[The role of oxytocin in neonatal hyperbilirubinemia].
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Biomedical subjects
Publications and source records attributed to M Gemelli.
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43 patients over 60 years of age underwent an aortocoronary bypass operation between 1974 and 1977. The observation period after surgery ranged from 4 to 7 years. Clinical results of this group were compared with the results of a group who presented with the same presurgical and surgical characteristics, randomly chosen between 212 patients under 60 years of age operated on in the same period. Surgical mortality was 16.2%, higher than that of the control group (5.5%); similar and very low is the late mortality in both groups (average follow-up on 5.3 years): 2.9% vs 5.5%. The effects on angina are favourable: 79.4% of elderly patients are free from angina and improvement in symptoms is present in all; left ventricular failure is rarely present (7.6%); congestive heart failure is absent. Moreover we pointed out the efficacy of the aortocoronary bypass on return to work. These results lead to a more favourable attitude towards operation in subset of patients showing serious symptoms of coronary heart disease in old age.
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A case is recorded of persistent neonatal hypoglycaemia characterized by early onset, normoinsulinaemia and improvement following glucagon therapy. The pancreatic A cell were very few in number and were mainly degranulated. There was a slight increase of B cells, but changes in cells producing somatostatin and human pancreatic polypeptide were not encountered. The differential diagnosis is discussed with the conclusion that the most probable causative factor was the deficiency of A cells.
Pituitary testicular function was investigated in 19 prepubertal and in 5 pubertal male thalassaemic patients. Total plasma testosterone in prepubertal and in pubertal patients was significantly lower than in controls. In the prepubertal thalassaemics, the lower total testosterone concentration correlated with the diminished sex hormone binding globulin binding capacity (SHBGcap), and the free testosterone levels were normal. The lower testosterone is probably due to the damaged liver function rather than to a diminished testicular function. In the pubertal patients, the testosterone reduction is equally due to the SHBG bound testosterone fraction and the free testosterone fraction. Basal and LHRH stimulated plasma gonadotrophin levels were also significantly decreased in the pubertal subjects. The observed hypotestosteronemia in the pubertal thalassaemics seems to depend on the impaired pituitary gonadotrophin secretion probably due to the chronic iron overload.
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We report the case history of a child with congenital adrenal hyperplasia which was complicated by recurrent hypoglycaemic episodes during common infections. There are few reports in literature on the association of hypoglycaemia and congenital adrenal hyperplasia. In accordance with others, we believe that hypoglycaemic attacks in adrenal hyperplasia are perhaps more frequent than recorded in literature.
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