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Biomedical subjects

M Cisternino

Publications and source records attributed to M Cisternino.

71 records · Page 4Linked to original sources

Absolute bioavailability of ceftriaxone after intramuscular administration to healthy volunteers.

The disposition and bioavailability of ceftriaxone, a novel cephalosporin, was studied in 7 healthy volunteers after a single 1.5-gram intramuscular administration in comparison with the same dose given by the intravenous route. The plasma levels were measured by means of a high-performance liquid chromatography method up to 48 h after administration. Comparable areas under plasma concentration-time curve (AUC) and biological half-life were obtained proving that ceftriaxone, if assessed by conventional methods, is completely bioavailable when given by the intramuscular route. However, taking into account its nonlinear pharmacokinetics it becomes obvious that direct comparison of AUC values generally leads to a certain overestimation of bioavailability after extravascular administration. This aspect is briefly discussed.

Adult↗

Antiinflammatory drugs and gastric emptying. A comparison between acetylsalicylic acid and carprofen.

Continuing their studies of gastric emptying modifications induced by nonsteroid anti-inflammatory drugs, the authors investigated the effects of 6-chloro-a-methylcarbazole-2-acetic acid (carprofen, Imadyl) versus those of acteylsalicylic acid (ASA) in an open crossover study of 10 healthy volunteers with normal gastric motility. The subjects received a standard meal labeled with 99Tc DTPA and were monitored for gastric emptying over time by scintiscanning with a gamma ray camera wired to a computer. Each subject was examined in basal conditions and after dosing with carprofen and ASA in random sequence with a 10-day washout period between tests. With the ASA treatment, all subjects showed considerable prolongation of gastric transit compared to pretreatment values, both in terms of first discharge of labeled bolus into the duodenum and of percent gastric radioactivity dissipated at 20 min. With carprofen, both parameters were influenced in the same direction to a significantly lower degree, to the point where the difference from pretreatment values was statistically improbable.

Adult↗

LHRH test in Bartter's syndrome before and during treatment with prostaglandin synthesis inhibitors.

LHRH tests were performed in two children with Bartter's syndrome before and during treatment with prostaglandin synthesis inhibitors. Before treatment, in patient 1 both basal and peak FSH and LH levels were elevated; in patient 2 basal and peak FSH levels were above the normal range, while basal and peak LH levels were normal. During treatment with an inhibitor of prostaglandin synthesis, abnormal values decreased into the normal range. These results support a possible role of endogenous prostaglandins in regulating gonadotrophin secretion in humans.

Aspirin↗

Plasma concentrations of amitriptyline during single nightly and thrice daily administration. Cross-over study.

Plasma amitriptyline and nortriptyline concentrations were measured in ten depressed in-patients after administration of amitriptyline hydrochloride 75 mg in three divided doses or as a single nightly dose. Mean steady state plasma concentrations during the two dosage regimens were similar. Plasma level differences between dosage schedules at sampling times were small and not significant. It was concluded that the single nightly administration of amitriptyline is a helpful therapeutic schedule which can be used instead of the divided dose when the opportunity is given.

Amitriptyline↗

Cyproterone acetate treatment in precocious puberty.

Seven girls with precocious puberty, idiopathic in 6 and associated with the McCune Albright syndrome in 1, were treated with 70 mg/M2/die of cyproterone acetate (CPA) for 11 to 36 months. Before and during treatment clinical parameters (weight, height, bone age, height velocity, prediction of adult height and pubertal development) were evaluated and plasma hormone assays in basal conditions (LH, FSH, 17 beta-estradiol, progesterone, testosterone, PRL, ACTH and cortisol) and after stimulation (LH, FSH, cortisol, GH) were carried out to assess the efficacy and eventual side effects of CPA. The regression observed in the clinical signs of puberty was considered satisfactory and the increase observed in the developmental quotient indicated an improved prognosis for adult height. No symptoms of adrenal insufficiency were observed but an adrenal suppressive effect of CPA was evident from the response to insulin hypoglycemia observed in 4 patients.

Child↗

Recombinant growth hormone treatment in short patients with thalassemia major: results after 24 and 36 months.

Treatment with recombinant growth hormone (rhGH), 0.6 IU/kg/week s.c., previously successfully conducted for one year, was continued in 15 (Group A) and 8 (Group B) short thalassemia major patients with reduced GH reserve, for two and three years, respectively. In Group A, height for chronological age (Ht SDSCA) increased significantly (p = 0.021) from the start of treatment, but the positive effect was only apparent because of the concomitant slight worsening of height for bone age (Ht SDSBA). Median deltaHt SDSCA/deltaHt SDSBA was <1.0 with respect to both the start (0.87) and the end of the first year of rhGH therapy (0.89). IGF-I levels increased significantly (p = 0.043) compared with values both at the start and at the end of the first year of rhGH therapy. In Group B neither Ht SDSCA nor Ht SDSBA differed statistically from starting values, the former having a positive trend and the latter a negative one. Median deltaHt SDSCA/deltaHt SDSBA was 0.92 with respect to the start, and 0.94 with respect to the end of the second year. IGF-I levels increased significantly (p = 0.043) with respect to starting values. Our data show that the encouraging results described from the first year of rhGH treatment did not persist during the second and third years, and we conclude that this is because increase in bone age with continued treatment is equal to, or slightly greater than the height age increase. We propose that patients with thalassemia major with short stature should receive rhGH treatment for only one year, and that more prolonged treatment should be reserved for selected adolescents who have psychological problems due to shortness; for these patients growth acceleration could represent the main goal, even if this leads to a substantially unchanged or slightly decreased final height.

Body Height↗

Final height outcome in both untreated and testosterone-treated boys with constitutional delay of growth and puberty.

The present retrospective study is based on a historical follow-up of 49 boys with constitutional delay of growth and puberty (CDGP) who went into puberty spontaneously (27 cases) or induced by depotestosterone treatment, 50 mg/ month for 6 months (22 cases). At the time of puberty the two groups of boys were similar in bone age, height deficiency, target height (TH) and had similar predicted final heights (FH). Their FH was measured and compared with TH calculated from measured parents' heights. FH did not significantly differ between the untreated boys and those treated. In the two groups of patients FH was similar and corresponded to both TH and height predicted at puberty onset. This study confirms that most boys with CDGP spontaneously attain a FH within the target range (24/27 cases). A short-term and low dose course of depotestosterone can be used without adverse effects on FH. The Bayley-Pinneau method can be generally considered accurate for predicting FH in CDGP, although significant discrepancies between FH and predicted height have been recorded in a fair number of both untreated and treated boys.

Adolescent↗

McCune-Albright syndrome: a longitudinal clinical study of 32 patients.

We report the diagnostic clinical features and their long term evolution in 32 patients with McCune-Albright syndrome. Patient data are made up of two periods: the first, classified as personal history, is from birth until the time when the diagnosis of McCune-Albright syndrome was made; the second, classified as clinical observation, is from the first observation until the end of follow up. The total duration of these two periods was 9.6+/-2.9 yr; mean age at first observation was 5.7 yr (range 0.7-11 yr). The probability of manifesting main clinical signs according to age was calculated: almost all had skin dysplasia at birth, 50% probability of peripheral precocious puberty in females at 4 years and 50% of bone dysplasia at 8 years of age were found. Other clinical signs had diagnostic relevance when preceding the main signs leading to diagnosis of McCune-Albright syndrome even without specific genetic investigation. The most important clinical manifestations have different evolutions: skin lesions increase in dimensions according to body growth; precocious puberty in females evolves rapidly but periods of regression can be seen in some patients; bone dysplasia in most patients evolves with an increase both in the number of affected bones and in the severity of lesions.

Child↗

[Hyperthyroidism in children (author's transl)].

The present paper analyzes the causes, signs and symptoms of hyperthyroidism in children and the problems, complications and results associated with the various therapeutic regimes. Childhood hyperthyroidism is usually due to Grave's disease, an autoimmune thyroid disease. Genetic factors are also involved in its development. The diagnosis and in particular the differential diagnosis with Hashimoto's thyroiditis are discussed. Treatment of Graves' disease is controversial, but medical therapy is commonly accepted as the treatment of choice. Some dosage schedules of antithyroid drugs are considered, and some techniques for predicting remission status and relapse of disease are reported. Both the minor and more serious complications of medical therapy are examined. Careful follow-up for the development of hypothyroidism is advocated, especially in patients treated with radiation or surgery. Autonomous hyperfunctioning thyroid adenoma is rare, but occurs even in childhood, and can degenerate into carcinoma.

Adolescent↗