Epidemiological studies have shown that asthma and rhinitis often coexist in the same patients and the prevalence of asthma is greater in patients with rhinitis. The aim of this study was to evaluate the differences in bronchial reactivity in subjects with seasonal and perennial rhinitis. We enrolled 128 subjects with seasonal or perennial allergic rhinitis divided into three groups: A with perennial rhinitis and allergy to “Dermatophagoides Pteronissynus”; B with seasonal rhinitis and allergy to “Graminae” and “Parietaria”, who underwent methacholine challenge test (MCHt) during the exposure period (fron March until May); C with seasonal rhinitis and allergy to “Graminae” and “Parietaria”, who underwent MCHt during the non exposure period (from June until February). The PC20 mean values of group A (1774.8 ± 20.7) and group B (1740.7 ± 38.8) were not significantly different, but significantly lower than those of group C (3010.0 ± 56.9) (p=0.001). The subjects with group A were positive to the MCHt in 54.54%, against 29.28% of group B and 11.62% of group C (p=0.007). The results show differences in the degree of bronchial responsiveness. The dose-response curves documented a lower value of PC20 in the group with perennial rhinitis and a statistically significant difference of bronchial hyperresponsiveness prevalence between the three groups (p=0.007).

OBJECTIVE: An association between body fat distribution indices and the amount of visceral adipose tissue (AT) with blood pressure (BP) has been documented. However, most studies used casual morning BP values as the dependent variable. The aim of our study was to identify which of the obesity indices (the body mass index (BMI), waist-to-hip ratio (WHR), sagittal diameter or visceral (AT) measured by ultrasonography (US)) better correlated with BP determined by 24 h ambulatory monitoring. DESIGN: Retrospective study on obese women, outpatients at the Obesity Clinic, Internal Medicine Institute, Chieti University, Italy. SUBJECTS AND MEASUREMENTS: In ®fty-one obese outpatient women, BP was determined with a single morning measurement (casual BP) and with 24 h ambulatory monitoring (ABPM). The obesity parameters were the BMI, WHR, sagittal diameter and the amount of intra-abdominal and subcutaneous fat determined by US. RESULTS: Except for the BMI, all obesity indices as WHR, sagittal diameter and visceral AT measured by US were strongly correlated with both casual and 24 h ambulatory BP values. When such parameters were evaluated in a multivariate analysis, only the WHR remained signi®cantly related to 24 h ABPM parameters and not to casual values. CONCLUSIONS: These results suggest that a simple measure of fat distribution as the WHR could represent a good predictor of hypertension in obesity, providing that BP is measured in a more reproducible manner, such as by 24 h ambulatory BP monitoring.

A circadian variation of cardiac function with peak in the early morning was documented about twenty years ago. A circadian rhythm of platelet aggregability, in the same time of the day, was demonstrated in healthy young male subjects. The morning hours were also reported as crucial for sympathetic nervous system activity, for heart rate variability, and for the abrupt rise in blood pressure. Altogether, these trigger factors may explain the high incidence of sudden cardiac death during the morning.In the primary prevention of sudden death in patients with high cardiovascular risk, many strategies were proposed, such as implantable cardioverter-defibrillators, antiarrhythmic and antihypertensive therapies, particularly beta-blockers and more recently, aspirin. Also in subjects without cardiovascular risk factors, it is predictable that early and continuous administration of low-dose aspirin, by inhibiting platelet aggregation and thrombin formation, particularly in morning hours, may represent an effective therapy for the prevention of myocardial infarction and morning sudden cardiac death.

The goal of sulphonylurea (S) treatment in Non-Insulin-Dependent Diabetes Mellitus (NIDDM-type 2 diabetes) subjects should be to obtain a satisfactory glycaemic control (fasting glycaemic levels < 140 mg%). The loss of an adequate blood glucose control after an initial variable period of S is known as secondary failure (SF). The number of SF are extremely variable among different trials for many reasons, some of which are patient-related: increased food intake, weight gain, non-compliance, poor physical activity, stress, diseases and/or impaired pancreatic beta cell function, desensitization after S chronic therapy, reduced absorption, concomitant therapies. Many therapeutic strategies have been proposed to achieve an adequate metabolic control in type 2 diabetes patients: switch to intensive insulin therapy and subsequent return to S therapy; association with insulin; association with sulphonylureas plus biguanides. The association biguanides and S, in particular glibenclamide plus metformin, is now widely used by diabetologists in SF since glibenclamide improves insulin secretion while metformin exerts its antidiabetic effect by different mechanisms.