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Biomedical subjects

G Amabile

Publications and source records attributed to G Amabile.

At least 19 recordsLinked to original sources

Novel mutations of thyrotropin receptor gene in thyroid hyperfunctioning adenomas. Rapid identification by fine needle aspiration biopsy.

Hyperfunctioning thyroid adenomas are clonal neoplasms with the intrinsic capacity of growing and differentiate independently of thyroid-stimulating hormone (TSH). We analysed the mRNA encoding thyrotropin receptor of 11 adenomas obtained by fine needle aspiration biopsy (FNAB) and found 7 mutants all located in three aminoacids clustered in the sixth transmembrane domain of the receptor. These mutations were somatic and specifically present in the tumour tissue. DNA sequence revealed that 80 to 90% of the mutations can be rapidly screened and identified by restriction enzyme analysis of the amplified cDNA obtained from the FNABs. The mutation Thr->Ile was introduced in the wild type receptor and expressed in mouse fibroblasts. These cells constitutively activate the transcription of a reporter gene under the control of cyclic AMP responsive element.

Adenoma

[Evaluation of amlodipine in stable effort angina in office cardiologic practice].

A multicentre trial was undertaken in order to evaluate the therapeutic efficacy and ease of use of amlopidine in 1890 patients with stable effort angina. Involving prescribing conditions close to those of everyday practice, it revealed an improvement in angina symptomatology with one daily dose of amlopidine. After one month's treatment, 49.8% of patients were able to reduce or stop their use of fast-acting nitrites. After three months' treatment with amlopidine, 51% of patients had become asymptomatic. This study also revealed a decrease in the duration and severity of angina attacks. Safety/acceptability of amlopidine, assessed by clinical and laboratory parameters, was good, adverse events (22.7%), most often benign, improving or disappearing in more than half of all cases.

Adult

[Left ventricular hypertrophy in hypertensive patients].

Left ventricular hypertrophy associated with hypertension is characterised by an increase in ventricular mass, secondary to hypertrophy of myocardial cells and to the development of collagen tissue and capillaries. Easily detectable by electrocardiography, it occurs in 30 to 60% of hypertension patients, in a concentric form with symmetric or asymmetric thickening of the walls, or in an eccentric form with dilatation of the ventricular cavity. It impairs the functional properties of the myocardium, first affecting diastolic function then, later, systolic function. It interferes with the coronary circulation, with a decrease in coronary reserves and hypoperfusion of subendocardial layers. It predisposes to the onset of ventricular and supraventricular arrhythmias. It is a major and independent risk factor, severely marring the prognosis of hypertension sufferers.

Animals

Indapamide reduces hypertensive left ventricular hypertrophy: an international multicenter study.

The effect of 6 months of treatment with indapamide (IND, 2.5 mg/day) on regression of left ventricular hypertrophy (LVH), an independent predictor of poor prognosis in hypertension, was compared by echocardiography to that of nifedipine (NFD, 40 mg/day), enalapril (ENL, 20 mg/day), atenolol (ATL, 100 mg/day), and hydrochlorothiazide (HCTZ, 25 mg/day) in four parallel double-blind studies in 151 hypertensive patients with a diastolic blood pressure between 95 and 120 mm Hg and a raised left ventricular mass index (LVMI) (mg/m2) (Devereux). Patients were randomized to IND or comparator following a 2-week washout (1 month in the IND vs. ATL study). Respective baseline and 6-month LVMI values (mg/m2) were: IND (n = 20) vs. HCTZ (n = 20): 151.4 +/- 6.3 and 125.70 +/- 4.6 (p < 0.001) vs. 141.3 +/- 6.6 and 135.6 +/- 8.3 (p = N.S.); IND (n = 22) vs NFD (n = 19): 144.1 +/- 5.3 and 125.1 +/- 4.3 (p < 0.001) vs. 170.4 +/- 6.6 and 148.2 +/- 6.2 (p < 0.001); IND (n = 9) vs. ENL (n = 9): 155.1 +/- 6.3 and 143.4 +/- 5.2 (p < 0.001) vs. 142.0 +/- 6.7 and 130.0 +/- 5.9 (p < 0.001); IND (n = 17) vs. ATL (n = 12): 146.2 +/- 5.1 and 130.8 +/- 6.5 (p < 0.001) vs. 156.7 +/- 8.4 and 142.9 +/- 10.3 (p < 0.01). All drugs significantly reduced diastolic blood pressure, and all except HCTZ induced a significant and similar reduction in left ventricular mass.

Adult

[Italian Study on Atrial Fibrillation (SIFA): status report].

Non-valvular atrial fibrillation increases the risk of stroke by a factor of 5 and is present in about 15% of patients with acute stroke. Its prevalence in the general population increases from 0.5% at 50-59 years to > 10% at 80-99 years. In patients with non-valvular atrial fibrillation the risk of stroke increases with age, blood pressure and other evidence of cardiac disease. In addition, non-valvular atrial fibrillation is associated with a greater early mortality and a greater risk of recurrent stroke. The anticoagulant therapy to prevent early recurrent embolism is likewise controversial. Anticoagulant therapy appears to reduce this risk, but there is the danger of accentuating hemorrhagic infarction, especially in patients with large strokes. The effectiveness of antiplatelet drugs in patients with cardioembolic stroke is also not defined. The Studio Italiano Fibrillazione Atriale (SIFA) is a multicentric, randomized trial to assess the efficacy and safety of anticoagulant, warfarin, versus antiplatelet treatment, indobufen, a reversible inhibitor of platelet cyclo-oxygenase, in the prevention of recurrent cerebral ischemia and other systemic embolisms in non-valvular atrial fibrillation patients. Patients of both sexes, aged > 30 years with non-valvular atrial fibrillation, who have presented in the last 2 weeks an ischemic cerebral event (transitory ischemic attack or non-disabling stroke) and who have given their informed consent, were eligible. Patients with hemorrhagical diseases or contraindications to anticoagulant therapy were excluded. Patients were randomly given either indobufen (400 mg/die) or oral warfarin to an international normalized ratio of 2.0-3.5. The primary end-points were: recurrence of cerebral ischemia, systemic embolisms, intracranial or fatal hemorrhage, acute myocardial infarction, vascular death.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Association of "top of the basilar" syndrome with megadolichobasilar artery. Clinical and neuroimaging evaluation.

We describe the case of a patient with a history of trigeminal neuralgia who suddenly developed the "top of the basilar" syndrome. MRI disclosed ischemic lesions in the left paramedian mesencephalic tectum, in the left ventral thalamus, in the left occipital lobe and a megadolichobasilar artery (MDBA). The association of MDBA with the top of the basilar syndrome is rarely reported. We discuss the possible hemodynamic mechanism producing a top of the basilar syndrome in the presence of MDBA.

Aged

Dopaminergic pharmacological manipulations in normal humans confirm the specificity of the visual (PERG-VEP) and cognitive (P300) electrophysiological alterations in Parkinson's disease.

Retinal and occipital visual evoked potentials and event-related potentials (P300) have been recorded in normal human subjects before and after the administration of the dopaminergic receptor antagonist, haloperidol, and/or the dopaminergic precursor L-DOPA. The data show that either retinal or occipital visual potentials and P300 are delayed by haloperidol. These findings are consistent with the hypothesis that haloperidol in healthy subjects mimicks the electrophysiological abnormalities observed in Parkinson's disease. On the other hand, L-DOPA does not generally modify these latencies in normals, while it is known to decrease the same parameters in parkinsonian patients. This is in accord with the involvement of a specific mechanism in the recovery observed in parkinsonian patients after L-DOPA therapy. Our data confirm that the alterations of visual and cognitive potentials observed in Parkinson's disease are closely related to the impairment of dopaminergic transmission.

Acoustic Stimulation

On a case of early-onset post-traumatic facial hemispasm.

In a 49 year old woman an injury to the right frontotemporal region was quickly followed first by paresis and then by spasm of the right side of the face. The early onset of the spasm prompts a critical review of current views on the pathogenesis of facial spasm.

Brain Concussion

Nasal polyposis in cystic fibrosis treated by beclomethasone dipropionate.

Nasal polyposis appears frequently in C. F. patients. Our study intends to evaluate the efficacy of topical beclomethasone dipropionate (BMD) when administered in a position designed to increase exposure of nasal and paranasal sinuses mucosa to the drug. 14 patients were analysed: the size of the polyps was assessed by rhinoscopy and rhinomanometry at the beginning and at the end of the therapy. Our findings show that nasal polyps can be successfully treated medically in a significant number of C. F. patients.

Administration, Intranasal

[Late potentials in patients with hypertension].

UNLABELLED: The presence of late potentials (LP) is considered as the evidence of an anatomical and electrophysiological condition which can give rise to life threatening ventricular arrhythmias. The aim of this work has been to study the incidence of LP in the setting of hypertension and to study their relation to ventricular hypertrophy on one hand and to ventricular arrhythmias on the other. Our study was conducted in 45 hypertensive patients (mean age +/- SD = 53 +/- 12). None of them had clinical evidences of a coronaropathy and only 5 had never been treated. For every patient we carried out a signal averaged electrocardiogram to detect LP, an echocardiogram to determine the myocardial mass index and 48 hours Holter monitoring to record ventricular arrhythmias filed according to the Lown classification. RESULTS: LP have been found in 13 patients. The following table summaries relations between LP, ventricular arrhythmias and myocardial hypertrophy: [table: see text] CONCLUSION: LP are frequently found in hypertensive patients (29%); their incidence is not higher in patients with left ventricular hypertrophy although they more frequently have serious ventricular arrhythmias; the severity of ventricular arrhythmias is not correlated with the presence of LP.

Adult

Thyrotropin-releasing hormone enhances event-related brain potentials and growth hormone release in man.

Changes in contingent negative variation (CNV), a brain-evoked potential related in arousal, as well as in serum triiodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH), prolactin (PRL), cortisol and growth hormone (GH) levels were recorded in 12 male volunteers receiving either thyrotropin-releasing hormone (TRH) or saline infusion. Only during TRH administration an increase in CNV (P less than 0.02) and, 30 min later, in GH (P less than 0.05) occurred; thyroid hormones and PRL increased as well, in the absence of any correlation with CNV areas. Cortisol was not affected by TRH. As dopamine (DA) agonistic drugs notoriously increase both CNV areas and GH levels and experimental evidence for prodopaminergic properties of TRH has accumulated in animal models, a possible explanation of the results here presented might be the activation of DA pathways by TRH also in the human.

Adult

Comparison of bisoprolol with nifedipine for treatment of essential hypertension in the elderly: comparative double-blind trial.

Beta blockers are often considered to be less effective for blood pressure control in elderly patients with essential hypertension than calcium antagonists. We therefore compared the efficacy and tolerability of the new beta blocker bisoprolol with those of nifedipine. Fifty-nine patients over 60 years of age with essential hypertension (supine diastolic blood pressure, DBP: 95-115 mmHg) took part in a randomized double-blind study. After 14 days on placebo the patients received either 10 mg bisoprolol o.d. or 20 mg nifedipine SR b.i.d. for 4 weeks. The doses were doubled in patients whose DBP remained greater than 90 mmHg, for a further 4 week period. Blood pressure was measured about 24 hours after bisoprolol and about 12 hours after nifedipine administration. Fifty-six patients were available for efficacy analysis. After 4 weeks there was a distinct decrease of SBP and DBP in both groups (bisoprolol: -22 +/- 16; -15 +/- 9 mmHg; nifedipine: -24 +/- 17; -17 +/- 7 mmHg) with no significant difference between the treatments. DBP was normalized in 22/28 (79%) patients on bisoprolol and in 24/28 (86%) patients on nifedipine (bisoprolol vs nifedipine: NS). There were 7/29 bisoprolol and 14/30 nifedipine patients who experienced at least one side-effect. Overall the tolerability of bisoprolol was considered to be better than that of nifedipine (P = 0.043). In conclusion, bisoprolol 10-20 mg o.d. proved to be as equally effective as nifedipine SR 20-40 mg b.i.d. for the treatment of essential hypertension in the elderly.

Aged

Event-related potentials as a tool in the evaluation of cognitive functions in young subjects through the execution of a simple task.

Event-related potentials (ERPs) were recorded in 20 student volunteers. Three recordings were performed using aural stimuli of 4,000 (rare tones) and 250 Hz. In the target recording subjects were asked to count the rare tones. Endogenous and exogenous components of ERP recordings were analyzed. During the target recording N2 and P3 components were observed at 200 ms and approximately 300 ms, respectively, in addition to N1 (100 ms) and P2 (180 ms). The N2 and P3 waves are indicative of analysis at a higher cognitive level and have been termed the 'response set'. The P3 wave appeared to be stable in all subjects and may represent a useful electrophysiological method to explore mnemonic and cognitive functions in man.

Adolescent