[Biological factors in aggressivity].
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Biomedical subjects
Publications and source records attributed to E Ferrari.
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The study concerns the adrenocortical glucocorticoid responsiveness to the ACTH 1-17 analogue given at different times of the day, namely near to the zenith and the nadir of the circadian curve of plasma cortisol. Two schedules of administration of the heptadecapeptide have been performed: a pulse i.v. injection of 4 microgram; b. i.m. injection of 100 microgram. Both the doses were given to the same subject in the morning and in the evening of different days. The chrono-sensitivity of the adrenal cortex to ACTH 1.17 analogue is well evident after pulse stimulation by a micro-dose of the heptadecapeptide; in fact the plasma cortisol increase from basal values is significantly higher in evening than in the morning (p less than 0.001). The cortico-stimulatory effect of the higher dose of ACTH 1.17 analogue lasts about 12 h. and then plasma and urinary glucocorticoids take the usual circadian pattern again.
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A chronobiological study was carried out in pituitary GH- and PRL-secreting adenomas and in the empty sella syndrome. The circadian rhythms of plasma GH and plasma PRL were abolished respectively in GH- and PRL-secreting pituitary tumors, and they were again detectable after selective transsphenoidal adenomectomy. In the empty sella syndrome only the chrono-organization of GH secretion was disturbed, whereas plasma PRL exhibited the usual circadian pattern. A normal circadian rhythmicity of plasma cortisol was demonstrable in the 3 groups of patients. The diagnostic significance of the chronobiological findings obtained is discussed.
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We studied somatosensory evoked potentials after median nerve stimulation in a sporadic case of dopa responsive dystonia and in two brothers with different combinations of dystonia and parkinsonism. The latencies of all potentials were normal. The amplitude of the P20-N30 frontal complex showed a significant reduction in all cases. Our results suggest a common neurophysiopathological pattern underlying these two conditions.
The lack of knowledge of the origin of venous thrombosis (VT) causes frustration and distress to the clinician. Some results published in the literature suggest a lot of potential aetiologies. Anyhow, we are far from getting a proof that a systematic and exhaustive search for a potential cause, for instance impairment of blood coagulation or infraclinical cancer, could be of benefit for the patient and could present a good cost/efficacy ratio. Consensus recommendations limit the extent of blood coagulation studies only to some precise clinical situations. New biological data evidencing a resistance to activated C protein in 20 to 50 per cent of VT cases, will likely bring new rules. As far as infraclinical cancers are concerned and whether their relationship to idiopathic VT is well-established, it is still doubtful that such systematic heavy and expensive checking up could be of any benefit.
The circadian pattern of melatonin and cortisol secretion was evaluated in two groups of elderly subjects (aged 66-90 years), one with Alzheimer's type of multiinfarct dementia (n = 27) and the other without cognitive impairment (n = 16); 13 clinically healthy women aged 20 to 30 years were chosen as controls. All demented patients had severe mental impairment, corresponding to stage 6 of the Global Deterioration Scale. All subjects, either young or aged, were studied as in-patients and were well synchronized with respect to meal timing, diurnal activity and nocturnal rest. At the population mean cosinor analysis (Halberg, 1969) both melatonin and cortisol circadian rhythms reached statistical significance in the three groups of subjects. However, the melatonin circadian profile was clearly flattened in the two groups of elderly subjects by comparison with young controls, due to the selective impairment of melatonin nocturnal secretion. In both elderly groups, but particularly in demented patients, plasma cortisol levels were significantly higher by comparison to young controls, particularly at evening and night time. A significant direct relationship linked the subjects' age and the nadir values of plasma cortisol. Furthermore, the sensitivity of the hypothalamo-pituitary-adrenal axis to dexamethasone (DXM) suppression test (1 mg orally at 2300) was significantly reduced in both elderly groups, and especially in old demented patients, by comparison with young controls. Finally, plasma cortisol response to pulse i.v. injection of a small dose of synthetic corticotropin (Synacthen 2,500 ng) was significantly higher and more prolonged in old demented patients than in mentally healthy old subjects and in young controls.(ABSTRACT TRUNCATED AT 250 WORDS)
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The development of transient right-sided lower cervical root impairment is reported in a 49-year-old woman affected by cervical dystonia, who had previously received botulinum toxin injections into the left sternocleidomastoid and the right trapezius. The possibility of a causal relationship was discussed with consideration of: 1) the absence of intercurrent illness or trauma; 2) the positive correlation between sensory-motor disturbances and the botulinum toxin-induced remission of cervical dystonia; 3) the reversibility of cervical radiculopathy (there was no recurrence in the two years following the interruption of the treatment). Magnetic resonance imaging investigation disclosed an abnormal cervical spine geometry together with moderate spondylosis. We feel that mechanical postural changes following the successful botulinum toxin treatment for cervical dystonia might have played some role in the development of cervical radiculopathy. Thus, skeletal abnormalities should be checked when attempting to correct muscle overactivity by botulinum toxin.
The authors have studied the use of sodic piperacillin in surgical gynecological prophylaxis. The drug, used in the intravenous tract, has proved efficacious for broad spectrum of antibacterial action versus gram+, gram-, and anaerobic and aerobic. It has shown an excellent tolerability by reducing hospital surgical infections (11% of cases) and sepsis (9.2% of cases) with social, economic and professional advantages.