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D Fedele

Publications and source records attributed to D Fedele.

140 records · Page 8Linked to original sources

Chronobiological pattern of growth hormone secretion in normal subjects and in retinopathic diabetics. Lack of suppression by a plurichronocorticoid drug.

Nyctohemeral variations in plasma concentrations of HGH, glucose, and FFA were studied in 22 normal subjects and 48 diabetic patients affected with retinopathy. In the normal subjects, (fourteen males and eight females, mean age 40+/-3 years; body weight less than 110% of I.B.W.) the determinations were made on blood samples drawn every hour. Seven of these normal subjects were examined before and after 10 days of administration of a new plurichronocorticoid drug (administered at 08(00) and 15(00), with a total amount of 14 mg of prednisolone and 15 mg of cortisone). In patients with diabetic retinopathy (32 male and sixteen female patients, mean age 46+/-2 years, body weight less than 110% of I.B.W.) the determinations were made on blood samples drawn every 3 hrs. All the diabetic patients were insulin treated and were under good or discrete metabolic control, and presented advanced retinopathy. Both in the normal subjects and in retinopathic diabetics, the mean HGH curve showed a characteristic elevation during the early nighttime hours (between 21(00) and 02(00). Despite higher values in plasma glucose and FFA, in diabetics the nocturnal elevation of HGH was only slightly lower than in the normals. The comparison between daytime and nighttime determinations, both in the normal subjects and in the diabetics, reveals statistically significant differences. These results suggest that in subjects with diabetic retinopathy, in the phase of good or discrete metabolic control, spontaneous HGH secretion is not increased, and that nocturnal elevation of HGH is not substantially influenced by higher plasma levels of glucose and FFA. Ten days of plurichronocorticoid treatment with a new drug which exhausts its activity before the evening, did not modify the circadian rhythm of HGH.

Adolescent↗

Evaluation of the vagal-sympathetic interaction in diabetics with autonomic neuropathy through power spectrum density analysis of the heart rate. A critical revision of the natural history of diabetic autonomic neuropathy is possible.

In this paper we apply spectral analysis methods to heart rate variability to assess the autonomic nervous system activity in normal subjects and in patients affected by different degrees of diabetic autonomic neuropathy. The current opinion, based on different clinical tests, is that parasympathetic impairment occurs earlier in autonomic dysfunctions. However, the use of power spectrum density analysis based on a single parameter (heart rate) suggests a simultaneous involvement of parasympathetic and sympathetic pathways leading to the conclusion that perhaps the natural history of diabetic autonomic neuropathy should be substantially rewritten.

Autonomic Nervous System Diseases↗

Auditory brainstem evoked responses in the clinical evaluation and follow-up of insulin-dependent diabetic subjects.

In the last few years the use of ABR in the dysmetabolic encephalopathies has aroused considerable interest. Even though brainstem involvement in these syndromes is not yet entirely understood, ABR techniques have provided new and important insights. We studied 60 insulin-dependent diabetic subjects, 29 females and 31 males aged to 17 to 55 yrs, and observed ABR abnormalities in 28.2% of the cases. This impairment affects the I-V interval or central transmission time (CTT), which is considered the most reliable index of brainstem function. The ABR pattern was considered pathologic when the CTT was due 2DS as compared with a sex- and age-matched control. Follow-up studies performed on 20 of these subjects revealed no significant variation in the ABR tracing. This fact, together with the absence or correlation between ABR involvement and metabolic control and glycemia level during the test, could be attributed to a 'structural' damage of the brainstem tissue. In diabetics, we observed a significant correlation (p less than 0.05) between I-V interval shift and an EMG-proved reduction in motor conduction velocity (MCV) of the peroneal nerve. We also found a high incidence of ABR impairment (53%) in diabetics with cardiovascular autonomic failure.

Adolescent↗

[Insulin therapy].

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Diabetes Mellitus, Type 1↗