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Biomedical subjects

F Sciarra

Publications and source records attributed to F Sciarra.

At least 55 records · Page 3Linked to original sources

[Clinical study of the efficacy of oral potassium canrenoate and spironolactone in essential arterial hypertension].

A group of 13 male and 8 female out-patients (mean age: 40.57 years), with primary arterial hypertension, was submitted to two periods of treatment in a cross-over study with spironolactone and potassium canrenoate. Each preparation was given at the dose of 200 mg/day per os for 21 days, with a 10-day interval between treatments. Both preparations proved active on the systolic and diastolic pressure values controlled 7 days. However, potassium canrenoate showed a greater and more rapid effect, particularly on diastolic arterial pressure, as also demonstrated by the statistical analyses. PRA and aldosteronemia increased with both treatments, but this increase resulted significantly lower with potassium canrenoate. The minor stimulating action on the renin-angiotensin-aldosterone mechanism by potassium canrenoate may be the reason for its greater anti-hypertensive effect. Both treatments were perfectly tolerated locally and systemically.

Administration, Oral↗

Response to a single dose of human chorionic gonadotropin in prepubertal boys.

In normal men a single dose of hCG induces an increase in plasma testosterone (T) and 17 alpha-hydroxyprogesterone (17 alpha-OHP) 2-4 h after the injection; after 24-36 h a maximum increase in plasma 17 beta-estradiol (E2) and 17 alpha-OHP occurs followed by a second surge in T after 48-96 h. The present investigation focuses on the effect of a single dose of hCG (3500 IU/m2 body surface) on testicular steroid production in 12 boys aged 13 months to 12 yr. Plasma hCG, 17 alpha-OHP, androstenedione (A), T, dihydrotestosterone, and E2 were measured basally and 2, 4, 24, 48, 72, and 96 h after hCG administration. Plasma hCG was measured using a double antibody RIA technique and steroids by RIA after celite chromatography. The results show that hCG peaked 2 h after administration of the hormone and high levels persisted for up until 72 h. Plasma T and dihydrotestosterone increased after 48 h and remained significantly high for another 48 h; 17 alpha-OHP, A, and E2 did not change. These findings show that hCG stimulation in prepubertal boys induces significant production of T without affecting the precursors or aromatization product, in contrast to observation in the adult man, where 17 alpha-OHP, A, and E2 increase significantly. A response comparable to that observed in children has been recorded in adult males with hypogonadotropic hypogonadism.

Aging↗

Is hirsutism an evolving syndrome?

The possibility that hirsutism is an evolving syndrome rather than a static condition involving only one gland has been considered. To assess this proposal 60 untreated hirsute patients aged 12-32 years were divided into five groups according to the duration of the hirsutism (less than 1, 1-2, 2-3, 3-5 and greater than 5 years). Peripheral plasma concentrations of LH and FSH, androstenedione, dehydroepiandrosterone sulphate, testosterone, 5 alpha-dihydrotestosterone, 5 alpha-androstane-3 alpha, 17 beta-diol, 5 alpha-androstane-3 beta, 17 beta-diol, cortisol, oestradiol-17 beta and oestrone were determined by radioimmunoassay. When the values obtained were compared with those from normal menstruating women, the results showed that in group I there was a significant increase only in the mean plasma 5 alpha-androstane-3 alpha, 17 beta-diol concentration. The mean concentration of this steroid was also raised in all other groups. In groups II and III mean basal levels of plasma dehydroepiandrosterone sulphate were also significantly increased and showed a marked increase after ACTH stimulation (1 mg tetracosactide acetate, i.m.) as did the concentrations of androstenedione and 17 alpha-hydroxyprogesterone. Finally, in groups IV and V, a significant increase in mean plasma concentrations of LH, androstenedione, oestrone and testosterone was found in the basal condition. The clinical picture also became gradually more severe from group I to group V. These data suggest that hirsutism could be an evolving syndrome progressively involving peripheral androgen metabolism, the adrenal gland and finally the ovary possibly through alterations of hypothalamic-pituitary function.

Adolescent↗

Is 3 alpha-androstanediol a marker of peripheral hirsutism?

The behaviour of 5 alpha-reduced metabolites of testosterone, dihydrotestosterone1, 3 alpha-androstanediol and 3 beta-androstanediol, was studied in 36 hirsute women: Group I: 24 patients with high plasma levels of testosterone, androstenedione and/or dehydroepiandrosterone sulphate and Group II: 12 patients with normal plasma concentrations of these steroids. Testosterone and its 5 alpha-reduced metabolites were determined by radioimmunoassay after chromatographic separation on celite 535 microcolumns. Plasma 3 alpha-androstanediol was found to be elevated both in Group I (26.9 +/- 10.8 SD ng/100 ml) and in Group II patients (23.2 +/- 10.5 SD ng/100 ml). 3 beta-Androstanediol and dihydrotestosterone, on the contrary, were elevated in only a few cases: in 6 cases in Group I and in 2 and in 1 case, respectively, in Group II. The finding of high plasma 3 alpha-androstanediol levels in hirsute women, with normal values of the other androgens, may be an index of hirsutism of peripheral origin, since this steroid is produced almost exclusively in the extraglandular compartment.

Adolescent↗

[Behavior of aldosterone and plasma renin activity after ACTH administration and insulin-induced hypoglycemia in patients with essential arterial hypertension].

The response of plasma aldosterone (PA) and plasma renin activity (PRA) to ACTH stimulation (0.25 mg Tetracosactide infusion/10 h) and to insulin-induced hypoglycemia (0.1 U/kg b.w.) has been studied in 34 essential hypertensive (EH) patients. Corticotrophin stimulation increases significantly PA, the percent increase being higher in normal PRA EH patients than in controls but comparable to controls in low PRA EH patients. PRA shows a slight and transient elevation. A significant increase in PA is observed also during the insulin test, but the percent increase is lower than that under ACTH stimulation. The possibility that aldosterone is involved, under severe and frequent stress, in the genesis of essential hypertension is discussed.

Adrenocorticotropic Hormone↗

The hormone pattern in a case of arrhenoblastoma.

A case of ovarian arrhenoblastoma in a 14-year-old girl is reported. The patient presented with primary amenorrhea, severe diffuse hirsutism, moderate clitorial enlargement and slight decrease in breast size. Hormonal examinations revealed high plasma testosterone and androstenedione levels, normal plasma prolactin, drhydroepiandrosterone-sulphate, 17-alpha-hydroxyprogesterone, urinary 17 beta oestradiol, oestrone, FSH and LH. Androgen concentrations decreased under dexamethasone suppression test. Following tumor ablation menses occurred spontaneously and normal hormone patterns were observed.

17-Ketosteroids↗

18-hydroxy-11-deoxycorticosterone response to ACTH, insulin and furosemide administration in essential hypertensive patients.

Investigations were carried out on the behavior of 18-hydroxy-11-deoxycorticosterone (18-OH-DOC) in essential hypertension (EH) under exogenous administration of synthetic ACTH and insulin. 40 stable EH patients and 21 normal subjects were included in the study. The increase (12-fold basal values) in plasma 18-OH-DOC in normal subjects under Tetracosactide was significantly higher than cortisol (4-fold basal values). Furthermore, insulin hypoglycemia increased 18-OH-DOC levels 5-fold, whilst basal values of cortisol were increased 2-fold. An increase in 18-OH-DOC and cortisol was also observed in EH patients: in the subgroup with normal and low plasma renin activity, however, the rise in these two steroids was significantly lower than in normal subjects both under Tetracosactide and insulin. No significant hormonal modifications were observed after furosemide administration either in the normal subjects or in the EH patients. 18-OH-DOC by itself does not, therefore, appear to play a pathogenetic role in EH.

18-Hydroxydesoxycorticosterone↗

18-Hydroxy-11-deoxycorticosterone in hypertensive uremic patients during hemodialysis.

The present study was carried out in 25 hypertensive uremic patients on regular 4 h dialysis, 3 times a week. Plasma 18-hydroxy-11-deoxycorticosterone (18-OH-DOC), aldosterone (PA) and corticosteroids were determined by radioimmunoassay and competitive protein binding technique before and at the end of the 1st, 2nd and 3rd hour of hemodialysis. Plasma 18-HD-DOC was normal before dialysis and did not change significantly during hemodialysis, whereas body fluids and electolytes decreased progressively. No correlation was observed between blood pressure and 18-OH-DOC during dialysis. 18-OH-DOC did not correlate with PA which decreases progressively during hemodialysis and was correlated to plasma corticosteroids only at the 3rd hour of dialysis, probably on account of the enhanced influence of ACTH on the adrenal cortex.

18-Hydroxydesoxycorticosterone↗

Behaviour of plasma renin activity and aldosterone during the first 72 h of life.

Plasma renin activity (PRA) and plasma aldosterone concentrations (PAC) were determined in fifty normal newborns during the first 72 h of life. PRA was elevated in all cases and tends to increase from the first (6.79 +/- 0.69SE ng/ml/h) to the third day of life (8.24 +/- 0.96SE ng/ml/h). PAC was also elevated and rose from 24.06 +/- 3.23SE ng/dl on the first day to 39.20 +/- 4.25SE ng/dl on the third day. No significant correlation was observed between PRA and PAC. Serum sodium was within the normal range, whereas serum potassium was slightly elevated during the first 48 h of life. The physiological significance of the high levels of PRA and PAC in newborns is not clear at present. Many factors may be involved in the increased activation of the renin-angiotensin-aldosterone system: low blood pressure, hypersensitivity of the macula densa to catecholamines, relative insensitivity of the immature kidney to aldosterone, hyperkalaemia and other control mechanisms for aldosterone secretion all of which probably operate simultaneously during the first days of life.

Aldosterone↗

24 hour profile of 18-hydroxy-11-deoxycorticosterone in normal supine man: relationship with cortisol and aldosterone.

Daily profiles of plasma 18-hydroxy-11-deoxycorticosterone (18-OH-DOC) were studied in four normal supine men on a normal sodium intake. Blood was taken every hour from 01.00 to 24.00 hours. Plasma cortisol (F) and aldosterone (A) were determined hourly for comparative studies. 18-OH-DOC fluctuated considerably during the 24 h period of investigation, the highest values being found during the early morning hours in synchrony with F. The episodic secretions of 18-OH-DOC were also significantly correlated with those of A, which in turn paralleled those of F. We conclude that ACTH, plays a definite role in the regulation of 18-OH-DOC in normal supine men on a normal sodium diet.

18-Hydroxydesoxycorticosterone↗

Influence of hyperprolactinaemia due to metoclopramide on gonadal function in men.

Five clinically normal male volunteers were given metoclopramide, 10 mg t.d.s. for 6 weeks. During treatment prolactin concentrations were elevated (over 50 ng/ml) in all. LH, FSH, testosterone and cortisol concentrations were not altered. No change was observed in LH or FSH responses to LHRH testing 4 weeks after the beginning of therapy, compared with pre-treatment values. A reduction in seminal volume and total sperm count were observed in each subject. Four noticed a decrease in libido and three lost spontaneous erections. While the metoclopramide-induced hyperprolactinaemia could be the cause of the observed changes in semen and erectile activity, it is possible that this dopamine receptor blocking drug might directly affect central or peripheral mechanism of erection, the testes or accessory organs.

Adult↗

Diurnal 18-hydroxy-11-deoxycorticosterone pattern in human stable hypertension.

Diurnal 18-hydroxy-11-deoxycorticosterone (18-OH-DOC) pattern was studied with RIA technique in 33 hypertensive patients in supine position and on normal sodium diet. The compound was evaluated every 2 h from 0800-2000 h. Simultaneously, plasma aldosterone and cortisol were measured. Abnormal 18-OH-DOC behavior was observed in only 2 out of 4 patients with Cushing's disease, while sporadic and slight elevations, synchronous with F, were seen in 5 out of 24 stable essential hypertensive patients [1 with normal plasma renin activity (PRA), 1 with low PRA, and 3 with high PRA]. 18-OH-DOC was normal in 2 cases of hypertension due to renal artery stenosis, in 1 patient with nephrosclerosis, and in 1 patient with horseshoe kidney. From these results, 18-OH-DOC does not seem to play an important pathogenetic role in stable essential hypertension, considering also the low mineralocorticoid activity of the compound.

18-Hydroxydesoxycorticosterone↗

Hormonal pattern in prostatic carcinoma following orchidectomy: 5-year follow-up.

Clinical and hormonal findings have been collected from 14 patients affected by carcinoma of the prostate observed over a 5-year period following orchidectomy. Plasma testosterone decreased significantly after surgery (62 ng +/- 21 SD/100 ml), remaining below 100 ng/100 ml even in cases showing only a partial regression or increase of the tumour. Gonadotropin FSH increased 1 year after orchidectomy to 28 mIU +/- 5/ml and remained constantly elevated up to the 5th year, whilst LH increased progressively up to the 5th year (30 mIU +/- 12/ml). Finally, plasma cortisol increased progressively up to 23.2 microng +/- 17.4/100 ml at the 5th year post-orchidectomy, especially in those cases showing partial regression or increase of the tumoral mass, indicating an adrenal hyperfunction which is probably responsible for increased production of weak androgens that can be transformed in the prostate into more active compounds. These results suggest therefore that after orchidectomy, cortisol and adrenal androgen determination may be of value in detecting the potential activation of prostatic adenocarcinoma.

Adenocarcinoma↗