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Biomedical subjects

C Carella

Publications and source records attributed to C Carella.

At least 73 records · Page 4Linked to original sources

ACTH and cortisol plasma levels in cancer patients treated with medroxyprogesterone acetate at high dosages.

The effects of medroxyprogesterone acetate (MPA) at high dosages on ACTH and cortisol plasma levels have been studied on seven patients which were carriers of ER+ and PR+ neoplasm. ACTH and cortisol plasma levels were studied at 8:00 a.m., before and after a 4-week treatment with MPA at dosages of 1000 mg/die at basal conditions and after a metyrapone stimulation test. The results obtained show that the MPA treatment causes a highly significant drop of both cortisol and ACTH plasma levels. The metyrapone stimulation test performed before and after MPA treatment confirms the suppressive effect of MPA on the hypothalamus-pituitary-adrenal gland axis. These data suggest a cortisol-like action of MPA with a negative feed-back mechanism on the hypothalamus-pituitary-adrenal gland axis.

Adrenocorticotropic Hormone↗

TSH response to TRH in hemodialysis and CAPD patients.

The thyroid status was studied in 19 uremic patients (11 on HD and 8 on CAPD) and in a group of 17 healthy adult patients. In uremic patients T3 and T4 were significantly reduced (p less than 0.001) and rT3 was increased (p less than 0.001). The time course TSH response to TRH showed a lower peak response (in 5 patients it did not exceed 5 microU/ml) which on turn was also delayed (the peak was observed at 60 minutes in 63% of them). TSH concentrations in uremics were increased at 0 time (p less than 0.02), lower at 20 minutes (p less than 0.01) and increased at 120 minutes (p less than 0.02). No difference existed between HD and CAPD. The thyroid response to TSH was normal as showed by a normal percent increase over basal values of T3 concentrations at 120 minutes. Uremic patients also showed a peak GH response at 20 minutes which was not observed in controls. The data exclude the existence on a primary form of hypothyroidism and point to the existence of hypothalamic-pituitary abnormalities, which should not be taken as indicative of secondary and/or tertiary hypothyroidism since FT4 values were normal in HD and increased in patients undergoing CAPD (p less than 0.05) who on turn showed lower plasma albumin concentrations (p less than 0.05).

Adult↗

Thyroid status and nephron loss--a study in patients with chronic renal failure, end stage renal disease and/or on hemodialysis.

Thyroid function was measured in 30 healthy subjects and 84 patients with various degrees of nephron loss (GRF: 70 +/- 15 m/min, 30 +/- 16 ml/min, 10 +/- 7 ml/min and 2.1 +/- 1.3 ml/min). A low T3 and T4 syndrome is evident when GRF is reduced to 30 +/- 16 ml/min while a blunted TSH response is detected earlier in the course of nephron loss. T3 response to TRH was normal and FT4 was not affected by renal dysfunction. The data indicate that in nephron loss hypothalamic-pituitary abnormalities occur.

Adolescent↗

Thyroidal status in uremia - effects of hemodialysis and CAPD.

Thyroid function was explored in 27 CAPD patients and 25 HD patients. Dialysis was associated with low T3 and T4 levels, increased rT3 concentrations, normal T4 : T3 and reduced T4 : rT3 ratios, normal FT3 and Thyroglobulin concentrations. TSH levels increased during dialysis but still fell within normal limits. The data rule out a condition of primary hypothyroidism and point out to increased thyroidal dismission associated with the block T4-T3 in peripheral cells. Also the increased FT4 levels in CAPD patients could be due to de novo dismission of thyroidal T4.

Adult↗

[Metabolism of thyroxine in acute viral hepatitis].

Aim of this report was to define the correlation between hepatic acute damage and thyroxine metabolism. We have studied plasma levels of T4, T3, rT3 and TSH in 18 adult male subjects with acute viral hepatitis. No significant variation of T4, T3 and TSH plasma levels was found in different phases of disease. However, plasma rT3 levels were clearly elevated in 72% of patients in the first 7 days (mean 440 pg/ml vs 198 pg/ml of normal controls) and in 17% of cases in the second 10 days of disease (mean 269 pg/ml). Plasma rT3 concentration was always normal in the subsequent phases of disease. Our results indicate a diversion of peripheral thyroxine metabolism in the early stages of acute hepatitis.

Acute Disease↗

The adenylate cyclase-cyclic AMP-phosphodiesterase system in pathological human thyroid.

The adenylate cyclase-cyclic AMP-phosphodiesterase system of human thyroid tissues adjacent to cold nodules (control), two follicular adenomas, one hyperplastic thyroid and one hyperfunctioning follicular carcinoma have been compared. In the hyperfunctional follicular carcinoma the basal adenylate cyclase is much higher than in control tissue, carcinoma adenylate cyclase does not respond to TSH and prostaglandin E1, whereas it responds normally to fluoride. In the hyperplastic, but hypofunctional thyroid the basal adenylate cyclase is higher than in normal tissue whereas the response to TSH, PGE1, and fluoride is normal. No difference between the follicular adenomas and normal thyroid stimulated and unstimulated adenylate cyclase was observed. Furthermore in various thyroid tissues no changes in the level of cyclic AMP phosphodiesterase was found. Our data indicate a greater change in the synthesis rather than in degradation of cyclic AMP in the human pathological thyroids studied.

Adenocarcinoma↗

Two cases of the chromatin positive variety of ovarian dysgenesis (XO/XX mosaicism) associated with hGH deficiency and marginal impairment of other hypothalamic-pituitary functions.

Plasma hGH response to provocative tests (insulin-induced hypoglycaemia and arginine infusion) appears normal in Turner's syndrome. Two cases are reported of the chromatin positive variety of ovarian dysgenesis (XO/XX mosaicism) with unusual absence of plasms hGH response to provocative tests (arginine infusion, insulin-induced hypoglycaemia). Study of other pituitary functions supports the view that a hypothalamic-pituitary impairment is present in these cases. In fact, in these cases we observed low values of gonadotrophin excretion and limited responses of plasma ACTH and plasma corticosteroids to provocative tests (insulin-induced hypoglycaemia, metopyrone). Moreover, markedly abnormal plasma TSH response to TRF was observed in Case 2. The results are discussed with reference to the significance of this rare association.

Adolescent↗

Effect of L-dopa on plasma TSH levels in primary hypothyroidism.

Plasma TSH responses after an i.v. injection of 100 mg of L-dopa were evaluated by radioimmunoassay in 4 normal euthyroid subjects and in 8 patients with primary hypothyroidism. In agreement with previous results, no variations to plasma TSH levels were observed in the euthyroid subjects. In contrast, in primary hypothyroidism L-dopa induced a biphasic response in plasma TSH. In fact, we observed a transitory increase witha maximum at 30 min (mean plus or minus SEM equals 54 plus or minus 18%) followed by a decrease reading a minimum level of plasma TSH basal values at 90 min (mean plus or minus SEM equals 15 plus or minus 6%). Thesefindings demonstrate that the plasma TSH response to L-dopa in primary hypothyroidism is time-dependent . Some speculation on the possible mechanism of this action is presented.

Adult↗

[Clinical use in the radioimmunologic determination of plasmatic TSH].

Clinical value of plasma TSH radioimmunoassay in various thyroid diseases (primary hypothyroidism, hyperthyroidism and simple goiter) is discussed. In particular, the results obtained of plasma TSH after TRH administration either in thyroid disease either in various disorders of endocrinologic interest (massive obesity, Laurence-Moon Biedl's syndrome, true precocious puberty, congenital adrenal hyperplasia, Klinfelter's and Turner's syndromes) are discussed.

Adrenocortical Hyperfunction↗