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Biomedical subjects

G Mazzuoli

Publications and source records attributed to G Mazzuoli.

At least 55 records · Page 3Linked to original sources
PubMed1987

Biochemical picture accompanying sclerotic bone metastases of prostatic origin.

This study was carried out to evaluate the metabolic consequences of osteosclerotic skeletal metastases of prostatic origin in a homogeneous group of patients. We found significantly increased mean values of serum alkaline phosphatase activity and significantly reduced mean values of serum phosphate, 24-h urinary calcium, fasting calcium excretion and TmP/GFR in cancer patients with respect to age-matched controls. Mean serum immunoreactive parathyroid hormone (iPTH) levels were raised, with two patients showing increased values of the hormone above our normal limits. Our findings indicate that mild secondary hyperparathyroidism is a feature of these patients. However, it cannot be excluded that both the reduced serum phosphate and TmP/GFR values may be related, at least in some cases, to the effects of the tumour itself on tubular reabsorption of phosphate.

Aged↗
PubMed1987

Recurrent hyperparathyroidism: a study of 3 cases with evaluation of some pathogenetic and clinical aspects.

Three patients with recurrent hyperparathyroidism (15, 8 and 3 years respectively, after the first operation) are described in order to establish the causes and define the clinical characteristics of the disease. The observation that in the present series recurrent hyperparathyroidism was associated either with an adenoma (two cases) or a carcinoma (one case), appears to stress the possibility of the pathological involvement of one gland even though recurrent hyperparathyroidism should be considered due to the chronic extrinsic stimulation of the parathyroid glands. The severity of the clinical and metabolic picture observed at the time of the first diagnosis and/or at the time of recurrence together with the simultaneous presence of bone and stone disease in the patients described is of particular interest. The cases reported underline the importance of carrying out careful metabolic investigations in patients with hyperparathyroidism not only before but also for a prolonged period of time after operation.

Adenoma↗
PubMed1985

Pathophysiological studies in hypercalciuric and normocalciuric stone formers.

This study has been carried out in order to investigate the effects of a standard oral calcium load in 18 hypercalciuric and 18 normocalciuric recurrent stone formers. Following oral loading there was not a significant difference in the two groups studied, as far as serum calcium increment was concerned; however, urinary calcium excretion was significantly greater in hypercalciuric stone formers. The results obtained, although they do not exclude the presence of intestinal calcium hyperabsorption, seem to demonstrate the existence of a diminution of renal tubular calcium reabsorption in patients with idiopathic hypercalciuria.

Administration, Oral↗
PubMed1985

Clinical significance of free plasma hydroxyproline measurement in metabolic bone disease.

Free hydroxyproline was measured in plasma of 67 normal subjects and in 70 patients with bone disease including primary hyperparathyroidism (n = 19), osteoporosis (n = 18), Paget's disease (n = 14), cancer involving bone (n = 8), chronic renal failure (n = 6), and osteomalacia (n = 6), and osteomalacia (n = 5). A good correlation was found between plasma and urinary values of the amino acid in normal subjects (r = 0.66; p less than 0.001). In patients with skeletal disorders a highly significant direct correlation was observed between free plasma hydroxyproline on the one hand and urinary hydroxyproline (r = 0.92; p less than 0.001) and serum alkaline phosphatase activity (r = 0.86; p less than 0.001) on the other, even though there were a few examples of dissociations among these parameters. Free plasma hydroxyproline decreased in the patients with Paget's disease following chronic administration of salmon calcitonin. Following successful parathyroidectomy, free plasma levels of hydroxyproline decreased in all the cases studied. Measurement of free plasma hydroxyproline thus appears to provide a specific index of bone metabolism that may be usefully employed as an alternative to the assay of other markers of bone turnover.

Adult↗
PubMed1985

[Frontal radiogram of the thorax in the present-day diagnosis of the mediastinum. Technic of execution and semeiology].

The advantages of high kilovoltage and pulmonary filters in frontal chest X ray are described, underliing the possibility of a simultaneous demonstration of both pulmonary fields and mediastinal structures. A description is given of the most important mediastinal lines and of their semeiological value in pathologic conditions. The excellent results obtained by means of hemifiltration in patients with opaque hemithorax are stressed. An increased diffusion of such technique could be justified by its simplicity, and by the low cost and high benefit.

Adult↗
PubMed1985

Changes in mineral content and biochemical bone markers at the menopause.

Serum alkaline phosphatase activity, serum bone gamma-carboxyglutamic acid protein, urinary hydroxyproline and bone mineral content were simultaneously measured in 30 age-matched pre- and postmenopausal women in order to define the temporal relationship between skeletal turnover and bone loss. In postmenopausal women, mean values of phosphatase activity, serum bone gamma-carboxyglutamic acid protein and urinary hydroxyproline were significantly higher, and mean values of mineral content were significantly lower than in premenopausal women. A marked loss of bone mineral content together with a persistent increase in skeletal turnover is already evident shortly after the menopause.

1-Carboxyglutamic Acid↗
PubMed1983

Plasma calcitonin and tumors.

Plasma levels of calcium, phosphorus, immunoreactive calcitonin (iCT), immunoreactive parathyroid hormone (iPTH), and carcinoembryonic antigen (CEA) were measured in patients affected by tumors of various organs: 22 breast, 41 lung, 23 kidney, 16 gastrointestinal tract, and 8 other types, iCT plasma level was elevated in 53.6% of patients with bronchogenic cancer, in 31.8% with breast cancer, in 65.3% with renal cancer, in 31.2% with gastrointestinal cancer, and in 62.5% with other tumors. Blood calcium level was increased in 6 patients suffering from lung cancer; iCT plasma level was increased in all but one of these subjects. iPTH plasma level, measured in 35 patients, was elevated only in one case, in which normo-calcemia was present. Our results demonstrate that plasma iCT is increased in a high percentage of cancer patients and that it is probably a good tumor marker. The simultaneous measurement of CEA increases the diagnostic probability of the individual marker. The incidence of laboratory findings suggestive of primary or ectopic hyperparathyroidism was very low in our series of patients.

Blood Proteins↗
PubMedDate not supplied

Effects of age on the urinary excretion of total and non-dialyzable hydroxyproline.

This study was carried out in order to investigate the effects of age on the urinary excretion of total and non-dialyzable hydroxyproline (OHPr) in normal subjects. We found that total urinary OHPr was negatively correlated with age but, by means of partial regression analysis, no correlation was found after correction for changes in creatinine clearance; on the contrary, non-dialyzable OHPr showed a statistically significant negative correlation with age (r = -0.56) even when creatinine clearance was held constant (p less than 0.05). A highly significant direct correlation was found between total and non-dialyzable OHPr in the whole group (r = 0.54) and when only premenopausal women and men under 60 years of age were considered (r = 0.51). No correlation was found when postmenopausal women and men more than 60-year-old were taken into account. Our data appear to indicate that also the decrease in osteogenetic activity is responsible for the physiological late involutional bone loss; they also show the importance of hormonal changes in inducing an uncoupling between bone formation and resorption.

Adult↗
PubMedDate not supplied

Parathyroid storm: immediate recognition and pathophysiological considerations.

A 56-year-old white man was referred for evaluation of severe hypercalcemia following a three-week history of progressive weakness, nausea, and depression. Initial laboratory results showed serum total and ionized calcium (Ca++) values of 5.3 and 2.6 mmol/l, respectively. A short intact PTH assay was immediately performed and an extremely high value was obtained in just 30 min (1315 ng/l, normal values 6.4-70.4). The patient was therefore treated with saline solution and with salmon calcitonin (1200 IU/day, half by continuous i.v. infusion and half by i.m. route) for 10 days. There was a sudden decrease of both Ca++ and intact PTH during the first six days; then there was a trend to reach a steady-state until parathyroidectomy was performed. After withdrawal of calcitonin therapy it was possible to observe a positive uncoupling between bone formation (serum alkaline phosphatase and osteocalcin) and resorption (serum tartrate-resistant acid phosphatase) markers. On day 35 the patient underwent neck exploration, and an enlarged lower left parathyroid gland was removed that on macroscopic examination revealed the presence of a haemorrhagic cyst; microscopic appearance was suggestive of a previous glandular infarction. This is the first time the daily clinical course of a parathyroid crisis has been documented. Furthermore, changes of biomarkers of bone turnover following calcitonin therapy show that high doses of the hormone may cause a prolonged positive uncoupling of the two processes of bone remodeling.

Acid Phosphatase↗
PubMedDate not supplied

[Primary hyperparathyroidism].

Primary hyperparathyroidism (PHPT) is characterized by excessive PTH secretion in respect to calcium homeostasis needs, due to parathyroid adenoma (80% of cases), hyperplasia (15-20%), or carcinoma (1-2%). In familial forms of PHPT, several mutations have an established role: menin gene for MEN type 1, RET for MEN type 2a, calcium-sensing receptor gene for familial hypocalciuric hypercalcemia, parafibromin gene for PHPT-jaw tumour and carcinoma. Etiology of sporadic adenomas (80% of PHPT cases) is less defined, being most commonly found a mutation of menin gene or activation of PRAD1 oncogene. In recent years, the classical features of the disease became less common. Typically, bone involvement is now represented by a reduced bone mass at skeletal sites more rich in cortical tissue. Prominently trabecular skeletal sites are relatively spared, because of the anabolic effects of a slight PTH excess on trabecular tissue. PHPT patients may have increased fracture risk, though it is not clear why bone damage is more severe in a subgroup of patients. Clinical features of hypercalcemia may be fatigue, anorexia, thirst, and polyuria. Vague neurological and psychiatric symptoms, such as weakness, anxiety, depression, paresthesias, and muscular cramps may ameliorate after parathyroidectomy. Recent reports indicate increased cardiovascular mortality in PHPT patients. Diagnosis is based on the detection of hypercalcemia, together with inappropriately high serum PTH levels. Preoperative localization of the diseased glands is mandatory in persistent or recurrent PHPT, as like as when minimally invasive surgery is planned. High resolution ultrasonography and SPECT double-phase 99m Tc-sestamibi scintigraphy are the most commonly employed techniques. Intraoperatory PTH assay may confirm successful surgery when serum concentrations decrease more than 50%. Surgical therapy is indicated in patients with renal or skeletal complications, such as in those with previous parathyrotoxic crisis. Many surgeons in recent years adopted minimally invasive parathyroidectomy. Medical treatment is an option for patients unwilling or unfitted for surgery because of severe concomitant diseases. Employed therapy includes estrogens, SERMs, bisphosphonates and calcimimetics.

Adult↗
PubMedDate not supplied

[Primary hyperparathyroidism: the recent findings].

Primary hyperparathyroidism is a quite frequent disease, the incidence of which has been found to increase over the past two decades. At the same time there has been a remarkable change in its clinical presentation; therefore this endocrine disorder earlier considered rare but almost always associated with complications, now appears a quite common and uncomplicated disease. In our series of 150 patients diagnosed between 1966 and 1989 the female/male ratio was found to be 1.77. The ratio has significantly increased (2.09), beginning from 1983; this was mainly due to the availability of a bone densitometer at our Mineral Metabolism Service with consequent greater demand of serum calcium determination as a part of routine metabolic screening for prevention of postmenopausal osteoporosis. Whilst the percentage of patients with renal manifestations of the disease has not significantly changed during these years, the amount of asymptomatic patients (yrs 1966-1983 = 3.7% vs yrs 1984-1989 = 39.7%) has progressively increased to the detriment of patients with skeletal symptoms. Serum intact parathyroid hormone determination by immunoradiometric assay (and possibly by immunochemiluminometric assay) seems to have overcome some of the methodological problems inherent in conventional radioimmunoassay. Surgical treatment of primary hyperparathyroidism is safe and highly effective in experienced hands. Recurrence has been observed only in three cases after resection of parathyroid adenoma, thus indirectly supporting a monoclonal origin of the tumor. Medical behavior (conservative or surgical management) in respect to patients with the mild or asymptomatic form of the disease, especially when diagnosed in old age, is uncertain at this point in time. Future prospective studies carried out on a large number of patients are needed to better clarify this issue.

Humans↗
PubMedDate not supplied

[Clinical and prognostic importance of changes in the number of circulating lymphocytes in cerebral infarction of the ischemic type].

Aim of the present study was to assess the increase of peripheral white blood cell (WBC) count and its clinical and prognostic significance in patients with cerebral ischemic infarction (CI). Thirty-six subjects (17 males, 19 females; mean age 73 +/- 10 years) with CI confirmed at CT scans were studied. A significant increase of WBC, not related to complicating infections, was observed in the early phase of CI. There was a significant linear correlation between the level of serum creatine phosphokinase and the number of circulating WBC which were higher in patients who died 6-30 days after the occurrence of CI. These data suggest that the increase in circulating WBC is dependent on the extent of the cerebral damage and should be considered as unfavourable prognostic sign.

Aged↗