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Biomedical subjects

F Maneschi

Publications and source records attributed to F Maneschi.

53 records · Page 3Linked to original sources
PubMed1981

24-Hour studies of prolactin and growth hormone levels in diabetic impotence.

Serum prolactin and growth hormone levels were measured hourly over 24 h in 8 insulin-treated diabetic males, 4 of whom were impotent. All patients showed normal sleep-related peaks of both hormones during the night. The mean 24-hour concentrations of prolactin and growth hormone were similar in patients with impotence (9.4 +/- 1.0 ng/ml and 3.8 +/- 0.4 microIU/ml, respectively) and without it (10.5 +/- 1.0 ng/ml and 4.7 +/- 1.1 microIU/ml, respectively). The mean prolactin and growth hormone concentration during the day time (7.00 a.m. to 7.00 p.m.) and the night time (7.00 p.m. to 7.00 a.m.) were also similar in patients with and without impotence. These results suggest that impotence in diabetic patients is not mediated by abnormalities of prolactin and growth hormone secretion.

Adult↗
PubMed1981

Development of diabetic microangiopathy and diabetic control. A study in non-insulin-dependent diabetics.

The relationship between the development of microangiopathy and the degree of diabetic control was investigated in 61 noninsulin-dependent diabetics after 5-10 years of known duration of diabetes. The degree of diabetic control was assessed by fasting blood glucose (FBG) at the last assessment, haemoglobin A1 (HbA1) and by the mean of all the fasting blood glucose values throughout the follow up (MWFBG). The 29 patients who developed microangiopathy had higher FBG at last assessment (10.1 +/- 0.6 vs 8.2 +/- 0.5 mmol/l, p less than 0.02), HbA1 (13.4 +/- 0.8 vs 11.0 +/- 0.6%, p less than 0.02) and MWFBG (8.0 +/- 0.4 vs 7.5 +/- 0.4 mmol/l, p less than 0.05) than those without microangiopathy. The FBG values at each year of the follow-up were higher in the microangiopathy group. HbA1 determined in 1979 correlated with the mean FBG values of each one of the years 1975-1978 (r = 0.575, r = 0.646, r = 0.657, r = 0.631, p less than 0.001, respectively). These data support the hypothesis that in noninsulin-dependent diabetics the development of microangiopathy is related to the degree of diabetic control.

Blood Glucose↗
PubMed1980

Reappraisal of bromocriptine treatment for acromegaly.

11 acromegalics were treated with bromocriptine for 2--18 months. Their hormonal response was assessed by an acute suppression test with bromocriptine (AST), an oral glucose tolerance test (GTT), and by measuring growth hormone (GH) concentrations during a day of hospital life. The GTTs and the 24-hour profiles were performed before and after bromocriptine. During the AST all patients showed a decrease of GH concentrations ranging from 33 to 86% of the basal. Following bromocriptine, the mean GH concentration was lowered in 7 out of 11 patients during the GTT, and in 8 out of 11 during the profile, but it was within the normal range in 4 patients only during the GTT, and in 1 during the profile. Bromocriptine normalises radioimmunoassayble GH levels in a percentage of patients (12%) which is less than those following conventional treatment of acromegaly, surgery (80%) and pituitary irradiation (70%). Clinically, however, bromocriptine was more effective than judged by the changes of GH levels. Subjective and objective symptoms of acromegaly, such as articular pain, excessive sweating, hypertension, amenorrhoea, urinary hydroxyproline excretion and heel pad thickness decreased in our patients after bromocriptine. A specific action of bromocriptine on the degradation rate of 'little' GH may result in a selective reduction of the bioactive monomeric component of GH and may explain the discrepancy between the clinical and the biochemical response to bromocriptine. This discrepancy might also be explained by a specific action of bromocriptine on the somatomedin levels.

Acromegaly↗
PubMed1978

[125I]hGH metabolism in acromegaly: effects of chronic treatment with 2-Br-alpha-ergocryptine.

To assess the effects of 2-Br-alpha-ergocryptine (CB-154 Sandoz) on hGH metabolism, six acromegalic women were studied before and after 2 months of treatment with 10 mg bromocriptine/day. GH kinetics were evaluated by noncompartmental analysis of the plasma disappearance curve of immunoprecipitable [125I]human GH after pulse administration of the labeled hormone. MCR was increased in all acromegalics after treatment; the difference between the means [153 +/- 11 vs. 200 +/- 16 ml/min . m2 (mean +/- SE)] was highly significant. Secretion rate (SR), measured as the product of MCR by integrated 12-h concentration, was decreased in four patients after treatment, while it was slightly increased in the other two. No change was found after treatment, either initial distribution volume [2.0 +/-0.1 before (B) vs. 2.1 +/- 0.1 liters/m2 after (A)] or total distribution volume [5.0 +/- 0.3 (B) vs. 5.4 +/- 0.4 liters/m2 (A)]. Diffusion of GH from the intravascular pool, measured as reentry rate, was unchanged with treatment [66 +/- 4 (B) vs. 76 +/- 11 ml/min . m2 (A)]. In conclusion, our study shows that in acromegaly, by increasing the MCR of the hormone, and 2) by reducing the SR. The mechanisms by which bromocriptine increased MCR of the GH are also suggested on the basis of kinetic results; like dopamine, bromocriptine could induce a redistribution of blood flows to different organs, thus resulting in a net increase of blood flow to the liver and kidneys which are the major catabolic sites of GH.

Acromegaly↗
PubMedDate not supplied

Changes in insulin resistance with long-term insulin therapy.

Thirteen newly diagnosed diabetic subjects, 5 with insulin-dependent diabetes mellitus (IDDM) and 8 with non-insulin-dependent diabetes mellitus, mean age 37.1 yr (range 25-64 yr), underwent glucose-clamp studies at diagnosis of diabetes at plasma glucose 200 mg/dl. Each subject was then treated twice daily with insulin for 6 mo with improvement in glycemic control, and the glucose-clamp studies repeated. Changes in glucose uptake at an insulin infusion rate of 1.0 mU X kg-1 X min-1 varied greatly from diagnosis to 6 mo. There were significant negative correlations between change in glucose uptake and diabetes type (r = -.78, P less than .002), C-peptide secretion (r = -.66, P less than .05), and age (r = -.62, P less than .05). At an insulin infusion rate of 10 mU X kg-1 X min-1 there was improvement in glucose uptake from diagnosis to 6 mo that did not reach statistical significance. During the steady-state periods of the glucose-clamp studies at diagnosis, growth hormone (GH) rose above basal, which reached statistical significance at the higher insulin infusion rate. This increase in GH was not apparent at the time of the glucose-clamp studies after insulin therapy. Our results indicate that in the clinical situation, only patients with IDDM can expect an improvement in their sensitivity to physiologic insulin levels with long-term insulin therapy. In all subjects, improvement in glycemic control leads to abolition of GH secretion in the presence of hyperglycemia.

Adult↗
PubMedDate not supplied

Successful treatment of immune-mediated insulin resistance by human insulin (recombinant DNA).

An 82-yr-old woman with type II diabetes developed antibody-mediated insulin resistance while on mixed pork-beef insulin concomitantly with a non-Hodgkin lymphoma. Insulin resistance was initially treated with highly purified pork insulin, but this was unsuccessful. Treatment with human insulin (recombinant DNA) was associated with marked decrease of both insulin requirement and high-affinity antibodies, increase of free insulin levels, and improvement of diabetic control. This patient's case shows that human insulin can be considered as an alternative treatment for immune-mediated insulin resistance.

Aged↗
PubMedDate not supplied

The relationship of hand abnormalities to diabetes and diabetic retinopathy.

The hands of 299 diabetic patients with and 161 without retinopathy were examined for abnormalities. Almost all abnormalities were finger joint contractures resulting in limited joint mobility (LJM) and/or Dupuytren's contractures (DC). Both LJM and DC occurred not only in insulin-dependent diabetes (IDDM) but also in non-insulin-dependent diabetes (NIDDM). In retinopathy patients LJM and DC occurred in 48% and 36% of patients, respectively, compared with 24% and 16% in those without retinopathy. These differences were statistically significant (P less than 0.001). The higher prevalence of LJM in the retinopathy group affected mainly those with severe retinopathy, there being no difference between background and nonretinopathy patients. DC was less clearly related to severe retinopathy. LJM was more severe in those with than without retinopathy. LJM and DC were also related to age and duration of known diabetes. Subgroups matched for age and duration of known diabetes showed that the main relationship of hand abnormalities was to retinopathy in IDDM, but more to age and duration of known diabetes in NIDDM.

Adolescent↗
PubMedDate not supplied

Ovulatory patterns in women with juvenile and late-onset/persistent acne vulgaris.

The ovulatory patterns in women with acne vulgaris were evaluated in order to understand their relationship with androgenic levels. Ovulation disturbances were found in 58.3% of patients with prevalence of anovulation in the juvenile acne and of luteal insufficiency in the late-onset/persistent acne. Significant negative correlation was found between T free and P in the late-onset/persistent group (r: -0.629; p = 0.016): This may be interpreted as a rather steady endocrine status in which the raised androgenic levels, probably due to peripheral conversion, are concomitant to absent or insufficient ovulations. In the younger patients both the androgen excess and the ovulation disturbances could be due to an abnormal or delayed maturation of the hypothalamus-pituitary ovarian axis. The evaluation of the ovarian function in women with acne vulgaris may be useful to detect ovulatory disturbances in view of a possible resolution of both the problems by specific endocrine management.

Acne Vulgaris↗
PubMedDate not supplied

[Maternal-fetal transmission of infection with hepatitis B virus: evaluation of viral markers in maternal and fetal biological materials and relation with the vaccine response].

From July 1984 to September 1987, 981 women at third trimester of pregnancy were screened for HBsAg. 26 women were identified as being HBsAg carrier. The study of HBV markers and anti-HBV antibodies was conducted on these women and their offspring to evaluate the presence of intrauterine infection, and the newborns response to passive active immunization in relationship to their markers status during pregnancy. HBsAg, HBeAg, anti-HBe and anti-HBc were assayed on the plasma drawn form the mother, on the amniotic fluid drawn by transabdominal amniocentesis and on funicolar blood samples drawn immediately after delivery. IgM anti-HBc were assayed on amniotic and funicolar samples. HBsAg, anti-Hbc and anti-Hbe were present in 42.8%, 100% and 50% of amniotic samples; whereas the percentage of the same markers in funicolar samples were 50% for HBsAg and 100% for anti-HBc and anti-HBe. In no amniotic or funicolar samples were IgM anti-HBc antibodies present. Anti-HBs, anti-HBc and anti-HBe were assayed on the newborns at 2, 16, 12, 18 months to evaluate the response to immunization. Response to passive-active immunization was protective in all newborns independently from their antigenic status during intrauterine life. Anti-HBc antibodies were cleared within 18 months from delivery, while anti-HBs got a protective title within 6 months from delivery, persisting in 88.8% of cases at 18 months.(ABSTRACT TRUNCATED AT 250 WORDS)

Carrier State↗
PubMedDate not supplied

Reproductive performance in women with uterus didelphys.

The reproductive history of 19 women with the diagnosis of uterus didelphys is reported. With this goal the patients were divided into two groups: A) composed of 15 patients who did not undergo any surgical correction of uterine anomaly; B) composed of 4 patients where metroplasty was performed. Diagnosis was made in 17 cases (85.9%) for reasons not related to the uterine anomaly, only in 2 cases did patients present with infertility complaints. Vaginal malformation was associated in 16 (85%) cases; in 11 cases longitudinal septum was present; whereas in 5 hemivagina atretica was found. Eleven group A patients had a total of 23 pregnancies of which 3 (13%) ended in spontaneous abortions, 2 (8.7%) were voluntarily interrupted, 3 ended in premature birth and 15 in term births, with 17 live babies for a live birth rate of 74%. If we consider that two pregnancies were voluntarily interrupted, we had 17 live babies out of 21 naturally evolved pregnancies, for a live birth rate of 81%. In group B 3 patients before treatment had 3 pregnancies all ending in spontaneous abortion. After treatment all had a live baby. Reproductive and gestational performances of women with uterus didelphys are preserved. In patients with infertility complaints, all associated causes must be ruled out before surgical correction. If these are present its correction must be attempted as first therapeutic step, and term pregnancy with live baby is the rule. Only if repeated abortions are not related to any other cause, can metroplasty, according to Bret-Palmer technique, be performed.

Abortion, Spontaneous↗
PubMedDate not supplied

Hysteroscopic treatment of uterine septum.

Authors report their 4 years experience in the treatment of uterine septum by hysteroscopic metroplasty. 35 patients underwent procedure; no complications occurred. Postoperative reproductive outcome was evaluated in 29 women with follow-up longer than 6 months. Patients were divided into 2 groups according to presence or absence of associated factors compromising fertility. Group A composed of 19 women in which uterine septum was the only cause of pregnancy wastage. Preoperatively they had 40 pregnancies all ending in spontaneous abortion. Postoperatively 15 (79%) patients conceived and 13 (68%) had a live baby. Totally they had 18 pregnancies, 2 (12%) ended in abortion, 1 in molar pregnancy, 1 in premature delivery, 11 delivered at term and 3 are currently beyond 20 weeks pregnant, for a live birth rate of 78%. Life table analysis showed an estimated pregnancy rate of 82% at 12 months, monthly fecundability was 0.13. Group B composed of 10 women in which other factors compromising fertility were present. Preoperatively only 5 experienced pregnancy. Totally they had 8 pregnancies 7 (86%) of which ended in abortions and one in extrauterine pregnancy. Postoperatively only 3 (30%) had pregnancy and all had a live baby. Totally they had 4 pregnancies, 1 ended in abortion and 3 at term for a live birth rate of 75%. Life table analysis showed an estimated pregnancy rate of 11% at 12 months, monthly fecundability rate was 0.01. Hysteroscopic metroplasty proved to be safe and effective for solving pregnancy wastage caused by uterine septum. If other factors compromising fertility were present metroplasty did not increase fecundability, but improved live birth rate.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Habitual↗
PubMedDate not supplied

Reproductive impairment of women with unicornuate uterus.

The reproductive history of 18 women with a diagnosis of unicornuate uterus is reported. The study was conducted with retrospective analysis, and 7 patients with primary infertility were followed up for 1 to 6 years. Four patients had a cavitary noncommunicating horn, 12 a noncavitary rudimentary horn, and 2 no rudimentary horn. The cause of diagnosis was: primary infertility in 7 cases (39%), recurrent abortion in 6 (33%), obstetric complications in 5 (28%). Out of 7 patients that presented with primary infertility in 5 cases an associated reason was present. Twelve women had a total of 38 pregnancies, 21 (55%) ended in abortion, 3 in premature labour, 14 in term births, with a live birth rate of 39%. Of the 17 births 9 (53%) were in breech and 1 (1.6%), in transverse presentations and 11 (65%) were cesarean sections. Cervical cerclage, based on clinical or radiological indications, has been performed in 4 out 6 cases with recurrent abortion with improvement of reproductive performance in 3. Fetal survival rate passed from 0 to 83%. Reproductive impairment seems to depend equally on the difficulty in conceiving and on the reduced ability to carry a pregnancy to term.

Abortion, Habitual↗
PubMedDate not supplied

Ovarian function after therapy for Hodgkin's disease.

Ovarian function has been evaluated in 10 women in fertile age, free of disease, who underwent therapy for Hodgkin's disease. Women were divided into groups according to their age at the time of the diagnosis and therapy used. In the group of 6 women treated with chemotherapy alone or associated with sovradiaphragmatic roentgentherapy, 4 (66%) are regularly menstruating and 2 (33%) have become amenorrheic; while among the 4 women treated with TNI or inverted Y, 3 (75%) have become amenorrheic and 1 (25%) is regularly menstruating. 7 women were younger than 30 at the time of the diagnosis: 5 (72%) are regularly menstruating and 2 (28%) have become amenorrheic; while in the group older than 30 at the time of the diagnosis all 3 (100%) have become amenorrheic. These results show that, at present, it is not possible to predict the preservation or the renewal of the ovarian function after therapy for Hodgkin's disease; only taking in account all elements such as age, ovarian function prior to therapy and kind of treatment is it possible to propose a prognostic hypothesis.

Adult↗
PubMedDate not supplied

Reproductive performance in women with bicornuate uterus.

The medical records of 21 patients with bicornuate uterus were analyzed. Thirteen patients did not undergo corrective surgery, whereas eight underwent metroplasty. The pregnancies in patients who did not undergo surgery, and the outcome evaluated. The outcome of pregnancies after corrective surgery was also analyzed. The cumulative pregnancy rates at 12 and 24 months were 67% and 95% in patients without surgical correction and 63% and 88% in patients after surgical correction. The probability of giving birth to a live-born infant with no corrective surgery was 30%, 58% and 79% for the first, second and third pregnancy respectively; the probability of giving birth to a live-born infant after corrective surgery was 71% for the first and 86% for the second pregnancy. Fertility is not impaired in patients with bicornuate uterus, but gestational capacity is. A prognostic estimate of the likelihood of giving birth to a live-born infant can be formulated according to the number of pregnancies and/or surgical correction.

Adult↗