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Biomedical subjects

A Cavallo

Publications and source records attributed to A Cavallo.

At least 91 records · Page 5Linked to original sources
PubMed1988

[Angiographic and clinical evaluation of the topical administration of nitrate derivatives in distal obstructive arteriopathies of the legs. Initial experiences].

The vasodilator effect obtained by the topic use of a nitroglycerin compound (TNG) has been angiographically tested on 11 patients affected by distal arteriopathy of the legs. All patients presented arteriosclerotic vascular lesions; two of them also suffered from diabetic angiopathy. Arteriography of the legs has proved to be a very important tool in the evaluation of the patients' response to the administration of the drug. An hour after 80 mg of TNG had been applied to the skin of the examined leg, arteriography showed a marked dilation, especially of the muscular arteries and the undamaged tracts of the arteries of the legs. Angiographic evaluation of the functional blood supply thus obtained provides prognostic information and helps in the choice of the subsequent therapy. Furthermore, the clinical efficacy of prolonged treatment with this drug has been tested in 10 out of the 11 patients. They all responded with an immediate and persistent hemodynamic improvement, evaluated according to Fontaine's classification.

Administration, Topical↗
PubMed1987

Diagnostic validity of 12-hour integrated concentration of growth hormone.

We tested the hypothesis that integrated concentration of human growth hormone (ICGH) during the 12-hour nighttime (8 pm to 8 am) period is closely correlated with the 24-hour integrated concentration and would be as useful for diagnostic purposes. We determined hourly ICGH during 24 hours in 67 children and calculated the 12- and 24-hour values. Nineteen children had normal stature, 13 had classic growth hormone deficiency, four had growth hormone neurosecretory dysfunction, 23 had short stature but no hormonal abnormality could be diagnosed, and eight had miscellaneous disorders. There was a close correlation between the 12- and the 24-hour ICGH. For diagnostic purposes, 12-hour nighttime ICGH is as useful as 24-hour ICGH. Use of the shorter test for determination of physiologic growth hormone secretion will save the patients time, expense, and blood volume.

Child↗
PubMed1987

The complications of surgery for intersex: changing patterns over two decades.

To evaluate the changing patterns of complications of surgery for intersex, the records of 58 patients operated on for ambiguous genitalia over the last two decades were reviewed. Patients with 21-hydroxylase deficiency constitute the largest group. These patients required the fewest operations and had the fewest complications. Surgery for all other diagnoses was accompanied by a high incidence of multistaged procedures and a high complication rate. The operations associated with the highest complication rate were those for vaginal reconstruction and severe hypospadias. Stenosis of the vagina and urinary tract problems accounted for most of the problems. Before 1975, the management of intersex was associated with a later age at diagnosis and initial operation, and a higher incidence of multistaged procedures performed by multiple surgeons from different specialties. These factors contributed to a higher complication rate than that observed after 1975, when patients were diagnosed and operated on earlier and had fewer complications.

Adolescent↗
PubMed1987

Evaluation of 5-hydroxytryptophan administration as a test of pineal function in humans.

We tested the hypothesis that acute 5-hydroxytryptophan (5-HTP) administration would cause an increase in concentrations of plasma melatonin to levels observed during the spontaneous nocturnal melatonin surge. We administered 5-HTP orally (5-12 mg/kg) to 10 healthy children and 5 healthy adults, and measured melatonin concentrations in plasma samples obtained every 30 min for 3-6 h. There was no appreciable increase in melatonin after 5-HTP stimulation, even though a melatonin increase has been reported in sheep treated with 5-HTP.

5-Hydroxytryptophan↗
PubMed1987

In vivo immunoreactive adrenocorticotropin (ACTH) production by human mononuclear leukocytes from normal and ACTH-deficient individuals.

Mononuclear leukocytes from 25 children (16 with normal pituitary ACTH production and 9 with ACTH deficiency) were examined for in vivo ACTH production by immunofluorescence with antiserum to ACTH-(1-13) amide. The protocol included 3 study periods: control, after administration of insulin, and after administration of typhoid vaccine (an interferon-alpha inducer). Plasma cortisol and mononuclear leukocyte ACTH immunofluorescence were measured before (0900 h) and 1, 2, 4, 6, 8, and 10 h after treatment on each of the 3 study days. In vitro studies with human leukocytes from normal subjects incubated with ACTH, insulin, or typhoid vaccine were also performed. Patients with normal pituitary ACTH production had an increase in the number of ACTH immunofluorescence-positive cells 1 h after insulin administration [25 +/- 5% (+/- SEM) to 44 +/- 6% P less than 0.05], and no change after typhoid administration. ACTH-deficient patients had no change after insulin administration and a significant rise 6 h after typhoid vaccine treatment (24 +/- 12% to 50 +/- 6%; P less than 0.05). The number of ACTH immunofluorescence-positive cells did not increase when mononuclear leukocytes were incubated in vitro with ACTH or insulin (with or without glucose deprivation). However, typhoid antigen enhanced this response from 8% to 55%. These data suggest that the number of human mononuclear leukocytes containing immunoreactive ACTH is increased by at least 2 stimuli: 1) a central factor(s), such as CRH, accounting for the in vivo rise 1 h after insulin administration in patients with an intact hypothalamic-pituitary axis, and 2) an interferon inducer (e.g. typhoid antigen), accounting for the typhoid antigen-induced rise in the number of ACTH-positive cells in vivo in ACTH-deficient patients and in vitro.

Adolescent↗
PubMed1986

Insulin resistance with acanthosis nigricans: the roles of obesity and androgen excess.

The roles of hyperandrogenemia and obesity in the syndrome of severe insulin resistance with acanthosis nigricans were evaluated in studies of 11 females with this condition. Our results in these subjects were compared to evaluations of control subjects matched for degree of androgen excess or obesity. Fasting insulin levels were 3-, 5-, and 15-fold higher in the obese (OB), hyperandrogenemic (HO), and acanthosis nigricans (AN) groups, respectively, when compared to normal females. Responsiveness to a standard bolus of exogenous insulin was 78% of normal in the OB group, 40% of normal in the HO group, and 30% of normal in the AN group. Insulin binding to monocytes from both the OB group, and the HO group was modestly diminished primarily due to decreased receptor number. As a group, AN subjects when compared to either normal or weight-matched controls, demonstrated a significant decrease in monocyte insulin binding predominantly due to a decrease in receptor number. However, two patients in the AN group had normal insulin binding suggesting a postreceptor mechanism for the insulin resistance in at least some of these subjects. In vivo glucose utilization insulin dose response curves were determined in 3 acanthotic subjects using the euglycemic clamp technique. All 3 of these subjects had a right shift of the curve and diminished maximal utilization, consistent with combined receptor and postreceptor defects in insulin action. In evaluating the relationship between hyperandrogenemia, insulin resistance, and acanthosis nigricans, significant correlations among basal levels of plasma insulin, and both testosterone and androstenedione were demonstrated.(ABSTRACT TRUNCATED AT 250 WORDS)

Acanthosis Nigricans↗
PubMed1985

Is there a thyrotoxic cardiomyopathy in children?

We measured left ventricular ejection fraction by radionuclide angiocardiography at rest and during graded exercise in eight thyrotoxic children. Five patients were reassessed after return to a clinically euthyroid state. In the thyrotoxic state the left ventricular ejection fraction was 69% +/- 8% at rest, and increased normally by 7% to 10% during exercise in four patients but did not change significantly or decreased by as much as 8% in the other four patients. The change in left ventricular ejection fraction during exercise correlated inversely with serum concentrations of thyroxine (r = -0.82, P less than 0.02) and triiodothyronine (r = -0.88, P less than 0.01). A comparison between patients who had normal left ventricular response to exercise with those who had abnormal response while thyrotoxic failed to uncover any significant differences between their resting ejection fractions or resting and exercise heart rates and systolic blood pressures. Three abnormal and two normal responders were reassessed after return to a clinically euthyroid state. The left ventricular ejection was 64% +/- 6% at rest, and increased during exercise in all patients. Our study suggests that thyrotoxicosis causes diminished left ventricular reserve (compensated functional cardiomyopathy) in some patients, but appears to be reversible. Severity of thyrotoxicosis, as measured by thyroid hormone blood levels, may be a determining factor in the development of functional cardiomyopathy.

Adolescent↗
PubMed1985

Obesity, acanthosis nigricans, insulin resistance, and hyperandrogenemia: pediatric perspective and natural history.

We studied the syndrome of acanthosis nigricans, obesity, insulin resistance, and hyperandrogenemia in 22 patients. Although isolated case reports in adolescents have appeared, this syndrome has not received full recognition as a pediatric entity. Our patients (17 girls, five boys) had a mean weight 5.7 SD above the mean for age, although mean height was only 0.5 SD above the mean for age. All patients had acanthosis nigricans. Their insulin resistance was significantly greater than that in a control group with comparable obesity. Fasting insulin concentration was 5.25 microU/ml in lean controls, 19.6 microU/ml in obese controls, and 49.8 microU/ml in study patients (P less than 0.002). Mean glucose disappearance rate during an insulin tolerance test was 6.7%/min in lean controls, 5.19%/min in obese controls, and 2.35%/min in study patients (P less than 0.02). After menarche, mean plasma testosterone concentration was 106 ng/dl, compared with less than 50 ng/dl in all lean and obese control patients. Data derived from our series of patients lead us to conclude that (1) this is a genetic syndrome, although the exact mode of inheritance is unclear; (2) the natural history of the syndrome invariably begins with the onset of obesity, followed by acanthosis nigricans that worsens with progressive weight gain; (3) acanthosis nigricans is thus a marker for hyperinsulinemia, which occurs before hyperandrogenemia; (4) hyperandrogenemia occurs only after menarche. Identification of this syndrome should permit monitoring for the development of hyperandrogenemia during puberty and determination of other affected family members.

Acanthosis Nigricans↗
PubMed1985

[Radiologic changes of the hands in psoriatic rheumatism].

The radiological features of the psoriatic arthritis, already known in the literature, are reviewed by the authors. On the basis of their own record (33 patients), they underline 3 peculiar features of the disease: thickening of the soft tissue involving the whole finger, three joints involvements of the same finger, association of subchondral proliferation and periostitis.

Arthritis↗
PubMed1984

Plasma prolactin and cortisol concentrations in epileptic patients during the night.

Plasma cortisol and prolactin concentrations were determined every four hours, from 8 PM to 8 AM, in 19 epileptic patients during EEG recording of sleep. Data were compared with those obtained from 12 healthy young male volunteers studied under similar conditions. Patients had normal cortisol rhythm, with peak levels at 4 AM or 8 AM and trough at midnight. A sleep-related increase in prolactin concentration was observed in all patients. The range of prolactin concentrations in the patients was also normal. Treatment with valproic acid (ten patients) and frequent abnormal EEG discharges (five patients) did not affect cortisol and prolactin secretion.

Adolescent↗
PubMed1984

Cardiac complications in juvenile hyperthyroidism.

During a retrospective study, we discovered unusual cardiac manifestations in seven of 21 hyperthyroid patients. Three patients had a transient apical systolic murmur, one had persistent cardiomegaly, and the remaining three had persistent apical systolic murmurs and cardiomegaly; mitral regurgitation and congestive heart failure developed in two of these three patients. Severe, persistent cardiac complications occurred only in patients who had prolonged hyperthyroidism caused by poor compliance with antithyroid drug treatment.

Adolescent↗
PubMed1984

A family study of ankylosing spondylitis.

Clinical, radiological and scintigraphic studies and HLA type assessment were performed in 38 subjects, constituting all the first-degree members of three generations of the families of six patients affected with ankylosing spondylitis (AS). The families included both parents, all siblings and all children of the probands. Definite AS was found in three men and possible AS in another. In another man and in a woman, a diagnosis of asymptomatic bilateral sacroiliitis was made. These six subjects indicate a family prevalence of AS reaching 15.8%. HLA B27 was present in 20 individuals (52.6%), including those with definite and possible AS and the case with asymptomatic sacroiliitis. The woman with asymptomatic sacroiliitis lacked HLA B27 antigen. Our study confirms the familial occurrence of AS, but it shows the occurrence to be lower than that previously reported.

Adolescent↗