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Biomedical subjects

E D'Erasmo

Publications and source records attributed to E D'Erasmo.

At least 19 recordsLinked to original sources
PubMed1998

Primary hyperparathyroidism and osteoporosis.

Primary hyperparathyroidism (PHPT) is considered a cause of secondary osteoporosis as a consequence of its known catabolic effect promoting osteoclast activity and bone resorption. However, recent in vitro and in vivo studies have shown that parathyroid hormone (PTH) may also have an anabolic effect on the mammalian skeleton. These two paradoxical effects of parathyroid hormone are discussed in the light of recent results of basic research, and of bone densitometric and histomorphometric data collected in patients affected by PHPT. Review of the literature leads to the conclusion that in PHPT skeletal damage involves prevalently cortical bone, while the mineral content of trabecular bone is preserved or even increased. On the basis of bone mineral density (BMD) measurements, osteoporosis prevalence in the early postmenopausal period seems to be significantly higher in women affected by PHPT than in the general population. As age progresses, osteoporosis prevalence seems to decrease in PHPT, while it increases exponentially with age in the general population. Similarly in PHPT, vertebral and appendicular fractures occur prevalently in the earlier decades of life with a higher frequency than in normal subjects, while with advancing age the fracture incidence becomes equal to that of the general population. When bone density is measured in lateral projection at lumbar level, BMD values in patients with mild asymptomatic PHPT are significantly higher than in controls. We conclude that PTH hypersecretion may represent a risk factor for osteoporosis and fractures in the young and in the early postmenopausal period, while it may have a protective effect on trabecular bone in elderly postmenopausal women.

Aged↗
PubMed1998

False-positive diagnosis of adrenal pheochromocytoma on iodine-123-MIBG scan.

1-123 metaiodobenzylguanidine (1-123 MIBG) scintigraphy is known for its high specificity in detecting pheochromocytoma and other tumors of neural crest origin. In this rare case report, we describe a definite adrenocortical adenoma that demonstrated false-positive uptake at I-123 MIBG scintigraphy and a remarkable accumulation of 75-SE-6-beta-selenomethyl-norcholesterol.

3-Iodobenzylguanidine↗
PubMed1998

Relationship between spine bone mineral density and vertebral body heights.

The aim of this study was to investigate the correlation between lumbar spine bone mineral density (LS-BMD) and the vertebral body heights with advancing age and years since menopause. One hundred and sixty-three women ages 39-74 years (77 normal premenopausal, ages 39-54, and 86 normal postmenopausal, ages 46-74 years) were studied. LS-BMD was measured by dual energy X-ray absorptiometry. Vertebral heights were evaluated, using morphometry, as the sum of anterior (AHs), middle (MHs), and posterior (PHs) vertebral body heights from T4 to L5. The AHs/PHs ratio at the same level was also calculated. AHs, MHs, PHs, and AHs/PHs ratio directly correlated with LS-BMD; the correlations are AHs r = 0.80, P < 0.0001, MHs r = 0.75, P < 0.0001, PHs r = 0.76, P < 0.0001, and AHs/PHs r = 0.66, P < 0.001. Both LS-BMD and AHs are inversely correlated with age, and the regressions fit with both linear and cubic curves. The statistical significance of the correlations persists while maintaining age constant. The linear regression curve of AHs with age indicates that the spine height decrement rate is 2.12 mm/year, corresponding to 7.4 cm in 35 years. AHs decreases immediately after menopause fitting with a cubic curve model, with a decrement rate of about 3 cm in the first 5 years after menopause. We conclude that the measurement of the sum of vertebral body heights could usefully integrate LS-BMD evaluation in the clinical and epidemiological investigation of osteoporosis.

Adult↗
PubMed1998

[Drug-induced osteomalacia].

The osteomalacia is a metabolic bone disease, characterized by a defect of bone mineralization, due to a lot of causes; among these an important role may be attributed to some drugs. The drugs most frequently associated with osteomalacia are: cholestyramine, phenytoin, phenobarbital, rifampicin, isoniazid, aluminium-containing antacid, saccharated ferric oxide, cadmium, lead, bisphosphonates, fluoride and aluminum. In this review we discuss about the pathophysiologic mechanisms related to drug-induced osteomalacia involving vitamin D metabolism, phosphorus homeostasis and bone mineralization.

Drug-Related Side Effects and Adverse Reactions↗
PubMed1998

Clinical and prognostic significance of hyperfibrinogenemia in cerebral ischemia.

In order to evaluate the clinical and prognostic significance of early hyperfibrinogenemia in patients with transient ischemic attack (TIA) and ischemic cerebral infarction (ICI), we analyzed the relationships between plasma fibrinogen, brain damage severity, clinical status on admission and intra-hospital mortality. Vascular damage severity was estimated by measuring the necrotic area by computed axial tomography (CT) and indirectly by means of changes in some plasma enzymes (CK, LDH, GPT/ALT, and GOT/AST). Plasma fibrinogen levels were statistically higher in ICI than in TIA and control subjects (p < 0.0005; analysis of variance). Moreover, plasma fibrinogen was directly related to the extension of the necrotic area at CT scan (p < 0.05) and in ICI patients was positively correlated with CK (r = 0.50, p < 0.01), LDH (r = 0.41, p < 0.05) and GOT/AST (r = 0.42, p < 0.05) serum levels, but not with GPT/ALT. A higher plasma fibrinogen value was observed in patients with stupor or coma compared with those with alert consciousness (p < 0.05). In patients who died during hospitalization, fibrinogen levels were higher than those of subjects who were discharged (p < 0.005). The results indicate that in the early phase of cerebral ischemia, plasma fibrinogen levels are related to the severity of the clinical status and to the extension of the brain vascular damage, thus representing a negative clinical and prognostic factor of the disease.

Aged↗
PubMed1997

Pulmonary lymphangioleiomyoma in a patient with multiple endocrine neoplasia type I.

The multiple endocrine neoplasia (M.E.N.) syndromes consist of a group of proliferative disorders that selectively target specific sets of endocrine and soft tissue cells. Here we report a case of lymphangioleiomyoma of the lung in a patient with multiple endocrine neoplasia Type I (M.E.N. I). This is the first time such an association has been reported. In our opinion it could possibly be ascribed to the genetic predisposition to proliferative disorders of patients with M.E.N. syndromes.

Female↗
PubMed1997

Serum albumin level at admission: mortality and clinical outcome in geriatric patients.

We evaluated serum albumin at time of admission, within 72 hours, in 135 geriatric patients who were older than 70 years to establish its role as a predictor of death and clinical outcome at time of discharge. Serum albumin values were reduced significantly in patients who died compared with those who were discharged in unchanged/impaired and improved conditions (3.01 +/- 0.68 g/dL, 3.18 +/- 0.55 g/dL, and 3.65 +/- 0.52 g/dL respectively, P < 0.0001). A correlation between serum albumin concentration at admission and number of days elapsed from admission and death was found (r = 0.43, P < 0.05). Mortality rate was 38.6% in patients with serum albumin values < 3.3 g/dL compared with 14.1% in those with albumin values > or = 3.3 g/dL (P < 0.005). Similar results were obtained even when the main diagnostic conditions, such as cardiocerebrovascular disease and cancer, were considered. The results demonstrate that in geriatric patients the serum albumin level at admission may be a predictor of mortality and clinical outcome at discharge.

Aged↗
PubMed1995

Aging changes in vertebral morphometry.

We analyzed the vertebral morphometry of healthy premenopausal women and their changes with age and menopause in order to better define the reference population for the clinical and epidemiological evaluation of vertebral fractures. Vertebral morphometry has been performed on lateral thoracic and lumbar spine films from 50 premenopausal and 76 postmenopausal normal women, age range 39-74 years. Vertebral heights and the anterior height/posterior height ratio are significantly lower in postmenopausal compared with premenopausal women. Vertebral anterior height decreases about 1.5 mm/year, whereas middle and posterior height decreases about 1.3 and 1.2/mm year, respectively. A statistically significant reduction of vertebral heights by around 1 mm/vertebra was observed in postmenopausal (n = 16) compared with premenopausal women (n = 20) of the same age (P < 0.05). The results demonstrate that vertebral heights are lower with advancing age and menopause and that the vertebral heights difference in elderly people is not only the consequence of a cohort effect. The results also contribute to better defining the reference population to be chosen for evaluating vertebral deformation.

Adult↗
PubMed1994

[Calcium and bone mass at different periods of life].

In this review we report some considerations on the relationships between calcium intake and bone density during life time, with particular regard to postmenopausal women. We also report some practical aspects concerning calcium salt supplementation.

Adolescent↗
PubMed1993

Clinical aspects of early increase in serum gamma-glutamyl transferase in cerebral infarction.

Gamma-glutamyl transferase (GGT) serum levels were measured in 42 female patients within 72 hours, and on day 10, after an ischaemic cerebral infarction (CI) and correlated with neurological impairment at admission and with mortality during hospitalization. Mean +/- SEM GGT serum value within 72 hours after CI was significantly higher compared to the mean +/- SEM value observed in control subjects (26.7 +/- 2.5 vs 16.5 +/- 1.2 U/L, P < 0.001) and it correlated with the severity of neurological status and with mortality. A positive correlation between GGT and creatine kinase (CK) serum levels was also observed (r = 0.47, P < 0.01). On day 10 after CI, normalization of serum GGT values was found. We conclude that GGT serum level increases in CI as a consequence of brain damage and that this increment may be considered as a clinical and prognostic unfavourable index of the disease.

Aged↗
PubMed1993

Neurological state, infarct size and clinical outcome are related to early platelet count decrease in stroke.

We performed this study in order to verify the existence of a correlation between early platelet count reduction and initial neurological impairment, infarct extension and mortality or clinical outcome in an established ischemic cerebral infarction. The results demonstrate that the platelet consumption and/or accumulation in the infarct area, expressed by circulating platelet decrease, is related to the severity of neurological involvement, infarct size and poor clinical outcome.

Aged↗
PubMed1993

Plasma fibrinogen and platelet count in stroke.

Plasma fibrinogen levels and platelet counts were evaluated in 30 patients with acute ischemic cerebral infarction (CI) three and nine days after the onset of symptoms. Hyperfibrinogenemia (379.4 +/- 80.3 vs 327.3 +/- 48.3 mg/dL of controls, p < 0.005), a reduction of platelet count (207.133 +/- 48.388 vs 288.375 +/- 61.373 x 10(9)/L of controls, p < 0.001), and an inverse correlation (r = -0.41, p < 0.05) between the two parameters were observed on day three. On day nine, platelet counts normalized while plasma fibrinogen levels slightly increased; the inverse correlation no longer occurred. The results suggest that in the earliest phase of stroke plasma fibrinogen levels may condition the extent of platelet accumulation or consumption in the ischemic area. This confirms in vivo that the platelet aggregation process is strictly dependent on fibrinogen concentration.

Aged↗
PubMed1992

[Efficacy of L-thyroxine (L-T4) therapy on the volume of the thyroid gland and nodules in patients with euthyroid nodular goiter (ENG)].

The efficacy of treatment with TSH suppressive doses of L-thyroxine was evaluated by echography in 35 patients with euthyroid nodular goiter. Patients have been subdivided in two groups comparable for sex age and size of the goiter. Sixteen patients were treated for nine months with suppressive doses of thyroxine and nineteen were followed without therapy as control. Patients in treatment were then followed up for additional 9 months without therapy. The mean decrease of thyroid volume at nine months was 25% (27 +/- 10 ml vs 20 +/- 8 ml; p < 0.01). After discontinuation of treatment thyroid volume increased and had returned to base line values after nine months of follow up. In the control group mean thyroid volume had increased by 17.7% at nine months (28 +/- 17 vs 33 +/- 19 ml; p < 0.001). Thyroid nodules in response to thyroid hormone treatment showed a variable behaviour: 30.7% (4/13) of the nodules responded to the therapy with a reduction > to 25% at the ninth month; the remaining nodules were insensitive to the therapy. In conclusion suppressive thyroxine treatment is effective in reducing the goiter, nodules instead are only in part sensitive to the treatment. Thyroxine therapy of euthyroid nodular goiter must be followed for long term since upon thyroxine discontinuation there is a prompt reappearance of the goiter.

Adult↗