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Biomedical subjects

G Reda

Publications and source records attributed to G Reda.

At least 19 recordsLinked to original sources

Plasmatic endothelin-1 levels in hyperthyroid patients before and after antithyroid therapy.

BACKGROUND: The Endothelin-1 (ET-1) is a powerful vasoconstrictor peptide produced by endothelial cells in many vascular diseases probably as a response to vessel damage. In hyperthyroidism as in other endocrinological diseases elevated ET-1 plasma levels have been found. METHODS: The effect of antithyroid therapy on ET-1 plasmatic levels was evaluated by measuring ET-1 plasma levels before and 2 and 6 months after treatment with methimazole in 14 patients affected by hyperthyroidism. RESULTS: The hyperthyroid patients had significantly higher ET-1 levels than the controls (18.85 +/- 5.7 vs 10.9 +/- 2.1 pg/ml), while after treatment no difference was found. The ET-1 plasma levels of hyperthyroid patients correlated closely with the raised thyroid metabolic activity independently of its cause. It is possible that the increased ET-1 levels in hyperthyroid patients are the expression of blood vessel damage caused by high thyroid hormone levels. CONCLUSIONS: Moreover the results of this study could suggest that, in future, ET-1 plasmatic levels might be considered as a functional thyroid index in hyperthyroid diseases.

Adult↗

[Pre-surgical medical therapy of hyperthyroidism].

The Authors analyze the use and the efficacy of antithyroidal drugs administered to the patients affected by hyperthyroidism, that must undergo thyroidectomy. The aim is that the patients arrive to the operation in euthyroidism: this is very important to avoid the complications that can occur during or just after the thyroidectomy. They believe that till today the most effective treatment of hyperthyroidism before thyroidectomy is based on the use of thyonamide and iodine. In case of intolerance to these drugs or if it is necessary an emergency thyroidectomy or in case of a low compliance of the patient, there is the possibility to use different therapeutic approaches with beta-blockers or betametasone plus iopanoic acid and propranolol administered together for a few days. As concerning the possible complications that can occur during or after the thyroidectomy, the Authors analyze in particular the thyrotoxicosis and the "hungry bone" syndrome.

Antithyroid Agents↗

[Hashimoto's thyroiditis. A rare case of familial hereditary transmission].

Authors describe an uncommon case of inheritance of Hashimoto's thyroiditis that affected all the members of a family throughout three generations. Authors analyze recent advances about etiopathogenesis of this disease. In a recent paper was demonstrated that antithyroid peroxidase antibodies (anti-TPO) that have a cytotoxic activity are inherited in a dominant autosomic pattern. However only some epitopes of the antigen thyroid peroxidase predispose to the development of this disease. The peculiarity of this paper is that all the members of this family not only have elevated levels of anti-TPO, but are also all affected by disease. The study on the histocompatibility of antigens did not demonstrate significant date. Authors assert that in the pathogenesis of this disease, genetic factors have a relevant role, also if they are not well known yet. The involvement of environmental factors in this case seems to be unlikely: in fact not all the members of this family were born and lived in the same geographic area.

Adolescent↗

[Tolosa Hunt syndrome and autoimmune polyglandular syndrome. A rare case report].

The authors refer to a case report in which two rare clinical syndromes, the Tolosa Hunt Syndrome (THS) and the polyglandular auto-immune syndrome (PGA) co-exist in the same patient and make a detailed analysis of the literature regarding this kind of diseases. The THS is a rare clinical condition characterized by a painful ophthalmoplegia due to an involvement of the cranial nerves and of the sympathetic nerve-fibres going through the cavernous sinus and the superior orbit cavity. Nowadays the diagnosis of TSH is made by high resolution computerized tomography aimed at the cavernous sinus and the upper orbital cavity. This method allows to notice if at the basis of this syndrome there are vascular, neoplastic or inflammatory diseases or if, as in e case here presented, by exclusion, we must think of an inflammatory process with unknown pathogenesis. In this case report the patient under observation process to be affected by THS and also by auto-immune polyglandular syndrome type III, as she was affected by diabetes type I, Basedow disease and alopecia. The authors believe that an auto-immune mechanism can be at basis of the THS, and this fact has already been pointed out in the literature in two previous works. An important feature of this case report has been the definitive improvement of the symptoms by an antithyroid effect and, also, by an immune suppressor activity. The Authors hope that there will be reported a greater number of cases pointing to the coexistence of the THS with autoimmune diseases.

Adult↗

[The euthyroid sick syndrome. Its incidence and clinical significance in an internal medicine department].

In this paper the authors have evaluated the incidence and the clinical implications of sick euthyroid syndrome (SES) in a group of 144 patients in a department of internal medicine. SES is an alteration of thyroid hormone values in the absence of a thyroid disease, which is seen in patients suffering from serious diseases. Having classified SES into 3 subgroups according to the different alterations seen in the values of T3, T4, FT3, FT4, TSH, rT3 and TBG, they show the hypotheses that explain the biochemical mechanisms which are at the basis of these hormonal alterations. Fourteen of the 144 patients under observation were excluded as they were suffering from ascertained or subclinical thyroid disease. Thirty (23% of cases) of the remaining 130 patients had alterations of the thyroid hormones in accordance with SES diagnosis. Of these 30 patients, 19 had hormone values found in SES type I (63%), 2 in SES type II (6.5%) and 9 in SES type III (30.5%). In SES type I the diseases seen, in order of frequency, were: obstructive chronic bronchopneumopathy with acute respiratory failure, diabetic ketoacidosis, neoplasms, ischemic heart disease, cardiac failure, chronic renal failure, liver diseases, acute cerebral vasculopathies, sepsis and collagenopathies. The disease seen in the 2 cases of SES type II was obstructive chronic bronchopneumopathy with acute respiratory failure. In SES type III the diseases seen were, in order of frequency: diabetic ketoacidosis, lung diseases, ischemic heart disease, cardiac failure, peripheral arteriopathies, acute cerebral vasculopathies, neoplasms, liver diseases, acute renal failure. The incidence of SES in 23% of the admitted to hospital patients was found to be slightly higher than in other studies; this could be explained by a stricter selection of inpatients: in fact self-sufficient patients or those not needing urgent admission, were sent to an efficient out patient clinic where necessary examinations were quickly carried out, hospitalization being reserved for patients with more serious illnesses. We would like to underline how the incidence of SES is much greater than that of what is known as thyroid disease (23% compared to 5%), thereby confirming that it is the most frequent cause of alterations of thyroid hormones. With regard to the pathogenetical hypotheses, it is confirmed that in SES, the reduction of T3 values is accompanied by an increase in the values of rT3 as for reduced activity of 5-desiodinasis enzyme. In SES type III the increase of T4 values is due to the increase of TBG resulting in an increase in the link for T4 and therefore a reduced peripheral hormone activity.(ABSTRACT TRUNCATED AT 400 WORDS)

Aged↗

Lack of inhibition of anterior pituitary hormone release during chronic treatment with calcium antagonists.

Calcium antagonists are widely used for the treatment of cardiovascular disorders, especially ischaemic heart disease. It has been demonstrated that these drugs, either in vitro or acutely administered in humans, inhibit the basal and stimulated secretion of pituitary hormones by blocking calcium influx through slow calcium channels. To see if a similar effect could be detected after their chronic administration, we studied the basal, TRH- and LHRH-stimulated TSH, PRL, LH and FSH release in 18 male subjects with chronic stable angina before and on the 30th day of oral treatment with verapamil (n = 8;80 mg three times a day) or with nifedipine (n = 10; 10 mg three times a day). Neither drug had any effect on basal TSH, PRL, LH and FSH values or on their response to the specific hypothalamic-releasing hormones. These results suggest that the chronic administration of calcium antagonists, at the usual therapeutic doses, does not effect the process of stimulus-secretion coupling of anterior pituitary hormones, ruling out any impairment of the related target glands which have been expected on the basis of previous studies.

Aged↗

Chronobiological approach to the treatment of essential hypertension: preliminary data.

The effect on bioperiodic parameters of hypertension elicited by the beta-blocking agent mepindolol, administered as a single dose of 10 mg at 8 a.m. vs 10 mg at 8 p.m., was evaluated in this study. Circadian blood pressure monitoring was performed in age-matched patients with essential hypertension after a two-week wash-out period with placebo and four weeks treatment. Patients were randomly allocated to one of the two treatment groups. Standard blood chemistry and electrocardiogram were performed at the beginning and end of the treatment period. Statistical analysis of blood pressure circadian rhythm characteristics (mesor, amplitude, acrophase) showed a significant decrease of mesor of systolic and diastolic blood pressure in both groups. Values of the mesor were not significantly different between the two groups. Interestingly, changes of acrophase and amplitude induced by the drug were different in regard to the time mepindolol was administered. Side effects were generally mild.

Adult↗

17 alpha-hydroxylase deficiency: mineralocorticoid hormone profiles in an affected family.

The plasma concentrations of mineralocorticoid hormones, basal and after stimulation and suppression with ACTH, can identify the heterozygotes in a family with two siblings with 17 alpha-hydroxylase deficiency. Both parents and one sibling had elevated levels of plasma deoxycorticosterone, corticosterone, 18-hydroxydeoxycorticosterone, and 18-hydroxycorticosterone, but normal cortisol and aldosterone concentrations. Stimulation with ACTH effected additional increases in the elevated steroid and cortisol levels, but not in aldosterone, further increasing the discrepancy and the ratio between 18-hydroxycorticosterone and aldosterone. One sibling had normal steroid patterns and an 18-hydroxycorticosterone to aldosterone ratio. Suppression of ACTH restored the steroids to low normal levels. In addition, the ratio of the gas chromatographic analysis of the total major urinary metabolites of corticosterone to total metabolites of cortisol was greater, and the sum of urinary androsterone and etiocholanolone to total corticosterone and cortisol metabolites was less in the heterozygotes than in normal subjects. This identifies deficient 17-hydroxylation, which is required for the production of cortisol and C-19 steroids. These criteria appear unique for the 17 alpha-hydroxylase defect in the heterozygote.

18-Hydroxycorticosterone↗

Effect of bromazepam on growth hormone and prolactin secretion in normal subjects.

The growth hormone and prolactin response to oral bromazepam (3 mg) was assessed in 5 normal men and 5 normal women. A peak growth hormone response of 11.9 +/- 3.7 ng/ml (mean +/- SD), significantly above the baseline (p less than 0.01), was achieved in the men. On the other hand, there was no statistically significant response of growth hormone secretion in the women. No change in prolactin secretion was observed in either sex.

Administration, Oral↗