Biomedical subjects

L Ceroni

Publications and source records attributed to L Ceroni.

At least 19 recordsLinked to original sources

PubMed2004

Response of the hypothalamic-pituitary-adrenal axis to small dose arginine-vasopressin and daily urinary free cortisol before and after alprazolam pre-treatment differs in obesity.

OBJECTIVE: Arginine vasopressin (AVP) has a central role in the response of the hypothalamic-pituitary-adrenal (HPA) axis to stress conditions. A low dose of AVP has been shown to have a modest, but significant effect on ACTH response in normal weight subjects. The aim of this study was to test the response of the HPA axis in obese subjects in order to assess eventual primary neuroendocrine alterations, previously demonstrated by using AVP combined with corticotropin releasing hormone (CRH). In addition, given its central inhibitory action on the HPA axis, we investigated whether the suppressive capacity of alprazolam (APZ) pretreatment on the hormone response to low-dose AVP challenge and daily urinary free cortisol (UFC) excretion rate may be altered in the presence of obesity. DESIGN: Fifteen overweight or obese women and eight normal-weight controls randomly underwent two low-dose AVP tests (0.3 UI iv bolus), one without (AVP test) and the other preceded by APZ administration (0.5 mg at midnight and 0.5 mg 90 min before the test in the morning at 08:30 h) (APZ/AVP test). Blood samples for ACTH and cortisol assay were obtained at baseline and throughout each test. The day before each test, 24h-UFC/ creatinine was also mea-sured. RESULTS: Basal ACTH levels were similar in the two groups, whereas cortisol concentrations were significantly lower in the overweight/obese group. Overweight/obese women had higher ACTH and cortisol responses to the AVP tests and significantly greater hormone inhibition after APZ than controls. In both groups, AVP-induced delta-peak cortisol values before and after APZ pre-treatment were significantly correlated. Body fat distribution had no effect on the HPA axis response to AVP either before or after APZ. Moreover, APZ decreased 24h-UFC/creatinine values unsignificantly in controls and by approximately 50% in the overweight/obese subjects. These changes were unrelated to the cortisol response to the AVP test before and after APZ pretreatment. On the other hand, percent changes of 24h-UFC/creatinine after APZ were negatively related to the body mass index (BMI) but positively with waist circumference values, which indicates that the abdominal obesity phenotype may counteract the 24 h-UFC/creatinine that would be expected on the basis of BMI values. CONCLUSIONS: Our data further support the concept that in women obesity may represent a condition of hyperresponsiveness or hypersensitivity of the HPA axis to neuroendocrine stimuli, which appear to be independent of feedback control. In addition, the data on the inhibiting capacity of APZ on UFC excretion confirm that the alterations of the HPA axis in obesity is particularly evident in the abdominal phenotype.

Adult↗

PubMed2001

Relationship between socio-economic and cultural status, psychological factors and body fat distribution in middle-aged women living in Northern Italy.

This study analyses the relationships between body fat distribution and socioeconomic and psychological factors in a cohort of 426 healthy middle-aged women living in Virgilio, Mantua (Northern Italy). The information concerning their occupational, social and psychological conditions and smoking habits were obtained by means of questionnaires. Psychological factors were investigated using the Italian version of the Illness Behaviour Questionnaire and the Symptom Questionnaire. Anthropometric measurements, body mass index (BMI) (kg/m2), waist/hip ratio (WHR) and clinical/hormonal menopausal status were also collected for each subject. The women reported significantly higher or lower psychological factor scores (symptoms of conversion: p=0.005; perception of disease: p=-0.018; denial: p=0.021; hostility: p=0.57; and laxity: p=0.047) as their WHR increased, thus indicating some concern about their health. In a multiple regression model, their WHR and waist circumference (W) significantly correlated with symptoms of conversion (p=0.005 and p=0.029), and W was also significantly related to the perception of disease (p=0.043). There was a significant inverse correlation between the WHR and educational level (p<0.001). The prevalence of partners who were entrepreneurs or self-employed also decreased as WHR increased (p<0.001). Furthermore, the number of women living in the centre of town significantly diminished, whereas those living in the suburbs or in the country significantly increased (p=0.005). However, using age, BMI and menopausal status as covariates, only the partner's work significantly and negatively correlated with the WHR (p=0.029). These results are consistent with the hypothesis that psychological and socio-economic handicaps are associated with a higher prevalence of abdominal fatness in middle-aged women living in Northern Italy

Adult↗

PubMed2000

alpha2-adrenoceptor regulation of the hypothalamic-pituitary-adrenocortical axis in obesity.

BACKGROUND: Abdominal obesity is associated with hyper-responsiveness of the hypothalamic-pituitary-adrenocortical (HPA) axis to stimulatory neuropeptides and to stress. Catecholamines are involved in the regulation of the HPA axis, particularly during stress, via alpha-adrenoceptor modulation. DESIGN: In this study, we investigated the effects of pre-treatment with an alpha2-adrenoceptor agonist, clonidine (2 microg/kg over 10 minutes) and antagonist, yohimbine (0.125 mg/kg bolus, followed by 0. 001 mg/kg/minutes per 90 minutes infusion) on the HPA axis, measured by ACTH and cortisol response to combined CRH (human, 100 microg) plus AVP (0.3 IU) administration, and on noradrenalin (NA) and adrenalin (A) blood levels, in a group of obese women with abdominal (A-BFD) or peripheral (P-BFD) body fat distribution and in nonobese controls. RESULTS: During the control CRH + AVP test the ACTH but not the cortisol response was higher (P < 0.05) in obese A-BFD women than in controls, with minor and transient variations of NA levels. Neither the control test nor clonidine or yohimbine influenced basal or post CRH + AVP A concentrations. Clonidine pretreatment similarly and significantly decreased NA levels in all women and, compared to the control test, marginally influenced the ACTH response to CRH + AVP. Conversely, during yohimbine infusion NA levels steadily and similarly increased to values more or less double baseline values in all groups. Compared to the control test, however, the ACTH response to the CRH + AVP test performed during yohimbine infusion significantly decreased in the control subjects whereas a tendency to a further increase occurred in the obese groups and, specifically, in the A-BFD group significantly (P < 0.05) more than in the P-BFD group. CONCLUSIONS: This study shows that alpha2-adrenoceptor regulation of the HPA axis is different in obese and nonobese women, particularly in stressed conditions. We suggest that the abnormal ACTH response to CRH + AVP challenge with increased noradrenergic tone may represent a specific pathophysiological aspect of the abnormal response to stress or to other specific stimulatory factors in obese women, particularly those with abdominal body fat distribution.

Adrenergic alpha-Agonists↗

PubMed2000

[Steroid therapy and adrenal function].

Glucocorticoids are frequently used for both diagnostic and therapeutic purposes. Their action mimics endogenous glucocorticoid actions by altering the activity of the hypothalamic-pituitary-adrenal (HPA) axis. Therefore, they can be responsible for iatrogenic diseases, particularly if used at high doses and for a long time. The aim of this brief review is to show the main pharmacological characteristics and the endocrine effects of glucocorticoids. The HPA axis insufficiency, related to acute glucocorticoid withdrawal, is also discussed.

Adrenal Insufficiency↗

PubMed2000

[Pseudo-Cushing syndrome. Physiopathologic aspects and differential diagnosis].

Pseudo-Cushing Syndromes (PCS) are a heterogeneous group of disorders, including alcoholism and depression, that share many of the clinical and biochemical features of Cushing's Syndrome (CS). It has been suggested that hypercortisolism of PCS may be the result of increased hypothalamic corticotropin-releasing hormone secretion in the context of a hypothalamic-pituitary-adrenal axis that is otherwise normally constituted. The substantial overlap in clinical features and daily urinary free cortisol levels between several patients with CS and those with PCS can make the differential diagnosis difficult. The most accurate tests in the distinction of CS from alcohol-induced PCS are dexamethasone-CRH and a midnight serum cortisol measurement. In depressed patients, the insulin tolerance test may be useful, although some overlap may exist. This brief review summarises the principal pathophysiological events of PCS and provides a useful strategy for differential diagnosis.

Adrenocorticotropic Hormone↗

PubMed1999

ACTH and cortisol response to combined corticotropin releasing hormone-arginine vasopressin stimulation in obese males and its relationship to body weight, fat distribution and parameters of the metabolic syndrome.

OBJECTIVES: To investigate the activity of the hypothalamic-pituitary-adrenal (HPA) axis in male obesity and its relationship with several prominent parameters of the metabolic syndrome. DESIGN: A cross-sectional clinical study of the activity of the HPA axis in groups of obese males and normal-weight controls. SUBJECTS: Seventeen obese non-diabetic males with a body mass index (BMI) >28 and eight normal-weight controls were examined. MEASUREMENTS: Fat free mass (FFM) and fat mass (FM) were measured by bioelectrical impedance, and the waist-to-hip circumference ratio (WHR) was calculated in all subjects. Baseline samples were taken for sex hormone and lipid determination, and an oral glucose tolerance test (OGTT) was performed for glucose and insulin determination. The activity of the HPA axis was determined by the combined administration of human corticotropin releasing hormone (CRH) (100 microg) and arginine vasopressin (AVP) (0.3 IU). RESULTS: As expected, FFM and FM and the WHR were higher in obese men than in controls, as were fasting insulin and stimulated (as area under the curve (AUC)) glucose and insulin concentrations. Baseline adrenocorticotropin (ACTH) and cortisol concentrations were similar in both groups, but stimulated (as AUC), ACTH was higher (P < 0.05) in obese subjects than in controls, whereas no significant difference in cortisolAUC was present. Since the main differences between obese subjects and controls were present during the early 30 min of the test, the correlation coefficients between total and incremental ACTH(AUC 0-30 min) and CortisolAUC 0-30 min and all other variables were analyzed. A significant correlation coefficient was present between them and all anthropometric parameters, fasting insulin and insulinAUC, but not with androgens and gonadotrophins. In addition, a significant correlation was present between total and incremental ACTH(AUC 0-30 min) and triglyceride concentrations. However, after adjusting for BMI or FM values, all correlation coefficients became non-significant, except the one between incremental ACTH(AUC 0-30 min) and insulinAUC (P < 0.05). CONCLUSION: These findings indicate that obese men may also have an altered pituitary response to combined CRH/AVP stimulation, which appears to be predominantly related to body size and total body fat. ACTH hyperresponsiveness after CRH/AVP stimulation also appears to be related to hyperinsulinaemia, but underlying mechanisms of this relationship remain to be elucidated.

Adipose Tissue↗

PubMed1997

A case-control study on alcohol and seizures: study design, protocol, and data collection. The ALCE (Alcohol and Epilepsy) Study Group.

We designed a multicenter case control study to evaluate whether chronic alcoholism and alcohol are risk factors for developing a first generalized tonic-clonic epileptic seizure. Cases were 278 patients (92 women, 186 men), with a first generalized tonic-clonic seizure (either idiopathic or symptomatic), matched to 556 controls for center, sex, age, and weekday of the seizure. Information on risk factors was obtained through a questionnaire. This paper focuses on the study design (selection of cases and choice of controls), the validity of the instruments for data collection, and the strategies of study conduction (interviews, use of proxy respondents). Inter-rater agreement was excellent for drinking status, patterns of drinking, and broad indicators of consumption (yes/no). Agreement was variable for the number of servings/week, but was excellent (r = 0.91) for a summary of daily alcohol intake.

Adult↗

PubMed1992

[A comparison between computed tomography and magnetic resonance in the verification of prolactinomas].

First, computer tomography and subsequently magnetic resonance have profoundly changed the diagnostic protocol for the study pituitary pathology. Conventional X-ray and examination with the use of contrast media are being employed less and less. Tomographic techniques (CT and RM) permit direct identification of anomalies as well as precise evaluation of their relationship with surrounding structures.

Contrast Media↗

PubMed1992

[Role of magnetic resonance in the evaluation of thrombosis of large thoraco-abdominal vessels].

Magnetic resonance (MR) has been found to be a method suitable for the study of the vascular system since it permits to distinguish between moving (circulating blood) and static (thrombi, atherosclerotic plaques, intimal flaps) tissues. The sequences used for the evaluation of thrombi are Spin Echo (SE) and Gradient Echo (GE). If both sequences are used the diagnosis of thrombosis is considerably more reliable. The limits of the technique are represented by spatial resolution which is not optimal and makes the evaluation of thrombi in small or medium-size vessels difficult; further, small or non occlusive thrombi may be difficult to identify. Nowadays, with the technique of angiography with magnetic resonance (AMR) it has become possible to obtain high quality images of the vessels of the head, neck, abdomen and limbs. Further improvements of the AMR technique are likely to replace diagnostic angiography.

Abdomen↗

PubMed1990

[MR in rectal cancer recurrences].

Fourteen patients, who had undergone surgery for rectal carcinoma, were studied by MR imaging to evaluate the presence of recurrences. MR results were compared to those obtained by needle biopsy or laparotomy. MR imaging proved to be a valuable method in diagnosing tumor recurrences on the basis of tissular morphology, whereas its capabilities were poor in differentiating recurrence from fibrosis on the basis of the signal intensity on T2-weighted images.

Biopsy↗

PubMed1990

[The role of magnetic resonance in the study of cerebrospinal malformations in childhood. An analysis of 51 clinical cases].

This study was aimed at assessing MR utility in the evaluation of cerebral-medullar malformative pathologic conditions in infants. Among 274 patients 2 months to 15 years old examined by means of MR imaging, 51 (18.6%) were affected with cerebral-medullar abnormalities. Seventeen different types of pathologic conditions were identified, some of which single and some multiple; tethered cord was the most frequent finding. 45/51 patients affected with malformative pathologic conditions required sedation. The high incidence of malformative pathologic conditions in pediatrics highlights the importance of this subject for all the radiologists dealing with MR imaging in pediatrics. MR imaging appears to be the method of choice for the evaluation of cerebral-medullar abnormalities.

Abnormalities, Multiple↗

PubMed1989

[MR in the evaluation of schizencephaly].

This study was aimed at evaluating MR utility in the diagnosis of schizencephaly in patients with seizures and developmental delay. In 7 patients, 8 months to 15 years old, MR imaging detected the presence of unilateral (5 cases) and bilateral (2 cases) hemisferic clefts. Moreover, MR imaging allowed the presence of such anomalies as dysgenesis of the corpus callosum, and agenesis of the septum pellucidum to be demonstrated, together with areas of polymicrogyria and heterotopic gray matter.

Adolescent↗

PubMed1989

[CT in the evaluation of carcinoma of the pancreas].

The routine use of CT has given a great contribution both to the diagnosis and to the evaluation of the extent of pancreatic carcinomas. Forty-three patients clinically suspected of pancreatic carcinoma were examined with CT. Forty of them underwent surgical control. This study was conducted to evaluate the role of CT in the diagnosing and staging of pancreatic carcinomas. 31/43 neoplasms were identified, with a diagnostic accuracy of 90%. CT was extremely accurate in the demonstration of late metastases, while it had lower accuracy in assessing the involvement of lymph nodes and peripancreatic vessels (60-70%). CT proved to be extremely useful in diagnosing pancreatic carcinomas, for it allows the detection of masses associated with Wirsung's duct dilatation and atrophy, which are a highly pathognomonic sign of pancreatic neoplasms. Moreover, CT proved useful in the staging, by assessing the presence of lymph nodes and metastases.

Aged↗

PubMed1988