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Biomedical subjects

G Natali

Publications and source records attributed to G Natali.

At least 37 records · Page 2Linked to original sources

Atrial natriuretic peptide-renin-aldosterone system in cirrhosis of the liver: circadian study.

Plasma levels of immunoreactive atrial natriuretic peptide (ANP), plasma renin activity (PRA), and plasma aldosterone (PA) were measured for an entire day at 6:00 am, 8:00 am, 12:00 pm, 6:00 pm, 8:00 pm, and 12:00 am in 6 healthy subjects, in 10 patients with compensated cirrhosis of the liver, and in 10 cirrhotics with ascites. The subjects, after synchronized standard life conditions lasting for 6 days were held in a clinostatic position during the study. The data were analyzed by the "cosinor" method. The results show significant circadian rhythms for the three biological variables in healthy subjects. In the compensated cirrhotic group, a circadian rhythm was detected only for PA. No rhythm was demonstrated in the ascitic patients. These data suggest that in cirrhosis of the liver, great variations in secretion rhythmicity for PRA and ANP are present, while maintaining the intrinsic PA rhythmicity, which is lost in patients with ascites. This progressive derangement in PA circadian rhythm in the ANP-PRA-PA system can be considered as an index of evolution in the natural history of cirrhosis of the liver.

Adult↗

[Circadian rhythm of atrial natriuretic peptide, plasma renin and aldosterone activity in healthy subjects and in patients with compensated liver cirrhosis].

The circadian variations in atrial natriuretic peptide (ANP), plasma renin activity (PRA) and plasma aldosterone (PA) have been investigated in a group of 6 patients with compensated cirrhosis of the liver compared with a group of 6 healthy subjects. All studied subjects were kept for a week on standardized life conditions, with a defined daily intake of 120 mEq of sodium and 60 mEq of potassium. Venous blood samples were collected during a whole day at 6, 8, 12, 18, 20 and 24 hours, with the subjects resting in the clinostatic position during the study. Plasma levels of ANP, PRA and PA were determined by radioimmunoassay. The data were analyzed by the cosinor method. The results show that healthy subjects present a significant circadian rhythm for the three biological variables, while patients with cirrhosis of the liver present a significant rhythm for PA only. Acrophase and amplitude of PA do not present any difference between control and patient groups. The levels of PRA and ANP are significantly higher in the cirrhotic patients. These data suggest in cirrhosis a deep variation in the secreting rhythm of PRA and ANP with maintenance, even at higher levels, of intrinsic PA rhythm. This is a possible index of time-related alterations of water-electrolyte balance and cardiovascular processes in liver cirrhosis.

Adult↗

[Prognostic factors in multiple myeloma. Selection using multivariate analysis].

In order to assess the prognostic value of 15 different prognostic variables for multiple myeloma and to select the variables with the best prognostic significance, the multivariate analysis according to Cox's proportional hazard regression model was employed for a group of 80 patients followed from first diagnosis to their demise. The significant prognostic variables were bone marrow plasma cell percentage, degree of lytic bone lesions, Bence-Jones proteinuria, and haemoglobinaemia. A scoring clinical staging system was also developed, assigning the score of 1 to each of the following features: bone marrow plasma cells more than 30%, lytic bone lesions of 2-3 degrees, presence of Bence-Jones proteinuria, and haemoglobinaemia less than 110 g/l. Therefore, the score for each patient ranges from 0 to 4, and the entire group of patients with multiple myeloma is subdivided into five clinical stages: stage I = score 0, stage II = score 1, stage III = score 2; stage IV = score 3, stage V = score 4. Significant differences exist between both mean survivals (p less than 0.01), and between the survival curves (p less than 0.0001) within the five scoring clinical stages.

Adult↗

[Endocrine changes of the liver in the cirrhotic alcoholic: analysis of circadian rhythms of anteriopituitary, adrenocortical, and gonadal hormones].

Circadian rhythms of anteropituitary (ACTH, HGH, TSH, FSH, LH, PRL), adrenocortical (cortisol, aldosterone, DHEA-S), and gonadal (testosterone, 17 beta-estradiol, progesterone) hormones were investigated in a group of male patients with alcoholic cirrhosis of the liver, compared with group of male clinically healthy subjects. Each group consisted of six subjects. After a period of ten days of synchronized life conditions, venous blood samples were drawn every four hours during a whole day, the subjects resting in constant supine position. The plasma hormonal levels were determined by radioimmunoassay method. The results, analyzed by "cosinor" method, show a significant (p less than 0.05) circadian rhythm only for cortisol, aldosterone, and DHEA-S in the cirrhotic patients, while the control group exhibits a statistically significant (p less than 0.05) circadian rhythm for all hormones, except for 17 beta-estradiol. These data support the evidence of serious abnormalities in the biological time structure of anteropituitary and gonadal hormones in alcoholic cirrhosis of the liver, while the adrenalcortex seems to maintain its own intrinsic circadian rhythmicity. On the basis of these results, the authors discuss the main mechanisms of the chronobiological hormonal abnormalities in alcoholic cirrhosis of the liver. Further investigations in this area may provide new insights into hormonal mechanism responsible for the endocrine abnormalities in the alcoholic cirrhosis of the liver.

Adrenal Cortex Hormones↗

[Circadian rhythm in the incidence of sudden cardiac death].

Human mortality demonstrates a maximum incidence in the early morning, with a reduction in the late afternoon. In order to determine whether sudden cardiac death presents a circadian rhythm similar to that of overall human mortality, the time of the day has been analyzed in 269 cases of sudden cardiac death. The definitive criteria of sudden cardiac death were: death within 1 hour of the onset of symptoms and pathoanatomical findings. The cases of sudden cardiac death consisted of 161 males and 108 females, with ages ranging from 23 to 86 years, subdivided into 139 cases of acute myocardial infarction, 101 cases of coronary atherosclerosis, 12 cases of primary myocardiopathies, 4 cases of mitral valve prolapse and 13 cases with structurally healthy heart. All the deaths occurred outside the hospital, or immediately after resuscitation efforts had begun. The data were analyzed by means of chronograms, and with the "single cosinor" method, both for the total cases of sudden cardiac death, and for subdivisions into sex, pathoanatomical picture, and for age groups (less than 40, between 41 and 60, and more than 61 years). The results demonstrate a statistically significant (p less than 0.05) circadian rhythm of sudden cardiac death, with a peak from midnight to 8:00 am, and a minimum in the afternoon. Significant differences do not exist (p greater than 0.05) within the acrophases of sudden cardiac death between the 2 sexes, among the different age groups, or the pathoanatomical pictures of myocardial infarction and coronary atherosclerosis. No rhythm was detected regarding the sudden deaths by primary myocardiopathy, mitral valve prolapse, and "normal" heart.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Contemporaneous presentation of plasma cell leukemia and multiple myeloma. Description of a clinical case with a biclonal component].

A case of simultaneous evidence of plasma cell leukaemia and multiple myeloma is reported. Plasma cell leukaemia doesn't represent an evolution of multiple myeloma, but a primitive disease, because the two forms of plasma cell dyscrasia arose from two different neoplastic plasma cell populations. In fact, leukaemic plasma cell produced IgA and were PAS-positive, while myelomatous plasma cells produced IgG and were PAS-negative. From this case, some hypothesis on simultaneous development of the two types of plasma cell neoplasias are discussed.

Aged↗

[Prognostic factors in IgG and micromolecular multiple myeloma. Retrospective analysis of 50 consecutive cases].

Clinico-pathological findings in 50 consecutive previously untreated patients with IgG and micromolecular multiple myeloma were reviewed. The clinical factors related with a shorter survival were: Bence-Jones proteinuria, high level of serum creatinine and serum calcium, low level of haemoglobin, widespread bone lesions, and plasma cell percentage in bone marrow more than 20%. This factor is significantly correlated with survival. The staging systems proposed by Durie and Salmon and by Merlini et al. are a precious reference in the evaluation of survival and treatment.

Aged↗

[Serum levels of magnesium in hepatic cirrhosis].

In a group of 50 patients with liver cirrhosis compared with a group of 50 clinically healthy subjects serum magnesium levels were determined. The patients were divided according the aetiology of liver cirrhosis and to the presence or not of ascite and cholestasis. The serum magnesium levels were related to the main laboratory tests used in liver cirrhosis. The patients present a significant decrease of serum magnesium levels in comparison to controls. The patients with alcoholic cirrhosis of the liver and with ascite have significant lower magnesium levels in comparison with the patients with post-hepatitis cirrhosis and with patients without ascite. There is a significant correlation between serum magnesium levels and serum levels of aldosterone, albumin, gamma-glutamyl transpeptidase and total pool of bile acids. Direct and indirect effects of alcohol, a secondary hyperaldosteronism, the use of diuretics, and hypoalbuminaemia could account for magnesium serum level decrease in liver cirrhosis.

Aged↗

Somatomedin-C levels related to gestational age, birth weight and day of life.

Capillary blood samples on filter paper were assayed by means of an RIA method (Kit Nichols Institute USA) from 1096 newborns divided into full term, preterm and small-for-date infants. The somatomedin-C (Sm-C) mean value, which did not differ in the three groups, was 0.15 +/- 0.09 IU/ml. One hundred and ten (10%) showed Sm-C disc values less than or equal to 0.075 IU/ml, the minimum value measurable by our method. The day of life and birth weight had a significant influence on Sm-C levels. Gestational age did not have any significant effect. No significant interaction was found among the parameters considered. All the groups presented a progressive increase of Sm-C. Unlike preterm and small-for-date infants, in full term infants the latter increase seemed already to be evident from 5th day of life and reached higher levels from the 7th day of life onwards. In conclusion, Sm-C rates were reduced in the neonatal phase of life, but showed a tendency to rise later.

Age Factors↗

Relationships between growth factors (somatomedin-C and growth hormone) and body development, metabolic control, and retinal changes in children and adolescents with IDDM.

We used the radioimmunoassay (RIA) method to determine somatomedin-C (SmC) basal values in 59 diabetic children and adolescents (20 prepubertal and 39 pubertal subjects; age range 2.75-20.16 yr; duration of diabetes 0.08-15.83 yr) and in 274 control subjects. In comparing diabetic subjects with controls, we considered only those 50 diabetic subjects who were age matched with the controls, i.e., those not over 16 yr chronological age. SmC basal levels in pubertal diabetic patients were no different from those of pubertal age-matched control children, whereas in prepubertal diabetic patients SmC was significantly lower than in the respective control children (P less than .001). No correlation was found between the z score for SmC (i.e., the number of standard deviations each SmC level is from the age- and sex-normalized mean) and duration of disease, velocity standard deviation score, severity of fluoroangiographic retinal changes, basal C-peptide values and HbA1 levels. No differences were encountered in mean SmC and SmC z-score values in the separate groups of poorly, fairly, and well-controlled diabetic children, in the groups with and without residual pancreatic activity, and in the group with and without retinal changes. In 16 of the pubertal diabetics and in 15 pubertal controls, serum glucose, growth hormone (GH), and SmC concentrations were determined during the night. The integrated nocturnal secretion of SmC was no different in diabetics than in controls, whereas the integrated nocturnal secretion of GH was significantly (P less than .025) higher in diabetics than in controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Differences in somatomedin-C between short-normal subjects and those of normal height.

We evaluated basal somatomedin-C (SmC) levels in 98 subjects 2 to 16.6 years of age, with height less than 3rd centile (Tanner), and in 274 healthy controls 2 to 15.8 years, with height greater than 10th centile. Growth-retarded subjects were defined as short-normal when they had normal GH release (greater than 8 ng/ml) in at least one of three tests: arginine, L-dopa, and sleep. In control subjects, there was a significant positive correlation between SmC levels and chronologic age, bone age, and pubertal stage (pubic hair, breast or testicular volume). The same correlations were present in short-normal subjects, but SmC levels were significantly lower than in normal children. The percentage of subjects with very low SmC values (less than or equal to 0.25 IU/ml in those older than 6 years, and less than 0.1 IU/ml in those younger than 6 years) was higher in the short-normal group of children older than 6 years. In growth-retarded subjects, SmC values were significantly higher (P less than 0.005) in subjects with normal GH response in at least one of the two pharmacologic tests, compared with those with normal GH response only during sleep. We conclude that short-normal subjects have, on average, low SmC values, which might indicate insufficient GH release. Therefore, current criteria to define GH deficiency and children needing treatment may be too restrictive.

Adolescent↗

Acute fatty liver of pregnancy. Description of a case of survival.

The Authors describe a case of acute fatty metamorphosis of the liver in pregnancy in a patient who survived and delivered a living female child. Clinical and istopathologic features, possible etiologic factors and possible treatment for the mother and fetus are discussed. The Authors, finally, think that acute fatty liver of pregnancy is more frequent than expected and that it should be considered in all cases of jaundice in pregnancy.

Acute Disease↗