[Cutaneous allergy during idiopathic thrombopenic purpura treated with danazol].
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Biomedical subjects
Publications and source records attributed to E Ferrari.
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Two patients with Factor V-specific circulating anticoagulant are presented: one had coeliac disease, the other Crohn's disease. In both patients the inhibitor appeared during flare-ups of the disease and disappeared during remission. This sequence was repeated after 1 year in one case, which seems to exclude a fortuitous association. No haemorrhage was observed. None of the usual aetiological circumstances was noted, which suggests that the condition was most probably auto-immune.
Erythema nodosum is an unusual manifestation of Hodgkin's lymphoma. One patient with long remission of Hodgkin's disease manifested persistent erythema nodosum beginning one and three months before relapse was clinically evident. So, the diagnosis of Hodgkin's disease should be considered in patients with unexplained recurrent erythema nodosum.
Botulinum-A toxin (botAtox) was used in the treatment of blepharospasm (BS), idiopathic hemifacial spasm (HFS), idiopathic spasmodic torticollis (ST) and apraxia of eyelid opening (AEO). The injection of 7.5-30 U botAtox per eye spread over 3 or 4 sites in the palpebral part of orbicularis palpebrae (OP) reduced palpebral spasm in 12/13 cases of BS and in 7/8 cases of HFS. The effect lasted for 14.5 weeks on average (range 4-30 weeks). Palpebral ptosis (lasting 1-3 weeks) was the most frequent side effect (16/107 eyes treated) but was not related to dose of botAtox or number of inoculation sites. Injection of 60-160 U botAtox into the sternocleidomastoid, trapezius and splenius capitis muscles reduced ST objectively in 1/4 patients for about 4 weeks. In the other patients the reduction or abolition of the hypertrophy of the previous hyperactive muscles was accompanied by persistence or rearrangement of the dystonia pattern, suggesting a change in the pattern of activity of the neck muscles after botAtox. 5 U botAtox per eye spread over 4 sites in the OP significantly reduced the frequency of the episodes of involuntary eyelid closure in 2 patients with AEO but not BS. The therapeutic effect lasted for 7 months after the first treatment and for 8 months after the second in a 46 year old woman with a 6 month history while the second patient (72 year old parkinsonian) has now completed her 3rd month of treatment.
Baseline follicle stimulating hormone (FSH) and luteinizing hormone (LH) plasma levels and their responses to luteinizing hormone releasing hormone (LHRH) stimulation were investigated in 72 patients who met Research Diagnostic Criteria for affective disorders and in 72 healthy volunteers. Fifty-six patients were examined during a depressive phase and 16 during a normothymic phase. LH-FSH basal levels were significantly lower in postmenopausal depressed and normothymic women than in controls. In fertile women and men, concentrations of the two gonadotropins were also lower in patients than in controls, but the phenomenon did not generally reach statistical significance. LHRH-induced LH rises were lower in postmenopausal and fertile depressed and normothymic women than in controls, while FSH rises were reduced only in postmenopausal depressive women in both depressed and normothymic phases. The impairment underlying the gonadotropin secretory deficiency remains to be elucidated.
Dopaminergic agonists and antagonists were tested on the field-stimulated mouse vas deferens. Both LY 171555 and SK & F 38393, relatively selective DA2 and DA1 receptor agonists, respectively, produced concentration-dependent inhibition of the field stimulation-induced contractions, without modifying the baseline tone nor the contractile responses to the exogenous noradrenaline. Both LY 171555 and SK & F 38393 concentration-response curves were shifted rightward in a parallel manner by sulpiride (relatively specific DA2 antagonist) and SCH 23390 (relatively specific DA1 antagonist), respectively. The results are suggestive of the existence of pre-junctional dopamine receptors involved in the regulation of sympathetic neurotransmission in rodent vasa.
Gene expression in Bacillus subtilis can be controlled by alternative forms of RNA polymerase programmed by distinct sigma factors. One such factor, sigma D (sigma 28), is expressed during vegetative growth and has been implicated in the transcription of a regulon of genes expressed during exponential growth and the early stationary phase. We have studied several functions related to flagellar synthesis and chemotaxis in B. subtilis strains in which sigma D is missing or is present at reduced levels. Previous studies showed that a null mutant, which contains a disrupted copy of the sigma D structural gene (sigD), fails to synthesize flagellin and grows as long filaments. We now show that these defects are accompanied by the lack of synthesis of the methyl-accepting chemotaxis proteins and a substantial decrease in two autolysin activities implicated in cell separation. A strain containing an insertion upstream of the sigD gene that reduces the level of sigma D protein grew as short chains and was flagellated but was impaired in chemotaxis and/or motility. This reduced level of sigma D expression suggests that the sigD gene may be part of an operon. A strain containing an insertion downstream of the sigD gene expressed nearly wild-type levels of sigma D protein but was also impaired in chemotaxis and/or motility, suggesting that genes downstream of sigD may also be involved in these functions. Genetic experiments demonstrate that sigD is allelic to the flaB locus, which was initially isolated as a locus affecting flagellin expression (G. F. Grant and M. I. Simon, J. Bacteriol. 99:116-124, 1969).
Transdihydrolisuride (terguride), a 9,10-dihydrogenated analogue of the ergot dopamine agonist lisuride, is characterized as partial dopamine receptor agonist at CNS level. This compound was investigated for its effects on peripheral neurotransmission in the attempt to delineate its pharmacological profile. The contractile responses of field-stimulated mouse vas deferens were slightly inhibited by terguride at very high concentrations (10(-5)-10(-2) M); the selective antagonists for alpha 2-adrenergic and dopamine receptors failed to counteract this effect. Terguride was very effective in blocking the inhibitory effects of LY 171555 (selective DA2 agonist), SK&F 38393 (selective DA1 agonist) and clonidine (selective alpha 2 agonist). In no case the antagonism was competitive: the control dose-response curves were not shifted in a parallel and dose-dependent manner. Therefore terguride displays a mixed DA1, DA2 and alpha 2 antagonistic activity.
Arteriovenous fistula is one of the main causes of high output cardiac failure. The authors report a case following lumbar disc surgery. There are a number of features which may suggest this complication both during surgery and in the immediate postoperative period which are important because the patient may only become symptomatic a long time after operation with a clinical presentation which leads to a cardiological rather than to a surgical referral.
UNLABELLED: The administration of placebo (pharmacologically inactive substance) is justified in clinical trials of antihypertensive drugs, in order to avoid the inclusion of placebo-responders. The evaluation of antihypertensive treatments during exercise is an interesting end point, since aerobic exercising is part of antihypertensive treatment. The aims of this study are to determine the placebo impact on blood pressure, heart rate and catecholamine secretion profiles during exercise testing. METHOD: 10 untreated essential mild to moderate hypertensives participated to a single blind study comprising two successive submaximal exercise testings (85% of maximal theoretical heart rate), separated by a single oral administration of placebo. Blood pressure and heart rate were measured after 10 minutes of resting position and at the end of each effort step (2 mm, 20 Watts), both before and after placebo. Blood samples (5 ml) were collected at rest and during maximal exercise before and after placebo, in order to determine the effect of placebo on circulating catecholamines. RESULTS: there was no significant variations between the "control" and exercise testings after placebo, neither on blood pressure or heart rate profiles, nor in values of circulating catecholamines [Noradrenaline at rest: 1.88 +/- 0.96, exercise: 6.43 +/- 1.93 nm/l before placebo, 1.65 +/- 0.83 nm/l and 5.71 +/- 2.12 nm/l after placebo respectively (NS)]. CONCLUSION: the placebo, which effect is generally determined on blood pressure at rest by sphygmomanometry, seems devoid of any activity on blood pressure, heart rate or catecholamine profile during exercise, in essential moderate hypertensives. Thus, antihypertensive treatments at exercise can be evaluated by comparison to baseline cardiovascular parameters without placebo groups.
It is established practice in patients with thromboembolic disease without the classical predisposing factors to search for general causes and abnormalities of blood clotting. The authors report a case of paroxysmal nocturnal hematuria or the Marchiafava-Micheli syndrome, a rare but classical cause of venous thrombosis. In this patient, the hemopathy presented with venous thrombosis.
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The authors have made an inquiry about school-children of two villages of Northern Appennines: Bargagli and Ottone, formerly seats of endemic goiter. The disappearance of endemic goiter in the younger generations of these villages, is in accordance with previous observations by one of the writers suggesting that sheep represent an important ecologic factor in endemic areas.
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The paper describes the advantages and negligible side-effects of the use of E2-type (Suprostone) synthetic prostaglandin, administered i.m. in a dose of 250 mg, 2-3 hours before voluntary abortion during the first trimester of pregnancy in pre-cesarean-section patients.
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The performance of the assay and the clinical usefulness of a new short-term index (Fructosamine Plus: FP) of metabolic control in diabetes was evaluated. The FP concentration was determined with the Hitachi 704, Cobas Mira, and Cobas Fara analyzers. The "within run" and "between run" CVs were less than 2.67% and less than 4.26%, respectively. The reference interval (determined from data on 125 blood donors) was 191 to 288 mumol/l (mean 240 mumol/l). In poorly controlled diabetic patients FP was significantly higher than in the well controlled ones. Moreover FP was significantly correlated with HbA1c and blood glucose levels. Our preliminary data seem to demonstrate that relating FP to total protein does not improve the clinical value of the new index.