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Biomedical subjects

L Altomonte

Publications and source records attributed to L Altomonte.

At least 73 records · Page 4Linked to original sources

[Serum concentration of bile acids as an index of liver lesions in rheumatoid arthritis].

Many Authors reported an impairment of liver function tests in Rheumatoid Arthritis (R.A.) No study can be found on Serum Bile Acids (S.B.A.), which are a specific index of liver dysfunction. In a series of 20 patients, affected by R.A. and without other causes of hepatic damage, we found S.B.A. elevated in 80% (mean value 14,1 muM/l versus 2,6 muM/l in controls), bromosulphalein retenction (BSP) elevated in 60% and glutamyltranspeptidase (GT) in 55%. These results confirm BSP and GT frequent impairment, as found by others, and give evidence to S.B.A. reliability in evaluating liver function in R.A.

Aged↗

Effect of somatostatin on lower esophageal sphincter (les) pressure and serum gastrin in normal and achalasic subjects.

Serum gastrin and lower esophageal sphincter (LES) responses to somatostatin infusion were evaluated in ten normal subjects and in nine achalasic patients in order to determine evidence of hormonal (presumably gastrin)control of LES pressure. After somatostatin infusion, a significant decrease of serum gastrin was observed in normal subjects at 30 min (81.6 +/- 3.2 versus 40.0 +/- 4.7 pg/ml; p less than 0.01) and a rapid increase of LES pressure was also observed (26.0 +/- 1.3 versus 34.1 +/- 1.6 mmHg; p less than 0.01). In achalasia no change was observed in serum gastrin concentration after somatostatin infusion. LES pressure at 20 min however significantly decreased (45.8 +/- 7.6 versus 31.6 +/- 2.3 mmHg; p less than 0.05). Endogenous gastrin is not a major control factor for LES pressure in either normal or achalasic subjects.

Adult↗

[Gastrointestinal changes in mixed connective tissue disease. Apropos of a clinical case].

A case of mixed connective tissue disease is described. It began as chronic juvenile arthritis and progressed to acquire the typical features of SLE, PSS and PM. Dyspepsia and the patient's poor general condition, by focussing attention on the digestion and absorption functions, revealed the presence of the gastrointestinal alterations that often accompany SSP.

Adult↗

[Waldenström's macroglobulinemia; observation of 13 clinical cases].

Thirteen immuno-electrophoretically diagnosed cases of Waldenström's macroglobulinemia are presented in 11 women and 2 men aged 57-60 yr. Abdominal plain (53.34%), asthenia and weariness (46.15%), anorexia (38.46%), weight loss (38.46%), intercurrent infections (38.46%), haemorrhage (30.76%), and loss of vision (30.76%) were the most frequent symptoms. One patient presented intercostal neuritis with burning pains that only responded to cortisones. Mean survival from the date of observation was between 3.5 and 14 yr.

Female↗

[Lactic acidosis associated with fenformin therapy].

Irreversible lactic acidosis occurred in two phenformin-treated diabetics. In the first case, blood creatinine was 3 mg % ml, arterial blood pH was 7,12 and ketostix was negative; in the second case, blood creatinine was 1,3 mg% ml, arterial blood pH was 7,22 and ketostix was negative. Diabetic patients to be treated with phenformin must always be carefully selected and this treatment should be reserved for cases where there is a precise indication. Lactic acidosis may occur even in the presence of almost normal serum creatinine concentrations.

Acidosis↗

Comparative effects of chenodeoxycholic acid and ursodeoxycholic acid on lipid synthesis in rat liver.

Chenodeoxycholic and ursodeoxycholic acids reduce significantly the hepatic synthesis of lipids in rats. The present study has been carried out using (1-14C)acetate and evaluating its incorporation into different lipidic fractions of the liver by thin-layer radiochromatography. Ursodeoxycholic acid proved to be more active than chenodeoxycholic acid: in addition to a significant decrease of the hepatic incorporation of the acetate into cholesterol and triglycerides an increase of the hepatic incorporation of the acetate into phospholipids has been observed. The exogenous administration of bile acids diminishes the hepatic synthesis of cholesterol and therefore its biliary excretion; it enriches the bile acid and phospholipid pool in the liver and bile. By this way the action of bile acids establishes in the liver a condition which induces such an increase of availability of mixed micelles in the bile as to make it unsaturated in cholesterol.

Animals↗

Somatostatin and insulin infusion in the management of diabetic ketoacidosis.

The effect of low-dose insulin infusion (4.8 U/h) in diabetic ketoacidosis was compared to that of low-dose insulin infusion (4.8 U/h) plus somatostatin (500 microgram/h IV). Treatment with insulin only in 20 patients caused normalization of blood glucose levels within 6 hours and resolution of ketoacidosis within 5 hours. During insulin plus somatostatin infusion in 7 patients, blood glucose levels returned to normal within 4 hours and acidosis was reduced within 3 hours. Correction of acidosis is the most important problem in diabetic ketoacidosis: in the severest cases cardiovascular and cerebral complications may ensue. The data presented show that addition of somatostatin to treatment with low doses of insulin reduces and resolves acidosis in a shorter time while plasma levels of glucagon and GH were concomitantly reduced.

Blood Glucose↗

Prolactin release in liver cirrhosis with impaired glucose tolerance (IGT).

The effects of acute TRH and cimetidine administration on the plasma prolactin (PRL) response have been studied in cirrhotic patients with impaired glucose tolerance (IGT). I v. TRH administration stimulates PRL release both in cirrhotics and controls; i.v. cimetidine did not induced a significant rise of PRL in liver cirrhosis. Present findings demonstrate that PRL is not responsible for the deterioration of glucose handling in alcoholic cirrhotic patients examined.

Adult↗

[Serum biliary acids in hepatic cirrhosis].

Radioimmunological measurement of serum bile acids has shown that they increase in alcoholic cirrhosis of the liver. In normal subjects, the fasting value of serum bile acids averaged 2.5 +/- 0.41 microM/l, whereas in cirrhotics it was 37.8 +/- 7.9 microM/l (p < 0.001). This technique has proved more specific than routine liver function tests. Measurement of fasting serum bile acids is a sensitive, specific, reproducible index of liver bile function. A quality investigation of primary and secondary bile acids requires the adoption of more sensitive techniques which are not, however, readily adaptable to routine use.

Adult↗

[Celiac disease: association with rheumatoid arthritis and diabetes mellitus. Apropos of a clinical case].

A case of coeliac disease accompanied by serum-negative rheumatoid arthritis and (subsequently) by diabetes mellitus is described. The appearance of a similar clinical and sympatomatological enteric and articular picture in one of the patient's brothers is seen as evidence that the link between the components of the three-fold syndrome is to be found in common genetic factors, with an onset in the form of a cellular and biohumoral immunological disorder.

Adolescent↗

[Bile lipid composition in subjects with blood lipid disorders (types II and IV). Effect of a new hypolipemic drug (Etofibrate)].

The biliary lithogenous index before and after treatment with Etofibrate, a new hypolipaemizing substance, has been assessed in dyslipidaemic subjects (ypes II and IV). Etofibrate is the result of the association of a molecule of clofibrate and one of nicotinic acid. An analysis of relative molar concentrations of biliary lipides showed that subjects with type IV and IIb dyslipidaemia produced lithogenous bile in base condition, unlike subjects with type IIa dyslipidaemia. After 28 days of treatment with Etofibrate (900 mg/die) a clear-cut increase was observed in the biliary lithogenous index in all types of dyslipidaemia examined.

Adult↗

Insulin resistance in liver cirrhosis: decreased insulin binding to circulating monocytes.

Hyperinsulinemia and insulin resistance have been reported in patients with liver cirrhosis. Since insulin receptor decrease has been demonstrated in some conditions of insulin resistance, we have studied insulin binding to circulating monocytes in eleven patients with alcoholic liver cirrhosis. Specific insulin binding at tracer concentration was lower in cirrhotics than in control subjects (p < 0.005). Insulin binding to monocytes was correlated with basal plasma insulin level in cirrhotics (r = -0.76; p < 0.01). The inhibiting effect of native insulin on 125I-insulin binding was similar in cirrhotics and controls suggesting that concentration rather than affinity of the binding sites is affected in cirrhosis of the liver. These findings suggest that decrease in insulin receptor concentration exists in liver cirrhosis, probably as a consequence of chronic hyperinsulinemia.

Adult↗

Fetal origin of amniotic fluid insulin in the human mother.

To investigate the origin of insulin in amniotic fluid amniocenteses were carried out in pregnancies with live, dead and anencephalic fetuses. Amniotic fluid insulin of pregnant women bearing live fetuses was 9.0 +/- 2.1 microU/ml; in six women with dead foetuses amniotic fluid insulin was not detected. A significant positive correlation was observed between gestational age and the amniotic fluid concentration of insulin. In the amniotic fluid of the four women bearing anencephalic fetuses, the amount of hormone was within normal limits (10.0 +/- 1.4 microU/ml). Intravenous glucose administration (0.33 g/kg body weight) to the mother doses not influence levels of insulin in amniotic fluid, but brought about changes in amniotic fluid glucose concentration. These findings support the conclusion that human amniotic fluid insulin is of fetal rather than maternal origin.

Adult↗

[Budd-Chiari syndrome in the course of polycythemia rubra vera. Presentation of a clinical case].

An unusual case of Budd-Chiari syndrome during erythraemia is presented. Acute thrombosis of the suprahepatic veins became chronic with progressive improvement, shown clinically and radiologically in the form of partial recanalisation of thromboses of these veins and the porta. The pathogenetic relationship between polycythaemia and the Budd-Chiari syndrome is also discussed.

Budd-Chiari Syndrome↗