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Biomedical subjects

G Ragni

Publications and source records attributed to G Ragni.

At least 55 records · Page 3Linked to original sources

IVF: induction of ovulation in poor responders.

All IVF programs have a consistent rate of failure in inducing ovulations. Pharmacological induction of ovulation is otherwise crucial for an IVF program because of the need for more than one ovum. Since it is well known that the best candidates for HMG treatment are hypogonadotropic women a short reversible hypogonadotropic state was induced in IVF patients by LH-RH agonist (Buserelin). Superovulation was then achieved with very high initial doses of FSH (Metrodin) in order to maximize the ovarian response. This technique used in 116 IVF women induced a satisfactory follicle growth even in 70% of the patients already poorly responsive to HMG stimulation.

Adult↗

Ovarian stimulation of IVF patients: effects of the reversible hypogonadotrophic state induced by GnRH agonist.

Multiple ovulation was induced in 122 hypogonadotrophic IVF patients with large doses of HMG. The hypogonadotrophic state, short and reversible, was obtained by nasal administration of a GnRH agonist (200 micrograms, five times per day). In the 97 induced cycles, a mean of 9.1 follicles was recorded. A comparison of the results obtained for 36 patients who had already been treated with clomiphene and HMG showed both significantly more follicles per cycle (8.5 versus 3.0) and an increase in oocytes retrieved (6.7 versus 1.3) when treated with the agonist and HMG. In addition 11 of 18 already poorly responsive patients had normal responses. The luteal phase was supported by either HCG or progesterone injection. Plasma progesterone profiles were satisfactory and, as expected, the highest progesterone concentrations were associated with HCG treatment.

Adult↗

Gonadal function in male heroin and methadone addicts.

Gonadal function was elevated in 80 male heroin and/or methadone addicts by measuring basal plasma levels of follicle stimulating hormone (FSH), luteinizing hormone (LH), prolactin (PRL) and testosterone. In 41 subjects semen analyses were also undertaken. Three groups were distinguished consisting of 15 heroin addicts, 42 undergoing methadone treatment but continuing to take heroin, and 23 taking only methadone. All patients had normal plasma levels of FSH, LH and testosterone. Prolactin levels were normal in all subjects except for the 15 heroin addicts, in whom they were significantly higher than in controls (P less than 0.025). Semen analyses from all of the heroin addicts and from the dual heroin-methadone users were abnormal, whereas only 10 out of 22 (45%) of the methadone takers were pathological. In all cases asthenospermia was one of the abnormalities (100%). Twenty-four per cent also showed teratospermia and hypospermia and 17% showed oligozoospermia. Such seminal pathology, especially of forward motility, even in combination with normal hormone levels, might be an early indication of heroin toxicity to the male reproductive tract.

Adolescent↗

Abnormal renal responses to calcium entry blockade in normotensive offspring of hypertensive parents.

In nine young normotensive subjects with no family history of hypertension and nine age-matched normotensive subjects with one parent with essential hypertension, effective renal plasma flow (p-aminohippuric acid clearance), glomerular filtration rate (inulin clearance), and excretion of sodium and exogenously administered lithium were measured for 90 minutes before and after administration of a single 20-mg oral dose of the calcium entry blocker nifedipine. Segmental tubular handling of fluid and sodium was estimated using lithium clearance as a marker of proximal tubular reabsorption. Nifedipine did not cause any change in subjects with no family history of hypertension, but in those with one hypertensive parent there was a marked increase in effective renal plasma flow (from 644 +/- 39 to 847 +/- 42 [SEM] ml/min x 1.73 m2; p less than 0.001) and a decrease in filtration fraction (from 17.6 +/- 1.0 to 12.6 +/- 0.4%; p less than 0.001), while the glomerular filtration rate was unchanged, thus suggesting a prevailing efferent vasodilation. Sodium excretion rate (p less than 0.02) and fractional sodium excretion (p less than 0.025) increased slightly but significantly in subjects with one hypertensive parent, but not in normotensive subjects with no family history of hypertension. Lithium clearance also rose (from 29.0 +/- 2.0 to 32.8 +/- 1.9 ml/min, p less than 0.001), and the derived value of fractional proximal reabsorption diminished (from 75.8 +/- 1.0 to 71.3 +/- 1.2%, p less than 0.001). Estimated distal delivery of sodium and absolute distal sodium reabsorption both increased significantly (p less than 0.005), while fractional distal sodium reabsorption was unchanged.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

[Echography in the study of thoracic pathology. II-- Guided biopsy].

The usefulness of ultrasonic studies for guiding the needle during biopsy of solid lesions or evacuation of saccate effusions and empyemas. Is a explained possible diagnostic protocol is then proposed which includes the ultrasonic examination in the diagnostic approach to parietal, mediastinic or diaphragmatic lesions.

Biopsy↗

[Evolution and radiologic sequelae of pulmonary tuberculosis].

During the treatment of pulmonary tuberculosis, the radiologist is often asked the following questions: 1) is it really TB?; 2) is there any improvement?; 3) when is the X-ray check-up required?. In our opinion, the radiologist is in a position: 1) to confirm the diagnosis of TB; 2) to give a radiological diagnosis of "abnormality" but without a prognostic opinion; 3) to suggest, case by case, when the X-ray check-up is required. After some month or years, when radiological-clinical sequelae are present, the radiologist is often asked equally difficult questions: 1) is it still TB?; 2) is it still active?; 3) could it have caused the hemoptysis?. Again, in our opinion, the radiologist must bear in mind: 1) the not infrequent possibility of reinfections; 2) that the fine, smooth contour of the cavity, whose shape remains unchanged, does not necessarily signify absence of activity; 3) that, at the present time, other illnesses (bronchitis, bronchiectasis, lung cancer) are more frequently the cause of hemoptysis.

Adult↗

Gonadal toxicity after combination chemotherapy for Hodgkin's disease. Comparative results of MOPP vs ABVD.

The comparative gonadal toxicity following two equally effective and non-cross-resistant regimens (MOPP and ABVD) was prospectively evaluated in 53 males with Hodgkin's disease. The median age was 29 yr (range 16-45). MOPP produced azoospermia in 28/29 patients (97%) while ABVD induced oligoazoospermia in 13/24 patients (54%). Follicle-stimulating hormone levels were consistently and significantly increased after MOPP while their median value remained within normal range after ABVD. Sperm count was repeated in 34 patients. Recovery of spermatogenesis occurred in 3/21 cases treated with MOPP and in all 13 cases given ABVD. Present findings confirm that the two alkylating agents, mechlorethamine and procarbazine, included in the MOPP regimen cause sterility in most patients while the drugs included in ABVD are not associated with permanent gonadal dysfunction.

Adolescent↗

Evaluation of semen and pituitary gonadotropin function in men with untreated Hodgkin's disease.

The reproductive capacities of 35 patients with Hodgkin's disease were assessed before treatment by semen evaluation and determination of basal hypothalamic-hypophyseal function and after stimulation with gonadotropin-releasing hormone (GnRH). Sixty-five percent of the patients had asthenozoospermia, 46% had teratozoospermia, and 28% had oligozoospermia. Normal semen was more frequently seen in asymptomatic patients (7 of 18) than in symptomatic patients (2 of 15). All the patients had normal basal follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels and significantly low testosterone (T) levels (P less than 0.01). The FSH response to 100 micrograms of GnRH was normal, but the LH responses were all significantly low, both as delta % (28.4% +/- 18.7% versus 52.4% +/- 25.3%, P less than 0.005) and as peak values (36.7 +/- 20.7 mIU/ml versus 59.4 +/- 26.4 mIU/ml, P less than 0.01). It is believed that abnormal semen is a specific symptom of Hodgkin's disease, secondary to functional insufficiency of the hypothalamic-hypophyseal axis, with a relative decrease in T production.

Adolescent↗

Long-term treatment with cimetidine does not essentially affect the hypothalamic-pituitary-gonadal axis in man.

The effect of cimetidine maintenance treatment on gonadal function has been assessed by seminal analysis plus prolactin and gonadotropin blood level concentrations. Nine patients, all with duodenal ulcer, 5 of whom had received 400 mg cimetidine at night for 18, 3 for 24 and 1 for 36 months, were studied. All patients were presumably fertile, having fathered a child born not more than 3 years before the start of cimetidine treatment. In all patients two seminal analyses were performed and blood specimens were obtained for radioimmunoassay estimation of FSH, LH and prolactin concentrations both in basal conditions and 20', 30' and 60' after the i.v. injection of Gn-RH (100 micrograms) and TRH (200 micrograms). All but one patient, in whom mild oligoasthenozoospermia was detected, had normal sperm counts and motility; moreover hormonal levels both in basal conditions and after releasing factor stimulation were found to be similar to those observed in a control group. Cimetidine maintenance treatment has no effect on sexual activity, the quality of seminal fluid or the pituitary secretion of gonadotropins or prolactin.

Cimetidine↗

Gonadal damage in Hodgkin's disease from cancer chemotherapeutic regimens.

The paper re-emphasizes that intensive prolonged anticancer chemotherapy containing alkylating agents or procarbazine or both produces a high-incidence of gonadal failure, particularly in males. This evidence has been documented mostly in patients with Hodgkin's disease. On the contrary, effective combination regimens, such as ABVD, not including the above mentioned drugs induce a comparatively less and transient germ cell toxicity. In devising chemotherapy for potentially curable neoplastic diseases in young patients efforts should be made to avoid or minimize the potential risk of drug-induced gonadal failure.

Adolescent↗

Serum prolactin and ovarian function after discontinuation of drug treatment for hyperprolactinaemia: a study with bromocriptine and metergoline.

Serum prolactin (PRL) was estimated for up to 2 months after discontinuation of therapy with either bromocriptine (n = 33; 15 with idiopathic disease, 12 with pituitary microadenoma, and six with macroadenoma) or metergoline (n = 23; 11 with idiopathic disease, and 12 with microadenoma) that had been administered for 8-30 months. Only five patients treated with bromocriptine and two treated with metergoline had PRL levels that remained normal or below 50% of pretreatment values. Among the patients followed-up for up to 12 months, four showed a fall in PRL at 3-4 months, but this was followed by a rise in one patient. Five patients showing persistently lower or normal PRL after drug withdrawal were retested with thyrotrophin-releasing hormone; the two responsive women also had a normal response before treatment. Of 10 patients followed for 9 months, three had persistently normal PRL levels. Amenorrhoea and anovulation recurred, with some delay, in all the patients showing PRL rebound except one. Medical treatment of hyperprolactinaemia only rarely results in permanent benefit.

Adenoma↗

Hysteroscopy versus hysterosalpingography in infertile patients.

The purpose of this study is to compare the results of Hysterosalpingography (HSG) and those of Hysteroscopy (H) in order to evaluate intrauterine morphology in a sample of 47 infertile patients. In the HSG sample having no intrauterine pathology, H showed up a pathological condition in 30% of the cases. Similarly, in the cases in which HSG showed pathologies, H gave normal results in 33.3%. Considering H to be a simple diagnostic method, which causes little trauma to the patient, and is more precise than HSG, the authors recommend the hysteroscopic approach, especially in cases of sterility of unknown origin.

Adult↗

[Nuclear medicine in pneumonology in the light of 9 year's experience at the S. Luigi Gonzaga Hospital].

An attempt is made to draw a picture of the results obtained with nuclear medicine in the pneumological field in the light of 9 years experience. An attempt is also made to identify from among recently introduced techniques (T.A.C., echotomography) which ones might be substituted for radioisotopes and when, and on what occasion they can be used as complementary treatment. It is concluded that nuclear medicine is of absolute value for functional examinations of the respiratory apparatus (perfusors and ventilators) and for lung onconscannning with Ga67 citrate and Bleomycin-Co57 under present circumstances and that in other fields certain morphological scans (bone scans) are still useful by virtue of their cost-benefit ratio.

Bleomycin↗