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R Valcavi

Publications and source records attributed to R Valcavi.

44 records · Page 3Linked to original sources

The influence of oestrogens on the sensitivity of PRL, TSH and LH to the inhibitory actions of dopamine in hyperprolactinaemic patients.

The effects of oestrogen priming on the response of serum PRL, LH and TSH to dopamine (DA) infusion have been studied in hyperprolactinaemia. Seven hyperprolactinaemic females (aged 22-57 years; basal PRL 911-5130 mU/l, normal less than 420 mU/l), had submaximal DA infusions (0.06 micrograms/kg/min) over 3 h. The DA was repeated at the same dose after pretreatment with ethinyl oestradiol (E2) 100 micrograms daily by mouth for 3 d, and after a further 2 week interval, following pretreatment with tamoxifen (TAM) 20 mg twice a day by mouth for 3 d. Ethinyl oestradiol pretreatment stimulated a rise in basal PRL levels in all subjects (mean +/- SE, mU/l; 2903 +/- 761 vs 2293 +/- 684, P less than 0.05) while TAM produced a higher but more variable increase in basal PRL levels (mean +/- SE, mU/l; 3402 +/- 757, P = n.s.). The individual increments in basal PRL levels after both E2 and TAM pretreatment showed a significant positive correlation with the greater decrement in PRL levels during E2 and TAM primed DA infusions (E2, r = 0.93, P less than 0.01, TAM, r = 0.83, P less than 0.05). E2 pretreatment produced a rise in basal LH levels in 5/7 patients, and there was a significant positive correlation between the rise in basal LH levels after E2 and the decremental change in LH levels in E2 primed DA infusions (r = 0.94, P less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Detection and diagnosis of parathyroid incidentalomas during thyroid sonography.

PURPOSE: The aim of our study was to evaluate the incidence of incidentally found parathyroid adenomas (incidentalomas) in patients undergoing sonography of the neck for thyroid disease. METHODS: A total of 1,686 patients (305 men and 1,381 women) underwent sonography of the neck; the mean age was 49.6 +/- 21.7 years. In 38 patients (2.3%; 7 men and 31 women) with a mean age of 48.7 +/- 14.7 years, hypoechoic, homogeneous, oval nodules (mean volume, 1.0 +/- 0. 9 cm(3)) adjacent to the thyroid parenchyma were observed. All these lesions, compatible with the shape of an enlarged parathyroid gland, underwent ultrasound-guided fine-needle aspiration biopsy (FNAB), with measurement of parathyroid hormone (PTH) and thyroglobulin (Tg) levels in the needle washings (FNAB-PTH and FNAB-Tg). Biochemical screening for hyperparathyroidism was also performed. RESULTS: Cytologic examination plus FNAB-PTH/FNAB-Tg measurements revealed the presence of cellular material consistent with parathyroid tissue in 9 patients (24%), thyroid tissue in 22 patients (58%), and lymphoid tissue in 4 patients (11%). A tissue diagnosis was not established in 3 patients (8%). Five of 9 patients with parathyroid enlargement had high serum PTH and calcium levels. CONCLUSIONS: Enlarged parathyroid glands may be incidentally discovered during sonography of the thyroid. In patients with thyroid disease, the positive-predictive value of sonography in the identification of parathyroid tissue was low. Ultrasound-guided FNAB-PTH determination should be carried out when parathyroid adenoma is suspected. The incidental finding of an enlarged parathyroid may or may not be associated with yet undiagnosed hyperparathyroidism.

Adenoma↗

Plasma cortisol and aldosterone after ACTH 1-17: effect of different doses.

In order to evaluate the effects in adults of different doses of ACTH 1-17 on the cortisol and aldosterone secretion, 200 micrograms of ACTH 1-17 were injected i.m. at 07(00) in two groups of 6 patients each of both sexes. Sampling was done before and after ACTH 1-17 administration at 4-h intervals from 08(00) to 04(00) in order to define the circadian profiles of both cortisol and aldosterone. At the time of study all subjects were kept under the same routine conditions. The i.m. injection of 100 micrograms of ACTH 1-17 was followed by a maximum response of cortisol which coincided with the physiological circadian peak of the hormone (511.7 +/- 122.7 vs 195.5 +/- 92.9 ng/ml; mean +/- 1 SD; p less than 0.001). With this treatment no variations in the normal circadian rhythm were observed. After the injection of 200 micrograms ACTH 1-17, a marked variation in the circadian rhythm of cortisol (peak at 16(00): 390.0 +/- 49.8 ng/ml; mean +/- 1 SD) was observed. Significant variations in the circadian rhythm of aldosterone with respect to the normal profile were observed only after the injection of 200 micrograms ACTH 1-17 (peak at 16(00): 137.5 +/- 50.5 vs 50.8 +/- 36.1 ng/ml; mean +/- 1 SD; p less than 0.01). The hormone increase observed after the injection of 100 micrograms (peak at 08(00): 111.7 +/- 87.5 vs 61.3 +/- 16.5 ng/ml; mean +/- 1 SD) was not statistically significant. Our results indicate that the clinical use of ACTH 1-17 i.m. is not recommended at doses greater than 100 micrograms.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenocorticotropic Hormone↗