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Biomedical subjects

M G Cartechini

Publications and source records attributed to M G Cartechini.

26 records · Page 2Linked to original sources

[Adrenergic activity and glycometabolic compensation in patients with diabetes mellitus].

In an assessment of the degree of adrenergic activity in the course of diabetes mellitus, plasma levels and urinary excretion of norepinephrine and epinephrine were determined in 20 normal subjects and 47 diabetics: 11 in good control (group I), 23 in poor control (group II), 13 with frank ketoacidosis (group III). The study was repeated in groups II and III once good glycometabolic control had been achieved. Slightly above normal catecholamine levels were noted in group I, while there was a marked increase in group II. Group III shaved an enormous increase by comparison with the other two groups. After medical treatment values in group III fell to within the group I range. The conclusion is drawn that a close relationship exists between adrenergic acitivity and the degree of control of diabetes. The sympathetic nervous system, therefore, interferes in the course of diabetes with blood sugar control via numerous, complex mechanisms.

Adolescent↗

Effect of metabolic control on urinary excretion and plasma levels of catecholamines in diabetics.

Urinary excretion and plasma levels of catecholamines were determined in 20 normal and 39 diabetic subjects to evaluate the sympathetic activity. Diabetic patients were divided into 4 groups according to the metabolic control. Sympathetic activity showed no differences between normal and subjects with chemical diabetes (group I, n = 5). In insulin-treated diabetics in good metabolic control (group II, n = 11) only urinary excretion of free norepinephrine was significantly higher than normals (p less than .05). In insulin-treated diabetics in poor metabolic control (group III, n = 16) urinary excretion and plasma levels of norepinephrine showed a marked increase over groups I and II (p less than .001). In insulin-treated diabetics with ketosis (group IV, n = 7) urinary excretion and plasma levels of both norepinephrine and epinephrine showed the highest values (p less than .001 and less than .1). Finally, in groups III and IV, after achieving improved metabolic control, a significant decrease of urinary excretion and plasma levels of catecholamines was observed. The results confirm that there is an increased rate of catecholamine release in poorly controlled diabeties and suggest a close correlation between sympathetic activity and metabolic derangement in diabetes.

Adolescent↗

Urinary excretion and plasma levels of norepinephrine and epinephrine during diabetic ketoacidosis.

Sympathetic activity was determined in 13 ketoacidotic diabetics by evaluation of plasma and urinary catecholamines, before and in the course of medical management. Patients were divided into two groups. Group A (severe ketoacidosis, n = 5) and Group B (moderate ketoacidosis, = 8), depending on plasma glucose, pH and plasma bicarbonate levels. The results showed an enhanced sympathetic activity in all patients before treatment, with significant decrease during therapy. In Group A plasma catecholamines were higher than in Group B, both before and in the course of therapy. A significant correlation was found between basal plasma catecholamines and initial plasma glucose, plasma bicarbonate, hours of therapy and insulin dosage required to obtain plasma glucose levels below 150 mg/100 ml .These results, suggesting a close correlation between glycometabolic control and adrenergic activity, emphasize the role of the sympathetic nervous system as a powerful contrainsular factor in the pathogenesis and metabolic derangement of diabetic ketoacidosis.

Adolescent↗

Continuous subcutaneous insulin infusion treatment in insulin-dependent diabetic patients: a comparison with conventional optimized treatment in a long-term study.

The effects of continuous subcutaneous insulin infusion (CSII) by portable pump (Microjet MC2, Miles) and conventional optimized insulin therapy (OCT) on metabolic control were compared in a group of five insulin-dependent diabetic patients. A group of seven normal volunteers was examined as control. CSII treatment consisted of a basal insulin infusion and three boluses of 60 min, starting 30 min before each main meal. OCT was characterized by three daily s.c. insulin injections: regular insulin before breakfast and lunch, regular plus lente before dinner. Two protocols of study were performed. In the first one the metabolic (blood glucose, NEFA, 3-beta-OH-butyrate) and hormonal (free insulin, pancreatic glucagon, cortisol, growth hormone) profiles were examined in the hospital with the patients connected to a "blood glucose monitor," after 45 days of OCT and CSII treatment, respectively. In the course of CSII treatment, a better blood glucose profile was observed than during OCT (OCT: MBG = 162 +/- 18 mg/dl, M = 43 +/- 11, MAGE = 151 +/- 26 mg/dl. CSII: MBG = 133 +/- 8 mg/dl, M = 29 +/- 5, MAGE = 138 +/- 19 mg/dl: P less than 0.05), although the indices remained higher than in normal subjects (MBG = 85 +/- 3 mg/dl, M = 0.98 +/- 0.18, MAGE = 49 +/- 3.6 mg/dl). CSII treatment was also associated with an improvement of NEFA and 3-beta-OH-butyrate profiles. Plasma "free" insulin (IRI) ranged between 18.2 +/- 5.4 and 32 +/- 5.5 microU/ml during CSII. Plasma glucagon (IRG) concentration after overnight fast was 195 +/- 65 pg/ml and 220 +/- 55 pg/ml during OCT and CSII treatment, respectively, with minor changes throughout the day. (ABSTRACT TRUNCATED AT 250 WORDS)

3-Hydroxybutyric Acid↗

[Corticosteroids].

Adrenal steroids, particularly glucocorticoids, are used in a variety of conditions ranging from adrenal insufficiency requiring substitution therapy (glucocorticoids and mineral-corticoids), to a wide range of clinical disorders in which undesired inflammatory reactions must be reduced (glucocorticoids). The anti-inflammatory effect, typical of glucocorticoids, is mainly due to the interference with arachidonic acid metabolism, from which both prostaglandins and leukotriens, mediators of inflammation, take origin. ACTH is also employed with the same indications of glucocorticoids, but its use is limited, since its effect depends on the stimulation of cortico-adrenal gland with subsequent release of not only glucocorticoids but also mineral-corticoids and androgens. The therapeutical indications of glucocorticoids are numerous, but dose and duration of treatment vary in relation of the disease that is to be cured. The widespread use of steroids is accompanied by numerous unwanted reactions which depend on their metabolic actions. Therefore corticosteroids must be reserved to well defined clinical conditions and their use should be guided by criteria that are now codified. In this review the physiological and pharmacological effects and the clinical use of corticosteroids have been examined.

Adrenal Cortex Hormones↗