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Biomedical subjects

F Rota

Publications and source records attributed to F Rota.

12 recordsLinked to original sources

Growth hormone status in morbidly obese subjects and correlation with body composition.

Morbidly obese subjects are characterized by multiple endocrine abnormalities and these are paralleled by unfavorable changes in body composition. In obese individuals, either 24-h spontaneous or stimulated GH secretion is impaired without an organic pituitary disease and the severity of the secretory defect is proportional to the degree of obesity. The GHRH+arginine (GHRH+ARG) test is likely to be the overall test of choice in clinical practice to differentiate GH deficiency (GHD) patients. Similarly to other provocative tests, GHRH+ARG is influenced by obesity per se. Therefore, a new cut-off limit of peak GH response of 4.2 microg/l in obese subjects has been recently assumed. The aim of the present study was to investigate the reciprocal influence between decreased GH secretion and body composition in a group of 110 morbidly obese subjects, using the new cut-off limit of peak GH response to GHRH+ARG test for these subjects. In our study, GHD was identified in 27.3% of the obese subjects, without gender difference. In GDH obese subjects body mass index (BMI), waist circumference, waist-to-hip ratio (WHR), fat mass (FM), and resistance (R) were higher while reactance (Xc), phase angle, body cell mass (BCM), IGF-I, or IGF-I z-scores were lower than in normal responders (p<0.001). In all obese subjects, GH peak levels showed a negative correlation with age, BMI, waist circumference and FM, and a positive correlation with IGF-I. In the stepwise multiple linear regression, waist circumference and FM were the major determinants of GH peak levels and IGF-I. In conclusion, using the new cut-off limit of peak GH response to GHRH+ARG test for obese subjects, about 1/3 morbidly obese subjects were GHD. GHD subjects showed a significantly different body composition compared with normal responders, and the secretory defect was correlated to different anthropometric variables with waist circumference and FM as the major determinants.

Adipose Tissue↗

Circulating insulin-like growth factor-I levels are correlated with the atherosclerotic profile in healthy subjects independently of age.

To investigate the relationships between the GH-IGF-I axis and the atherosclerotic profile, we designed this open, observational, prospective study. Peak GH after GHRH+arginine (ARG) test, serum IGF-I and IGF binding protein-3 (IGFBP-3), lipid profile, homeostasis model assessment (HOMA) index and intima-media thickness (IMT) at common carotid arteries were measured in 174 healthy individuals (92 women, 82 men, aged 18-80 yr). Exclusion criteria for this study were: 1) body mass index (BMI) > or = 30 kg/m2; 2) personal history of cardiovascular diseases; 3) previous or current treatments of diabetes or hypertension; 4) previous corticosteroids treatment for longer than 2 weeks or estrogens for longer than 3 months; 5) smoking of more than 15 cigarettes/day and alcohol abuse. Subjects were divided according to age in decade groups from < 20 to > 70 yr. BMI increased with age, as did systolic and diastolic blood pressures, although they remained in the normal range. The GH peak after GHRH+ARG test was significantly higher in the subjects aged < 20 yr than in all the other groups (p < 0.01), but was similar in the remaining groups. An inverse correlation was found between the IGF-I z-score and total/HDL-cholesterol ratio (p = 0.02) and mean IMT (p = 0.0009); IGFBP-3 z-score and mean IMT (p = 0.043); IGF: IGFBP-3 molar ratio and total/HDL-cholesterol ratio (p < 0.0001) and mean IMT (p < 0.0001). Atherosclerotic plaques were found in 7 out of 12 subjects (53.8%) with a z-IGF-I score from < or = -2 to -1, in 4 out of 63 (6.3%) with a z-IGF-I score from -0.99 to 0.1 out of 66 (1.5%) with a z-IGF-I score from 0.1 to 1 and none of the 33 subjects with an IGF-I z-score >1 (p = 0.006). At multi-step regression analysis, age was the best predictor of HDL-cholesterol levels and mean IMT, IGF-I level was the best predictor of total cholesterol and total/HDL-cholesterol ratio, the IGF-I/IGFBP-3 molar ratio was the best predictor of triglycerides levels. The z-scores of IGF-I and IGFBP-3 were the second best predictors of mean IMT after age. In conclusion, IGF-I and IGFBP-3 were negatively correlated with common cardiovascular risk factors, studied as total/HDL-cholesterol ratio, and/or early atherosclerosis, studied as IMT at common carotid arteries. The prevalence of atherosclerotic plaques, though not hemodinamically significant, was higher in the subjects having a z-score of IGF-I of < or = -2 to -1. Our results support a role of the IGF/IGFBP-3 axis in the pathogenesis of atherosclerosis.

Adolescent↗

A structure-activity study for the inhibition of metalloproteinase-9 activity and gene expression by analogues of gallocatechin-3-gallate.

Catechins are able to modulate the gelatinolytic activity of matrix metalloproteinase-9 (MMP-9) by reducing its release from macrophages. Gallocatechins decrease MMP-9 secretion by lowering MMP-9 promoter activity and mRNA levels. The effect appears to be dependent on some structural and stereochemical requirements. In this study, the relationship between chemical structure and activity was studied by testing the effect of analogues of (+/-)-gallocatechin-3-gallate (+/-)-GCG, selectively deprived of hydroxyl groups, on MMP-9 activity, transcription, and secretion. Our results indicate that (+/-)-GCG and (+/-)-catechin-3-gallate are characterized by a substitution pattern compatible with direct inhibition of MMP-9 activity. Conversely, when transcription was the target, (+/-)-trans-3-flavanol-3-benzoate, lacking all the hydroxyl groups, was the most effective both in lowering MMP-9 promoter activity and consequently protein secretion, and in inhibiting nuclear-factor-kappaB-driven transcription. Our results suggest that the structural requirements for enzyme inhibition are different from those necessary for targeting gene expression.

Animals↗

Associated hormonal decline in aging: is there a role for GH therapy in aging men?

Aging is associated with decline in the somatotroph axis, a decline that has been considered to cause many of the catabolic sequelae of normal aging. Consequently, IGF-I levels decline progressively: this mainly reflects the impaired GH secretion, but decline in gonadal sex steroids and malnutrition also play a role. Decreases in GH secretion may partially explain the age-related changes in metabolism, bones, muscles, cardiovascular system, central nervous system, the immune system and sense of well-being. Normal aging and GH deficiency (GHD) share several clinical signs and symptoms: the endocrine pattern of aging is, however, distinct from the decrease of GH and/or IGF-I levels associated with hypopituitarism. Owing to clinical similarities between aging and GHD, the relative GH insufficiency of elderly subjects has been postulated as one important factor contributing to their frailty. However, it is currently unclear whether treatment with exogenous GH, or IGF-I can retard or reverse age-related changes in body structure and function. Several studies enrolling healthy elderly subjects showed that GH treatment was followed by increase of lean mass, decrease of fat mass and improvement of bone turnover, but other studies failed to confirm these data. The treatment with natural or synthetic GH secretagogues, that could represent a physiological approach to restore the GH and IGF-I secretion, requires further investigations. In conclusion, there is not sufficient evidence for a clear therapeutic role of rhGH, IGF-I, and secretagogues in aging. Further studies are needed to evaluate the real benefit of somatotropic treatment in aging men.

Aged↗

Somatopause: dismetabolic and bone effects.

The physiological changes that the human body undergoes during aging are similar to those observed in GH deficiency (GHD). Early changes of aging are represented by increased fat mass, increased cardiovascular risk, reduced muscle mass and strength, reduced exercise tolerance, thinned skin, decreased strength and impaired quality of life. These observations led to hypothesize that the elderly could be GH deficient and would benefit from GH treatment. However, the effects of GH treatment in healthy elderly subjects by randomized and controlled studies are less promising than initially hypothesized. The etiopathology of age-related bone loss is multifactorial including menopause, andropause, somatopause and secondary hyperparathyroidism. GH has multiple effects on bone, either direct or mediated by IGF-I, stimulating osteoblast proliferation as well as osteoclast differentiation. Consequently, decline in GH secretion reduces bone turnover that causes osteopenia in young adults, but it has been hypothesized that it could protect against fractures in elderly subjects. The increase of bone remodeling achieved by GH therapy may be helpful in elderly men and women who have severely decreased bone turnover and impaired osteoblastic function. In conclusion, the endocrine pattern of aging is distinct from the decrease of GH/IGF-I levels associated with hypopituitarism. However, GH plays a role in metabolism and bone physiology throughout the human life span, although there is insufficient evidence for a clear therapeutic role of rhGH in aging. Thus, more data are needed to define the effects of somatopause to identify who could potentially benefit from the effects of somatotropic treatment.

Adult↗

An evaluation of patients with hyperprolactinemia: have dynamic tests had their day?

Except for a few particular conditions, the diagnostic evaluation of hyperprolactinemia is easy since the routine use of magnetic resonance imaging (MRI) scan has permitted to identify even small microadenomas. Other conditions include the identification of large PRL molecular complex, dimers, trimers or polymers of PRL, called "big or big-big PRL", and of PRL autoantibodies and the biochemical finding of "high dose PRL hook effect". Finding elevated serum PRL levels should be considered as the beginning and not the conclusion of a diagnostic evaluation: first, a careful anamnesis should exclude possible physiologic, pharmacologic and organic causes of hyperprolactinemia; second, possibly one laboratory only, undergoing regularly quality controls, should analyze blood samples; serial serum PRL measurements at 0, 30, 60 min is a valuable and simple measure to identify stress-related hyperprolactinemia. In the past two decades several pharmacological tests were used in order to distinguish between small microprolactinomas and "non-tumoral hyperprolactinemia": the controversial results of these tests together with the availability of MRI has excluded all pharmacological tests in the work-up of hyperprolactinemia. MRI is preferred to computed tomography (CT) due to its better definition of very small lesions in the pituitary sella and better anatomical definition prior to surgery. Finally, once the diagnosis of prolactinoma is suspected, patients should be referred to a specialist centre for further assessment and treatment.

Decision Trees↗

Amniotic fluid nitric oxide metabolite levels and nitric oxide synthase localization in feto-placental tissues are modified in association with human labor.

Nitric oxide (NO) has a relaxant effect on uterine smooth muscle and may be implicated in maintaining uterine quiescence during pregnancy. In order to investigate the role of nitric oxide in human parturition, we have measured NO metabolite levels in maternal and fetal compartments in association with labor, both at term and preterm. We have also examined the localization and distribution of NO synthase (NOS) isoforms in placentas and fetal membranes after term and preterm delivery by means of immunohistochemistry. Although no differences were present in maternal and fetal blood and in maternal urine among groups, we found that NO metabolite concentrations were higher in amniotic fluid collected from women in labor than in non-laboring patients, both at term (15.4+/-1.6 vs. 6.8+/-0.6 microM/mg creatinine) and preterm (16.7+/-2.0 vs. 7.0+/-0.8 microM/mg creatinine). Ir-bNOS staining appeared to be decreased in fetal membranes collected after spontaneous labor at term and preterm. In contrast, a stronger staining for iNOS was detected in trophoblast cells of fetal membranes from women in labor than in those from non-laboring women. We suggest that NOS isoenzymes in fetal placental tissues are differently regulated and might play different roles during pregnancy.

Adult↗

Correlation between cervical intraepithelial neoplasia and human papillomavirus male infections: a longitudinal study.

BACKGROUND: Genital HPV infection is one of the most common sexually-transmitted diseases. The aim of the study was to evaluate the correlation between HPV-associated lesions in male partners of women affected by CIN. METHODS: 210 male partners of women affected by CIN were examined in a long-term follow-up (from 5 to 13 years). The diagnosis in females was performed by cytology, colposcopy and histology. Male partners were submitted to clinical examination, peniscopy and biopsy. RESULTS: 111/210 (53%) females had CIN I, 53/210 (25%) and 46/210 (22%) had CIN III. Subclinical lesions were associated with 18%, 28% and 24% of male partners of women with CIN I, CIN II and CIN III, respectively. Clinical lesions were observed in 7% and 10% of sexual partners of women with CIN I and CIN II, respectively. Mixed lesions affected only 3% of sexual partners of women with CIN I. CONCLUSIONS: Our data show that the transmissibility of HPV infection to the male partners of women affected by CIN was easier when there was a lower grade of CIN. In fact, male partners of women with CIN III had a lower percentage (26%) of clinical or subclinical HPV skin lesions.

Female↗

[An uncommon complication: cryptorchidism in an adult].

This unusual pathology has not been described in the medical literature of the last ten years. A 39-year-old patient, affected by unilateral cryptorchidism, on the right side, and congenital inguinal hernia, reached the operating theatre suffering from occlusive intestinal syndrome, due to a clogged hernial sac. This clog was caused by a retracting testicle which in turn stopped the ileal ansa from slipping back in to the peritoneum. Through this case we can underline the excursus of such pathology, which isn't very frequent in the adult but can, nevertheless create a fairly serious pathology, often leading to neoplan.

Adult↗

[Videolaparoscopic oncologic surgery of the right colon: our experience].

The authors present their experience in videolaparoscopic surgery for right colon cancer after two years of videolaparoscopic surgery for approach to colorectal cancer. In the period between March 2002 and March 2003 they have practiced 11 right emicolectomy by videolaparoscopic technique for neoplasms: 7 were males and 4 were females with age of about 70 years old. These case included: 7 right colon's cancers, 2 cecal cancers and two hepatic flexure cancers. One postoperative complications has been observed (9%) for bowel's occlusion for early adhesion syndrome. On the base of their experience the authors perform usually videolaparoscopic surgery (M.I.S.) for the approach to right colon cancer.

Aged↗

[Videolaparoscopic oncologic surgery of the left and right colon: our experience].

The authors present their experience in videolaparoscopic surgery for colorectal cancer. In the period between November 2000 and march 2003 they have treated 31 patients by videolaparoscopic surgery for colorectal cancer: 17 were males and 14 were females with age included between 41 and 93 y.o. These case included: 15 rectal cancers, 12 sigmoid cancer, 3 cases of lineal flexura's cancers and I case of transverse cancer. Postoperative complications has been observed in three cases (9.6%) in the first 14 operations practiced, then confirming the learning curve. The authors perform usually mini-invasive surgery (MIS) for the approach to colorectal cancer surgery.

Aged↗