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Biomedical subjects

A Lomeo

Publications and source records attributed to A Lomeo.

At least 19 recordsLinked to original sources

Isolated local recurrence of renal neoplasm with caval involvement 16 years after radical nephrectomy.

OBJECTIVE: To report a case of local recurrence 16 years after radical nephrectomy; to analyse literature data concerning, treatment and prognosis. METHODS/RESULTS: We report a case of local recurence associated with caval trombosis who was underwent an en-bloc resection of vena cava along with pericaval lesion and caval replacement with PTFE prosthesis. The Authors reviewed and analysed literature data. CONCLUSIONS: Local recurrence after radical nephrectomy is rare as it is reported only in 2-4% of patients. This condition is even rarer beyond 10 years especially if associated with caval trombosis. A case of isolated local recurrence of renal cell carcinoma with caval involvement 16 years after radical nephrectomy is described herein. To the best of our knowledge, this is the first case reported in literature. This case highlights the opportunity of a periodic checkup of patients submitted to radical nephrectomy, even many years after surgery.

Aged↗

Optimised determination of clobazam in human plasma with extraction and high-performance liquid chromatography analysis.

The analysis of clobazam by high-performance liquid chromatography and UV detection is described herein. After adding an internal standard, 600 microl of plasma were extracted under basic conditions onto disposable cartridges packed with celite. The organic extract was then evaporated to dryness and the residue reconstituted in 200 microl of mobile phase. A 20 microl aliquot was injected into chromatograph. The HPLC system was equipped with an Ultrasphere C8 analytical column coupled with an UV detector set at 235 nm. The mobile phase was an acetate buffer 20 mM, pH 5.5, containing acetonitrile and triethylamine 70:30:0.01 (v/v); the flow-rate was 1.8 ml/min. Using this method, clobazam can be detected with a sensitivity limit of 6 ng/ml and the RSD% intra- and inter-assay were lower than 5%. For its ruggedness and reliability, the proposed method is particularly suitable for therapeutic drug monitoring in epilepsy.

Anti-Anxiety Agents↗

Intracardiac extension of a calcified ovarian hemangioma--a case report.

The authors report a case of a fifty-five-year-old woman with clinical and echocardiographic diagnosis of right atrial myxoma. At fluoroscopy and phlebography a mobile calcified peduncle was appreciable originating from the left ovarian vein. This passed through the inferior cava to the right atrium where it wound round itself and extended into the right ventricle during diastole. The authors suspected the presence of a vascular leiomyoma. The tumor and its peduncle were removed by pulling through the right atrium during extracorporeal circulation. The site of origin was confirmed at pelvic surgery.

Calcinosis↗

Echocardiographic detection of aortic valve ring abscesses.

Valve ring abscess complication of infective endocarditis increases the expected morbidity and mortality rates of patients, but is seldom recognized by available noninvasive techniques. In our study, two-dimensional echocardiography successfully detected valve ring abscesses in eight patients with infective endocarditis affecting aortic valve prosthesis. Echocardiography showed the perivalvular abscess as an echo-free space in all patients. Prosthetic vegetations were seen in the only patient who had a biological prosthesis and excessive prosthetic rocking was observed in cases with severe aortic regurgitation. In two patients, the first echocardiographic examination showed an echo-free space without evident clinical signs of endocarditis or significant valve regurgitation. Severe aortic insufficiency and congestive heart failure followed the enlargement of the echo-free space. Valve replacement was required in all but one patient. The echocardiographic findings were confirmed at surgery. In one patient, the extension of the abscess to the interventricular septum was not detected by the echocardiography.

Abscess↗

Effect of subacute cabergoline treatment on prolactin, thyroid stimulating hormone and growth hormone response to simultaneous administration of thyrotrophin-releasing hormone and growth hormone-releasing hormone in hyperprolactinaemic women.

It is known that dopaminergic neurotransmission is involved in the control of PRL, TSH and GH secretion. Cabergoline (CAB) is a new ergolinic derivative with a long-acting dopaminergic activity. We evaluated 11 women with pathological hyperprolactinaemia before and during sub-acute CAB treatment (0.8-1.2 mg/p.o.; 8 weeks). Simultaneous administration of TRH (200 micrograms i.v.) and GHRH 1-44 (50 micrograms i.v.) were carried out before and after 4, 8 and 10 week intervals from the beginning of CAB treatment. Basal PRL levels (2453.5 +/- S.E. 444.5 mU/l) were significantly reduced during CAB administration (week 4: 164.5 +/- 66.5 mU/l; week 8: 168.0 +/- 66.5 mU/l; P less than 0.01) and no variations were observed 2 weeks after drug discontinuation (week 10: 210.0 +/- 98.0 mU/l). PRL percentage change after TRH was increased by CAB (P less than 0.05). No variation in basal and TRH-stimulated TSH levels was found during CAB administration. A slight increase in GH basal levels (3.0 +/- 0.6 mU/l) was found after weeks 4 (6.4 +/- 2.0 mU/l) and 10 (5.8 +/- 1.6 mU/l) (P less than 0.05). GH response to GHRH was significantly enhanced (ANOVA: P less than 0.01) during sub-acute CAB treatment. A positive correlation was found between GH secretory area and weeks of CAB therapy (P less than 0.01). Our data show that CAB is very effective in lowering PRL secretion in hyperprolactinaemia, and is able to modify PRL and GH responses after TRH and GHRH. The increasing trend in GH basal and GHRH-stimulated GH levels seems to indicate that CAB can override the central dopaminergic tone which is operative in hyperprolactinaemia.

Adult↗

Growth hormone and prolactin response to growth hormone-releasing in anorexia nervosa.

Anorexia nervosa (AN) is associated with several endocrine disorders. In order to investigate the role of these alterations, growth hormone-releasing hormone (GHRH) was administered in a group of 9 AN patients and in 9 healthy normal-weight women as control. Growth hormone (GH) and prolactin (PRL) levels were evaluated in both groups after GHRH and saline solution administration. In the AN group, luteinizing hormone (LH), follicle-stimulating hormone (FSH), thyrotropin (TSH) and cortisol serum levels were evaluated during GHRH administration; somatomedin-C (Sm-C) basal levels were also determined. In both groups, GHRH induced a prompt GH increase, which was significantly higher in AN patients (55.3 +/- 2.9 ng/ml, mean +/- SE) than in normal subjects (9.8 +/- 2.6 ng/ml: p less than 0.01). A significant positive correlation between mean GH basal values and GH peak after GHRH was observed only in the control group (R = 0.82, p less than 0.01). No significant relationship between GH mean peak and body mass index (BMI) or Sm-C, estradiol (E2) and glucose serum levels was found in AN patients. However, a positive significant correlation with triiodothyronine (T3) basal values was observed in this group (R = 0.80, p less than 0.01). Both groups showed no variation in PRL serum levels after GHRH infusion. Our data suggest the presence of a central derangement in hypothalamic control of pituitary function in patients with AN, which is not necessarily due to weight loss alone.

Adolescent↗

[Conduction disorders in aortic periprosthetic abscesses].

Active infective endocarditis (AIE) involving native and especially prosthetic aortic valve is often complicated by conduction abnormalities. These conduction disturbances are considered to represent extension of infection from the valve to the annulus and surrounding myocardium. The authors report their experience of conduction disorders in 6/8 patients in whom the aortic prosthetic valve infection was complicated by periprosthetic abscess. They underline the importance of conduction abnormalities as early markers of severe complication in patients with AIE. In fact, their detection is a useful tool in revealing severe complications since clinical, laboratory and other noninvasive examinations do not always allow early diagnosis of the extension of infection to the surrounding myocardium.

Abscess↗

The GH-releasing hormone (GHRH) test in acromegaly before and after adenomectomy.

The GHRH test may represent a new tool in the study of GH dynamics in acromegaly. GH responsiveness to GHRH 1-40 (50 micrograms iv) has been studied in 21 acromegalic patients. Nineteen out of 21 had active disease. Five patients were also studied 1-12 months after neurosurgery. Two apparently cured acromegalics were studied 1-2 yr after surgery. GH secretion has been evaluated in all patients by means of TRH, bromocriptine and insulin hypoglycemia tests, too. GH response to GHRH has also been performed in 14 normal subjects. In acromegaly, GH responses after GHRH (p less than 0.01 vs placebo) were variable. The GH peak ranged from 8 to 445 ng/ml in patients with active disease. Maximum GH increase after GHRH (calculated as peak/basal value ratio) was significantly reduced in acromegaly (2.9 +/- 0.5 ng/ml; mean +/- SE) in comparison to controls (34.1 +/- 10.9 ng/ml; p less than 0.01). No significant differences in GH pattern after GHRH were found between untreated and previously treated patients with active disease. A significant correlation was found between GH basal levels and GH incremental area (p less than 0.05) and between GH basal and peak levels (p less than 0.01) after GHRH. A significant increase in PRL secretion was observed in acromegalic patients after GHRH (p less than 0.01 vs placebo). No discernable variation was found in the other pituitary hormones pattern after the peptide administration. A positive correlation was observed between GH increase after GHRH and insulin hypoglycemia (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Acromegaly↗

Role of aging on growth hormone and prolactin release after growth hormone-releasing hormone and domperidone in man.

Growth hormone (GH) and prolactin (PRL) secretion after GH-releasing hormone (GHRH) and domperidone (DOM), an antidopaminergic drug which does not cross the blood-brain barrier (BBB), was evaluated in 8 healthy elderly men (65-91 years) and in 7 young adults (23-40 years). All received in random order at 2-day intervals: GHRH(1-40) (50 micrograms i.v.) bolus, DOM (5 mg/h) infusion, GHRH(1-40) (50 micrograms i.v.) plus DOM (5 mg/h i.v.), saline solution. In elderly men GH increase after GHRH was significantly lower than in young men. DOM alone did not change GH secretion in either of these groups, whereas it increased the GH response to GHRH only in young adults. PRL levels increased in both young and elderly men during both DOM and GHRH plus DOM, but the PRL release was more marked in young than in elderly men. Both integrated secretion of GH after GHRH and of PRL after DOM were inversely correlated to chronological age. Our data show an impairment of GH rise after GHRH and of PRL after DOM in elderly adults. It is also stressed that peripheral blockade of dopamine receptors by DOM is unable to amplify the GH response to GHRH only in elderly men. A reduction in GH release after GHRH might be related to aging, perhaps through a reduction of dopaminergic tonus.

Adult↗

Effect of ranitidine on the absorption of aspirin.

Six healthy male volunteers received 1 week's pretreatment with ranitidine, 150 mg twice daily, and placebo in a double-blind cross-over trial. On the 8th day, each volunteer received 1 g of aspirin in order to study the pharmacokinetics of this nonsteroidal anti-inflammatory drug. The results of this study suggest that ranitidine does not induce clinically significant alterations to the kinetics of a single dose of aspirin in healthy males.

Adult↗

Effect of simultaneous administration of GHRH (1-40) and TRH on GH, PRL and TSH secretion in normal man.

The GHRH test represents a new tool in the study of secretion in man. Nine normal fasting males received on separate occasions in random order 1) GHRH 1-40 (1 microgram/Kg bw) iv at time 0; 2) TRH (6 micrograms/min) infusion between -30 and +120 min; 3) GHRH 1-40 (1 microgram/Kg bw) iv at time 0 plus TRH (6 micrograms/min) infusion between -30 and +120 min. Blood samples were drawn for GH, PRL and TSH at -90, -60, -30, 0 min and then every 15 min for 2 h. GHRH significantly increased GH in all subjects. The same GH response was found during GHRH plus TRH test. No effect was found either on PRL and TSH secretion after GHRH administration, or on GH pattern after TRH administration. A significant decrease of TSH, but not of PRL response was observed after GHRH plus TRH administration in comparison to TRH alone. These results underline that the inhibitory effect exerted by TRH on GH secretion during some experimental conditions is not linked to a pituitary interference between GHRH and TRH. The difference in TSH secretion, following GHRH plus TRH in comparison with TRH alone, could be due to a GHRH-induced central inhibitory mechanism, probably GHRH-related.

Adolescent↗

The effects of growth hormone-releasing factor (GRF) and dopamine on growth hormone (GH) secretion in acromegaly.

GRF (1-40), dopamine (DA), DA plus GRF and placebo were administered to 6 acromegalic patients. The GRF administration induced a highly variable GH release (GH delta % 167.3 +/- 21.4; mean +/- SE). GRF did not provoke any change in PRL serum levels. During simultaneous GRF and DA administration GH release was found to be reduced (GH delta % 80.2 +/- 17.8) compared to that observed for a corresponding period of time after GRF alone (p less than 0.05). Our data underscore that in acromegaly the DA tonus inhibits GH secretion after GRF by acting directly at the pituitary level.

Acromegaly↗

Effects of GRF(1-40) and domperidone on GH secretion in normal man.

In eight normal adult men pituitary secretion following GRF(1-40) was studied. GRF administration (50 micrograms i.v.) was followed by an increase in GH release with a peak value between the 15 and 60 min. No effects were noticed on LH, FSH, PRL, TSH and ACTH secretion. GH and PRL release was also studied after domperidone (DOM) (5 mg i.v./h), and GRF plus DOM. PRL increased significantly after DOM and GRF plus DOM. During GRF plus DOM a more marked GH release was observed in comparison with the hormone response to GRF alone at 15-45 and 120 min (P less than 0.05). This phenomenon was found in in six out of eight subjects studied. Mean peak and secretory area was greater (P less than 0.05) after GRF plus DOM than after GRF alone. These data suggest that GRF(1-40) at the dose used is a useful tool in the study of GH secretion. The GH pattern during GRF plus DOM seems to indicate that dopaminergic tone may play a direct inhibitory role on GH secretion in man.

Adolescent↗