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Biomedical subjects

B Bruni

Publications and source records attributed to B Bruni.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

[Long-term clinical results with monocomponent insulin (MC lente) in infantile and juvenile diabetes].

The clinical role of insulin-antibody formation, with reference to the monocomponent insulin treatment (MC), is discussed in a series of diabetological conditions. On the basis of a five-year-experience, personal results with a MC Lente treatment are presented in 32 cases of juvenile diabetes subdivided as follows: 3 cases with insulin allergy, 5 cases with insulin lipoatrophy, 13 cases with high insulin requirement, 4 cases with brittle diabetes, 7 cases with diabetic microangiopathy (retinal and, or renal). The circulating antibody level was estimated by IgG-Insulin-Binding Capacity (IB), according to Christiansen. After transfer from conventional to MC insulin treatment it was observed: -- disappearance of allergy and total remission of lipoatrophy, in parallel with a reduction of IB titer; -- decrease in insulin requirement and stabilisation of labile diabetic control, not always in concomitance with IB reduction; -- deterioration of advanced diabetic retinopathy and, or nephropathy in spite of IB reduction. It is concluded that MC insulin constitutes a major tool in the treatment of the above mentioned diabetic conditions, except for advanced microangiopathy. Thus a MC insulin treatment should be started, as a rule, in newly diagnosed diabetics, to possibly prevent such complications. However further development of insulin purification techniques, with removal of residual pro-insulin antigenic sites, is to be considered.

Adolescent↗
PubMedDate not supplied

[TRH stimulation test in the diagnosis of hyperthyreosis].

After a review concerning the present knowledge on the hypothalamic peptide releasing hormones, the response of TSH to intravenous administration of TRH in man (Thyreotrophin Releasing Hormone Stimulation Test) is discussed, with regard to clinical endocrinology. Personal investigations with the TRH test were carried out in 3 groups of conditions correlated with thyroid hyperfunction: 1) suspected hyperthyroidism with equivocal routine tests (9 subjects); 2) autonomous thyroid decompensated adenoma, with or without clinical hyperthyroidism (5 subjects); 3) thyrotoxicosis (Graves' disease) in remission phase after pharmacological or surgical treatment (10 subjects). In these conditions the test provided useful diagnostic information for appropriate therapeutical decisions.

Adult↗
PubMedDate not supplied

[Semi-automatic determination of blood lactate during hypoglycemic treatment with biguanides].

Blood lactate levels were determined by Lactate Analyzer 640 Kontron in 67 adult insulin-independent diabetics during hypoglycemic treatment with usual therapeutical doses of phenformin. In 5 cases were found lactate values above 2 mmol/l and, in consideration of accompanying conditions prone to lactic acidosis, the drug was discontinued. However, the mean value of blood lactate in diabetics treated with phenformin was not significantly different from that found in a group of insulin-treated diabetics. The semiautomatic determination of blood lactate is proposed as a rapid screening of possible candidates for lactic acidosis during biguanide treatment.

Autoanalysis↗
PubMedDate not supplied

[Blood lactate semiautomatic estimation during acidotic diabetic coma (author's transl)].

Blood lactate levels were determined by Lactate Analyzer 640 Kontron during the course of 7 cases of hyperglycemic hyperosmolar diabetic coma, with severe acidosis and more or less marked ketosis. In 5 cases lactate values were found in normal range; slight increases around 2 mmol/l were rapidly corrected following standard coma treatment. One of these cases presented with extreme acidosis and relatively mild hyperglycemia, with differential problems in regard to lactic acidosis. In 2 cases, the former with alcoholic cirrhosis, the latter with myocardial infarction, blood lactate was markedly increased; in the second case, full clinical recovery was accompanied by normalization of lactate levels. A previous biguanide treatment could be ruled out as a cause of lactic acidosis. Thus the association of lactic acidosis and diabetic ketoacidosis seems to be unusual in the absence of concurrent serious conditions. The semiautomatic determination of blood lactate, because of its remarkable prognostic importance, should be included among the routine procedures for the emergency treatment of diabetic coma.

Adult↗
PubMedDate not supplied

[Introduction to new research on correlations between manic-depressive psychosis and adult obesity-linked diabetes].

The problem of the association between adult diabetes, obesity and manic-depressive psychosis is examined in the light of new endocrinological and psychopharmacological findings. After a critical review of the vast old and recent literature on the matter, a physiopathological interpretation of the clinical association is put forward on the basis of mental, nervous and endocrine correlations in carbohydrate metabolism, with special reference to manic-depressive psychosis. The insulin-like effect of lithium on carbohydrate metabolism and correlated ions (phosphates, calcium, magnesium, potassium) at cell membrane level is then discussed. Theoretical and practical conclusions are drawn on the basis of these data. The former propose an essentially "structural" or "intersection" hypothesis of the association and suggest depth study of the insulin function especially in the "normal" phase of manic-depressive psychosis. The latter show the possibility of a clinical trial with lithium and other anti-depressant drugs in obese diabetics, with a close cooperation between psychiatrist and diabetologist.

Adult↗
PubMedDate not supplied

[Evaluation of the antibody anti-insulin titer using Christiansen's radioimmunoelectrophoresis in clinical diabetology].

On the basis of personal experience concerning 2020 consecutive determinations, the radioimmunoelectrophoretic method of Christiansen for 125I-Insulin-Binding to IgG (= IB, significant limits = mU/ml) has been proved as a reliable tool for the evaluation of insulin antibody titer in clinical diabetology. After a critical review of the recent literature about insulin antibodies both without and after exogenous immunization, the following results are presented and discussed. 1) - In 163 diabetic subjects, never previously treated with insulin, the mean value of IB was X = 0,008 mUml (sigma = 0,023 . Sx = 0,002). 2) - In 221 longterm insulin-treated diabetics the mean value of IB was X = 1,50 mU/ml (sigma = 2,15 . Sx = 0,145). 3) -In 46 insulin-dependent diabetics, serial determinations of IB allowed to follow the insulin antibody production during a 5 years treatment with monocomponent insulin )Lente MC). No or slight antibody formation was observed in newly diagnosed patients, never previously treated with insulin. High antibody starting levels showed tendency to a gradual reduction, after switching from conventional insulin treatment to the monocomponent one. These modifications in the IB values have been studied in correlation with the clinical course of conditions possibly referred to an immunologic pathogenesis, such as: brittle diabetes, high insulin requirement, insulin allergy, insulin lipoatrophy, diabetic microangiopathy. No significant variations in IB values were observed after viral infections.

Adolescent↗
PubMedDate not supplied

[Giovanni Martinotti and experimental pancreatectomy, a century ago].

On July 13th, 1888, Giovanni Martinotti (1857-1928) announced in Torino the feasibility of a total pancreatectomy in the dog. The essential details for a successful outcome of the operation, as described by Martinotti, were employed by Oscar Minkowski (1859-1931) in Strassburg for the demonstration of diabetes after total removal of pancreas in the dog, on May 22nd, 1889. Martinotti's work deserves a reevaluation in the history of diabetology.

Animals↗
PubMedDate not supplied

[Pharmacologic control of breathing].

Recent advances in respiratory neuropharmacology and neurophysiology have allowed the assessment of the effects of different drugs on the control of the ventilation both qualitatively (alterations of ventilatory pattern) and quantitatively (size and duration of the ventilatory and haemogasometric alterations). In the control mechanism of ventilation, the pharmacological intervention can act both on the respiratory input (basal metabolism, peripheral chemo-receptors, pulmonary receptors, bulbar neurons, cortical nervous system) and on the respiratory output (respiratory muscles). Based on personal experience in this field and the recent literature, the Authors briefly discuss the seat and the mechanism of action of the drugs with stimulating effect (respiratory analeptics, almitrines, progesterone, acetazolamide, salicylates, protriptyline, theophylline) and depressing effect (narcotics and narcotic-antagonists, anaesthetics, barbiturates and benzodiazepines) on the ventilation, as well as the role of the neurotransmitters and modulators. The clinical (positive and negative) effects of these drugs, particularly related to the patients with chronic lung disease, are also illustrated.

Central Nervous System Stimulants↗
PubMedDate not supplied

[Diabetic foot: practical management of an old recurrent problem].

A simplified approach to the management of major lesions of the diabetic foot is presented. Two nosological types, the angiopathic foot and the neuropathic foot, are proposed, on the basis of diagnostic, therapeutic, prognostic and preventive criteria. A ten years personal experience is discussed.

Adult↗
PubMedDate not supplied

[Determination of plasmatic C-peptide and its clinical uses].

Physiopathological basis and methodological implications of the radioimmunological estimation of plasma C-peptide, as a test of beta cell secretory activity, are reviewed. Personal results are reported concerning C-peptide assay, both in basal and stimulative conditions, in insulindependent long-and short-term diabetes. In 1 case of organic, and 2 cases of functional hyperinsulinism, the test gave useful clinical information. The method of L. Heding-Novo Research Institute, Bagsvaerd, Denmark-, with previous elimination of proinsulin and insulinantibody in patients with high values of IgG insulin binding, proved to be suitable to endocrinological routine.

C-Peptide↗
PubMedDate not supplied

[Semi-automatic determination of blood lactate in the newborn infant of the insulin-dependent diabetic mother].

Blood lactate levels were determined by Lactate Analyzer 640 Kontron in 5 infants of diabetic mothers with pregestational insulin-dependent-diabetes, class B-C-D White, BPSP negative, in strict glycemic control all along the pregnancy. In the mothers blood lactate was found in a normal range after-delivery. In the absence of complications, the neonate of diabetic mother did not show blood lactate changes above the normal range. As well as in the neonate of non diabetic mother, blood lactate increases were found only in concomitance with respiratory acidosis. In the cases with favourable course, lactate values above 2 mmol/l were normalized in the first 24 hours after the birth. The semiautomatic determination of blood lactate supplies a good prognostic evaluation of the association between metabolic and respiratory acidosis in the neonate and should therefore be routinely used in centers for management of diabetic pregnancy.

Acidosis↗
PubMedDate not supplied

[Current management in the diagnosis and treatment of necrotic lesions of the diabetic foot].

A simplified classification for clinical pratical purposes of the diabetic foot necrotic lesions is proposed. Two types are considered both possibly with infection: 1. The angiopathic foot, as a manifestation of the diabetic macro- and microangiopathy. 2. The angioneuropathic foot, as an association of the preminent diabetic neuropathy with diabetic microangiopathy and macroangiopathy. This classification proved suitable to 63 personal observations during the last 7 years. Diagnosis and treatement, planned by a diabetological-orthopedic cooperation, are specified for the two headings. The measure of systolic peripheral blood pressure by means of the ultrasonic device Doplette 10 Danica is introduced.

Amputation, Surgical↗