Afterload reducing agents in congestive cardiomyopathy; a study with a calcium antagonist drug: nifedipine.
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Biomedical subjects
Publications and source records attributed to P Fioretti.
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Prenatal diagnosis by globin chain synthesis analysis on fetal blood samples obtained by placental aspiration was performed in two pregnancies at risk for beta-thalassaemia. Since both fathers had blood group AB, and both mothers had group O, fetal red cell concentration from maternal-fetal mixtures was obtained with the aid of anti-AB serum. With this approach it was possible to carry out globin chain synthesis analysis with very small amounts of fetal blood. Heterozygous and normal genotypes were ascertained and confirmed after birth.
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Plasma levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), dehydroepiandrosterone (DHA), dehydroepiandrosterone-sulphate (DHA-S), 17-hydroxyprogesterone (17P), androstenedione (A), testosterone (T), dihydrotestosterone (DHT) and estradiol (E2) were measured in basal conditions in eleven young women from 16 to 25 years of age characterized by delayed puberty. The gonadotropin response to LHRH (50 microgram iv) was also tested in these cases. The results, as far as gonadotropins and E2 are concerned, indicate that delayed pubertyin girls is a heterogeneous disorder: an impairment in the negative feedback between E2 and FSH coexists with a reduced ovarian response to endogenous gonadotropins. All cases showed evidence of a more or less pronounced delayed adrenarche, which was demonstrated by the markedly reduced levels of DHA-S and DHA (with the exception of this latter steroid in two cases with idiopathic hirsutism). Furthermore, the very low plasma progesterone (P) levels in all cases suggest the existence of impaired delta 5 - delta 4 isomerase activity in the adrenal cells. Despite the low levels of A and T, DHT is within the upper limits of the normal range in all cases.
The influence of gamma-amino-beta-hydroxy butyric acid (GABOB) treatment on pituitary function has been investigated in this study. Different doses (50 x 100 mg) of GABOB were iv injected into three and six normal women, respectively. PRL and GH plasma levels were measured before and after the injection. The treatment with 150 mg GABOB, performed in another two normal women, was interrupted because of side-effects (loss of consciousness etc.) due to the treatment. The treatment with 50 mg GABOB did not induce significant variations of the two hormones; however, significant increases of PRL (P less than 0.05) and GH (P less than 0.01) plasma levels were observed after injection with 100 mg GABOB. The present data suggest that gamma-amino butyric acid (GABA) itself of GABAergic drugs might play an important role in the control of hypothalamic-pituitary function.
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In women with physiological puerperal hyperprolactinaemia, acute administration of Piribedil (100 mg po), a drug which stimulates dopamine receptor sites, was as effective as that of 2-Br-alpha-ergocryptine (CB 154, 5 mg po) in suppressing the elevated baseline plasma prolactin (PRL) levels. In two hyperprolactinaemic women with radiological evidence of an intrasellar pituitary tumour, Piribedil (100 mg po), in contrast to CB 154 (5 mg po), failed to modify plasma PRL levels, whereas in 3 other hyperprolactinaemic women with no radiological evidence of pituitary tumour, its effect was not clear-cut, even though it could not be differentiated from that of CB 154. These results indicate that Piribedil is an effective suppressor of plasma PRL levels in the human and suggest that its action is more evident in puerperal than in pathological hyperprolactinaemia.
Cytogenetic, clinical and endocrinological studies were performed on a phenotypically female subject who had a XO/XY mosaicism. This patient had a primary amenorrhea. A disgenic testis on the left side and a primordial ovary on the right one was showed by laparotomy performed in this subject in the prepubertal age. The Y chromosome had not any fluorescence and was shorter than normal one. The basal plasma levels of various hormones and the hypothalamic-pituitary stimulation tests were similar to other subjects with gonadal disgenesis. However a low response of growth hormone to insulin tolerance test, showed in this case, suggest the necessity to early supply a sufficient replacement of therapy.
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Twenty puerperal women in 4th day after delivery were treated with a saline infusion containing 10 mg of PgF2alpha. Milk secretion, breast engorgement, prolactin plasma levels and side effects were determined. In all patients lactation disappeared within 48 hours after PgF2alpha infusion. During the following 12 hours after PgF2alpha treatment the prolactin plasma levels showed an important and significant decrease in all cases. In the following days the prolactin plasma levels decreased such as in normal puerperium. In some cases low gastralgia and in one case diarrhoea compaired. These results can be explained by PgF2alpha double action either on pituitary-hypothalamic function or on mammary gland cells.
Plasma immunoreactive ACTH (I.R.ACTH), immunoreactive human chorionic somatomammotrophin (I.R.HCS) and 11-OH steroids levels were measured during normal and pathological pregnancies. Plasma I.R.ACTH levels were found to be above normal during pregnancy, with a slight decrease near term. This observation correlates well with the recent description of human chorionic corticotrophin (HCC), i.e. a factor of placental origin possessing a high biological adrenocorticotrophic activity and presenting partial immunological cross-reaction with human ACTH. The 11-OH steroids levels, as measured by a fluorimetric method, increased regularly during pregnancy but, unlike ACTH, reached their highest value near term, I.R.HCS increased progressively until term when a slight decrease was observed. In pathological pregnancies, I.R.ACTH levels behaved like other placental hormones. On the contrary, 11-OH steroids levels remained generally unmodified. Treatment with high doses of prednisolone caused no inhibition of the plasma I.R.ACTH and of plasma 11-OH steroids levels. These data suggest placental autonomy of the secretion of HCC and low adrenal responsiveness to endogenous ACTH variations throughout pregnancy.
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In recent years, mono and biplane cardioangiography has been used to calculate the left ventricular volume. In order to evaluate the reliability of the various methods currently most used, a study of 14 hearts removed during autopsy was carried out. The left ventricle was filled with a mixture of paraffin and Lipiodol, the hearts were then X-rayed in anteroposterior projection (AP), laterolateral (LL) and left oblique posterior (OPS) at 30 degrees. The ventricles were opened and the real volume of the cost was obtained by means of the measurement of the volume of displaced liquid. The left ventricular volume was calculated using the methods of Dodge and coll., Sandler and Dodge, Greene and coll. and Kennedy and coll. The data obtained were statistically worked out. With all the tecniques used, there was a good correlation between values of true volume and the volume calculated with the angiographic methods. The coefficient of correlation varied between 0,940 (Dodge and coll. method) and 0,979 (Sandler and Dodge method). A more detailed analysis however, demonstrated that in the hearts with lower volumes, the correlation coefficient is lower and completely unsatisfactory with the methods of Kennedy and coll. and the method of Greene and coll. In these cases some indexes of ventricualr function (stroke volume, ejection fraction) may be not reliable.
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The high plasma cortisol and ACTH levels present in pregnant women as well as the non-parrallelism of their plasma extract dilution curves in comparison with the standard curve in the ACTH radioimmunoassay, are evidence for the presence of an ACTH-like substance during pregnancy which would interfere with the assay. Placental extracts were obtained by acid-acetone extraction, followed by partial purification with oxycellulose and by extraction with porous glass powder. A substance was detected which partially cross-reacted with synthetic human ACTH in the radioimmunoassay and which showed biological activity using the assay procedure described by Liscomb & Nelson. The data sustain the existence of an ACTH-like placental hormone: human chorionic corticotrophin (HCC).
On the basis of the behaviour during menstrual cycle of the pituitary hormones plasma levels, the Authors have studied during the different periods of the cycle (follicular, ovulatory and luteal) the effects of OGTT and ITT's on the plasma levels of Glucose, insulin, HGH and Cortisol. Significantly lower levels of IRI, HGH and Cortisol were found in follicular phase compared to ovulatory period and luteal phase except for Cortisol in luteal phase. A slightly higher glucose tolerance was found in follicular phase as well as a reduced hypoglicemia under insulin load. Reduced HGH response to ITT was found in follicular phase as well as a reduced Cortisol response compared to the results observed in ovulatory and luteal phase. These data sustain the concept that hormonal variations occurring in an ovulatory cycle are also capable of modifying the woman's body response to various stimuli such as OGTT and ITT.