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Biomedical subjects

M Messina

Publications and source records attributed to M Messina.

At least 109 records · Page 6Linked to original sources

Serotonergic anxiolytics and treatment of depression.

The serotonin 5-hydroxytryptamine-1A (5-HT1A) receptor agonists buspirone and gepirone have effects on serotonergic systems, including presynaptic and postsynaptic receptors, that predict both anxiolytic and antidepressant activity. Chronic administration of both drugs produces a down-regulation of 5-HT2 receptors, a finding common to most antidepressant drugs irrespective of mechanism of action. In addition, gepirone induces a full-blown serotonin syndrome in rodents and is active in the behavioral despair test mediated by an action on serotonergic neurons. Buspirone is active in this paradigm when injected directly into the serotonergic dorsal raphe nucleus. The therapeutic effects of both buspirone and gepirone have been assessed in placebo-controlled studies of patients with major depression. Findings in these studies support antidepressant efficacy in addition to anxiolysis. In double-blind studies of patients with major depression treated for 8 weeks, each drug was found to be superior to placebo in improvement in Hamilton Depression and Anxiety total scores as well as individual depressive symptoms. These clinical findings are consistent with preclinical pharmacology suggesting that 5-HT1A partial agonists may possess intrinsic antidepressant activity.

Adult↗

A case of methimazole-induced hypothyroidism in a patient with endemic goiter: effects of endogenous TSH hyperstimulation after discontinuation of the drug.

Serum thyroid hormone and TSH concentrations were monitored in a patient with multinodular endemic goiter and severe methimazole (MMI) induced hypothyrodism up to 190 days after drug withdrawal. Serum concentrations of TT3, TT4 and TSH returned to normal values at the 6th., the 140th, and the 120th. day respectively. Within the first 20 days after MMI withdrawal the increase of serum T3 levels was correlated with the observed decrease of serum TSH concentrations. Successively T3 values decreased and T4 levels progressively increased. Six months after MMI withdrawal basal serum TSH concentration was normal while an exaggerated response to TRH was observed. We think that this peculiar hormone pattern is due to iodine depletion. In this case TSH hyperstimulation increases predominantly T3 secretion demonstrating the reduced thyroidal ability to produce T4 when hyperstimulated.

Female↗

Initial treatment of thyrotoxic Graves' disease with methimazole: a randomized trial comparing different dosages.

We evaluated the efficacy of different doses of methimazole (MMI) as the initial therapy for Graves' disease. Fourteen patients were treated with 15 mg/die of the drug (group A) and 14 with 30 mg/die (group B). Blood samples for T3, T4, FT3 and FT4 were obtained before beginning therapy, every 48 h during the first 12 days and on the 45th day of treatment. All these hormonal parameters fell significantly from the 2nd day of therapy in both groups. All the patients, except for one in group B, had normal or subnormal levels of thyroidal hormones on the 45th day of treatment. The comparison between the two groups of regression coefficients over the first 12 days showed no significant differences. The absolute decrease of each examined parameter on day 12 was positively correlated with the relevant pretreatment value. These results demonstrate that doses of MMI (15 mg/die) much lower than those commonly recommended are able to rapidly control thyroidal overproduction as effectively as 30 mg/die.

Adult↗

Limited diagnostic value of lymphocytic karyotype in primary amenorrhea with streak gonads.

Cytogenetic data represent a first line diagnostic aid in gonadal dysgenesis. Generally, the results of a peripheral blood examination reflect the genotypic alteration of the patient. Nevertheless, on occasion one may encounter cases in which clinical and hormonal evidence suggestive of dysgenesis is not accompanied by an anomalous chromosomal finding, upon cytogenetic analysis of the peripheral blood. In these cases, a cytogenetic alteration may be present in cellular components of the ovary and the cutis. In the light of the above, two patients presenting with primary hypergonadotropic amenorrhea, streak gonads and normal peripheral karyotype are described. In one patient presenting with phenotype alterations, ovarian wedge biopsy via laparotomy followed by cytogenetic analysis of ovarian tissue and tissue from the cutis revealed a 45,X/46,XX-type mosaicism. In the other patient, the ovarian cytogenetic findings were unremarkable. Extending chromosomal analysis to several tissues, beyond the peripheral level, in selected cases, is discussed.

Adolescent↗

Mycetoma due to Nocardia caviae.

Mycetoma is the most frequent deep mycosis in Mexico and is caused by Nocardia brasiliensis in 86% of the cases. Two cases of mycetoma due to Nocardia caviae, the first in Mexico, are reported. The strains were identified by their biochemical properties according to the criteria of Gordon and Mihm (1962). Few cases of mycetoma caused by this actinomycete have been reported in the world. One of our cases was unusual: occurring on the trunk as a tumor and diagnosed by finding the "grains" on histologic examination.

Dapsone↗

Non-mosaic isodicentric X-chromosome in a patient with secondary amenorrhea.

An isodicentric X-chromosome idic(X) (pter----q26.1::q26.1----pter) was found in lymphocytes and ovarian tissue of a 40-year-old female patient with secondary amenorrhea. No mosaicism was observed. The phenotype-karyotype correlation of our case and of previously described non-mosaic cases of idic(X) (q::q) with different breakpoints is discussed.

Adult↗

Cellular distribution of lysosomal hydrolase activities in the regenerating rat liver.

Cathepsins B and D, beta-galactosidase, and acid phosphatase activities were found to be decreased in the regenerating rat liver, the reduction being maximal around the peak of hepatocyte mitoses (30 h). To investigate whether these changes could be heterogeneously distributed among hepatic cells, total cell populations from control or two-thirds hepatectomized rat livers were dissociated by the collagenase perfusion technique and analysed by different procedures. Isopycnic centrifugation in a Metrizamide gradient satisfactorily resolved hepatocytes and non-parenchymal cells from control animals but was not adequate when applied to 30-h regenerating liver cells. Colchicine treatment of the hepatectomized animals, resulted in substantial accumulation of phase M-hepatocytes. Subpopulations considerably enriched in fast-sedimenting phase M-cells were obtained by sedimentation at 1 g of the total liver cell population, and subsequently analysed by isopycnic equilibration. Phase M-hepatocytes were shown to have markedly reduced levels of beta-galactosidase, acid phosphatase, and cathepsin B activities in comparison, not only with control hepatocytes, but also with those parenchymal cells which were not metaphase-arrested in the same regenerating livers. Therefore, in partially-hepatectomized rats, hepatocytes progressing up to metaphase in the first mitotic cycle exhibited a selective depletion of lysosomal enzyme activities. The mechanism(s) underlying this change remain(s) presently unknown.

Acid Phosphatase↗

Minimum effective dose of etodolac for the treatment of rheumatoid arthritis.

Etodolac was compared with aspirin and placebo for efficacy and safety, and a minimum effective dose was established in 264 patients with adult-onset, active rheumatoid arthritis. In this six-week, 14-center, double-blind, parallel-group investigation, preceded by a washout period of up to two weeks, patients received daily doses of etodolac at 50, 100, or 200 mg/d; aspirin at 3,900 mg/d; or placebo. Both etodolac at the highest dose and aspirin produced statistically significant improvement from baseline in all disease activity assessments measured at four- and six-week end points and were superior to placebo in the majority of assessments. A greater number of patient complaints occurred with aspirin, especially in regard to gastrointestinal-related and otologic side effects. A significant therapeutic dose response was evident among the etodolac groups without an increase in side effects. Although the 100-mg/d dose was effective in many of the efficacy parameters measured, the 200-mg/d dose, which is comparably efficacious to aspirin 3.9 g/d, was suggested as the minimum effective dose for the relief of the signs and symptoms of active rheumatoid arthritis.

Acetates↗

Postpartum acute renal failure in a drug addict.

Renal diseases occur in intravenous drug abusers, especially heroin addicts, in the form of interstitial nephritis, nephrotic syndrome or acute renal failure due to rhabdomyolysis. We report a case of acute renal failure not ascribable to rhabdomyolysis nor to the main pathogenetic mechanisms of pregnancy-related acute renal failure in a pregnant heroin addict woman after vaginal delivery following uncomplicated pregnancy. Drug-related immunological abnormalities and microcirculatory distress may be involved.

Acute Kidney Injury↗

Echo-Doppler velocimetry in the diagnosis of renal artery stenosis on transplanted kidney.

Renal artery stenosis is one of the most important complications in the natural history of kidney transplantation. Particular care has to be taken in the use of angiography techniques because of the invasiveness and of the potential toxicity of radiopaque contrast material, even in the less invasive radiological tests, like endovenous sequential angiourography with image subtraction (SAU) and digital subtraction angiography (DSA). Fifty-one patients have been examined with echo-Doppler velocimetry (EDV) and also with SAU in order to verify the previous status of the artery. EDV exhibits a 100% sensitivity: all SAU detected stenosis have been formerly identified via EDV. The non-invasiveness and possibility of early repetition allows an early diagnosis capability for all transplanted patients. In this way, a surgical intervention may quite often be prevented by a precocious use of endoluminal angioplasty.

Adult↗

Hemostatic changes in children with acute lymphoblastic leukemia treated according to two different L-asparaginase schedules.

Hemostatic changes in 20 children with acute lymphoblastic leukemia (ALL) who were induced with L-asparaginase (L-asp), vincristine (VCR), and prednisone (PDN) (Group A) were prospectively evaluated. These data were compared with those of a previous group of ALL patients who received L-asp as a single agent during consolidation (Group B). In Group A patients, mean plasma antithrombin activity decreased in the first 2 weeks, though not significantly. Relative to pretreatment values, mean fibrinogen concentration diminished particularly by week 3 (p less than 0.001). Activated partial thromboplastin time (APTT) decreased in the last week as well as after cessation of therapy with L-asp (p less than 0.05). Mean platelet count increased significantly by week 3 (p less than 0.05). Thromboelastograms performed in seven patients confirmed the tendency for thrombosis evidenced by a decreased APTT. Patients in Group B (L-asp alone during consolidation) had decreased concentrations of fibrinogen, AT, and Factors IX and X after L-asp therapy. APTT was prolonged. Our data demonstrate that the tendency for thrombosis is the predominant manifestation of L-asp induced coagulopathy, when the drug is associated with VCR and PDN. Thus the risk/benefit ratio for the use of L-asp early in induction in children with low risk ALL needs to be further evaluated.

Adolescent↗

Acute renal failure in obstetric complications.

Early postpartum disseminated intravascular coagulation (DIC) was demonstrated by serial coagulation studies in 10 cases of acute renal failure (ARF) following obstetric complications (6 abruptio placentae, 3 retained placental fragments, 1 prolonged intrauterine fetal death). DIC abated within 48 hours irrespective of the therapeutic schedules employed. Renal damage was evidenced by a varying number of days of oligoanuric (6 cases) or polyuric (4 cases) ARF which always required dialytic treatment. Full renal recovery occurred in 9 cases. One patient died and no histological studies were performed. Renal damage seemed to correlate less with DIC than with the degree of anemia and shock.

Abruptio Placentae↗