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Biomedical subjects

M Capelli

Publications and source records attributed to M Capelli.

At least 91 records · Page 5Linked to original sources
PubMed1985

The artificial endocrine pancreas in the surgical treatment of insulinoma. Usefulness and limits.

The usefulness and the limits of the artificial endocrine pancreas in the surgical management of insulinoma has been evaluated in three male patients who underwent pancreatic resection because of previously detected adenoma. In particular, blood glucose and contemporary levels of insulin and C-peptide were continuously monitored before, during and after surgery, to record the temporal relationship between the removal of insulinomas and the variations of these parameters. In the pre-resection phase, only two cases revealed hypoglycemia and required dextrose infusion to correct hypoglycemia and reach euglycemic levels, whereas all the patients showed elevated insulin and C-peptide levels. After anesthesia and surgical incision, the pancreas was observed and manipulated in search of adenoma. In all patients this manoeuvre caused an increase of insulin and C-peptide levels and in two cases a slight decrease of blood glucose levels. After adenoma resection, a prompt increase of glycemia was observed only in one patient, in the other two the time which elapsed before significant blood glucose changes was more prolonged (55 and 80 min. respectively). On the contrary, a rapid fall in insulin and C-peptide levels was observed in all cases. We conclude that artificial endocrine pancreas has the advantage of maintaining the normoglycemia before and during surgery, preventing the risk of dangerous hypoglycemia in basal conditions and following manipulation of pancreas while localizing adenoma. However, the prolonged interval elapsed before significant blood glucose variations limits the usefulness of the artificial endocrine pancreas in localizing intraoperatively previously undetected adenomas.

Adenoma, Islet Cell↗
PubMed1984

[Urinary excretion of PGE2 and renal function in acute myocardial infarction].

In 17 hospitalized patients affected by acute myocardial infarction (AMI) PGE2 urinary excretion, renal function and, furthermore, cortisol urinary excretion were tested during a 21 days trial. In 12 patients all the parameters under consideration underwent a similar trend: PGE2 urinary excretion exactly like glomerular filtration rate, Na+ excretion and diuresis tended to be reduced during the first 5 days and they rapidly recovered the normality after this period. Cortisol urinary excretion displayed a characteristic pattern: i.e. the highest values were observed in the first days, followed by a progressive decrease towards physiological levels since the 4th day. Different findings were obtained in 5 cases treated with an antiinflammatory drug (Indoprophen i.m. 200 mg x2 die). In fact the low levels of urinary PGE2 on the first days did not display any increasing and GFR, urinary flow, and Na+ tubular balance underwent irregular and not significant variations. These data suggest that an impaired Prostaglandin synthesis may be related to a compromised renal function often occurring in AMI.

Dinoprostone↗
PubMed1984

Effect of 'physiological' doses of triiodothyronine replacement on the hormonal and metabolic adaptation to short-term semistarvation and to low-calorie diet in obese patients.

In four groups of obese patients matched for Body Mass Index (BMI), we studied the effects of different 3-week semi-starvation treatments followed by an 8-week hypocaloric (1008 kcal, protein 20%, carbohydrate 40%) diet with or without low doses of T3 therapy. Dietary intake (formula diet) in the semi-starvation period was 480 kcal, with 66 g protein (P) and 51 g carbohydrate (CHO) in groups I and III and with 33 g P and 84 g CHO in groups II and IV. Moreover, groups III and IV were given low doses (20 micrograms twice a day) of T3 while groups I and II received a placebo. During semi-starvation periods, a similar fall in BMI values was found in all groups, while during the low-calorie diet, T3-treated patients showed the greater BMI reduction. During semi-starvation, nitrogen balance was significantly more negative in low-protein than in high-protein-treated groups; differences between T3-treated (III and IV) and control (I and II) groups were not significant over this relatively short treatment period. No differences in 24 h urinary 3-methylhistidine or alanine excretion were evident between the four groups. During the entire period of study, daily urine creatinine excretion did not change in any group. In conclusion, in our study low-dose T3 therapy was seen to favour weight loss during low-calorie diet although negative effects on protein metabolism were not excluded, particularly when relatively small amounts of protein were administered.

Adult↗
PubMed1984

Steroid treatment lowers hepatic fibroplasia, as explored by serum aminoterminal procollagen III peptide, in chronic liver disease.

Serum aminoterminal type III procollagen peptide (sPIIIP) has been proposed as an index of hepatic fibroplasia. sPIIIP was retrospectively evaluated in 34 treated and five untreated patients affected by chronic active hepatitis with or without cirrhosis by an RIA test. Serum samples taken before and after 6 months of treatment were tested in all cases. In 15 of the treated and all untreated patients, 6-20 (median 13) sera, corresponding to a median follow-up of 43 months were studied. Before treatment, the sPIIIP median value was 18.6 ng/ml; after 6 months of treatment, it decreased to 13.6 ng/ml (p less than 0.005). Follow-up sPIIIP levels were significantly lower in treated than in untreated patients (p less than 0.05), at each interval considered, except for the last control (39 months). In seven patients, treatment was discontinued: sPIIIP rose rapidly in six; four of them were retreated and this was followed by a new decrease. In four patients, sPIIIP was tested weekly from the onset of the treatment: it reverted to normal values within the first week in all cases, while GOT decreased later. sPIIIP is significantly and rapidly reduced by steroids. Steroid withdrawal is generally followed by a rebound, with a new decrease when treatment is restarted. Since sPIIIP is more rapidly lowered than GOT levels, the above data support the hypothesis that steroids can directly affect collagen metabolism.

Adolescent↗
PubMed1984

Neonatal screening for cystic fibrosis by dried blood spot trypsin assay. Results in 47 127 newborn infants from a homogeneous population.

47 127 newborn infants from the Emilia-Romagna region were screened for cystic fibrosis by dried blood spot trypsin assay. In the initial 12 099 subjects screened with a non-standardized method, two children with cystic fibrosis were observed. Of the remaining 35 028 newborn infants, 299 showed high immunoreactive trypsin values; retesting revealed persistent elevation in 11. Sweat testing confirmed cystic fibrosis in 6 subjects and was normal in 5. Clinical monitoring of these 5 children has, as yet, shown no pathological signs. No false-negative test results have yet been identified. In our region, cystic fibrosis frequency would appear to be 1 case every 5 890 newborn infants. Our study confirms that elevated immunoreactive trypsin is characteristic of newborn infants with cystic fibrosis and that screening by determination of immunoreactive trypsin is of great benefit since it allows early diagnosis and a rational approach to therapy.

Cystic Fibrosis↗
PubMed1984

Seasonal variations of total and free thyroid hormones in healthy men: a chronobiological study.

The seasonal variations of iodothyronines and TSH serum concentrations were evaluated in 24 healthy subjects of both sexes. Using a 12 month cosine function, a significant circannual rhythm was found in T3, T4 and free T4 whose maximal values were found in September for T3, in August for T4 and in October for free T4. No significant seasonal variations in free T3 or TSH were found. Some circannual but not sinusoidal changes were found for reverse T3 and TBG. A positive linear correlation between T4, T3 and reverse T3 changes was observed, indicating that the sinusoidal oscillations of these hormones were in phase with each other. Relative weight was significantly lower in summer than in winter, though spontaneous caloric intake and physical activity did not change. A slight but significant correlation was found between relative weight and T4, free T4 and reverse T3 values measured during the period of study.

Acclimatization↗
PubMed1983

Relationships between iodothyronine peripheral metabolism and ketone bodies during hypocaloric dietary manipulations.

Relationships between iodothyronine and metabolic substrate metabolism during undernutrition were evaluated in four normal subjects who fasted for 48h (Group I) and in four groups (II to V) of obese patients who underwent selective dietary manipulations: 360 calories [carbohydrate (CHO) 40 g/day]; 800 calories containing respectively 19 g/day - ketogenic - (K) and 112 g/day - non ketogenic - (NK) of CHO; and a step-diet programme (during which total calories were progressively reduced from 2500 to 500). Serum T3 levels decreased significantly and constantly during fasting, 360 and 800 K studies, and transiently during the 800 NK diet. During the step-diet programme, a significant fall was found only when 1250 K or less were given. Conversely, serum reverse T3 rose significantly and constantly during 360 and 800 K diets, while a transient increase was found during the 800 NK diet. During the step-diet programme reverse T3 rose only when 750 calories were given. Ketogenesis developed in all studies but one (800 NK), and in the step-diet programme significantly below the 1000 calorie step. Other substrate modifications in each study were also evaluated. Serum T3 levels showed a significant correlation with ketone bodies (KB) in all the ketogenic studies, while no correlation was found in non ketogenic study (800 NK). During the step-diet programme ketone bodies and iodothyronine modifications appeared to be related to the amount of calories. Based on these results, we suggest a relationship between the dietary-induced modifications of iodothyronine metabolism and the development of ketogenesis.

Acetoacetates↗
PubMed1983

Circadian rhythm of gastric inhibitory polypeptide (GIP) in man.

The diurnal variations of serum gastric inhibitory polypeptide (GIP), serum insulin, plasma glucagon, plasma glucose and serum triglycerides were studied for 24 hr in 6 healthy young men, consuming three meals and performing their usual physical activities. Serum GIP levels peaked after each meal and stayed significantly elevated from the peak after lunch till late night. Glucose and insulin showed early and short-lasting postprandial peaks, declining thereafter to basal values within a short time. Plasma glucagon was inhibited by the meal ingestion and fluctuated around the basal levels in the interdigestive periods. On the other hand, serum triglycerides tended to parallel GIP changes for most of the day, being significantly elevated starting from lunch consumption to late night. The present results suggest that GIP may have effects other than the insulinogenic one, being probably involved in the control of lipid metabolism.

Adult↗
PubMed1983

A study of thyroid function in the pre- and post-menopause.

Serum levels of thyroid-stimulating hormone (TSH), triiodothyronine (T3), thyroxine (T4), free triidotthyronine (FT3), free thyroxine (FT4) and thyroxine-binding globulin (TBG) were measured in 382 healthy women who were attending a menopause clinic. Of these women, 140 were in the pre-menopausal phase, 162 had been post-menopausal for less than 3 yr and 60 had been post-menopausal for greater than 3 yr. Analysis of the results as a function of climacteric situation, revealed that the only significant difference was a lower serum concentration of FT3 in the women who had been post-menopausal for over 3 yr than in the women who were in the pre-menopausal phase. Statistical analysis of the results as a function of both climacteric situation and age showed that the serum level of TBG increases with age, while serum levels of circulating thyroid hormones decrease, and that although the menopause does not bring about marked changes in thyroid function, it nevertheless tends to reduce that function, especially when menopause occurs at the expected time. Finally, by correlating values with T4 values on an individual basis, it was possible to ascertain that when physiological changes in thyroid function do occur in the climacteric, they are not caused by primary changes in TSH secretion.

Adult↗
PubMed1983

Neonatal screening for congenital adrenal hyperplasia.

Capillary blood samples from 42930 infants born in the Italian region of Emilia-Romagna were collected for 17-hydroxyprogesterone radioimmunoassays on days 2, 3, 4, 5, 6, and 7, or between days 7 and 15 of life. A microfilter paper method modified from that of Pang et al.1 was used for this assay. Pathologic values of 17-hydroxyprogesterone were found in 5 infants giving an incidence in this homogeneous Caucasian population of 1:8586. We also investigated 17-hydroxyprogesterone values in relation to the day of sampling and the possible correlation between 17-hydroxyprogesterone values and birthweight and gestational age. We concluded that neonatal screening for congenital adrenal hyperplasia caused by 21-hydroxylase deficiency was possible by this method and that the infants' maturity and the particular day of collection of the samples affect the values but not the validity of the screening.

17-alpha-Hydroxyprogesterone↗
PubMed1983

Lack of correlation between free erythrocyte porphyrin and serum ferritin values at birth and at 2 months of life in low birthweight infants.

Red cell free erythrocyte porphyrin and serum ferritin determinations were performed on capillary blood specimens from 63 healthy infants weighing 2500 g or less at birth, during the first week of life, and, from 44 of them, again at 8-10 weeks. Free erythrocyte porphyrin values were high both at 3-7 days (mean 156 microgram/100 ml RBC) and at 8-10 weeks (mean 128 microgram/100 ml RBC). The respective serum ferritin values were also high (mean 226 and 107 ng/ml), excluding a depletion in iron stores. In addition, no correlation was found between free erythrocyte porphyrin and serum ferritin values either at birth or at age 2 months. These findings are consistent with an earlier hypothesis that in the presence of iron stores, the rate of iron release from the stores in low birthweight infants may not be sufficient to maintain optimal erythropoiesis if the demand is accelerated.

Erythrocytes↗
PubMed1983

Insulin resistance in patients with polycystic ovaries: its relationship to body weight and androgen levels.

Using a combined infusion of somatostatin, insulin and glucose, insulin resistance was assessed in vivo in two groups of females with polycystic ovaries (PCO), obese (PB-PCO) and normal weight (NO-PCO) and in two groups of matched (for age, sex and body mass index) controls (OB and NO). A steady state plasma glucose (SSPG) and insulin (SSPI) was attained after 90 min. OB-PCO and NO-PCO showed higher SSPG with respect to matched controls. The SSPG levels were related to body mass index (r = 0.69; P less than 0.001). The SSPG values were significantly correlated with the fasting insulin levels (r = 0.47; P less than 0.003). Gonadotrophin and steroid peripheral blood concentrations were also evaluated in the PCO females. A significant correlation was found between the SSPG values and the dehydroepiandrosterone sulphate levels (r = 0.46; P less than 0.05) and between the fasting insulin levels and the androstenedione concentrations (r = 0.64; P less than 0.01). Moreover, significant correlation coefficients were found between the glucose to insulin ratio and the A (r = -0.59; P less than 0.01) and the DHEA-S (r = -0.50; P less than 0.05) plasma levels. Finally, no relationship between body mass index and A or DHEA-S levels was found in PCO females considered as a group. We conclude that insulin resistance is present in females with PCO and it is mainly due to the presence of obesity, but other factors such as androgen levels, probably of adrenal sources, must be considered as a cause.

Adult↗
PubMed1982

Neonatal screening for congenital adrenal hyperplasia using a microfilter paper method for 17-alpha-hydroxyprogesterone radioimmunoassay. Experience gained from the study of 22,233 cases.

We examined 22,233 infants born in Emilia-Romagna (Italy). Capillary blood samples for 17-OH-progesterone assay were collected on the 3rd, 4th, 5th, 6th or 7th day of life on filter paper of the same type used for the screening of aminoacidopathy and hypothyroidism. 17-OH-progesterone values were determined using a micromethod modified from that of Pang and co-workers. 20 pg/disk was considered as a threshold value and called for a second assay, which was performed in 0.18% of the cases. Pathologic values of 17-OH-progesterone were confirmed in the serum of 4 neonates. In our population the incidence of 21-hydroxylase deficiency was found to be 1 out of 5,558 cases.

Adrenal Hyperplasia, Congenital↗
PubMed1982

Effect of somatostatin on fasting and glucose-stimulated gastric inhibitory polypeptide release in man.

The effect of intravenous somatostatin infusion on circulating gastric inhibitory polypeptide (GIP), insulin, glucagon and on blood glucose was investigated in 7 healthy volunteers in the fasting state and during the oral ingestion of 75 g glucose. Somatostatin (1.1 microgram/kg/h) infused 30 min before and continued 60 min after the ingestion of glucose did not affect fasting levels of any of the above parameters while it significantly suppressed the GIP and insulin response to glucose. The same somatostatin dose infused 30 min after the ingestion of glucose decreased significantly the raised levels of GIP and insulin and further increased blood glucose levels. It is concluded that somatostatin inhibits GIP release mainly at the level of the GIP-producing cells.

Adult↗
PubMed1982

Impairment of blood pressure control in patients with liver cirrhosis during tilting: study on adrenergic and renin-angiotensin systems.

Mean arterial pressure, phenylalanine, tyrosine, norepinephrine and plasma renin activity (PRA) were determined in the plasma of 6 healthy controls and 8 patients with liver cirrhosis receiving a controlled sodium intake (40 mEq/day), after 1 h of bed rest and 10 min after being tilted up at 90 degrees. After resting, patients showed lower arterial pressure (p less than 0.025) and higher plasma levels of phenylalanine (p less than 0.005), tyrosine (p less than 0.05), norepinephrine (n.s.) and PRA (n.s.) than controls. In spite of a prolonged and marked stimulation of the adrenergic system induced by tilting, arterial pressure of cirrhotics, after an initial increase, decreased significantly. A significant PRA increase was observed in both groups but in patients it was greater and lasted longer, up to 30 min, when PRA and arterial pressure were inversely and significantly correlated. The adrenergic system of cirrhosis then appeared unable to maintain adequate levels of arterial pressure, even though hyperstimulated. The renin-angiotensin system played an important compensatory role in this contest.

Adult↗