAC<span class="GramE">,2003</span>, <o:p></o:p></span></p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal"><span style="" lang="EN-GB"><span style=""> </span><a href="http://www.fac.org.ar/tcvc/marcoesp/marcos.htm">http://www.fac.org.ar/tcvc/marcoesp/marcos.htm</a> <o:p></o:p></span></p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal"><span class="GramE"><span style="" lang="EN-GB">8.Stagnaro</span></span><span style="" lang="EN-GB"> <span class="SpellE">Sergio.Biophysical</span> Semeiotic Constitutions, Genomics, and Cardio-Vascular Diseases. BMC Cardiovascular Disorders, 2004, http://www.biomedcentral.com/1471-2261/4/20/comments#95454 <o:p></o:p></span></p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal"><span class="GramE"><span style="" lang="EN-GB">9.Stagnaro</span></span><span style="" lang="EN-GB"> Sergio Endothelial cell function can ameliorate under safer drugs, such as Melatonin-Adenosine. <span class="GramE">BMC Cardiovascular disorders.</span> 2004 <o:p></o:p></span></p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal"><span style="" lang="EN-GB"><a href="http://www.biomedcentral.com/1471-2261/4/4/comments">http://www.biomedcentral.com/1471-2261/4/4/comments</a> <o:p></o:p></span></p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal"><span style="" lang="EN-GB">10<span class="GramE">.Stagnaro</span> S. Pre-Metabolic Syndrome: Locus primary prevention. NYAS web site. 1999 http://www.memberconnections.com/olc/membersonly/NYAS/mboards.html <o:p></o:p></span></p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal"><span style="" lang="EN-GB">11<span class="GramE">.Stagnaro</span> Sergio.</span><span style="" lang="EN-GB"> <span class="GramE">Role of Coronary <span class="SpellE">Endoarterial</span> Blocking Devices in Myocardial Preconditioning - c007i.</span> <span class="GramE"><i>Lecture</i>, V Virtual International Congress of Cardiology, 2007.</span> <a href="http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php">http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php</a><o:p></o:p></span></p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal"><span style="" lang="EN-GB">12<span class="GramE">.Stagnaro</span> Sergio.</span><span style="" lang="EN-GB"> <span class="maintextmodulestrong">Newborn-pathological <span class="SpellE">Endoarteriolar</span> Blocking Devices in Diabetic and <span class="SpellE">Dislipidaemic</span> Constitution and Diabetes Primary Prevention. </span><span class="GramE"><span class="maintextmoduleitalic"><i>The Lancet</i>.</span></span><span class="maintextmoduleitalic"> </span><st1:date st="on" year="2007" day="6" month="3"><span class="maintextmodule1">March 06 2007</span></st1:date><span class="maintextmodule1">. </span><a href="http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?totalcomments=1">http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?totalcomments=1</a><o:p></o:p></span></p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal"><span style="" lang="EN-GB">13<span class="GramE">.Stagnaro</span> Sergio. </span><strong><span style="font-weight: normal;" lang="EN-GB">New bedside way in <span class="GramE">Reducing</span> mortality in diabetic men and women. </span></strong><span class="SpellE"><strong><i><span style="font-weight: normal;">Ann</span></i></strong></span><strong><i><span style="font-weight: normal;">. Int. <span class="SpellE">Med</span>.</span></i></strong><strong><span style="font-weight: normal;">2007</span></strong><strong><span style="">.</span></strong><strong><span style=""> </span></strong><span style="" lang="EN-GB"><a href="http://www.annals.org/cgi/eletters/0000605-200708070-00167v1"><span style="" lang="IT">http://www.annals.org/cgi/eletters/0000605-200708070-00167v1</span></a></span><span style=""><o:p></o:p></span></p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal">14.Stagnaro S., Stagnaro-Neri M. <span class="SpellE">Istangiopatia</span> Congenita <span class="SpellE">Acidosica</span> <span class="SpellE">Enzimo</span> Metabolica. <span class="SpellE">Gazz</span>. <span class="SpellE">Med</span>. <span class="SpellE">It.-</span> Arch. Sci. <span class="SpellE">Med</span>. 144, 423, 1985. </p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal">15.Stagnaro S., Stagnaro-Neri M. Una patologia mitocondriale ignorata: <st1:personname st="on" productid="la Istangiopatia Congenita"><span class="GramE">la </span><span class="SpellE">Istangiopatia</span> Congenita</st1:personname> <span class="SpellE">Acidosica</span> <span class="SpellE">Enzimo-Metabolica</span>. <span class="SpellE">Gazz</span>. <span class="SpellE">Med</span>. It. - Arch. Sci. <span class="SpellE">Med</span>. 149, <span class="GramE">67</span> 1990. </p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal"><span class="GramE">16.Stagnaro-Neri</span> M., Stagnaro S., Cancro della mammella: prevenzione primaria e diagnosi precoce con la percussione ascoltata. <span class="SpellE">Gazz</span>. <span class="SpellE">Med</span>. <span class="SpellE">It.-</span><span style=""> Arch. Sc. <span class="SpellE">Med</span>. 152, 447 1993 <o:p></o:p></span></p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal"><span class="GramE">17Stagnaro</span> S., Stagnaro-Neri M., <span class="SpellE">Oncological</span> <span class="SpellE">Terrain</span>, <span class="SpellE">conditio</span> <span class="SpellE">sine</span> qua non <span class="SpellE">of</span> <span class="SpellE">Oncogenesis</span>, 2004: <a href="http://www.gutjnl.com/cgi/eletters?lookup=by_date&days=60">http://www.gutjnl.com/cgi/eletters?lookup=by_date&days=60</a> </p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal"><span style="" lang="EN-GB">18<span class="GramE">.Stagnaro</span> Sergio. "Genes, <span class="SpellE">Oncological</span> Terrain, and Breast Cancer" World Journal of Surgical Oncology., 2005, http://www.wjso.com/content/3/1/45/comments#205475 <o:p></o:p></span></p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal"><span style="" lang="EN-GB">19<span class="GramE">.Sergio</span> <span class="SpellE">Stagnaro</span>.</span><span style="" lang="EN-GB"> Mitochondrial Genome of the Mastodon highlights Human Constitutions. PLOS Biology, (<st1:date st="on" year="2007" day="1" month="8">01 August 2007</st1:date>) <a href="http://biology.plosjournals.org/perlserv/?request=read-response&doi=10.1371/journal.pbio.0050207#r1725">http://biology.plosjournals.org/perlserv/?request=read-response&doi=10.1371/journal.pbio.0050207#r1725</a> <o:p></o:p></span></p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal"><span style="" lang="EN-GB">20<span class="GramE">.Stagnaro</span> Sergio. Biological System Functional Modification parallels Gene Mutation. </span><a href="http://www.nature.com/"><span style="" lang="EN-GB">www.Nature.com</span></a><span style="" lang="EN-GB">, <st1:date st="on" year="2008" day="13" month="3">March 13, 2008</st1:date>, <o:p></o:p></span></p> <p style="text-align: justify; margin-left: 6pt;" class="MsoNormal"><span style="" lang="EN-GB"><span style=""> </span></span><a href="http://blogs.nature.com/nm/spoonful/2008/03/gout_gene.html"><span style="" lang="EN-GB">http://blogs.nature.com/nm/spoonful/2008/03/gout_gene.html</span></a><span style="" lang="EN-GB"><o:p></o:p></span></p> <p style="margin-left: 6pt;" class="MsoNormal"><span style="">21.Stagnaro Sergio.</span> Teoria Patogenetica Unificata, 2006, Ed. <span class="SpellE">Travel</span> <span class="SpellE">Factory</span>, Roma. <span style="color:navy;">2006. <o:p></o:p></span></p> <p style="margin-left: 6pt;" class="MsoNormal"><span style="">22.</span><b><span style=";font-family:Verdana;font-size:10pt;" > </span></b><span style=";font-family:Verdana;font-size:10pt;" >Stagnaro Sergio.</span><span style=";font-family:Verdana;font-size:10pt;" > Reale Rischio Semeiotico Biofisico. <span class="GramE">I Dispositivi <span class="SpellE">Endoarteriolari</span> di Blocco neoformati, patologici, tipo I, sottotipo a) oncologico, e b) aspecifico</span>. <span class="SpellE">Ediz</span>. <span class="SpellE">Travel</span> <span class="SpellE">Factory</span>, </span><span style=";font-family:Verdana;font-size:10pt;" lang="EN-GB" ><a href="http://www.travelfactory.it/" target="_blank"><span style="" lang="IT">www.travelfactory.it</span></a></span><span style=";font-family:Verdana;font-size:10pt;" >, Roma, 2009<span class="GramE">.<span style=";font-family:'Times New Roman';font-size:12pt;" >.</span></span></span> <span style="color:navy;"><o:p></o:p></span></p> <p style="margin-left: 6pt;" class="MsoNormal">23.Stagnaro Sergio e<i style=""> </i>Paolo <span class="SpellE">Manzelli</span>. <span style=""> </span>L’Esperimento di <span class="SpellE">Lory</span>. Scienza e Conoscenza, <span class="SpellE">N°</span> 23, 13 <span class="GramE">Marzo</span> 2008. <a href="http://www.scienzaeconoscenza.it/articolo.php?id=17775">http://www.scienzaeconoscenza.it//articolo.php?id=17775</a><span style="color:navy;"> <o:p></o:p></span></p> <p style="margin-left: 6pt;" class="MsoNormal">24.<span class="GramE">Stagnaro Sergio e<i style=""> </i>Paolo <span class="SpellE">Manzelli</span>,<b><span style="color:red;"> </span></b><span style="">09-1-2008</span>, Semeiotica Biofisica Quantistica: la manovra di attivazione <span class="SpellE">surrenalica</span> <span class="SpellE">jatrogenetica</span></span>.<b style=""> </b><span style="color:navy;"><o:p></o:p></span></p> <p class="MsoNormal"><span style=""> </span><a href="http://www.fcenews.it/index.php?option=com_content&task=view&id=161&Itemid=63">http://www.fcenews.it/index.php?option=com_content&task=view&id=161&Itemid=63</a> </p> <p class="MsoNormal"><span style=""> </span><span style="" lang="EN-GB">25. <span class="SpellE"><span style="">Stagnaro</span></span><span style=""> Sergio.</span> Epidemiological evidence for the non-random clustering of the components of the metabolic syndrome: multicentre study of the Mediterranean Group for the Study of Diabetes. </span><i style="">Eur J <span class="SpellE">Clin</span> <span class="SpellE">Nutr</span>. </i>2007 <span class="SpellE">Sep</span>;<span class="volume">61</span><span class="GramE">(</span><span class="issue">9</span>):<span class="pages">1143-4</span>. <span class="SpellE">Epub</span> 2007 <span class="SpellE">Feb</span> 7. <span class="GramE"><b>[MEDLINE</b></span><b>]</b><span style=""> </span></p> <p class="MsoNormal">26. <span style=";font-family:Verdana;font-size:10pt;" >Stagnaro S., Stagnaro-Neri M.</span><span style=";font-family:Verdana;font-size:10pt;" >, <st1:personname st="on" productid="La Melatonina">La Melatonina</st1:personname> nella Terapia del Terreno Oncologico e del “Reale Rischio” Oncologico. <span class="SpellE">Travel</span> <span class="SpellE">Factory</span>, Roma, 2004. <a href="http://www.travelfactory.it/">http://www.travelfactory.it/</a></span></p>Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-19204173872062854392009-09-25T06:47:00.000-07:002009-09-25T06:48:40.859-07:00Bedside Recognizing Diabetes since its initial stage of Inherited Real Risk<p><span style="font-size: 10pt; font-family: Verdana; color: black;" lang="EN-GB">Sirs, </span><span style="font-family: Arial; color: black;" lang="EN-GB"><o:p></o:p></span></p> <p><span style="font-size: 10pt; font-family: Verdana; color: black;" lang="EN-GB">In my opinion, there are a lot of fascinating papers on diabetes, but not useful at all in GPs day-to- day practice, since primary prevention ON VERY LARGE SCALE is far better than therapy, also in diabetic field, and GP role is central in such as enterprise! </span><span style="font-family: Arial; color: maroon;" lang="EN-GB"><o:p></o:p></span></p> <p><span style="font-size: 10pt; font-family: Verdana; color: black;" lang="EN-GB">Primary Prevention must be performed exclusively in individuals <em><span style="font-family: Verdana;">correctly</span></em> recognized in a quantitative way at inherited real risk with the aid of a stethoscope; in our case, at diabetes real risk since birth. </span><span style="font-family: Arial; color: maroon;" lang="EN-GB"><o:p></o:p></span></p> <p><span style="font-size: 10pt; font-family: Verdana; color: black;" lang="EN-GB">In fact, it is generally admitted by the Authors that diabetes is a growing epidemics. However, I state that with the aid of Quantum Biophysical Semeiotics, the until now either unknown or overlooked newborn-pathological, subtype a) oncological , and b), aspecific, type I, Endoarteriolar Blocking Devices in the tissues, wherein does really exist the real risk of human common and severe diseases, as diabetes.</span><span style="font-family: Arial; color: maroon;" lang="EN-GB"><o:p></o:p></span></p> <p><span style="font-size: 10pt; font-family: Verdana; color: black;" lang="EN-GB"> Obviously that happens in individuals with well-defined Quantum-Biophysical-Semeiotic Constitutions, in our case, Diabetic <strong><span style="font-family: Verdana;">“and”</span></strong> Dislipidaemic (See Practical Applications, 6 article on Diabetes, in my website http://www.semeioticabiofisica.it) (1-6). </span><span style="font-family: Arial; color: maroon;" lang="EN-GB"><o:p></o:p></span></p> <p><span style="font-size: 10pt; font-family: Verdana; color: black;" lang="EN-GB">Interestingly, e.g., in Diabetes Primary Prevention (PP), we need new clinical tools, aiming to lower the increasing number of patients, although the present, expensive screening: in above-cited website Practical Applications: Diabetes, and Quantum-Biophysical-Semeiotic Constitutions (1-7). </span><span style="font-family: Arial; color: maroon;" lang="EN-GB"><o:p></o:p></span></p> <p><span style="font-size: 10pt; font-family: Verdana; color: black;" lang="EN-GB">For instance, in the normal Langheran’s islets microcirculatory bed, there are exclusively “normal” type II (= in arterioles, according to Hammersen), but not type I (= in small arterioles) endoarteriolar blocking devices, i.e. EBD, of first and second classes, according to S.B.Curri (See http://www.semeioticabiofisica.it/microangiologia). In health, i.e., not involved by Diabetic Constitution, we cannot observe type I, newborn- pathological, EBD in above-mentioned biological system. On the contrary, in individuals involved by diabetic constitution as well as diabetic "Inherited Real Risk" and overt diabetes, of course, we observe with the aid of Quantum Biophysical Semeiotics also type I, newborn-pathological, subtype b) aspecific , EBD, facilitating the diagnosis and consequently diabetes primary prevention. In addition, the evaluation of Insulin Secretion Acute Pick Renal Test is significantly impaired, corroborating the clinical diagnosis (1-3).</span><span style="font-family: Arial; color: maroon;" lang="EN-GB"><o:p></o:p></span></p> <p><span style="font-size: 10pt; font-family: Verdana; color: black;" lang="EN-GB"> Finally, an interesting clinical tool in recognizing diabetic constitution -dependent inherited real risk, as well as in diagnosing diabetes since early stages and diabetic monitoring proved to be bedside <strong><span style="font-family: Verdana;">Quantum-Biophysical- Semeiotic Osteocalcin Test </span></strong>(10) As a matter of fact, Pre-hypertension during Young Adulthood may be involved by Coronary Calcium Later in Life exclusively in presence of Inherited Real Risk of CAD, typical for individuals with lithyasic Constitution, present in about 50% OF ALL CASES OF Pre-Metabolic and Metabolic Syndrome (13-15).</span><span style="font-family: Arial; color: maroon;" lang="EN-GB"><o:p></o:p></span></p> <p><span style="font-size: 10pt; font-family: Verdana; color: black;" lang="EN-GB">Considering the frequent association between hypertension and diabetes, with or without CAD INHERITED REAL RISK (14, 15) more important proved to be, in my 53-year-long clinical experience, <strong><span style="font-family: Verdana;">bedside </span></strong>recognizing diabetic predisposition, now-a-days possible since birth, utilising a lot of methods, different in difficulty, but all reliable. </span><span style="font-family: Arial; color: maroon;" lang="EN-GB"><o:p></o:p></span></p> <p><span style="font-size: 10pt; font-family: Verdana; color: black;" lang="EN-GB">For the first time, from the clinical view-point, I have recently illustrated an original manoeuvre, based on a singular activity of osteocalcin, and reliable in bedside detecting diabetes in one minute, with the aid of a stethoscope (10). In fact, osteocalcin, a product of osteoblasts, among other action mechanisms, stimulates both insulin secretion and insulin receptor sensitivity. As a consequence, osteocalcin, secreted by above-mentioned bone cells during mean-intense lasting digital pressure – for instance – applied upon lumbar vertebrae, brings about increasing pancreatic diameters, i.e., technically speaking, type I, associated, Langherans’s islet microcirculatory activation, so that doctors assess pancreas size augmentation, which in health, lasts 10 seconds exactly (1-11). After that, pancreas diameters return to basal value for 3 sec. The second pancreas size increasing lasts 20 sec., and finally the third show the highest value: 30 sec. I terme such as clinical investigation. On the contrary, in case of diabetic constitution (3, 4, 11, 13) the first pancreas increasing persists normally (10 sec.), but both the second and the third are less than physiological ones (i.e., less than 20 sec. and respectively 30 sec.). In presence of intense inherited real risk of diabetes (6), such as impairment is greater. Finally, in case of diabetes the alteration is present already in the first evaluation, wherein duration appears less than 10 sec., inversely related with disorder seriousness. Subsequently, I have ascertained that Ronald’s Manoeuvre result pathological already in individuals involved by both Diabetic Constitution and Inherited Diabetic Real Risk (1-11). Interestingly, not only in examining subject, but also in all others, even if kilometers way from him (her), according to Lory’s experiment, based of no local realm in biological systems (12), pancreas show identical modifications, allowing doctors to made clinical diagnosis until now impossible (1-13). </span><span style="font-family: Arial; color: black;" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal" style=""><span style="color: black;">1)Stagnaro S., Stagnaro-Neri M. Valutazione percusso-ascoltatoria del Diabete Mellito. Aspetti teorici e pratici. Epat. 32, 131, 1986 </span><span style="color: maroon;"><o:p></o:p></span></p> <p class="MsoNormal" style=""><span style="color: black;">2) Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. Travel Factory, Roma, 2004. </span><span style="color: maroon;"><a href="http://www.travelfactory.it/semeiotica_biofisica.htm">http://www.travelfactory.it/semeiotica_biofisica.htm</a></span><span style="color: black;"> </span><span style="color: maroon;"><o:p></o:p></span></p> <p class="MsoNormal" style=""><span style="color: black;">3) Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico- Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Travel Factory, Roma, 2004. </span><span style="color: maroon;"><a href="http://www.travelfactory.it/libro_costituzionisemeiotiche.htm">http://www.travelfactory.it/libro_costituzionisemeiotiche.htm</a><o:p></o:p></span></p> <p class="MsoNormal" style=""><span style="color: black;"> 4) Stagnaro S., Stagnaro-Neri M. Single Patient Based Medicine.La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. </span><span style="color: black;" lang="EN-GB">Travel Factory, Roma, 2005. </span><span style="color: maroon;" lang="EN-GB"><a href="http://www.travelfactory.it/libro_singlepatientbased.htm">http://www.travelfactory.it/libro_singlepatientbased.htm</a></span><span style="color: black;" lang="EN-GB"> <o:p></o:p></span></p> <p class="MsoNormal" style=""><span style="color: black;" lang="EN-GB">5) Stagnaro S. Pivotal role of Biophysical Semeiotic Constitutions in Primary Prevention. </span><span style="color: black;">Cardiovascular Diabetology, 2:1, 2003 </span><span style="color: maroon;"><a href="http://www.cardiab.com/content/2/1/13/comments#5753">http://www.cardiab.com/content/2/1/13/comments#5753</a><o:p></o:p></span></p> <p class="MsoNormal" style=""><span style="color: black;" lang="EN-GB"> 6) Stagnaro S. Stagnaro Sergio. Newborn-pathological Endoarteriolar Blocking Devices in Diabetic and Dislipidaemic Constitution and Diabetes Primary Prevention. The Lancet. March 06 2007. </span><span style="color: maroon;" lang="EN-GB"><a href="http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?totalcomments=1">http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?totalcomments=1</a></span><span style="color: black;" lang="EN-GB">. </span><span style="color: red;" lang="EN-GB">Hidden</span><span style="color: black;" lang="EN-GB">!!!. Therefore See either reference 13) or </span><span style="color: maroon;" lang="EN-GB"><a href="http://www.fce.it/">www.fce.it</a></span><span style="color: black;" lang="EN-GB">, </span><span style="color: maroon;" lang="EN-GB"><a href="http://www.fceonline.it/index.php?option=com_content&task=view&id=3736&Itemid=47">http://www.fceonline.it/index.php?option=com_content&task=view&id=3736&Itemid=47</a><o:p></o:p></span></p> <p class="MsoNormal" style=""><span style="color: black;" lang="EN-GB">7) Stagnaro S., <place><st1:place st="on">West PJ.</st1:place></place>, Hu FB., Manson JE., Willett WC. Diet and Risk of Type 2 Diabetes. N Engl J Med. 2002 Jan 24;346(4):297-298. [<b>Medline</b>] <o:p></o:p></span></p> <p class="MsoNormal" style=""><span style="color: black;" lang="EN-GB">8) Stagnaro Sergio. New bedside way in Reducing mortality in diabetic men and women. </span><span style="color: black;">Ann. Int. Med.2007. </span><span style="color: maroon;"><a href="http://www.annals.org/cgi/eletters/0000605-%20200708070-00167v1">http://www.annals.org/cgi/eletters/0000605- 200708070-00167v1</a></span><span style="color: black;"> </span><span style="color: maroon;"><o:p></o:p></span></p> <p class="MsoNormal" style=""><span style="color: black;">9) Stagnaro Sergio. </span><span style="color: black;" lang="EN-GB">Single Patient Based Medicine: its paramount role in Future Medicine. Public Library of Science. http://medicine.plosjournals.org/perlserv/?request=read-response 2005<o:p></o:p></span></p> <p class="MsoNormal" style=""><span style="color: black;" lang="EN-GB">10) Stagnaro Sergio. Bedside Biophysical-Semeiotic Osteocalcin Test in Diagnosing and Monitoring Diabetes. The Lancet, January 28, 2008. </span><span style="color: maroon;"><a href="http://www.thelancet.com/journals/lancet/article/PIIS0140673608601014/comments?action=view&totalComments=2"><span style="" lang="EN-GB">http://www.thelancet.com/journals/lancet/article/PIIS0140673608601014/comments?action=view&totalComments=2</span></a></span><span style="color: black;" lang="EN-GB">, HIDDEN !!!! See </span><span style="color: maroon;" lang="EN-GB"><a href="http://www.fce.it/">www.fce.it</a></span><span style="color: black;" lang="EN-GB">, </span><span style="color: maroon;" lang="EN-GB"><a href="http://www.fceonline.it/index.php?option=com_content&task=view&id=3736&Itemid=47">http://www.fceonline.it/index.php?option=com_content&task=view&id=3736&Itemid=47</a><o:p></o:p></span></p> <p class="MsoNormal" style=""><span style="color: black;">11) Stagnaro Sergio. Il test Semeiotico-Biofisico della Osteocalcina nella prevenzione primaria del diabete mellito. </span><span style="color: maroon;"><a href="http://www.fce.it/">www.fce.it</a></span><span style="color: black;">, </span><span style="color: maroon;"><a href="http://www.fcenews.it/index.php?option=com_content&task=view&id=909&Itemid=47">http://www.fcenews.it/index.php?option=com_content&task=view&id=909&Itemid=47</a></span><span style="color: black;"> </span><span style="color: maroon;"><o:p></o:p></span></p> <p class="MsoNormal" style=""><span style="color: black;">12) Stagnaro Sergio e Paolo Manzelli. L’Esperimento di Lory. Scienza e Conoscenza, N° 23, 13 Marzo 2008. http://www.scienzaeconoscenza.it//articolo.php?id=17775 </span><span style="color: maroon;"><o:p></o:p></span></p> <p class="MsoNormal" style=""><span style="color: black;" lang="EN-GB">13) </span><span style="font-size: 10pt; font-family: Verdana; color: black;" lang="EN-GB">Stagnaro Sergio.<strong><span style="font-family: Verdana;"> </span></strong></span><span style="font-size: 10pt; font-family: Verdana; color: red;" lang="EN-GB"> </span><span style="font-size: 10pt; font-family: Verdana; color: black;" lang="EN-GB"> Pre-Metabolic Syndrome and Metabolic Syndrome: Biophysical-Semeiotic Viewpoint. </span><span style="font-size: 10pt; font-family: Verdana; color: black;"><a href="http://www.athero.org/" target="_blank"><span style="" lang="EN-GB">www.athero.org</span></a></span><span style="font-size: 10pt; font-family: Verdana; color: black;" lang="EN-GB">, 29 April, 2009. <a href="http://www.athero.org/commentaries/comm904.asp" target="_blank">http://www.athero.org/commentaries/comm904.asp</a></span><span style="color: maroon;" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal" style=""><span style="font-size: 10pt; font-family: Verdana; color: black;" lang="EN-GB">14) Stagnaro Sergio.<strong><span style="font-family: Verdana;"> </span></strong> <strong><span style="font-family: Verdana; font-weight: normal;">Without CAD Inherited Real Risk no diabetic is involved by coronary disorder. </span></strong></span><strong><span style="font-size: 10pt; font-family: Verdana; color: black; font-weight: normal;">CMAJ, </span></strong><span style="font-size: 10pt; font-family: Verdana; color: black;">6 May 2009. <strong><span style="font-family: Verdana; font-weight: normal;"><a href="http://www.cmaj.ca/cgi/eletters/180/9/919#127646" target="_blank">http://www.cmaj.ca/cgi/eletters/180/9/919#127646</a></span></strong></span><span style="color: maroon;"><o:p></o:p></span></p> <p class="MsoNormal"><strong><span style="color: black; font-weight: normal;">15) Stagnaro Sergio.</span></strong><span style="color: black;"> <strong><span style="font-weight: normal;">Reale Rischio Semeiotico Biofisico. I Dispositivi Endoarteriolari di Blocco neoformati, patologici, tipo I, sottotipo a) oncologico, e b) aspecifico. Ediz. Travel Factory, </span></strong></span><span style="color: maroon;" lang="EN-GB"><a href="http://www.travelfactory.it/" target="_blank"><strong><span style="font-weight: normal; text-decoration: none;" lang="IT">www.travelfactory.it</span></strong></a></span><strong><span style="color: black; font-weight: normal;">,</span><span style="color: black;"> Roma, Luglio 2009.</span></strong><o:p></o:p></p> <p class="MsoNormal"><o:p> </o:p></p>Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-50631865969162413632009-05-25T05:27:00.001-07:002009-05-25T05:29:27.352-07:00Renal Artery Stenosis: bedside rapid Diagnosis even in its initial stage with Quantum-Biophysical-Semeiotics<p class="MsoNormal"><span style="" lang="EN-GB">Overlooked Quantum-Biophysical-Semeiotics does really exists(1-12). See also <a href="http://www.semeioticabiofisica.it/">www.semeioticabiofisica.it</a> <span style=""> </span>Interestingly, due to the presence of no local realm in all biological systems, in one second doctors may recognize that in urinary tract there is something wrong (10). Soon thereafter physicians can localize the precise site of disorder, ascertaining the real nature. As regards early diagnosis of renal artery stenosis, Quantum Biophysical Semeiotics allows doctor to bedside recognize kidney disorders, since initial stages of INHERITED Real Risk. Perhaps, for instance, available evidence does not clearly support one treatment approach over another for atherosclerotic renal artery stenosis. However, we must admit that patients with such as disorder are properly diagnosed exclusively a long time after initial disease onset, as in our case. Unfortunately, all around the world, General Practitioners know only the traditional physical semeiotics, that isn't so efficacious to allow doctor to recognize, since its first stage, Renal Artery Stenosis. Nowadays, physicians can bedside recognize SINCE BIRTH real risk of kidney diseases, both oncological and degenerative in nature (1-10). In order to recognize Renal Artery Stenosis, the following easy and quick manoeuvre proved to be really efficacious in my long year clinical experience: in health, doctor first of all delimits kidney area, as I described, e.g., in above-cited website, Technical Page N° 5 (14, 15). Subsequently, doctor increases the pressure of sthetoscope bell- piece, localized on kidney cutaneous projection, causing kidney dilation (due its congestion) immediately , than kidney size reduces (due to de- congestion)to its minimal value. At this point, in health pressure prompt interruption is "rapidly" - in 2 sec or less - followed by the return of kidney to its normal size, indicating a physiological blood flow in renal artery (15). On the contrary, in case of renal artery stenosis such as latency time results more than 2 sec., in relation to the severity of underlying disease (16). Interesting information about renal inherited real risk are illustrated in my previous paper (16). <o:p></o:p></span></p> <p class="MsoNormal">References: </p> <p class="MsoNormal">1. Stagnaro Sergio e Paolo Manzelli. Semeiotica Biofisica Quantistica. 15 Dicembre 2007 http://www.ilpungolo.com/leggi- tutto.asp?IDS=13&NWS=NWS5243 </p> <p class="MsoNormal">2. Stagnaro Sergio e Paolo Manzelli. Semeiotica Biofisica Endocrinologica: Meccanica Quantistica e Meccanismi d’Azione Ormonali. Dicembre 2007, www.fce.it, http://www.fcenews.it/index.php?option=com_content&task=view&id=816&Itemid=45 </p> <p class="MsoNormal">3. Stagnaro Sergio e Paolo Manzelli. Natura Quantistica di una Originale Manovra Semeiotico-Biofisica di Epatopatia . Dicembre 2007, http://www.fcenews.it/index.php?option=com_content&task=view&id=862&Itemid=45 </p> <p class="MsoNormal">4. Stagnaro Sergio e Paolo Manzelli. Semeiotica Biofisica: Realtà non- locale in Biologia. Dicembre 2007, www.ilpungolo.com, http://www.ilpungolo.com/leggi-tutto.asp?IDS=13&NWS=NWS5217 </p> <p class="MsoNormal">5. Stagnaro Sergio e Paolo Manzelli. Semeiotica Biofisica Quantistica: la manovra di attivazione surrenalica jatrogenetica, 09-1-2008, http://www.fcenews.it/index.php?option=com_content&task=view&id=161&Itemid=63 </p> <p class="MsoNormal"><span style="" lang="EN-GB">6. Stagnaro Sergio. Bedside Biophysical-Semeiotic Osteocalcin Test in Diagnosing and Monitoring Diabetes. The Lancet, January 28, 2008. http://www.thelancet.com/journals/lancet/article/PIIS0140673608601014/comments?action=view&totalComments=2 <o:p></o:p></span></p> <p class="MsoNormal">7. Stagnaro Sergio. Il test Semeiotico-Biofisico della Osteocalcina nella prevenzione primaria del diabete mellito. Febbraio 2008. http://www.fcenews.it/index.php?option=com_content&task=view&id=909&Itemid=47 </p> <p class="MsoNormal">8. Stagnaro Sergio. Esperimento di Lory e Crisi dei Fondamenti della Medicina Occidentale. www.ilpungolo.com. 17 Febbraio 2008 http://www.ilpungolo.com/leggi-tutto.asp?NWS=NWS5387&IDS=13 </p> <p class="MsoNormal">9. Stagnaro Sergio e Paolo Manzelli. L’Esperimento di Lory. Scienza e Conoscenza, N° 23, 13 Marzo 2008. http://www.scienzaeconoscenza.it//articolo.php?id=17775 </p> <p class="MsoNormal">10. Stagnaro Sergio. Reale Rischio Congenito di Cancro Renale Diagnosticato con <st1:personname productid="la Semeiotica Biofisica" st="on">la Semeiotica Biofisica</st1:PersonName>: il Segno di Pollio. www.ilpungolo.com, 25 Marzo 2008, http://www.ilpungolo.com/leggi- tutto.asp?NWS=NWS5480&IDS=13</p> <p class="MsoNormal"><span style=""> </span>11. Stagnaro Sergio. Biological System Functional Modification parallels Gene Mutation. www.Nature.com,March 13, 2008, http://blogs.nature.com/nm/spoonful/2008/03/gout_gene.html 12. Stagnaro Sergio. Melanoma? Escluso in 1 Secondo con <st1:personname productid="la Semeiotica Biofisica" st="on">La Semeiotica Biofisica</st1:PersonName> Quantistica. Il Reale Rischio Congenito di Melanoma. www.ilpungolo.com, 9 Aprile 2008, http://www.ilpungolo.com/leggi- tutto.asp?IDS=13&NWS=NWS5524</p> <p class="MsoNormal"><span style=""> </span>13. Stagnaro Sergio. Diagnosi clinica di cuore sano in un secondo! 7 Aprile 2008, http://www.fcenews.it/index.php?option=com_content&task=view&id=1218&Itemid=47 </p> <p class="MsoNormal"><span style="" lang="EN-GB">14. Stagnaro Sergio . Also Family Physicians are able of greatest clinical Discoveries! Annals Family Medicine,(16 April 2008), http://www.annfammed.org/cgi/eletters/6/2/175 <o:p></o:p></span></p> <p class="MsoNormal">15. Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. Ed. Travel Factory, Roma, 2004. http://www.travelfactory.it</p> <p class="MsoNormal"><span style=""> </span><span style="" lang="EN-GB">16) Stagnaro Sergio. Renin-angiotensin blockade and kidney disease inherited real risk. The Lancet.com, September 23, 2008. http://www.thelancet.com/journals/lancet/article/PIIS014067360861212X/comments?action=view&totalComments=2#1841<o:p></o:p></span></p>Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-68476490556245945892009-05-22T22:16:00.000-07:002009-05-22T22:22:08.955-07:00Quantum-Biophysical-Semeiotic bedside Detecting Atherosclerosis from initial, asymptomatic Stage. Inherited real Risk.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEin4xtbyQCkIM8jIBoUa4Sh12CK1CpeBc6Q8L5b7K0HntpP_GIKBAyAElzkRhDgOLExmXYGimWfVNumxeZrpOCevKo_S21TOcOxySR4DI_xnOhjjk5e9UdJOacknzPM61XHMhAKqfeIBeei/s1600-h/DEB+I+e+II.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 185px; height: 200px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEin4xtbyQCkIM8jIBoUa4Sh12CK1CpeBc6Q8L5b7K0HntpP_GIKBAyAElzkRhDgOLExmXYGimWfVNumxeZrpOCevKo_S21TOcOxySR4DI_xnOhjjk5e9UdJOacknzPM61XHMhAKqfeIBeei/s200/DEB+I+e+II.jpg" alt="" id="BLOGGER_PHOTO_ID_5338884814210133634" border="0" /></a> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Endoarteriolar Blocking Devices (EBD), derived from arteriolar medial layer, and ubiquitous in a<span style=""> </span>single point of vascular wall with two (= arterioles) or more (= small arteries) layers of smooth muscle cells, according to Hammersen <span class="referencia">[1]</span>, protruding to the lumen, show very different structure and form, under physiological and pathological conditions: small cushions with wide base, polypoid formations, generally pedunculated <span class="referencia">[2-5]</span>, sphincteric formations, intimal contractile architectures. More precisely speaking, only type II, normal, physiological, EBD, localized in arterioles, are ubiquitous. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">EBD are playing a primary role in local microcirculatory <span class="textocursiva">flow-motion </span>regulation, as the following clinical evidence demonstrates: when they are abnormal,<span style=""> </span>from both functional and structural quantum-biophysical-semeiotic viewpoint, EBD bring about Functional Microcirculatory Reserve (FMR) impairment, contributing to cause inherited real risk of disorders, like CAD, whose onset will possibly occur after years or decades, as allows me to state a 53-year-long clinical experience with the original physical semeiotics <span class="referencia">[6-19]</span>. Under such as condition, we observe tissue acidosis, assessed as lowering of gastric aspecific reflex latency time, indicating lowered tissue oxygenation. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Interestingly, the initial stage of whatever disorder, i.e., the inherited real risk, is characterised exclusively by a reflex duration lasting 4 sec. (NN < nn =" 8" style=""> </span>utilizing apnoea test.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">In health, the duration of apnoea is inversely correlated with latency time lowering, and directly related to gastric aspecific reflex lasting time (7-9). <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Quantum-biophysical Semeiotics allows doctor to find physiological, both type I and type II, EBD, the later exclusively in those biological systems which need temporarily high blood supply, as skeletal muscle, right cerebral hemisphere of individuals CAEMH-positive, and conjunctival mucosa, emphasizing their central role in microcirculatory flow-motion regulation, under physiological as well as pathological conditions,<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Beside normal or physiological, either inherited or newborn, type I<span style=""> </span>(= small arteries), and type II<span style=""> </span>(= arterioles), EBD, according to S.B. Curri <span class="referencia">[4,5]</span>, do really exist type I, newborn-pathological EBD, until now unknown by physicians. They are sub-divided in two subtypes: a) subtype, characteristic of oncological real risk, and b) subtype, aspecific, in all other disorder inherited real risks and present in different biological systems, I discovered and described in earlier papers, (See: Physiology, and Pathology, <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;"><a href="http://www.semeioticabiofisica.it/microangiology" target="_blank"><span style="" lang="EN-GB">http://www.semeioticabiofisica.it/microangiology</span></a></span><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">,) <span class="referencia">[6,7]</span>. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">These microcirculatory structures play a pivotal role in the patho-physiology of most common and serious human diseases, including diabetes, hypertension, ATS, CVD, cancer, permitting to define the link existing between <span class="textocursiva">genetic </span>factor and <span class="textocursiva">phenotype</span>, according to Angiobiopathy theory <span class="referencia">[6-18]</span>.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">In fact, decade-long clinical study of Endoarteriolar Blocking Devices has allowed me to discover and assess “quantitatively” the genetic abnormalities of all biological systems, preconditioning outcome is based on.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">As a consequence of above remarks, EBD clinical evaluation proved to be a paramount tool to bedside recognize individuals at inherited real risk of the more frequent and dangerous human disorders, as well as to comprehend fully the underlying different quantum-biophysical-semeiotic constitutions, I<span style=""> </span>have formerly described, since the birth <span class="referencia">[9-20]</span>.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Due to these reasons, I emphasize the essential value of knowing both anatomy and physiology of such microcirculatory structures, i.e., EBD, both physiological and pathological, at the present time unfortunately either ignored or overlooked by clinicians around the world. EBD are useful to understand the importance of <span class="textocursiva">Clinical Microangiology</span>, and particularly its branch, I suggested to term <span class="textocursiva">Clinical Microangiology of Endoarteriolar Blocking Devices </span><span class="referencia">[6-21]</span>.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Furthermore, Quantum-biophysical Semeiotics allows doctor to bed-side detect the persistent opening (technically speaking, hyperstomy) of all artero-venous anastomoses (AVA), ethimologically understood, as clinical and experimental evidence suggests.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">In healthy and young inividual, this reflex, that shows an intensity smaller than <st1:metricconverter productid="2 cm" st="on">2 cm</st1:metricconverter>, disappears rapidly if digital pressure becomes “highly intense”. In addition, if the subject hand is raised to 10-<st1:metricconverter productid="15 cm" st="on">15 cm</st1:metricconverter>. above the heart level, “mean-intense” digital pressure applied on the finger-pulp does not cause upper ureteral reflex. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">On the contrary, in arteriosclerotic patients, from initial stage of its inherited risk, “mean-intense” digital pressure, applied upon the microcirculatory bed, e.g. on the microvessels of a finger pulp, scars, great or little joints, of individuals lying down in the supine position, psycho-physically relaxed with open eyes (= melatonin secretion inhibition) brings about upper ureteral reflex (= upper ureteral tracts dilate about <st1:metricconverter productid="2,5 cm" st="on">2,5 cm</st1:metricconverter>.), lasting characteristically “stiff” also during “extreme-intense” pressure <span class="referencia">[6-21]</span>.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">In other words, in health, under the later condition, AVA are closed, and simultaneously type I and II EBD contract, when evaluated as middle ureteral reflex (See later on), facilitating the blood-flow through nutritional capillaries (= type I, associated, Microcirculatory Functional Reserve activation). Furthermore, since the very early stage of arteriosclerosis, such as reflex persists “stiff” also under the latter conditions, hindering blood supply to local parenchyma.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Interestingly, this quantum-biophysical-semeiotic sign increases suddenly when the patient moves the other, vertically raised hand as waving good-bye – "slightest effort test" – because of the increasing of blood viscosity, bedside detected. Analogously, during the "simulated cold test" (= patient is thinking to dip his hands or a single finger in ice-cold water), arterio-venous anastomoses result slightly opened in healthy subjects.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">On the contrary, under identical conditions, AVA opening appears to be particularly increased in patients involved by arteriosclerosis, even initial or asymtomatic: <st1:metricconverter productid="1,5 cm" st="on">1,5 cm</st1:metricconverter>. vs <st1:metricconverter productid="2,8 cm" st="on">2,8 cm</st1:metricconverter>., respectively: p<0,001,></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Finally, middle ureteral reflex, different in type, size, duration, nature, induced by digital pressure of different intensity, applied, e.g., on tissue-micro-vascular-units of finger tip, gives useful information about the diverse EBD, type I AVA as well as type II, group I, group II AVA, where present as in the foot-sole <span class="referencia">(16)</span><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">As a consequence, doctor can now-a-days assess the diverse EBDs at the bedside in easiest way, calculating the duration of heart-aspecific gastric and/or -caecal reflex duration: in presence of “normal” EBD alteration and type I newborn-pathological, type I, subtype b), EBD, reflex lasts 4 sec. or more (NN = less than 4 sec.), correlated with the seriousness of underlying disorder. Moreover, the final tonic Gastric Contraction (= intense tissue acidosis) indicates the presence of newborn-pathological, type I, subtype a), “oncological”, EBD, characterized by a large amount of smooth muscle cells. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Certainly, who knows the “direct” evaluation of middle ureteral reflexes can utilize a very refined, exhaustive, and reliable method <span class="referencia">[6-21].</span> <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Finally, knowing the precise location of physiological, type I, EBD (i.e., skeletal muscle, conjunctival mucosa, and right emisphere of individuals CAEMH-positive), doctor recognizes more quickly the type I, subtype a) and b), newborn-pathological EBD.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">At this point, reader has to take into account that pathological EBD can transform in physiological type, reducing contemporaneously their number, under efficacious therapy (diet, ethimologically speaking (= BMI about 25, physical exercise, avoiding tobacco smoking, a.s.o.), Melatonin, personalized applications of NIR-LED, a.s.o.), thus ameliorating local microcirculatory blood-flow (= pH), evaluated as duration of latency time and reflex lasting.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">It is well known for many years that patients with coronary heart disease may have no symptoms <span class="referencia">[20, 22]</span>, and that the electocardiographic feature of ischaemia may be induced by exercise without accompanying angina <span class="referencia">[22]</span>. Nevertheless, such "silent ischaemia" has only recently been recognized to be an important feature of ischaemic heart disease <span class="referencia">[7, 18]</span>. The silent ischaemia prevalence is unknown, although over a quarter of myocardial infarctions are unrecognized and half of them cause no symptoms at all <span class="referencia">[14]</span>. According to Cohn, there are three categories of people with silent ischaemia, who may be at such risk <span class="referencia">[5]</span>. People of type 1° have no symptoms and no history of myocardial infarction or angina; those of type 2° are symptomless survivors of myocardial infarction; fìnally, patients of type 3° have angina together with episodes of silent ischaemia, whose mechanisms in most cases are obscure.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">My data suggest that quantum-biophysical-semeiotic methods, illustrated above, are reliable, helpful, and then advisable in bed-side detecting individuals, even asymptomatic, who have to undergo, promptly and rationally, whatever stress testing, such as electrocardiographic exercise test, atrial pacing, thallium stress redistribution scintigraphy, exercise radionuclide ventriculography, and spiral CT, a.s.o., during which silent ischaemia usually may be elicited, corroborating bedside diagnosis <span class="referencia">[1, 2, 21]</span>. Furthermore, the clinical, quantum-biophysical-semeiotic selection of asymptomatic patients is interesting, because it can be applied on very large scale, helping doctors in actively searching for ischemic heart disease, particularly serious when silent, from the clinical viewpoint. As a matter of facts, a lot of data suggest that episodic, silent ischemia carries a poor prognosis in stable coronary artery disease <span class="referencia">[3, 23]</span>.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Given the accumulating evidence that ischemia, whether silent or not, carries a poor prognosis in patients with known coronary artery disease, it is justifìed to follow an active policy even in patients who are totally free of symptoms <span class="referencia">[4, 22]</span>. Essentially, the rationale for the use of histangioprotective drugs (like L-Carnitine, Co Q10, Coniugated-Melatonin, a.s.o.), associated with personalized applications of NIR-LED, in patients with ischemic heart disease clinically silent.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Three necessary premises:<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Firstly, the favourable effects of these products on lipid and glucose metabolism, ameliorating mitochondrial respiratory chain, I illustrated previously <span class="referencia">[14, 20-24]</span>.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Secondly, the positive influence of these drugs on angina pectoris as well as on myocardial ischaemic preconditioning, because they improve blood flow in cardiac tissue microcirculatory units <span class="referencia">[8, 9, 20, 23]</span>.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Thirdly, when utilized in early stage, histangio-protective drugs can ameliorate coronary microcirculatory remodelling, e.g., lowering the number of newborn-pathological type I, subtype b) EBD: the intensity of specific middle ureteral reflex significantly decreases under such treatment <span class="referencia">[23]</span>.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Practically, in order to ascertain clinically silent ischaemia it is advisable to assess shape and intensity of low ureteral reflex oscillations, i.e. vasomotion, as illustrated above, which permits doctor to calculate the fractal dimension of myocardial microvessels deterministic chaos (NN > 3 < oscillation =" 3/1"></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">As far as myocardial ischaemic preconditioning is concerned, it is suffìcient and hence advisable in day-to-day practice to assess the latency time of the second heart-gastric aspecific reflex, i.e., in the second evaluation, performed exactly after 5 sec. interruption, namely soon after 5 sec. from the end of basal evaluation: in health, latency time raises in a significant manner from 8 sec. (basal value) to 16 sec., i. e., to doubly value.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Another difficult, but also refined, elegant method proved to be reliable: the assessment of shortening of left ventricle enlargement duration during the above-described test (NN = from 7 sec. to 5 sec.) and/or conversely the prolonged latency time from 3 sec. to 5 sec. or more, preceding another ventricle dilation, paralleling Ejection Fraction of left ventricle. This latter evaluation, however, is a little more difficult to ascertain by doctors not experienced and skilled in the field of the original semeiotics.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">From the practical view-point, both duration (NN <> 3 sec. < class="referencia">[</span>7-10<span class="referencia">]</span>.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Actually, relevant data are easily obtained also by means of the latency time of heart-caecum and/or-aspecific gastric reflex, which informs about myocardial oxygen supply: in health, during “mean” digital pressure upon the skin projection area of heart, basal latency time value is 8 sec. However, doctor must remember that in case of CAD inherited real risk and CAD initial stage, such as parameter value is still normal (NN = 8 sec.), but reflex lasts 4 sec. or more (NN <></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">In addition, in health, during "intense" digital pressure upon cutaneous projection area of the heart, as above described, and immediately after about 7 sec. apnea test or Valsalva's manoeuvre, the basal latency time of cardiac-gastric aspecific reflex (basal value = 8 sec.) raises significantly to 16 sec., as well as after preconditioning (i.e., doubly value) (p<0,02),></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">In conclusion, in a long, well-established, clinical experience, the above-described quantum-biophysical-semeiotic methods proved to be reliable, easy to perform on very large scale, useful, and suitable for detecting ischemic coronary disease, even clinically silent or really initial, i.e. since CAD “real risk” <span class="referencia">[23]</span>. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Finally, Quantum-biophysical Semeiotics allows doctor to bedside recognize, in only one second, normal heart, as well as arteries <span class="referencia">[23,24-27]</span>: in health, “intense” digital pressure, applied upon skin projection area of the heart and respectively of a large artery, does not bring about “simultaneously” gastric aspecific reflex.<o:p></o:p></span></p> <p class="texto" style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="texto" style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><b style=""><span style="" lang="EN-GB">References<o:p></o:p></span></b></p> <p class="texto" style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><b style=""><span style="" lang="EN-GB"><o:p> </o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">1. Hammersen F (1968). Zur ultrastruktur der arterio-veno¨sen anastomosen. In: Hammersen F, Gross D (eds). Die Arterio-venoesen Anastomosen Anatomie, Physiologie, Pathologie, Klinik. Verlag Hans Hubert: <st1:city st="on">Bern</st1:City> und <st1:place st="on"><st1:city st="on">Stuttgart</st1:City></st1:place>. pp 24–37.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">2. Bailey I.K.,Griffìth L.S.C., Rouleau J,Strauss H.W., Pitt B., ThalUum201 myocardial perfusion imaging at rest and during exercise. Comparative sensitivity to electrocardiography in coronary artery disease, Circulation, 1977, 55, 79.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">3. Bonow R.O., Bacharach S.L., Gren M.V., <st1:personname productid="La Fremere R.L" st="on">La Fremere R.L</st1:PersonName>., Ehstein S.E., Prognostic implicaiions of symptomatic versus asymtomatic (silent) myocardial ischemia induced by exercise in mild symptomatic and in asymptomatic patients with angiographically dociimented coronary artery diseas, Am. J. Cardio!., 1987, 60, 77.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;">4. <span class="bibliografia">Curri S.B. Le Microangiopatie. Inverni della Beffa, Milano, 1986.</span> </p> <p class="MsoNormal" style="text-align: justify;">5. <span class="bibliografia">Curri S.B. Pannicolopatia Mammaria da Stasi, Parte seconda. Inverni della Beffa, Milano, 1984</span></p> <p class="MsoNormal" style="text-align: justify;"><span class="bibliografia">6. </span><span style="">Stagnaro Sergio.</span> <a name="911"><span class="maintextmodulestrong"><span style="" lang="EN-GB">Newborn-pathological Endoarteriolar Blocking Devices in Diabetic and Dislipidaemic Constitution and Diabetes Primary Prevention.</span></span></a><span class="maintextmodulestrong"><span style="" lang="EN-GB"> </span></span><span class="maintextmoduleitalic"><i><span style="" lang="EN-GB">The Lancet</span></i></span><span class="maintextmoduleitalic"><span style="" lang="EN-GB">. </span></span><span class="maintextmodule1"><span style="" lang="EN-GB">March 06 2007. </span></span><span style="" lang="EN-GB"><a href="http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?totalcomments=1">http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?totalcomments=1</a><span class="bibliografia"> and especially: </span><a href="http://www.fce.it/">www.fce.it</a>, <a href="http://www.fceonline.it/docs/stagnaro.pdf">http://www.fceonline.it/docs/stagnaro.pdf</a><span class="bibliografia"><o:p></o:p></span></span></p> <p class="texto" style="margin: 0cm 0cm 0.0001pt; text-align: justify;">7. <span class="bibliografia">Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. Travel Factory, Roma, 2004.</span> <span class="vinculochiquito"><a href="http://www.travelfactory.it/">http://www.travelfactory.it</a> <o:p></o:p></span></p> <p class="texto" style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span class="vinculochiquito">8. </span><span class="bibliografia">Stagnaro Sergio. Teoria Patogenetica Unificata, 2006, Ed. Travel Factory, Roma.<o:p></o:p></span></p> <p class="texto" style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span class="bibliografia"><span style="" lang="EN-GB">9.</span></span><span style="" lang="EN-GB"> Stagnaro Sergio. Role of Coronary Endoarterial Blocking Devices in Myocardial Preconditioning -c007i. Lecture, V Virtual International Congress of Cardiology. http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php<br />10. </span>Stagnaro S., Stagnaro-Neri M., Single Patient Based Medicine.La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. Ed. Travel Factory, Roma, 2005. http://www.travelfactory.it<br />11. Stagnaro Sergio. <span style="" lang="EN-GB">New bedside way in Reducing mortality in diabetic men and women. Ann. Int. Med. http://www.annals.org/cgi/eletters/0000605-200708070-00167v1<br />12. Stagnaro Sergio. Newborn-pathological Endoarteriolar Blocking Devices in Diabetic and Dislipidaemic Constitution and Diabetes Primary Prevention. The Lancet. March 06 2007. <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?totalcomments=1">http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?totalcomments=1</a><o:p></o:p></span></p> <p class="texto" style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style="" lang="EN-GB">13. <span style="">Stagnaro Sergio.</span> Epidemiological evidence for the non-random clustering of the components of the metabolic syndrome: multicentre study of the Mediterranean Group for the Study of Diabetes. <i style="">Eur J Clin Nutr. </i>2007 Sep;<span class="volume">61</span>(<span class="issue">9</span>):<span class="pages">1143-4</span>. Epub 2007 Feb 7. <b>[MEDLINE]</b><span style=""> </span><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">14. Stagnaro-Neri M, Stagnaro S., Deterministic chaotic biological system: the microcirculatory bed, Gazz. Med. It.-Arch. Sci. Med., 1994, 153, 99.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">15. Stagnaro S., Moscatelli G., Biophysical Semeiotics, Deterministic Chaos and Biological System, Gazz. Med. It. Arch. Sci . Med. 1996, 155, 125.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">16. Stagnaro-Neri M., Stagnaro S., Auscultatory percussion evaluation of arteriovenous anastomoses dysfunction in early arteriosclerosis, Acta Medica Mediterranea, 1989, 5, 141.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">17. Stagnaro-Neri M., Stagnaro S., Deterministic Chaos, Preconditioning and Myocardial Oxygenation evaluated clinically with the aid of Biophysical Semeiotics in the Diagnosis of ischaemic Heart Disease even silent. </span>Acta Med. Medit. 13, 109, 1997.</p> <p class="MsoNormal" style="text-align: justify;">18. <span class="bibliografia">Stagnaro-Neri M., Stagnare S., La manovra di Ferrero-Marigo nella diagnosi clinica di Iperinsulinemia - Insulinoresistenza, Acta Med. </span><span class="bibliografia"><span style="" lang="EN-GB">Medit., 1997, 13, 15.</span></span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="texto" style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style="" lang="EN-GB">19. <span style="">Stagnaro Sergio.</span> Role of Coronary Endoarterial Blocking Devices in Myocardial Preconditioning - c007i. <i>Lecture</i>, V Virtual International Congress of Cardiology, 2007. <a href="http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php"><span style="font-size: 10pt; font-family: Verdana;">http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php</span></a><o:p></o:p></span></p> <p class="texto" style="margin: 0cm 0cm 0.0001pt; text-align: justify;">20. <span class="bibliografia">Stagnaro S., Stagnaro-Neri M., <st1:personname productid="La Melatonina" st="on">La Melatonina</st1:PersonName> nella Terapia del Terreno Oncologico e del “Reale Rischio” Oncologico. Ed. Travel Factory, Roma, 2004.<o:p></o:p></span></p> <p class="texto" style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span class="bibliografia">21. Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico-Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. </span><span class="bibliografia"><span style="" lang="EN-GB">Ed. Travel Factory, Roma, 2004.<o:p></o:p></span></span></p> <p class="texto" style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style="" lang="EN-GB">22. <span class="bibliografia">Wood P., Me Gregor M., Magidson O., Writteker W. The effort test in angina pectoris, Br. </span></span><span class="bibliografia">Heart J., 1950, 12, 363.<o:p></o:p></span></p> <p class="texto" style="margin: 0cm 0cm 0.0001pt; text-align: justify;">23. <span class="bibliografia">Stagnaro Sergio. Il “Reale Rischio” Semeiotico-Biofisico. Ruolo diagnostico e fisiopatologico dei Dispositivi Endoarteriolari di Blocco, neoformati patologici tipo I, sottotipo a) e b). Ed. Travelfactory, Roma, <i style="">in press</i>.</span><span class="bibliografia"><span style="font-family: Verdana;"><o:p></o:p></span></span></p> <p class="texto" style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span class="bibliografia">24. Stagnaro S., Stagnaro-Neri M., <st1:personname productid="La Melatonina" st="on">La Melatonina</st1:PersonName> nella Terapia del Terreno Oncologico e del “Reale Rischio” Oncologico. Ed. Travel Factory, Roma, 2004. <o:p></o:p></span></p> <p class="texto" style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span class="bibliografia">25. </span><span style="font-size: 10pt; font-family: Verdana;">Stagnaro Sergio.</span><span style="font-size: 10pt; font-family: Verdana;"> Diagnosi clinica di cuore sano in un secondo! 7 Aprile 2008. <span style=""><a href="http://www.fce.it/" target="_blank">www.fce.it</a><b> </b></span><a href="http://www.fcenews.it/index.php?option=com_content&task=view&id=1218&Itemid=47" target="_blank">http://www.fcenews.it/index.php?option=com_content&task=view&id=1218&Itemid=47</a><o:p></o:p></span></p> <p class="texto" style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span class="bibliografia"><span style="" lang="EN-GB">26. </span></span><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Stagnaro Sergio.</span><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB"> <a name="1433">Bedside Biophysical-Semeiotic Osteocalcin Test in Diagnosing and Monitoring Diabetes.</a><span style=""> </span>The Lancet, <st1:date month="1" day="28" year="2008" st="on"><span class="maintextmodule">January 28, 2008</span></st1:date><span class="maintextmodule">.</span><br /></span><span style="font-size: 10pt; font-family: Verdana;"><a href="http://www.thelancet.com/journals/lancet/article/PIIS0140673608601014/comments?action=view&totalComments=2" target="_blank"><span style="" lang="EN-GB">http://www.thelancet.com/journals/lancet/article/PIIS0140673608601014/comments?action=view&totalComments=2</span></a></span><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">; See especially, <a href="http://www.fceonline.it/docs/stagnaro.pdf">http://www.fceonline.it/docs/stagnaro.pdf</a></span><span class="bibliografia"><span style="" lang="EN-GB"><o:p></o:p></span></span></p> <span style="font-size: 12pt; font-family: "Times New Roman";">27. </span><span style="font-size: 10pt; font-family: Verdana;">Stagnaro Sergio.<span class="maintextmodulestrong"><b> </b></span></span><span style="font-size: 10pt; font-family: Verdana;">Semeiotica Biofisica Quantistica: Diagnosi Clinica di Melanoma a partire dal suo Reale Rischio Congenito. <a href="http://www.fcenews.it/" target="_blank">www.fcenews.it</a>, 23 luglio 2008, </span><span style="font-size: 12pt; font-family: Verdana;"><a href="http://www.fcenews.it/index.php?option=comcontent&task=view&id=1599&Itemid=45" target="_blank"><span style="font-size: 10pt;">http://www.fcenews.it/index.php?option=comcontent&task=view&id=1599&Itemid=45</span></a></span>Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com1tag:blogger.com,1999:blog-8814429923003909469.post-72204502479608749972009-05-21T00:43:00.000-07:002009-05-21T00:47:39.418-07:00Biophysical-Semeiotic Bed-Side Evaluation of Endothelial Function<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwbhFrD_wNw9GMBJIPRlw3kGe8iQf68LVDfyQLBoUuGjrSTgU3F5w-s1qOhaKy3bYqrQBt1BZwcqiN2JeqK0Jqc_RCsVYTzJwZGIXRAPrvFeE12h7OcBqa3FxA1Yw6WNdtr-N8292f7PCf/s1600-h/sergio17.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 134px; height: 200px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhwbhFrD_wNw9GMBJIPRlw3kGe8iQf68LVDfyQLBoUuGjrSTgU3F5w-s1qOhaKy3bYqrQBt1BZwcqiN2JeqK0Jqc_RCsVYTzJwZGIXRAPrvFeE12h7OcBqa3FxA1Yw6WNdtr-N8292f7PCf/s200/sergio17.jpg" alt="" id="BLOGGER_PHOTO_ID_5338180022512212274" border="0" /></a> <p class="MsoBodyText" style="text-indent: 35.45pt;"><b style=""><span lang="EN-GB">Introduction.<o:p></o:p></span></b></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><b style=""><span lang="EN-GB"><o:p> </o:p></span></b></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span lang="EN-GB">It is generally admitted that endothelial dysfunction is an important factor in both the onset and the development of atherosclerosis, as I demonstrated<span style=""> </span>in earlier papers two decades ago, from the clinical view-point (1-6). </span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span lang="EN-GB">In fact, endothelium plays a pivotal role in the maintenance of vascular tone, taking part to the blood flow regulation in response to changes in tissue and organ perfusion requirements (5,6). When blood flow increases through a vessel, such as vessel dilates: from quantum-biophysical-semeiotic view-point, under such as condition, suddenly the enhancement occurs of both arterial-“in toto” ureteral reflex and arterial-gastric aspecific reflex (Fig.1), the latter easier to be assessed, (See <a href="http:///">http://</a><a href="http://www.semeioticabiofisica.it/">www.semeioticabiofisica.it</a>). </span></p> <p class="MsoBodyText"><span lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoBodyText" style="text-align: center;" align="center"><span lang="EN-GB">Fig.1</span></p> <p class="MsoBodyText" style="text-align: center;" align="center"><i><span lang="EN-GB">Gastric aspecific reflex ( in the stomach both fundus and body are dilated, while antral-pyloric region contracts) caused by digital pressure, applied on brachial artery of a patients in supine position, at rest.<o:p></o:p></span></i></p> <p class="MsoBodyText"><span lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span lang="EN-GB">One speaks of the phenomenon called flow-mediated dilatation (FMD). Over the past decade, a clinical quantum-biophysical-semeiotic technique has evolved to evaluate both flow-mediated vasodilation (FMD) and acethylcholine-mediated vasodilation (= Valsalva’s Manoeuvre), an important endothelium-dependent function, assessed, for instance, in the brachial artery (See <span style=""> </span>website <a href="http://%20hyperlink/">http://<span style="">www.semeioticabiofisica.it/microangiologia</span></a>). </span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span lang="EN-GB">In health, these stimuli provoke the endothelium to release free radical nitric oxide (NO), probably also by means of PPARS action (22), with subsequent vasodilation that can be assessed and quantified at the bed-side in different ways, as an index of vasomotor function. This technique is attractive because it is non-invasive and allows repeated measurements on very large scale. An increase in flow through the brachial artery can be induced by causing post-ischemic dilation in the downstream vascular bed of the distal forearm, that can be achieved by inflating a cuff placed around the forearm to supra-systolic pressure producing an ischemia in the distal vascular bed. </span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span lang="EN-GB">Really more simple, easier, faster to be performed, and, therefore, preferable in day-to-day practice, is the following bed-side manoeuvre: doctor applies an “intense”, obstructive digital pressure upon brachial artery, and immediately assesses the intensity of gastric aspecific reflex (or “in toto” ureteral reflex): NN = no aspecific gastric reflex happens.</span></p> <p class="MsoBodyText"><span lang="EN-GB"><span style=""> </span>On the contrary, in Arterioscleotic Constitution as well as in overt arteriopathy, of whatever nature the reflex intensity is <st1:metricconverter productid="0,5 cm" st="on">0,5 cm</st1:metricconverter>. or more, in relation ti the severity of underlying disorder (Fig.1) </span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span lang="EN-GB">After the rapid with-drawl of digital pressure (or of the cuff pressure), a sudden increase of blood flow through the dilated vascular bed occurs, due to flow-mediated<sup> </sup>vaso-dilation. Firstly, physiologically the reflex disappears rapidly, and soon thereafter, a further reflex occurs spontaneously, showing a three times higher intensity. </span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span lang="EN-GB">In health, the significant increase in shear stress in the down-stream artery causes a NO-dependent dilation of the brachial artery, that can be evaluated clinically also in a different way, i.e., paralleling the basal value of finger pulp-gastric aspecific reflex, evaluated as latency time (in health, <b>8 sec.,</b> if digital pressure upon finger-pulp is “mean intense”) with the second value, which increases to <b>16 sec.,</b> i.e., doubled value.</span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span lang="EN-GB">The arterial dilator response to shear-stress can be almost completely blocked by pre-treatment with nitric oxide synthase inhibitors (7, 8) and therefore it has been suggested that the phenomenon is predominantly due to endothelial release of radical nitric oxide. In fact, the endothelium can no longer be viewed as a static physical<sup> </sup>barrier that simply separates blood from tissue. It is evident<sup> </sup>that disturbed endothelial function may be an early marker of<sup> </sup>an ongoing atherosclerotic process. Thus, inherited endothelial dysfunction<sup> </sup>has increasingly been recognized to play an important role in<sup> </sup>a number of conditions associated with a high prevalence of<sup> </sup>atherosclerotic CVDs (1-6), according to my Microvascular Arteriosclerosis Theory (partly illustrated in above-cited website, URL </span></p> <p class="MsoBodyText"><span lang="EN-GB"><a href="http://www.semeioticabiofisica.it/microangiologia/Documenti/Eng/A%20Stadio%20preipertensiv%25">http://www.semeioticabiofisica.it/microangiologia/Documenti/Eng/A%20Stadio%20preipertensiv%</a>.</span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span lang="EN-GB">A 53-year-long “clinical” experience allows me to state that endothelial function assessed by this method correlates significantly with invasive testing of coronary endothelial function (7, 9) and with the severity and extent of coronary atherosclerosis (10). </span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span lang="EN-GB">Interestingly, at this point, coronary artery endothelial function can analogously be easily evaluated by means of Quantum-Biophysical Semeiotics (1, 2, 11). The precise mechanisms for the acute detection of shear forces and subsequent signal transduction to modulate vasomotor tone are not fully understood. The endothelial cell membrane contains specialized ion channels, such as calcium-activated potassium channels, that open in response to shear stress (5). The effect of potassium channel opening is to hyperpolarize the endothelial cell, increasing the driving force for calcium entry (there are no voltage-gated calcium channels in endothelial cells). Calcium activates an enzyme, endothelial nitric oxide synthase (eNOS), and the subsequent generation of NO appears to account for FMD (6).</span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span lang="EN-GB">In humans, the measurement of FMD has been widely adopted to explore endothelial function. However, a number of variations of the method have been described. Cuff placement above or below the scanned part of the artery has been described, and varying duration and pressures for cuff inflation have been used. The brachial artery has been the target artery in most studied, but radial and femoral arteries have also been measured (7). Due to these technical modifications, the normal ranges established in some laboratories differ from normal ranges observed in others (7-8). </span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span lang="EN-GB">In my long clinical experience, Valsalva’s manoeuvre proved to be quiet practical, easy, reliable, and useful, lasting <b>only 5 sec</b>.: in health, manoeuvre-dependent acetylcholine secretion brings about notoriously smooth muscle cells relexation, in the identical way, illustrated above. </span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span lang="EN-GB">In my opinion, based on a large number of clinical quantum-biophysical-semeiotic observations, underlying patho-physiological action mechanism of acetylcholine are more complex, acting favourably also on healthy microcirculation, increasing both vasomotility and vasomotion.</span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span lang="EN-GB">On the contrary, in case of DM,<span style=""> </span>dyslipidaemia, arterial hypertension, a.s.o., doctor mainly either does not observe any change or worsening condition, in relation to the severity of underlying disorder. Diet, ethimologically speaking, and physical exercise (walkig 45 minutes/day, 120 steeps/min), Coniugated Melatonin, improve in general endothelial function rapidly, according to other authors (12). </span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span lang="EN-GB">In addition, melatonin-adenosine, a potent histangioprotective substance (21, 23), in my experience proved to increase vasomotility and vasomotion in the microcirculatory bed of both tissue, and arterial wall.</span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span lang="EN-GB"><span style=""> </span>On contrast, FMD is inversely correlated with age, type 2 diabetes mellitus, dyslipidaemia, hypertension, and tobacco smoking: smokers have decreased FMD (1-6). </span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span lang="EN-GB">In addition, inactivation of endothelium-derived nitric oxide due to increased production of oxygen free radicals in the vessel wall is thought to be an important mechanism for endothelial dysfunction (13, 14-23). </span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span lang="EN-GB">As a result, much interest has focused on antioxidants, such as vitamin E, vitamin C, and other free radical scavengers, like melatonin, as I demonstrated previously, for the first time “clinically” (14-27), since they remove successfully free radicals and, therefore, improve endothelial function. </span></p> <p class="MsoBodyText"><span lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal">*<b style=""><span style=";font-family:Arial;font-size:10;" > Sergio Stagnaro MD<o:p></o:p></span></b></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" >Via Erasmo Piaggio 23/8, CP. 42</span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" >16039 Riva Trigoso (<st1:city st="on">Genoa</st1:city>) <st1:place st="on"><b style="">Europe</b></st1:place></span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" >Founder of Quantum Biophysical Semeiotics</span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" >Who's Who in the World (and <st1:place st="on"><st1:country-region st="on">America</st1:country-region></st1:place>)</span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" >since 1996 to 2009<o:p></o:p></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" >Ph 0039-0185-42315<o:p></o:p></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" >Cell. 3338631439</span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" ><a href="http://www.semeioticabiofisica.it/"><span style="" lang="EN-GB">www.semeioticabiofisica.it</span></a></span><span style=";font-family:Arial;font-size:10;" > </span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoBodyText"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" ><a href="mailto:dottsergio@semeioticabiofisica.it">dottsergio@semeioticabiofisica.it</a></span><span style=""><o:p></o:p></span></p> <p class="MsoBodyText"><span style=""><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><strong><span style="">References<o:p></o:p></span></strong></p> <p class="MsoNormal" style="text-align: justify;"><strong><span style=""><o:p> </o:p></span></strong></p> <p class="MsoNormal">1) Stagnaro S., Stagnaro-Neri M., Basi microcircolatorie della semeiotica biofisica. Atti del XVII Cong. Naz. Soc. Ital. Studio Microcircolazione, Firenze ott. 1995, Biblioteca Scient. Scuola Sanità Militare, 1995, 2, 94.<span style="color:red;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="">2) </span><span style="">Stagnaro-Neri M., Stagnaro S., Semeiotica Biofisica: valutazione della compliance arteriosa e delle resistenze arteriose periferiche. Atti del XVII Cong. Naz. Soc. Ital. Studio Microcircolazione, Firenze Ott. 1995, Biblioteca Scient. Scuola Sanità Militare, 2, 93.<o:p></o:p></span></p> <p class="MsoNormal" style=""><span style="">3) Stagnaro-Neri M., Stagnaro S., Auscultatory Percussion Evaluation of<span style=""> </span>Arterio-venous Anastomoses Dysfunction in early Arteriosclerosis. Acta Med. Medit. 5, 141</span>, <span style="">1989</span></p> <p class="MsoNormal" style="text-align: justify;"><span style="">4) </span>Stagnaro-Neri M., Stagnaro S. Indagine clinica percusso-ascoltatoria delle unità microvascolotessutali della plica ungueale. <span style="" lang="EN-GB">Acta Med. Medit. </span>4, 91<b><span style="">, </span></b><span style="">1988<b>.</b><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="">5) </span><span style="">Il test della Apnea nella Valutazione della Microcircolazione cerebrale Stagnaro S., Stagnaro-Neri M., in Cefalalgici. Atti, Congr. Naz. Soc. Ita. Microangiologia e Microcircolazione. A cura di C. Allegra. Pg. 457, Roma 10-13 Settembre 1987. Monduzzi Ed. Bologna<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="">6) Stagnaro S., Valutazione percusso-ascoltatoria della microcircolazione cerebrale globale e regionale. Atti, XII Congr. Naz. Soc. It. di Microangiologia e Microcircolazione. 13-15 Ottobre, Salerno, e Acta Medit. </span><span style="" lang="EN-GB">145, 163, 1986.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">7) </span><span style="" lang="EN-GB">Joannides R, Haefeli WE, Linder L, et al. Nitric oxide is responsible for flow-dependent dilatation of human peripheral conduit arteries in vivo. Circulation 1995;91:1314-19.<br />8) Agewall S, Hulthe J, Fagerberg B, et al. Post-occlusion brachial artery vasodilatation after ischaemic handgrip exercise is nitric oxide mediated. Clin Physiol Funct Imaging 2002;22:18-23.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="FR">9) Takase B, Uehata A, Akima T, et al. </span><span style="" lang="EN-GB">Endothelium-dependent flow-mediated vasodilation in coronary and brachial arteries in suspected coronary artery disease. Am J Cardiol 1998;82:1535-39.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="DE">10) Neunteufl T, Katzenschlager R, Hassan A, et al. </span><span style="" lang="EN-GB">Systemic endothelial dysfunction is related to the extent and severity of coronary artery disease. Atherosclerosis 1997;129:111-18.<br />11) </span><span style="" lang="EN-GB">Stagnaro S. A clinical efficacious maneouvre, reliable in bed-side diagnosing coronary artery disease, even initial or silent, as well as "heart coronary risk". 3rd Virtual International Congress of Cardiology, FAC, 2003,<span style=""> </span></span><span style=""><a href="http://www.fac.org.ar/tcvc/marcoesp/marcos.htm"><span style="" lang="EN-GB">http://www.fac.org.ar/tcvc/marcoesp/marcos.htm</span></a></span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" > </span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span style="" lang="EN-GB">12) </span><span lang="EN-GB" style="color:black;">Sowers JR, Lester MA. Diabetes and cardiovascular disease. Diabetes Care. 1999;22(suppl 3):C14-C20. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">13) Ohara Y, Peterson TE, Zheng B, Kuo JF, <st1:place st="on">Harrison</st1:place> DG. Lysophosphatidylcholine increases vascular superoxide anion production via protein kinase C activation. </span><span style="">Arterioscler Thromb 1994;14:1007-13.<br />14) </span><span style="">Stagnaro-Neri M., Stagnaro S., Amlodipina: Calcio-Antagonista e Scavenger dei Radicali Liberi. Tec. 4, 43, 1993.</span><span style=""><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="">15)</span><span style=""> Stagnaro-Neri M., Stagnaro S., Ketanserina: antagonista dei recettori 5Ht2-serotoninergici e scavenger dei radicali liberi. </span><span style="" lang="EN-GB">Clin. Ter. 141, 465, 1992 </span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" ><span style=""> </span><b>[MEDLINE]</b></span><span style="color: rgb(51, 102, 255);" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="">16) </span><span style="">Stagnaro-Neri M., Stagnaro S., Radicali liberi e alterazioni del microcircolo nelle flebopatie ipotoniche costituzionali. Min. Angiol. 18, Suppl. 2 al N. 4, 105, 1993.</span><span style=""><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="">17) </span><span style="">Stagnaro Stagnaro-Neri M., Stagnaro S., Silimarina: un potente scavenger dei radicali liberi. Studio clinico percusso-ascoltatorio. Epat. 38, 3, 1992.</span><span style=""><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="">18) </span><span style="">Stagnaro<span style=""> </span>S., Stagnaro-Neri M. Il danno da radicali liberi sul microcircolo. Congr. Naz. SISM., Milano,10 giugno,1991, Comun. Atti, Min. Angiologica, Suppl. 1, N°1 16,398,1991</span><span style=""><o:p></o:p></span></p> <p class="MsoNormal">19) <span style="">Stagnaro-Neri M., Stagnaro S., Acidi grassi </span><span style="font-family:Symbol;"><span style="">w</span></span><span style="">-3, scavengers dei radicali liberi e attivatori del ciclo Q e della sintesi del Co Q10. </span><span style="" lang="EN-GB">Gazz. Med. It. – Arch. Sc. Med. 151, 341, 1992 <b><span style="color: rgb(51, 102, 255);">(Infotrieve)<o:p></o:p></span></b></span></p> <p class="MsoNormal"><span style="">20) </span><span style="">Stagnaro Sergio, Stagnaro-Neri Marina.<b> </b>Introduzione alla Semeiotica Biofisica. Il Terreno oncologico”. </span><span style="" lang="EN-GB">Travel Factory SRL., Roma, 2004. </span><a href="http://www.travelfactory.it/semeiotica_biofisica.htm">http://www.travelfactory.it/semeiotica_biofisica.htm</a></p> <p class="MsoNormal">21) Stagnaro S., Stagnaro-Neri M., <st1:personname productid="La Melatonina" st="on">La Melatonina</st1:personname> nella Terapia del Terreno Oncologico e del “Reale Rischio” Oncologico. <span style="" lang="EN-GB">Ediz. Travel Factory, Roma, 2004.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">22) </span><span style="" lang="EN-GB">John A. Polikandriotis; Louis J. Mazzella; Heidi L. Rupnow; C. Michael Hart <o:p></o:p></span></p> <p class="MsoNormal"><em><span style="font-style: normal;" lang="EN-GB">Arteriosclerosis, Thrombosis, and Vascular Biology.</span></em><span style="" lang="EN-GB"> 2005;25: 1810.</span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span style="" lang="EN-GB">23) </span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" >Stagnaro Sergio</span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" > Endothelial cell function can ameliorate under safer drugs, such as Melatonin-Adenosine. BMC <i>Cardiovascular disorders</i>. 2004. </span><span style=";font-family:Verdana;font-size:10;" ><a href="http://www.biomedcentral.com/1471-2261/4/4/comments"><span style="" lang="EN-GB">http://www.biomedcentral.com/1471-2261/4/4/comments</span></a><o:p></o:p></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" >24) <span style="">Stagnaro Sergio.</span> Role of Coronary Endoarterial Blocking Devices in Myocardial Preconditioning - c007i. <i>Lecture</i>, V Virtual International Congress of Cardiology, 2007. </span><span lang="EN-GB" style="font-family:Verdana;"><a href="http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php"><span style="font-size:10;">http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php</span></a><o:p></o:p></span></p> <p class="MsoNormal"><span style="" lang="EN-GB">25) </span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" >Stagnaro Sergio.<b> </b></span><span style=";font-family:Verdana;font-size:10;color:red;" lang="EN-GB" > </span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" > Pre-Metabolic Syndrome and Metabolic Syndrome: Biophysical-Semeiotic Viewpoint. </span><span style=";font-family:Verdana;font-size:10;" ><a href="http://www.athero.org/" target="_blank"><span style="" lang="EN-GB">www.athero.org</span></a></span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" >, 29 April, 2009. <a href="http://www.athero.org/commentaries/comm904.asp" target="_blank"><span style="">http://www.athero.org/commentaries/comm904.asp</span></a></span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" >26) <span style="">Stagnaro Sergio.<b> </b></span><span style="color:red;"> </span> CAD Inherited Real Risk, Based on Newborn-Pathological, Type I, Subtype B, Aspecific, Coronary Endoarteriolar Blocking Devices. Diagnostic Role of Myocardial Oxygenation and Biophysical-Semeiotic Preconditioning. <a href="http://www.athero.org/" target="_blank"><span style="">www.athero.org</span></a>, 29 April, 2009 <a href="http://www.athero.org/commentaries/comm907.asp" target="_blank"><span style="">http://www.athero.org/commentaries/comm907.asp</span></a><o:p></o:p></span></p> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" >27) <span style="">Stagnaro Sergio.</span> Epidemiological evidence for the non-random clustering of the components of the metabolic syndrome: multicentre study of the Mediterranean Group for the Study of Diabetes. <i>Eur J Clin Nutr</i>. 2007 Feb 7; <b>[MEDLINE]</b></span><span style="" lang="EN-GB"><o:p></o:p></span></p> <span style=";font-family:";font-size:12;" lang="EN-GB" ><br /></span>Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-71419693566771016832009-05-19T02:55:00.000-07:002009-05-19T03:00:03.827-07:00Quantum-Biophysical-Semeiotic Hypertensive Constitution.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh1jPt03lnULEmMxlZfh0fLdrvEJQn12UYD2PnWinzkm4-zcYMkSLRkvSA8nFzVK_4_pEhJ_KgES1nj6GjBXI3L2bj0ikPXNXCRmTtcwMjRLJ-OdQ70zwSSmWMiBzCcy5Mx5PPjK-DY-6wv/s1600-h/diagramma_tacogramma.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 200px; height: 133px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEh1jPt03lnULEmMxlZfh0fLdrvEJQn12UYD2PnWinzkm4-zcYMkSLRkvSA8nFzVK_4_pEhJ_KgES1nj6GjBXI3L2bj0ikPXNXCRmTtcwMjRLJ-OdQ70zwSSmWMiBzCcy5Mx5PPjK-DY-6wv/s200/diagramma_tacogramma.jpg" alt="" id="BLOGGER_PHOTO_ID_5337471816635160226" border="0" /></a><br /><br /><h1><span lang="EN-GB">Abstract</span></h1> <p class="MsoNormal"><span style=";font-family:Verdana;font-size:9;" lang="EN-GB" >It's evident that neither all people become hypertensive nor all hypertensive patients are suffering from left ventricular impairment as well as from other well-known hypertension-dependent complications, regardless of environmental conditions. Indeed, the existence of biophysical-semeiotic hypertensive constitution accounts for the reason that only some individuals are hypertensive, and among them,<span style=""> </span>only those with real risk in well defined biological system, are involve by myocardial failure or by other known hypertension complications. In the article, bedside diagnosis of both biophysical-semeiotic hypertensive constitution and hypertension complication real risk is fully described.<o:p></o:p></span></p> <p class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal"><b><span style="" lang="EN-GB">Key Words.<o:p></o:p></span></b></p> <p class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal"><span style="" lang="EN-GB">Biophysical-Semeiotics. </span><span style="" lang="FR">Hypertensive Constitution.<span style=""> </span>Hypertension. Clinical Microcirculation.<o:p></o:p></span></p> <p class="MsoNormal"><span style="" lang="FR"><o:p> </o:p></span></p> <p class="MsoNormal"><span style="" lang="FR"><span style=""> </span><o:p></o:p></span></p> <h3 style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt; line-height: 200%;"><span style="" lang="EN-GB">Introduction.<o:p></o:p></span></h3> <p class="MsoNormal" style="text-indent: 35.45pt;"><u><span style="" lang="EN-GB"><o:p><span style="text-decoration: none;"> </span></o:p></span></u></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">In the primary prevention of arterial hypertension, based on the <i>pre-morbid, pre-metabolic stage</i> (See: Arteriosclerotic Constitution in the website <a href="http://www.semeioticabiofisica.it/">http://www.semeioticabiofisica.it</a>, <span style=""> </span>and particularly the URL <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><a href="http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Eng/Costituzione%20ipertensiva%25">http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Eng/Costituzione%20ipertensiv%</a>), we have to devote a particular discussion to <i>pre-hypertensive</i> state of arterial hypertension (AH), component of pre-metabolic, and obviously, metabolic syndrome, classic and “variant”, often associated to other human Congenital Acidosic Enzyme-Metabolic Histangiopathy-</span><span style="font-family:Symbol;"><span style="">a</span></span><span style="" lang="EN-GB"> (CAEMH-</span><span style="font-family:Symbol;"><span style="">a</span></span><span style="" lang="EN-GB">) -dependent diseases. CAEMH-</span><span style="font-family:Symbol;"><span style="">a</span></span><span style="" lang="EN-GB"> is a singular, functional mitochondrial cytopathy, inherited almost always by mother (1-3). For further information See above-cited website and Bibliography.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><span style=""> </span>Really, the <i>pre-hypertensive state</i> allowed me to define clinically the<b> hypertensive constitution</b>, discussed in this article.<b> <o:p></o:p></b></span></p> <p class="aL"><span style="" lang="EN-GB">In order to understand such as topic usefully, we must remember that the primary function of blood circulation as well as of complex mechanisms, which rule pressure values (i.e., cardiac out-put, peripheral arteriolar resistance, blood volume, arterial compliance), is represented by physiological tissue supply of material-information-energy (O<sub>2</sub>, various metabolites, enzymes, hormones, a.s.o.), and by catabolites removal, in particular CO<sub>2 </sub><span style=""> </span>and produkts of tissue secretion.<o:p></o:p></span></p> <p class="aL"><span style="" lang="EN-GB">Possible pH tissue variations bring about necessarily haemodinamic-haemorheological modificatioms, aiming to maintain metabolic “homeostasis” or, more exactly speaking, to keep in the normal ranges the physiological condition of deterministic chaos, both microvascular and parechymal, according to my Angiobiopathy theory (4).<o:p></o:p></span></p> <p class="aL"><span style="" lang="EN-GB">Notoriously, blood circulation influences cellular metabolism, which, in turn, interferes on the regulation of blood pressure complex mechanisms, as prostaglandyns synthesis, thromboxane, radical NO, vasoactive amines, neurotransmitters, a.s.o., beside pH oscillations, axones reflexes and baro-receptorial mechanisms.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">Our research data have, published in 1990, we demonstrated that Congenital Acidosic Enzyme-Metabolic Hystangiopaty-</span><span style="font-family:Symbol;"><span style="">a</span></span><span style="" lang="EN-GB"> (CAEMH-</span><span style="font-family:Symbol;"><span style="">a</span></span><span style="" lang="EN-GB">) represents the <i>conditio sine qua non</i> “also” of essential arterial hypertension, as we suggested for a lot of years, on the base od clinical evidence (1-4).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">On the other hand, all authors agree on the fundamental role played by “genetic factor” on the onset of arterial hypertension (4, 20-24).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">Analogously to diabetes mellitus, arteriosclerosis, malignancies, and all other severe human diseases, also in arterial hypertension it is possible to observe an early, <i>first stage</i>, clinically silent, although initial tissue hypoxic disorder, particularly in skeletric muscle, which we suggested to term <i>pre-hypertensive stage</i> (4), on the analogy of<span style=""> </span>what we wrote in the introductory article on <b style="">Quantum-<span style="">Biophysical-Semeiotic Constitutions</span></b> (5, 9).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">All individuals, which have suffered over the last years from an episode of the so-called “white-cloth” arterial hypertension (or have had arterial hypertension in the past, but now are normotensive) are under this condition, that takes a part of the so-called <st1:place st="on"><st1:placename st="on"><i>Grey</i></st1:placename><i> <st1:placename st="on">Zone</st1:placename></i></st1:place>, namely the site of primary prevention.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">However, nowadays, doctors belittle real significance of such hypertensive episodes, considered mainly as trivial and transitory consequence of commonplace neuro-hormonal reaction to stress situations, while they really represent the peak of an ice-berg, to which we have to pay all our attention and devote an accurate biophysical-semeiotic evaluation.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">In fact, in individuals CAEMH-</span><span style="font-family:Symbol;"><span style="">a</span></span><span style="" lang="EN-GB"> positive of great intensity, particularly if localized in microvascular, e.g., muscular tissue, the reaction of smooth muscle cells of resistance vessels (i.e., small arteries and arterioles, according to Hammersen) to vasomotor physiological stimuli appears clearly exceeding, as we will say later (4, 15, 32).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">In “initial” stage, however, such abnormal reaction can be still counterbalanced by vasodilation upward, i.e. in the <i>vasa publica,</i> according to Ratschow, and by blood re-distribution in various destricts, especially<span style=""> </span>in the splancnic territory. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">In other words, in <i>pre-clinical</i>, initial, <i>pre-hypertensive </i>stage, as well as in <b>hypertensive constitution</b>, blood pressure does not result increased at all – a part from episode of sympathetic hypertonus and/or Renine-Angiotensin-Aldosterone System (RAAS) – but peripheral blood supply is slightly “reduced”, causing tissue disorder, due to acidosis, as consequence of increased peripheral arteriolar resistances (PAR), which bring about elastic vessels dilation and opening of Arterio-Venous Anastomoses, functionally speaking, in always CAEM-</span><span style="font-family:Symbol;"><span style="">a</span></span><span style="" lang="EN-GB">-positive individuals (5, 9, 10).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <h3 style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><span style=""> </span><a name="_Toc114299977"><u>Methods.</u></a><u><o:p></o:p></u></span></h3> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <h5><span style="text-decoration: none;" lang="EN-GB">With the aid of <b>Biophysical Semeiotics</b> doctor can quickly recognize bedside such as special microcirculatory situation, e.g., in skeletric muscles by the method of the <i>preconditioning</i>.<o:p></o:p></span></h5> <h5><span style="text-decoration: none;" lang="EN-GB"><span style=""> </span>In healthy, at basal line, latency time of biceps muscle-gastric aspecific reflex (= in the stomach, both fundus and body dilate, while antral-pyloric junction contracts), when digital pressure stimulation is “mean-intense, results <b>8 sec.</b>, and it lasts for <b><> (= parameter value of paramount importance, duew to the fact that it is inversely correlated with Microcirculatory Functional Reserve), while at second evaluation, performed after 5 sec. exactly, latency time increases to </b></span><b><b><span style="text-decoration: none;font-family:Symbol;" ><span style="">³</span></span></b><b><span style="text-decoration: none;" lang="EN-GB"> 12 sec.</span></b><span style="text-decoration: none;" lang="EN-GB"><o:p></o:p></span></b></h5><b> </b><p class="aL"><span style="" lang="EN-GB"><b>On the contrary, in a subject with <b>hypertensive constitution </b>under identical experimental condition, basal latency time appears normal (NN = 8 sec.), but the duration results <b>4 sec. or more</b>, and it does not ameliorate or sometimes lowers in the second evaluation, <i>pathogical preconditioning</i>, in relation to the severity of hypertensive “real risk” itself, as a consequence of impaired Microcirculatory Functional Reserve (9) (For further technical information, See <o:p></o:p></b></span></p><b> </b><p class="aL" style="text-indent: 0cm;"><span style="" lang="EN-GB"><b><a href="http://www.semeioticabiofisica.it/microangiologia">http://www.semeioticabiofisica.it/microangiologia</a>). <b><o:p></o:p></b></b></span></p><b> </b><p class="aL"><span style="" lang="EN-GB"><b>In the <i>pre-hypertensive state</i>, which can last clinically silent years or decades, and, then, very difficult to recognize by physical orthodox semeiotics (21, <st1:metricconverter productid="26, in" st="on">26, in</st1:metricconverter> 4), doctor observes the typical microcirculatory metabolic abnormalities in <i>post-absorptive state</i>, i.e. at least 4 hours after meels, characterized by AL + PL duration (= duration of microcirculatory wave oscillation, which parallel ureteral reflexes) of pancreatic vasomotion (for instance, more easy to detect, duration of pancreatic body inferior margin lowering: see Technical Page <st1:metricconverter productid="5, in" st="on">5, in</st1:metricconverter> above-cited website) lasting more than those of muscular, hepatic and adipose tissues, evaluated by means of upper (vasomotility) and lower (vasomotion) reflex oscillations, during “light” stimulation of related trigger-points (Fig 1). <o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b>. </b></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><!--[if gte vml 1]><v:shapetype id="_x0000_t75" coordsize="21600,21600" spt="75" preferrelative="t" path="m@4@5l@4@11@9@11@9@5xe" filled="f" stroked="f"> <v:stroke joinstyle="miter"> <v:formulas> <v:f eqn="if lineDrawn pixelLineWidth 0"> <v:f eqn="sum @0 1 0"> <v:f eqn="sum 0 0 @1"> <v:f eqn="prod @2 1 2"> <v:f eqn="prod @3 21600 pixelWidth"> <v:f eqn="prod @3 21600 pixelHeight"> <v:f eqn="sum @0 0 1"> <v:f eqn="prod @6 1 2"> <v:f eqn="prod @7 21600 pixelWidth"> <v:f eqn="sum @8 21600 0"> <v:f eqn="prod @7 21600 pixelHeight"> <v:f eqn="sum @10 21600 0"> </v:formulas> <v:path extrusionok="f" gradientshapeok="t" connecttype="rect"> <o:lock ext="edit" aspectratio="t"> </v:shapetype><v:shape id="_x0000_i1025" type="#_x0000_t75" style="'width:203.25pt;" bordertopcolor="this" borderleftcolor="this" borderbottomcolor="this" borderrightcolor="this"> <v:imagedata src="file:///C:\DOCUME~1\SERGIO~1\IMPOST~1\Temp\msohtml1\01\clip_image001.jpg" title="diagramma_tacogramma"> <w:bordertop type="single" width="4"> <w:borderleft type="single" width="4"> <w:borderbottom type="single" width="4"> <w:borderright type="single" width="4"> </v:shape><![endif]--><!--[if !vml]--><b><img src="file:///C:/DOCUME%7E1/SERGIO%7E1/IMPOST%7E1/Temp/msohtml1/01/clip_image002.jpg" shapes="_x0000_i1025" border="0" height="194" width="273" /><!--[endif]--></b></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><o:p><b> </b></o:p></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>Fig.1<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoBodyTextIndent2" style="text-align: justify;"><span style="" lang="EN-GB"><b>The figure shows physiological vasomotion of all biological systems, assessed directly (e.g., as values of pancreas periodic, deterministic chaotic oscillations: lowering of inferior pancreatic margin) or indirectly as ureteral reflexes fluctuations, upper – vasomotility – and lower – vasomotion – brought about by “light” stimulation of related trigger-points, e.g., muscular and central, adipose tissue.<o:p></o:p></b></span></p><b> </b><p class="MsoBodyTextIndent2" style="text-align: justify;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="aL"><span style="" lang="EN-GB"><b>In other words, there is dissociation between insulin secretive-metabolic activity and that of “peripheral” tissues, indicating, in a refined biophysical-semeiotic manner, hyperinsulinaemia-insulinresistance: “classic” metabolic syndrome (5, 6, 10, 11, 12).<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>On the contrary, in the “variant” metabolic syndrome, the<span style=""> </span>AL + PL Phase of liver vaso-dynamics, under identical condition, i. e., in the <i>post-absorptive state</i>, results <i>lower</i> than those of adipose tissue, musculare tissue, and above all of pancreas, which is the most instense (AL + PL) of all<span style=""> </span>.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><span style=""><b> </b></span><b>In other words, in case of “variant” metabolic syndrome, exclusively hepatic insulin receptors are normally sensitive to the hormone, and, under the above-mentioned circumstance, i.e., after at least 4 hours after meels, insulin normally controls hepatic glucose secretion, but not the lipidic secretion from “central” adipose tissue<span style=""> </span>(13, 14).<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>At this point, it is necessary to underline that insulin secretion activity, if not properly ameliorated by diet, etymologically speaking, and/or histangioprotective drugs, such as coniugated melatonine can go on slowly towards progressive its insufficiency (6), characterized by gradual, before limited, and after widespread, changing of pancreatic beta-cell insulin activity<span style=""> </span>from type I, associated, (in which both vasomotility and vasomotion are intense: active hyperaemia), to type II, intermediate (origin of IGT) and, finally, to type III, dyssociated (first stage of microcirculatory insufficiency), when pancreatic tissue acidosis is highest (<b>real begin of DM)</b>. (See also Diabetic Constitution and Diabetes Mellitus in Practical Applications, in above-cited website and in the<span style=""> </span>website <a href="http://www.indmedica.org/">www.indmedica.org</a>, 2 Cyber Lectures: Diabetic and Dyslipidaemic constitutions).<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>Starting from this stage, pancreatic <i>interstitium</i> becomes more large than the normally, mainly due to amyloid deposit, as formerly demostrated: pancreatic-“in toto” ureteral reflex results </b></span><span style="font-family:Symbol;"><span style=""><b>³</b></span></span><span style="" lang="EN-GB"><b> <st1:metricconverter productid="1 cm" st="on">1 cm</st1:metricconverter>. (NN < <st1:metricconverter productid="1 cm" st="on">1 cm</st1:metricconverter>.) (See Diabetes mellitus, in <a href="http://www.semeioticabiofisica.it/">http://www.semeioticabiofisica.it</a>, Practical Applications, URL <o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><b><a href="http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Eng/Diagnosis%20DM,%20amyloid.doc">http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Eng/Diagnosis%20DM,%20amyloid.doc</a>). <o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>At this point, we can finally understand more clearly the really frequent association between arterial hypertension and DM, which appears “always” on the common base of a congenital inherite factor, i.e. CAEMH-</b></span><span style="font-family:Symbol;"><span style=""><b>a</b></span></span><span style="" lang="EN-GB"><b>., particularly intense in both Langherans’s pancreatic isles and skeletric muscle arteriols, i.e,<span style=""> </span>resitance vessel wall-<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>For the first time it is possible to speak of real <i>beginning</i> of diabetes mellitus, a term until now used without scientific support, namely in acritical manner, despite the progress of sophysticated instrumental semeiotics.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span lang="EN-GB" style="font-family:Verdana;"><b>At a large number of congresses I have showed the misuse of such termin in front of well-known diabetologists, who appeared without exception surprised, annoyed and totally unable to falsify our statement (7).<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span lang="EN-GB" style="font-family:Verdana;"><span style=""><b> </b></span><o:p></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>DM type II, so-called NIDDM, – more than 94% of all cases – from biophysical-semeiotic viewpoint shows a <i>precise, clear-cut beginning</i>, which corresponds to the <i>first </i>onset of<span style=""> </span>pancreatic isles microcirculatory activation type II, intermediate, in individuals involved by dyslipidaemic “and” diabetic constitutions, causing histangic acidosis anf further, pancreatic amyloyd deposit, and reduction of local insulin receptors sensitivity,<span style=""> </span>essential factor in the self-regulation of hormone secretion.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>In a few words, such characteristic microcirculatory condition parallels the activation of “only” vasomotility, evaluated at the bed-side as fluctuations of upper ureteral reflex, during “light” stimulation of pancreatic trigger-points: AL + PL, i.e. duration of oscillation wave (Fig.1), is 7-8 sec. (NN = 6 sec.), whereas vasomotion, i.e. the fluctuations of lower ureteral reflex, shows a AL + PL duration unchanged (6 sec.), due to impairment of loca AVA and especially of<span style=""> </span>Endoarteriolar Blocking Devices (EBD).<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>From the haemoreological-microcirculatory view-point, that indicates an impairment of Microcirculatory Functional Reserve, and consequently initial abnormality of insulin secretion, according to Angiobiopathy theory.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>In addition, it has to be considered that elastic artery dilation, evaluated clinically by means of <b>Biophysical Semeiotics</b>, as it will be once more illustrated in following, aims to counterbalance the dangers of increased peripheral artery resistance. However, repeated and acute dilation, e.g. during stresses, brings about initial alterations of endothels (denuding) and smooth muscle cells<span style=""> </span>endo-reduplication, with subsequent arterial wall structural abnormalities, as intimal thikening (4, 25, 26).<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>At this point, we briefly remember the contemporaneous alterations of local <i>vasa-vasorum</i>, caused mainly by wall dilation, which brings about, in turn, further impairment of related microcirculation and consequently arterial wall damage.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>In biophysical semeiotic detecting <i>pre-hypertensive state</i>, i.e. <b>hypertensive constitution </b>and <b>hyrtension real risk</b>,<b> </b>beside muscular <i>preconditioning</i>, illustrated above, to which we will return later, a primary role is played by the diagram of finger-pulp tissue microvascular unit, in which Phase A is reduced (gastric aspecific reflex < <st1:metricconverter productid="1 cm" st="on">1 cm</st1:metricconverter>.) and disappearing time of tGC results prolonged, after rapid interruption of digital pressure: Oxygen Recovery Time < <st1:metricconverter productid="1 cm" st="on">1 cm</st1:metricconverter>. (O<sub>2</sub>RT) (15-17).<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>Interestingly, O<sub>2</sub>RT (NN </b></span><span lang="EN-GB" style="font-family:Symbol;"><span style=""><b>£</b></span></span><span style="" lang="EN-GB"><b> 2 sec.) is in relation to the recovery of normal tissue oxygenation, after interruption of jatrogenetically induced histangic acidosis, “aerobic” glycolisis restoration, H<sup>+ </sup>washing, and, then, post-ischaemic reactive hyperaemia, strictly related to Microcirculatory Functional Reserve, always altered also in the <i>pre-hypertensive state</i>, as clinical and experimental evidence shows: O<sub>2</sub>RT (NN = 2 sec.) > 2 sec., directly related to the seriousness of <b>hypertensive constitution</b>.<o:p></o:p></b></span></p><b> </b><p class="MsoBodyTextIndent2" style="text-align: justify;"><span style="" lang="EN-GB"><b>Unavoidable to evaluate </b></span><span style="font-style: normal;" lang="EN-GB"><b>pre-hypertensive state</b></span><span style="" lang="EN-GB"><b>, it proved to be ausculatory percussory outlining of common femoral artery, which can be performed with the bell-piece of stethoscope, properly localized on this arterial vessel at the groin, or, in a practical way, immediately under umbelicus, at right or at left. <o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>At this point, auscultatory percussion has to be applied, directly and “gently” from right to left and viceverse, right below umbelicus as far as hypophonetic and intense sound<span style=""> </span>is perceived, indicating the cutaneous projection area of common femoral artery: if the individual, which is examined, performes <i>boxer’s test</i> <i>or, apnea test or Restano’s manoeuvre </i>(contemporaneously, he performes the two tests), in healthy,<span style=""> </span>the artery dilates clearly; on the contrary, in hypertensive state as well as in hypertensive patients, of course, the vessel dilate just a little or does not dilate at all (70).<span style=""> </span><o:p></o:p></b></span></p><b> <b><span style=";font-family:Arial;font-size:13;" lang="EN-GB" > </span></b> </b><h3 style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><b><a name="_Toc114299978"><span style="" lang="EN-GB">Quantum-Biophysical-Semeiotic evaluation of hypertensive constitution and hypertension real risk.</span></a><span style=""></span><span style="font-weight: normal;" lang="EN-GB"><o:p></o:p></span></b></h3><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>By recognizing the <i>pre-clinical </i>condition, pre-hypertensive stage or <b>hypertensive constitution, as well as hypertension real risk, </b>which<b> </b>may evolve to arterial hypertension, doctor has to consider accurately a lot of parameters, really different in bed-side evaluation difficulty.<b><o:p></o:p></b></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="aL"><b><a name="_Toc508701429"></a><a name="_Toc507830101"></a><a name="_Toc504460694"></a><a name="_Toc504118561"><span style=""><span style=""><span style=""><span style="" lang="EN-GB">1) Systolic arterial pressure (SAP).<o:p></o:p></span></span></span></span></a></b></p><b> <span style=""></span><span style=""></span><span style=""></span><span style=""></span> </b><p class="aL"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>2) Diastolic arterial pressure (DAP)<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>3) Mean arterial pressure (MAP = SAP – DAP/3 + DAP) <o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>4) Heart rate (HR).<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>5) Systo-diastolic oscillations of left ventricle at rest and during <i>boxer’s test</i> (NN = 1 and, respectively, <st1:metricconverter productid="2 cm" st="on">2 cm</st1:metricconverter>.): this paramter may be overlooked, although it is really interesting.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>6) Tissue pH, evaluated as latency time of Critical Point (CP) of <st1:metricconverter productid="5 cm" st="on">5 cm</st1:metricconverter>. in tissue-microvascular-unit diagram. In healthy young, CP is generally absent (Fig. 2).<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>7) O<sub>2 </sub>Recovery Time (O<sub>2 </sub>RT), assessed as latency time of tGC disappearing (NN =<span style=""> </span>2 </b></span><span style="font-family:Symbol;"><span style=""><b>±</b></span></span><span style="" lang="EN-GB"><b> 0,5 sec.) .<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="aL"><span style="" lang="EN-GB"><b>8) Arterial peripheral resistance (APR = MAP/10 x O<sub>2 </sub>RT); normal value </b></span><span style="font-family:Symbol;"><span style=""><b>£</b></span></span><span style="" lang="EN-GB"><b> 20.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>9) Basal arterial diameter (BAD), evaluated, e.g., as diameter of cutaneous projection of common iliac artery in a relaxed patient (NN </b></span><span style="font-family:Symbol;"><span style=""><b>£</b></span></span><span style="" lang="EN-GB"><b> <st1:metricconverter productid="2 cm" st="on">2 cm</st1:metricconverter>.).<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>10) Dilation index (DI = Max AD/BAD; NN<span style=""> </span></b></span><span style="font-family:Symbol;"><span style=""><b>³</b></span></span><span style="" lang="EN-GB"><b> <st1:metricconverter productid="2 cm" st="on">2 cm</st1:metricconverter>.); artery diameter is assessed at basal line and, then, during <i>boxer’s test, for instance.</i><o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b>11) Arterial compliance (Co = DI x 10 / O<sub>2</sub>RT; NN = 8-17).</b></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><o:p><b> </b></o:p></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>12) Skeletal muscle <i>preconditioning</i>. <o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>In practice, the <i>preconditioning</i> can be performed at the level of biceps muscle (or other muscle, of course). It is a simple, and reliable manoeuvre, which permits rapidly <b>by itself </b>to diagnose<b> hypertensive constitution</b>: in healthy, in supine position and psycho-physically relaxed with open eyes to avoid melatonin secretion, doctor evaluates basal lt of biceps muscle-gastric aspecific reflex and/or caecal reflex by mean of “mean-intense” pressure (NN = <b>8 sec.</b>). <o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>After 5 sec. “exactly” – <i>preconditioning</i> –<span style=""> </span>the same parameter is evaluated for the second time: in healthy, latency time appears prolonged significantly, while in the individual with <b>hypertensive constitution</b>, and, of course, in <b>hypertensive patient</b>, latency time is either unchanged or lowered, in inverse<span style=""> </span>relation to the seriousness of arterial hypertension.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><span style=""><b> </b></span><b>Without going on in the pathophysiology discussion, in which we are not concern at this moment, this method allows doctor to “quantify” peripheral arterial resistance. In a 50-year-long well established experience, the method proved to be reliable in 100% of cases. <o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>It is easy to understnd that DI is related directly to distension ability of arterial wall, i.e., to arterial wall elasticity, impoortant factor of arterial <i>compliance</i>, evaluated by a different, more refined method (12-14). <o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>In individuals under 60 years of age, DI is </b></span><span style="font-family:Symbol;"><span style=""><b>³</b></span></span><span style="" lang="EN-GB"><b> <st1:metricconverter productid="2 cm" st="on">2 cm</st1:metricconverter>., when evaluated as<span style=""> </span>cutaneous projection area of<span style=""> </span>vessel, while over 60 years DI appears reduced to less than <st1:metricconverter productid="2 cm" st="on">2 cm</st1:metricconverter>.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>Clinical and experimental evidence suggests that O<sub>2</sub>RT is related to PAR, as we demonstrated<span style=""> </span>in an our research:<span style=""> </span>r = + 0,84; tr = 4,378; p <></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>Generally, Co is assessed by Bramwell and Hill’s formula, which consider the speed of wave puls and vascular elasticity, observed with sophysticated methods.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>However, at the bed-side it proved reliable the datum obtained by this formula, opportunely modified, using DI, which gives information about common iliac artery elasticity ( or, of course, of other artery) and<span style=""> </span>O<sub>2</sub>RT inversely related to blood-flow in tisssue-microvascular unit, during the phase of post-ischaemic hyperaemia (exclusively because of calculation reasons, DI is multiplied for 10). In aging, over 60 years, Co results <></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>At this point, it is possible clinically to face the <b>aethiopathogenetic problems </b>of AI in a new way, i.e., trying to define <i><span style=""> </span>pre-hypertensive state</i>, which shows a particular <b>hypertensive constitution</b>, analogously at what we described<span style=""> </span>as regards the diabetic, migraine constitution rheumatic arteriosclerotic constitution, and other constitution, such the oncological terrain.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>Exclusively in this way it is possible to bed-side recognize pre-clinic stage of arterial hypertension, whose knowledge is essential for the primary prevention of hypertension. <o:p></o:p></b></span></p><b> </b><p class="aL"><b><a name="_Toc508701439"></a><a name="_Toc507830111"></a><a name="_Toc504460704"></a><a name="_Toc504118571"><span style=""><span style=""><span style=""><span style="" lang="EN-GB">Among young individuals, CAEH-</span></span></span></span></a><span style=""><span style=""><span style=""><span style=""><span style="font-family:Symbol;"><span style="">a</span></span></span></span></span></span><span style=""><span style=""><span style=""><span style=""><span style="" lang="EN-GB"> positive, with blood pressure in normal ranges, it is relatively easy to regognize those with increased PAR (> 20), even during stress test, DI < <st1:metricconverter productid="2 cm" st="on">2 cm</st1:metricconverter>., O<sub>2</sub>RT > 2 sec.<span style=""> </span>and Co < style=""> </span>physiological conditions.<o:p></o:p></span></span></span></span></b></p><b> <span style="" lang="EN-GB"> <span style=""></span><span style=""></span><span style=""></span><span style=""></span></span> </b><p class="aL"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><b><span style="" lang="EN-GB">Biophysical-Semeiotic Evaluation of Natriuretic Peptides.</span></b><span style="" lang="EN-GB"><o:p></o:p></span></b></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><span style=""><b> </b></span><b>From practical view-point, I advice such as “easy” evaluation of NP, offering a lot of usefull and interesting information on NP biological activity, particularly as hypertensive constitution is concerned.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><span style=""><b> </b></span><b>In fact, individuals with hypertensive consitution (<i>pre-hypertensive state</i>) as well as overt hypertension, show a significantly decreased renal biological activity of natriuretic peptides, as patients involved by CAD, when down-regulation of renal specific receptors is caused by high levels of NP. <o:p></o:p></b></span></p><b> </b><p class="aL"><span style="" lang="EN-GB"><b>As a consequence, the impaired biological renal activity of natriuretic peptides plays a paramount role in bedside detecting hypertensive biophysical-semeiotic constitution. (For further technical information, See in above-mentioned website, the URL <o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><b><a href="http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Eng/BNP%20engl.doc">http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Eng/BNP%20engl.doc</a> .<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="aL"><span style="" lang="EN-GB"><b>In following, an easy way reliable in such evaluation is described: in healthy, lying down in supine position, “intense”, sub-occlusive digital pressure is applied upon phemoral artery at the groin (or on another great muscular artery); the subsequent artery dilation upstrem brings about left cardiac atrial and left ventrical dilation, and then NP<sub>s</sub> secretion. After about 15 sec., kidney does not fluctuates <span style=""> </span>as usually, showing congestion for 30 sec. exactly.<o:p></o:p></b></span></p><b> </b><p class="aL"><span style="" lang="EN-GB"><b>On the contrary, in individuals with hypertesive constitution and obviously overt hypertension, kidney congestion lasts for a time varying between 20 sec. and less than 30 sec., in relation to the severity of underlying disorder.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><div align="center"><b> </b><table class="MsoNormalTable" style="border: medium none ; margin-left: 219.5pt; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 197.3pt;" valign="top" width="263"> <h4 style="text-align: justify;"><b><span style="" lang="FR">Hypertensive Constitution<o:p></o:p></span></b></h4> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><span style="" lang="FR"><o:p> </o:p></span></b></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><span style="" lang="FR"><span style=""> </span>PAR<span style=""> </span>> 20<o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><span style="" lang="FR"><span style=""> </span></span>DI<span style=""> </span>< <st1:metricconverter productid="2 cm" st="on">2 cm</st1:metricconverter>.<o:p></o:p></b></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><span style=""> </span>O<sub>2</sub>RT<sub> </sub><span style=""> </span>> 2 sec.<o:p></o:p></b></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><span style="" lang="EN-GB"><span style=""> </span>Co<span style=""> </span><></span></b></p> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">Muscolar Preconditioning pathologic<o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">Evaluation of Natriuretic Peptides <o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> </td> </tr> </tbody></table><b> </b></div><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><span style=""><b> </b></span><span style=""><b> </b></span><o:p></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>Getting rid of abnormalities of <i>pre-clinical, pre-metabolic stage</i>, we can hpefully prevent the serious diseases, which otherwise can onset, and,<span style=""> </span>mainly the well-known complications in different biological systems.<o:p></o:p></b></span></p><b> </b><p class="aL"><span style="" lang="EN-GB"><b>On the contrary, we must rely only on treatments of high arterial pressure, often apparently efficacious, due to the fact that complication are already present and therapeutic monitoring is based exclusively upon lowered pressure values, gathered by the aid of a sphygmomanometer, which nothing are able to say about what really happen in target organs and tissue.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>Actually, at the beginning of third millennium, doctors, for the fist time, agree with those few colleagues, who over years state that arterial hypertension, evaluated untill now at the level of <i>vasa publica </i>in a large variety of ways, is not significant as regards what really happens in tissue-microvascular-units under the same conditions.<b> </b><o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>In other words, the urgency of assessing organs damage begins to play the deserving role, also in the mind of those with scarse ability of criticism and creative imagination.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>Really, since the descovery of CAEMH I stated without success that our colleagues would pay a great deal of attention to this mitochondrial cytopathology, overlooked for too long<span style=""> </span>time, since I have realized that the war against the most serious human diseases, including arterial hypertension, can obtain the best results only in case of a prompt selection of individuals at “real risk” for them, so that they undergo “clincal” tests, reliable in “quantifying” such as risk, initiating rapidly the correct diet, etymologically speaking, that normalizes the muscular reactions, pathological at the beginning during <i>boxer’s test, simulated stress test, “sucking simulation test, </i>in which rythmic mamma palpation physiologically brings about – by nervous reflex, inhibiting dopamine neurons of TIDA – increase of<span style=""> </span>PRL secretion, which enhances peripheral arteriolar resistance as well as insulin secretion, and negative consequences, we previously described (4, 10).<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>It is worth for saying that <i>primary</i> prevention of AH allows doctors to prevent contemporaneously also disorders and syndromes (ATS, DM, gout, malignancies, in indivuals, of course, with “oncological terrain”, a.s.o.) with favorable influences, both individual and social (20-22). <o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>In fact, clinical evidence demonstrates that, beside AH, in the same patient there are frequently other serious disorders, cause of morbidity and mortality, based upon the commom genetic factor, i.e. CAEMH<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><span style=""><b> </b></span><b>The authors agree generally on both exsistence and importance of “genetic factor” of arterial hypertension, which has to explain following facts:<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>1)<span style=""> </span>sympatethic hypertonus;<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>2) “intense and rapid “ response of<span style=""> </span></b></span><span style="font-family:Symbol;"><span style=""><b>a</b></span></span><span style="" lang="EN-GB"><b>-adrenergic receptors, present in fifferent way in arterial and venous districts;<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>3) “rapid and intense” response of the vessels, which dilate;<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>4) “rapid and intense” congestion and subsequent similar decongestion of splancin organs, a part from intestine.<o:p></o:p></b></span></p><b> <span style="" lang="EN-GB"> </span> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><h3 style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><b><a name="_Toc114299979"><span style="" lang="EN-GB">Clinical evidence in favour of pre-hypertensive state.</span></a><span style="" lang="EN-GB"><o:p></o:p></span></b></h3><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>In <i>hypertensive state</i>, in fact, in a previous research performed on 249 individuals CAEMH-</b></span><span style="font-family:Symbol;"><span style=""><b>a</b></span></span><span style="" lang="EN-GB"><b>, negative for AH, in the age between 15-80 years, the duration of kidney congestion during boxer’s test, resulted 4-5 sec., while in 467 individuals, comparable to age,<span style=""> </span>CAEMH-</b></span><span style="font-family:Symbol;"><span style=""><b>a</b></span></span><span style="" lang="EN-GB"><b> positive, among them 175 hypertensive (37,5%), and the other normotensive, but with family history positive for AH (292; 62,5%), kidney congestion duration was <></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>CAEMH-</b></span><span style="font-family:Symbol;"><span style=""><b>a</b></span></span><span style="" lang="EN-GB"><b> – as we demonstrated previously (2-4, 9, 10, 11, 14, 18, 19) – represents the <i>conditio sine qua non </i>of ATS, migraine, DM, autimmune disorders, incuding Acute Benigne Variant Polymyalgya Rheumatica (18, 19), tumours (10), solid and liquid, : “all” hypertensive individuals, we observed over the last 50 years, are or were<span style=""> </span>involved by the mitochondrial cytopathology, I described, as allows us to state also the clinical evidence: digital pressure, applied on a nail-fold, e.g. of the big toe, of a young CAEMH-</b></span><span style="font-family:Symbol;"><span style=""><b>a</b></span></span><span style="" lang="EN-GB"><b> negative, causes temporary dilation of homolateral common iliac artery<span style=""> </span>(<st1:metricconverter productid="0,5 cm" st="on">0,5 cm</st1:metricconverter>.), while both aorta and controlateral common iliac artery “practically” show unchanged diameters.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>On the contrary, in the young CAEMH-</b></span><span style="font-family:Symbol;"><span style=""><b>a</b></span></span><span style="" lang="EN-GB"><b> positive homolateral iliac artery shows a dilation </b></span><span style="font-family:Symbol;"><span style=""><b>³</b></span></span><span style="" lang="EN-GB"><b> <st1:metricconverter productid="1 cm" st="on">1 cm</st1:metricconverter>. and, simultaneously, both aorta and controlateral common iliac artery dilate clearly and significantly, permitting thus pressure values to be normal.<o:p></o:p></b></span></p><b> </b><p class="aL"><span style="" lang="EN-GB"><b>Really, CAEMH-</b></span><span style="font-family:Symbol;"><span style=""><b>a</b></span></span><span style="" lang="EN-GB"><b> is the <i>genetic factor</i>, clinically “quantifiable”, at the base of various formes of neuro-vegetative dystonia (8), of particular </b></span><span style="font-family:Symbol;"><span style=""><b>a</b></span></span><b><sub><span style="" lang="EN-GB">2</span></sub><span style="" lang="EN-GB">-receptors <i>overactivity</i>, as in case of alexytimia, frequently associated to AH (4, 28). The incapacity for speaking correctly and describe emotions by Autonomous Nervous System, due to internal tensions, plays a primary role in the pathogenesis of AH associated with this nervous disorder.<o:p></o:p></span></b></p><b> </b><p class="aL"><span style="" lang="EN-GB"><b>From the above remarks, in order to prevent efficaciously AH we have to be considered, in “healthy subjects, i.e. without AH or other clinical phenomenology, but CAEMH-</b></span><span style="font-family:Symbol;"><span style=""><b>a</b></span></span><span style="" lang="EN-GB"><b> positive, the possibility of assessing hemoreological-haemodynamic as well as metabolic-biochemical modifications (<i>post-absorptive state</i> with abnormalities in central and peripheral vessels dynamics), even caused by numerous tests: boxer’s test, simulated stress, apnea test, sucking simulated test, Restano’s manoeuvre, a.s.o.<o:p></o:p></b></span></p><b> </b><p class="aL"><span style="" lang="EN-GB"><b>We must consider interesting the data collected, as usually, by tissue-microvascular-unit of finger-pulp or nail-foild, in which A Phase is characteristically of small intensity and O<sub>2</sub>RT is > 2 sec.<o:p></o:p></b></span></p><b> </b><p class="aL"><span style="" lang="EN-GB"><b>Beside the family history, the results of this evaluation allow to recognize promptly individuals at “real” risk for arterial hypertension, starting from the initial stage, we suggested to term <i>pre-hypertensive state</i> of AH, in which tissue pH appears to be lowered, O<sub>2</sub>RT prolonged, PAR increased, DI abnormal, arterial Co pathological, according<span style=""> </span>to the values, illustrated above in the scheme.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>These individuals show metabolic-biochemical conditions, characteristic of <i>pre-morbid state</i>, in which is present hyperinsulinaemia-insulinresistance,observable, the first, by specific renal test (brief kidney congestion and prolonged decongestion; NN 4-5 sec. and, respectively, 10 sec.) and by suprarenal glands evaluation (reduced microvascular activity since the third fluctuation), during insulinaemic acute pick secretion, due to the phenomenon of <i>down-regulation</i> of kidneys insulin receptors<span style=""> </span>as well as insulin “vasocostriction” action caused by functional dysendotelization, as we observe as regards acethyl-choline<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><i><span style="" lang="EN-GB">In conclusion</span></i><span style="" lang="EN-GB">, by a large number of biophysical semeiotic methods, of different difficulty and refinement (we illustrated above some among the less difficult methods, although reliable and practically easy to perform) nowadays is possible to recognize individual at risk for AH, since the first two decades of life, in a “quantitative” manner, due to the severity of their <b>hypertensive constitution</b>.<o:p></o:p></span></b></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>Consequently, now we can perform fortunately the primary prevention of this widespread and dangerous disease, notoriously complicated, if diagnosed to late, by morbidity and mortality, which can nowadays be prevented, because we can detect the disease in its <i>pre-morbid stage</i>, before complications onset, clinically, and, therefore, on very large scale.<o:p></o:p></b></span></p><b> <span style=""> </span> </b><p class="MsoNormal"><b>*<b style=""><span style=";font-family:Arial;font-size:10;" > Sergio Stagnaro MD<o:p></o:p></span></b></b></p><b> </b><p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" ><b>Via Erasmo Piaggio 23/8, CP. 42</b></span></p><b> </b><p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" ><b>16039 Riva Trigoso (<st1:city st="on">Genoa</st1:city>) <st1:place st="on"><b style="">Europe</b></st1:place></b></span><span style="" lang="EN-GB"><o:p></o:p></span></p><b> </b><p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" ><b>Founder of Quantum Biophysical Semeiotics</b></span><span style="" lang="EN-GB"><o:p></o:p></span></p><b> </b><p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" ><b>Who's Who in the World (and <st1:place st="on"><st1:country-region st="on">America</st1:country-region></st1:place>)</b></span><span style="" lang="EN-GB"><o:p></o:p></span></p><b> </b><p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" ><b>since 1996 to 2009<o:p></o:p></b></span></p><b> </b><p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" ><b>Ph 0039-0185-42315<o:p></o:p></b></span></p><b> </b><p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" ><b>Cell. 3338631439</b></span><span style="" lang="EN-GB"><o:p></o:p></span></p><b> </b><p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" ><b><a href="http://www.semeioticabiofisica.it/"><span style="" lang="EN-GB">www.semeioticabiofisica.it</span></a></b></span><span style=";font-family:Arial;font-size:10;" ><b> </b></span><span style="" lang="EN-GB"><o:p></o:p></span></p><b> </b><p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" ><b><a href="mailto:dottsergio@semeioticabiofisica.it"><span style="" lang="EN-GB">dottsergio@semeioticabiofisica.it</span></a></b></span><span style=";font-family:Arial;font-size:10;" ><b> </b></span><span style="" lang="EN-GB"><o:p></o:p></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><b><span style="font-size:14;"><o:p> </o:p></span></b></b></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><b><span style="font-size:14;"><o:p> </o:p></span></b></b></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><span style=""><b> </b></span><o:p></o:p></span></p><b> </b><h3 style="margin: 0cm 0cm 0.0001pt; text-indent: 35.45pt;"><b><a name="_Toc114299980"><span style="" lang="EN-GB">Referencees</span></a><span style="" lang="EN-GB"><o:p></o:p></span></b></h3><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b> </b></o:p></span></p><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><b>1) <b><span style=";font-family:Verdana;font-size:10;" >Stagnaro S.</span></b><span style=";font-family:Verdana;font-size:10;" >, Istangiopatia Congenita Acidosica Enzimo-Metabolica condizione necessaria non sufficiente della oncogenesi. XI Congr. Naz. Soc. It. di Microangiologia e Microcircolaz. Abstracts, pg 38, 28 Settembre-1 Ottobre, Bellagio, 1983.</span></b></p><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><b>2) <b><span style=";font-family:Verdana;font-size:10;" >Stagnaro S.</span></b><span style=";font-family:Verdana;font-size:10;" >, Istangiopatia Congenita Acidosica Enzimo-Metabolica. X Congr. Naz. Soc. It. di Microangiologia e Microcircolazione. Atti, 61. 6-7 Novembre, Siena, 1981.</span></b></p><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><b>3) <b><span style=";font-family:Verdana;font-size:10;" >Stagnaro S.</span></b><span style=";font-family:Verdana;font-size:10;" >, Istangiopatia Congenita Acidosica Enzimo-Metabolica. </span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" >Gazz Med. It. – Asch. </span><span style=";font-family:Verdana;font-size:10;" >Sci, Med. 144, 423, 1985.</span></b></p><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><b>4) <b><span style=";font-family:Verdana;font-size:10;" >Stagnaro-Neri M., Stagnaro S.</span></b><span style=";font-family:Verdana;font-size:10;" >, Stadio pre-ipertensivo e monitoraggio terapeutico della ipertensione arteriosa. Omnia Medica Therapeudica. Archivio, 1-13, 1989-90.<o:p></o:p></span></b></p><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><span style=";font-family:Verdana;font-size:10;" ><b>5) </b></span><b><b><span style="color: rgb(51, 51, 51);font-family:Verdana;font-size:10;" >Stagnaro-Neri M., Stagnaro S.</span></b><span style="color: rgb(51, 51, 51);font-family:Verdana;font-size:10;" > Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. </span><span style="color: rgb(51, 51, 51);font-family:Verdana;font-size:10;" lang="EN-GB" >Travel Factory, Roma, 2004.</span><span style=";font-family:Verdana;font-size:10;color:red;" lang="EN-GB" ><span style=""> </span></span><span style=";font-family:Arial;font-size:10;" lang="EN-GB" ><a href="http://www.travelfactory.it/semeiotica_biofisica.htm">http://www.travelfactory.it/semeiotica_biofisica.htm</a><o:p></o:p></span></b></p><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><span style=";font-family:Arial;font-size:10;" ><b>6) </b></span><b><b><span style=";font-family:Verdana;font-size:10;" >Stagnaro-Neri M., Stagnaro S.</span></b><span style=";font-family:Verdana;font-size:10;" >, Sindrome di Reaven, classica e variante, in evoluzione diabetica. Il ruolo della Carnitina nella prevenzione del diabete mellito. Il Cuore. 6, 617, 1993.<o:p></o:p></span></b></p><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><span style=";font-family:Verdana;font-size:10;" ><b>7) </b></span><b><b><span style=";font-family:Verdana;font-size:10;" >Stagnaro S., </span></b><span style=";font-family:Verdana;font-size:10;" >Risk of Type 2 Diabetes.<span style=""> </span></span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" >N Engl J Med. 2002 Jan 24;346(4):297-298. letter <b>[MEDLINE].<o:p></o:p></b></span></b></p><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><span style=";font-family:Verdana;font-size:10;" ><b>8) <b>Stagnaro-Neri M, Stagnaro S.</b>, Valutazione clinica percusso-ascoltatoria del sistema nervoso vegetativo e del sistema renina-angiotensina, circolatorio e tessutale. </b></span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" ><b>Arch. Med. Int. </b></span><span style=";font-family:Verdana;font-size:10;" ><b>XLIV, 17378, 1992.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><span style=";font-family:Verdana;font-size:10;" ><b>9) </b></span><b><b><span style=";font-family:Verdana;font-size:10;" >Stagnaro S., Stagnaro-Neri M.</span></b><span style=";font-family:Verdana;font-size:10;" >, Le Costituzioni Semeiotico-Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. </span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" >Travel Factory, Roma, 2004. <a href="http://www.travelfactory.it/libro_costituzionisemeiotiche.htm"><span style="">http://www.travelfactory.it/libro_costituzionisemeiotiche.htm</span></a><o:p></o:p></span></b></p><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><span style=";font-family:Verdana;font-size:10;" ><b>10) </b></span><b><b><span style="color: rgb(51, 51, 51);font-family:Verdana;font-size:10;" >Stagnaro-Neri M., Stagnaro S.</span></b><span style="color: rgb(51, 51, 51);font-family:Verdana;font-size:10;" > Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. </span><span style="color: rgb(51, 51, 51);font-family:Verdana;font-size:10;" lang="EN-GB" >Travel Factory, Roma, 2004.</span><span style=";font-family:Verdana;font-size:10;color:red;" lang="EN-GB" ><span style=""> </span></span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" ><a href="http://www.travelfactory.it/semeiotica_biofisica.htm"><span style="">http://www.travelfactory.it/semeiotica_biofisica.htm</span></a><o:p></o:p></span></b></p><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" ><b>11) </b></span><b><b><span style="" lang="EN-GB">Stagnaro<span style=""> </span>Sergio</span></b><span style="" lang="EN-GB">. Bedside Assessing ANS, RAAS, and IIR: a complex Relation to type 2 Diabetes<i>. Cardiovascular Diabetology</i>,15 November 2005. <a href="http://www.cardiab.com/content/4/1/15/comments#215501"><span style="">http://www.cardiab.com/content/4/1/15/comments#215501</span></a><o:p></o:p></span></b></p><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>12) <b>Stagnaro<span style=""> </span>Sergio</b>. </b></span><b><strong><span style="font-weight: normal;" lang="EN-GB">Microalbuminuria and Diabetes Mellitus: a primary predictor. <i>CMAJ</i>. 22 August, 2002. </span></strong><a href="http://www.cmaj.ca/cgi/eletters/163/5/561"><span style="" lang="EN-GB">http://www.cmaj.ca/cgi/eletters/163/5/561</span></a>.</b></p><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>13) <b>Stagnaro Sergio</b>. </b></span><span style="" lang="EN-GB"><b>Single Patient Based Medicine: its paramount role in Future Medicine. </b></span><span style="" lang="EN-GB"><b>Public Library of Science. 2005.<a href="http://medicine.plosjournals.org/perlserv/?request=read-response"><span style="">http://medicine.plosjournals.org/perlserv/?request=read-response</span></a>.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><b>14) <b>Stagnaro S., Stagnaro-Neri M</b>. Single Patient Based Medicine.La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. <span style="" lang="EN-GB">Travel Factory, Roma, 2005. <a href="http://www.travelfactory.it/libro_singlepatientbased.htm"><span style="">http://www.travelfactory.it/</span></a></span><a href="http://www.travelfactory.it/libro_singlepatientbased.htm"><span style="" lang="EN-GB">libro_singlepatientbased.htm</span></a><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" ><o:p></o:p></span></b></p><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><span style=";font-family:Verdana;font-size:10;" ><b>15) </b></span><b><b>Stagnaro-Neri M., Stagnaro S.</b> Indagine clinica percusso-ascoltatoria delle unità microvascolotessutali della plica ungueale. <span style="" lang="EN-GB">Acta Med. Medit. </span>4, 91, 1988<b>.<o:p></o:p></b></b></p><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><b>16)<span style=""> </span><b>Stagnaro-Neri M., Stagnaro S</b>., Semeiotica Biofisica: valutazione della compliance arteriosa e delle resistenze arteriose periferiche. Atti del XVII Cong. Naz. Soc. Ital. Studio Microcircolazione, Firenze Ott. 1995, Biblioteca Scient. Scuola Sanità Militare, 2, 93, 1995.</b></p><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><b>17) <b>Stagnaro-Neri M., Stagnaro S.</b>, Auscultatory Percussion Evaluation of<span style=""> </span>Arterio-venous Anastomoses Dysfunction in early Arteriosclerosis. Acta Med. Medit. 5, 141, 1989.</b></p><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>18) <b>Stagnaro S.</b>, Auscultatory Percussion of Rheumatic Diseases. X European Congress of Rheumatology. <st1:city st="on"><st1:place st="on">Moscow</st1:place></st1:city>. 26 June-July, Proceedings, pg 175, 1983.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><b>19) <b>Stagnaro S.</b>, Polimialgia Reumatica Acuta Benigna Variante. Clin. Ter. 118, 193,1986<span style=""> </span><b>[Medline]</b> </b></p><b> </b><p class="MsoNormal" style="text-align: justify;"><span style=""><b> </b></span><b>20) <b>Kannel W.B., Schatzkin A</b>. — Analisi dei Fattori di Rischio. Progressi in Patologia Vascolare,Vol. XXVII, 5.-9, 1984</b></p><b> </b><p class="MsoNormal" style="text-align: justify;"><span style=""><b> </b></span><span style=""><b> </b></span><b>21) <b>Malamani V.</b> — L'evoluzione del pensiero medico in tema di ipertensione. <span style="" lang="EN-GB">Fed. Med. </span><span style="" lang="DE">XXXVIII, 5,<span style=""> </span>511-516,1985.<o:p></o:p></span></b></p><b> </b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="DE"><span style=""><b> </b></span><b>22) <b>Patzscheke U</b>. Milde Hypertonie: Behandein Oder Nicht Behandein? Med. Klin. 21, 80, 574-578,<span style=""> </span>1985.<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>23)<b> Ratschow M.</b> <span style=""> </span>Angiologia. </b></span><b>Patologia, Clinica E<span style=""> </span>Terapia Dei Disturbi Circolatori Periferici. I Ed.<span style=""> </span>Italiana Pag. 115 Casa Editrice Ambrosiana. Milano, 1962.</b></p><b> </b><p class="MsoNormal" style="text-align: justify;"><span style=""><b> </b></span><b>24) <b>Zanchetti A.</b> Ipertensione Arteriosa: Filosofia Attuale Di Un Trattamento Flessibile E Personalizzato. Il Polso, Ottobre 1987, Pag. 41-47.</b></p><b> </b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><span style=""><b> </b></span><b>25) <st1:city st="on"><st1:place st="on"><b>Pickering</b></st1:place></st1:city><b> G.</b> High Blood Pressure. </b></span><b>Ii Ed. London. <span style="" lang="EN-GB">J. &A. Chruchill, 1986, Pg. 35.<o:p></o:p></span></b></p><b> </b><p class="MsoNormal" style="text-align: justify;"><span style=""><b> </b></span><b>26) <b>Schirosa G.</b> Le Malattie Del Cuore. I Ed. Vol. Ipag. 61 Società Editrice Universo. <span style="" lang="DE">Roma 1970.<o:p></o:p></span></b></p><b> </b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="DE"><span style=""><b> </b></span><b>27) <b>Schwartz S.M., Ross R.</b><span style=""> </span></b></span><st1:personname productid="La Proliferazione Cellulare" st="on"><b>La Proliferazione Cellulare</b></st1:personname><b> Nell'arteriosclerosi E Nell'ipertensione. Progressi In Patologia Vascolare, Voi. XXVII, N° 4, 63-81, 1984.</b></p><b> </b><p class="MsoNormal" style="text-align: justify;"><span style=""><b> </b></span><b>28) <b>Ciraolo O., Quartarone M., Barbera N. E Coli.</b> Alexitimia E Ipertensione. Atti Ix Congr. <span style="" lang="EN-GB">Naz. Soc. It. </span>Patologia Vascolare. Copanello 6-9<span style=""> </span>Giungo 1987. Pg. 639-644 Monduzzi Editore Bologna 1987.</b></p><b><br /></b>Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-29166207706681911252009-05-11T02:17:00.000-07:002009-05-11T02:20:55.107-07:00Quantum Biophysical Semeiotics: The Theory of Angiobiopathy<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiaw3VehzvvnL9pGr04pCR4EYwoX7f6wMREybqud28uIEAGniqfZyN95GO1zY2BphuCinpF0RwEy3V70v8Iokf-wEZq-YtCBMVcRgcZayT6CgqN17JxIlue3-ODfBQVvqorLE50BM8yAmPw/s1600-h/sergio17.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 134px; height: 200px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiaw3VehzvvnL9pGr04pCR4EYwoX7f6wMREybqud28uIEAGniqfZyN95GO1zY2BphuCinpF0RwEy3V70v8Iokf-wEZq-YtCBMVcRgcZayT6CgqN17JxIlue3-ODfBQVvqorLE50BM8yAmPw/s200/sergio17.jpg" alt="" id="BLOGGER_PHOTO_ID_5334493748082291122" border="0" /></a><br /><br /><p style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><b style=""><span style="" lang="EN-GB">Introduction.<o:p></o:p></span></b></p> <p style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><b style=""><span style="" lang="EN-GB"><o:p> </o:p></span></b></p> <p style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style="" lang="EN-GB">Microvessels and microcirculation play a paramount role in Quantum Biophysical Semeiotics.<o:p></o:p></span></p> <p style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style="" lang="EN-GB">In reality, chaotic-determinist dynamics of the biological systems, present in the three zones, Zone White (health), <st1:place st="on"><st1:placename st="on">Grey</st1:placename> <st1:placename st="on">Zone</st1:placename></st1:place> (pre-pathology) and Black Zone (disease) (1-5), are caused by the analogous oscillations of the single structures of relative tissue microvascular <span style=""> </span>units, i.e., microcirculatory bed, according to Anglo-Saxon Authors (6-10). From the conceptual point of view, problematics regarding micro-circle and the microcirculation, are comprised, as well as analyzed, in the best way, when we are thinking, for analogy, to the street map of a city or country: from the large peripheral street begin wide roads, to only sense, different for number, directed towards the centre. The main roads, in double sense, progressively go shrinking itself till to become small street. In the vascular structure, the wider roads correspond to the Ratschow’s "vasa publica", while smallest, under 100 micron, represents for analogy the "vasa privata" , that participate to the formation of tissue microvascular unit (11). Naturally, blood “return” is realized by micro and the venous macro-vessel and the lymphatic ones.<o:p></o:p></span></p> <p style="text-align: justify;"><b style="">The Theory of Angiobiopathy <o:p></o:p></b></p> <p style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style="" lang="EN-GB">For the first time in clinical way (V. <a href="http://www.semeioticabiofisica.it/">http://www.semeioticabiofisica.it</a>), thanks to Quantum Biophysical Semeiotics, has been realized biological-molecular study of parenchimal activity by studying the related micro-vessels and <span style=""> </span>microcirculation in the biological systems, both at rest and under utilization of numerous substances, completing the assessment during dynamic tests, much rich of information. This theory, Angiobiopathy Theory, completes usefully Angiobiotopy theory, according to F. Tischendorf, brilliant student of microvessel anatomy, friend and collaborator of my Master of Microangiology-Microcirculation, S.B. Curri.<o:p></o:p></span></p> <p style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style="" lang="EN-GB">According to Angiobiopathy Theory a determined parenchyma is supplied of a specific microvascular system, really complex from the structural point of view, result of an co-organization happened in the course of evolution. In reality, such anatomy of tissue-micro-vascular unit can modify within the same apparatus, due to physiological reasons, correlated constantly with particular situations of the local tissue, as it happens in the skin microcirculation of lower limb. Tischendorf’s definition of Angiobiotopy as reagards the Zone White (Health), emphasises <span style=""> </span>the anatomical aspect, and it has been completed from the Angiobiopathy Theory, that emphasizes parenchimal-microvessel correlations also in the pre-pathological conditions, Grey Zone ("locus" of the primary prevention), and in the several diseases, Black Zone, as I have illustrated in previous papers (1-6). In other words, between parenchyma and relative micro-vascular system is present constantly an anatomical and functional correlation, bedside assessed not only in physiological but also in pre-pathological and pathological conditions, as clinical evidence demonstrates. <o:p></o:p></span></p> <p style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style="" lang="EN-GB">To this point, I call for attention to above-mentioned analogy, in order to comprise in details these Medicine advances, really fundamental for Clinical Microangiology. We think next to the existing <span style=""> </span>relationship between the houses of a country or a quarter and the local roads, ways, alleys, but also the water, gas, etc. In fact, as the vessels of every tissue, they supply material-energy-information for the life of the inhabitants and provide to remove the harmful debris, catabolites, events of essential importance for the survival of residents (7-21). <o:p></o:p></span></p> <p style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style="" lang="EN-GB">We still continue with the aid of the same analogy in order to explain a fundamental concept in the Quantum<span style=""> </span>Biophysical Semeiotics: from the movement of the several feeding goods, materials, newspapers, books, a.s.o., and flowing drinkable water, as well as black water, sewer, or drainage white water, in a limited city area, can obtain precise information on the culture, understanding broadly speaking, of a community and on the way people face the several existential problems. Therefore, the reader can easily comprise that the way “to be and to work” of the microvessels, included the vase vasorum (12), studied now also with Clinical Microangiology, using a stethoscope (the 6-10) (<a href="http://www.semeioticabiofisica.it/microangiologia">www.semeioticabiofisica.it/microangiologia</a>), gives information, anatomo-functional in origin, about correspondent biological system, aim of doctor’s evaluation. <o:p></o:p></span></p> <p style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style="" lang="EN-GB">In health, the micro-vascular oscillations as well as macro-oscillations, are chaotic-determinist, unforeseeable, apparently stocastic, showing an intensity (0,5 - <st1:metricconverter productid="1,5 cm" st="on">1,5 cm</st1:metricconverter>., conventional measure) and duration of the cycles (oscillating between 9 and 12 sec., i.e., 6 circle /sec.), but regulated, in reality, from a more refined order, than binds them inside of a strange attractor in the space phase (1-11).<o:p></o:p></span></p> <p style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style="" lang="EN-GB"><span style=""> </span>From the above microcirculatory remarks, derives that Clinical investigation allows doctor to gather, for the first time clinical, precious information on the biological system function and structure, through the data observed on the structure and activity of the relative microcirculatory system, both at rest and during stress tests. The evaluation of biological activity is based above all on bedside analysing micro-vascular system of several parenchymas under different situations, normal or not, according to Angiobiopaty theory. <o:p></o:p></span></p> <p style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style="" lang="EN-GB">In reader’s interest, to comprise the real significance of Angiobiopaty, whose role is fundamental in the Quantum Biophysical Semeiotics, is firstly unavoidable <span style=""> </span>to examine in details the concept of Angiobiotopy , according to Tischendorf.<strong><o:p></o:p></strong></span></p> <p style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style="" lang="EN-GB">First of all, it is not surprising the fact that the biological systems adapt, so to speak, the relative tissue-micro-vascular units to the single request of their various regions. For example, the system of the so-called “preferential channels” represents, for still unknown reasons, a structural particularitity of intestine and eye conjunctive, while the formation of meshes of the arterioles and the venules characterises the skeletal musculature. Naturally, a structural disposition of both above-mentioned vessel types can be observed - in less or more intense way - also in other organs and tissue, for instance, to mesentery and pia mater. In mesentery the formation of ring-like anastomoses of the arteries and the veins is limited generally to the branches of greater bore, while the smallest arteries and the arteriole are subdivided dycotomically of new, like branches of a tree, in order to end in the capillaries. Moreover, during their transformation in smaller vessels its diameter constantly becomes conical: for this their form is not still cylindrical, but conical and is fine. According to S.B. Curri, we may admit the hypothesis that these structural differences regarding microvessel modifications are not connected exclusively to the various function of the supplied tissues, but also to their various disposition it spaces, and therefore, to topographical factors. Thus as an example the micro-structure of the human skin constitutes one of the more meaningful aspects of the combination between the "structural principle to net" and the dycotomic subdivision of the capillaries. While in derma deeper regions micro-vessels form the artero-arterioses and veno-venose anastomoses in the subpapillare plex, cutaneous arterial and venous, the capillaries in epidermis from small arteries end in smallest vessels: these are found horizontal under epidermis, circulating itself in a capillary after other that heads vertically towards high; or they go directly towards the epidermis layer bases, circulating in many capillaries to form of small bush. An other example of micro-vessel structure is represented from the capillary beds of the liver and of the spleen, that show how much clearly the anatomical structure of an organ and its specific functions are in a position to modifying distribution model space of the little vessels, radically different <span style=""> </span>from the two above-mentioned fundamental models.<o:p></o:p></span></p> <p style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style="" lang="EN-GB"><span style=""> </span>It can be said therefore that the rules of the architectonic plan of the capillary nets are subordinated to the organ-specific architectonic peculiarities. From above shortly reported information, one comprehends that the structure of the capillary beds cannot be identical, always the same, and that differences are present, so that various structural principles can coexist. On the other hand, there are body regions, e.g., eye conjunctive, whose circle ends much irregular and it seems un-forseable: thus, <span style=""> </span>it’s possible one or another type of microcirculatory bed. As states my Master,<span style=""> </span>main goal of the future researches is to determine for every important region of an organ or tissue - from patho-physiological view-point – what is the constructive plan of the capillary bed. The intuition, before, and the demonstration, then, of the correlation tightened between structure and function of every parenchyma and that one of the relative micro-vascular system represents the central aspect of the Angiobiopathy theory, that has opened revolutionary new way to diagnosis, differential-diagnosis, therapeutic monitoring and clinical research.<o:p></o:p></span></p> <p style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <form> <p class="MsoNormal"><b style=""><span style="" lang="EN-GB">Krogh was right! <o:p></o:p></span></b></p> <p class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">As Krogh had previewed in its Lecture in occasion of the Nobel Prize ceremony in 1920 (1), the study of the micro-vessels shows today fortunately its original, essential and reliable utilization in bedside examination of all biological systems, beside obviously macro- and micro-circulatory system, in physiological and pathological conditions, emphasising a paramount value in diagnosing and researching, thanks to Quantum Biophysical Semeiotics. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In fact, the clinical study of the micro-circle and the microcirculation of every apparatus and tissue, allows to doctor bedside gathering reliable information on structure and functions of all biological system, as well as <span style=""> </span>to recognize and analyze biological and biological-molecular events of the relative parenchyma, under different conditions. Moreover, in every biological systems there is no-local realm, I have demonstrated for the first time, wherein information is simultaneous, beside the well-known local realm. At this point, I have to thank my friend Paolo Manzelli, discoverer of the triadic nature of information (12-24), for his <span style=""> </span>precious advices on Quantum Physics. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Interestingly, the "intense" digital pressure, applied, e.g., upon trigger-points of the neuronal centres for release hormone, provokes the simultaneous associated microcirculatory activation of type I, physiological, <span style=""> </span>in all nervous system, including the above-mentioned centres. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In health, “simultaneously” with the beginning of the stimulation, the stomach does not show any modification of its form and volume, which occurs only after the physiological latency time, as aspecific gastric reflex. In other words, under this experimental condition, is absent the simultaneous non-specific gastric reflex at the beginning of the test.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">On the contrary, in presence of whatever cerebral lesion, both structural and functional in nature, like CAEMH (1-7), we simultaneously observe aspecific gastric reflex, whose intensity in cm. parallels th seriousness of underlying disorder (12-24. Therefore, on the base of the no-local realm in Biology, it is possible to bedside recognize, with a stethoscope, in a second, in reliable, elegant, and quick way, brain disorders, and analogously those of different parenchyma, by means of the evaluation of the relative tissue-microvascular units, “simultaneously” activated in the correspondent biological system by such “intense” stimulation of the relative trigger-points (10-25). The data, quickly gathered, direct subsequently the physical examination towards the really suffering biological system or tissue, allowing to utilise it at the best loosing<span style=""> </span>less time. <o:p></o:p></span></p> </form> <p class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal"><strong>References</strong></p> <ol start="1" type="1"><li class="MsoNormal" style="text-align: justify;">Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. Travel Factory, Roma, 2004. <a href="http://www.travelfactory.it/">http://www.travelfactory.it</a></li><li class="MsoNormal" style="text-align: justify;">Stagnaro S., Stagnaro-Neri M., <st1:personname productid="La Melatonina" st="on">La Melatonina</st1:personname> nella Terapia del Terreno Oncologico e del “Reale Rischio” Oncologico. Travel Factory, Roma, 2004.</li><li class="MsoNormal" style="text-align: justify;">Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico-Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Travel Factory, Roma, 2004.</li><li class="MsoNormal" style="text-align: justify;">Stagnaro S., Stagnaro-Neri M., Single Patient Based Medicine.La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. Travel Factory, Roma, 2005.</li><li class="MsoNormal" style="text-align: justify;">Stagnaro Sergio. Teoria Patogenetica Unificata, 2006, Ed. Travel Factory, Roma.</li><li class="MsoNormal" style="text-align: justify;">Stagnaro Sergio.<b style=""> </b>Semeiotica Biofisica Quantistica: <st1:personname productid="La Teoria" st="on">La Teoria</st1:personname> dell’Angiobiopatia. <a href="http://www.fce.it/">www.fce.it</a>,<span style=""> </span><a href="http://www.fcenews.it/index.php?option=com_content&task=view&id=1451&Itemid=47">http://www.fcenews.it/index.php?option=com_content&task=view&id=1451&Itemid=47</a></li><li class="MsoNormal" style="text-align: justify;">Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica. Gazz Med. It. – Asch. Sci, Med. 144, 423, 1985.</li><li class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Stagnaro-Neri M., Stagnaro S., Auscultatory Percussion Evaluation of Arterio-venous Anastomoses Dysfunction in early Arteriosclerosis. Acta Med. Medit. </span>5, 141, 1989.</li><li class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Stagnaro-Neri M., Moscatelli G., Biophysical Semeiotics: deterministic Chaos and biological Systems. </span>Gazz. Med. It. – Arch. Sc. Med. 155, 125, 1996.</li><li class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Stagnaro-Neri M., Stagnaro S., Deterministic Chaos, Preconditioning and Myocardial Oxygenation evaluated clinically with the aid of Biophysical Semeiotics in the Diagnosis of ischaemic Heart Disease even silent. </span>Acta Med. Medit. 13, 109, 1997.</li><li class="MsoNormal" style="text-align: justify;"><span style=";font-family:Verdana;font-size:10;" >Stagnaro Sergio.</span><span style=";font-family:Verdana;font-size:10;" > Diagnosi clinica di cuore sano in un secondo! 7 Aprile 2008. <span style=""><a href="http://www.fce.it/" target="_blank">www.fce.it</a><b> </b></span><a href="http://www.fcenews.it/index.php?option=com_content&task=view&id=1218&Itemid=47" target="_blank">http://www.fcenews.it/index.php?option=com_content&task=view&id=1218&Itemid=47</a></span></li><li class="MsoNormal" style="text-align: justify;"><span style=";font-family:Verdana;font-size:10;" >Stagnaro Sergio e<i> </i>Paolo Manzelli.</span><span style=";font-family:Verdana;font-size:10;" > Semeiotica Biofisica Endocrinologica: Meccanica Quantistica e Meccanismi d’Azione Ormonali. Dicembre 2007, <a href="http://www.fce.it/">www.fce.it</a>, </span><span style="font-family:Verdana;"><a href="http://www.fcenews.it/index.php?option=com_content&task=view&id=816&Itemid=45"><span style="font-size:10;">http://www.fcenews.it/index.php?option=com_content&task=view&id=816&Itemid=45</span></a></span></li><li class="MsoNormal" style="text-align: justify;"><span style=";font-family:Verdana;font-size:10;" >Stagnaro Sergio e<i> </i>Paolo Manzelli.</span><span style=";font-family:Verdana;font-size:10;" > Natura Quantistica di una Originale Manovra Semeiotico-Biofisica di Epatopatia. Dicembre 2007, <a href="http://www.fce.it/">www.fce.it</a>, <a href="http://www.fcenews.it/index.php?option=com_content&task=view&id=862&Itemid=45">http://www.fcenews.it/index.php?option=com_content&task=view&id=862&Itemid=45</a></span></li><li class="MsoNormal" style="text-align: justify;"><span style=";font-family:Verdana;font-size:10;" >Stagnaro Sergio e<i> </i>Paolo Manzelli.</span><span style=";font-family:Verdana;font-size:10;" > Semeiotica Biofisica Quantistica.<span style="color:red;"> </span></span><span style=";font-family:Verdana;color:red;" ><a href="http://www.ilpungolo.com/leggi-tutto.asp?IDS=13&NWS=NWS5243"><span style="font-size:10;">http://www.ilpungolo.com/leggi-tutto.asp?IDS=13&NWS=NWS5243</span></a></span> <span style=";font-family:Verdana;font-size:10;color:navy;" >2007</span></li><li class="MsoNormal" style="text-align: justify;"><span style=";font-family:Verdana;font-size:10;" >Stagnaro Sergio e<i> </i>Paolo Manzelli</span><span style=";font-family:Verdana;font-size:10;" >,<b><span style="color:red;"> </span></b>Semeiotica Biofisica Quantistica: la manovra di attivazione surrenalica jatrogenetica. 09-1-2008, <b><span style=""> </span></b><a href="http://www.fcenews.it/index.php?option=com_content&task=view&id=161&Itemid=63">http://www.fcenews.it/index.php?option=com_content&task=view&id=161&Itemid=63</a></span></li><li class="MsoNormal" style="text-align: justify;"><span style=";font-family:Verdana;font-size:10;" >Stagnaro Sergio e<i> </i>Paolo Manzelli.</span><span style=";font-family:Verdana;font-size:10;" > L’Esperimento di Lory. Scienza e Conoscenza, N° 23, 13 Marzo 2008. <a href="http://www.scienzaeconoscenza.it/articolo.php?id=17775" target="_blank">http://www.scienzaeconoscenza.it//articolo.php?id=17775</a></span></li><li class="MsoNormal" style="text-align: justify;"><span style=";font-family:Verdana;font-size:10;" >Stagnaro <strong><span style="font-family:Verdana;"> </span></strong>Sergio<strong><span style="font-family:Verdana;">.</span></strong></span><strong><span style="font-weight: normal;font-family:Verdana;font-size:10;" > </span></strong><span style=";font-family:Verdana;font-size:10;" >Non Local Realm. <strong><span style="font-weight: normal;font-family:Verdana;" > </span></strong></span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" >Response to Selection for Social Signalling Drives the Evolution of Chameleon Colour Change. (<st1:date month="2" day="1" year="2008" st="on">01 February 2008</st1:date>). <a href="http://www.plos.com/" target="_blank">www.plos.com</a>, <a href="http://biology.plosjournals.org/perlserv/?request=read-response&doi=10.1371/journal.pbio.0060025" target="_blank">http://biology.plosjournals.org/perlserv/?request=read-response&doi=10.1371/journal.pbio.0060025</a></span><span style="" lang="EN-GB"><o:p></o:p></span></li><li class="MsoNormal" style="text-align: justify;"><span style=";font-family:Verdana;font-size:10;" >Stagnaro Sergio.<b> </b></span><st1:personname productid="La Diagnosi Clinica" st="on"><strong><span style="font-weight: normal;font-family:Verdana;font-size:10;" >La Diagnosi Clinica</span></strong></st1:personname><strong><span style="font-weight: normal;font-family:Verdana;font-size:10;" > nella Semeiotica Biofisica Quantistica</span></strong><strong><span style=";font-family:Verdana;font-size:10;" >.</span></strong><span style=";font-family:Verdana;font-size:10;" > <a href="http://www.fce.it/" target="_blank">www.fce.it</a> </span><span style=";font-family:Verdana;font-size:10;" >02-05-2008, <span style=""><a href="http://www.fcenews.it/index.php?option=com_content&task=view&id=1285&Itemid=47" target="_blank">http://www.fcenews.it/index.php?option=com_content&task=view&id=1285&Itemid=47</a></span></span></li><li class="MsoNormal" style="text-align: justify;"><span style=";font-family:Verdana;font-size:10;" >Stagnaro Sergio.<b> </b></span><span style=";font-family:Verdana;font-size:10;" >Semiotica Biofisica Quantistica: Diagnosi di Cuore sano in un Secondo in paziente distante <st1:metricconverter productid="200 KM" st="on">200 KM</st1:metricconverter>! <b><a href="http://www.fce.it/" target="_blank">www.fce.it</a>, </b>07-05-2008 <a href="http://www.fcenews.it/index.php?option=com_content&task=view&id=1316&Itemid=47" target="_blank">http://www.fcenews.it/index.php?option=com_content&task=view&id=1316&Itemid=47</a></span></li><li class="MsoNormal" style="text-align: justify;"><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" >Stagnaro Sergio.<b> </b></span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" >Role of NON-LOCAL Realm in Primary Prevention with Quantum Biophysical Semeiotics. <a href="http://www.nature.com/" target="_blank">www.nature.com</a>, <st1:date month="2" day="1" year="2008" st="on">01 Feb, 2008-05-17</st1:date><a href="http://www.nature.com/news/2008/080130/full/451511a.html" target="_blank"> http://www.nature.com/news/2008/080130/full/451511a.html</a></span><span style="" lang="EN-GB"><o:p></o:p></span></li><li class="MsoNormal" style="text-align: justify;"><span style=";font-family:Verdana;font-size:10;" >Stagnaro Sergio e Manzelli Paolo<b>. </b></span><span style=";font-family:Verdana;font-size:10;" > Semeiotica Biofisica Quantistica: Livello di Energia libera tessutale e Realtà non locale nei Sistemi biologici. <span style="color:red;"><a href="http://www.fce.it/" target="_blank">www.fce.it</a> </span>, 29 maggio 2008, <a href="http://www.fcenews.it/index.php?option=com_content&task=view&id=1421&Itemid=47" target="_blank">http://www.fcenews.it/index.php?option=com_content&task=view&id=1421&Itemid=47</a></span></li><li class="MsoNormal" style="text-align: justify;"><span style="">Stagnaro Sergio</span>. <span style="color:red;"><span style=""> </span></span><span style=""> </span>SEMIOTICA BIOFISICA Quantistica.<span style=""> </span>Scienza&Conoscenza, 8-10-2008<span style=""> </span><a href="http://www.scienzaeconoscenza.it/articolo.php?id=21568">http://www.scienzaeconoscenza.it/articolo.php?id=21568</a></li><li class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Stagnaro Sergio</span><span style="" lang="EN-GB">. <span style=""> </span>Benjamin Libet’s experiments: Quantum Biophysical Semeiotics view-point! <i style="">The General Science Journal. </i>31 Dec. 2008.</span><span lang="EN-GB"> </span><span style="" lang="EN-GB"><a href="http://www.wbabin.net/comments/stagnaro.htm">http://www.wbabin.net/comments/stagnaro.htm</a> </span></li><li class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Stagnaro Sergio</span><span style="" lang="EN-GB">. <span style=""> </span>Quantum Biophysical Semeiotics Enlightens Benjamin Libet’s Experiments. <a href="http://www.fce.it/"><span style="" lang="IT">www.fce.it</span></a></span>, 14<span style=""> </span>gennaio 2009. <span style="" lang="EN-GB"><a href="http://www.fceonline.it/index.php?option=com_content&task=view&id=2194&Itemid=45">http://www.fceonline.it/index.php?option=com_content&task=view&id=2194&Itemid=45</a><o:p></o:p></span></li><li class="MsoNormal" style="text-align: justify;"><span style="">Stagnaro Sergio</span>. Ruolo dell’Angiobiopatia nella Semeiotica Biofisica Quantistica, <a href="http://www.ilpungolo.com/">www.ilpungolo.com</a>, <span class="bodydochome">29 Maggio 2008, </span><span style="color: rgb(51, 51, 51);"><a href="http://www.ilpungolo.com/leggi-tutto.asp?IDS=13&NWS=NWS5609">http://www.ilpungolo.com/leggi-tutto.asp?IDS=13&NWS=NWS5609</a> </span><span style="" lang="EN-GB"><o:p></o:p></span></li></ol> <p class="MsoNormal" style="margin-left: 18pt; text-align: justify;"><o:p> </o:p></p> <p class="MsoNormal" style="margin-left: 18pt; text-align: justify;"><o:p> </o:p></p> <p class="MsoNormal"><b style=""><span style=";font-family:Arial;font-size:10;" >Sergio Stagnaro MD<o:p></o:p></span></b></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" >Via Erasmo Piaggio 23/8, CP. 42</span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" >16039 Riva Trigoso (Genoa) <b style="">Europe</b></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" >Founder of Quantum Biophysical Semeiotics</span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" >Who's Who in the World (and <st1:place st="on"><st1:country-region st="on">America</st1:country-region></st1:place>)</span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" >since 1996 to 2009<o:p></o:p></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" >Ph 0039-0185-42315<o:p></o:p></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" >Cell. 3338631439</span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" ><a href="http://www.semeioticabiofisica.it/"><span style="" lang="EN-GB">www.semeioticabiofisica.it</span></a></span><span style=";font-family:Arial;font-size:10;" > </span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" ><a href="mailto:dottsergio@semeioticabiofisica.it"><span style="" lang="EN-GB">dottsergio@semeioticabiofisica.it</span></a></span><span style="" lang="EN-GB"><o:p></o:p></span></p>Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-73571197862141224602009-05-07T01:14:00.000-07:002009-05-07T01:16:44.373-07:00Quantum Biophysical Semeiotics Evaluation of pancreatic beta-Cell Function by means of acute pick stimulation of GH-RH secretion.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhkd-wL9FbH4q2jy2H4skvnElAW03SQ7qXeQ_TqbLIs0Pje1WTiHgMBRsGQl2PQouyn-BQKSCn0VB4AuqIXb6yAedzFQU6gCG_reZDij2TTKeZV56jX8zcpExIvysR_UQFOqIKWr7JmuGj-/s1600-h/sergio.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 200px; height: 143px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhkd-wL9FbH4q2jy2H4skvnElAW03SQ7qXeQ_TqbLIs0Pje1WTiHgMBRsGQl2PQouyn-BQKSCn0VB4AuqIXb6yAedzFQU6gCG_reZDij2TTKeZV56jX8zcpExIvysR_UQFOqIKWr7JmuGj-/s200/sergio.jpg" alt="" id="BLOGGER_PHOTO_ID_5332992952464816738" border="0" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhPeUg36g3CMlcd3eRS5rQhdPcF9tL8b4mXj406UTFdOxvH7WRHd9KtA5sCcutT-i2BwYD3YyrFC4rOvZmTh2oObU5kdTlTzjdI9qsA-oQqU9ueOZGfcojihAhPrFPEVwPri0wLvjco11iN/s1600-h/Pancreas.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 144px; height: 200px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhPeUg36g3CMlcd3eRS5rQhdPcF9tL8b4mXj406UTFdOxvH7WRHd9KtA5sCcutT-i2BwYD3YyrFC4rOvZmTh2oObU5kdTlTzjdI9qsA-oQqU9ueOZGfcojihAhPrFPEVwPri0wLvjco11iN/s200/Pancreas.jpg" alt="" id="BLOGGER_PHOTO_ID_5332992801287360738" border="0" /></a><br /><br /><h3><a name="_Toc114878442"><span style="" lang="EN-GB">Introduction.</span></a><span style="" lang="EN-GB"> <o:p></o:p></span></h3> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">Among other well-known biological activities, Growth Hormone (GH) plays an important role in metabolism, as well as in regulating insulin secretion <span style="color:black;">from </span>the </span><span lang="EN-GB" style="font-family:Symbol;"><span style="">b</span></span><span style="" lang="EN-GB">-pancreatic cells, additionally controlling GH-RH secretion (analogously, e.g., thyroid hormone) (1-8). <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">Interestingly, the emerging age of Quantum Biophysical Semeiotics allows doctors, especially General Practitioners, to assess pancreas chaotic-determinist oscillations (fluctuations – 6 x sec. –<span style=""> </span>of pancreatic body vertical diameter) (1-8), correlated with functional endocrine activity of the gland, according to Angiobiopathy theory (6-12).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">(For technical information,See <a href="http://www.semeioticabiofisica.it/">http://www.semeioticabiofisica.it</a>, Technical Page 4).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><span style=""> </span>The acute stimulation of GH-RH secretion, is brought about by “mean-intense” digital pressure applied on the related trigger-points (Fig.1 and 2).<o:p></o:p></span></p> <p class="MsoBodyText2"><span lang="EN-GB"><span style=""> </span>Consequently, with the aid of Quantum Biophysical Semeiotics, physicians can evaluate bedside endocrine pancreas efficiency during the acute stimulation of the GH-RH and, thereby,<span style=""> </span>obtaining useful and reliable GH information regarding current insulin secretion activity and efficiency (1, 2, 4, 7, 8). </span></p> <p class="MsoBodyText2"><span lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">Moreover,<span style=""> </span><b style="">quantum-<span style="">biophysical-semeiotic preconditioning </span></b>(9), (also <a href="http://www.semeioticabiofisica.it/">http://www.semeioticabiofisica.it</a> ),<span style=""> </span>enables the the practitioner<span style=""> </span>can assimilate information (</span><span style="" lang="EN-US">using the variables of Auscultatory Percussion and so-called Auscultatory Percussion-Reflex-Diagnostic, which studies non-linear dynamics of all biological systems)</span><span style="" lang="EN-GB"> regarding the patient’s condition, as well as the possible insulin secretion evolution: physiological insulin secretion, hypersecretion of insulin (IIR) with or without initial failure of the pancreatic </span><span lang="EN-GB" style="font-family:Symbol;"><span style="">b</span></span><span style="" lang="EN-GB">-cells (prediabetes), overt type 1 and type 2 diabetes mellitus, even in early phase. <o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">Finally, bedside evaluation can also reveal pancreatic endocrine activity, employing analogously other “endogenous” hormones of insulin counter-regulation (i.e., thyroid hormone, glucagone, adrenalin) (6, 7). <o:p></o:p></span></p> <p class="MsoBodyTextIndent" style="text-align: left;" align="left"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoBodyTextIndent" style="text-align: left; text-indent: 0cm;" align="left"><b style=""><span style="" lang="EN-GB"><span style=""> </span><o:p></o:p></span></b></p> <h3><a name="_Toc114878443"></a><a name="_Toc114795894"><span style=""><span style="" lang="EN-GB">Method.</span></span></a><span style="" lang="EN-GB"><o:p></o:p></span></h3> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">With the subject in supine position, psycho-physically relaxed (eyes open to avoid the melatonin secretion), the practitioner performs repetitive auscultatory percussion of a short tract of the lower pancreatic margin, assessing accurately its fluctuations, chaotic-determinist under physiological condition (Fig. 1). <o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">For comprehensible reasons, the gathered data are meal-dependent, showing different parametric values in relation to the meals, i.e., in the absorptive or in the post-absorptive state.<o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">However, <span style=""> </span>in the practice, such as fact results neither important nor significant.<o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">Notoriously, in overt type 2 diabetes, that is to say in manifest disorder, the dimensionality (i.e., value of deterministic chaos in a determined biological system, in our case the pancreas) fluctuations appear significantly and gradually reduced, all equal, and minimal, showing the fractal dimension of 1, i.e., topological dimension (6). <o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">At this point, General Practitioner applies “mean-intense” digital pressure on the trigger-points of<span style=""> </span>GH-RH neuronal centre, that is located <st1:metricconverter productid="2 cm" st="on">2 cm</st1:metricconverter>. over external auditory meatus (Fig. 2), evaluating accurately the pancreatic size behaviour. <o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">In health, after approximately 6 seconds, the pancreas decongests suspending temporarily its secretive activity: the lower margin of the pancreatic body rises and remains in this higher position for <b>10 sec. exactly.</b> In the absorptive state, the duration is approximately <b>11-12 seconds</b> (in a non significant manner).<o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB"><span style=""> </span>Under this experimental condition, pancreatic microcirculation shows the phenomenon of “microcirculatory disactivation”, characterized from minimal microvessel activity, resulting from the lesser flow-motion: in both vasomotility and<span style=""> </span>vasomotion, <span style="color:black;">according to Hammersen (7) </span>fluctuation intensity is hardly <st1:metricconverter productid="0,5 cm" st="on">0,5 cm</st1:metricconverter>., and the durartion of AL + PL phase appears to be 5 sec., (6, 8, 10,11, 12) (See the above cited web site <a href="http://www.semeioticabiofisica.it/microangiologia">http://www.semeioticabiofisica.it/microangiologia</a>).<span style=""> </span><o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">On the contrary, in the subject with insulin hypersecretion<span style=""> </span>(IIR), the pancreas decongestion (i.e., pancreatic functional rest) appears prolonged (<b>12-14 sec.</b> significantly) in direct relationship with the intensity of insulin secretion (i.e., hyperinsulinaemia). <o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">The behavior of the pancreas during the biophysical-semeiotic preconditioning is briefly illustrated, allowing the practioner to immediately recognize insulin hypersecretion (IIR), with or without slow tendency to the </span><span lang="EN-GB" style="font-family:Symbol;"><span style="">b</span></span><span style="" lang="EN-GB">-pancreatic cell failure, and, lastly, overt type 2 diabetes. <o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">In diabetes mellitus, even in its initial phases, the duration of pancreatic decongestion appears significantly reduced (</span><b><span style="font-family:Symbol;"><span style="">£</span></span></b><b><span style="" lang="EN-GB"> 9 sec.</span></b><span style="" lang="EN-GB">), in obvious relation the severity of<span style=""> </span>the underlying disorder.<o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoBodyTextIndent" style="text-indent: 0cm;"><span style="" lang="EN-GB"><span style=""> </span>Beside evaluation can result in important data regarding insulin secretion<span style=""> </span>using <b style="">quantum-<span style="">biophysical-semeiotic preconditioning</span></b>. (After accurately assessing the duration of pancreatic decongestion brought about by the acute peak of the GHRH secretion, withdraw the digital pressure, consequently removing<span style=""> </span>the hormonal hypersecretion of GH, <b>for 5 seconds exactly</b>. Immediately repeat the evaluation a second time, as described above.)<o:p></o:p></span></p> <p class="MsoBodyTextIndent" style="text-indent: 0cm;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB"><span style=""> </span>In a healthy patient, the duration of the pancreatic decongestion rises from <b>exactly 10 sec.</b> (i.e., normal basal value) to <b>14 sec.,</b> in a statistically significant way, a result of the physiological activation of local Microcirculatory Functional Reserve (9, 10). <o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">Interestingly, in hyperinsulinsecretion (IIR), one observes a large number of parameter (i.e., duration) behaviours, which parallel the present functional efficacy of the endocrine pancreas activity, in individuals with or without diabetic constitution (11):<o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoBodyTextIndent" style="text-indent: 0cm;"><span style="" lang="EN-GB">a)<span style=""> </span>in preconditioning, the duration of pancreatic decongestion can arise either to <b>more than 14 sec.</b> or hardly to <b>11-12 sec.</b> in not meaningful way, in relation to the efficiency condition of insulin secretion; <o:p></o:p></span></p> <p class="MsoBodyTextIndent" style="text-indent: 0cm;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoBodyTextIndent" style="text-indent: 0cm;"><span style="" lang="EN-GB">b) the duration does not show modification, so that<span style=""> </span>it persists unchanged in the comparison of the initial, basal value;<o:p></o:p></span></p> <p class="MsoBodyTextIndent" style="text-indent: 0cm;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoBodyTextIndent" style="text-indent: 0cm;"><span style="" lang="EN-GB">c) this parametric value (= duration length) results reduced, e.g., <b>9 sec.</b>, indicating the “quantitative” alteration of </span><span lang="EN-GB" style="font-family:Symbol;"><span style="">b</span></span><span style="" lang="EN-GB">-cell secretion. <o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">Identical are the data collected also, for example, using the stimulation of the TSH-RH (Fig.2), that provokes the acute peak of thyroid hormone secretion, as demonstrates the contemporaneous associated microcirculatory activation, type <st1:metricconverter productid="1, in" st="on">1, in</st1:metricconverter> the thyroid (8, 9): “variant” biophysical semeiotics test. <o:p></o:p></span></p> <h3 style="text-align: justify;"><a name="_Toc114878444"></a><a name="_Toc114795895"><span style=""><span style="" lang="EN-GB">Discussion and conclusions.</span></span></a><span style="" lang="EN-GB"><o:p></o:p></span></h3> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">Today, literature worldwide reflects an increased urgency for early recognition of the Metabolic Syndrome,<span style=""> </span>and its risk factors (CAD, CVD, type 2 DM, etc.) as well as its pathophysiological and clinical definition (13-15). <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">From quantum-biophysical-semeiotic view-point (6, 12, 14, 15), Pre-Metabolic Syndrome, always precedes Metabolic Syndrome for years and even decades,<span style=""> </span>(V. also <a href="http://www.semeioticabiofisica.it/microangiologia">http://www.semeioticabiofisica.it/microangiologia</a>), and involves<span style=""> </span>both sexes, <b>with</b> or <b>without</b> diabetes, but “all” experiencing dyslipidaemic complication.. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">For this reason, we can finally understand why glucose metabolism alterations and type 2 diabetes are present only in well-defined patient population with metabolic syndrome, as well as why doctors can now fortunately recognize numerous early clinical stages of the metabolic syndrome resulting in positive and favorable benefits in primary prevention.. <o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">Because of the numerous and dangerous complications of Metabolic Syndrome in individuals with both dyslipidaemia and diabetes,<span style=""> </span>large scale optimal primary prevention of metabolic syndrome, is needed to allow doctors<span style=""> </span>the diagnostic “clinical” tool, to determine pancreatic endocrine complications<span style=""> </span>and enabling<span style=""> </span>future monitoring.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><span style=""> </span>As recent as four years ago, Biophysical Semeiotic testing became a reliable and useful means for clinicians, to assess insulin-secretion conditions, physiological and pathological, including functional failure of pancreatic </span><span style="font-family:Symbol;"><span style="">b</span></span><span style="" lang="EN-GB">-cells, even in the initial stage.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">In conclusion, Quantum-Biophysical Semeiotic testing, above briefly described,<span style=""> </span>is a useful tool for diagnosis, therapeutic monitoring, and clinical research.<o:p></o:p></span></p> <span style=";font-family:";font-size:12;" lang="EN-GB" > </span> <p class="MsoNormal"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <h3><a name="_Toc114878445"></a><a name="_Toc114795896"><span style="">References.</span></a></h3> <p class="MsoNormal"><o:p> </o:p></p> <p class="MsoNormal" style="text-align: justify;"><span style="">1)<b><span style=""> </span></b><span style="">Stagnaro S., Stagnaro-Neri M<b>.</b></span> Valutazione percusso-ascoltatoria del Diabete Mellito. Aspetti teorici e pratici. Epat. 32, 131</span>, <span style="">1986.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style=""><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="">2)<b><span style=""> </span></b><span style="">Stagnaro-Neri M., Stagnaro S.</span>, Il Segno di Bilancini-Lucchi nella diagnosi clinica del diabete mellito. </span><span style="" lang="EN-GB">The Pract. Ed. It. 176, 30</span><span style="" lang="EN-GB">,</span><span style="" lang="EN-GB">1993.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;">3) <span style="">Stagnaro-Neri M., Stagnaro S.</span><span style="">, Sindrome di Reaven, classica e variante, in evoluzione diabetica. Il ruolo della Carnitina nella prevenzione del diabete mellito. Il Cuore. 6, 617, 1993 </span><b><span lang="EN-GB" style="font-family:Symbol;"><span style="">[</span></span></b><b style=""><span style="">Medline<span style="">]</span></span></b><span style=""> </span></p> <p class="MsoNormal" style="text-align: justify;"><o:p> </o:p></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">4)<b><span style=""> </span></b><span style="">Stagnaro S.<b>, </b></span>Diet and Risk of Type 2 Diabetes.<span style=""> </span></span><span style="" lang="EN-GB">N Engl J Med. 2002 Jan 24;346(4):297-298. letter </span><b><span lang="EN-GB" style="font-family:Symbol;"><span style="">[</span></span></b><b style=""><span style="" lang="EN-GB">Medline<span style="">]<o:p></o:p></span></span></b></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">5) </span><span style="" lang="EN-GB">Stagnaro S</span><span style="" lang="EN-GB">. </span><span style="" lang="EN-GB">Pre-metabolic syndrome: the real initial stage of metabolic-syndrome, type 2 diabetes and arteroscleropathy. </span><i><span style="">Cardiovascular Diabetology</span></i><span style=""> 2004, <b>3:</b>1</span><span style="color:black;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style=""><a href="http://www.cardiab.com/content/3/1/1/comments">http://www.cardiab.com/content/3/1/1/comments</a>.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style=""><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="">6) <span style="">Stagnaro Sergio, Stagnaro-Neri Marina</span>.<b> </b>Introduzione alla Semeiotica Biofisica. Il Terreno oncologico”. </span><span style="" lang="EN-GB">Travel Factory SRL., Roma, 2004. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><a href="http://www.travelfactory.it/semeiotica_biofisica.htm"><span style="" lang="EN-GB">http://www.travelfactory.it/semeiotica_biofisica.htm</span></a><span style="" lang="EN-GB">.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span lang="EN-GB" style="color:black;">7) Cited in: S.B. Curri. </span><span style="color:black;">Le Microangiopatie. Inverni della Beffa, Verona, 1986.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><o:p> </o:p></p> <p class="MsoNormal" style="text-align: justify;">8) <span style="">Stagnaro-Neri M., Stagnaro S.</span>, Semeiotica Biofisica: valutazione clinica del picco precoce della secrezione insulinica di base e dopo stimolazione tiroidea, surrenalica, con glucagone endogeno e dopo attivazione del sistema renina-angiotesina circolante e tessutale. <span style="" lang="EN-GB">Acta Med. Medit. </span>13, 99, 1997.</p> <p class="MsoNormal" style="text-align: justify;"><o:p> </o:p></p> <p class="MsoNormal" style="text-align: justify;">9) <span style="">Stagnaro-Neri M., Stagnaro S<b>.</b></span><span style="">, Semeiotica Biofisica: la manovra di Ferrero-Marigo nella diagnosi clinica della iperinsulinemia-insulino resistenza. </span><span style="" lang="EN-GB">Acta Med. Medit. 13, 125</span><span style="" lang="EN-GB">,</span><span lang="EN-GB" style="color:navy;">1997.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span lang="EN-GB" style="color:navy;"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">10) </span><span style="" lang="EN-GB">Stagnaro-Neri M., Stagnaro S<b>.</b></span><span style="" lang="EN-GB">, Deterministic Chaos, Preconditioning and Myocardial Oxygenation evaluated clinically with the aid of Biophysical Semeiotics in the Diagnosis of ischaemic Heart Disease even silent. Acta Med. Medit. </span><span style="">13, 109</span>,<span style="">1997.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style=""><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="">11) </span><span style="">Stagnaro S., Stagnaro-Neri M<b>.</b></span>, Le Costituzioni<span style=""> </span>Semeiotico-Biofisiche. Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. <span style="" lang="EN-GB">Ediz. Travel Factory, Roma, 2004. </span><a href="http://www.travelfactory.it/semeiotica_biofisica.htm">http://www.travelfactory.it/semeiotica_biofisica.htm</a></p> <p class="MsoNormal" style="text-align: justify;"><span style=""><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;">12) <span style="">Stagnaro S., Stagnaro-Neri M</span>., <a name="_Toc86035793"></a><a name="_Toc80345074"></a><a name="_Toc75513822"><span style=""><span style="">Single Patient Based Medicine.</span></span></a><a name="_Toc86035794"></a><a name="_Toc80345075"></a><a name="_Toc75513823"><span style=""><span style="">La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina.</span></span></a> <span style="" lang="EN-GB">Travel Factory SRL., Roma, 2005. </span><span style=""><a href="http://www.travelfactory.it/semeiotica_biofisica.htm">http://www.travelfactory.it/semeiotica_biofisica.htm</a><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><b><o:p> </o:p></b></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-US">13) <strong><span style="font-weight: normal;">Kahn R., Buse J., Ferrannini<span style=""> </span>E. and Stern M</span>. </strong>The Metabolic Syndrome: Time for a Critical Appraisal.Joint statement from the American Diabetes Association and the European Association for the Study of Diabetes . <i>Diabetes Care</i> 28:2289-2304, 2005.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-US"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">14) <b style="">Stagnaro Sergio.<span style=""> </span></b></span><span style=";font-family:Verdana;color:red;" lang="EN-GB"><span style=""> </span></span><span style="" lang="EN-GB"><span style=""> </span>Pre-Metabolic Syndrome and Metabolic Syndrome: Biophysical-Semeiotic Viewpoint. <a href="http://www.athero.org/">www.athero.org</a>, 29 April, 2009. </span><a href="http://www.athero.org/commentaries/comm904.asp" target="_blank"><span style="" lang="EN-GB">http://www.athero.org/commentaries/comm904.asp</span></a><span style="" lang="EN-GB"><br /></span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" >15)<span style="color:red;"><span style=""> </span></span></span><b style=""><span style="" lang="EN-GB">Stagnaro Sergio.<span style=""> </span></span></b><span style=";font-family:Verdana;color:red;" lang="EN-GB"><span style=""> </span></span><span style="" lang="EN-GB"><span style=""> </span>CAD Inherited Real Risk, Based on Newborn-Pathological, Type I, Subtype B, Aspecific, Coronary Endoarteriolar Blocking Devices. Diagnostic Role of Myocardial Oxigenation and Biophysical-Semeiotic Preconditioning. <a href="http://www.athero.org/">www.athero.org</a>, 29 April, 2009<span style=""> </span></span><a href="http://www.athero.org/commentaries/comm907.asp" target="_blank"><span style="" lang="EN-GB">http://www.athero.org/commentaries/comm907.asp</span></a><strong><span style="font-weight: normal;" lang="EN-US"><o:p></o:p></span></strong></p> <strong><span style="font-weight: normal;font-size:12;" > </span></strong>Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-86226779997047995432009-05-05T08:59:00.000-07:002009-05-05T09:01:38.107-07:00Cerebral Tumour detected by Quantum-Biophysical Semeiotics since its Inherited Real Risk.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgV1tjOLMgdWcqp8wdYJriBipp-JGrZTbDMSi9Ol2FPoSHEQSg8U4aYr2_J5tM2pIG_SRedNd3h9m331GumwTUYo5RuP4_Uz37GBHQWfI-q4hVda0K5YM-481igxmk2FlTBc95hW8D5QAZA/s1600-h/sergio17.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 134px; height: 200px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgV1tjOLMgdWcqp8wdYJriBipp-JGrZTbDMSi9Ol2FPoSHEQSg8U4aYr2_J5tM2pIG_SRedNd3h9m331GumwTUYo5RuP4_Uz37GBHQWfI-q4hVda0K5YM-481igxmk2FlTBc95hW8D5QAZA/s200/sergio17.jpg" alt="" id="BLOGGER_PHOTO_ID_5332370511493234610" border="0" /></a><br /> <h2><br /><span style="" lang="EN-GB"></span></h2><h2><span style="" lang="EN-GB">Introduction<o:p></o:p></span></h2> <p class="MsoNormal" style="text-align: justify;"><u><span style="" lang="EN-GB"><o:p><span style="text-decoration: none;"></span></o:p></span></u><span style="" lang="EN-GB">From its initial stage, brain oncological process, occupying space, provokes local circulatory modifications of both hyperemic and ischemic type, secondary to biochemical and/or compressive events. Quantum Biophysical Semeiotics (BS) permits doctor to observe microcirculatory phenomena as well as<span style=""> </span>variations of the tissue pH<span style=""> </span>at the bed-side (See: my website <a href="http://www.semeioticabiofisica.it/">www.semeioticabiofisica.it</a>) (1-8). <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Furthermore, the cerebral potentials (1, 5), whether spontaneous or evoked, clearly altered or totally absent in case of tumour, may be evaluated “quantitatively” with the aid of BS, even in early stage.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In following, it is referred both the usefulness and reliability of such as semeiotics in diagnosing cerebral tumour, even in the initial phase of Inherited Real Risk (6, 9-14).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <h2><span style="" lang="EN-GB">Method <o:p></o:p></span></h2> <p class="MsoNormal" style="text-align: justify;"><u><span style="" lang="EN-GB"><o:p><span style="text-decoration: none;"> </span></o:p></span></u></p> <p class="MsoBodyText"><span style="" lang="EN-GB">As regards QBS of cerebral tumour, it is enough to know, from the technological point of view, the auscultatory percussion of the stomach (in above-cited website, Technical Page N° 1), which is performed with digital percussion, directly and “gently”, applied on abdominal skin, from outer areas towards the bell-piece of stethoscope along radial and centripetal lines, as indicated in Fig.1<o:p></o:p></span></p> <p class="MsoBodyText"><span style="" lang="EN-GB">When percussion is applied on organ or viscera skin projection areas, percussory sound is perceived as altered, modified, dull or hyperfonetic, in relation to the density of investigated structure, in any case “as originating from a site close to the doctor’s ears”.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Obviously, a complete knowledge of QBS permits<span style=""> </span>doctor to gather further information.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><span style=""> </span>There are a large number of other Quantum Biophysical Semeiotics data referring to cerebral tumour; however, as follows, are referred only some unavoidable signs, easy to evaluate and reliable in bed-side detecting cerebral tumour.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <h2><span style="" lang="EN-GB">Quantum Biophysical Semeiotic Signs of Cerebral Tumour<o:p></o:p></span></h2> <p class="MsoNormal" style="text-align: justify;"><u><span style="" lang="EN-GB"><o:p><span style="text-decoration: none;"> </span></o:p></span></u></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">At first doctor has to ascertain the so-called <span style="">oncological terrain<i> </i></span>(6), <i>conditio sine qua non </i><span style=""> </span>of malignancy , and<span style=""> </span>is composed particularly of:<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">1) <span style="">Congenital Acidosic Enzyme-Metabolic Histangiopaty</span> (CAEMH). Briefly, digital pressure of “middle” intensity upon skin projection area, e.g., of temporal convolutions (temporal lobe), brings about a gastric aspecific reflex more intense when right cerebral lobe is stimulated, due to the <span style="">right cerebral dominance</span>, typical for CAEMH: dominance of the right <span style="">Planum temporale</span>. (2,10).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">2) <span style="">Psycho-neuro-endocrine-immunological system dysfunction (6)</span>: in a easy manner doctor ascertains this pathological condition inviting the patient to close intensively his (her) eyes (= dark increases melatonin secretion, which in turns stimulates the secretion of endogenous oppioids, the so-called <span style="">orchestra directors of immunological system</span>): after 15 sec.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In health, digital pressure of small intensity, directly applied ,e.g., on a breast gland, causes gastric aspecific reflex with latency time of <b>3</b> sec.( i.e. <span style="">acute antibody synthesis syndrome</span>). <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">On the contrary, when eyes are open, latency time is <b>6</b> sec.(i.e. <span style="">chronic antibody synthesis syndrome</span>). <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">3) S<span style="">uck simulated test to provoke Prolactin Secretion</span>: repeated palpation of mammary gland provokes, in healthy individuals of both sexes and of middle<span style=""> </span>age,<span style=""> </span>gastric aspecific reflex of exact <b>6 </b>sec. duration. In case of inflammatory process, as flu, however, duration results prolonged (<b>7</b> sec. exactly). Finally, in subject with <span style="">oncological terrain</span> duration appears </span><b><span style="font-family:Symbol;"><span style="">³</span></span></b><b><span style="" lang="EN-GB"> 7</span></b><span style="" lang="EN-GB"> sec., in a direct relation to the degree of the psycho-neuro-endocrine-immunological system dysfunction. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">The duration is very prolonged, of course, in case of tumour. Physiologically, the test presents the most elevated duration in pregnacy, due to the particular endocrine situation, since initial stage.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><span style=""> </span>In a patient, who presents with a symptomatology suggestive of cerebral tumour (or in<span style=""> </span>asymptomatic patient, of course) other QBS signs are properly investigated.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">An interesting sign, particularly useful and reliable in bed-side detecting the presence of “something wrong” in the head is the following:<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">4) <i><span style=""> </span></i><span style="">Aspecific gastric-oculo reflex</span>. In health, the appearance of gastric aspecific reflex, physiologically <i>symmetric</i>, during digital pressure on the eye-ball (when patient’s eyes are closed, naturally) after a latency time<span style=""> </span><b>6</b> sec. and 1-<st1:metricconverter productid="2 cm" st="on">2 cm</st1:metricconverter>. in intensity.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">On the contrary, in case of cerebral neoplasia as well as other cerebral disorder, when pressure is exerted on the homolateral eye-ball, doctor observes initially a gastric aspecific reflex (lt <b>3</b> sec.; intensity > <st1:metricconverter productid="2 cm" st="on">2 cm</st1:metricconverter>.; duration 3 sec.), and, soon thereafter, the “autoimmune syndrome”: gall-bladder and stomach contract (gastric tonic contraction = <b>GTC</b>) and spleen become empty of blood: in practice, it is sufficient for the diagnosis ascertaining <b>GTC</b>.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In diagnosing clinically the cerebral tumour,<span style=""> </span>a major role is played by the:<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">5)<span style=""> </span>C<span style="">erebral-gastric aspecific reflex</span>: finger-pulp as well as finger-nail pressure (type I and type II, respectively) on skin projection area of the tumour provokes the “autoimmune syndrome”, as described above. Finally, in the presence of cerebral malignancy, there is always the:<o:p></o:p></span></p> <p class="MsoBodyText"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoBodyText"><span style="" lang="EN-GB">6) <span style="">Reticulo-Endothelial System Hyperfunction Syndrome</span> (RESHS) of “complete” type, that corresponds to BSR, but it is more sensitive and sensible.<o:p></o:p></span></p> <p class="MsoBodyText"><span style="" lang="EN-GB">In health, finger-pulp pressure on the middle line of sternal-body, iliac crests and skin projection area of the spleen causes aspecific gastric reflex after a latency time = 10 sec.exactly.<o:p></o:p></span></p> <p class="MsoBodyText"><span style="" lang="EN-GB">On the contrary, in case of cerebral cancer latency time results lowered, <span style=""> </span>in relation to disorder seriousness.<o:p></o:p></span></p> <p class="MsoBodyText"><span style="" lang="EN-GB">Finally, one must remember that <span style="">acute phase proteins</span> are augmented and both the <span style="">acute</span> <span style="">autoantibody secretion syndrome</span> and <span style="">circulating immuncomplex syndrom<i>e</i></span> (boxer’s test, i.e. patient is clenching his or her<span style=""> </span>fists, brings about gastric tonic contraction -GTC-, after appearing gastric aspecific reflex lasting 3 sec.) are present (2-9).<o:p></o:p></span></p> <p class="MsoBodyText"><span style="" lang="EN-GB">Due to the lack of reader’s Quantum Biophysical Semeiotic knowledge, at this moment I do not illustrate numerous other signs of cerebral tumour.<o:p></o:p></span></p> <p class="MsoBodyText"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">To summarize, QBS diagnosis of cerebral tumour is based (<i>at least</i>) on the following signs:<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">1)<span style=""> </span>Congenital Acidosic Enzymo-Metabolic Histangiopathy (CAEMH), which plays a primary role in the psycho-neuro-endocrine-immunological system dysfunction, I termed as <span style="">Oncological Terrain.</span><o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">2)<span style=""> </span>Oncological terrain (1-6);<o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">3)<span style=""> </span>Reticulo Endothelial System Hyperfunction Syndrome (RESHS) type “complete” (4);<o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">4)<span style=""> </span>Oculo-gastric aspecific reflex and then gastric tonic contraction (GTC) (1-6, 9,14);<o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">5)<span style=""> </span>Cerebro-gastric aspecific reflex (type I and II) followed by GTC(1-6, 9,14);<o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">5)<span style=""> </span>Acute phase proteins augmentation (3, 6);<o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">6)<span style=""> </span>Acute autoantibody secretion syndrome ((1-6, 9,14);<o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">7)<span style=""> </span>Circulating Immunocomplex Syndrome, above-described .<o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB"><o:p> </o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In addition, a lot of <span style="">clinical microangiological</span> signs, gathered at the bed-side by evaluating both <span style="">vasomotility</span> and <span style="">vasomotion</span> of cerebral microvessels, are actually interesting and precious in recognizing also cerebral malignancy since its first stage: due to reader’s inadequate Quantum Biophysical semeiotic knowledge:<span style=""> </span>I will illustrate these signs next,<span style=""> </span>in the future. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">As far as <span style="">Cerebral Evoked Potentials </span>is concerned, it is well-known that visive, auditory and somato-sensorial stimuli, through nervous in-puts, provoke physiologically the activation of corresponding nervous centres by mean of depolarization. Consequently, local cerebral microcirculation results more or less activated, allowing doctor to evaluate these events by means of Quantum Biophysical Semeiotics.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">If a subject looks at a light source, e.g., due to the stimulation of optic channels, impulses reache the bilateral cortical-occipital region and activate it, that is,<span style=""> </span>they evoke electrical potentials, demonstrating the anatomo-functional integrity of such nervous structures. Analogously, auditive and <span style="">somato-sensorial</span> stimuli (the later really more practical and therefore advisable) provoke electrical potentials, obviously in corresponding cortical centres. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Experimental (an individual is invited, e.g., to move or to “think of moving “ a hand) and clinical (epileptic focus, e.g.) evidence suggests that the cerebral evoked potentials can be evaluated by means of Quantum Biophysical Semeiotics, because of the hemoreological and microcirculatory phenomenology of the active hyperemic areas (In termes of <span style="">Cinical Microangiology</span>: activation type I, associated, of both <span style="">vasomotility</span> and <span style="">vasomotion</span>). In fact, the finger-pulp pressure of “middle” intensity on the cutaneous projection of an activated cerebral zone causes gastric aspecific reflex. Consequently, in case of cerebral malignancy, the absence of the cerebral evoked potentials shows the suffering of precise nervous channels, due to a disorder, easily ascertained at the bed side.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><b style=""><span style="" lang="EN-GB">References <!--[if !supportLineBreakNewLine]--> <!--[endif]--><o:p></o:p></span></b></p> <p class="MsoNormal"><span style="" lang="EN-GB">1)<span style=""> </span><span style="">Stagnaro S., Stagnaro-Neri M</span>. Auscultatory Percussion in Detection Focal Liver Lesions even Clinically Silent. Acta Med. Medit. 8, 89-94, 1992.</span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><span style="" lang="EN-GB">2) <span style="">Stagnaro S.</span>, Auscultatory percussion of the cerebral tumour: Diagnostic importance of the evoked potentials, Biol. Med., 7, 171-175, 1985.<o:p></o:p></span></p> <p class="MsoNormal"><span style="">3) <span style="">Stagnaro-Neri M., Stagnaro S.</span>, Cancro della mammella: prevenzione primaria e diagnosi precoce con la percussione ascoltata. Gazz. Med. It. – Arch.<span style=""> </span>Sc.<span style=""> </span>Med. 152, 447, 1993.<o:p></o:p></span></p> <p class="MsoNormal"><span style="">4) </span><span style="">Stagnaro S.</span>, Sindrome percusso-ascoltatoria di Iperfunzione del Sistema Reticolo-IstiocitarioMin. Med. 74, 479, 1983 <b><span style="font-family:Symbol;"><span style="">[</span></span>MEDLINE</b><b><span style="font-family:Symbol;"><span style="">]</span></span>.<span style=""> </span><o:p></o:p></b></p> <p class="MsoNormal">5)<span style=""> </span><span style=";font-family:Verdana;font-size:10;" >Stagnaro S.</span><span style=";font-family:Verdana;font-size:10;" >, Percussione Ascoltata degli Attacchi Ischemici Transitori. Ruolo dei Potenziali Cerebrali Evocati. Min. Med. 1985, 76, 1211 </span><b><span style="font-family:Symbol;"><span style="">[</span></span>MEDLINE</b><b><span style="font-family:Symbol;"><span style="">]</span></span>.<span style=""> </span></b></p> <p class="midsans">6)<span style="font-size:10;"> Stagnaro Sergio, Stagnaro-Neri Marina. Introduzione alla Semeiotica Biofisica. Il Terreno oncologico”. Travel Factory SRL., Roma, 2004. </span><span style=";font-family:Arial;font-size:10;" ><o:p></o:p></span></p> <p class="midsans"><span style="font-size:10;">7) Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico-Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. </span><span lang="EN-GB" style="font-size:10;">Ediz. Travel Factory, Roma, 2004. <o:p></o:p></span></p> <p class="MsoNormal"><span style="" lang="EN-GB">8) Stagnaro Sergio. Bed-Side Prostate Cancer Detecting, even in early stages (“Real Risk” of Cancer): BMC Family Practice, 6:24 doi:10.1186/1471-2296-6-24 <a href="http://www.biomedcentral.com/1471-2296/6/24/comments#202466">http://www.biomedcentral.com/1471-2296/6/24/comments#202466</a><o:p></o:p></span></p> <span style=";font-family:";font-size:12;" lang="EN-GB" > </span> <p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" >9) </span><span style="" lang="EN-GB">Sergio Stagnaro Mitochondrial Bed-Side Evaluation: a new Way in the War against Cancer (21 December 2005). Cancer Cell International <a href="http://www.cancerci.com/content/5/1/34/comments#218502">http://www.cancerci.com/content/5/1/34/comments#218502</a> <o:p></o:p></span></p> <p class="MsoNormal"><span style="" lang="EN-GB"> <o:p></o:p></span></p> <p class="MsoNormal"><span style="" lang="EN-GB">10) Stagnaro S. Genes and Cancer: a clinical view-point. The Oncological Terrain. BioMed Central Informatics, 2004. </span><a href="http://www.biomedcentral.com/1471-2105/5/21/comments#10454">http://www.biomedcentral.com/1471-2105/5/21/comments#10454</a></p> <p class="MsoNormal"> </p> <p class="MsoNormal">11) Stagnaro S., Stagnaro-Neri M., Oncological Terrain, conditio sine qua non of Oncogenesis, GUT, 2004. <a href="http://www.gutjnl.com/cgi/eletters?lookup=by_date&days=60">http://www.gutjnl.com/cgi/eletters?lookup=by_date&days=60</a></p> <p class="MsoNormal"> </p> <p class="MsoNormal"><span style="" lang="EN-GB">12) Stagnaro Sergio. "Genes, Oncological Terrain, and Breast Cancer", World Journal of Surgical Oncology. 2005, <a href="http://www.wjso.com/content/3/1/45/comments#205475">http://www.wjso.com/content/3/1/45/comments#205475</a><o:p></o:p></span></p> <p class="MsoNormal"><span style="" lang="EN-GB"> <o:p></o:p></span></p> <p class="MsoNormal"><span style="" lang="EN-GB">13)Stagnaro Sergio. GPs , Quantum Biophysical Semeiotics, and bedside cancer diagnosis. 08 July 2007, International Seminar of Surgical Oncology, <a href="http://www.issoonline.com/content/4/1/11/comments#281539">http://www.issoonline.com/content/4/1/11/comments#281539</a> <o:p></o:p></span></p> <p class="MsoNormal"><span style="" lang="EN-GB"> <o:p></o:p></span></p> <p class="MsoNormal"><span style="" lang="EN-GB">14) Stagnaro Sergio. Overloking Oncological Terrain and oncological Real Risk, no paper is up-dated! 18 January 2008 Ann. Intern Med. http://www.annals.org/cgi/eletters/147/11/775 <o:p></o:p></span></p>Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-28812446276597347542009-04-26T04:51:00.000-07:002009-04-26T04:54:57.555-07:00MICROALBUMINURIA: CARDIOVASCULAR RISK FACTOR OR SIGN OF “ARTERIOSCLEROTIC CONSTITUTION”?<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiI1VA_iot_zs96zF7uEH8ovECICALSNC9jWX6p-AMqJVc3IJPmSbTbwCgc2zKqADW2K0y-8Co3lI288BTo5pY9IGhn8sBn3kBCrMsjPMQ3v6jEqUY8t9vFSL6PcBnzQDydaMPL4DoyoQlr/s1600-h/DEB.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 200px; height: 140px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiI1VA_iot_zs96zF7uEH8ovECICALSNC9jWX6p-AMqJVc3IJPmSbTbwCgc2zKqADW2K0y-8Co3lI288BTo5pY9IGhn8sBn3kBCrMsjPMQ3v6jEqUY8t9vFSL6PcBnzQDydaMPL4DoyoQlr/s200/DEB.jpg" alt="" id="BLOGGER_PHOTO_ID_5328967174926043826" border="0" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhM-5pKu95xIWVT9wI8k7Iq36qC_eS6nSlZeB2vTampWkX6vJGq4fWVGfdqZbtVsAmg3uqZ7qlx0_ibAnvC3DZh1fViIaOXrzmM73BldoCREY2XWnLHlMrylhc2lZTYs_XxeoaQGmPsanyE/s1600-h/sergio17.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 134px; height: 200px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEhM-5pKu95xIWVT9wI8k7Iq36qC_eS6nSlZeB2vTampWkX6vJGq4fWVGfdqZbtVsAmg3uqZ7qlx0_ibAnvC3DZh1fViIaOXrzmM73BldoCREY2XWnLHlMrylhc2lZTYs_XxeoaQGmPsanyE/s200/sergio17.jpg" alt="" id="BLOGGER_PHOTO_ID_5328967069603201618" border="0" /></a><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgFu3rKr7UbpHYB6VMpsyNOhQu4JGEasN-HrOsumEXexDYSE1OdE9LG7dXrfRNtonSvYUJSa7K8A8FCQJ4VdgSZRGBVDc0jOJBAQ5faBi8FAktVD11m1iDxAKIISLYrv9IHV1Jh2VXfosZs/s1600-h/sergio16.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 158px; height: 200px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgFu3rKr7UbpHYB6VMpsyNOhQu4JGEasN-HrOsumEXexDYSE1OdE9LG7dXrfRNtonSvYUJSa7K8A8FCQJ4VdgSZRGBVDc0jOJBAQ5faBi8FAktVD11m1iDxAKIISLYrv9IHV1Jh2VXfosZs/s200/sergio16.jpg" alt="" id="BLOGGER_PHOTO_ID_5328966911372003026" border="0" /></a><br /><br />Introduction।<br />Before illustrating the contribution of Biophysical Semeiotics to enlighten significancy and etiopathogenesis of microalbuminuria, as follows, theorical and practical interesting aspects of such renal pathology are investigated, which, without the aid of this original physical semeiotics, persists for years or decades unrecognized, untreated and, therefore, worsening.<br />Although the association between microalbuminuria and cardiovascular disease was initially described in individuals with diabetes, it is now well established that microalbuminuria is associated with a 1,5- to 4-fold increased risk of cardiovascular disease among individuals with and without diabetes. However, the pathophysiological mechanism linking microalbuminuria to cardiovascular disease is unknown (1, 2). It is important to stress that the association between microalbuminuria and cardiovascular disease is unlikely to reflect a direct, causal pathway, because there is no plausible mechanism that can directly link the quantitatively trivial urinary loss of albumin (15-300 mg per 24 hours) to atherothrombosis.<br />Authors do not agree on causal relation, due to the fact that are lacking acceptable mechanisms, which should link the trivial urinary loss of albumin (15-300 mgr/24 ore) to arteriosclerosi.<br />In following, I will examine the present view-point on this argument and will illustrate the original biophysical-semeiotic interpretation.<br /><br />Association between Microalbuminuria and Cardiovascular Diseases: the common point of view.<br /><br />Microalbuminuria is associated with several cardiovascular risk factors, notably age, male gender, hypertension, smoking, obesity, dyslipidemia (high triglyceride and low HDL-cholesterol), diabetes, hyperhomocysteinemia and, among diabetic individuals, glycemic control. According to some investigators, microalbuminuria is also associated with insulin resistance, but this is controversial.<br />An obvious hypothesis, therefore, is that the association of microalbuminuria with cardiovascular disease simply reflects, and can be explained by, the association of microalbuminuria with one or more of these well-known cardiovascular risk factors. However, and perhaps somewhat surprisingly, epidemiological studies show that the association between microalbuminuria and cardiovascular disease remains when such conventional cardiovascular risk factors are taken into account, even though all these risk factors have been associated with the development of microalbuminuria in prospective studies, i.e. they may play a role in its pathogenesis (www.ATHERO-ORG..com, 3 July 2002, Coen D.A. Stehouwer, MD PhD, Professor of Medicine, Department of Internal Medicine,<br />Institute for Cardiovascular Research, and Institute for Research in Extramural Medicine,<br />Vrije Universiteit Medical Center).<br />Finally, although there is not agreement among authors, hyperinsulinemia-insulinresistance has been correlated with microalbuminuria, as corroborate personal research (data unpublished). It seems, therefore, that a strong relation probably exists between one or more well-known cardiovascular risk factors and the loss of small amount of albumine in urine.<br />On the contrary, and really not surprisingly, epidemiological study demonstrate that the association between microalbuminuria and cardiovascular disease is unsolved, even when the common risk factors, cited above, show to end, over the time, in albuminuria, indicating, therefore, to play a “possible” role in its pathogenesis.<br />At this point, it is advisable to examine an interesting aspect of the problem, on which all authors are in agreement, summarized in a fascinating way by Coen D.A. Stehouwer (paper cited above), who suggested me the following biophysical-semeiotic considerations on the relation between microalbuminuria, inflammation, endothelial dysfunction, and atherosclerosis. I assessed such parameters “clinically” with the aid of Biophysical Semeiotics.<br />The most commonly held view is that microalbuminuria reflects a pathophysiological process predisposing to atherothrombosis. Atherothrombosis is a low-grade inflammatory disease of the vessel wall characterized by endothelial dysfunction and increased transendothelial passage of leukocytes. These features, therefore, could be the pathogenic factor linking microalbuminuria to cardiovascular disease.<br />In support of this hypothesis, increased levels of C-reactive protein (CRP), which reflect inflammatory activity, increased plasma levels of von Willebrand factor (vWf), a marker of endothelial dysfunction, and increased plasma levels of soluble vascular cell adhesion molecule-1 (sVCAM-1), an adhesion molecule which reflects recruitment of leukocytes into the vessel wall (1, 2), have all been associated not only with the increased risk of cardiovascular events, but also with the development of microalbuminuria.<br />Such associations, moreover, were independent of conventional cardiovascular risk factors. These findings indicate, on the one hand, that inflammatory activity, endothelial dysfunction and leukocyte adhesion play a role in the pathogenesis of microalbuminuria, and, on the other hand, that these processes may, perhaps, explain microalbuminuria's link with cardiovascular disease (Stehouwer CDA:, above-cited article).<br />In other words, above-referred data, on the one hand, show that the inflammatory activity, endothelial dysfunction and cellular adhesion play a role in the pathogenesis of albuminuria, and, on the other hand, these processes can, probably, enlighten some-how the link between microalbuminuria and cardiovascula diseases.<br />At the moment, without disclosing biophysical-semeiotic view-point on the significancy and real nature of urinary loss of small amount of albumin, it is opportune, however, to underscore a remarkable fact: in the really “initial”, and “primary” stages of microalbuminuria, I observed at first “clinically”, and then coroborated by laboratory data, hepato-aspecific gastric reflex, type II, which is physiologically negative (= Acute Phase Proteins absent) (See in my site, HONCode, N° 233736, http://www.semeioticabiofisica.it, Practical Applications, and Article N° 2, Appendicitis, in the Page, I hold weekly in the italian site www.katamed.it), as well as all other biophysical semeiotic signs of inflammation: Rethiculo-Endothelial System Hyperfunction Syndrome, Antibody Synthesis, a.s.o.<br /><br />Etiopathogenesis of Microalbuminuria: Biophysical-Semeiotic view-point.<br /><br /> From a renal pathophysiological point of view, microalbuminuria must be caused by increased glomerular permeability to albumin, increased glomerular pressure, and (or) decreased tubular albumin reabsorption. The renal endothelium is intimately involved in the regulation of these processes, but how endothelial dysfunction and increased leukocyte adhesion cause microalbuminuria in molecular terms is not completely understood.<br />In addition, it is plausible that low-grade inflammation is causally related to the development of microalbuminuria. The main stimulators of production of acute phase reactants such as CRP are proinflammatory cytokines. Interleukin-6 may be an important mediator of mesangial cell proliferation and matrix overproduction, but also of an increase in general vascular permeability without involvement of the kidney. Thus, increased proinflammatory cytokines, as reflected by increased acute phase reactants such as CRP, may cause microalbuminuria through both renal and non renal vascular mechanisms.<br />As I will refer later in detail, biophysical-semeiotic data, at least in initial stages, do not agree with those of such, otherwise interesting, theories. Infact, in initial stage we can not observe neither increase of Acute Phase Proteins APP), nor body’s defence reactions (Rethiculo-Endothelial System Hyperfunction Syndrome, Antibody Synthesis, a.s.o.). In addition, there is no inflammation at glomerular level (= renal-aspecific gastric reflex, type II, i.e., caused by ungueal stimulation of kidney trigger-points, is absent).<br />In fact, the above-referred results should invite us to consider inflammatory activity and endothelial dysfunction as probable, and even plausible, causes of microalbuminuria, on the one hand, and atheroscleorsis, on the other hand, enlightening, by such way, the link between microalbuminuria and cardiovascular disease. However, the link between microalbuminuria and cardiovascular disease cannot be explained by increased inflammatory activity or endothelial dysfunction.<br /> The findings reviewed above raise the possibility, and even the plausability, that inflammatory activity and endothelial dysfunction may cause microalbuminuria on the one hand and atherothrombosis on the other, and thus explain the link between microalbuminuria and cardiovascular disease. However, two recent studies (1, 2) (quite unexpectedly) show that the association between microalbuminuria and cardiovascular disease or mortality is not affected by adjustment for these determinants of microalbuminuria. Thus, inflammatory activity, endothelial dysfunction, and leukocyte adhesion apparently cannot explain the association between microalbuminuria and cardiovascular mortality, either in individuals with or without diabetes. Therefore, the problem persists unsolved: what then can explain the link between microalbuminuria and risk of cardiovascular motality?<br />“One possibility is that microalbuminuria reflects a prothrombotic state or another, as yet unidentified cardiovascular risk factor. Alternatively, microalbuminuria may reflect a certain susceptibility to the vascular adverse effects of a variety of cardiovascular risk factors. This concept is supported by the observation that determinants of the development of microalbuminuria, such as diabetes, hypertension, inflammatory activity, and endothelial dysfunction, do not appear to confound the microalbuminuria-cardiovascular disease link. These possibilities require further study. For the present, microalbuminuria is a clinically useful marker of increased cardiovascular disease risk, even though the pathophysiological explanation of the association remains enigmatic”, states Coen D.A. Stehouwer, author of the fascinating article, posted in the site www.ATHERO-ORG.com., often cited in the present paper, who thinks, in my opinion, in a compelling way, that microalbuminuria could be either the expression of pre-thrombotic state or of different condition, such as cardiovascular risk factor, untill now unidentified.<br />“Alternatively, microalbuminuria may reflect a certain susceptibility to the vascular adverse effects of a variety of cardiovascular risk factors”, the author suggests.<br />With this point of view is in agreement the observation, corroborated also by biophysical-semeiotic method, that determinant causes of albuminuria occurrence, such as DM, hypertension, inflammatory activity, endothelial dysfunction, are acceptable in linking microalbuminuria to cardiovascular disease. These possibilities, the author concludes, require further study.<br /><br />Biophyical-Semeiotic Contribution to clarifying relation between Microalbuminuria and Cardiovascular Disease.<br /><br />In order to understand, in the best and successful way, the following topic, it is unavoidable studying all articles on “Biophysical-Semeiotic Constitutions”, posted in the site http://www.semeioticabiofisica.it<br />In my mind, from the healthy state, white zone, slowly, really slowly, one reaches the morbid state, blach zone – DM, ATS, arterial hypertension, gouthy, dyslipidemia, malignancy, a.s.o. – going through a long, very long, intermediate stage – pre-morbid stage, pre-metabolic stage – or grew zone, which, if undiagnosed, can last years or decades, without whatever clinical syntomatology, which is the subject of present consideration, as regards arteriosclerotic coronary diseases.<br />The grew zone is made up of an initial stage, or Zero Stage, and by successive poli-metabolic syndrome, X syndrome or Reaven’s synrome, both classic and “variant”, we described previously (3, 4), which mostly goes before the black zone.<br />Due to this reason we define the grew zone as pre-morbid or pre-metaolic syndrome. (See papers also in http://www.semeioticabiofisica.it/microangiologia, in www.Staibene.it, November 2001, and in the article N° 13 of the Page, I hold in www.katamed.it).<br />Reaven’s syndrome, both classic and “variant”, is based on Congenital Acidosic Enzyme-Metabolic Hystangiopathy- (CAEMH-), that represents a functional mitochondrial cytopathology, inherited by mother, completely asyntomatic at the beginning, and over many years or decades, before ending up with poli-metabolic syndrome (5, 6, 7 and the sites, above referred).<br />In order to understand and recognize “quantitatively” the “real” arteriosclerotic risk of an individual, it could be of interest the knowledge of the nature of link exsisting between microalbuminuria and arteriosclerotic cardiovascular disease, but, in my opinion, going “beyond microalbuminuria” gives doctor more information.<br />Certainly, primary problem, we face with, is bed-side recognizing and defining molecular-biological events, which characterize the grew zone, including its Zero Stage, with the aid of an efficacious method, reliable and rapidly to perform on very large scale, as Biophysical Semeiotics.<br />We desire that such as method allows us to recognize, in a clinical and quantitative way, the Zero Stage of grew zone, and classic and “variant” Reaven’s syndrome, i.e., pre-morbid, pre-metabolic syndrome, which is the locus (space-time) of primary prevention of the most serious human diseases (8) (See above-cited sites).<br />First of all, we must find a key-stone (a new reading way), biophysical-semeiotic in origin, totally different from that based upon “classic” signs and symptoms of the traditional physical semeiotics, including the microalbuminuria, completely absent in pre-morbid, pre-metabolic syndrome, that permits us to make the proper bed-side diagnosis in a “quantitative” way, during the common physical examination, in whatever patient.<br />Let’us consider, therefore, what happen at metabolic-endocrine level in both extreme situations, at first, in white zone and, then, in black zone in order to underline existing differences, usefull to our aim, i.e., to recognize and describe the intermediate, asymptomatic stage, I named grew zone.<br />In fact, different metabolic-endocrine behaviour of healthy individual, and, respectively, of patient involved by classic and “variant” Reaven’s syndrome, will help us to recognize, clinically on a very large scale and during the common physical examination, people apparently “healthy”, but who absolutely need intense and accurate consideration, due to their “real” risk for cardiovascular diseases, even at the moment without microalbuminuria, that is not always present, neither in successive stages.<br /><br />Arterial Abnormalities in Off-sprimg of Patients involved by Myocardial Infarction, even premature.<br /><br />Among a large number of important risk factors for cardiovascular disorders is coronary artery disease in family history (9, 10).<br />We discusse, therefore, although briefly, the relation between relatives and parents’s CAD and offspring’s cardiovascular disorder, that we corroborated clinically by means of Biophysical Semeiotics, since it represents a perfect introduction to explaining our microcirculatory theory of arteriosclerosi,s as well as to comprehending microalbuminuria pathogenesis.<br />The numerous theories of arteriosclerosis pathogenesis show clearly our present insufficient knowledge of this argument, although the well-known progresses of sophysticated semeiotics, including that with images.<br />All authors agree, recently, about primary importance of initial endothelial damage: I will examine its underlying pathological mechanisms later on.<br />As knows reader, who visites the above-cited sites, over last three decades we tried to persuade the colleagues to pay accurate attention, from the “clinical” biophysical-semeiotic view-point, to the primary role played by endothelial cells in both physiology (for instance, in Microcirculatory Funcional Reserve activation) and in pathology (for instance, in the onset of cardiovascular disease).<br />Interestingly, the risk of ischaemia, as elechtrocardioram shows, is about 40% higher, and mortality risk due to cardiac events is 2,5% larger in individuals with “positive” family history for premature CAD than in people without such as family history (11).<br />Among a large variety of similar evidences, we remember that arteriosclerotic lesions were found at autoptic examinations of very young patients with family history for coronary artery disease (12). Over last decades, B-mode ultrasonography at high resolution proved to be a valid and reliable tool in order to detect the initial arteriosclerotic alterations in vessel wall (13).<br />Intimal and media thickening of carotid artery wall has been observed in individuals involved by risk factors for cardiovascular diseases, proving to be a remarkable marker of the presence of coronary arteriosclerosis and its complications.<br />Skilled reader knows perfectly that Biophysical Semeiotics allows doctor to recognize such macrovascular lesions both directly (= vessel-aspecific gastric and -caecal reflex; pathological preconditioning, a.s.o.), and indirectly by evaluating local vasa vasorum (= type II or dissociated activation) as I will demonstrate later (See in former above-cited site: Arteriosclerotic Constitution).<br />In a few words, in healthy, supine and psycho-physically relaxed, “intense” digital pressure, e.g., applied on brachial artery brings about “in toto” ureteral reflex (= ureter dilates) (Fig.1) of about 1 cm. in intensity (NN 0,5 cm), while, during Valsalva’s manoeuvre, ureter diameter increases at least two-fold, when compared with basal value, due to well-known reasons (acethyl-choline increases, as well as endothelial radical NO and GTP synthesis: vessel smooth muscle cells are relaxed).<br />On the contrary, starting from “really” initial stage of arteriosclerosis, arterial compliance appears clearly compromised. In our “clinical” research, performed and concluded a lot of years ago, we demonstrated the reduced responsiveness of brachial artery, observed at bed-side, by the use of sphygmomanometer at different pressure levels to stimulate the artery (14).<br />Finally, we remember that brachial artery responsiveness, blood-flow-mediated, is compromised in persons with overt arteriosclerosis as well as in symptomless individuals with coronary risk factors (16).<br />In healthy, finger-pulp-aspecific gastric reflex, provoked by “mean-intense” digital pressure on a finger-pulp of the subject at rest, shows a latency time (lt) of 8 sec., while, assessed a second time after exact 5 sec., starting from blood-flow recovery, and rapidly applied, lt rises to a 10 sec.<br />By contrast, in case of “real” arteriosclerotic risk and, obviously, of arteriosclerosis, lt persists unchanged (basal value 8 sec.) or, respectively, lowered in a clear-cut manner.<br />As regards the easiest performance of our method, doctor assesses the intensity of “in toto” ureteral reflex (= ureteral dilation, Fig 1) during “intense” digital pressure on brachial artery (or, of course, in whatever other artery) evaluating precisely its value in cm.<br />Contemporaneously, it appears also the artery-aspecific gastric reflex, which is more easy to performe by doctor not jet expert of the new semeiotics.<br /><br />Fig.1<br /><br />(Figure shows the correct location of the bell-piece of stethoscope and lines upon which doctor must apply digital percussion, gently and directly, in order to draw,at least in mind, cutaneous projection areas of kidney and ureter).<br /><br /><br /><br />At this point, patient is invited to perform Valsalva’s manoeuvre (= acethyl-choline increase) lasting about 10 sec., and assesses, soon thereafter, the value of the same reflexes parameter for a second time. In healthy, the intensity of both “in toto” ureteral reflex and aspecific gastric reflex results two-fold greater or, in any case, significantly increased.<br />Clinical evidence shows that arteriosclerosis seriousness and the intensity reduction of “in toto” ureteral reflex and/or aspecific gastric reflex, during Valsalva’s manoeuvre, are inversely correlated.<br />Another easy biophysical evaluation of the same events is the comparison between basal data and those observed during boxer’s test, lasting at least 5 sec., which dilates arteries up-wards resistance vessels, and contemporaneously activates vasomotor activity of vasa vasorum, quantified by Biophysical Semeiotics, as skilled reader knows: in healthy, during such a test, the intensity of artery-“in toto” ureteral reflex results practically two-fold when compared with the basal value, and the latency time of artery- caecal reflex clearly prolonged (= histangic acidosis, temporarily reduced, as during Valsalva’s manoeuvre).<br />In fact, there is a clear coherence between basal -caecal and -aspecific gastric reflexes, which appear double (two-fold) after acethyl-choline secretion, induced by Valsalva’s manoeuvre and, in the second experiment, after physiological production of free-radical NO.<br />The same results are gathered during the test of insulin secretion acute pick and confronting the observed result with basal parameter value (See in above-cited site: Diabetes Mellitus and Glossary).<br />The data gathered by these dynamic methods, on the contrary, result pathologically modified in those individuals at “real” risk for arteriosclerosis, even in the first two decades of life, as we referred in former papers (17, 18, 19, 20).<br />These facts, we observed in a long clinical experience, corroborate, without any doubt, our microangiological theory of arteriosclerosis, since they clearly underline the earliest functional and structural lesion of arterial wall, secondary to, however, as will be said later on, Endoarteial Blocking Devices (EBD) abnormality in related microvessel, that represents, in my mind, the first of all and essential alteration, genetically inherited.<br />As a matter of fact, it has been demonstrated that family history of CAD points out an independent risk factor for cardiovascular diseases, showing in a clear manner “inherited” component of such as disorder (we identified as CAEMH-).<br />These anamnestic data have been enclose to guide-lines fo CAD prevention and is at present utilized in paediatric cardiology, beside genetic study of gene mutation, codifying lipoproteins receptors, a research surely complex and expensive, not possible to apply on very large scale.<br />Since, at the present, we cannot know when the first vascular (and parenchymal) abnormalities occur, an useful “clinical” method, reliable in recognizing the presence and in quantifying the seriousness of such vascular alterations, appears to be an important event.<br />The data of our researches parallel, and agree with, those of other authors, carried out with sophysticated methods, in the sense that they show, as markers of early arteriosclerosis, the association between reduced reactivity of brachial artery and/or carotyd intimal-media thickening, observable in young individuals with positive family history for previous myocardial infarction. Such an association is really interesting, due to the fact that abnormal vasodilatory response to acethyl-choline as well as endogenous insulin can be easy evaluated at the bed-side, as we referred in previous papers in individuals formerly involved by inherited alterations of microvessels, including particularly Arterial-Venous Anastomose (AVA), functionally speaking (19, 21, 22).<br />In other words, arteriosclerotic earliest abnormalities are “pre-clinical”, i.e., pre-clinical lesions; they come before decades the so-called fatty-streaks. Now-a-days, for the first time, with the aid of the original physical semeiotics, doctor is able to recognize at the bed-side these alterations, primarily functional, also by means of analogous modifications of anastomoses, including EBD, as well as of reduced arterial vasodilation – caused by a large variety of methods – always associated with intimal-media thickening or functional-structural endothelial lesions, in our opinion, taking part of primitive alteration of vasa vasorum, CAEMH--mediated.<br />At this points, one must remember that arteriosclerosis is notoriously a systemic disorder, which involves all circulatory tree and notably, sooner or later, is accompanied by other common diseases.<br />Consequently, functional and structural alterations, observed in loco, are present also in other locations in youg men, completely asymptomatic, i.e., without any clinical phenomenology. In addition, such as association between altered vascular reactivity-intimal-media thickening, observed by many authors, has been corroborated by us in a clinical way. The same we can say also as regards hypertensive patients as well as patients with suspected CAD (23, 24).<br />These fact, on which almost all authors agree, are referred and discussed in detail because they offer further evidence to our microcirculatory theory of arteriosclerosis: endothelial suffering, provoked by CAEMH- and worsened by numerous environmental risk factors, partly known (at least 300), due to reduced synthesis of free-radical NO, augmented secretion of vasoconstrictor factors and endothelial-dependent imbalance of haemostatic system, can predispose to monocytes and platelets adhesion, proliferation of media vascular smooth muscle cells and their migration towards intima, storage of monocytes-derived macrophages, and lipoproteins in arterial wall.<br />Surely, numerous other factors, as inflammation, can take part of pathogenesis of arteriosclerosis, but later, in our opinion, and always in well-defined individuals. However, the genetic factor is of primary, essential importance. It is necessary in enlightening the various moments of natural history of arteriosclerosis.<br />To conclude, beyond practical aspects, as early bed-side recognizing primitive functional alterations of artery wall, and successively “anatomical” modifications in symptomless individuals, unavoidable to can define arteriosclerotic constitution, former discussion about the relation, surely existing, between altered reactivity of arterial wall and initial intimal-media thickening introduces to the explanation of our “intuition” on the existence of a particular constitution, conditio sine qua non of atherogenesis, which allows to give precise answers, we lack untill now, useful to primary prevention, hopefully efficacious when applied on very large scale.<br /><br />Biophysical-Semeiotic Arteriosclerotic Constitution.<br /><br /><br />Clinical evidence suggests the existence of arteriosclerotic constitution:<br /><br />a) Acute Myocardial Infarction, for instance, can involve an individual “without” well-known risk factors, but “always” CAEMH---positive (as in my personal case).<br />Moreover, the so-called minimal changes are already present at an age, when known risk factors surely are absent;<br /><br /> b) not “all” dyslipidemic and/or diabetic and/or hypertensive and/or hyperomocysteinaemic patients die due to ictus, myocardial infarction or other arteriosclerotic complications;<br /><br />c) not “all” hypertensive patients are going to suffer from generalized or localized (CAD) arteriosclerosis; by contrast, are described cases (15-19) of people died from arteriosclerotic complications during the first two life decades, “without” presenting well-known risk factors (18);<br /><br />d) even in presence of well-known risk factors, arteriosclerosis involves defined, limited areas of arterial wall, rather than “all” wall;<br /><br />Therefore, arteriosclerotic constitution does really exist, as that diabetic, osteoporotic, rheumatic, artrosic, hypertensive, glaucomatos, oncological, i.e., Oncological Terrain (See above cited site, and article N° 13 in italian site www.katamed.it, as well as two articles on Oncological Terrain in www.Staibene.it, November 2001).<br />In the same individual, of course, can be present contemporaneously diverse constitutions, which, in fact, originate always on the base of common inherited alteration: CAEMH--.<br /><br />In following, easy clinical methods to recognize as well as to quantify the “real” arteriosclerotic risk with the aid of Biophysical Semeiotics, since two first life decade, are described. Most accurate and refined ascertaining requires necessarily a very good knowledge of original diagnostic method (19, 20, 27).<br /><br />1) In healthy, “mean-intense” digital pressure, applied on whatever artery (brachial, femoral, carotid artery, a.s.o.) of a supine, psycho-physically relaxed individual, brings about aspecific gastric reflex (Fig.2) after latency time (lt) of 8-10 sec., age-dependent value.<br />Moreover, after artery preconditioning (doctor evaluates such a parameter value a second time, after exact 5 sec. interval) lt raises to 12 sec.<br /><br />Fig.2<br /><br />Figure indicates the correct location of the bell-piece of stethoscope and lines upon which doctor must apply digital percussion, directly and gently, in order to define the limit of stomach cutaneous projection area of the stomach great curve. It is sufficient to delimit a small segment of curve for assessing the reflex. Aspecific gastric reflex: in the stomach, both fundus and body dilate, while antral-pyloric region contracts.<br /><br />On the contrary, in a subject at “real” arteriosclerotic risk, and obviously in arteriosclerotic patient, basal artery-aspecific gastric reflex shows a lt 8 sec., inversely related to the intensity of risk or underlying disease. In addition, really interesting from diagnosis view-point, artery preconditioning results pathological: second evaluation, performed exactly after 5 sec. from the former, shows a lt either unchanged (e.g., 8 sec.) or reduced in a clear-cut manner, when compared with basal value, in relation to the seriousness of arteriosclerotic constitution or, in case of basal value lower than normal, of underlying disease.<br />Identical data as those of preconditioning, one can collect at the bed-side with Valsalva’s manoeuvre, which brings about increase of acetyl-choline secretion, indicating internal and external coherence of biophysical-semeiotic theory (= loss of production and secretion of free-radical NO, due to endothelial alteration and consequently arterioles and small arterioles smooth muscle cells contractions, due to direct stimulation by acetyl-choline.<br />Moreover, in case of vessel wall calcium deposit (calcification involves exclusively individuals positive for “variant” Reaven’s syndrome), aspecific gastric reflex, after reaching its highest intensity, and soon thereafter lowers of a third of it.<br />The reader understands correctly that it is easy to evaluate the actual condition of whatever arterial vessels, for example, coronary arteries (25) and cerebral arteries (26) (See above-cited site, Practical Applications: CAD and Cerebral Tumour).<br /><br />2) the subject, doctor is examining, clenches his fists: boxer’s test. In healthy, after a latency time of 10 sec. appears the aspecific gastric reflex of 1 cm. (Fig. 2), whereas in presence of either arteriosclerotic constitution or overt arteriosclerosis, lt results, once again, 10 sec. and reflex intensity is > 1 cm.<br />If doctor performs such as evaluation, applying boxer’s test, after exact 5 sec. from the first one (preconditioning), the data observed are the same of those formerly illustrated at point 1).<br /><br />In conclusion, these two easy methods, applied also in “dynamic” way, are reliable and sufficient to allow recognizing arteriosclerotic constitution, that can be quantified with the aid of parameter values, observed during basal and dynamic evaluation.<br />Without facing physiopathological discussion of biophysical-semeiotic signs, certainly interesting, but not pertinent to the aims of present article, the illustrated physical examination allows doctor to collect useful information on function as well as structure of adventitial microcirculatory bed, steadly correlated with nutritional condition of local artery wall, i.e., with local Microcirculatory Functional Reserve.<br />It is easy to understand that the very good knowledge of this new physical semeiotics permits doctor to gather a large variety of clinical microangiological signs, really abundant of information.<br /><br />Among these interesting signs, I am going to illustrate only some, which allow a refined evaluation of anatomy and function of microcircle, including the adventitial microvessels – vasa vasorum – both at rest and during activation:<br /><br /><br />1) in healthy, “mean-intense” (but not highest) digital pressure, applied upon a finger-pulp of a supine and psycho-physically relaxed individual, causes upper ureteral reflex (= dilation of upper third of ureter), which gives information on type II, group B AVA, according to Bucciante. At this point, if digital pressure becomes highest, reflex disappears, underscoring the normal structur-function (elasticity) of the same anastomoses, which physiologically control microcirculatory blood-flow.<br /><br />2) under identical circumstances, the behaviour of mean ureteral reflex (= mean third of ureter dilation) appears the same: it gives information on the real situations of local Endoarteriolar Blocking Devices (EBD) (Fig.3)<br /><br /><br />Fig. 3<br /><br />Arrow indicates a particular endoarteriolar formation, like elephant trunk (EBD), whose contraction increases the flow-motion towards, and along, capillaries and post-capillaries venules. On the contrary, the relaxation of EBD smooth muscle cells decreases the blood-flow towards nutritional capillaries. (For kind permission of Prof. S.B.Curri, whose as much excellent as large literature in the field of microcircle and microcirculation originated my enthusiasm about the study of this fascinating and almost ignored branch of Medicine)<br /><br />3) “mean-intense” digital pressure, applied as illustrated above, provokes upper ureteral reflex (See example 1), which shows the opening of type II, group B AVA. However, if the individual arises his (her) arm in vertical position, the reflex rapidly disappears: closure of AVA, aimed to supply a larger amount of blood flow, and, consequently, to control histangic pH also during such posture test;<br /><br />4) under identical condition, described above at point 3), if the subject lowers vertically his (her) arm, the intensity of upper third ureteral reflex increases rapidly: type II, group B AVA augment their diameter, and, therefore, their haemoderivative function increases, aiming to maintain a physiological microcirculatory blood-flow in normal ranges, under different positions. Such as physiological microcirculatory adaptations clearly suggest the normal functioning of venular-arteriolar reflex (VAR):<br /><br />5) in healthy, “mean-intense” digital pressure on a finger-pulp brings about aspecific gastric reflex after a latency time of about 10 sec. (lt value is obviously age-dependent). This value persists unchanged, under physiological condition, when the arm is located in every of three posture positions, due to functional microvessel adaptations, explained above.<br />All these dynamic tests result altered, obviously of a different degree, in case of arteriosclerosis, starting from the earliest stage, i.e., arteriosclerotic constitution.<br /><br />BIOPHYSICAL-SEMEIOTICS OF MICROALBUMINURIA.<br /><br />In table 1, is summarized the diagnostic biophysical-semeiotic iter, usefull and reliable in bed-side recognizing presence and nature of nephrone disease, even clinically silent and localized.<br />Really, Biophysical Semeiotics does not allow doctor to make “clinical” diagnosis of microalbuminuria, but surely permits to exclude it (100%) or to suspect it, in rational way, conditio sine qua non of ascertaining the real nature of an aspecific damage of nephrone, even limited in some areas of kidney.<br />In fact, facing the problems of kidney showing normal size, i.e., when are absent biophysical-semeiotic signs of inflammation, parameter values of kidney-aspecific gastric and –caecal reflexes are still in “extreme” limits of normality or clearly pathological, preferably when assessed in selective way, by stimulating, at first, renal trigger-points of upper third, then those of mean third, and finally those of lower third.<br />Nephrone suffering, even circumscribed, is outlined by renal preconditioning, whose results – lt of kidney-aspecific gastric reflex unchanged or pathological, i.e., reduced in second evaluation – is aspecific expression of nephropathy.<br />Of essential importance proved to be the “selective” evaluation of renal vasomotion, which shows the characteristic type II, dyssociated microcirculatory activation or, in initial and slight forms, type III, dyssociated microcirculatory activation: the fluctuations of upper third of ureter (vasomotility: arterioles and small arterioles, according to Hammersen) are increased with AL + PL of 7-8 sec. (NN = 6 sec.), while the oscillations of lower third of ureter (vasomotion: nutritional capillaries and post-capillary venules) are normal with AL + PL of 6 sec., but large “in toto” ureteral reflex: > 1 cm.(= interstitium).<br /><br />In conclusion, from biophysical-semeiotic data, it is likely that the base of microalbuminuria is an inherited microvascular-microcirculatory alteration of nephrone, even circumscribed, primarily functional, acidosic, that cause function abnormality of the vascular smooth muscle cells and, then, of Endoarterial Blocking Devices (EBD), involved selectively, although systematically (including vasa vasorum), by a particular mitochondrial cytopathology, CAEMH-, influencing in negative manner both microvessel dynamics and haemoreology (hyperviscosity) under sympathetic hypertonus conditions, ischaemia, and hormonal impairement (IIR), as we observe frequently in pre-morbid or pre-metabolic syndrome, as wel as in subsequent Reaven’s syndrome, classic and “variant” (3, 4).<br />Therefore, from the above-referred data, gathered by the aid of Biophysical Semeiotics, microalbuminuria, if present, does not represent a “causal factor” of CAD, and , in general, of ATS, but an early microvascular functional CAEMH--induced abnormality of the nephrones, whose patho-physiological mechanisms are the same of ATS, according to our microcirculatory theory of arteriosclerosis, which allows doctor to foresee only the future onset of CAD.<br /> In performing efficacious prevention of arteriosclerosis, applied on very large scale, I suggest to go “beyond microalbuminuria”, that is present “exclusively” in case of selective microvessel suffering of the nephrone, caused by the mitochondrial cytopathology, we termed Congenital Aciodosic Enzyme-Metabolic Histangiopathy, conditio sine qua of the most serious human diseases (5, 6, 6, 7).<br /><br />BIOPHYSICAL- SEMEIOTIC DIAGNOSTIC ITER OF GLOMERULAR-TUBULAR SUFFERING<br /><br />KIDNEY AUSCULTATORY PERCUSSION<br /><br />TEST OF SIMULATED URINATION<br /><br />INFLAMMATORY SIGNS (RESHS “COMPLETE”, ACUTE PHASE PROTEINS, A.S.O.)<br /><br />CIRCULATORY IMMUNOCOMPLEXES SYNDROME<br /><br />AUTOIMMUNE LOCAL SYNDROME<br /><br />TYPE I AND II KIDNEY-ASPECIFIC GASTRIC REFLEX<br /><br />KIDNEY-CAECAL REFLEX<br /><br />RENAL PRECONDITIONING<br /><br />ERITHROPOIETINE TEST<br /><br />VASOMOTILITY AND VASOMOTION OF KIDNEY<br /><br /><br /><br />Tab. 1<br /><br />Sergio Stagnaro MD<br />Via Erasmo Piaggio 23/8<br />16039 Riva Trigoso (Genoa) Europe<br />Founder of Quantum Biophysical Semeiotics<br />Who's Who in the World (and America)<br />since 1996 to 2009<br />Ph 0039-0185-42315<br />Cell. 3338631439<br />www.semeioticabiofisica.it<br />dottsergio@semeioticabiofisica.it<br /><br /><br /><br /><br />Bibliografia.<br /><br />1. Jager A, van Hinsbergh VW, Kostense PJ, Emeis JJ, Nijpels G, Dekker JM, Heine RJ, Bouter LM, Stehouwer CD. C-reactive protein and soluble vascular cell adhesion molecule-1 are associated with elevated urinary albumin excretion but do not explain its link with cardiovascular risk. Arterioscler Thromb Vasc Biol 2002;22:593-98.<br />2. Stehouwer CD, Gall MA, Twisk JW, Knudsen E, Emeis JJ, Parving HH. Increased urinary albumin excretion, endothelial dysfunction, and chronic low-grade inflammation in type 2 diabetes: Progressive, interrelated, and independently associated with risk of death. Diabetes 2002;51:1157-65.<br />3. Stagnaro S.-Neri M., Stagnaro S., Sindrome di Reaven, classica e variante, in evoluzione diabetica. Il ruolo della Carnitina nella prevenzione del diabete mellito. Il Cuore. 6, 617, 1993 (Pub-Med indexed for Medline).<br />4. Stagnaro-Neri M., Stagnaro S., La “Costituzione Colelitiasica”: ICAEM-, Sindrome di Reaven variante e Ipotonia-Ipocinesia delle vie biliari. Atti. XII Settim. It. Dietol. ed Epatol. 20, 239, 1993.<br />5. Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica. X Congr. Naz. Soc. It. di Microangiologia e Microcircolazione. Atti, 61. 6-7 Novembre, 1981, Siena.<br />6. Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica condizione necessaria non sufficiente della oncogenesi. XI Congr. Naz. Soc. It. di Microangiologia e Microcircolaz. Abstracts, pg 38, 28 Settembre-1 Ottobre, 1983, Bellagio.<br />7.Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica. Una Patologia Mitocondriale Ignorata. Gazz Med. It. – Arch. Sci. Med. 144, 423,1985 (Infotrieve).<br />8) Stagnaro S., West PJ., Hu FB., Manson JE., Willett WC. Diet and Risk of Type 2 Diabetes. N Engl J Med. 2002 Jan 24;346(4):297-298. [MEDLINE].<br />9) Phillips R.L., Lilienfeld A.M., Kagan A. Frequency of coronary heart disease and cerebrovascular accidents in parents and sons of coronary heart disease index cases and controls. Am. J. Epidemiol. 100, 87-100, 1974.<br />10) Friedlander Y., Siscovic D.S., Weinmann S. et al Phillips R.L., Lilienfeld A.M., Kagan A. Family history as a risk factor for primary cardiac arrest. Circulation. 97, 155-60, 1998.<br />11) De Bacquer D., De Backer G., Kornitzer M., Blacburn H.Parental history of premature coronary heart disease mortality and signs of ischemia on the resting electrocardiogram. J.Am.Coll.Cardiol. 33, 1491-8, 1999.<br />12) Kaprio J., Norio R., Pesonen E, Sarna S. Intimal thickening of the coronary arteries in infants in relation to family history of coronary artery disease.Circulation. 87, 1960-8,1993.<br />13) Gaeta G., De Michele M., Cuomo S., et al. Arterial abnormalities in the offspring of patients with premature myocardial infarction. N.Engl.J.Med. 343,840-45,2000.<br />14) Celermajer D.S., Sorensen K.E., Gooch V.M., et al. Non-invasive detection of endothelial dysfunction in children and adults at risk of artheriosclerosis. Lancet. 340, 1111-8,1992.<br />15) Stagnaro-Neri M., Stagnaro S., Il diagramma venoso nelle arteriopatie obliteranti periferiche. Atti Congr. Naz. Soc. It. Flebologia Clinica e Sperimentale. Firenze 10-12 Dicembre 1990. A cura di G. Nuzzaci, pg. 169, Monduzzi Ed. Bologna.<br />16 Neunteufl T., Katzenschlager R., Hassan A., et al. Systemic endothelial dysfunction is related to the extent and severity of coronary artery disease. Atherosclerosis. 129, 111-8, 1997.<br />17) Stagnaro S., Valutazione percusso-ascoltatoria della microcircolazione cerebrale globale e regionale. Atti, XII Congr. Naz. Soc. It. di Microangiologia e Microcircolazione. 13-15 Ottobre, Salerno, e Acta Medit. 145, 163, 1986.<br />18) Stagnaro-Neri M., Stagnaro S., Aneurisma Aortico Addominale: una Diagnosi clinica con la Semeiotica Biofisica. Acta Cardiol. Medit. 14, 17, 1986.<br />19) Stagnaro-Neri M., Stagnaro S., Auscultatory Percussion Evaluation of Arterio-venous Anastomoses Dysfunction in early Arteriosclerosis. Acta Med. Medit. 5, 141, 1989.<br />20) Stagnaro-Neri M., Stagnaro S., Modificazioni della viscosità ematica totale e della riserva funzionale microcircolatoria in individui a rischio di arteriosclerosi valutate con la percussione ascoltata durante lavoro muscolare isometrico. Acta Med. Medit. 6, 131-136, 1990<br />21) Stagnaro S., Stagnaro-Neri M., Valutazione percusso-ascoltatoria degli attacchi ischemici transitori e della insufficienza cerebrovascolare cronica in pazienti trattati con mesoglicano. Atti, IX Congr. Naz. It. Patologia Vascolare. Copanello, 6-9 Gennaio 1987. A cura di R. Del Guercio, G. Leonardo e G. Zanini. Pg. 765, Monduzzi Ed. Bologna, 1987.<br />22) Stagnaro-Neri M., Stagnaro S., Microangiologia clinica della ipertrofia prostatica benigna. Ruolo patogenetico delle modificazioni del sistema microlovascolotessutale valutate con la Semeiotica Biofisica. Acta Cardiol. Medit. 14, 21, 1986.<br />23) Ghiadoni L., Taddei S., Virdis A, et al. Endothelial function and common carotid artery thickening in patients with essential hypertension. Hypertension. 32, 25-32, 1998.<br />24) Enderle M.D., Scroeder S., Ossen R., et al. Comparison of peripheral endothelial dysfunction and intimal media tickness in patients whit suspected coronary artery disease. Heart. 80, 349-54, 1998.<br />25) Stagnaro-Neri M., Stagnaro S., Deterministic Chaos, Preconditioning and Myocardial Oxygenation evaluated clinically with the aid of Biophysical Semeiotics in the Diagnosis of ischaemic Heart Disease even silent. Acta Med. Medit. 13, 109, 1997.<br />26) Stagnaro S. Depression, Anxiety and Psychosis. B C Medical Journal, Volume 43, Number 6, page 321, July-August, 2001.<br />27) Stagnaro-Neri M., Stagnaro S. Indagine clinica percusso-ascoltatoria delle unità microvascolotessutali della plica ungueale. Acta Med. Medit. 4, 91 ,1988.<br />28) Stagnaro Sergio. New bedside way in Reducing mortality in diabetic men and women. Ann. Int. Med.2007. http://www.annals.org/cgi/eletters/0000605-200708070-00167v1<br />29) Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. Ed. Travel Factory, Roma, 2004. http://www.travelfactory.it/<br />30) Stagnaro Sergio. Newborn-pathological Endoarteriolar Blocking Devices in Diabetic and Dislipidaemic Constitution and Diabetes Primary Prevention. The Lancet. March 06 2007. http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?totalcomments=1, and especially www.fce.it, http://www.fceonline.it/docs/stagnaro.pdf<br />31) Stagnaro Sergio. Biophysical-Semeiotic Bed-Side Detecting CAD, even silent, and Coronary Calcification. 4to Congreso International de Cardiologia por Internet, 2005, http://www.fac.org.ar/ccvc/marcoesp/marcos.php.<br />32) Stagnaro Sergio. Role of Coronary Endoarterial Blocking Devices in Myocardial Preconditioning - c007i. Lecture, V Virtual International Congress of Cardiology. http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php<br />33) Stagnaro Sergio. Bedside Evaluation of CAD biophysical-semeiotic inherited real risk under NIR-LED treatment. EMLA Congress, Laser Helsinki August 23-24, 2008. "Photodiagnosis and photodynamic therapy", Elsevier, Vol. 5 suppl 1 august 2008 issn, Page S17.Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-21317668105179187902009-04-19T23:28:00.000-07:002009-04-19T23:33:18.885-07:00PRE-METABOLIC SYNDROME, CLASSIC AND VARIANT, PRECEEDES FOR DECADES THE METABOLIC SYNDROME.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiGRcL2I6ZHYWjf_RwDRKVtrlB92_kebM_JW3YbB8Anlb1ybluf2ez83yLDgqFw4W3rMxZH3aixYiJ26JCIdnGhyphenhyphen6IRePBITZbL2rz03ZQ-0x5xiLoBCgGP6GhQRYU6hWQl8ofH6syFx6Zt/s1600-h/sergio16.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 158px; height: 200px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiGRcL2I6ZHYWjf_RwDRKVtrlB92_kebM_JW3YbB8Anlb1ybluf2ez83yLDgqFw4W3rMxZH3aixYiJ26JCIdnGhyphenhyphen6IRePBITZbL2rz03ZQ-0x5xiLoBCgGP6GhQRYU6hWQl8ofH6syFx6Zt/s200/sergio16.jpg" alt="" id="BLOGGER_PHOTO_ID_5326657119751977650" border="0" /></a><br /><br /><h3><a name="_Toc47515364"></a><a name="_Toc47515303"></a><a name="_Toc47346881"></a><a name="_Toc47346862"><span style=""><span style=""><span style=""><span style="" lang="EN-GB"></span></span></span></span></a></h3><h3><a name="_Toc47346862"><span style=""><span style=""><span style=""><span style="" lang="EN-GB">Introduction.</span></span></span></span></a><span style="" lang="EN-GB"><o:p></o:p></span></h3> <p class="aL" style="text-indent: 0cm;"><span style="" lang="EN-GB"><span style=""> </span>First of all, before studying an argument playing a primary role in the <i>Clinical Microangiology</i>, such as microcirculatory activation in the <i>post-absorptive state</i>, under physiological as well as pathological conditions, unavoidable in bedside diagnosing <b style=""><span style="">Pre-Metabolic Syndrome</span>,</b><i> </i>it is necessary that reader has steady knowledge of the topics illustrated in earlier articles on Microcirculatory Physiology (1-11) (See my website <a href="http://digilander.libero.it/semeioticabiofisica">www.semeioticabiofisica.it</a> and <a href="http://www.semeioticabiofisica.it/microangiologia">www.semeioticabiofisica.it/microangiologia</a>, especially URL <o:p></o:p></span></p> <p class="MsoNormal"><span lang="EN-GB" style="font-size:11;">(<a href="http://www.semeioticabiofisica.it/microangiologia/Documenti/Eng/Pre-metabolic%20syndrome%25"><b>http://www.semeioticabiofisica.it/microangiologia/Documenti/Eng/Pre-metabolic%20syndrome%</b></a>).<span style=""> </span><o:p></o:p></span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><a name="_Toc47515304"><span style="" lang="EN-GB">Doctor must be skilled at auscultatory percussion of both kidney and ureter, which allows to outline properly skin projection area of urinary tract and evaluate three ureteral reflexes, i.e., upper, middle, and lower, caused by “light” stimulation of trigger-points of the diverse examined biological systems (Fig 1). In fact, upper, middle, and lower ureteral reflexes give information on both functional and structural conditions of small arteries and arterioles, according to Hammersen (= upper ureteral reflex), Endoarterial Blocking Devises (EBD) (= middle reflex), as well as capillaries and post-capillary venules (= lower reflex) (1-4).</span></a><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="aL" style="text-indent: 0cm;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">At the begin of third millennium, the researchers on type 2 <b>Diabetes Mellitus</b> initiate fortunately to find new ways in the prevention, diagnosis, therapeutic monitoring, in a direction, I have indicated more than 20 years ago (1-3).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">My old Rapid Response to <i style="">BMJ </i>proved to be really warning: Sergio Stagnaro.<strong><span style="font-weight: normal;"> “Pre-Metabolic Syndrome. Locus of Type 2 Diabetes Primary Prevention”.</span></strong><b> </b> 1 August 2003, (<a href="http://bmj.com/cgi/eletters/327/7409/266#35204">http://bmj.com/cgi/eletters/327/7409/266#35204</a>.<o:p></o:p></span></p> <p class="aL"><span style="" lang="EN-GB">Nowadays physician’s opinion has clearly changed on the fasting glycemia (FPD), considering<span style=""> </span>the post-prandium glycemia (PPG) more predicative of so-called “complications”, since it is somehow related to the endocrine-metabolic situation of <i>post-absorptive state</i>, which we can fortunately evaluate from biophysical-semeiotic view-point, as follows. <o:p></o:p></span></p> <p class="aL"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="aL" style="text-indent: 0cm;"><b><span style="" lang="EN-GB">Over the last two decades, I have suggested to distinguish, in a clear-cut way, <i>Glycemology </i>from <i>Diabetology</i>;<span style=""> </span>the later<span style=""> </span>includes, unfortunately, less physicians among its followers than the first (1).<o:p></o:p></span></b></p> </td> </tr> </tbody></table> <p class="aL"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="aL"><span style="" lang="EN-GB">Indeed, the value of PPG is a reliable barometer of diabetic condition, physiologically based, because its abnormalities are predicative of the disease, and, thus, represents an useful data for the prevention as well as for glycosilated hemoglobins intensity, to which is related. Moreover, there is an increasing number of authors, who consider PPG abnormalities related to, and predicative of,<span style=""> </span>future micro- and macro-scopic diabetic complications.<o:p></o:p></span></p> <p class="MsoBodyText"><span style="" lang="EN-GB"><span style=""> </span>As it is easy to understand, scholars agree generally nowadays with the direction clinically provided with the aid of <b>Quantum-Biophysical Semeiotics </b>(1, 2, 3), and, in our mind, this event represents an epoch-making time in the war against diabetes mellitus, as I wrote earlier (bmj.com, 10 June <st1:metricconverter productid="2001, in" st="on">2001, in</st1:metricconverter> the Rapid Response: “Bed-side primary prevention is the major step in the war against diabetes mellitus”).<o:p></o:p></span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span style="" lang="EN-GB">In fact, apart from the therapy, based on the utilization of </span><span style="font-family:Symbol;"><span style="">a</span></span><span style="" lang="EN-GB">-glucosidase-inhibitors and fast insulines, such a thinking change, originated from physio-pathological, epidemiological, endocrine-metabolic findings, correlates with <b>microcirculatory phenomena</b>, which cause diabetes mellitus onset, on the base of diabetic constitution-dependent inhereted real risk, i.e. <i>genetically</i> directed, such as diabetic as well as dyslipidemic constitutions (See my website, <a href="http://digilander.libero.it/semeioticabiofisica"><span style="">www.semeioticabiofisica.it</span></a>, “Biophysical-Semeiotic Constitutions: URL <a href="http://www.semeioticabiofisica.it/constitutions.htm">www.semeioticabiofisica.it/constitutions.htm</a>) we have some years ago indentified clearly, and described as Congenital Acidosic Enzyme-Metabolic Histoangiopathy, at the URL: <a href="http://www.semeioticabiofisica.it/Documenti/Eng/istangiopatia%20cong.acidos.enzimo">www.semeioticabiofisica.it/Documenti/Eng/istangiopatia cong.acidos.enzimo</a>, initially evolved to <b>pre-metabolic syndrome</b>, and, then, to metabolic syndrome, both classic and “variant”, slowly worsening to diabetes (1, 2, 3). <o:p></o:p></span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <h3><a name="_Toc47515365"></a><a name="_Toc47515305"></a><a name="_Toc47346882"></a><a name="_Toc47346864"></a><a name="_Toc46906288"></a><a name="_Toc46905350"></a><a name="_Toc46800447"></a><a name="_Toc46717832"></a><a name="_Toc46717792"><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style="" lang="EN-GB">Physiological and pathological microcirculatory activation in the <i>post-absorptive state</i>.</span></span></span></span></span></span></span></span></span></a><span style="" lang="EN-GB"><o:p></o:p></span></h3> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span style="" lang="EN-GB">If doctors do not know the original physical semeiotics, and consequently the large variety of essential results of the research, performed in the diabetology by the aid of this precious clinical tool, they must pay a particular attention to PPG, surely of greater significance than that of FPG, as regards the primary prevention of diabetes mellitus, since it represents for such authors the early alteration, predicative of the future disease and its complications.<o:p></o:p></span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span style="" lang="EN-GB">At this point, we briefly remember (this argument, certainly interesting, is beyond article’s aims)<span style=""> </span>that PPG increases oxidative processes as well as activates PKC, bringing about <i>vascular spasms and histangic lesion</i>, as we have demonstrated by the original semeiotics, at which we will come back later on (4).<o:p></o:p></span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span style="" lang="EN-GB">However, in our opinion, such as change of thinking among physicians must be considered of great value, even as the beginning of a long way, which over time, hopefully short, will reach a point, where <i>micorcirculatory abnormalities</i>, in particular the microcirculatory activation, playing a primary role, will be considered expression of alterations predicative of diabetes mellitus, and, thus, characteristic signs of the primary prevention <i>locus.</i><o:p></o:p></span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span style="" lang="EN-GB">Indeed, the phenomenon of<i> type I, associated, type II, dissociated, and type III incomplete or “variant” form of the type II, microcirculatory activation</i> plays a pivotal role in physiology and, respectively, in the pathogenesis of most common and dangerous human diseases,<b> </b>including <b>diabetes mellitus, </b>which originate on the base of <b>CAEMH </b>(1-4). <o:p></o:p></span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span style="" lang="EN-GB">From the above remarks it follows that the early bed-side recognising <i>microcirculatory abnormalities</i><span style="">,</span> as well as their “quantification” with the aid of <b>Quantum-Biophysical Semeiotics</b> represents, in our mind, a milestone in natural history of this syndrome, i.e., <b>pre-metabolic syndrome</b>, of physical semeiotics in general, and particularly of primary prevention.<o:p></o:p></span></p> </td> </tr> </tbody></table> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span style="" lang="EN-GB">On this subject, we must briefly remember,<span style=""> </span>especially as regards the <b>macroangiopaties</b>, that the estimation of both microcirculatory function and structure, including the adventitial one, plays a primary role in bed-side diagnosing these common and serious diseases, starting from initial, subclinical stage. In fact, clinical and experimental evidence suggests that partial occlusion of a muscular artery –<span style=""> </span><i>vasa publica</i>,<i> </i>according to Ratschow – provokes quickly the compensatory, associated, type I, microcirculatory activation, in both local <i>adventitial vasa privata</i> and in distal related tissues.<o:p></o:p></span></p> <p class="MsoBodyText" style="text-indent: 35.45pt;"><span style="" lang="EN-GB">Doctor must bear in mind that the microcirculatory bed<span style=""> </span>represents the “<b>peripheral heart</b>”, which increases its autochthonus, sphygmic activity, when local blood supply decreases, even in a light manner, due to haematologic (anemia) as well as vascular causes, or cardiac insufficiency, which act up-wards. If these disorders, of course, are not promptly eliminated, such an activation of <i>vasomotility </i>and <i>vasomotion</i> slowly ends in the dangerous micorcirculatory insufficiency and, ultimately, of <i>failure of local microcirculatory bed</i>, characterized by the <i>spatial inhomogeneity</i>, accurately illustrated in some papers of my above cited site <a href="http://www.semeioticabiofisica.it/microangiologia">www.semeioticabiofisica.it/microangiologia</a>. <u style=""><o:p></o:p></u></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">Adventitial microcirculatory biophysical-semeiotic evaluation, in case of <b>aortic aneurism</b>, gives us an example of the preventive-diagnostic value of evaluating local microcirculatory situation (See URL:<span style=""> </span>Practical Application, Abdominal Aortic Aneurism, <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><a href="http://www.semeioticabiofisica.it/Documenti/Eng/Aneurism%20A%20Aorti_eng.doc">www.semeioticabiofisica.it/Documenti/Eng/Aneurism A Aorti_eng.doc</a>). <span style="" lang="EN-GB">The anatomical lesion of aortic wall, really, can be evaluated at the bed-side by assessing adventitial microcirculatory activity of aneurism.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <h3><a name="_Toc47515366"></a><a name="_Toc47515306"></a><a name="_Toc47346883"></a><a name="_Toc47346865"></a><a name="_Toc46906289"></a><a name="_Toc46905351"></a><a name="_Toc46800448"></a><a name="_Toc46717833"></a><a name="_Toc46717793"><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style="" lang="EN-GB">Pathophysiology of<span style=""> </span>the “peripheral heart” Failure.</span></span></span></span></span></span></span></span></span></a><span style="" lang="EN-GB"><o:p></o:p></span></h3> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">One can easily understand that microcirculatory activation aims to maintain physiological<span style=""> </span>blood-flow in the nutritional capillaries and post-capillary venules, and, thus, to supply related parenchyma with sufficient material-energy-information.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">As regards diagnosis as well as prevention, it is plain the usefulness of knowing the course of these adaptable microcirculatory events, never observed till now at the-bed side, i.e. clinically, by data collected with a simple stethoscope during physical examination.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">As clinical and experimental evidence demonstrates, e.g., in case of partial, incomplete jatrogenetic occlusion of ileo-phemoral artery, in healthy, cutaneous, sub-cutaneous, muscular microcirculation downwards, at least in the first minutes, is activated, according to type I, associated. Clearly, such event can be observed also in case of non complete obstruction of wathever other vessel, for instance, the carotid, which brings about in related distal tissues the greatest increase of cerebral “vasomotion” (“vasomotion” indicates both <i>vasomotility </i>and <i>vasomotion</i>) (5, 6, 7, 8) (Fig 1, 2, 3).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">Once again, the final result of Microcirculatory Functional Reserve (MFR) is maintaining tissue energy in normal range, which unfortunately is often only transitory, since till now doctor was not able to recognize “clinically” this dangerous situation of<span style=""> </span>“<i>unstable compensation</i>” of the peripheral heart and, thus, of blood-flow,<span style=""> </span><i>flow- </i>and<i> flux-motion</i>, maintained in physiological ranges, although at lower levels, in related tissue components.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">In other words, at the bed-side, till now, doctor is not capable to recognize the minimal, initial, rapid reactions of “distal” microcirculatory activation, secondary to <b>macroangiopathy</b> in its early and asymptomatic stage. MFR activation can last “silent” even years before clinical phenomenology occurs, obviously related to “<i>peripheral heart decompensation</i>”.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">From the above remarks it follows that, in an individual psychophysically relaxed and in supine position, i.e. in a state of complete rest, recognizing type I, associated, microcirculatory activation by “light” digital pressure, e.g., on the skin of a limb or on a finger-pulp, allows doctor to assess three ureteral reflexes and, then, diagnosing without doubt the presence of <b>macrovascular disorder</b> up-wards, even initial and/or in early, symptomless stage, which can be diagnosed by numerous biophysical-signs, characteristic of the angiopathy (See above-cited sites).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">“At rest”, the presence of type I, associated, peripheral microcirculatory activation in an apparently healthy individual indicates a “silent” macroangiopathy up-wards, i.e., in related <i>vasa publica</i>, according to Ratschow, that doctor must assess accurately and promptly treat.<o:p></o:p></span></b></p> </td> </tr> </tbody></table> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">By contrast, if the patient presents with clinical signs, characteristis of <b>pripheral vascular disorders</b>, such as <i>intermittens claudicatio</i>, the micocirculatory activation (“peripheral heart” activated) modifies over time and becomes of type II, dissociated, and, ultimately, ends in the dangerous situation of pathological functional microcirculatory “rest”, due to microvessel sphygmicity failure: <i>vasomotion</i> shows <b>AL + PL </b></span><b><span style="font-family:Symbol;"><span style="">£</span></span></b><b><span style="" lang="EN-GB"> 5 sec. </span></b><span style="" lang="EN-GB">( NN = 6 sec. at rest),<b> I = <st1:metricconverter productid="0,5 cm" st="on">0,5 cm</st1:metricconverter>.</b> ( NN = 0,5 – <st1:metricconverter productid="1,5 cm" st="on">1,5 cm</st1:metricconverter>.), periods fixed at 10 sec. </span><span style="" lang="FR">( NN = 9 – 12 sec.) (Fig.s At URL </span><span lang="EN-GB" style="font-size:11;">(<a href="http://www.semeioticabiofisica.it/microangiologia/Documenti/Eng/Pre-metabolic%20syndrome%25"><b>http://www.semeioticabiofisica.it/microangiologia/Documenti/Eng/Pre-metabolic%20syndrome%</b></a></span><span style="" lang="FR">).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">From the clinical-microangiological point of view, such as situation characterizes “<i>peripheral heart</i>” failure. The above-described pathological condition can be localized in a very small area of a limb – finger, calf, a.s.o.), where patient feels the “ischaemic” pain.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><span style="" lang="EN-GB">In conclusion, </span></b><span style="" lang="EN-GB">bed-side evaluation of microcirculatory activation (activation of MFR) represents a noteworthy progress in the field of physical semeiotics or, more precisely speaking, in Biophysical-Semeiotic Clinical Microangiology, playing a primary role, from now on, in the diagnosis, prevention, prognosis, therapeutic monitoring and research of all biological systems. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">Bed-side recognizing microcirculatory activation, localized in various, well-defined biological systems, easy and rapid to perform, in a long experience proved to be reliable and useful in both phsiological and pathological conditions, offering original ways of clinical research.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <h3><span style="" lang="EN-GB"><span style=""> </span><a name="_Toc47515367"></a><a name="_Toc47515307"></a><a name="_Toc47346884"></a><a name="_Toc47346866"></a><a name="_Toc46906290"></a><a name="_Toc46905352"></a><a name="_Toc46800449"></a><a name="_Toc46717834"></a><a name="_Toc46717794"><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style="">Post-Prandial and Post-Absorptive State Activation, in physiological and pathological conditions: Pre-Metabolic<span style=""> </span>Syndrome.</span></span></span></span></span></span></span></span></a><o:p></o:p></span></h3> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">The microcirculatory behaviour in <i>post-absorptive state</i>, i.e., at least 3-4 hours after meals (this time, however, can be lower, because it is in relation to the food amount, the subject has eaten, his digestion as well as absorption capacity, insulin-secretion and insulin-receptors sensitivity), in the liver, scheletric muscle, adipose tissue, both central and peripheral, brain, pancreas, is essential in order to assess the particular metabolic-endocrine situation, as well as the complete and deep understanding the <b>pre-metabolic syndrome</b>, scientifically defined.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">The assessment of the microcirculatory activation of pancreas, liver, striated muscle, adipose tissue, both central and peripheral, under physiological as well as pathological conditions, allowed to define precisely the <i>pre-metabolic syndrome </i>, i.e. the grey zone.<o:p></o:p></span></b></p> </td> </tr> </tbody></table> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">In fact, it is not possible to realize the essence of this particular condition of biological systems, real <b>locus </b>(site) of the primary prevention of most common and serious human disorders, without the steady biophysical semeiotic knowledge of<span style=""> </span>both <i>absorptive state </i>and <i>post-absorptive state</i>, more or less abnormally modified, when the slow transition initiates from CAEMH to pre-metabolic syndrome, frstly, to metabolic syndrome subsequently, or Reaven’s syndrome, both classic and “variant”, and ultimately to the diseases.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">With reference to the “variant” form of metabolic syndrome, we previously described (2), it is interesting to note that under such as condition only epatic microcirculation behaviour appears <i>physiological</i>, as regards insulin action, since local insulin-receptors are normally functioning, helping, thus, to defining and recognizing<span style=""> </span>it by a refined way (10, 11). In a few words, hepatic and pancreatic microcirculation is identical, in the sense that the former parallels the later (Fig.1 and 2).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">To recognize at the bed-side the presence of these <i>bridge-events </i>in a “quantitative” manner, which link the “<b>whithe zone</b>”, physiological, to the “<b>black zone</b>”, pathological, representing, thus,<span style=""> </span>the “<b>grey zone</b><span style="">”, or <i>pre-morbid stage,</i> or better speaking<i> pre-metabolic syndrome</i>, that can last for years or decades, it is unavoidable that doctor has a steady knowledge of this original clinical method, which allows him to estimate “quantitatively” the microcirculatory condition, both functional and structural, in the different tissues, beginning generally from thre-four hours after meals. Fortunately, the <i>preconditioning</i> of diverse biological systems, mentioned above, facilitates enormously the diagnose of<span style=""> </span><i>pre-metabolic state </i></span>(See later on).<span style=""><o:p></o:p></span></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">In fact, as the reader undestands easily, clinical evaluation of metabolic situation thre-four hours after meals, i.e. in the <i>post-absorptive state</i>, is adaptable also in evaluating metabolic condition, regarding glucose, lipids and proteins, soon thereafter the meals (<i>absorptive state</i>): for example, interesting data are collected by the evaluation of pancreatic, hepatic, muscular, abdominal sub-cutaneous adipose tissue (<i>very different is the metabolism of “distal” adipose tissue, e.g. thigh,whose insulin-receptors are always physiologically functioning</i>) microcirculation under both rest condition and after giving two coffee-spoons of sugar dissolved in water. After two minutes, or less, appears gastric hypermia, due to digestive phenomena, increased peristaltic gastric wave velocity (= period 12 sec. <i>versus </i>18 sec.), and glucose absorption: gastric “vasomotion” results clearly increased according to type I. Soon thereafter, doctor observe the activation of pancreatic microcirculation, and, then, successively, the hepatic, muscular and adipose tissue microcirculatory activation.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">At empty stomach, swallowing 2-3 coffee-spoons of sugar dissolved in water, allows doctor to estimate functional gastric digestive activity, and, successively the functional metabolic capacity of pancreas, liver, skeletal muscle, adipose tissue, both central and peripheral, and heart.<o:p></o:p></span></b></p> </td> </tr> </tbody></table> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">As far as pancreatic microcirculatory activation after giving two coffee-spoons of sugar dissolved in water is concerned, we must remember that this <i>test</i> proved to be of diagnostic value in diabetology greater than that of the OGTT, which is surely more expensive and complex.<o:p></o:p></span></p> <p class="aL"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">In healthy, there is enlargement solely of the <i>pancreatic interstitium</i> (= “in toto” ureteral reflex </span><span style="font-family:Symbol;"><span style="">³</span></span><span style="" lang="EN-GB"> <st1:metricconverter productid="1 cm" st="on">1 cm</st1:metricconverter>.), indicating pulsated ormonal secretion, actually, as demonstrates also the deterministic-chaotic behaviour of <i>interstitiomotility</i><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">In contrast, during the test (as well as in the <i>absorptive </i>state), in all biological systems, referred above, doctor observes the phenomenon of absorption, characterized by “in toto” ureteral reflex of smallest degree: < <st1:metricconverter productid="1 cm" st="on">1 cm</st1:metricconverter>. We underscore that these data, reader must know perfectly, play a paramount role in recognizing such as metabolic condition, i.e.<i> pre-metabolic syndrome</i>. In fact, there is a strict relation between “in toto” ureteral reflex intensity, on the one hand, and both <i>absorption </i>or tissue <i>secretion-output, </i>on the other hand.<i><o:p></o:p></i></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">The “in-toto” ureteral reflex intensity < <st1:metricconverter productid="1 cm" st="on">1 cm</st1:metricconverter>. during “light-moderate” stimulation of trigger-points of a biological system indicates a condition of tissue absorption of material-energy-informaton, while the intensity </span></b><b><span style="font-family:Symbol;"><span style="">³</span></span></b><b><span style="" lang="EN-GB"> <st1:metricconverter productid="1 cm" st="on">1 cm</st1:metricconverter>. is expression of actual secretion, or output of metabolites or hormons.</span></b><span style="" lang="EN-GB"><o:p></o:p></span></p> </td> </tr> </tbody></table> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><span style=""> </span><o:p></o:p></span></p> <p class="aL"><span style="" lang="EN-GB">Moreover, it is easy to understand that pancreas interstititum is steadily <i>large</i> (“in toto” ureteral reflex </span><span style="font-family:Symbol;"><span style="">³</span></span><span style="" lang="EN-GB"> <st1:metricconverter productid="1 cm" st="on">1 cm</st1:metricconverter>.), although according to a deterministic-chaotic behaviour, related to <i>insulin secretion pulsatility</i>, as shows clearly the pancreatic diagram as well as pancreatic microvascular fluctuations.<o:p></o:p></span></p> <p class="aL"><span style="" lang="EN-GB">Such as biophysical-semeiotic knowledge allows doctor, for the first time, to recognize if the individual, he examines, is fasting or not: the examination gives a lot of<span style=""> </span>information, but, at times, it is missleading due to erroneous estimate in the transition from <i>absorptive </i>to <i>post-absorptive </i>state, which really lasts only for a few minutes.<i><o:p></o:p></i></span></p> <p class="aL"><span style="" lang="EN-GB">This doubt can be easily resolved by dynamic tests, which stimulate (as VI dermatomere-pancreatic reflex during “middle-intense” stimulation) or restrain (“intense” stimulation of pancreatic trigger-points, apnea test, boxer’s test, Restano’s manoeuvre) <i>insulin secretion</i>: in former case, in fact, hepatic interstitium immediately appears smaller, i.e. < <st1:metricconverter productid="1 cm" st="on">1 cm</st1:metricconverter>., while it increases clearly during stress tests, that notoriously cause <i>reduction</i> of the insular hormone secretion.<o:p></o:p></span></p> <p class="aL"><span style="" lang="EN-GB">In addition, interestingly appears the perfect agreement of AL + PL duration of both <i>vasomotility </i>and<i> vasomotion</i> in all aforementioned biological systems. <o:p></o:p></span></p> <p class="aL"><span style="" lang="EN-GB">By contrast, in <i>hyperinsulinemia-insulinresistance</i>, where lacking is the increase of kidney volume during insulin acute pick secretion (<b>evaluation test of insulin secretion,</b> of greatest value) as well as suprarenal glands show a diagramm of disactivated microcirculation (See: test of hyperinsulinemia-insulinresistance by renal and suprarenal gland diagrams: Glossary), AL + PL in “peripheral biological systems is 7 sec., while the pancreatic AL + PL is > 7 sec., in direct relation to glicidic dysmetabolism (Fig. 1 and 2).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">In absorptive state, the dissociation of AL + PL of vasomotility values between pancreas and peripheral tissue, e.g., pancreatic AL + PL > 7,5 sec., while the value in other biological systems is 7 sec., indicates glicidic dysmetabolism as well as hyperinsulinemia-insulinresistance.<o:p></o:p></span></b></p> </td> </tr> </tbody></table> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">It is important for doctor to know<span style=""> </span>that the unique<span style=""> </span>exception, under above-mentioned condition, is the “normal” microcirculatory activation of “peripheral” adipose tissue (for example, thigh adipose tissue), whose insulin receptors are normally sensitive to hormone in “all” cases.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><span style=""> </span>As a matter of fact, during the <i>absorptive state</i> AL + PL of <i>vasomotility </i>duration is identical to that of the pancreas, while obviously in the <i>post-absorptive state</i> results the shortest of all, because the sensitivity of these insulin receptors in a moment of hyperinsulinemia capable to restrain the hepatic glucose output<span style=""> </span>and FFA output from adipose tissue: pancreatic AL + PL 8 sec., hepatic (in classic Reaven’s syndrome, but <b>not</b> in the “variant” form) and “central” adipose tissue parameter value 7 sec., while in “peripheral” adipose tissue only 6 sec. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">In the “variant” Reaven’s syndrome, under<span style=""> </span>the same condition, hepatic “vasomotion” AL + PL lowers to only 6 sec., due to physiological response of the local insulin receptors, that characterizes such as particular form,<span style=""> </span><i>conditio sine qua non </i>of lithyasis as well as tissue calcium deposit, including vasal wall. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><span style="" lang="EN-GB">A long well established experience allows us to state that, at the moment, biophysical-semeiotics clinical evaluation of the <i>absorptive state </i>and <i>post-absorptive state</i> microcirculation represents the uppermost attained goal, as well as the most fruitful area of research in <span style="">Clinical Microangiology.</span></span></b><span style="" lang="EN-GB"><o:p></o:p></span></p> </td> </tr> </tbody></table> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <h3><a name="_Toc47515368"></a><a name="_Toc47515308"><span style=""><span style="" lang="EN-GB">Bed-side diagnosing pre-metabolic syndrome by means of biophysical-semeiotic preconditioning.</span></span></a><span style="" lang="EN-GB"><o:p></o:p></span></h3> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">Biophysical-semeiotic <i>preconditioning</i> of pancreas, lever, skeletric muscle, adipose tissue, both central and peripheral, allows doctor to recognize the pre-metabolic syndrome easily and rapidly; it is performed in two different ways, micro- and macroscopic (fully illustrated in the site <a href="http://www.semeioticabiofisica.it/microangiologia">www.semeioticabiofisica.it/microangiologia</a>, at the URL: <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><a href="http://digilander.libero.it/semeioticabiofisica">www.semeioticabiofisica.it/microangiologia/Documenti/Eng/A PRECONDIZIONAMENTO%:<span style=""> </span><o:p></o:p></a></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><o:p> </o:p></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">1) <i>macroscopic way</i>: direct and quantitative evaluation of non-linear dynamic behaviour of a biological system (e.g., pancreas), by drawing the relative diagram, and /or, <u>more practical</u> in every day practice, by caecal and/or gastric aspecific reflex latency time (lt);<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">2) <i>microscopic way</i>: quantitative evaluation of local microcirculatory activation type and intensity. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal"><span style="" lang="EN-GB">As an example of the former way, i.e., “macroscopic”, of assessing the <i>preconditioning</i> we consider that cardiac, earlier illustrated (2): “mean-intense” digital pressure with the aid of bell-piece of stethoscope, placed on left heart ventricle projection area, in healthy, provokes ventricular dilation, lasting for <b>7 sec.</b> Continuing such as stimulation – or if it is again applied after an interval of exact 5 sec. for one or two times – this periods lowers to <b>6 sec.</b> and ultimately to <b>5 sec</b>. (BioMedCentral, </span><a href="http://www.biomedcentral.com/1471-2261/3/12/comments/#11454"><span style="" lang="EN-GB">Biophysical Semeiotics is really useful in order to bed-side recognizing heart ischaemic disease, even before its onset, i.e., real risk of coronary artery disease.</span></a><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal"><a href="http://www.biomedcentral.com/1471-2261/3/12/comments/comments"><span style="" lang="EN-GB">http://www.biomedcentral.com/1471-2261/3/12/comments/comments</span></a><span style="" lang="EN-GB">). <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">By contrast, in case of <b>ischaemic heart disease</b>, for example,<i> </i>initial, first duration is<span style=""> </span></span><b><span style="font-family:Symbol;"><span style="">³</span></span></b><b><span style="" lang="EN-GB"> 7</span></b><span style="" lang="EN-GB"> sec., in relation to the seriousness of coronary disorder, and persists unchanged during successive evaluations. Identical results are gathered in case of <b>valvular, hypertensive and amiloydosis cardiopathy.</b><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span lang="EN-GB" style="font-family:Arial;">Contemporaneously, in healthy, lt of the cardio-caecal and –gastric aspecific reflexes rises from 8 sec. to 10 sec. (age-dependent), while it is unchanged (about 8 sec.) in<span style=""> </span>the initial or not severe disease – <i>intermediate preconditioning, type II</i> - , whereas it worsens in the advanced disease – <i>pathological precoditioning, type III</i> – nth expression of internal and external coherence of the biophysical-semeiotic theory.</span><span style="" lang="EN-GB"><o:p></o:p></span></p> </td> </tr> </tbody></table> <p class="aL" style="text-indent: 0cm;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">In the later way, “microscopic”, i.e., in assessing tissue-microvascular unit activation, <u>basal</u><span style=""> </span><i>vasomotility</i> as well as<span style=""> </span><i>vasomotion</i> show the typical<span style=""> </span>physiological deterministic-chaotic behaviour.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">At the end of the third stimulation, caused by pressure of the bell-piece of stethoscope, as above referred, we observe microcirculatory activation, type I, associated: AL + PL of the fluctuations of III upper (<i>vasomotility</i>) and of third lower (<i>vasomotion</i>) ureter persist for 7-8 sec. (NN = 6 sec.); it is necessary to estimate togheter, as an identical parameter, AL + PL, wich indicate the velocity, intensity and duration of arterioles and, respectively capillaries and post-capillaries venules opening, according to a synergistic model.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><span style=""> </span>In fact, the transition from the rest state to the activation occurs by degrees: firstly PL increases (3 sec.</span><span style="font-family:Symbol;"><span style="">®</span></span><span style="" lang="EN-GB"> 5<span style=""> </span></span><span style="font-family:Symbol;"><span style="">®</span></span><span style="" lang="EN-GB"> 6 sec. </span><span style="font-family:Symbol;"><span style="">®</span></span><span style="" lang="EN-GB"> 7 sec. </span><span style="font-family:Symbol;"><span style="">®</span></span><span style="" lang="EN-GB"> 8 sec.), whereas intensity and height of oscillation wave remain the same. Subsequently, all fluctuations become highest spikes (HS), aiming to supply gradually a greater flow-motion (Fig. at URL <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span lang="EN-GB" style="font-size:11;">(<a href="http://www.semeioticabiofisica.it/microangiologia/Documenti/Eng/Pre-metabolic%20syndrome%25"><b>http://www.semeioticabiofisica.it/microangiologia/Documenti/Eng/Pre-metabolic%20syndrome%</b></a></span><span style="" lang="EN-GB">).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">With reference to this topic, it is necessary to remember the important function, played by EBD in this original clinical investigation, where their opening becomes more and more intense and prolonged during physiologic <i>preconditioning</i> occurrence, while “closure” duration progressively shortens. On the contrary, in pathology it is always observable <i>ab initio</i>, an alteration, firstly functional, and, then, structural, of the endoarteriolar blocking devices so that estimating EBD, from both functional and structural view-point, gives the same information as the <i>preconditioning</i>, expression of strict logic connection of theory, we support.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><span style="" lang="EN-GB">To summarize, in healthy the <i>preconditioning</i> brings about, as natural consequence, an optimal tissue supply of material-information-energy, by increasing local <i>flow-motion as well as<span style=""> </span>flux-motion</i>.<o:p></o:p></span></b></p> </td> </tr> </tbody></table> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="aL"><span style="" lang="EN-GB">At this point, we come back to the former example: in the initial phase of <b><span style=""> </span>coronary heart disease</b>, what evolves very slowly toward successive phases, “basal” biophysical-semeiotic data can “apparently” result normal. However, under careful observation, the duration of cardio-gastric aspecific reflex results prolonged: <b>> 4 sec. </b>(NN </span><span style="font-family:Symbol;"><span style="">£</span></span><span style="" lang="EN-GB"> 4 sec.), indicating a local microcirculatory disorder.<o:p></o:p></span></p> <p class="aL"><span style="" lang="EN-GB">Really, in these conditions, EBD function is clearly compromised, but for some time the increased <i>vasomotility </i>counterbalances efficaciously the impaired supply of normal blood amount to parenchyma: also the <i>vasomotion</i>, at rest, shows parameter values oscillating in physiological ranges, due to the augmented arteriolar sphygmicity; such a condition can be “technically” defined <i>peripheral heart compensation</i>.<o:p></o:p></span></p> <p class="aL"><span style="" lang="EN-GB">Noteworthy, from the diagnostic point of view, are also the cardio-caecal and -gastric aspecific reflexes, when accurately assessed: after a lt still normal (8 sec.), doctor observes a reflexes duration, before the successive one initiates, of <b>4,5 sec. </b>(NN </span><span style="font-family:Symbol;"><span style="">£</span></span><span style="" lang="EN-GB"> 4 sec.), and a differential lt (= duration of reflex disappearing before the beginning of the following) of only<span style=""> </span><b>3 sec.</b> (NN<span style=""> </span>> 3 <></span></p> <p class="aL"><span style="" lang="EN-GB">Clinical recognizing of these “slight” abnormalities, really useful in diagnosing initial and/or symptomless disorders, altough not difficult to perform, requests a good knowledge, a steady experience and a precise performance of the new semeiotics.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">In these cases, <i>preconditioning </i>allows in simple and reliable manner to recognize the pathological modifications, mentioned above, which indicate the altered physiological adaptability, even initial or slight, of the biologial system to changed conditons as well as to increased tissue<span style=""> </span>demands (Tab.1).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify;"><b><i><span style="" lang="EN-GB">Physiological, type I</span></i></b><b><span style="" lang="EN-GB"> Preconditioning </span></b><b><span style="font-family:Symbol;"><span style="">®</span></span></b><b><span style="" lang="EN-GB"> Tissue-microvascular unit activation<span style=""> </span></span></b><b><span style="font-family:Symbol;"><span style="">®</span></span></b><b><span style="" lang="EN-GB"><span style=""> </span>MFR normal<span style=""> </span></span></b><b><span style="font-family:Symbol;"><span style="">®</span></span></b><b><span style="" lang="EN-GB"><span style=""> </span><span style=""> </span>outcome<span style=""> </span>+<o:p></o:p></span></b></p> </td> </tr> <tr style=""> <td style="border-style: none solid solid; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><span style="" lang="EN-GB">(<i>Physiological</i> DEB<i> </i>Function)<span style=""> </span>type I, associated<o:p></o:p></span></b></p> </td> </tr> <tr style="height: 41.75pt;"> <td style="border-style: none solid solid; padding: 0cm 3.5pt; width: 488.9pt; height: 41.75pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><span style="" lang="EN-GB"><o:p> </o:p></span></b></p> <br /></td> </tr> <tr style=""> <td style="border-style: none solid solid; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify;"><b><i><span style="" lang="EN-GB">Intermediate, type II</span></i></b><b><span style="" lang="EN-GB"><span style=""> </span>Preconditioning </span></b><b><span style="font-family:Symbol;"><span style="">®</span></span></b><b><span style="" lang="EN-GB"> Tissue-microvascular unit activation<span style=""> </span></span></b><b><span style="font-family:Symbol;"><span style="">®</span></span></b><b><span style="" lang="EN-GB"> MFR compromised </span></b><b><span style="font-family:Symbol;"><span style="">®</span></span></b><b><span style="" lang="EN-GB"> outcome </span></b><b><span style="font-family:Symbol;"><span style="">±</span></span></b><b><span style="" lang="EN-GB"><o:p></o:p></span></b></p> </td> </tr> <tr style=""> <td style="border-style: none solid solid; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><span style="" lang="EN-GB">(EBD function slightly modified: closure)<span style=""> </span>type II<span style=""> </span><span style=""> </span><o:p></o:p></span></b></p> </td> </tr> <tr style=""> <td style="border-style: none solid solid; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB"><span style=""> </span><o:p></o:p></span></b></p> <br /></td> </tr> <tr style="height: 41.75pt;"> <td style="border-style: none solid solid; padding: 0cm 3.5pt; width: 488.9pt; height: 41.75pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><span style="" lang="EN-GB"><o:p> </o:p></span></b></p> <br /></td> </tr> <tr style=""> <td style="border-style: none solid solid; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify;"><b><i><span style="" lang="EN-GB">Patological, tipo III</span></i></b><b><span style="" lang="EN-GB"><span style=""> </span>Precondizioning </span></b><b><span style="font-family:Symbol;"><span style="">®</span></span></b><b><span style="" lang="EN-GB"><span style=""> </span>Tissue-microvascular unit activation </span></b><b><span style="font-family:Symbol;"><span style="">®</span></span></b><b><span style="" lang="EN-GB"> MFR<span style=""> </span>absent </span></b><b><span style="font-family:Symbol;"><span style="">®</span></span></b><b><span style="" lang="EN-GB"><span style=""> </span>outcome<span style=""> </span></span></b><b><span style="font-family:Symbol;"><span style="">-</span></span></b><b><span style="" lang="EN-GB"><o:p></o:p></span></b></p> </td> </tr> <tr style=""> <td style="border-style: none solid solid; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><span style="" lang="EN-GB">(EBD function<i> pathological</i>)<span style=""> </span>type II, dissociated<o:p></o:p></span></b></p> </td> </tr> </tbody></table> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-GB">Tab. 1<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">From the above remarks it appears plain that the various parameters of caecal, gastric aspecific and choledocic reflex, type of activation and, then, EBD function, related to a defined biological system, parallel the data of <i>preconditioning</i>.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><span style=""> </span>Another example to clarify the abstract value of the concept: in healthy, pancreatic-gastric aspecific and –caecal reflex is characterized by lt of about <b>12-13 sec</b>., D of </span><b><span style="font-family:Symbol;"><span style="">£</span></span></b><b><span style="" lang="EN-GB"> 4 sec.</span></b><span style="" lang="EN-GB"> and differential lt or <b>fractal dimension > 3 <> (NN =<span style=""> </span>3,81). Contemporaneously “basal” pancreatic “vasomotion” shows the typical deterministic-chaotic behaviour, known to reader by now, in which AL + PL lasts 6-7 sec. physiologically, fluctuations intensity varies from 0,5 to <st1:metricconverter productid="1,5 cm" st="on">1,5 cm</st1:metricconverter>. (conventional value), the period fluctuates between 9 sec. to 12 sec., average value 10,5, <b>fractal</b> number (8).<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>Soon therafter pancreatic <i>preconditioning</i> (“mean-intense” cutaneous pinching of VI thoracic dermatomere for 15 sec., repeated three times with 5 sec. interval exactly), in healthy, caecal-, gastric aspecific-, and choledocic-reflexes show lt<span style=""> </span>of<span style=""> </span>14 sec. (NN basal value = 12 sec.), duration </b></span><span style="font-family:Symbol;"><span style=""><b>£</b></span></span><span style="" lang="EN-GB"><b> 3,5 sec., and differential lt > 3,81 </b></span><span style="font-family:Symbol;"><span style=""><b>£</b></span></span><span style="" lang="EN-GB"><b> 4. Simultaneously, occurs pancreatic microcirculatory activation, according to type I, associated, with AP + PL of 7-8<span style=""> </span>sec., intensity of the ureteral fluctuations, both upper and lower, greatest (<st1:metricconverter productid="1,5 cm" st="on">1,5 cm</st1:metricconverter>.), as we observe in HS, EBD physiologically activated:middle ureteral reflex intensity, brought about by “mean” stimulation of related trigger-points of 1,5-<st1:metricconverter productid="2 cm" st="on">2 cm</st1:metricconverter>., reflex duration 22-24 sec. (basal 20 sec.), and duration of its disappearance 4 sec. (basal 6 sec.).<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>By contrast, in <b>impaired glucose tollerance (IGT)</b>, above-referred parameters, at least in its initial phase (= <i>pre-metabolic syndrome</i>) and in slight cases, do not modify, but worsen statistically exclusively in advanced stages, in relation to disease seriousness: lt decreases to<span style=""> </span></b></span><b><b><span style="font-family:Symbol;"><span style="">£</span></span></b><b><span style="" lang="EN-GB"> 11 sec</span></b><span style="" lang="EN-GB">., while the duration rises to </span><b><span style="font-family:Symbol;"><span style="">³</span></span></b><b><span style="" lang="EN-GB"> 4 sec.,</span></b><span style="" lang="EN-GB"> and differential latency time results smaller than that initial, border-line<span style=""> </span>(= 2,5-3 sec.): <b><> Under this condition, microcirculatory activation is of type II, dissociated, indicating the actual situation of <i>pre-morbid state</i> in an individual completely symptomless, even for decades.<o:p></o:p></b></span></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>Interestingly, the <i>preconditioning</i> can be easily applied in estimating both function and structure of all biological systems, which at this moment, at rest, can<span style=""> </span>reveal apparently normal conditions, but, in reality, show clear-cut abnormalities of numerous parameters values of the biophysical-semeiotic signs (Tab. 2).<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 97.75pt;" valign="top" width="130"> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">HEALTH<o:p></o:p></span></b></p> </td> <td style="border-style: solid solid solid none; padding: 0cm 3.5pt; width: 97.75pt;" valign="top" width="130"> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="FR">Tl 12 - 14 sec.<o:p></o:p></span></b></p> </td> <td style="border-style: solid solid solid none; padding: 0cm 3.5pt; width: 97.8pt;" valign="top" width="130"> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="FR">Duration </span><><b><span style="" lang="FR"> sec<o:p></o:p></span></b></b></p><b> </b></td> <td style="border-style: solid solid solid none; padding: 0cm 3.5pt; width: 97.8pt;" valign="top" width="130"> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">Differetial lt >3</span></b><b><span style="font-family:Symbol;"><span style="">£</span></span></b><b><span style="" lang="EN-GB">4<o:p></o:p></span></b></p> </td> <td style="border-style: solid solid solid none; padding: 0cm 3.5pt; width: 97.8pt;" valign="top" width="130"> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">mvtU. activation type I associated<o:p></o:p></span></b></p> </td> </tr> <tr style=""> <td style="border-style: none solid solid; padding: 0cm 3.5pt; width: 97.75pt;" valign="top" width="130"> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">IGT in slow diabetic evolution<o:p></o:p></span></b></p> </td> <td style="border-style: none solid solid none; padding: 0cm 3.5pt; width: 97.75pt;" valign="top" width="130"> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">Tl<span style=""> </span>normal or </span></b><b><span style="font-family:Symbol;"><span style="">£</span></span></b><b><span style="" lang="EN-GB"> 11 sec.<o:p></o:p></span></b></p> </td> <td style="border-style: none solid solid none; padding: 0cm 3.5pt; width: 97.8pt;" valign="top" width="130"> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">Duration </span></b><b><span style="font-family:Symbol;"><span style="">³</span></span></b><b><span style="" lang="EN-GB"> 4 sec.<o:p></o:p></span></b></p> </td> <td style="border-style: none solid solid none; padding: 0cm 3.5pt; width: 97.8pt;" valign="top" width="130"> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">Tl differenziale<o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><b><span style="font-family:Symbol;"><span style="">£</span></span></b><b><span style="" lang="EN-GB"> 3 - 2,5<o:p></o:p></span></b></p> </td> <td style="border-style: none solid solid none; padding: 0cm 3.5pt; width: 97.8pt;" valign="top" width="130"> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">mvtU. activation typeII dissociated<o:p></o:p></span></b></p> </td> </tr> </tbody></table><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-GB"><b><b>Tab. 2<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoBodyText" style="text-align: center;" align="center"><b><b><i><span style="" lang="EN-GB">Parameters of pancreatic-gastric apecific and –caecal reflex after the<span style=""> </span>preconditioning in healthy and in a individual with impaired glucose tollerance in slow diabetic evolution.<o:p></o:p></span></i></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><b><b><i><span style="" lang="EN-GB">(explanation in the text).<o:p></o:p></span></i></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><b><b><i><span style="" lang="EN-GB"><o:p> </o:p></span></i></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><span style="" lang="EN-GB">Gradual worsening of the parameters values of reflexes, observed <i>bed-side</i> with the <i>preconditioning</i>, related to the actual functional and structural conditions of the investigated biological systems, can be “geometrically” represented, in a refined way, by the temporal changes of the “strange attractor”, apparently such at rest, which, after proper tissue stimulations, firstly becomes a “close-loop attractor”, and, ultimately, a “fixed-point attractor”: </span></b><b><span style="" lang="EN-GB"><span style=""> </span></span></b><b><span style="" lang="EN-GB">from the biological view-point</span></b><span style="" lang="EN-GB">,<span style=""> </span></span><b><span style="" lang="EN-GB">the life is<span style=""> </span>the trajectory of the strange attractor<span style=""> </span>of biological systems</span></b><b><span style="" lang="EN-GB">”.</span></b><span style="" lang="EN-GB"><o:p></o:p></span></p> </td> </tr> </tbody></table><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><h3><b><b><a name="_Toc47515369"></a><a name="_Toc47515309"></a><a name="_Toc47346885"></a><a name="_Toc47346867"></a><a name="_Toc46906291"></a><a name="_Toc46905353"></a><a name="_Toc46800450"></a><a name="_Toc46717835"></a><a name="_Toc46717795"><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style="" lang="EN-GB">Tissue microcirculation in the <i>post-absorptive state </i><span style=""> </span>in various diabetic stages.</span></span></span></span></span></span></span></span></span></a><span style="" lang="EN-GB"><o:p></o:p></span></b></b></h3><b><b> </b></b><p class="MsoNormal"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>In the interest of reader, to facilitate the understanding of following argument,<span style=""> </span>we refer briefly some fundamental knowledges of the original semeiotics, remembering elementary concepts of glycidic metabolism after three-four hours, at least, after meals, in healthy, in case of IGT, and finally in diabetes mellitus, showing that, at every moment of the day, doctor is able to evaluate insulin-secretion, as well as insulin-resistance at the bed-side by means of <b>Biophysical Semeiotics</b> (1, 2, 9, 10, 11). In this connection, both <i>acute pick of insulin-secretion test</i> (See later on) and<span style=""> </span><i>post-prandial glycemia </i>(PPG) are really fundamental.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>In fact, doctor is able to recognize “clinically” initial abnormalities of glycidic metabolism, since i<i>nsulinemic pick </i>results always reduced, even in different degree (assessed as latency time, duration and intensity of pancreatic-aspecific gastric reflex, for instance (NN = lt 12-13 sec., D 3 < productid="1,5 cm" st="on">1,5 cm.), and prescribe early, in selective and rational way, the best therapy, including diet, etymologically speaking, carrying out efficaciously <b>diabetes mellitus primary prevention </b>on a very large scale.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><b><b>If doctor evaluates over and over again, at least three times, with unavoidable intervall of 5 sec. – <i>biophysical semeiotic </i><span style=""> </span><i>preconditioning </i>– the <i>acute pick of insulin secretion</i>, he observes the described diabetic pathological condition, even initial and/or slight, characterized by various degrees of basal parameters values: at basal line, in <b>diabetes mellitus</b> the <b>VI thoracic dermatomere-gastric aspecific reflex lt </b>(i.e.<b> </b><i>acute pick of insulin secretion</i>) is <b><> (NN = 12-13 sec.), <b>D > 4 sec</b> (NN > 3 <>differential lt </b>before the occurring of successive reflex<span style=""> </span><b><>(= > 3 <><o:p></o:p></b></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>In reality, it appears very interesting that these values are statistically modified, in the pathological sense, in case of both <b>IGT </b>and <b>its different stages </b>during<b> diabetic evolution</b>, particularly after <i>biophysical semeiotic preconditioning</i>: <b>lt </b>appears reduced over time, lowering from <b>12-13 sec.</b> or <b>> 13 sec.</b> in case of insulin hypersecretion, to <b>10 sec.<span style=""> </span>or </b></b></b></span><b><b><b><span style="font-family:Symbol;"><span style="">£</span></span></b><b><span style="" lang="EN-GB"> 9 sec.</span></b><span style="" lang="EN-GB">, inversely related to the seriousness of hormone secretion impairement.<o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>In contrast, in healthy, pancreatic islets <i>preconditioning</i> brings about a clear-cut amelioration of all pancreatic-gastric aspecific reflex parameters, by significant way. Contemporaneously, both pancreatic and peripheral microcirculatory bed is activated, according to type I, associated, where <i>vasomotility</i> as well as<span style=""> </span><i>vasomotion</i> clearly increased in the pancreas: <b>AL + PL </b>rises <b>from 6 sec. to 8 sec.</b>,<span style=""> </span><b>I</b> becomes maximal, i.e. <st1:metricconverter productid="1,5 cm" st="on"><b>1,5 cm</b></st1:metricconverter><b>.</b> (HS) and<span style=""> </span><b>DEB </b>result <b>activated</b> (closure duration <> 20 sec.) (Fig. 1, 2, 3). <o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>As regards the peripheral tissues, the values depend on the presence or absence of classic or “variant” metabolic syndrome, as referred above.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>On the contrary, in case of <b>IGT</b>, the values of ureteral reflex parameters are the same of those typical of dissociated microcirculatory activation, where only the <i>vasomotility</i> appears increased, while the <i>vasomotion</i> is lowered, and, as usually, is observable DEB dysfunction, more or less intense (Fig. 2).<o:p></o:p></b></b></span></p><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><b><b>It follows that doctor observes histangic disorder, acidosic in origin, indicating the real pathogenetic role played by microcirculatory activation, type II, dissociated, in whom, in our mind, the abnormal activity of Endoarterial Blockomg Devises (DEB), ubiquitarious in contrast to AVA, type II, group A and B, as well as AVA, type I, according to Bucciante) plays a primary role in the onset of most common and dangerous human diseases, degenerative, connective and neoplastic in nature.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><h3><b><b><a name="_Toc47515370"></a><a name="_Toc47515310"></a><a name="_Toc47346886"></a><a name="_Toc47346868"></a><a name="_Toc46906292"></a><a name="_Toc46905354"></a><a name="_Toc46800451"></a><a name="_Toc46717836"></a><a name="_Toc46717796"><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style="" lang="EN-GB">Histangic different response to endogenous insulin, in physiology, in Pre-Metabolic Syndrome and in pathology.</span></span></span></span></span></span></span></span></span></a><span style="" lang="EN-GB"><o:p></o:p></span></b></b></h3><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><b><b>Biophysical-semeiotic evaluation of pre-metabolic syndrome, characterized by the absence of disease due to compensation, even unstable, as regards receptorial hyporesponsiveness, is based chiefly on clinical and quantitative evaluation<span style=""> </span>of insulin-resistance (11) in insulin-dependent tissues, as liver, striated muscle, “abdominal” adipose tissue, bresat and thorax, whose metabolic behaviour is clearly more “vulnerable” than the peripheral adipose tissue.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>Physiologically, endogenous insulin, secreted by means of the stimulation of VI thoracic dermatomere due to digital pressure or prolonged pinching of the related skin, activates various microcirculatory systems also of these biological systems.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>By contrast, interestingly, since the first stage of slow and progressive evolution of CAEMH to metabolic syndrome, classic or “variant”, i.e., in the above-illustrated condition termed <i>pre-morbid or pre-metabolic<span style=""> </span>state</i>, insulin brings about type II microcirculatory activation, dissociated, and consequently tissue acidosis, subsequent to the reduction of insulin-receptor activity (responsiveness) toward its hormone, as well as nor-epinephrine (nor-adrenalin) as well as epinephrine (adrenalin), and, thus, compensatory increase of insulin, epinephrine and nor-epinephrine (= enhancement of suprarenal glands macro-fluctuations as well as microcirculatory oscillations), causing the well-known abnormal consequences.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>At the begin of this paper we have remembered that, in healthy, the insulin activates the microcircle, while under pathological conditions, such as<b> hyperinsulinemia-insulinresistance, </b>evolving slowly towards diabetes mellitus, provokes increase of free radicals and Protein-Kinase-C (PKC), which, in turn, causes macro-and micro-vascular spasms (Millennium of Diabetes Treatment, Medscape 2000), as we previously demonstrated clinically (2, 9,11). It follows that the microcirculatory bed is activated, according to activation type II, dissociated.<i><o:p></o:p></i></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><span style="" lang="EN-GB">To recognize and “quantify” clinically the interesting and dangerous hyperinsulinemia-insulinresistance, clinically silent, <i>by the easiest way </i>doctor performs the basal evaluation of lt of finger-pulp-gastric aspecific or caecal reflex. After <i>acute pick of insulin secretion</i> (=cutaneous pinching, lasting about 15 sec., inwards to the crossing point of hemiclavicular line and homolateral costal arch: VI thoracic dermatomere), doctor assesses for the second time lt of the same reflexes, which physiologically rises from 7-8 sec. to 9-10 sec., while in the later, pathological condition, i.e, in <i>pre-metabolic stage, </i>characterized by<span style=""> </span><i>hyperinsulinemia-insulinresistance,</i> the lt first appears unchanged and, then, becomes shorter, in inverse relation to the seriousness of dysmetabolic condition.<o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> </td> </tr> </tbody></table><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>In this condition, hyperinsulinemia causes the microcircultory activation, type II, dissociated, and, then, the “centralization” of <i>flow-motion</i>.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>Doctor observes characteristic behaviours of insulin receptors at renal level, which account for the reason of the <i>renal test of hyperinsulinemia-insulinresistance</i>, mentioned above (See Glossary in the site Semeiotica Biofisica): receptorial <i>down-regulation</i>, consequence of the increased hormonal blood level, hinders the physiological response of kidneys to <i>acute pick of insulin secretion</i>, characterized by microcirculatory activation, type I, associated, wich explains the insulin-dependent modifications of kidney diagramm: <b>in healthy</b>, after a <b>lt of 3 sec., </b>the kidney enhances intensely its size (congestion) for <b>10</b> sec., while in the <b>diabetic lt rises to only 6 sec.</b> with slight and short increase of its diameters and prevailing renal decongestion.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB"><span style=""> </span>In the <i>pre-metabolic syndrome</i> and in the steady IGT, one speaks of insulin-resistance if<span style=""> </span>AL + PL value of both pancreatic<i> vasomotility</i> and <i>vasomotion</i> in the <i>post-prandial state</i> is higher than that<span style=""> </span>osserved in the liver (with the exception of “variant” metabolic syndrome), striated muscle and abdominal adipose tissue.</span></b><span style="" lang="EN-GB"><o:p></o:p></span></p> </td> </tr> </tbody></table><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>In other words, under such as situation, peripheral metabolic activity needs a more amount of insulin to counterbalance insulinreceptors abnormal sensitivity, and thus to maintain in physiological ranges the glico-lipidic metabolism,<span style=""> </span>by the aid of hyperinsulinemia (2, 9). In this condition, the <i>renal test of hyperinsulinemia</i> results negative, i.e., <i>pathological</i>, as described above.<span style=""> </span><o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>However, when endocrine pancreas goes on slowly toward functional insufficiency, even with different intensity, in the<span style=""> </span><i>post-absorptive state</i> the duration of AL + PL is greater in peripheral tissues (liver, “central” adipose tissue, striated muscle) than in the pancreas. From the metabolic-biochemical view-point, these events are explained by the fact that the insulin dos not reach sufficient blood level to “check” glucose secretion by the liver as well as FFA by abdominal-thorax adipose tissue away from the meals. Notoriously, physiological amount of hormone controls, on the one hand, glucagone activity (hepatic glucogenolysis and no-glucogenogenesis) and, on the other hand, lipolysis (free fatty acids secreted in the blood).<span style=""> </span><o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>The curbing insulin action influences, of course, microvascular system function in diverse tissues, where <i>vasomotility </i>and<i> vasomotion </i>show the same intensity.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><span style="" lang="EN-GB">In fact, as I demonstrated clinically, there is a strict functional relation between parenchyma and relative microcircle (Introduzione alla Semeiotica Biofisica), which allows bed-side anatomo-functional evaluation of a precise parenchyma by assessing the relative microcircle, representing, thus, the climax of <i>Clinical Microangiology</i>.<o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> </td> </tr> </tbody></table><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>At this point, as regards what is illustrated above, it is of great interest the fact that, if the parenchyma is activated in the sense of absorption and/or synthesis (for example, the liver synthesizes glucogen, as we observe in <i>post-prandial state</i>), intertitium appears “minimal” (= “in toto” ureteral reflex, brought about <b>in the first 6 sec.,</b> after “light” stimulation, is really small: <b>< <st1:metricconverter productid="1 cm" st="on">1 cm</st1:metricconverter>.</b> (NN = <st1:metricconverter productid="0,5 cm" st="on">0,5 cm</st1:metricconverter>.), while in case of microcirculatory activation indicstes the presence of secretion (FFA or glucose output in blood stream) the interstitium is clearly “large” : > <st1:metricconverter productid="1 cm" st="on">1 cm</st1:metricconverter>. (12, 13, 14, 15).<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>In contrast, when glycidic metabolism is altered, even in initial and/or silent stage, rceptor insulin sensitivity results reduced and consequently we observe hyperinsulinemia in order to counterbalance such hormone insufficiency, increase of hepatic glucoeogenesis as well as glicogenolysis, initially properly controlled ba periheral absorption (adipose tissue and muscles, including the myocardium), achieving, thus, a new <i>steady state </i>plamatic glycidic concentration (1, 2, 9, 11, 12). <o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>In this metabolic situation, which can last for years or decades, the microcirculation in the diverse tissues is necessarily activated, i.e., the<span style=""> </span><i>vasomotility </i>and <i>vasomotion</i> are showing progressively basal conditions and, then, a large variety of microcirculatory situations, different from both quantitative and qualitative point of view, whose investigation open new and fascinating ways in medicine and particularly in primary prevention. <o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><h3><b><b><a name="_Toc47515371"></a><a name="_Toc47515311"></a><a name="_Toc47346887"></a><a name="_Toc47346869"></a><a name="_Toc46906293"></a><a name="_Toc46905355"></a><a name="_Toc46800452"></a><a name="_Toc46717837"></a><a name="_Toc46717797"><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style="" lang="EN-GB">Pre-Metabolic Syndrome: microcirculatory activaton in initial phases of principal diseases.</span></span></span></span></span></span></span></span></span></a><span style=""><span style=""><span style=""><span style=""><span style=""><span style="" lang="EN-GB"> Two pressures test.</span></span></span></span></span></span><span style="" lang="EN-GB"><o:p></o:p></span></b></b></h3><b><b> </b></b><p class="MsoNormal"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><b><b>In following, we refer the data of our research, initiated in October <st1:metricconverter productid="1998 in" st="on">1998 in</st1:metricconverter> patients with pre-metabolic syndrome, to study the microcircle in the initial phases of principal human diseases. These results appear to be, from now on, really interesting altough referred exclusively to some diseases, though very frequent to observed in day-to-day practice: <b>diabetes mellitus, arteriosclerosis, dyslipidemia, ischaemic heart disease, arterial hypertension, kidney<span style=""> </span>and gall-bladder-stones, and malignancies.<o:p></o:p></b></b></b></span></p><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><b><b>From at least 20 years, we claim unheeded that CAEMH-</b></b></span><span style="font-family:Symbol;"><span style=""><b><b>a</b></b></span></span><span style="" lang="EN-GB"><b><b> represents the <b><span style=""> </span></b><i>conditio sine qua non</i> of most common, serious, human pathologies (1-6, 18-20). The unavoidable way from this functional mitochondrial cytopathology to various diseases has been clinically recognized and indentified by us as poli-metabolic alteration, metabolic X syndrome, we termed untill now as <i>Reaven’s Syndrome, </i>of whose we described the so-called<i> “variant” </i>form (2, 9), which preceeds and<span style=""> </span>then can be associated with kidney and gall-bladder-stones, as well as the calcium deposit in all tissues, incuding arterial walls, and consequently we consider it <b><i>the conditio sine qua non</i> </b>of lythiasic disorders.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>The microangiological data, observed in the <i>post-absorptive state</i>, corroborate our former statements, enlightening the complexity of physio-pathological mechanisms at the base of malignancies (See in the above-cited site: Oncological Terrain) as well as metabolic and infectious diseases, unfortunately nowadays not complicately utilized on large scale.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><span style=""><b><b> </b></b></span><b><b>In addition, this biophysical-semeiotic microangiological study allows to gather at the bed-side essential information, which provides the possibility of the interpretation of the real nature of the passage from health stage –<i> white zone</i> – to that of disease – <i>black zone</i> – explaining, although incompletely, clinical significance and suggesting, thus, nosological definition of the term <i>pre-metabolic state</i>, <i>premetabolic syndrome, Grey Zone, </i>place of the “primary” prevention, rationally and individually realized.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal"><b><span style="" lang="EN-GB"><span style=""> </span><span style=""> </span><a name="_Toc46717838"></a><a name="_Toc46717798"><span style="">White Zone<span style=""> </span></span></a></span></b><span style=""><span style=""><b><span style="font-family:Symbol;"><span style="">®</span></span></b></span></span><span style=""><span style=""><b><span style="" lang="EN-GB"><span style=""> </span>Pre-Metabolic Syndrome or <st1:place st="on"><st1:placename st="on"><i>Grey</i></st1:placename><i> <st1:placename st="on">Zone</st1:placename></i></st1:place><span style=""> </span></span></b></span></span><span style=""><span style=""><b><span style="font-family:Symbol;"><span style="">®</span></span></b></span></span><span style=""><span style=""><b><span style="" lang="EN-GB"><span style=""> </span>Black Zone</span></b></span></span><b><span style="" lang="EN-GB"> <o:p></o:p></span></b></p> </td> </tr> </tbody></table><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><span style=""><b><b> </b></b></span><o:p></o:p></span></p><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><b><b>The activation of<span style=""> </span>tissue-microvascular system is not<span style=""> </span>a monotonous event, always identical. The transit from basal state, or at rest, to that of “active hyperemia” is dependent from the primitive parenchyma activation. <o:p></o:p></b></b></span></p><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><b><b>After the end of <i>post-prandial stage</i>, i.e. about 3 hours after the meal, in healthy, insulin secretion modulates the glucagonic activity, hepatic glycogenolysis and lipolysis. Consequently, physiologically, in the <i>post-absorption state, </i>we observe in the pancreas, striated muscle, adipose tissue, both “central” and<span style=""> </span>“peripheral”, and in the liver<span style=""> </span>a functional situation, characterized by a “vasomotion” showing periods and intensity with deterministic-chaotic behaviour and normally functioning AVA.<i><o:p></o:p></i></b></b></span></p><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><b><b>The physiological <i>steady-state</i> of glycemia indicates that glycemic concentration are normal on an empty stomach, since there is perfect relation between <i>vasomotility</i> as well as <i>vasomotion</i> in all tissues: AL + PL = 7 sec.; I = 1 - <st1:metricconverter productid="1,5 cm" st="on">1,5 cm</st1:metricconverter>.; fD = 3, and<span style=""> </span>AVA, including EBD, normally functioning (Fig. 1, 2, 3).<o:p></o:p></b></b></span></p><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><b><b>It is plain that it exsists “always” microcirculatory activation in the tissues, although time-dependent of different intensity: biological systems are systems open to exchange of material-energy-information.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><b><b>It follows that the caecal reflex (= caecal dilation, caused by mean digital pressure on whatever biological system) latency time appears physiological in all tissues, mentioned above (pancreas = 12 sec.; liver = 10 sec.; adipose tissue = 10 sec.; striated muscle = 10 sec. and, ultimately, brain and heart = 6 and respectovely 8 sec., age-dependent, of course).<o:p></o:p></b></b></span></p><b><b> </b></b><p class="aL"><b><b><b><i><span style="" lang="EN-GB">The two pressure test</span></i></b><span style="" lang="EN-GB"> gives rapidly interesting information as regards parameters values of tissue oxygenation. In fact, they allow to recognize promptly the physiological “vasomotion”: soon therafter caecal reflex appears, doctor increases manual, digital pressure (even the pressure caused by the bell-piece of stethoscope), in relation to the type of stimulation, enhancing, thus, the intensity of related trigger-points stimulation.<o:p></o:p></span></b></b></p><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><b><b>In our case, i.e., stimulation with a lasting “light-moderate” pinching, doctor increases its intensity, obviously. Temporaneously, the reflex rapidly disappears for th duration, in healthy, of > 3 sec.<></b></b></span></p><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><b><b>The referred results, i.e. the information given by <b><i>the two pressure test</i></b>, is related to the activation intensity of local microcirculatory system (FMR, functional microcirculatory reserve), causing a greater O<sub>2</sub> and metabolites supply to tissues, resulting in clear amelioration of<span style=""> </span>of tissue pH, and, thus, caecal reflex disappearing, wich indicates, therefore, histangic acidosis.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><b><b>In contrast, when the microcircle is already activated, as during the gland secretion, and basal lt is physiological (= normal tissue oxygenation), <b><i>the two pressure test</i></b> results abnormal, showing value lowered to <></b></b></span></p><b><b> <b><span style="" lang="EN-GB"> </span></b> </b></b><h3><b><b><a name="_Toc47515372"></a><a name="_Toc47515312"></a><a name="_Toc47346888"></a><a name="_Toc47346870"></a><a name="_Toc46906294"></a><a name="_Toc46905356"></a><a name="_Toc46800453"></a><a name="_Toc46717839"></a><a name="_Toc46717799"><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style="" lang="EN-GB">Microcirculatory</span></span></span></span></span></span></span></span></span></a><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style="" lang="EN-GB"> </span></span></span></span></span></span></span></span></span></span><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style="" lang="EN-GB">activation in glucose metabolism impairment.</span></span></span></span></span></span></span></span></span></span><span style=""></span><span style=""></span><span style=""></span><span style=""></span><span style=""></span><span style=""></span><span style=""></span><span style=""></span><span style=""></span><span style="" lang="EN-GB"><o:p></o:p></span></b></b></h3><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>At this point, to understand properly the essence of <i>pre-metabolic syndrome</i>we, we must consider the <i>vasomotility </i>and <i>vasomotion</i> in early stages of IGT during the <i>absorptive state</i> and, then, in <i>post-absorptive state</i>. Of course, these are different events related to residual insulin secretory activity of Langheran’s islets cells, variable from individual to individual, as well as in the same subject, over time. We must remember the normal function of insulin receptors of lever, characteristically present in the “variant” form of metabolic syndrome (2, 21).<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>In the IGT, in initial stage, insulin secretion in general appears substantially “increased”, likely due to reduced insulin receptor sensitivity, including the same receptors of Langheran’s </b></b></span><span style="font-family:Symbol;"><span style=""><b><b>b</b></b></span></span><span style="" lang="EN-GB"><b><b>-pancreatic cells (the question about the relation between insulin-resistance and hyperinsulinemia untill now are not clarified, although doctors speak about compensatory hyperinsulinemia)<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>At the beginning of the process, both hepatic glycogenolysis and neoglycogenesis are normal, successively glycogenolysis enhances, analogously to the lipolysis in adipose tissue, depending from receptor sensitivity, as well as responsivity as far as insulin is concerned.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>It follows that the microcirculatory activation in the liver, brain, adipocytes and in striated muscle shows always a pathologial behaviour, although different from case to case, as referred above in case of <i>pre-metabolic syndrome</i>. <o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>From biophysical-semeiotic view-point, <b>glucose dysmetabolism</b> is characterized by the “dissociation” between pancreatic microcirculatory activation, assessed as AL + PL duration, and that peripheral. In brief, in presence of reduced receptor sensitivity, obviously, in the <i>absorptive state,</i> i.e., untill 3-4 hours after meals, the opening duration of microvessels is more intense at level of pancreatic cells <i><span style=""> </span></i>(<b>AL + PL = 8 sec.</b>) rather than in the striated muscle, liver (in the absence of<span style=""> </span>“variant” form” metabolic syndrome) or adipose tissue of thorax and abdomen, where <b>AL + PL</b> persits for <b>7,5 sec.</b>, exclusively in the vasomotility<b> </b>(Fig. 1).<o:p></o:p></b></b></span></p><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><b><b>It is now well known that, under this condition, in thight adipose tissue there is a microcirculatory activation similar to the Langheran’s pancreatic islets (AL + PL = 8 sec.), because local insulin receptors are physiologically functioning.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>On the contrary, during the <i>post-absorptive state</i>, due to the reduced “curbing” insulin action – <b>hyperinsulinemia-insulinresistance </b>– we observe microcirculatory events completely opposite: <b>pancreatic AL + PL </b>really intense, showing value of <b>7-8 sec.</b>, while in the <b>liver AL + PL is 8-9 sec. </b>(apart from “variant” type of metabolic syndrome, where the value is 7-8 sec. as that pancreatic), as well as in <b>thoracic and abdominal adipose tissue</b>. <o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>Once again, at level of thigh adipose tissue, the microcirculation appears similar to that in pancreas: AL + PL = 7-8 sec. Interestingly, in striated muscle microcirculatory activation is usually reduced<span style=""> </span>(AL + PL = 6-7) in comparison with the pancreatic one, since muscular tissue is always in<span style=""> </span>greater or less absorption state, actually in presence of reduced insulin receptor sensitivity.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>Therefore, in the initial stages of IGT, local microcirculatory activation is capable to maintain, “at rest”, an apparently normal supply of material-energy-information to parenchymas, whereas in advanced IGT, when “peripheral” microcirculatory pattern, related to “vasomotion” in <i>post-absorptive state</i>,<span style=""> </span>it results<span style=""> </span>as follows: AL + PL = 8-9 sec., I = 1,5 (HS),<span style=""> </span>caecal reflex lt normal, D > 4 sec. </b></b></span><span style="font-family:Symbol;"><span style=""><b><b>£</b></b></span></span><span style="" lang="EN-GB"><b><b> 5 sec. <o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>In contrast, under the same condition, we observe pancreatic microcirculatory activation<span style=""> </span>dissociated, type II, with AL + PL (Fig. 2),<span style=""> </span>exclusively at the level of <i>vasomotility</i>, clearly increased (8 sec.), showing differential lt of the pancreatic-caecal reflex <>test of <i>two pressures</i> results pathological (increasing pinching intensity at level of VI thoracic dermatomere causes the disappearance of caecal and/or gastric aspecific reflex for solely 1 sec.).<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB"><span style=""> </span>In realty, interestingly, the accurate biophysical-semeiotic evaluation in IGT allows doctor to ascertain that the lt of pancreatic-gastric aspecific and/or caecal reflex is normal (12 sec.), but reflexes duration is greater (</span></b><b><span style="font-family:Symbol;"><span style="">³</span></span></b><b><span style="" lang="EN-GB"> 4 sec.) and differenzial lt (= duration of reflex disappearance) shorter (fD </span></b><b><span style="font-family:Symbol;"><span style="">£</span></span></b><b><span style="" lang="EN-GB"> 3 sec.), indicating clearly the conditon of unstable metabolic<span style=""> </span>equilibrium, which can be recognized by the precious tool of <i>preconditioning</i>.</span></b><span style="" lang="EN-GB"><o:p></o:p></span></p> </td> </tr> </tbody></table><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>It is impossible to request further performances to a similar microcircle, which is functioning, at rest, even in initial phase, at maximal level of its activity, and successively goes on toward a slow and progressive failure, as the <i>test of two pressures </i><span style=""> </span>clearly demonstrates.<span style=""> </span><o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><h3><b><b><a name="_Toc47515373"></a><a name="_Toc47515313"></a><a name="_Toc47346889"></a><a name="_Toc47346871"></a><a name="_Toc46906295"></a><a name="_Toc46905357"></a><a name="_Toc46800454"></a><a name="_Toc46717840"></a><a name="_Toc46717800"><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style="" lang="EN-GB">Hyperinsulinemia-insulinresistance as independent risk factor of the most severe human diseases.</span></span></span></span></span></span></span></span></span></a><span style="" lang="EN-GB"><o:p></o:p></span></b></b></h3><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>The following clinical and expermental evidence, formerly illustrated, demonstrates clearly the primary<span style=""> </span>role of <b>hyperinsulinemia-insulinresistance</b>, in the pathogenesis of a large number of human diseases, as we claim from the clinical view-point: after assessing basal parameters of finger-pulp – caecal reflex, as well as local <i>vasomotility</i> and <i>vasomotion</i>, doctor<span style=""> </span>provokes, by mean (not to much intense) pinching of VI thoracic dermatomere, the acute pick of insulin secretion (2, 9, 11). Soon thereafter, doctor estimates the reflex parameters for the second time: in healthy, physiological microcirculatory activation ameliorates tissue O<sub>2</sub>, likely to what occurs during the <i>two pressures test</i>, while in the IGT the favourable influences become more and more smaller and finally disappear, in inverse relation to the impairement degree of glucose metabolism or, more exactly speaking, in relation to the reduced sensitivity of insulin receptors as well as to “vasocontraction”, present in this pathologic situation.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">The vascular response to the acute pick of insulin secretion in healthy is clearly different from that we observe in hyperinsulinemia-insulinresistance: in the former, in fact, there is microcirculatory activation, whilst in the later, there is progressive disactivation and subsequent histangic lesion.<o:p></o:p></span></b></p> </td> </tr> </tbody></table><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><span style=""><b><b> </b></b></span><o:p></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>Finally, when metabolic syndrome, both classic and “variant”, is leading to <b>DM</b>, “endogenous” insulin worsens transitory all reflex parameters during the <i>test of acute pick of insulin secretion.<o:p></o:p></i></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>From <b>Clinical Microangiology</b><i> </i>view-point, noteworthy in the <i>pre-metabolic stage</i> are functional and structural AVA abnormalities, in particular those of EBD, as well as the progressive, variable in intensity, dissociation between <i>vasomotility </i>and <i>vasomotion</i> (1, 2, 9, 11, 21), which allows to realize a subdivision of microcirculatory activation, useful for bed-side diagnosing as well as therapeutic monitoring.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>As a matter of fact, two are the chief types of microcirculatory activation (it exists also the microcirculatory activation type III, incomplete, as the reader knows well: <b>Type I, associated, </b>global or circumscribed,<span style=""> </span>in whom both the <i>vasomotility</i> and the <i>vasomotion</i> show increase of their fluctuations and AL + PL duration of 7-8 sec., while AVA are predominantly “closed” (Fig.2); <b>Type II, dissociated</b>, global or confined, when only the <i>vasomotility</i> is increased, whilst the <i>vasomotion</i>, initially is<span style=""> </span>normal (AL + PL of 6 sec.), but progressively becomes reduced, characterized by short (<>plateau line and from a period fixed at 10 sec. The AVA are mainly “open” in hyperstomy stage (we remember that the adjactive “open” indicates the intense blood-shunt along arterious-venous anastomoses) (Fig. 3). Between these two “extreme” types, we may observe a large variety of intermediate forms.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>In the type I, global, physiological microcirculatory activation (involving all tissues, mentioned above: the so-called <i>active hyperemia</i>) and in the type II, global, pathological, really we encounter a large variety of microcirculatory patterns during the <i>post-absorptive state</i>, whose evolution will lead over time to different disorders, if doctor does not suggest the correct and prompt therapy.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>For example, in <b>cancer</b> the microcirculatory bed shows type II, dissociated, pathological activation, characterized by intense <i>vasomotility</i> with AL + PL of 8 sec. as well as maximal oscillations (<st1:metricconverter productid="1,5 cm" st="on">1,5 cm</st1:metricconverter>.= HS), but the <i>vasomotion</i> shows<span style=""> </span>AL + PL of only 5 sec., whose intensity is minimal and fixed at <st1:metricconverter productid="0,5 cm" st="on">0,5 cm</st1:metricconverter>., and AVA in hyperstomy phase. Such as behaviour is extrem from the pathological point of view, preceded and accompanied<span style=""> </span>by an intense oncological terrain.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><b><b>From the above remarks it is plain that we face interesting microcirculatory problems, really original, and that we are moving in a field of research, interesting and fascinating, due to its implications.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>The doctor, who rightly shares our enthusiasmus, will necessarily share also the need, we are feeling strong, to reach all possible goals, conducting our research on a ground “to which not even the angels would dare to put their foot”. <o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><span style="" lang="EN-GB">When these targets will be attained, it will start and hopefully perform successfully the “primary” prevention of the most common and serious human diseases, invalidating or deadly, conducted in a personal, prompt manner, in rationally selected individuals, on a very large scale, by means of Biophysical Semeiotics.</span></b><span style="" lang="EN-GB"><o:p></o:p></span></p> </td> </tr> </tbody></table><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>In NIDDM (but even in IDDM) pancreatic microcirculatory activation is, of course, of type II or dissociated. In fact, in type 2 diabetes mellitus the <i>stady-state</i> is laying at a glicemic level higher than that physiological, but the hepatic glucose secretion as well as its perpheral utilization (due to the mass-effect of glucose) are the same. Performing the acute pick of insulin secretion does not normalize micorcirculation in these disease, at the most reduces its activation.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="aL"><span style="" lang="EN-GB"><b><b>Really, we can observe cases of IDDM in which extra-pancreatic microcircle, or a part of it, result normally functioning. In other words, the pathological microcirculatory activation in diabetes mellitus doen not involve all tissue-microvascular units of the patient, since CAEMH-</b></b></span><span style="font-family:Symbol;"><span style=""><b><b>a</b></b></span></span><span style="" lang="EN-GB"><b><b>, due to its definition, varys from subject to subject, from tissue to tissue and, finally, from part to part of the same tissue.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>In <b>ischemic heart disease</b> doctor observe microcirculatory activation, type II and coronary EBD disactivation, and sometime in adipose tissue, as in dyslipidemia, even if it was present solely over the past years. In <b>ATS</b> one recognizes the pathological adventitial microcirculatory activity of the involved arteries. In these conditions, obviously, the AVA are hyperfunctioning (blood-shunting in microcirculatory bed) and subsequent tissue hypoxia. The acute pick of insulin secretion reduces the microcirculatory activation: AL + PL decreases from 8 sec. to about 6 sec., with clearly pathological consequences.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>Interestingly, one observes a<span style=""> </span>microcirculatory pattern typical of the dysplipidemia, actually present or not, in which firstly there is microcirculatory activation of type II “partial” (striated muscle and adipose tissue), to which follows the type II also in the liver and myocardium, when insulin-resistance and hyperinsulinemia pathologically activate the microcircle, so that over time microvascular activation pattern changes slowly.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>At the moment, the biophysical-semeiotic research in <i>pre-morbid stage</i> is a long way within the bounds of it possibilities. However, we are allowed to state<span style=""> </span>that the metabolic syndrome, classic or “variant” (2), represents the <b>link</b> from CAEMH-</b></b></span><span style="font-family:Symbol;"><span style=""><b><b>a</b></b></span></span><span style="" lang="EN-GB"><b><b> to DM, arterial hypertension, dyslipidemia, gout, ATS, cancer, a.s.o.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><b><i><span style="" lang="EN-GB"><o:p> </o:p></span></i></b></b></p><b><b> </b></b><table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify;"><b><span style="" lang="EN-GB">Between CAEMH and metabolic syndrome, classic and “variant”, there is the territory,<span style=""> </span>until now “unexplored”, i.e. Pre-Metabolic Stage, locus of the primary prevention of most common and severe human diseases.</span></b><span style="" lang="EN-GB"><o:p></o:p></span></p> </td> </tr> </tbody></table><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>Likely, as monstrates the tissue-microvascular unit activation during the <i>postabsorptive state</i>, hyperinsulinelia-insulinresistance, as an effect re-acting on its cause, worsens the histangic acidosis: e.g., the adventitial microcircle or <i>vasa vasorum</i>, is not capable to eliminate the catabolite from the arterial wall, which consequently appears damaged by the excess response – responsivity – to arteriosclerotic risk factors, according to our “Microcirculatory Arteriosclerotic Theory”, at the base of CAD (23, 24).<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>Clinical and experimental evidence shows that it is more dangerous for the tissues the abnormal elimination of the local catabolites, than analogous reduction of blood-supply to the same tissue: in healthy, digital “intense” pressure of the thumb finger-pulp against that of forfinger, brings about caecal reflex (= tissue acidosis) after latency time of <b>8</b> sec. (age-dependent, of course). After the beginn of digital pressure on brachial artery, obstructing it “partially” so that “radial pulsations” result clearly less intense than before, for 5 sec., lt of caecal reflex decreases to <b>6</b> sec. By contrast, a “light” pressure for 5 sec. upon inner surface of the same arm, able to ostruct exclusively brachial vein and local superficial lymphatics, causes caecal reflex after only <b>4</b> sec., as a<span style=""> </span>consequence of interstitial stasis, compromised elimination of catabolites anf hydrogenions, and, then, the greater tissue lesion. <o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><b><b style=""><span style="" lang="EN-GB">In conclusion</span></b><span style="" lang="EN-GB">, we have always to remember that during the slow evolution of <i>pre-metabolic syndrome</i> toward hyperinsulinemia-insulinresistance, IGT, type II DM, and/or Arterial Hypertension, Dyslipidemia (metabolic syndrome, both classic and “variant<b style="">”) </b>the microcirculatory activation, type I, becomes of type II, showing really a large variety of patterns, which shows a progressive dissociation, until “<i>vasomotion</i>” appears characterized by AL + PL of 5 sec. and I of <st1:metricconverter productid="0,5 cm" st="on">0,5 cm</st1:metricconverter>., while AVA dysfunction results more and more intense, characterized by permanent hyperstomy. Bed-side recognizing microcirculatory activation “even” at rest, and classifying it correctly by a clinical method, open new and promising outlooks on the primary prevention.<o:p></o:p></span></b></b></p><b><b> <b><span style="" lang="EN-GB"> </span></b> </b></b><h3><span style="" lang="EN-GB"><span style=""><b><b> </b></b></span></span><b><b><a name="_Toc47515374"></a><a name="_Toc47515314"></a><a name="_Toc47346890"></a><a name="_Toc47346872"></a><a name="_Toc46906296"></a><a name="_Toc46905358"></a><a name="_Toc46800455"></a><a name="_Toc46717841"></a><a name="_Toc46717801"><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style="">Bibliografia</span></span></span></span></span></span></span></span></a><span style=""></span><span style=""></span><span style=""></span><span style=""></span><span style=""></span><span style=""></span><span style=""></span><span style=""></span><span style=""></span><span style="font-weight: normal;"><o:p></o:p></span></b></b></h3><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><b><b><o:p> </o:p></b></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b>1) </b><b><span style="">Stagnaro S., Stagnaro-Neri M.</span></b><span style=""> Valutazione percusso-ascoltatoria del Diabete Mellito. Aspetti teorici e pratici. Epat. 32, 131, 1986.<o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b><span style="">2) Stagnaro S.-Neri M., Stagnaro S.</span></b><span style="">, Sindrome di Reaven, classica e variante, in evoluzione diabetica. Il ruolo della Carnitina nella prevenzione del diabete mellito. Il Cuore. </span><span style="" lang="EN-GB">6, 617, 1993. <b>[Medline]</b><o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal"><b><b><b><span style="" lang="EN-GB">3)<span style=""> </span></span></b><b><span style="" lang="EN-GB">Stagnaro S. </span></b><span style="" lang="EN-GB">Diet and Risk of Type 2 Diabetes. </span><span style="" lang="EN-GB">N Engl J Med. 2002 Jan 24;346(4):297-298. <b>[Medline]</b></span><span style="" lang="EN-GB"> <o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b><span style="" lang="EN-GB">4) Stagnaro Sergio.</span></b><span style="" lang="EN-GB"> <a name="911"><span class="maintextmodulestrong">Newborn-pathological Endoarteriolar Blocking Devices in Diabetic and Dislipidaemic Constitution and Diabetes Primary Prevention.</span></a><span class="maintextmodulestrong"> </span></span><span class="maintextmoduleitalic"><i>The Lancet</i>. </span><span class="maintextmodule1">March 06 2007. </span><span style="" lang="EN-GB"><a href="http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?totalcomments=1"><span style="" lang="IT">http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?totalcomments=1</span></a></span>, and especially <span style="" lang="EN-GB"><a href="http://www.fce.it/"><span style="" lang="IT">www.fce.it</span></a></span>, <span style="" lang="EN-GB"><a href="http://www.fceonline.it/docs/stagnaro.pdf"><span style="" lang="IT">http://www.fceonline.it/docs/stagnaro.pdf</span></a></span><span lang="EN-GB"> </span></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b><span style="">5) Stagnaro S.</span></b><span style="">, Valutazione percusso-ascoltatoria della microcircolazione cerebrale globale e regionale. Atti, XII Congr. Naz. Soc. It. di Microangiologia e Microcircolazione. 13-15 Ottobre, Salerno, e Acta Medit. 145, 163, 1986.<o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b><span style="">6) Stagnaro-Neri M., Stagnaro S.</span></b><span style="">, Auscultatory Percussion Evaluation of<span style=""> </span>Arterio-venous Anastomoses Dysfunction in early Arteriosclerosis. Acta Med. Medit. 5, 141, 1989.<o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b><span style="">7)</span></b><span style=""> </span><b>Stagnaro-Neri M., Stagnaro S., </b>Modificazioni della viscosità ematica totale e della riserva funzionale microcircolatoria in individui a rischio di arteriosclerosi valutate con la percussione ascoltata durante lavoro muscolare isometrico. <span style="" lang="EN-GB">Acta Med. Medit. 6, 131-136, 1990.<o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b><span style="" lang="EN-GB">8) </span></b><b><span style="" lang="EN-GB">Stagnaro-Neri M., Stagnaro S.</span></b><span style="" lang="EN-GB">, Deterministic Chaos, Preconditioning and Myocardial Oxygenation evaluated clinically with the aid of Biophysical Semeiotics in the Diagnosis of ischaemic Heart Disease even silent. </span><span style="">Acta Med. Medit. 13, 109, 1997.<o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b><span style="">9)<span style=""> </span>Stagnaro S., Stagnaro-Neri M.</span></b><span style="">, Valutazione percusso-ascoltatoria del sistema degli oppioidi endogeni nei pazienti cefalalgici. Contributo alla definizione della costituzione emicranica. Epat. 33, 35, 1987.<b><o:p></o:p></b></span></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b><span style="">10) </span>Stagnaro-Neri M., Stagnaro S.</b>, Semeiotica Biofisica: valutazione clinica del picco precoce della secrezione insulinica di base e dopo stimolazione tiroidea, surrenalica, con glucagone endogeno e dopo attivazione del sistema renina-angiotesina circolante e tessutale – Acta Med. Medit. 13, 99, 1997</b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b><span style="">11) Stagnaro-Neri M., Stagnaro S.</span></b><span style="">, Semeiotica Biofisica: la manovra di Ferrero-Marigo nella diagnosi clinica della iperinsulinemia-insulino resistenza. </span><span style="" lang="EN-GB">Acta Med. Medit. 13, 125, 1997.<o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b><span style="" lang="EN-GB">12) </span></b><b><span style="" lang="EN-GB">Signorelli S.</span></b><span style="" lang="EN-GB"> Regional Pathology of the smole vessels and diabetic microangiopathy. </span>Acta Diabetol. Latina, pag.367-370, Vol. <span style="" lang="EN-GB">XXII, 104,1985.<o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b><span style="" lang="EN-GB">13) Gaehtgens<span style=""> </span>P.</span></b><span style="" lang="EN-GB"> Relevance of the Microcirculation for Ischemic Disease. In: Microcirculation and Ischaemic Vascular Disease. Advances in Diagnosis and Therapy. Proceedings of Congress. <st1:place st="on"><st1:city st="on">Munich</st1:city></st1:place>, 1980,pag. 3-7.Edited by Messmer, <st1:place st="on"><st1:city st="on">Abbott</st1:city>,<st1:country-region st="on">USA</st1:country-region></st1:place>.<o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b><span style="" lang="EN-GB">14) Hassmann F.</span></b><span style="" lang="EN-GB"> Patterns and Structure of the Microcirculatory Bed. In: Microcirculation and Ischaemic Vascular Disease. Advances in Diagnosis and Therapy. Proceedings of Congress. <st1:place st="on"><st1:city st="on">Munich</st1:city></st1:place>, 1980pag. 3-7.Edited by Messmer, <st1:place st="on"><st1:city st="on">Abbott</st1:city>,<st1:country-region st="on">USA</st1:country-region></st1:place>.<o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b><span style="" lang="EN-GB">15) Schmidt-Schonbein H.</span></b><span style="" lang="EN-GB"> Physiology and Pathophysiology of the Microcirculation and Consequences of its treatment by Drugs. In: Microcirculation and Ischaemic Vascular Disease. Advances in Diagnosis and Therapy. Proceedings of Congress. <st1:place st="on"><st1:city st="on">Munich</st1:city></st1:place>, 1980, pag. 12-16. Edited by Messmer, <st1:place st="on"><st1:city st="on">Abbott</st1:city>,<st1:country-region st="on">USA</st1:country-region></st1:place>.<o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b>16) </b><b><span style="">Stagnaro S.</span></b><span style="">, Istangiopatia Congenita Acidosica Enzimo-Metabolica condizione necessaria non sufficiente della oncogenesi. XI Congr. Naz. Soc. It. di Microangiologia e Microcircolaz. Abstracts, pg 38, 28 Settembre-1 Ottobre, Bellagio, 1983.<o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b><span style="">17) Stagnaro S.</span></b><span style="">, Istangiopatia Congenita Acidosica Enzimo-Metabolica. X Congr. Naz. Soc. It. di Microangiologia e Microcircolazione. Atti, 61. 6-7 Novembre, Siena, 1981.</span></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b><span style="">18)</span></b><span style=""> <b>Stagnaro S.</b>, Istangiopatia Congenita Acidosica Enzimo-Metabolica. X Congr. Naz. Soc. It. di Microangiologia e Microcircolazione. Atti, 61. 6-7 Novembre, Siena 1981</span></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b><span style="">19)</span></b><span style=""> <b>Stagnaro S.</b>, Istangiopatia Congenita Acidosica Enzimo-Metabolica. Una Patologia Mitocondriale Ignorata. Gazz Med. It. – Arch. Sci. Med. 144, 423,1993. <b>(Infotrieve)</b></span><b><o:p></o:p></b></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b>20) Dinnoen S., Gerich J., Rizzo R.</b>: Carbohydrate Metabolism in non insulin-dipendent Diabetes Mellitus. N.Engl.J.Med. 327,707-708,1992.</b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b>21) Stagnaro-Neri M., Stagnaro S</b>., La “Costituzione Colelitiasica”: ICAEM-<span style="font-family:Symbol;"><span style="">a</span></span>, Sindrome di Reaven variante e Ipotonia-Ipocinesia delle vie biliari. <span style="" lang="EN-GB">Atti. XII Settim. It. Dietol. ed Epatol. 20, 239, 1993.<o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b><span style="" lang="EN-GB">22)<span style=""> </span></span></b><b><span style="" lang="EN-GB">Stagnaro-Neri M., Stagnaro S.</span></b><span style="" lang="EN-GB">, Deterministic Chaos, Preconditioning and Myocardial Oxygenation evaluated clinically with the aid of Biophysical Semeiotics in the Diagnosis of ischaemic Heart Disease even silent. </span><span style="">Acta Med. Medit. 1997, 13, 109.<o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b style=""><span style="" lang="EN-GB">23) </span></b><b><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" >Stagnaro Sergio.</span></b><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" > Role of Coronary Endoarterial Blocking Devices in Myocardial Preconditioning - c007i. <i>Lecture</i>, V Virtual International Congress of Cardiology, 2007. </span><span lang="EN-GB" style="font-family:Verdana;"><a href="http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php"><span style="font-size:10;">http://www.fac.org.ar/qcvc/llave/c007i/stagnaros.php</span></a></span><b style=""><span style="" lang="EN-GB"><span style=""> </span><o:p></o:p></span></b></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><b><b><b><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" >24) Stagnaro Sergio.<span class="maintextmodulestrong"> </span></span></b><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" > Bedside Evaluation of CAD biophysical-semeiotic inherited real risk under NIR-LED treatment. EMLA Congress, Laser <st1:place st="on"><st1:city st="on">Helsinki</st1:city></st1:place> <st1:date month="8" day="23" year="2008" st="on">August 23-24, 2008</st1:date>. "Photodiagnosis and photodynamic therapy", Elsevier, Vol. 5 suppl 1 august 2008 issn, </span><span class="txt"><i><span style="" lang="EN-GB">Page S17</span></i></span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" >.</span><b><span style="" lang="EN-GB"><o:p></o:p></span></b></b></b></p><b><b> <span style="" lang="EN-GB"> </span> </b></b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal"><b><b><b>*</b><b style=""><span style=";font-family:Arial;font-size:10;" > Sergio Stagnaro MD<o:p></o:p></span></b></b></b></p><b><b> </b></b><p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" ><b><b>Via Erasmo Piaggio 23/8</b></b></span></p><b><b> </b></b><p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" ><b><b>16039 Riva Trigoso (Genoa) <b style="">Europe</b></b></b></span></p><b><b> </b></b><p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" ><b><b>Founder of Quantum Biophysical Semeiotics</b></b></span><span style="" lang="EN-GB"><o:p></o:p></span></p><b><b> </b></b><p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" ><b><b>Who's Who in the World (and <st1:place st="on"><st1:country-region st="on">America</st1:country-region></st1:place>)</b></b></span><span style="" lang="EN-GB"><o:p></o:p></span></p><b><b> </b></b><p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" ><b><b>since 1996 to 2009<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" ><b><b>Ph 0039-0185-42315<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" lang="EN-GB" ><b><b>Cell. 3338631439</b></b></span><span style="" lang="EN-GB"><o:p></o:p></span></p><b><b> </b></b><p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" ><b><b><a href="http://www.semeioticabiofisica.it/"><span style="" lang="EN-GB">www.semeioticabiofisica.it</span></a></b></b></span><span style=";font-family:Arial;font-size:10;" ><b><b> </b></b></span><span style="" lang="EN-GB"><o:p></o:p></span></p><b><b> </b></b><p class="MsoNormal"><span style=";font-family:Arial;font-size:10;" ><b><b><a href="mailto:dottsergio@semeioticabiofisica.it"><span style="" lang="EN-GB">dottsergio@semeioticabiofisica.it</span></a></b></b></span><span style=";font-family:Arial;font-size:10;" ><b><b> </b></b></span><span style="" lang="EN-GB"><o:p></o:p></span></p><b><b> <b><span style="" lang="EN-GB"> </span></b></b></b>Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-18424208094128142802009-04-17T22:36:00.000-07:002009-04-17T22:38:25.879-07:00Type 2 Diabetes Mellitus begins as dyslipidemic and diabetic Quantum-Biophysical-Semeiotic Constitutions and related Inherited Real Risk.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgzFvbqNAhTrbPt3XpmU26HUTO4EYjZYY1AI7Rqg_l5q2fXzeT7UTQR08zOyjTamQ9eI_4fn4iv5pxo54aIHkbuoQIlKL455WyumWxsxFA9_dJ2yJD_4vUGFLlDQrqxxTowga7abCDVc06f/s1600-h/sergio17.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 134px; height: 200px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgzFvbqNAhTrbPt3XpmU26HUTO4EYjZYY1AI7Rqg_l5q2fXzeT7UTQR08zOyjTamQ9eI_4fn4iv5pxo54aIHkbuoQIlKL455WyumWxsxFA9_dJ2yJD_4vUGFLlDQrqxxTowga7abCDVc06f/s200/sergio17.jpg" alt="" id="BLOGGER_PHOTO_ID_5325901503629070130" border="0" /></a><br /> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><br /></span></p><p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In my opinion, based on a 53 year-long clinical experience, the primary prevention of type 2 diabetes mellitus and its well-known and harmful so-called “complications”, which precede really for decades diabetes occurrence, as well as the prevention of all other serious and common human diseases, often associated to form Pre-Metabolic, and then Metabolic Syndrome, is nowadays possible on very large scale if we want it. <span style=""> </span><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">As a consequence, doctor may initiate a “particular” type of primary prevention, easy and efficaciously realized at the bed-side, i.e., with the aid of a stethoscope (See </span><a href="http://www.semeioticabiofisica.it/"><span style="text-decoration: none;color:#000000;" lang="EN-GB">http://www.semeioticabiofisica.it</span></a><span style="" lang="EN-GB">, Biophysical-Semeiotic Constitutions). In a few words, performing an efficacious primary prevention of type 2 diabetes mellitus, we must go “beyond obesity, adiposity, LDL raised blood level, and even hyperinsulinemia-insulin-resistance” in the sense that doctors must know and recognize “quantitatively the “biophysical-semeiotic diabetic constitution”. In other words, every screening programme for whatever disease and its complications, including diabetes and cancer, needs efficacious "clinical" tools to obtain the best results. In fact, for instance, it is generally admitted that non-insulin-dependent diabetes mellitus (i.e. about 95% of diabetic disorders) may occur at least 12 years before the clinical diagnosis of DM is made, i.e., after long time of IIR, adiposity, obesity, a.s.o., and retinopathy can develop at least 7 years before the diagnosis. In a few words, national screening programmes for diabetic complications should be intended for people who don't present any clinical symptomatology, at the moment, a part from “diabetic and dislipidemic constitutions” with related Inherited Real Risk. Actually, during the time that diabetes is "undiagnosed" and untreated, complications, that could be avoided by a different, really efficacious prevention, are developing. Therefore, early diagnosis must certainly be established in "asymptomatic" patients who are evolving slowly towards diabetes mellitus, i.e. long time before disease onset, in order to avoid those complications. In fact, to prevent well known diabetic complications, including diabetic retinopathy, it is extremely necessary that doctors use a clinical tool reliable in diagnosing early diabetes mellitus stages, i.e. from its initial stages, i.e., even before Reaven’s syndrome, both classic and “variant”, I described previously (1, 2, 3, 5). Until now, unfortunately, diabetes mellitus is too often diagnosed accidentally, e.g. by occasional urinary or blood tests. Furthermore, epidemiological studies indicate that 50% of individuals with 2-hour postglucose challenge values over 200 mg/dL, a value diagnostic for diabetes, were not previously diagnosed as being diabetic (3, 4). Fortunately, it is now easy to realize "clinically" an efficacious DM primary prevention, as well as the prevention of other common human diseases, including malignancies, in a simple manner, with the aid of some biophysical-semeiotic signs, reliable in recognizing the different ”constitutions”, in a quantitative way. Certainly, we can prevent type2 diabetes mellitus if we know the above-referred clinical method, easy to perform, which can be Authors agree with such statement, written in <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Medscape(</span><a href="http://boards.medscape.com/forums?10@33.MZq8as0jbdr%5e0@.ee99d0a"><span style="" lang="EN-GB">http://boards.medscape.com/forums?10@33.MZq8as0jbdr^0@.ee99d0a</span></a><span style="" lang="EN-GB">): "Diabetes is, of course, a disease of complications. But landmark studies such as the Diabetes Control and Complication Trial have shown that achieving tight glycemic control can directly reduce the risk of complications, especially microvascular complications. New screening tools and potential new treatments also hold promise for making microvascular complications such as retinopathy and neuropathy more manageable and less inevitable". I agree with it, of course, exclusively regarding diabetes occurrence. Unfortunately, this statement indicates that now-a-days, even skilled diabetologists all over the world, ignore or, worse, <span style=""> </span>overlook the existence of quantum-biophysical-semeiotic "diabetic and dislipidemic" constitutions, recongnised at the bed-side in a "quantitative" way, which allows us to perform diabetes mellitus PRIMARY PREVENTION, conditio sine qua non of all diabetic so-called “complications”, including the microvasculopathies disorders. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Finally, in doing that, we do not need, at least initially, laboratory methods, as oral glucose tollerance test, PPG, FG, in order to recognize individuals at inherited real risk of type 2 diabetes mellitus (4-9). Thanks to a new physical semeiotics, i.e. Quantum-Biophysical Semeiotics (<a href="http://www.semeioticabiofisica.it%29/">http://www.semeioticabiofisica.it)</a> doctors can, all around the world with the aid of a simple stethoscope, recognize and quantitatively evaluate the presence of "diabetic, and dislipidemic constitutions", by means of bed-side assessing microcirculatory conditions of the Langheran's islets, as I described previously (2, 3, 7-12). In facts, in both absorptive and post-absorptive state, we can "clinically" assess pancreatic histangium acidosis, correlated with local microcirculatory blood-flow situation or more precisely evaluating local Microcirculatory Functional Reserve (MFR) in Langheran's islets: in healthy, lasting cutaneous pinching of VI thoracic dermatomere, brings about gastric aspecific reflex after a latency time (lt) of 12 sec. exactly, which is the measure of local histangium acidosis. By contrast in subjects at "inherited real" risk of type 2 diabetes and obviously in diabetic patients, reflex latency time is less than 12 sec, in inverse relation to pancreatic islets impairment. In addition, biophysical-semeiotic “preconditioning” (doctor assess for a second time the same parameters after an intervall of exact 5 sec.) give useful information: in healthy, lt is more than 12 sec.; on the contrary, in subject at real risk of type 2 diabetes latency time either appears unchanged or clearly reduced, in relation to the severity of underlying metabolic disorder. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">For further information See other article in <a href="http://www.schiphu.com/">www.schiphu.com</a> an especially my website <a href="http://www.semeioticabiofisica.it/">www.semeioticabiofisica.it</a> .<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style=";font-family:";" lang="EN-GB"><o:p> </o:p></span></p> <p style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style=";font-family:";" >1) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica condizione necessaria non sufficiente della oncogenesi. XI Congr. Naz. Soc. It. di Microangiologia e Microcircolaz. Abstracts, pg 38, 28 Settembre-1 Ottobre, 1983, Bellagio <o:p></o:p></span></p> <p style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style=";font-family:";" >2) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica. X Congr. Naz. Soc. It. di Microangiologia e Microcircolazione. Atti, 61. 6-7 Novembre, 1981, Siena <o:p></o:p></span></p> <p style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style=";font-family:";" >3) Stagnaro S., Istangiopatia Congenita Acidosica Enzimo-Metabolica. Una Patologia Mitocondriale Ignorata. </span><span style=";font-family:";" lang="EN-GB">Gazz Med. It. Arch. Sci. Med. 144, 423, 1985 (Infotrieve). <o:p></o:p></span></p> <p style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style=";font-family:";" lang="EN-GB">4) Stagnaro S. Diet and Risk of Type 2 Diabetes. </span><span style=";font-family:";" >N Engl J Med. 2002 Jan 24;3 (<b style="">Medline</b>) 5) Stagnaro-Neri M., Stagnaro S., Semeiotica Biofisica: la manovra di Ferrero-Marigo nella diagnosi clinica della iperinsulinemia-insulino resistenza. Acta Med. Medit. 13, 125, 1997.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;">6) Stagnaro-Neri M., Stagnaro S., Semeiotica Biofisica: valutazione clinica del picco precoce della secrezione insulinica di base e dopo stimolazione tiroidea, surrenalica, con glucagone endogeno e dopo attivazione del sistema renina-angiotesina circolante e tessutale Acta Med. <span style="" lang="EN-GB">Medit. 13, 99, 1997. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">7) </span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" >Stagnaro Sergio.</span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" > <a name="911"><span class="maintextmodulestrong">Newborn-pathological Endoarteriolar Blocking Devices in Diabetic and Dislipidaemic Constitution and Diabetes Primary Prevention.</span></a><span class="maintextmodulestrong"> </span><span class="maintextmoduleitalic"><i>The Lancet</i>. </span><st1:date year="2007" day="6" month="3" st="on"><span class="maintextmodule1">March 06 2007</span></st1:date><span class="maintextmodule1">. </span></span><span lang="EN-GB" style="font-family:Verdana;"><a href="http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?totalcomments=1"><span style="font-size:10;">http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?totalcomments=1</span></a>, </span><span style="" lang="EN-GB">and especially <a href="http://www.fce.it/">www.fce.it</a>, <a href="http://www.fceonline.it/docs/stagnaro.pdf">http://www.fceonline.it/docs/stagnaro.pdf</a><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">8) </span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" >Stagnaro Sergio.<b> </b></span><strong><span style="font-weight: normal;font-family:Verdana;font-size:10;" lang="EN-GB" >New bedside way in Reducing mortality in diabetic men and women. <i>Ann. Int. Med.</i></span></strong><strong><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" > </span></strong><span lang="EN-GB" style="font-family:Verdana;"><a href="http://www.annals.org/cgi/eletters/0000605-200708070-00167v1"><span style="font-size:10;">http://www.annals.org/cgi/eletters/0000605-200708070-00167v1</span></a></span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;">9) <span style=";font-family:Verdana;font-size:10;" >Stagnaro S., Stagnaro-Neri M.</span><span style=";font-family:Verdana;font-size:10;" > Valutazione percusso-ascoltatoria del Diabete Mellito. Aspetti teorici e pratici. Epat. 32, 131, 1986.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style=";font-family:Verdana;font-size:10;" >10) <span style="">Stagnaro S., Stagnaro-Neri M.</span>, Le Costituzioni Semeiotico-Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. </span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" >Travel Factory, Roma, 2004. <a href="http://www.travelfactory.it/libro_costituzionisemeiotiche.htm">http://www.travelfactory.it/</a><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style=";font-family:Verdana;font-size:10;" >11) <span style="">Stagnaro S., Stagnaro-Neri M.</span>, Le Costituzioni Semeiotico-Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Travel Factory, Roma, 2004. </span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" ><a href="http://www.travelfactory.it/libro_costituzionisemeiotiche.htm"><span style="" lang="IT">http://www.travelfactory.it/</span></a><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style=";font-family:Verdana;font-size:10;" >12) <span style="">Stagnaro S., Stagnaro-Neri M</span>., Single Patient Based Medicine.La Medicina Basata sul Singolo Paziente: Nuove Indicazioni della Melatonina. </span><span style=";font-family:Verdana;font-size:10;" lang="EN-GB" >Travel Factory, Roma, 2005. <a href="http://www.travelfactory.it/libro_singlepatientbased.htm">http://www.travelfactory.it/</a></span></p> <p class="MsoNormal" style="text-align: justify;"><o:p> </o:p></p> <p class="MsoNormal" style="text-align: justify;"><o:p> </o:p></p>Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-69624649150323627082009-04-16T09:02:00.000-07:002009-04-16T09:03:45.105-07:00INSULIN SECRETION ACUTE PICK TEST AND RENAL TEST OF HYPERINSULINEMIA-INSULINRESISTANCE.<p class="MsoNormal" style="text-align: justify;"><a name="_Toc60654054"></a><a name="_Toc60654029"><span style=""><b style=""><span style="" lang="EN-GB">Introduction.</span></b></span></a><b style=""><span style="" lang="EN-GB"><o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Since decades, it is generally admitted that insulin represents an hormone or signal, which comunicates to muscular, hepatic and adipose cells<span style=""> </span>the information necessary to blood glucose up-take, and utilize it in order to produce energy, unavoidable to survival.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">As regards <b style="">Quantum-<span style="">Biophysical Semeiotics</span></b> and especially <b style=""><span style="">Clinical Microangiology</span></b>, “endogenous” insulin, obtained by the <i>acute pick test of insulin secretion</i>, is useful, due to its different and opposite action on tissue-microvascular unit of various biological systems under physiological and pathological conditions, even if the later are initial or early or “potential”, as demonstrates the particular microcirculatory activation in<span style=""> </span><i>post-absorptive state </i>as well as in <i>absorptive state</i>, described previously (See <a href="http://www.semeioticabiofisica.it/">www.semeioticabiofisica.it</a>, and the linked website <a href="www.Microangiology.it">www.Microangiology.it</a>).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Really, insulin is also a growth-factor, which modulates proteasomic activity and stimulates ILGF<sub>1</sub>-receptors, <sub><span style=""> </span></sub>beeng active similarly on parenchyma and related microcircle.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Analogously to GH, as I demonstrated clinically (See Bibliography in the site), in both tissues at “real” risk for disease, i.e., in the so-called <i><span style=""> </span>pre-morbid-stage, grew zone</i>, <i>pre-metabolic syndrome</i> and in initial or light morbid phase, without any clinical phenomenology, the <i>acute pick test of insulin secretion</i> provokes exclusively the increase of arteriolar blood-flow and, thus, “opening” of AVA, functionally speaking (EBD obviously appear “closed” for a time longer than normal under similar conditions) and, then, it follows that there is microcirculatory activation, dissociated, type II or III (intermediate), i.e., increased <i>vasomotility</i>, but contemporaneously reduced or respectively “normal” <i>vasomotion</i> (1-13), so that it is present the dangerous micorcirculatory phenomenon of the “centralization” of<span style=""> </span>blood-flow, more or less severe, throughout microvessels.<i> <o:p></o:p></i></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Such as pathological phenomenon accounts for the reason<span style=""> </span>that tissue O<sub>2 </sub>as well as locale pH are reduced, as doctor can assess in a quantitative manner by <b style="">Quantum-<span style="">Biophysical Semeiotics</span></b>: both gastric aspecific and caecal reflex show<b> </b>a reduced latency time,<b> </b>a prolonged duration (</span><span style="font-family: Symbol;" lang="EN-GB"><span style="">³</span></span><span style="" lang="EN-GB"> 4 sec.) and lowered differential lt (= reduced <i>fractal dimension</i> of both tissue and microvascular non-linear dynamics of the studied biological system), while choledocic reflex , i.e. choledocic contraction, during apnea test shows a duration lasting more than the physiological one (NN > 3 < style=""> </span>fD).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Once again, these parameters values underscore the internal and external coherence of the biophysical-semeiotic theory, to which we shall come back often, due to its epistemological significance: as we have really frequently stated, internal and external coherence of whatever scientific theory does not surely coincide with its “thrut”, but it represents the <i>conditio sine qua non</i> of such as thrut.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><a name="_Toc60654055"></a><a name="_Toc60654030"><span style=""><b style=""><span style="" lang="EN-GB">Insulin Microvascular Action Mechanisms: Insulin-Secretion Acute Pick Test.</span></b></span></a><b style=""><span style="" lang="EN-GB"><o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">The dual effect of insulin through receptor activation is nowadays generally admitted, as follows: one is based on the insulin receptor substrates (IRSs); the other goes through a different class of molecules known as Shc, which leads to the activation of the mitogen-activated protein kinase (MAPK) pathway. Under insulin resistance condition, there is a pro-atherogenic effect that is mediated through activation of MAPK activated by the increased insulin levels, while the non-atherogenic pathway through phosphatidylinositide-3-kinase (PI3-kinase) activation, responsible for glucose transport, as well as nitric oxide (NO)-mediated-vasodilation are attenuated. Activation of the angiotensin II receptor further magnifies the pro-atherogenic effect (14). Since now, we can understand already the real reason of vasoconstriction brought about by insulin in presence of insulin-resistance. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In other words, insulin-dependent “pathological” vasocostriction parallels insulin-resistance. In addition, although the majority of patients with IGT have the metabolic syndrome (IIR), the latter can also be present in individuals before they develop IGT (14), i.e., in the Pre-Metabolic Syndrome, possibly evolving to Metabolic Syndrome, as I suggested previously, for long time (See the linked website <a href="www.microangiology.it">www.microangiology.it</a>: <i>Pre-Metabolic Syndrome</i>). <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">At this point, one must consider the primary role played by central adiposity in the occurrence of IIR and pre-metabolic and metabolic syndrome, all authors agree with. </span><span style="color: black;" lang="EN-GB">Patients with insulin resistance have low adiponectin levels that can improve, e.g., after weight loss (See <span style=""> </span><a href="http://www.semeioticabiofisica.it/">www.semeioticabiofisica.it</a>, Practical Applications). Resistin, another adipokine, appears to antagonize the effects of insulin on glucose homeostasis and to contribute to insulin resistance in animals (15) Further studies are necessary to clarify the role in human physiology and pathophysiology. Abdominal or visceral fat cells are also responsible for the formation and release of toxic proinflammatory cytokines such as tumor necrosis factor-</span><span style="color: black;">α</span><span style="color: black;" lang="EN-GB"> (TNF-</span><span style="color: black;">α</span><span style="color: black;" lang="EN-GB">), interleukin-6 (IL-6), and serum amyloid A (16). These cytokines contribute to insulin resistance and play an important role in accelerating the atherogenic process. Finally, central adiposity is also associated with high levels of PAI-1, causing impaired fibrinolysis and contributing to the development and progression of CVD (16).</span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In diseased parenchymas, even seemingly healthy from the clinical view-point, insulin induces tissue-microvascular modifications of great diagnostic importance: for instance, digital “light-moderate” pressure, applied on whatever joint at “real” risk of rheumatic disease or, of course, involved slightly or initially by a form of <i>connectivitis</i>, e.g., causes the occurrence of deterministic chaotic fluctuations of both upper and lower ureteral reflexes, showing a fD of 3,81, or slightly altered. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In other words, both <i>vasomotility </i><span style=""> </span>and <i>vasomotion</i> appear to be apparently normal or show really slight modification, so that rheumo-gastric aspecific reflex and/or caecal reflex latency time results only slight reduced or normal (NN = 8 sec.), reflex duration slight prolonged, i.e., </span><span style="font-family: Symbol;" lang="EN-GB"><span style="">³</span></span><span style="" lang="EN-GB"> 4 sec. (NN <> 4 sec.: f D = 3,8).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">By contrast, after the<i><span style=""> </span>acute pick</i> <i>of</i> <i>insulin secretion</i>, under above-mentioned <i>pre-morbid</i> situation, we observe intense microcirculatory modifications of “vasomotion”, i.e., blood-flow “centralization”, reduced blood supply to parenchyma, and consequently histangic acidosis, which brings about reduced insulin- as well as adrenergic-receptors sensitivity.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In other words, the secretion of acute insulin pick displays the “latent” abnormality of Microcirculatory Functional Reserve in biological systems or their regions, in which there is not at this moment any disorders, causing a behaviour changing similar to that induced by <i>biophysical- semeiotic preconditioning</i> (See Glossary in the website <a href="http://www.semeioticabiofisica.it/">www.semeioticabiofisica.it</a>), which is a clinical tool really efficacious in the research, diagnosis, and<span style=""> </span>therapeutic monitoring. Such as topic has been in detail discussed in former article in the site <a href="http://www.microangiologia.it/">www.microangiologia.it</a>. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Other numerous applications of this test provide doctor bed-side useful information, allowing the refined investigation of all biological systems, starting from the potential or initial stages of the local disorder, for instance, in “real risk” of malignancy. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In healthy, digital pressure applied on radial artery is followed by occurrence of “in toto” ureteral reflex, <st1:metricconverter productid="1 cm" st="on">1 cm</st1:metricconverter>. in intensity, which increases after the test illustrated above: <i>normal arterial compliance</i>.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><span style=""> </span>On the contrary, in case of reduced <i>arterial compliance</i>, as it happens, e.g., in both <b>arterial hypertension </b>and<b> arteriosclerosis</b>, starting from the stage of “real” risk, i.e., early stage, characterized generally by hyperinsulinemia-insulinresistance, detected by <b style="">Quantum-<span style="">Biophysical Semeiotics</span></b>, basal “in toto” ureteral reflex is < <st1:metricconverter productid="1 cm" st="on">1 cm</st1:metricconverter>. and it lowers after <i>insulin secretion acute pick test</i>, due to pathological vasoconstriction (17-20).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Notoriously, under such as conditions the hormone brings about negative phenomena in micro-and macro-vessels, characterized by “vasospasm”, as consequence of the increase of PKC as well as of free oxygen radicals. caused by insulin in pathological conditions, even initial, as <i>grew , pre-morbid stage or grew zone</i>. It is a matter of vessel behaviour similar to that observed in case of acetyl-choline, which in healthy dilates the arteries, while in presence of functional or structural endothelial damage brings about notoriously vasospasm.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In conclusion, both tissue and microvascular response to transitory endogenous <i>jatrogenetic </i>hyperinsulinemia is really different in healthy subject, in individual at “inherited real risk” of degenerative, metabolic or oncological disease (See biophysical constitutions in the first website) and, of course, in diseased subject, even in absence of clinical phenomenology, as consequence of diverse receptor response to the hormone under different conditions.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;" lang="EN-GB">Therefore, it is possible to utilize the twofold behaviour of biological systems in case of increased insulin blood level (<b>insulin secretion acute pick test</b>) aiming to diagnosis and prevention, utilizing<span style=""> </span>the different, opposite, receptors responsiveness of <i>smooth muscle cells</i> to insulin, but also to catecholamines<span style=""> </span>(apnea test or Restano’s manoeuvre) as well as to acetylcholine (Valsalsa’s manoeuvre)<o:p></o:p></span></p> </td> </tr> </tbody></table> <p class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">From the above remarks, it appears clear the patho-physiology of histangic ph lowering during the test, where whatever diease is already present or it will occur.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <table class="MsoNormalTable" style="border: medium none ; border-collapse: collapse;" border="1" cellpadding="0" cellspacing="0"> <tbody><tr style=""> <td style="border: 1pt solid windowtext; padding: 0cm 3.5pt; width: 488.9pt;" valign="top" width="652"> <p class="MsoNormal" style="text-align: justify;"><span style="font-family: Arial;" lang="EN-GB">Consequently, it is not surprising our opinion, based on a long clinical experience, that <b>CAEMH-</b></span><b><span style="font-family: Symbol;"><span style="">a</span></span></b><b><span style="font-family: Arial;" lang="EN-GB"> represents the <i>conditio sine qua non</i> of most common and dangerous human diseases: DM, Dyslipidemia, ATS, Rheumatic disorders, malignancies, Arteral Hypertension, a.s.o.</span></b><span style="font-family: Arial;" lang="EN-GB"> </span><span style="" lang="EN-GB"><o:p></o:p></span></p> </td> </tr> </tbody></table> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">The relation, we demonstrated “clinically” and surely existent, between <i>insulin and sympathetic nervous system</i>, as well as that between <b>hyperinsulinemia and insulinresistance</b>, is not nowadays interpreted in the same way by the authors. In other words, authors do not agree on the primary cause between the two hormonal alterations.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><span style=""> </span><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">The following biophysical-semeiotic experimental evidence – “<i>insulin secretion acute pick test” </i>– demonstrates, in healthy, that <i>jatrogenetic</i> hyperinsulinemia is immediately followed by type I, associated microcirculatory activation of supra-renal gland (AL + PL = 8 sec.) and, then, by “sympathetic hypertonus”, event on which all authors agree, and we demonstrated by sophysticated semeiotics: lower mesenteric plexus-caecal reflex (= in practice, digital pressure on the area below umbelicus, slightly at right) shows a basal duration > 10 sec. (NN = 10 sec.). In fact, under normal condition, digital pressure brings about caecal dilation of about <st1:metricconverter productid="3 cm" st="on">3 cm</st1:metricconverter>., lasting 10 sec. exactly.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">By contrast, after 10 sec. from the beginning of Restano’s manoeuvre (= sympathetyc hypertonus: see Glossary) reflex duration is > 10 sec. due to sympathetic hypertonus, while after 7-10 sec. from Valsalva’s manoeuvre starting the duration of caecal dilation lowers significantly to <></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><u><span style="" lang="EN-GB">To summarize,</span></u><span style="" lang="EN-GB"> hyperinsulinemia, beside all other actions, provokes notoriously<i> sympathetic hypertonus, </i>as allows us to state <b style="">Quantum-<span style="">Biophysiacal Semeiotics.</span></b> On the other site, the stimulation of supra-renal trigger-point (the skin of hypocondrium immediately below the costal arch along anterior ascellar line) brings about increasing of supra-renal gland volume, and successively that pancreatic one, with subsequent augmentation of insular hormonal secretion.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">The data, referred above, demonstrate that both biological systems activate each other reciprocally by positive feed-back mechanisms. At this point, however, in health, the <i>positive arm</i> of the “biological cross” of psycho-neuro-endocrine-immunological system, i.e., SST, melatonin, endogenous oppioids, which controls insulin, epinephrine and nor-epinephrine secretion, leading it in normal ranges in an opposite way to that occurs in presence of “Oncological Terrain” (See Oncological Terrain in my above-cited website). <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">With regards to this argument, it is useful to underline the importance of dismetabolic-dishormonal components – <i>hyperinsulinemia-insulinresistance </i>– as well as that of sympathetic hypertonus in the pathological <i>pre-morbid</i> condition, I termed “Oncological Terrain”.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><a name="_Toc60654056"></a><a name="_Toc60654031"><span style=""><b style=""><span style="" lang="EN-GB">Hyperinsulinemia-Insulinresistance Renal Test.</span></b></span></a><b style=""><span style="" lang="EN-GB"><o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">As follows, it is described a further interesting and reliable test to evaluate hyperinsulinemia-insulinresistance: <b>hyperinsulinemia-insulinresistance renal test</b> (See Glossary in above-cited website).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">In health, acute pick of insulin secretion, performed as illustrated formerly, after a latency time < productid="3 cm" st="on">3 cm</st1:metricconverter>. with duration of 10 sec. precisely.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">“Vasomotion” duration last (AL + PL Phase) 8 sec. (NN = 6 sec.), analogously to what we observe during the <b style="">atrial natriuretic peptides renal test</b> (See above-cited website in Practical Application).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Similarly to what doctor observes in both cardiac failure and coronary artery disease, as regards “atrial”<span style=""> </span>natriuretic peptides, due to renal receptors <i>down-regulation</i>, the physiological increasing of kidney augmentation during acute pick of insulin secretion test appears to be slightest, not significant, very short or absent (= intensity <<span style=""> </span><st1:metricconverter productid="2 cm" st="on">2 cm</st1:metricconverter>. and duration </span><span style="font-family: Symbol;"><span style="">£</span></span><span style="" lang="EN-GB"> 8 sec.), allowing bed-side assessment of a pathological situation, really dangerous, and otherwise impossible to be recognized, because it is at the moment completely asymptomatic: <b>hyperinsulinemia-insulinresistance.</b><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">Moreover, the “quantitative” evaluation of increasing lt of renal diameters during the performance of acute pick insulin secretion test as well as augmentation rate of kidney size permit to “quantify” the seriousness of underlying pathological disorder.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><u><span style="" lang="EN-GB">In conclusion</span></u><i><span style="" lang="EN-GB">,</span></i><span style="" lang="EN-GB"> renal test of hyperinsulinemia-insulin resistance results both quantitatively and qualitatively “abnormal” in disorders, even initial, of glucose metabolism: in <b>Diabetes Mellitus,</b> kidney does not increase the size or the increase of their diameters is not at all significant from the statistical view-point.<o:p></o:p></span></p> <span style="font-size: 12pt; font-family: "Times New Roman";" lang="EN-GB"><br /> </span> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><a name="_Toc60654057"></a><a name="_Toc60654032"><span style="">References.</span></a></p> <p class="MsoNormal" style="text-align: justify;"><o:p> </o:p></p> <p class="MsoNormal" style="text-align: justify;"><span style="">1) </span><b>Stagnaro-Neri M., Stagnaro S.</b> Indagine clinica percusso-ascoltatoria delle unità microvascolotessutali della plica ungueale. <span style="" lang="EN-GB">Acta Med. Medit. 4, 91</span><b><span style="" lang="EN-GB"> ,</span></b><span style="" lang="EN-GB">1988<b>.</b><br />2) <b>Stagnaro-Neri M., Stagnaro S.</b>, Auscultatory Percussion Evaluation of<span style=""> </span>Arterio-venous Anastomoses Dysfunction in early Arteriosclerosis. </span><span style="">Acta Med. Medit. 5, 141</span>, <span style="">1989</span></p> <p class="MsoNormal" style="text-align: justify;"><span style="">3) <b>Stagnaro-Neri M., Stagnaro S.</b>, Il Glutatione nella terapia microvascolare. Act Med. Medit. 7, 11</span>, <span style="">1991<b><o:p></o:p></b></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="">4) <b>Stagnaro-Neri M., Stagnaro S.</b>, Sul meccanismo d’azione di Sulodexide a livello di correlazioni istangiche acrali patologicamente alterate: studio clinico percusso-ascoltatorio. Giornate Naz. di Angiologia. Milano, 23-29 Giugno 1991. Atti Min. Med., 40, 1991<b> (Infotrieve)</b></span><span style=""> </span></p> <p class="MsoNormal" style="text-align: justify;"><span style="">5) <b>Stagnaro<span style=""> </span>S., Stagnaro-Neri M.</b> Il danno da radicali liberi sul microcircolo. Congr. Naz. SISM., Milano, 10 giugno 1991, Comun. Atti, Min. Angiologica (Suppl. 1 al N° 1) 16,398, 1991.<span style=""> </span><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;">6) <b>Stagnaro-Neri M., Stagnaro S., </b>Modificazioni della viscosità ematica totale e della riserva funzionale microcircolatoria in individui a rischio di arteriosclerosi valutate con la percussione ascoltata durante lavoro muscolare isometrico. Acta Med. Medit. 6, 131-136, 1990.</p> <p class="MsoNormal" style="text-align: justify;">7) <b>Stagnaro S., Stagnaro-Neri M.,</b> Basi microcircolatorie della semeiotica biofisica. Atti del XVII Cong. Naz. Soc. Ital. Studio Microcircolazione, Firenze ott. 1995, Biblioteca Scient. Scuola Sanità Militare, 1995, 2, 94.<span style="color: red;"><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;">8) <b><span style="">Stagnaro S., Stagnaro-Neri M.</span></b><span style="">, Il test della Apnea nella Valutazione della Microcircolazione cerebrale in Cefalalgici. Atti, Congr. Naz. Soc. Ita. Microangiologia e Microcircolazione. A cura di C. Allegra. Pg. 457, Roma 10-13 Settembre 1987. Monduzzi Ed. Bologna, 1987.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="">9) <b>Stagnaro S.</b>, Valutazione percusso-ascoltatoria della microcircolazione cerebrale globale e regionale. Atti, XII Congr. Naz. Soc. It. di Microangiologia e Microcircolazione. </span><span style="" lang="EN-GB">13-15 Ottobre, <st1:city st="on"><st1:place st="on">Salerno</st1:place></st1:City>, e Acta Medit. 145, 163</span><span style="" lang="EN-GB">, </span><span style="" lang="EN-GB">1986.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">10) </span><span style="" lang="EN-GB"><span style=""> </span></span><b><span style="" lang="EN-GB">Stagnaro-Neri M., Stagnaro S.</span></b><span style="" lang="EN-GB">, Deterministic chaotic biological system: the microcirculatoory bed. Theoretical and practical aspects. </span><span style="">Gazz. Med. It. – Arch. Sc. Med. 153, 99, 1994.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;">11) <b><span style="">Stagnaro-Neri M., Stagnaro S.</span></b><span style="">, Radicali liberi e alterazioni del microcircolo nelle flebopatie ipotoniche costituzionali. Min. Angiol. 18, Suppl. 2 al N. 4, 105</span>, <span style="">1993.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="">12) <b>Stagnaro<span style=""> </span>S., Stagnaro-Neri M.</b> Il danno da radicali liberi sul microcircolo. Congr. Naz. SISM., Milano, 10 giugno 1991, Comun. Atti, Min. Angiologica (Suppl. 1 al N° 1) 16,398.<span style=""> </span>1991.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;">13) <b><span style="color: rgb(51, 51, 51);">Stagnaro-Neri M., Stagnaro S.</span></b><span style="color: rgb(51, 51, 51);"> Introduzione alla Semeiotica Biofisica. </span><span style="color: rgb(51, 51, 51);" lang="EN-GB">Il Terreno Oncologico. Travel Factory, Roma, in stampa.</span><span style="color: red;" lang="EN-GB"><span style=""> </span><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">14) </span><b><span style="color: black;" lang="EN-GB">Pantaleo A., Zonszein J. </span></b><span style="" lang="EN-GB">Using Insulin as a Drug Rather Than as a Replacement Hormone During Acute Illness: A New Paradigm, <a href="http://www.medscape.com/viewarticle/463524_print"><span style="">http://www.medscape.com/viewarticle/463524_print</span></a> , </span><span style="color: black;" lang="EN-GB">Heart Dis 5(5):323-334, 2003.</span><span style="" lang="EN-GB"><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="color: black;" lang="EN-GB">15) <b>Janke J, Engeli S, Gorzelniak K</b>, et al. Resistin gene expression in human adipocytes is not related to insulin resistance. </span><i><span style="color: black;" lang="DE">Obes Res</span></i><span style="color: black;" lang="DE">. 2002;10:1-5.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="DE">16) </span><b><span style="color: black;" lang="DE">Kahn BB, Flier JS.</span></b><span style="color: black;" lang="DE"> </span><span style="color: black;" lang="EN-GB">Obesity and insulin resistance. </span><i><span style="color: black;" lang="DE">J Clin Invest</span></i><span style="color: black;" lang="DE">. 2000;106:473-481. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">17) <span class="maintextmodule"><b style="">Stagnaro S., <st1:place st="on">West PJ.</st1:place>, Hu FB., Manson JE., Willett WC.</b> Diet and Risk of Type 2 Diabetes. N Engl J Med. 2002 Jan 24;346(4):297-298. [<b style="">Medline</b>]</span><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">18) <span class="maintextmodule0"><b style="">Stagnaro Sergio.</b> Newborn-pathological Endoarteriolar Blocking Devices in Diabetic and Dislipidaemic Constitution and Diabetes Primary Prevention. The Lancet. March 06 2007. <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?totalcomments=1">http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?totalcomments=1</a> SEE particularly URL: </span></span><span style="font-family: Verdana;" lang="EN-GB"><a href="http://www.fceonline.it/docs/stagnaro.pdf">http://www.fceonline.it/docs/stagnaro.pdf</a><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">19) </span><b><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Stagnaro S</span></b><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">. Pre-metabolic syndrome: the real initial stage of metabolic-syndrome, type 2 diabetes and arteroscleropathy. </span><i><span style="font-size: 10pt; font-family: Verdana;">Cardiovascular Diabetology</span></i><span style="font-size: 10pt; font-family: Verdana;"> <b>3:</b>1<span style="color: black;"> </span><a href="http://www.cardiab.com/content/3/1/1/comments">http://www.cardiab.com/content/3/1/1/comments</a><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">20) <b>Stagnaro Sergio.</b> Bedside recognizing diabetics with or without CHD real risk or silent CHD.<i> </i></span><span style="font-size: 10pt; font-family: Verdana;">BMC Cardiovascular Disorders 2006, 6:41</span><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB"> </span><span style="font-family: Verdana;"><a href="http://www.biomedcentral.com/1471-2261/6/41/comments#243544"><span style="font-size: 10pt;" lang="EN-GB">http://www.biomedcentral.com/1471-2261/6/41/comments#243544</span></a><o:p></o:p></span></p> <span style="font-size: 12pt; font-family: Verdana;"><br /> </span> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p>Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-76831254167650004002009-04-15T21:56:00.000-07:002009-04-15T22:10:57.249-07:00Osteocalcin Quantum-Biophysical-Semeiotic Manoeuvre in bedside Recognizing Diabetes, even in initial stage of diabetic Constitution.<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgHgUF254e9ZBbllMvURKGtRu8XdI3nuQ59K8DRWWuyxwORtg9qVnHi_MZ-ubO6OFP5ZvyOi774gy7qqER8-0cL2GJz_Nx_-3JXzJZuJRiHmgeA-mtBZVbQ_6-WkYWX7tvBAdua7CmPijOT/s1600-h/Pancreas.jpg"><img style="margin: 0px auto 10px; display: block; text-align: center; cursor: pointer; width: 164px; height: 227px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgHgUF254e9ZBbllMvURKGtRu8XdI3nuQ59K8DRWWuyxwORtg9qVnHi_MZ-ubO6OFP5ZvyOi774gy7qqER8-0cL2GJz_Nx_-3JXzJZuJRiHmgeA-mtBZVbQ_6-WkYWX7tvBAdua7CmPijOT/s320/Pancreas.jpg" alt="" id="BLOGGER_PHOTO_ID_5325149192739060066" border="0" /></a><br /> <p class="MsoNormal" style="text-align: justify;"><strong><span style="font-weight: normal;" lang="EN-GB">Prehypertension during Young Adulthood may be involved by <span style=""> </span>Coronary Calcium Later in Life exclusively in presence of Inherited Real Risk of CAD, typical for individuals with lithyasic Constitution, present in about 50% OF ALL CASES of Pre-Metabolic and Metabolic Syndrome </span></strong><span class="maintextmodule"><span style="" lang="EN-GB">(<a href="http://www.semeioticabiofisica.it/">www.semeioticabiofisica.it</a>; Constitutions and Bibliography). Regarding the frequent association between hypertension and diabetes, in my opinion based on 53-year-long clinical experience, is more important bedside recognizing diabetic predisposition, now-a-days possible since birth, utilising a lot of methods, different in difficulty, but all reliable in day-to-day practice. </span></span><b style=""><span style="" lang="EN-GB"><o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB">For the first time, from the clinical view-point, I have formerly<span style=""> </span>illustrated on The Lancet.com an original manoeuvre, based on a singular activity of osteocalcin, and reliable in bedside detecting diabetes in one minute,<span style=""> </span>with the aid of a stethoscope (1). In fact, <span class="maintextmodule">osteocalcin, a product of osteoblasts, among other action mechanisms, stimulates both insulin secretion and insulin receptor sensitivity. As a consequence, osteocalcin, secreted by above-mentioned bone cells during mean-intense lasting digital pressure, for instance, applied upon lumbar vertebrae, brings about increasing pancreatic diameters, i.e., technically speaking, type I, associated, Langherans’s islet microcirculatory activation, so that doctors assess pancreas size augmentation, which in health, lasts 10 seconds exactly (1-7). After that, pancreas diameters return to basal value for 3 sec. The second pancreas size increasing lasts 20 sec., and finally the third show the highest value: 30 sec. On the contrary, in case of diabetic constitution (3, 4) the first pancreas increasing persists normally (10 sec.), but both the second and the third are less than physiological ones (i.e., less than 20 sec. and respectively 30 sec.).<o:p></o:p></span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="maintextmodule"><span style="" lang="EN-GB">On the contrary, in presence of intense inherited real risk of diabetes (6), such as impairment is present usually in the second and third evaluations. In fact, osteocalcin manoeuvre proved to be pathological already in<span style=""> </span>individuals involved by both Diabetic Constitution and Inherited Diabetic Real Risk (7-9).<o:p></o:p></span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="maintextmodule"><span style="" lang="EN-GB">Finally, in case of diabetes the alteration is present already in the first evaluation, wherein duration appears less than 10 sec., inversely related with disorder seriousness.<o:p></o:p></span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="maintextmodule"><span style="" lang="EN-GB">Interestingly, not only in examining subject, but also in all others, even if kilometers way from him (her), according to Lory’s experiment, based of no local realm in biological systems (10), doctor’s pancreas shows surprisingly identical modifications, allowing doctors to made clinical diagnosis until now impossible (11-15)<o:p></o:p></span></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><i style=""><span style="" lang="EN-GB">Figure shows Pancreas Auscultatory Percussion, unavoidable in bedside evaluating pancreas size, i.e., its diameter values. For further information, See <o:p></o:p></span></i></p> <p class="MsoNormal" style="text-align: justify;"><i style=""><span style="" lang="EN-GB"><a href="http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Eng/pagina4pancreas_eng.doc">http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Eng/pagina4pancreas_eng.doc</a> and <a href="http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Eng/A%20Picco%20insulin.%20Test%20engl.doc">http://www.semeioticabiofisica.it/semeioticabiofisica/Documenti/Eng/A%20Picco%20insulin.%20Test%20engl.doc</a> <o:p></o:p></span></i></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><br /><br /></span><span class="maintextmodule">1) </span><span style="font-size: 10pt; font-family: Verdana;">Stagnaro Sergio.</span><span style="font-size: 10pt; font-family: Verdana;"> </span><a name="1433"><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">The Lancet, <span class="maintextmodule0">January 28, 2008. </span>Bedside Biophysical-Semeiotic Osteocalcin Test in Diagnosing and Monitoring Diabetes.</span></a><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB"><br /></span><span style="font-size: 10pt; font-family: Verdana;"><a href="http://www.thelancet.com/journals/lancet/article/PIIS0140673608601014/comments?action=view&totalComments=2" target="_blank"><span style="" lang="EN-GB">http://www.thelancet.com/journals/lancet/article/PIIS0140673608601014/comments?action=view&totalComments=2</span></a></span><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">; See better <a href="http://www.fceonline.it/docs/stagnaro.pdf">http://www.fceonline.it/docs/stagnaro.pdf</a> <span class="maintextmodule"><o:p></o:p></span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="maintextmodule">2) Stagnaro Sergio. Il test Semeiotico-Biofisico della Osteocalcina nella prevenzione primaria del diabete mellito. <a href="http://www.fce.it/">www.fce.it</a>, <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="maintextmodule"><a href="http://www.fcenews.it/index.php?option=com_content&task=view&id=909&Itemid=47">http://www.fcenews.it/index.php?option=com_content&task=view&id=909&Itemid=47</a><span style=""> </span>.</span><br /><span class="maintextmodule">3) Stagnaro-Neri M., Stagnaro S. Introduzione alla Semeiotica Biofisica. Il Terreno Oncologico. Ed. Travel Factory, Roma, 2004 <a href="http://www.travelfactory.it/">www.travelfactory.it</a></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="maintextmodule">4) Stagnaro-Neri M., Stagnaro S., Semeiotica Biofisica: la manovra di Ferrero-Marigo nella diagnosi clinica della iperinsulinemia-insulino resistenza. Acta Med. Medit. 13, 125, 1997</span><br /><span class="maintextmodule">5) Stagnaro S., Stagnaro-Neri M., Le Costituzioni Semeiotico-Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. </span><span class="maintextmodule"><span style="" lang="EN-GB">Travel Factory, Roma 2004<o:p></o:p></span></span></p> <p class="MsoNormal" style="text-align: justify;"><span class="maintextmodule"><span style="" lang="EN-GB">6) Stagnaro S., <st1:place st="on">West PJ.</st1:place>, Hu FB., Manson JE., Willett WC. Diet and Risk of Type 2 Diabetes. N Engl J Med. 2002 Jan 24;346(4):297-298. [Medline]</span></span><span style="" lang="EN-GB"><br /><span class="maintextmodule">7) Stagnaro Sergio. Newborn-pathological Endoarteriolar Blocking Devices in Diabetic and Dislipidaemic Constitution and Diabetes Primary Prevention. The Lancet. March 06 2007. <a href="http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?totalcomments=1">http://www.thelancet.com/journals/lancet/article/PIIS0140673607603316/comments?totalcomments=1</a> SEE particularly URL: </span></span><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB"><a href="http://www.fceonline.it/docs/stagnaro.pdf">http://www.fceonline.it/docs/stagnaro.pdf</a></span><span class="maintextmodule"><span style="" lang="EN-GB"><o:p></o:p></span></span></p> <p class="MsoNormal"><span class="maintextmodule"><span style="" lang="EN-GB">8) </span></span><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB">Stagnaro Sergio.<b> </b></span><strong><span style="font-size: 10pt; font-family: Verdana; font-weight: normal;" lang="EN-GB">New bedside way in Reducing mortality in diabetic men and women. </span></strong><strong><i><span style="font-size: 10pt; font-family: Verdana; font-weight: normal;">Ann. Int. Med.</span></i></strong><strong><span style="font-size: 10pt; font-family: Verdana; font-weight: normal;">2007. </span></strong><strong><span style="font-size: 10pt; font-family: Verdana; font-weight: normal;"><span style=""> </span></span></strong><span style="font-family: Verdana;" lang="EN-GB"><a href="http://www.annals.org/cgi/eletters/0000605-200708070-00167v1"><span style="font-size: 10pt;" lang="IT">http://www.annals.org/cgi/eletters/0000605-200708070-00167v1</span></a></span></p> <p style="margin: 0cm 0cm 0.0001pt;">9) <span style="font-size: 10pt; font-family: Verdana;">Stagnaro S., Stagnaro-Neri M.</span><span style="font-size: 10pt; font-family: Verdana;">, Le Costituzioni Semeiotico-Biofisiche.Strumento clinico fondamentale per la prevenzione primaria e la definizione della Single Patient Based Medicine. Travel Factory, Roma, 2004. </span><span style="font-size: 10pt; font-family: Verdana;" lang="EN-GB"><a href="http://www.travelfactory.it/libro_costituzionisemeiotiche.htm"><span style="" lang="IT">http://www.travelfactory.it/</span></a></span><br />10) <span style="font-size: 10pt; font-family: Verdana; color: red;"><span style=""> </span></span><span style="font-size: 10pt; font-family: Verdana;">Stagnaro Sergio e<i> </i>Paolo Manzelli.</span><span style="font-size: 10pt; font-family: Verdana;"> <span class="bodydochome">03 Gennaio 2008, <a href="http://www.ilpungolo.com/leggi-tutto.asp?IDS=13&NWS=NWS5267">http://www.ilpungolo.com/leggi-tutto.asp?IDS=13&NWS=NWS5267</a> Limiti della Medicina Ufficiale. L’Esperimento di Lory.</span></span></p> <p class="MsoNormal">11) <span style="font-size: 10pt; font-family: Verdana;">Stagnaro Sergio e<i> </i>Paolo Manzelli.</span><span style="font-size: 10pt; font-family: Verdana;"> L’Esperimento di Lory. Scienza e Conoscenza, N° 23, 13 Marzo 2008. <a href="http://www.scienzaeconoscenza.it/articolo.php?id=17775" target="_blank">http://www.scienzaeconoscenza.it//articolo.php?id=17775</a> </span></p> <p class="MsoNormal" style="text-align: justify;">12) <span style="font-size: 10pt; font-family: Verdana;">Stagnaro Sergio.</span><span style="font-size: 10pt; font-family: Verdana;"> Reale Rischio Congenito di Cancro Renale Diagnosticato con <st1:personname productid="la Semeiotica Biofisica" st="on">la Semeiotica Biofisica</st1:PersonName>: il Segno di Pollio. <a href="http://www.ilpungolo.com/" target="_blank">www.ilpungolo.com</a>, 25 Marzo 2008, </span><span class="bodydochome"><span style="font-size: 10pt; font-family: Verdana;"><a href="http://www.ilpungolo.com/leggi-tutto.asp?NWS=NWS5480&IDS=13" target="_blank"><span style="">http://www.ilpungolo.com/leggi-tutto.asp?NWS=NWS5480&IDS=13</span></a></span></span><br />13) <span style="font-size: 10pt; font-family: Verdana;">Stagnaro Sergio<b>.</b></span><span style="font-size: 10pt; font-family: Verdana;"> Melanoma? Escluso in 1 Secondo con <st1:personname productid="la Semeiotica Biofisica" st="on">La Semeiotica Biofisica</st1:PersonName> Quantistica. Il Reale Rischio Congenito di Melanoma. <a href="http://www.ilpungolo.com/" target="_blank">www.ilpungolo.com</a>, </span><span class="bodydochome"><span style="font-size: 10pt; font-family: Verdana;">9 Aprile 2008, </span></span><span style="font-size: 10pt; font-family: Verdana;"><a href="http://www.ilpungolo.com/leggi-tutto.asp?IDS=13&NWS=NWS5524" target="_blank">http://www.ilpungolo.com/leggi-tutto.asp?IDS=13&NWS=NWS5524</a></span> </p> <p class="MsoNormal" style="text-align: justify;">14) <span style="font-size: 10pt; font-family: Verdana;">Stagnaro Sergio.</span><span style="font-size: 10pt; font-family: Verdana;"> Diagnosi clinica di cuore sano in un secondo! 7 Aprile 2008. <b><a href="http://www.fce.it/" target="_blank">www.fce.it</a> </b><a href="http://www.fcenews.it/index.php?option=com_content&task=view&id=1218&Itemid=47" target="_blank">http://www.fcenews.it/index.php?option=com_content&task=view&id=1218&Itemid=47</a><o:p></o:p></span></p> <span style="font-size: 10pt; font-family: Verdana;">15) <span style="">Stagnaro Sergio e<i> </i>Paolo Manzelli.</span> L’Esperimento di Lory. Scienza e Conoscenza, N° 23, 13 Marzo 2008. <a href="http://www.scienzaeconoscenza.it/articolo.php?id=17775" target="_blank">http://www.scienzaeconoscenza.it//articolo.php?id=17775</a></span><span style=";font-family:Verdana;font-size:10;" ><a href="http://www.scienzaeconoscenza.it/articolo.php?id=17775" target="_blank"></a></span>Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0tag:blogger.com,1999:blog-8814429923003909469.post-26508877265078002872009-04-14T04:11:00.000-07:002009-04-14T06:07:49.273-07:00BIOPHYSICAL SEMEIOTIC DIAGNOSIS OF ACUTE APPENDICITIS .<a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiyA9hTIzEeNbXZNr8gf4hQCtSqxIvdzhHsaNW1we7AbyhYp9wYMv-IIPDiTRYyW3XCydw6za_5OfOMJz_oXWRG7ltlYF8DRbtYOC00Y84wsy8U_vI9DGjKZcFeyG2RqIdp2MyOb9Rmb0UX/s1600-h/sergio+CGt.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 214px; height: 320px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEiyA9hTIzEeNbXZNr8gf4hQCtSqxIvdzhHsaNW1we7AbyhYp9wYMv-IIPDiTRYyW3XCydw6za_5OfOMJz_oXWRG7ltlYF8DRbtYOC00Y84wsy8U_vI9DGjKZcFeyG2RqIdp2MyOb9Rmb0UX/s320/sergio+CGt.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5324533057785982306" /></a><br /><br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgXC6bXUEgpAXIcqbbOfnet75vc1CKFTdl3KJAQYnKA1lYZgxjrYEfjvRvYa44PEJIhAgMfuHadIkxhTUKvMZy0HTzcn3vzVjVgmFIRXoKrn9K2Kx92eDg6fXIbPXXGCdj2yvROoB1EpMS8/s1600-h/sergio8.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 230px; height: 292px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEgXC6bXUEgpAXIcqbbOfnet75vc1CKFTdl3KJAQYnKA1lYZgxjrYEfjvRvYa44PEJIhAgMfuHadIkxhTUKvMZy0HTzcn3vzVjVgmFIRXoKrn9K2Kx92eDg6fXIbPXXGCdj2yvROoB1EpMS8/s320/sergio8.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5324532822794850866" /></a><br /><br /><br /><a onblur="try {parent.deselectBloggerImageGracefully();} catch(e) {}" href="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEitrLBQVkwtPrjY_qywXEWuNtJcC8cunC3tJ2ZX2sSib4y61ZlSkvzHoC2stXvmDwVS5JRLubSeX7czcPJjGkorrYHdd-jJNlzMpkMyuBsIYB5tMdCG-qFff_VFbe11xY5zO6OoUg8LFgTS/s1600-h/sergio.jpg"><img style="display:block; margin:0px auto 10px; text-align:center;cursor:pointer; cursor:hand;width: 320px; height: 229px;" src="https://blogger.googleusercontent.com/img/b/R29vZ2xl/AVvXsEitrLBQVkwtPrjY_qywXEWuNtJcC8cunC3tJ2ZX2sSib4y61ZlSkvzHoC2stXvmDwVS5JRLubSeX7czcPJjGkorrYHdd-jJNlzMpkMyuBsIYB5tMdCG-qFff_VFbe11xY5zO6OoUg8LFgTS/s320/sergio.jpg" border="0" alt=""id="BLOGGER_PHOTO_ID_5324532405033016834" /></a><br /><br /><br /><p class="MsoToc3" style=""><!--[if supportFields]><span style="'mso-element:field-begin'"></span><span style="'mso-spacerun:yes'"> </span>TOC \o "1-3" \h \z <span style="'mso-element:field-separator'"></span><![endif]--><span class="MsoHyperlink"><span style=""><a href="http://www.blogger.com/post-create.g?blogID=8814429923003909469&pli=1#_Toc23736005">Introduction.<span style="display: none; text-decoration: none;color:#000000;" ><span style=""> </span></span><!--[if supportFields]><span style="'display:none;mso-hide:screen;text-decoration:none;color:windowtext;"><span style="'mso-element:field-begin'"></span></span><span style="'display:none;mso-hide:screen;text-decoration:none;color:windowtext;"> PAGEREF _Toc23736005 \h </span><span style="';color:windowtext;"><span style="'mso-element:field-separator'"></span></span><![endif]--><span style="display: none; text-decoration: none;color:#000000;" >1</span><span style="display: none; text-decoration: none;color:#000000;" ><!--[if gte mso 9]><xml> <w:data>08D0C9EA79F9BACE118C8200AA004BA90B02000000080000000D0000005F0054006F006300320033003700330036003000300035000000</w:data> </xml><![endif]--></span><!--[if supportFields]><span style="';color:windowtext;"><span style="'mso-element:field-end'"></span></span><![endif]--></a></span></span><span style=""><o:p></o:p></span></p> <p class="MsoToc3" style=""><span class="MsoHyperlink"><span style=""><a href="http://www.blogger.com/post-create.g?blogID=8814429923003909469&pli=1#_Toc23736006"><span style="" lang="EN-GB">Biophysical-semeiotic diagnosis of the appendicitis. Tonic Gastric Contraction, Berti-Riboli’s, and Bella’s signs.</span><span style="display: none; text-decoration: none;color:#000000;" ><span style=""> </span></span><!--[if supportFields]><span style="'display:none;mso-hide:screen;text-decoration:none;color:windowtext;"><span style="'mso-element:field-begin'"></span></span><span style="'display:none;mso-hide:screen;text-decoration:none;color:windowtext;"> PAGEREF _Toc23736006 \h </span><span style="';color:windowtext;"><span style="'mso-element:field-separator'"></span></span><![endif]--><span style="display: none; text-decoration: none;color:#000000;" >1</span><span style="display: none; text-decoration: none;color:#000000;" ><!--[if gte mso 9]><xml> <w:data>08D0C9EA79F9BACE118C8200AA004BA90B02000000080000000D0000005F0054006F006300320033003700330036003000300036000000</w:data> </xml><![endif]--></span><!--[if supportFields]><span style="';color:windowtext;"><span style="'mso-element:field-end'"></span></span><![endif]--></a></span></span><span style=""><o:p></o:p></span></p> <p class="MsoToc3" style=""><span class="MsoHyperlink"><span style=""><a href="http://www.blogger.com/post-create.g?blogID=8814429923003909469&pli=1#_Toc23736007"><span style="" lang="EN-GB">Clinical microangiology of acute appendicitis.</span><span style="display: none; text-decoration: none;color:#000000;" ><span style=""> </span></span><!--[if supportFields]><span style="'display:none;mso-hide:screen;text-decoration:none;color:windowtext;"><span style="'mso-element:field-begin'"></span></span><span style="'display:none;mso-hide:screen;text-decoration:none;color:windowtext;"> PAGEREF _Toc23736007 \h </span><span style="';color:windowtext;"><span style="'mso-element:field-separator'"></span></span><![endif]--><span style="display: none; text-decoration: none;color:#000000;" >4</span><span style="display: none; text-decoration: none;color:#000000;" ><!--[if gte mso 9]><xml> <w:data>08D0C9EA79F9BACE118C8200AA004BA90B02000000080000000D0000005F0054006F006300320033003700330036003000300037000000</w:data> </xml><![endif]--></span><!--[if supportFields]><span style="';color:windowtext;"><span style="'mso-element:field-end'"></span></span><![endif]--></a></span></span><span style=""><o:p></o:p></span></p> <p class="MsoToc3" style=""><span class="MsoHyperlink"><span style=""><a href="http://www.blogger.com/post-create.g?blogID=8814429923003909469&pli=1#_Toc23736008">Discussion.<span style="display: none; text-decoration: none;color:#000000;" ><span style=""> </span></span><!--[if supportFields]><span style="'display:none;mso-hide:screen;text-decoration:none;color:windowtext;"><span style="'mso-element:field-begin'"></span></span><span style="'display:none;mso-hide:screen;text-decoration:none;color:windowtext;"> PAGEREF _Toc23736008 \h </span><span style="';color:windowtext;"><span style="'mso-element:field-separator'"></span></span><![endif]--><span style="display: none; text-decoration: none;color:#000000;" >7</span><span style="display: none; text-decoration: none;color:#000000;" ><!--[if gte mso 9]><xml> <w:data>08D0C9EA79F9BACE118C8200AA004BA90B02000000080000000D0000005F0054006F006300320033003700330036003000300038000000</w:data> </xml><![endif]--></span><!--[if supportFields]><span style="';color:windowtext;"><span style="'mso-element:field-end'"></span></span><![endif]--></a></span></span><span style=""><o:p></o:p></span></p> <p class="MsoToc3" style=""><span class="MsoHyperlink"><span style=""><a href="http://www.blogger.com/post-create.g?blogID=8814429923003909469&pli=1#_Toc23736009"><span style="" lang="EN-GB">Conclusion.</span><span style="display: none; text-decoration: none;color:#000000;" ><span style=""> </span></span><!--[if supportFields]><span style="'display:none;mso-hide:screen;text-decoration:none;color:windowtext;"><span style="'mso-element:field-begin'"></span></span><span style="'display:none;mso-hide:screen;text-decoration:none;color:windowtext;"> PAGEREF _Toc23736009 \h </span><span style="';color:windowtext;"><span style="'mso-element:field-separator'"></span></span><![endif]--><span style="display: none; text-decoration: none;color:#000000;" >9</span><span style="display: none; text-decoration: none;color:#000000;" ><!--[if gte mso 9]><xml> <w:data>08D0C9EA79F9BACE118C8200AA004BA90B02000000080000000D0000005F0054006F006300320033003700330036003000300039000000</w:data> </xml><![endif]--></span><!--[if supportFields]><span style="';color:windowtext;"><span style="'mso-element:field-end'"></span></span><![endif]--></a></span></span><span style=""><o:p></o:p></span></p> <p class="MsoToc3" style=""><span class="MsoHyperlink"><span style=""><a href="http://www.blogger.com/post-create.g?blogID=8814429923003909469&pli=1#_Toc23736010">References.<span style="display: none; text-decoration: none;color:#000000;" ><span style=""> </span></span><!--[if supportFields]><span style="'display:none;mso-hide:screen;text-decoration:none;color:windowtext;"><span style="'mso-element:field-begin'"></span></span><span style="'display:none;mso-hide:screen;text-decoration:none;color:windowtext;"> PAGEREF _Toc23736010 \h </span><span style="';color:windowtext;"><span style="'mso-element:field-separator'"></span></span><![endif]--><span style="display: none; text-decoration: none;color:#000000;" >11</span><span style="display: none; text-decoration: none;color:#000000;" ><!--[if gte mso 9]><xml> <w:data>08D0C9EA79F9BACE118C8200AA004BA90B02000000080000000D0000005F0054006F006300320033003700330036003000310030000000</w:data> </xml><![endif]--></span><!--[if supportFields]><span style="';color:windowtext;"><span style="'mso-element:field-end'"></span></span><![endif]--></a></span></span><span style=""><o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><!--[if supportFields]><span style="'mso-element:field-end'"></span><![endif]--><o:p><br /></o:p></p> <p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><o:p> </o:p></p> <h3><a name="_Toc23736005"></a><a name="_Toc23734817"></a><a name="_Toc23734564"></a><a name="_Toc23652385"></a><a name="_Toc23652290"></a><a name="_Toc23645859"></a><a name="_Toc23592958"></a><a name="_Toc23592928"></a><a name="_Toc23591383"></a><a name="_Toc23583908"><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style="">Introduction.</span></span></span></span></span></span></span></span></span></a></h3> <p class="MsoNormal"><o:p> </o:p></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">In former articles about acute appendicitis diagnosis, the Authors constantly ignore the clinical diagnosis made with the aid of auscultatory percussion, for the first time described in 1987 (5) (See: <a href="http://www.semeioticabiofisica.it/">www.semeioticabiofisica.it</a>, Practical Applications), which recently was enriched by numerous signs, collected at the bed-side by means of the Biophysical Semeiotics (1,2,3,6),<span style=""> </span>method of investigation based chiefly on auscultatory percussion, and completely described as follows. <o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">Because of the <i>insufficient</i> reliability of the traditional physical semeiotics and since the classic history of anorexia and periumbilical pain, followed by right lower quadrant pain and vomiting, is present in fewer than 60% of cases, 30% of surgical operations are made, unfortunately, on healthy appendix </span><span style="font-family:Symbol;"><span style="">[</span></span><span style="" lang="EN-GB">does it really exsist the <i>white appendicitis</i>?</span><span style="font-family:Symbol;"><span style="">]</span></span><span style="" lang="EN-GB"> and surely a larger percentage regards<span style=""> </span>late operations.<o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">Really, at least in some cases, </span><span style="" lang="EN-GB">there is neuroproliferation in the appendix, in association with an increase in cytochines and neurotransmitters SP and VIP; this event may be involved in the pathophysiology of acute right abdominal pain in the absence of an acute inflammation of the appendix (8). In my opinion, due to the relation between neurologic system and immunological system </span><span style="" lang="EN-GB">(See Oncological Terrrain in my site HONCode 233736 at<span style=""> </span>URL <a href="http://www.semeioticabiofisica/oncological.htm">www.semeioticabiofisica/oncological.htm</a>) it is possible the existence of <i>neuroappendicitis.<o:p></o:p></i></span></p> <p class="MsoBodyTextIndent"><b><span style="" lang="EN-GB">Biophysical Semeiotics</span></b><span style="" lang="EN-GB">, based on auscultatory percussion, auscultatory percussion reflex-diagnostics, and on the use of mathematical models of non-linear physics allows doctor to recognise rapidly as well as easily a large number of signs, among them <b>tonic Gastric Contrection Sign</b><span style=""> </span>(<b>tGC</b>), <b>Berti-Riboli’s Sign, and Bella’s Sign, </b>present in 100% of the cases, regardless the location and the severity of appendicitis, as a 45-year-long clinical experience permits me to state (1-6).<o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <h3><a name="_Toc23736006"></a><a name="_Toc23734818"></a><a name="_Toc23734565"></a><a name="_Toc23652386"></a><a name="_Toc23652291"></a><a name="_Toc23645860"></a><a name="_Toc23592959"></a><a name="_Toc23592929"></a><a name="_Toc23591384"></a><a name="_Toc23583909"><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style="" lang="EN-GB">Biophysical-semeiotic diagnosis of the appendicitis.</span></span></span></span></span></span></span></span></span></span></a><span style=""><span style=""><span style=""><span style=""><span style="" lang="EN-GB"> </span></span></span></span></span><span style=""><span style=""><span style=""><span style="" lang="EN-GB">Tonic Gastric Contraction, Berti-Riboli’s, and Bella’s signs.</span></span></span></span><span style="" lang="EN-GB"><o:p></o:p></span></h3> <p class="MsoBodyTextIndent" style="text-indent: 0cm;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoBodyTextIndent"><b><span style="" lang="EN-GB">Tonic Gastric Contraction (tGC)</span></b><span style="" lang="EN-GB"> permits by itself to evaluate both the presence and the seriousness of appendicitis, i.e. therapeutic monitoring, performed also with the aid of other numerous biophysical semeiotic signs, which are divided in “common” – inflammation signs observed in all processes, infective, connectival, tumoural in origin – and “specific” , i.e. present exclusively in the appendicitis (1,2,3,5).<o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">Among other important signs of inflammation, I remember <u>at first</u> the <b>Rethiculo-Endothelial System Hyperfunction Syndrome (RESHS),</b> now known<span style=""> </span>as Monocytes-Macrophages System (2,3), <b>Acute Antibodies Synthesis Syndrom </b>(AASS), and the increase of <b>Acute Phase Proteins</b> production (4,5) (See in my above-cited site, Practical Applications).<o:p></o:p></span></p> <p class="MsoBodyTextIndent"><b><span style="" lang="EN-GB">RESHS</span></b><span style="" lang="EN-GB"> corresponds to the ESR raising<span style=""> </span>and to altered proteins electrophoresis, but is of both more sensitive as well as specific (1,2,3,6). To detect these signs and syndromes, from the technical viw-point, doctor has to know <u>only</u> the Auscultatory Percussion of the stomach (Fig.1), really easy to perform, described even in the <i>classic</i> text-books , such as <b><i>Rasario</i></b>, IX edition.<o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB"><span style=""> </span>At this point, in the interest of reader, who is not yet skilled of biophysical semeiotic technique, in the following<span style=""> </span>I refer <u>particularly</u> some signs, which doctor can easily observe at the bed-side by auscultatory percussion evaluation of the stomach.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><!--[if gte vml 1]><v:shapetype id="_x0000_t75" coordsize="21600,21600" spt="75" preferrelative="t" path="m@4@5l@4@11@9@11@9@5xe" filled="f" stroked="f"> <v:stroke joinstyle="miter"> <v:formulas> <v:f eqn="if lineDrawn pixelLineWidth 0"> <v:f eqn="sum @0 1 0"> <v:f eqn="sum 0 0 @1"> <v:f eqn="prod @2 1 2"> <v:f eqn="prod @3 21600 pixelWidth"> <v:f eqn="prod @3 21600 pixelHeight"> <v:f eqn="sum @0 0 1"> <v:f eqn="prod @6 1 2"> <v:f eqn="prod @7 21600 pixelWidth"> <v:f eqn="sum @8 21600 0"> <v:f eqn="prod @7 21600 pixelHeight"> <v:f eqn="sum @10 21600 0"> </v:formulas> <v:path extrusionok="f" gradientshapeok="t" connecttype="rect"> <o:lock ext="edit" aspectratio="t"> </v:shapetype><v:shape id="_x0000_i1025" type="#_x0000_t75" style="'width:111pt;" bordertopcolor="this" borderleftcolor="this" borderbottomcolor="this" borderrightcolor="this"> <v:imagedata src="file:///C:\DOCUME~1\SERGIO~1\IMPOST~1\Temp\msohtml1\01\clip_image001.jpg" title="sergio15"> <w:bordertop type="single" width="4"> <w:borderleft type="single" width="4"> <w:borderbottom type="single" width="4"> <w:borderright type="single" width="4"> </v:shape><![endif]--><!--[if !vml]--><img src="file:///C:/DOCUME%7E1/SERGIO%7E1/IMPOST%7E1/Temp/msohtml1/01/clip_image002.jpg" shapes="_x0000_i1025" border="0" height="196" width="150" /><!--[endif]--><span style="" lang="EN-GB"><span style=""> </span><b><span style=""> </span></b></span><b><!--[if gte vml 1]><v:shape id="_x0000_i1026" type="#_x0000_t75" style="'width:109.5pt;height:144.75pt'" bordertopcolor="this" borderleftcolor="this" borderbottomcolor="this" borderrightcolor="this"> <v:imagedata src="file:///C:\DOCUME~1\SERGIO~1\IMPOST~1\Temp\msohtml1\01\clip_image003.jpg" title="contrazione"> <w:bordertop type="single" width="4"> <w:borderleft type="single" width="4"> <w:borderbottom type="single" width="4"> <w:borderright type="single" width="4"> </v:shape><![endif]--><!--[if !vml]--><img src="file:///C:/DOCUME%7E1/SERGIO%7E1/IMPOST%7E1/Temp/msohtml1/01/clip_image004.jpg" shapes="_x0000_i1026" border="0" height="195" width="148" /><!--[endif]--></b><b><span style="" lang="EN-GB"><o:p></o:p></span></b></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><span style="" lang="EN-GB"><span style=""> </span><span style=""> </span></span></b><span style="" lang="EN-GB"><span style=""> </span>Fig. 1<span style=""> </span>Fig. 2 <o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p> </o:p></span></p> <p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><span style=""> </span>In practice,<span style=""> </span>a short segment of stomach great curvature in its lower part, as indicated in Fig.1 (arrows upwards), is detected, useful in ascertaining <u>some</u> important, above-describred signs, unavoidable to recognize the appendicitis: with the bell-piece of sthetoscope (bps) properly located – a patient’s finger fixes the bps – doctor applies digital percussion as usually, i.e. with middle finger slightly bended, functioning as “a little hammer”, <i>directly</i> and <i>gently</i> (i.e. with <u>slight</u> intensity) on the skin, two times on the same point, moving than towards the bell piece of stethoscope, along radial and centripetal lines, starting from te umbelical horizontal line.<o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">When digital percussion is applied “directly” on cutaneous projection area of the stomach (or of whatever viscera, e.g. caecum), percussion sound is perceived clearly modified, hyperfonetic, and “it seems to originate near to the doctor’s ears” (5).<o:p></o:p></span></p> <p class="MsoBodyTextIndent"><span style="" lang="EN-GB">In healthy, the reflex lasts > 3 sec. < time =" fractal"></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">The doctor evaluates the <b>RESHS </b>by the aid of digital pressure of “mean” intensity applied on the median line of sternal (breast-bone) body, iliac crests and cutaneous projection area of the spleen: in healty individual, after a latency time (lt) of <b>10 sec. exactly</b>, both fundus and body of the stomach dilate – <b>1-<st1:metricconverter productid="2 cm" st="on">2 cm</st1:metricconverter>.</b> – whereas antro-pyloric region contracts (Fig.2) (<b>gastric aspecific reflex,<span style=""> </span>vagal type</b>) (See: Technical Page N° <st1:metricconverter productid="1, in" st="on">1, in</st1:metricconverter> Home-Page).<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">On the contrary, in whatever infectious (caused by Gram +) as well as<span style=""> </span>connective disorder, malignant tumour, a.s.o., lt appears <u>lower</u> than normal, i.e. <b>6 sec.</b> ( <b>3</b> sec. in case of <i>cancer</i>, <u>apart</u> from the initial stages), in relation to the degree of disorder, and dilation is <b>> <st1:metricconverter productid="2 cm" st="on">2 cm</st1:metricconverter>.</b>: <b>RESHS “complete”</b>.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">As a matter of facts, there are two other types of this syndrome: </span><span style=";font-family:";" lang="EN-GB">a)</span><span style="" lang="EN-GB"> <b>RESHS “incomplete”</b>, <u>characteristic of flu</u>: spleen does not synthesize <i>acutely </i>antibodies (where lt of spleen-gastric aspecifix reflex is <b>3 sec.</b> <i>during slight digital pressure</i>), consequently<span style=""> </span>pressure of “mean” intensity on spleen<span style=""> </span>projection area <u>cannot</u> bring about the gastric aspecific reflex after <i>pathological</i> lt;<span style=""> </span></span><span style=";font-family:";" lang="EN-GB">b) </span><b><span style="" lang="EN-GB">RESHS “intermediate”</span></b><span style="" lang="EN-GB"> is <u>typically</u> present in case of infectious diseases, caused by bacteria Gram -, as <i>E.coli </i>e<i> H.pylori</i>, characterized by the fact that gastric aspecific reflex is clearly <i>less intense</i> when digital pressure stimulates splenic <i>trigger-points</i>. In other words, in case of Gram- infections, splenic-gastric aspecific reflex is present, but “smaller” than breast-bone or iliac crests-gastric aspecific reflex, allowing doctor to recognize <u>at the bed-side</u> the real nature of bacteriological agents, causing the disease. The reduction of spleen antibodies synthesis accounts for the reason that<span style=""> </span>the <b>RESHS </b>is termed <b><span style=""> </span>“intermediate”</b>.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB">In very initial stages of whatever disorder, if this syndrome appears to be negative, doctor has to evaluate<span style=""> </span><b>RESHS</b><span style=""> </span>in a “sensitive” manner, i.e. with <i>boxer’s test, apnea test, Restano’s manoeuvre</i> (= the two tests are simultaneously applied), lasting roughly <b>10 sec.</b> (sympathetic hypertone): after <b>3 sec.</b> a gastric aspecific reflex appears, </span><b><span style="font-family:Symbol;"><span style="">³</span></span></b><b><span style="" lang="EN-GB"> <st1:metricconverter productid="2 cm" st="on">2 cm</st1:metricconverter></span></b><span style="" lang="EN-GB"> in intensity, with a reinforcing after <b><> (NN: <st1:metricconverter productid="1 cm" st="on"><b>1 cm</b></st1:metricconverter><b>.</b> and reinforcing lt </b></span><b><b><span style="font-family:Symbol;"><span style="">³</span></span></b><b><span style="" lang="EN-GB"> 9 sec.</span></b><span style="" lang="EN-GB">, respectively) (See. </span>Glossario in Home-Page).<span style=""> </span></b></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>The <b>Antibodies Synthesis Syndrome</b> (<b>ASS</b>) can be <u>easily</u> ascertained by means of gastric aspecific reflex, caused by “<i>slight</i>” digital pressure, applied on whatever MALT (<i>mucose associated lymphatic tissue</i>) site, e.g. on cutaneous projection area of the liver, appendix, breast, anterior thorax wall, along mean clavicular line (BALT), on spleen (except for flu), a.s.o.: in healthy, lt is <b>6</b> sec. exactly and intensity 1-<st1:metricconverter productid="2 cm" st="on">2 cm</st1:metricconverter>.: <b style="">ASS type chronic. </b><span style="">On the contrary, i</span>n case of <u>acute appendicitis</u>, lt drops to <b>3</b> sec. exactly and the reflex intensity is <b>> <st1:metricconverter productid="2 cm" st="on">2 cm</st1:metricconverter>.</b>: <b style="">ASS type acute</b>. <o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>Interestingly, a <u>diseased appendix</u> <i>does not</i> synthesize antibodies at all; therefore, are locally absent both <b style="">ASS acute </b>and <b style="">chronic. </b>Identical behaviour show <u>all other</u> biological systems, which physiologically synthetize antibodies:<span style=""> </span>in case of wathever local disorder, regional antibodies synthesis appears interrupted. For instance, in a <i>breast involved by cancer</i>, <i>even in initial stage</i>, acute type of <b style="">ASS is </b><span style="">locally</span><b style=""> absent</b>, at least in the precise area of the tumour. (I can not describe “here and now” interesting modifications of the <i>microcirculation</i> in cancer, due to technical lack of reader’s knowledge).<o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>At this point, in order to recognize and “quantitatively” evaluate the<b> tGC Sign </b><span style=""> </span>doctor applies digital pressure on appendix cutaneous projection, possibly localized by auscultatory percussion; after a latency time </b></span><span lang="EN-GB" style="font-family:Symbol;"><span style=""><b>£</b></span></span><span style="" lang="EN-GB"><b> <b>6 sec. (NN = 10 sec.)</b>, digital pressure brings about intense gastric aspecific reflex, followed by <b>tGC.</b><span style=""> </span><o:p></o:p></b></span></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>Thereafter,<span style=""> </span>doctor asks the patient “to press down its abdomen as to evacuate” (<i>simulated evacuation test</i>); practically<span style=""> </span>patient is invited to carry out Valsalva’s manoeuvre, that causes the same sign – <b>Berti-Riboli’s Sign</b> – likely when physician (the manoeuvre is most refined) applies digital pressure <u>precisely</u> on cutaneous projection area of the inflammed appendix, previously localized by means of auscultatory percussion (Fig.2): <u>immediatly (1-3 sec.)</u> stomach dilates (i.e. the gastric aspecific reflex suddenly appears), then,<span style=""> </span>after <b>3 sec. precisely</b>, stomach contracts rapidly in intense manner:<span style=""> </span><b>TGC Sign</b><span style=""> </span>of </b></span><b><b><span style="font-family:Symbol;"><span style="">³</span></span></b><b><span style="" lang="EN-GB"> <st1:metricconverter productid="2 cm" st="on">2 cm</st1:metricconverter>.</span></b><span style="" lang="EN-GB"> (3,6) (Fig.2). <o:p></o:p></span></b></p><b> </b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b>In healty individual, in identical condition, gastric aspecific reflex lt is <b>10 sec.</b>, duration <b>> 5 sec.</b> and, finally, <b>TGC<span style=""> </span><><o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>In case of <i>retrocaecal appendicitis</i>, until now really difficult to recognize clinically with the aid of old, accademic, physical semeiotics, the patient bends its stretced <u>right</u> leg towards abdomen: the “spontaneous” <b>TGC</b> <u>suddenly</u> appears (100% of cases), after a gastric aspecific reflex with <b>1-2 lt</b> and lasting<span style=""> </span>once more <b>3 sec.</b>: <b>Bella’s Sign </b>“classic” (<b>Bella’s Sign </b>“variant”: patient bends the <u>lef</u>t leg in identical manner as described above, with the same results in case of appendix located in left ileo-pelvic region). <o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>In<span style=""> </span>healthy, in identical above-described conditions, lt of gastric aspecific reflex is <b>10 sec.</b>, duration <b>>5 sec.</b> and <b>TGC</b> intensity is <b>< <st1:metricconverter productid="2 cm" st="on">2 cm</st1:metricconverter>.</b><span style=""> </span>Interestingly, the degrees of reflexes paramaters<span style=""> </span>are the same in both signs, pointing out internal and external coherence of biophysical semeiotic theory. <o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>As regards the evaluation of <b>Acute Phase Proteins,</b> completely described in my above-cited site, it is sufficient to stimulate hepatic trigger-point by a finger-nail and assess the <i>patological </i>hepato-gastric aspecific reflex, absent in healthy, showing a latency time of <b>3 sec., </b>which becomes greater untill disappears when appendicitis ameliorates as far as the <i>restitutio ad integrum</i>.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><o:p><b><b> </b></b></o:p></p><b><b> </b></b><div style="border: 1pt solid windowtext; padding: 1pt 4pt;"><b><b> </b></b><h5><b><b><a name="_Toc23734566"><span lang="EN-GB">BIOPHYSICAL-SEMEIOTIC SIGNS OF APPENDICITIS</span></a></b></b></h5><b><b> </b></b><p class="MsoNormal" style="border: medium none ; padding: 0cm; text-align: center;" align="center"><b><b><b><span style="" lang="EN-GB"><o:p> </o:p></span></b></b></b></p><b><b> </b></b><p class="MsoNormal" style="border: medium none ; padding: 0cm; text-align: center;" align="center"><b><b><a name="_Toc23734567"><b><span style="" lang="EN-GB">“COMPLETE” RESHS</span></b></a><b><span style="" lang="EN-GB"><o:p></o:p></span></b></b></b></p><b><b> </b></b><p class="MsoNormal" style="border: medium none ; padding: 0cm; text-align: center;" align="center"><b><b><b><span style="" lang="EN-GB">ACUTE PHASE PROTEINS AND OTHER SIGNS OF INFLAMMATION ANTIBODY SYNTHESIS ACUTE SYNDROME<o:p></o:p></span></b></b></b></p><b><b> </b></b><p class="MsoNormal" style="border: medium none ; padding: 0cm; text-align: center;" align="center"><b><b><b>BERTI-RIBOLI’S SIGN<o:p></o:p></b></b></b></p><b><b> </b></b><p class="MsoNormal" style="border: medium none ; padding: 0cm; text-align: center;" align="center"><b><b><b>DI BELLA’S SIGN<o:p></o:p></b></b></b></p><b><b> </b></b><h4><b><b>APPENDIX ENLARGEMENT</b></b></h4><b><b> </b></b><p class="MsoNormal" style="border: medium none ; padding: 0cm; text-align: center;" align="center"><b><b><b>ABSENCE OF PHYSIOLOGICAL PERISTALSIS<o:p></o:p></b></b></b></p><b><b> </b></b><h4><b><b><a name="_Toc23734568">CLINICAL MICROANGIOLOGICAL SIGNS</a></b></b></h4><b><b> </b></b></div><b><b> </b></b><h6><span style="font-weight: normal;"><b><b>Tab.1<a name="_Toc23652387"></a><a name="_Toc23652292"><span style=""><o:p></o:p></span></a></b></b></span></h6><b><b> </b></b><p class="MsoNormal" style="text-align: center;" align="center"><span style=""><span style=""><o:p><b><b> </b></b></o:p></span></span></p><b><b> </b></b><h3><span style=""><span style=""><b><b><a name="_Toc23736007"></a><a name="_Toc23734819"></a><a name="_Toc23734569"><span style=""><span style=""><span style="" lang="EN-GB">Clinical microangiology of acute appendicitis.</span></span></span></a></b></b></span></span><span style="" lang="EN-GB"><o:p></o:p></span></h3><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>Other <u>numerous</u> biophysical semeiotic signs (detectable by doctor <u>skilled</u> of the new method) and described in earlier articles (16-22), are illustrated in following.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>Auscultatory percussion, accurately performed, allows doctor to recognize the increase, even small, of <b>appendix transverse diameter</b>: </b></b></span><b><b><b><span style="font-family:Symbol;"><span style="">³</span></span></b><b><span style="" lang="EN-GB"> <st1:metricconverter productid="1 cm" st="on">1 cm</st1:metricconverter>.</span></b><span style="" lang="EN-GB"> </span>(NN = <st1:metricconverter productid="0,5 cm" st="on">0,5 cm</st1:metricconverter>.), due to edema-infiltration-endoluminal effusion. <span style="" lang="EN-GB">Contemporaneously, physiological <b>appendicular peristalsis</b><i> is absent</i>: in healthy, every 18 sec. <i><span style=""> </span></i>one can observe, with the aid of auscultatory percussion, a wave moving from a pace-maker localised at the bottom of viscera as far as to its meatus. <o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoBodyTextIndent"><span style="" lang="EN-GB"><b><b>In a 45-year-long bed-side experience, infact, clinical-microangiological signs proved to be really essential in corroborating appendicitis diagnosis, made on the base of above-described signs (Tab.1), so that in folowing they are illustrated in detail.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-US"><b><b>From the practical point of view it is sufficient and reliable to evaluate periods as well as intensity of low ureteral reflex oscillation (= vasomotion), for example, during mean digital pressure, applied upon the middle third of biceps muscle, compressing it between thumb and other fingers, of a supine individual, psychophysically relaxed. The pressure on whatever scheletric muscle (e.g. biceps muscle between the thumb and the other fingers)<span style=""> </span>allows doctor to examine resistance microvessels dynamics and flowmotion along nutritional capillaries.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoBodyTextIndent"><span style="" lang="EN-US"><b><b>However, the original morphological analysis of vasomotion, i.e., the precise evaluation of low ureteral reflex oscillations, interestingly reveals the actual condition of related tissue-micro vascular-units, in a synergetic model. In order to realize this analysis, it is unavoidable to transfer upon Cartesian coordinates intensity (ordinate, cm) and duration (abscisse, sec.) of three successive fluctuations of low ureteral reflex, observed, for example, in the above-mentioned situation, during biceps muscle microvascular units stimulation. <o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoBodyTextIndent"><span style="" lang="EN-US"><b><b>In healthy, we observe a characteristic diagram (Fig. 3).<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoBodyTextIndent"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-US"><!--[if gte vml 1]><v:shape id="_x0000_i1027" type="#_x0000_t75" style="'width:195pt;height:114.75pt'" bordertopcolor="this" borderleftcolor="this" borderbottomcolor="this" borderrightcolor="this"> <v:imagedata src="file:///C:\DOCUME~1\SERGIO~1\IMPOST~1\Temp\msohtml1\01\clip_image005.jpg" title="diagramma_tacogramma"> <w:bordertop type="single" width="4"> <w:borderleft type="single" width="4"> <w:borderbottom type="single" width="4"> <w:borderright type="single" width="4"> </v:shape><![endif]--><!--[if !vml]--><b><b><img src="file:///C:/DOCUME%7E1/SERGIO%7E1/IMPOST%7E1/Temp/msohtml1/01/clip_image006.jpg" shapes="_x0000_i1027" border="0" height="155" width="262" /><!--[endif]--><o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-US"><b><b>Fig. 3<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-US"><b><b>Interestingly, in 3 sec (ascending line: AL in Fig.4) oscillation reaches its highest intensity (normal intensity is varying from 0,5 to1,5 cm); the "plateau" line (PL) lasts physiologically 3 sec, then in 1 sec (descending line: DL) the line returns to the basal value (i.e. abscisse), where persists for 2-5 sec, varying the periods from 9 to 12 seconds under physiological conditions. <o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoBodyTextIndent"><span style="" lang="EN-US"><b><b>On the contrary, in pathological situations, e.g. <b>essential hypertension</b>, the diagram results interestingly modified (Fig.4): AL as well as DL are normal, 3 sec. and 1 sec respectively; intensity is approximately <st1:metricconverter productid="0,5 cm" st="on">0,5 cm</st1:metricconverter>, in a "predictable" manner; the physiological highest waves, i.e. highest spikes of <st1:metricconverter productid="1.5 cm" st="on">1.5 cm</st1:metricconverter> intensity (HS), are absent.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoBodyTextIndent"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-US"><!--[if gte vml 1]><v:shape id="_x0000_i1028" type="#_x0000_t75" style="'width:238.5pt;height:180.75pt'" bordertopcolor="this" borderleftcolor="this" borderbottomcolor="this" borderrightcolor="this"> <v:imagedata src="file:///C:\DOCUME~1\SERGIO~1\IMPOST~1\Temp\msohtml1\01\clip_image007.jpg" title="attrattori1"> <w:bordertop type="single" width="4"> <w:borderleft type="single" width="4"> <w:borderbottom type="single" width="4"> <w:borderright type="single" width="4"> </v:shape><![endif]--><!--[if !vml]--><b><b><img src="file:///C:/DOCUME%7E1/SERGIO%7E1/IMPOST%7E1/Temp/msohtml1/01/clip_image008.jpg" shapes="_x0000_i1028" border="0" height="243" width="320" /><!--[endif]--><o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-US"><b><b>Fig.4<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoBodyTextIndent" style="text-indent: 0cm;"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoBodyTextIndent"><span style="" lang="EN-US"><span style=""><b><b> </b></b></span><b><b>Finally, in case of <b>hyperfunctioning tissues</b>, e.g. the bone-marrow during infective disorders of whatever nature, digital pressure upon the middle line of breast bone, brings about low ureteral reflex oscillations, characterized by PL of 5 or more sec, intensity as well as periods practically identical each other (Fig. 5). Intensity and PL of every oscillation are directly correlated: more high the intensity, more prolonged appears PL and consequently more efficacious is the flow-motion of related nutritional capillaries. <o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoBodyTextIndent"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-US"><!--[if gte vml 1]><v:shape id="_x0000_i1029" type="#_x0000_t75" style="'width:210pt;height:130.5pt'" bordertopcolor="this" borderleftcolor="this" borderbottomcolor="this" borderrightcolor="this"> <v:imagedata src="file:///C:\DOCUME~1\SERGIO~1\IMPOST~1\Temp\msohtml1\01\clip_image009.jpg" title="attrattori4"> <w:bordertop type="single" width="4"> <w:borderleft type="single" width="4"> <w:borderbottom type="single" width="4"> <w:borderright type="single" width="4"> </v:shape><![endif]--><!--[if !vml]--><b><b><img src="file:///C:/DOCUME%7E1/SERGIO%7E1/IMPOST%7E1/Temp/msohtml1/01/clip_image010.jpg" shapes="_x0000_i1029" border="0" height="176" width="282" /><!--[endif]--><o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-US"><b><b>Fig. 5<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoBodyTextIndent"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-US"><b><b>This clinical evidence underlines the inner consistence of <b>Biophysical Semeiotics</b>.<b><o:p></o:p></b></b></b></span></p><b><b> </b></b><p class="MsoBodyTextIndent"><span style="" lang="EN-US"><span style=""><b><b> </b></b></span><b><b>In addition, superimposing the parameters of three subsequent oscillations of low ureteral reflex, in accordance with the lenght of single period, we realize really interesting figures. In healthy people the obtained area shows a "strange" shape, like a "strange" attractor (Fig. 6): fractal dimension (fD) >3 (16-19), that corresponds to the space occupied by a fractal structure. <o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-US"><!--[if gte vml 1]><v:shape id="_x0000_i1030" type="#_x0000_t75" style="'width:236.25pt;height:171.75pt'" bordertopcolor="this" borderleftcolor="this" borderbottomcolor="this" borderrightcolor="this"> <v:imagedata src="file:///C:\DOCUME~1\SERGIO~1\IMPOST~1\Temp\msohtml1\01\clip_image011.jpg" title="attrattori3"> <w:bordertop type="single" width="4"> <w:borderleft type="single" width="4"> <w:borderbottom type="single" width="4"> <w:borderright type="single" width="4"> </v:shape><![endif]--><!--[if !vml]--><b><b><img src="file:///C:/DOCUME%7E1/SERGIO%7E1/IMPOST%7E1/Temp/msohtml1/01/clip_image012.jpg" shapes="_x0000_i1030" border="0" height="231" width="317" /><!--[endif]--><o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-US"><b><b>Fig. 6<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><b><b><i><span style="" lang="EN-US">Strange attractor: healthy subject.<o:p></o:p></span></i></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-US"><b><b>On the contrary, under pathological condition, e.g. essential hypertension as far as biceps muscle microcirculatory bed is concerned, the area obtained in this manner appears quite small, resembling an attractor at fixed point (Fig. 7).<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-US"><!--[if gte vml 1]><v:shape id="_x0000_i1031" type="#_x0000_t75" style="'width:232.5pt;height:136.5pt'" bordertopcolor="this" borderleftcolor="this" borderbottomcolor="this" borderrightcolor="this"> <v:imagedata src="file:///C:\DOCUME~1\SERGIO~1\IMPOST~1\Temp\msohtml1\01\clip_image013.jpg" title="attrattori2"> <w:bordertop type="single" width="4"> <w:borderleft type="single" width="4"> <w:borderbottom type="single" width="4"> <w:borderright type="single" width="4"> </v:shape><![endif]--><!--[if !vml]--><b><b><img src="file:///C:/DOCUME%7E1/SERGIO%7E1/IMPOST%7E1/Temp/msohtml1/01/clip_image014.jpg" shapes="_x0000_i1031" border="0" height="184" width="312" /><!--[endif]--><o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-US"><b><b>Fig. 7<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoHeading7"><span lang="EN-US"><b><b>Fixed point attractor: hypertensive patient</b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoBodyTextIndent"><span style="" lang="EN-US"><b><b>Finally, the area corresponding to hyperfunctioning microcirculatory units results the largest one, due exclusively to its large Euclidean perimeter; its shape, however, resembles clearly a deformed circle, corresponding to a “closed loop” attractor (Fig. 8) (23, 24).<sup><o:p></o:p></sup></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><b><sup><span style="" lang="EN-US"><o:p> </o:p></span></sup></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-US"><!--[if gte vml 1]><v:shape id="_x0000_i1032" type="#_x0000_t75" style="'width:244.5pt;height:149.25pt'" bordertopcolor="this" borderleftcolor="this" borderbottomcolor="this" borderrightcolor="this"> <v:imagedata src="file:///C:\DOCUME~1\SERGIO~1\IMPOST~1\Temp\msohtml1\01\clip_image015.jpg" title="attrattori5"> <w:bordertop type="single" width="4"> <w:borderleft type="single" width="4"> <w:borderbottom type="single" width="4"> <w:borderright type="single" width="4"> </v:shape><![endif]--><!--[if !vml]--><b><b><img src="file:///C:/DOCUME%7E1/SERGIO%7E1/IMPOST%7E1/Temp/msohtml1/01/clip_image016.jpg" shapes="_x0000_i1032" border="0" height="201" width="328" /><!--[endif]--><o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-US"><b><b>Fig. 8<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><span style="" lang="EN-US"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: center; text-indent: 35.45pt;" align="center"><b><b><i><span style="" lang="EN-US">Closed loop attractor in hyperfunctioning bone-marrow.<o:p></o:p></span></i></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><b><i><span style="" lang="EN-US"><o:p> </o:p></span></i></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><b><i><span style="" lang="EN-US"><o:p> </o:p></span></i></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-US"><b><b>From the above remarks it results that morphological analysis of vasomotion, by means of <b>Biophysical Semeiotics</b>, in physiological as well as in pathological conditions, represents an original, reliable and usefull tool in clinics, research, and therapeutic monitoring, as allows me to state a long, well established experience. (For further information on this topic, See my site <a href="http://digilander.libero.it/microangiologia">www.semeioticabiofisica.it/microangiologia</a>). <o:p></o:p></b></b></span></p><b><b> </b></b><h3><b><b><a name="_Toc23736008"></a><a name="_Toc23734820"></a><a name="_Toc23734570"></a><a name="_Toc23652388"></a><a name="_Toc23652293"></a><a name="_Toc23645861"></a><a name="_Toc23592960"></a><a name="_Toc23592930"></a><a name="_Toc23591385"></a><a name="_Toc23583910"><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style="">Discussion.</span></span></span></span></span></span></span></span></span></a></b></b></h3><b><b> </b></b><p class="MsoNormal"><o:p><b><b> </b></b></o:p></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style=""><b><b> </b></b></span><span style="" lang="EN-GB"><b><b>The general practitioner, who knows <b>Biophysical Semeiotic</b> in a <i>safe</i>, satisfactory manner,<span style=""> </span>certainly<span style=""> </span>is able to diagnose, promptly<span style=""> </span>and clinically, the appendicitis, regardless of its clinical phenomenology, seriousness of the disease or site of appendix, even with the above-described signs. <o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>A long, well established experience allows me to state that,<span style=""> </span>by means of <b>Biophysical Semeiotics, </b>the diagnosis of appendicitis is<i> a clinical one</i>. Unfortunately, now-a-days bed-side diagnosing appendicitis is still often difficult and actually this fact accounts for the reason that a large number of patients are operated to late.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify;"><span style="" lang="EN-GB"><span style=""><b><b> </b></b></span><b><b>In fact, although acute appendicitis is the most common disease of the appendix, other potential pathologic conditions affecting the appendix include swallowed foreign bodies, pinworms, fecaliths, carcinoids, cancer, villous adenomas, and diverticula. The appendix may also be involved in idiopathic ulcerative colitis or the ileocolitis of Crohn's disease (15).<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoBodyText"><span lang="EN-GB"><b><b>Except for hernia, acute appendicitis is the most common cause in the <st1:country-region st="on"><st1:place st="on">USA</st1:place></st1:country-region> of an attack of severe, acute abdominal pain that requires abdominal operation. Because symptoms and signs vary widely and because delay before operation is so hazardous, it is accepted that nearly 15% of operations for acute appendicitis lead to other findings at laparotomy or even to findings of no disease.<b><o:p></o:p></b></b></b></span></p><b><b> </b></b><p class="MsoBodyTextIndent"><span style="" lang="EN-GB"><b><b>Acute appendicitis is common, but its aetiology remains "vague and indefinite" (8). The causes of appendicitis are not well understood, but it is believed to occur as a result of one or more of these factors: an obstruction within the appendix, the development of an ulceration (an abnormal change in tissue accompanied by the death of cells) within the appendix, and the invasion of bacteria.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>Under these conditions, bacteria may multiply within the appendix. The appendix may become swollen and filled with pus (a fluid formed in infected tissue, consisting of while blood cells and cellular debris), and may eventually rupture. Signs of rupture include the presence of symptoms for more than 24 hours, a </b></b></span><b><b><a href="http://www.chclibrary.org/micromed/00048240.html"><span style="" lang="EN-GB">fever</span></a><span style="" lang="EN-GB">, a high white blood cell count, and a fast heart rate. <o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>However, skilled doctor knows very well that the disease in a large number of cases goes on in a really different way: clinical phenomenology appears difficult and surely not useful in bed-side diagnosing appendicitis.<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>In the latter part of the 19th century, an eminent text noted that it had become quite common in "highly civilized countries such as <st1:country-region st="on">Great Britain</st1:country-region>", with lower occurrence rates in <st1:country-region st="on">Denmark</st1:country-region> and <st1:country-region st="on"><st1:place st="on">Sweden</st1:place></st1:country-region> (9). A perforated appendix found in an Egyptian mummy, however, indicates that the disease has been around since ancient times (10). <o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>Originally known as perityphlitis (Greek; <i>peri</i>, around + <i>typhlos</i>, blind + <i>-itis</i>, inflammation), the disease was described by John Hunter in a case at autopsy in 1769 (10); the first use of "appendicitis" is credited to Fitz, who used the term at the inaugural meeting of the Association of American Physicians in 1886 (10). <o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>One of the earliest aetiological theories for acute appendicitis (to which our mothers still subscribe) is that a small foreign body, such as a seed, might lodge in the appendix, thus initiating an acute inflammatory reaction (11). Such as cause of appendicitis is surely possible, but really rare (12).<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>In 70% of patients with acute appendicitis, the diagnosis is made clinically based on classic signs and symptoms. In the remaining 30% of patients with uncertain clinical findings, radiologic imaging is needed to establish the diagnosis, obviously if doctor ignores the <b>Biophysical Semeiotics</b>. Both graded compression sonography or CT can be utilized, when it is possible, of course, to evaluate patients with suspected appendicitis, but certainly not on large scale. Advantages with sonography include lower cost and real-time observation of bowel peristalsis, which can be evaluated by means of the original physic semeiotics. Ultrasound is also superior to CT in diagnosing gynecologic diseases which may mimic appendicitis: as well known <b>Biophysical Semeiotics </b>allows doctors to proceed without doubt in the differential diagnosis. CT is performed in patients with marked obesity, tense ascites or severe pain in whom sonography may be technically difficult or non-diagnostic. CT is also preferred in patients likely to have an abscess (13). Every doctor, particularly if general practitioner, knows that at the bed-side such sophysticated semeiotics are not to be utilized at all.<o:p></o:p></b></b></span></p><b><b> </b></b><p style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>Sonographic criteria for acute appendicitis include a noncompressible appendix with an outer AP diameter of at least <st1:metricconverter productid="7 mm" st="on">7 mm</st1:metricconverter>, mural thickness of <st1:metricconverter productid="3 mm" st="on">3 mm</st1:metricconverter> or greater, or presence of an appendicolith in an appendix of any size. Presence of a hypoechoic fluid collection containing an appendicolith or a fluid collection adjacent to a gangrenous appendix is diagnostic of a periappendiceal abscess. Percutaneous drainage of large periappendiceal abscesses prior to appendectomy can be performed under both CT or ultrasound guidance. <o:p></o:p></b></b></span></p><b><b> </b></b><p style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>In experienced hands, graded compression sonography has a greater than 90% accuracy for diagnosing acute appendicitis, surely less than the accuracy of the sign of Gastric tonic Contraction. False-negative diagnoses may occur in retrocecal appendicitis, perforated appendicitis or in pregnant patients, when <b>Biophysical Semeiotics</b> permitts easily to recognize appendicitis, even retrocecal and in pregnant woman. False-positive results may be seen in women with a dilated fallopian tube or in inflammatory conditions such as tubo-ovarian abscess or Crohn's disease, which may secondarily affect the appendix. <o:p></o:p></b></b></span></p><b><b> </b></b><p style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>The majority of patients imaged for right lower quadrant pain do not have acute appendicitis. In up to 70% of these patients, sonography may detect alternative diagnoses such as salpingitis, Crohn's disease, bowel obstruction, ureteral calculi or degenerating uterine leiomyomas, that is, diagnoses correctly made with properly applyied <b>Biophysical Semeiotics </b>(1, 3, 5) (See above-cited site). <o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="text-align: justify; text-indent: 35.45pt;"><b><b><strong><span style="font-weight: normal;" lang="EN-GB">Researchers have developed a more accurate method of diagnosing appendicitis that may spare thousands of children who develop the potentially fatal problem unnecessary pain and complications, if doctor is ot skilled of </span></strong><strong><span style="" lang="EN-GB">Biophysical Semeiotics</span></strong><strong><span style="font-weight: normal;" lang="EN-GB">. A new study documents for the first time in children the diagnostic accuracy of a technique known as computerized tomography with rectal contrast (CTRC), a procedure that uses computerized enhancements of X-ray images (14).<o:p></o:p></span></strong></b></b></p><b><b> </b></b><p style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><h3><b><b><a name="_Toc23736009"></a><a name="_Toc23734821"></a><a name="_Toc23734571"></a><a name="_Toc23652389"></a><a name="_Toc23652294"></a><a name="_Toc23645862"></a><a name="_Toc23592961"></a><a name="_Toc23592931"></a><a name="_Toc23591386"></a><a name="_Toc23583911"><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style="" lang="EN-GB">Conclusion.</span></span></span></span></span></span></span></span></span></span></a><span style="" lang="EN-GB"><o:p></o:p></span></b></b></h3><b><b> </b></b><p style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><span style=""><b><b> </b></b></span><b><b>A careful examination, possibly with the aid of <b>Biophysical Semeiotics</b>, of course,<span style=""> </span>is the best way to diagnose appendicitis. It is often difficult, infact,<span style=""> </span>even for experienced physicians to distinguish the symptoms of appendicitis from those of other abdominal disorders only by means of the traditional, acàdemic, physical semeiotics. Therefore, very specific questioning and a thorough biophysical-semeiotic </b></b></span><b><b><a href="http://www.chclibrary.org/micromed/00060760.html"><span style="" lang="EN-GB">examination</span></a><span style="" lang="EN-GB"> are crucial. The physician, at first, should ask questions, such as where the pain is centered, whether the pain has shifted, and where the pain began. Soon thereafter, the physician should press on the abdomen to judge the location of the pain and the degree of tenderness. However, of essential importance it is to evaluate the above-described biophysical-semeiotic signs.<o:p></o:p></span></b></b></p><b><b> </b></b><p style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>The typical and classical sequence of symptoms, in fact, is present in about 50% of cases. In the other half of cases, however, less typical patterns may be seen, especially in pregnant women, older patients, and infants. In pregnant women, appendicitis is easily masked by the frequent occurrence of mild abdominal pain and nausea from other causes. Elderly patients may feel less pain and tenderness than most patients, thereby delaying diagnosis and treatment, and leading to rupture in 30% of cases. Infants and young children often have diarrhea, vomiting, and fever in addition to pain.<o:p></o:p></b></b></span></p><b><b> </b></b><p style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>The correct and carefull performance of <b>Biophysical Semeiotics</b> allows doctor to make the proper diagnosis in “every” case of appendicitis, a part from location, severity, clinical phenomenology, a.s.o.<o:p></o:p></b></b></span></p><b><b> </b></b><p style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>While laboratory tests cannot establish the diagnosis, an increased white cell count, often absent, may point to appendicitis. </b></b></span><b><b><a href="http://www.chclibrary.org/micromed/00069670.html"><span style="" lang="EN-GB">Urinalysis</span></a><span style="" lang="EN-GB"> may help to rule out a urinary tract infection that can mimic appendicitis for doctor who ignores the new, original physical semeiotics, of course. <o:p></o:p></span></b></b></p><b><b> </b></b><p style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>Under these conditions, patients whose symptoms and physical examination are compatible with a diagnosis of acute appendicitis are usually taken immediately to surgery, where a laparotomy (surgical exploration of the abdomen) is done to confirm the diagnosis. Often, <u>without </u>the aid of the new physical semeiotics, the diagnosis is not certain until an operation is done. To avoid a ruptured appendix, surgery may be recommended without delay if the symptoms point clearly to appendicitis and diagnosis is corroborated by the original semeiotics (1-4). <o:p></o:p></b></b></span></p><b><b> </b></b><p style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>Now-a-days there would be no possibility that, as in the past years in case of appendicitis was strongly suspected in a woman of child-bearing age, a diagnostic </b></b></span><b><b><a href="http://www.chclibrary.org/micromed/00054370.html"><span style="" lang="EN-GB">laparoscopy</span></a><span style="" lang="EN-GB"> (an examination of the interior of the abdomen) was sometimes recommended before the appendectomy in order to be sure that a gynecological problem, such as a ruptured ovarian cyst, was<span style=""> </span>not causing the pain.<o:p></o:p></span></b></b></p><b><b> </b></b><p style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>As regards sophysticated semeiotics, a part from their limited use in bed-side diagnosing appendicitis, particularly by general pratitioners, they show limited sensitivity, as continuous research of new tool demonstrates.<o:p></o:p></b></b></span></p><b><b> </b></b><p style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>Now-a-days, all around the world, physician skilled of <b>Biophysical Semeiotics</b> is able to recognize “whatever” appendicitis, regardless its location, clinical symptomatology, and seriousness, evaluate its severity, and in case monitor it over the time, so that a normal appendix <u>is not jet</u> discovered, as in the last years, in about 10-20% of patients who undergo laparotomy, because of suspected appendicitis. <o:p></o:p></b></b></span></p><b><b> </b></b><p style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><b><b>In conclusion, my 45-years-long clinical experience allows me to state that the diagnosis of acute appendicitis is a “clinical” diagnosis, regardless location of appendix and seriousness of disease.<o:p></o:p></b></b></span></p><b><b> <span style=";font-family:";font-size:12;" lang="EN-GB" ><br /></span> </b></b><p style="margin: 0cm 0cm 0.0001pt; text-align: justify;"><span style="" lang="EN-GB"><b><b>I dedicated these signs to:<o:p></o:p></b></b></span></p><b><b> </b></b><p class="MsoNormal" style="margin-left: 35.45pt;"><b><b>*<span style=""> </span>Prof. Edoardo Berti-Riboli,<span style=""> </span>docente Semeiotica Chirurgica Department, Genoa University</b></b></p><b><b> </b></b><p class="MsoNormal" style="margin-left: 35.45pt;"><b><b>**Luigi Bella, Assistente Semeiotica Chirurgica Department, Genoa University</b></b></p><b><b> </b></b><p style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><b><b><i><span style="" lang="EN-GB">as a token of my friendship and esteem</span></i><span style="" lang="EN-GB">.<o:p></o:p></span></b></b></p><b><b> <span style=";font-family:";font-size:12;" lang="EN-GB" ><br /></span> </b></b><p style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><p style="margin: 0cm 0cm 0.0001pt; text-align: justify; text-indent: 35.45pt;"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b><h3><b><b><a name="_Toc23736010"></a><a name="_Toc23734822"></a><a name="_Toc23734572"></a><a name="_Toc23652390"></a><a name="_Toc23652295"></a><a name="_Toc23645863"></a><a name="_Toc23592962"></a><a name="_Toc23592932"></a><a name="_Toc23591387"></a><a name="_Toc23583912"><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style=""><span style="">References.</span></span></span></span></span></span></span></span></span></a></b></b></h3><b><b> </b></b><p class="MsoNormal"><o:p><b><b> </b></b></o:p></p><b><b> </b></b><p class="MsoNormal" style="margin: 0cm 77.45pt 0.0001pt 36pt; text-align: justify; text-indent: -18pt;"><!--[if !supportLists]--><b><b><b style=""><span style="" lang="EN-US"><span style="">1)<span style=";font-family:";font-size:7;" > </span></span></span></b><!--[endif]--><b style="">Stagnaro-Neri M., Stagnaro S</b>., Appendicite. <span style="" lang="EN-US">Min. Med. 87, 183, 1996 <span style=""> </span></span><span lang="EN-US" style="font-family:Symbol;"><span style="">[</span></span><b><span style="" lang="EN-US">Medline</span></b><span lang="EN-US" style="font-family:Symbol;"><span style="">]</span></span><span style="" lang="EN-US">.<o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal" style="margin-right: 77.45pt; text-align: justify;"><b><b><b style="">2) Stagnaro S</b>., Sindrome percusso-ascoltatoria di Iperfunzione del Sistema Reticolo-Istiocitario. Min. Med. 74, 479, 1983.<span style=""> </span><span lang="EN-US" style="font-family:Symbol;"><span style="">[</span></span><b> Medline</b><span lang="EN-US" style="font-family:Symbol;"><span style="">]</span></span>.</b></b></p><b><b> </b></b><p class="MsoNormal"><b><b><b style="">3) Stagnaro S</b>., Il Ruolo della Percussione Ascoltata nella “difficile Diagnosi” di Appendicite. Biol. Med. 8, 71,1986.</b></b></p><b><b> </b></b><p class="MsoNormal"><b><b><b style="">4) Stagnaro-Neri M., Stagnaro S</b>., Semeiotica Biofisica del torace, della circolazione ematica e dell’anticorpopoiesi acuta e cronica. <span style="" lang="EN-GB">Acta Med. Medit. </span>13, 25, 1997.</b></b></p><b><b> </b></b><p class="MsoNormal"><b><b><b style="">5) Stagnaro S</b>., Rivalutazione e nuovi sviluppi di un fondamentale metodo diagnostico: la percussione ascoltata. Atti Accademia Ligure di Scienze e Lettere. Vol. XXXIV, 1978.</b></b></p><b><b> </b></b><p class="MsoNormal"><b><b><b style="">6) Stagnaro-Neri M., Stagnaro S</b>., Cancro della mammella: prevenzione primaria e e diagnosi precoce con la percussione ascoltata. <span style="" lang="EN-GB">Gazz. Med. It. – Arch.<span style=""> </span>Sc.<span style=""> </span>Med. 152, 447,1993.<o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal"><b><b><b style=""><span style="" lang="EN-GB">7) Stagnaro-Neri M., Stagnaro S</span></b><span style="" lang="EN-GB">.,Deterministic Chaos, Preconditioning and Myocardial Oxygenation evaluated clinically with the aid of physical Semeiotics in the Diagnosis of ischaemic Heart Disease even silent. Acta Med. Medit. </span>13, 109,1997</b></b></p><b><b> </b></b><p class="MsoNormal"><b><b><b>8) </b><b><span style="">Pierluigi Di Sebastiano, Thorsten Fink,</span></b><span style=""> et al.</span> <span style="" lang="FR">Neuroimmune appendicitis. </span><span style="" lang="FR">Lancet 1999; 354: 461-66. <o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal"><b><b><b><span style="" lang="EN-GB">9) Williams RS.</span></b><span style="" lang="EN-GB"> Appendicitis: historical milestones and current challenges. <i>Med J Aust</i> 1992; 157: 784-787. <o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal"><b><b><b><span style="" lang="EN-GB">10) </span></b><b><span style="" lang="EN-GB">Bouchier IAD, Allan RN, Hodgson HJF, Keighley MRB</span></b><span style="" lang="EN-GB">. Textbook of gastroenterology. <st1:place st="on"><st1:city st="on">London</st1:city></st1:place>: Bailliere Tindall, 1984: 733</span><span style="" lang="EN-GB"><br /><b>11) </b></span><b><span style="" lang="EN-GB">Jacobi A. </span></b><span style="" lang="EN-GB">The intestinal diseases of infancy and childhood. </span><span style="" lang="FR">Detroit: GS Davis, 1887: 234-235. </span><span style="" lang="FR"><o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal"><b><b><b><span style="" lang="EN-GB">12) </span></b><b><span style="" lang="EN-GB">Roger <st1:place st="on">W Byard</st1:place>, Nicholas D Manton and Richard H Burnell.</span></b><span style="" lang="EN-GB"> </span><span style="" lang="EN-GB">Acute appendicitis in childhood: did mother know best?</span><span style="" lang="EN-GB"> </span><span style="" lang="EN-GB">A pathological analysis of 1409 cases</span><span style="" lang="EN-GB">. A kernel of truth?<o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal"><b><b><i><span style="" lang="EN-GB">MJA</span></i><span style="" lang="EN-GB"> 1998; 169: 647-648.<o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal"><b><b><b><span style="" lang="EN-GB">13) </span></b><b><span style="" lang="EN-GB">BrighamRAD Teaching Case</span></b><span style="" lang="EN-GB"> Database:</span><a href="http://brighamrad.harvard.edu/education/online/tcd/tcd.html"><span style="" lang="EN-GB">http://brighamrad.harvard.edu/education/online/tcd/tcd.html</span></a><span style="" lang="EN-GB">.<br /></span><b>14) </b><b><span style="">Garcia Pena BM., Mandel KD</span></b><span style="">, et al. </span><span style="" lang="EN-GB">JAMA 1999; 282:1041-1046. </span><span style="" lang="EN-GB">Ultrasonography and Limited Computed Tomography in the Diagnosis and Management of Appendicitis in Children</span><span style="" lang="EN-GB"><br /><b>15) The Merck Manual of Diagnosis and Terapy.</b> Section<span style=""> </span>3<sup>rd</sup>. </span><span style="" lang="FR">Gastrointestinal Disorder. </span><span style="" lang="EN-GB">Chapter 25. Acute Abdomen and Surgical Gastroenterology.<b> </b></span><strong><span lang="EN-GB" style="color:white;">T1614 he Merck Manual of Diagnosis and </span></strong><span style="" lang="EN-US">1. </span><b>16)Stagnaro-Neri M, Stagnaro S</b>. Flebopatie ipotoniche istangiopatiche. Minerva Angiol, 19, 5, 1994</b></b></p><b><b> </b></b><p class="MsoNormal" style="margin-right: 77.45pt; text-align: justify;"><b><b><b>17) Stagnaro-Neri M, Stagnaro S</b>. Flebopatie ipotoniche istangiopatiche: effetti dell'eparansolfato sulle alterazioni primitive della unita microvascolotessutale. Min. Angiol.18, Suppl. 2 al N 4, 105, 1993</b></b></p><b><b> </b></b><p class="MsoNormal" style="margin-right: 77.45pt; text-align: justify;"><b><b><b>18)</b> <b>Stagnaro-Neri M, Stagnaro S.</b> Vasomotility e Vasomotion nelle flebopatie ipotoniche istangiopatiche. Sui meccanismi d'azione dell'eparansolfato. Giornate Naz. di Angiologia, Milano 23-29 Giugno 1991 Dicembre 12, 1995. Atti Min. Med., 40</b></b></p><b><b> </b></b><p class="MsoNormal" style="margin-right: 77.45pt; text-align: justify;"><b><b><b>19)</b> <b>Stagnaro-Neri M, Stagnaro S.</b> Vasomotility e Vasomotion nelle flebopatie ipotoniche istangiopatiche: caos deterministico e unita microvascolotessutale. Comun. Congresso Naz Soc It Flebologia Clin e Speriment, Cata-nia, 4-7/12/1993. </b></b></p><b><b> </b></b><p class="MsoNormal" style="margin-right: 77.45pt; text-align: justify;"><b><b><b>20) Stagnaro-Neri M, Stagnaro S.</b> Valutazione percusso-ascoltatoria del sistema nervoso vegetative e del sistema renina angiotensina, circolante e tessutale. <span style="" lang="EN-US">Arch Med Int 1992;3:173-92.<o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal" style="margin-right: 77.45pt; text-align: justify;"><b><b><b>21) Stagnaro-Neri M, Stagnaro S.</b> Sindrome di Reaven, classica e variante, in evoluzione diabetica. II ruolo della carnitina nella prevenzione primaria del diabete mellito. II Cuore 1993;6:6l7-24. <span lang="EN-US" style="font-family:Symbol;"><span style="">[</span></span><b><span lang="EN-US"> </span></b><b><span style="" lang="EN-US">Medline</span></b><span lang="EN-US" style="font-family:Symbol;"><span style="">]</span></span><span style="" lang="EN-US"><o:p></o:p></span></b></b></p><b><b> </b></b><p class="MsoNormal" style="margin-right: 77.45pt; text-align: justify;"><b><b><b>22) Stagnaro-Neri M, Stagnaro S.</b> Radicali liberi e alterazioni del microcircolo nelle flebopatie ipotoniche istangiopatiche. Minerva Angiol 1993;4(Suppl 2):105-8.</b></b></p><b><b> </b></b><p class="MsoNormal" style="margin-right: 77.45pt; text-align: justify;"><b><b><b><span style="" lang="DE">23) Peitgen HO, Richter PH</span></b><span style="" lang="DE">. </span>La bellezza dei frattali. Immagini di sistemi dinamici complessi. Torino: Ed Bollati Boringhieri, 1991.</b></b></p><b><b> </b></b><p class="MsoNormal" style="margin-right: 77.45pt; text-align: justify;"><b><b><b>24) Ruelle D</b>. Caso e caos. Torino: Ed Bollati Boringhieri, 1992.</b></b></p><b><b> <span style=";font-family:";font-size:12;" ><br /></span> </b></b><p class="MsoNormal" style="margin-right: 77.45pt; text-align: justify; text-indent: 35.45pt;"><o:p><b><b> </b></b></o:p></p><b><b> </b></b><p class="MsoNormal"><b><b><strong><span lang="EN-GB" style="color:white;">1</span></strong><strong><span style="font-weight: normal;color:white;" lang="EN-GB">T16)herapy</span></strong><b><span style="" lang="EN-GB"> </span></b><strong><span lang="EN-GB" style="color:white;"> The Merck Manual of Diagnosis and Therapy</span></strong><b><span style="" lang="EN-GB"> </span></b><b><span style="" lang="EN-GB"><o:p></o:p></span></b></b></b></p><b><b> </b></b><p class="MsoNormal"><span style="" lang="EN-GB"><o:p><b><b> </b></b></o:p></span></p><b><b> </b></b>Stagnarohttp://www.blogger.com/profile/12340616002338559392noreply@blogger.com0