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Biomedical subjects

M Nardi

Publications and source records attributed to M Nardi.

At least 181 records · Page 10Linked to original sources

[Hyperkinetic ventricular arrhythmia induced by atropine administration].

We report the case of a patient with ventricular tachyarrhythmia, which occurred after atropine was given intravenously for diagnostic purposes. The arrhythmia was accompanied with precordial pain and nitroglycerin promptly reduced both events. On the ECG an elevated ST segment in leads I, aVL, V4, V5, V6 was observed for few hours after the end of the arrhythmia, followed by a pattern of myocardial ischemia. Serum enzymes were repeatedly normal. Spontaneous anginal attacks, usually accompanied with ECG signs of myocardial ischemia and 2nd degree AV block, were often observed by means of 24 hours ECG monitoring (Holter) in the following weeks, in spite of appropriate treatment. Either myocardial ischemia, induced by the increased heart rate following atropine administration, or direct electrophysiologic effects of the drug upon the ventricle muscle (possibly in association with ischemia) could have caused the ventricular arrhythmia.

Atropine↗

[Brain cortex phospholipids and pituitary gonadotropin incretion (diagnostic use of an acute BC-PL test in secondary amenorrhea of presumably diencephalic origin)].

Bovine brain cortex phospholipids (BC-PL) have a partially dopaminergic effect on the human CNS. This leads to modifications in gonadotropins (FSH, LH and prolactin) pituitary incretion in normal subjects. The Authors have developed an acute test for phospholipids (300 and 600 mg by fast i.v. injection) to be performed in patients suffering from secondary normoprolactinemic amenorrhea possibly of diencephalic origin (hypothesis: hypothalamus function test). In these subjects no change in FSH and LH incretion was observed, whereas blood prolactin levels appeared remarkably reduced. In a small group of patients affected by hyperprolactinemia brain cortex phospholipids produced a more rapid and more marked reduction in blood prolactin (similar to that caused by bromocriptine) in functional conditions in comparison to the organic ones.

Amenorrhea↗

[Persistence of suppression after treatment for strabismic amblyopia: some remarks on two particular cases (authors' transl)].

The dominant eye of these patients, successfully treated for strabismic amblyopia, has become myopic, while the previous amblyopic eye is now emmetropic: monocular visual acuity of the latter is good, but binocular vision, without correction, is equal to that of the non-corrected dominant myopic eye. During binocular vision the dominant eye maintains fixation even though its visual acuity is reduced with respect to the other eye: indeed the latter cannot be utilized to the best of its functional possibility, due to the presence of a suppressive central scotoma. A similar situation may be present during treatment with penalization of a strabismic amblyopia: it may not, therefore, be sufficient to lower the visual acuity of the dominant eye to a value less than that of the amblyopic eye (monocularly determined) to ensure utilization and exercise of this latter.

Adolescent↗

[Dynamic tests with GnRH, L-dopa, clomiphene, cyclophenyl, HCG and HMG in 98 cases of dysspermia due to a variety of causes].

Radioimmunological methods have been used to assay the plasma concentrations of gonadotropins, androgens (expressed as the sum of testosterone and dihydrotestosterone) and 17beta-oestradiol in 98 patients suffering from dysspermia of variable etiology, after stimulation with GnRH, Clomiphene, L-Dopa, Cyclophenyl, HCG in various dosage schemes, and HMG. Results show L-Dopa and HMG tests to be of little value in assessing the endocrine function in infertile men. They also confirm, in keeping with data found in the literature the usefulness of dynamic stimulation with GnRH, Clomiphene, and HCG for purposes of andrologic diagnosis. The GnRH proved useful for the distinction between primary and secondary hypogonadotropism as well as for assessing the therapeutic efficacy of releasing factors. The functional efficacy of the endocrine axis which is often impaired in patients with dysspermia can be evaluated by the Clomiphene test. In the small number of cases in which it was applied, Cyclophenyl brought about changes in gonadotropin concentration which require further study. The HCG tests, to be performed in patients with lower than normal testosterone plasma lavels, permits the discrimination between primary and secondary Leydig cell deficiencies as well as the assessment of interstitial tissue sensitivity to chorionic gonadotropin stimulation. Of the three dosage schemes (5000 IU, 7500 IU "step up", 10.000 IU) the last one is most suitable for clinical use.

Adult↗

[Gonadotropin releasing hormone test: diagnostic significance and limits in menstrual pathology].

The serum gonadotropin response to LH-RH (100 mug e.v.) in a group of women with various types of amenorrhea was critically evaluated. Most patients responded to rapid LH-RH injection with a significant rise in plasma LH and FSH. In the authors' opinion this response is observed in healthy women as well as in those with lesions, even severe ones, of the pituitary, so that quantification of the response does not supply reliable information on diagnosis and prognosis. On the other hand, a negative response to the injection of 100 mug LH-RH does not necessarily imply a pituitary lesion but is often a sign of altered hypothalamic function which can be diagnosed and in some instances restored by clomiphene administration.

Adult↗

[Dynamic tests with GN-RH L-dopa, clomiphene, HCG and HMG in normal adult men].

The plasma levels of gonadotrophins, androgens (expressed as testosterone) and 17beta-oestradiol in response to GnRH, L-dopa, clomiphene, HCG and HMG administration have been assayed by radioimmunological mehtods in 70 normal adult males. In keeping wih findings reported in the literature, the results obtained confirm the usefulness of dynamic stimulation with GnRH, clomiphene, and HCG in andrology for the purpose of evaluating the efficiency and integrity of the hypothalamic-pituitary-testicular system and of its individual glandular components. On the other hand, the administration of L-dopa and HMG does not appear to yield clinically useful findings.

Adult↗

[Cyproterone acetate - ethinylestradiol treatment of hirsutism, acne, seborrhea and alopecia].

Twenty-five female patients, aged 14 to 49, and suffering from syptoms of virilization (hirsutism, acne, seborrhea and alopecia) were treated with an estrogen-progestogen combinantion, i.e. cyproterone acetate and ethinylestradiol, having antiandrogenic and antiovulatory action. Patients were submitted to monitoring by means of a series of laboratory tests in order to detect any toxic or hormonal effects that might occur. In most cases symptoms of virilization were significantly reduced, while untoward side effects were not noted.

Acne Vulgaris↗

[Androgenic treatment with depot mesterolone in dyspermia].

The clinical use of testosterone, and more recently of orally administered mesterolone in disorders of male fertility is of limited therapeutic efficacy, as shown by data found in the literature. On the basis of these considerations, the authors have tested mesterolone cyclopentylproprionate in 15 subjects suffering from sperm disorders. The drug, which is slowly released in the tissues has been parenterally administered at a total dose of 1,200 mg (100 mg per week). During the therapeutic trial the following aspects have been studied: spermiologic and hormonal patterns, general conditions, libido, principal organic functions and the possible side effects. Results are critically evaluated.

Adult↗

Thyrotropin-releasing hormone-like material in human retina.

Thyrotropin-releasing hormone (TRH)-like material was found in human retina obtained at autopsy from eyes used for corneal grafts. The TRH-like material was extracted with methanol and was found to be indistinguishable from synthetic TRH in its immunoreactivity and bioreactivity and in its proteolytic degradation by fresh human serum. The TRH concentration in human retina was similar to that reported in human cerebral cortex. These data are in keeping with the notion that the retina is an extension of the central nervous system. The physiological function of human retinal TRH in unknown: probably it acts as a neurotransmitter.

Adult↗

Octreotide treatment does not affect the size of most non-functioning pituitary adenomas.

The somatostatin analogue, octreotide (OC) has commonly been used in the management of growth hormone- and thyrotropin-secreting pituitary tumors, and shown to be effective both on hormone production and tumor size. Because OC receptors may be expressed also in some nonfunctioning pituitary adenomas, it has been postulated that OC might play a role in the treatment of these tumors as well. In the present study, the morphological effects of OC administration, as assessed by computer tomography (CT) scan, were evaluated in 8 patients (5 men, 3 women, age range 25-79 yr) affected by non-functioning pituitary tumors. The drug was given sc at the dose of 100 micrograms tid for 3-6 months. No significant change in visual field or tumor size occurred after OC treatment in 7 patients, whereas one showed a significant improvement of visual field associated with a decreased tumoral mass. These data suggest that OC is not an effective drug in the management of nonfunctioning pituitary adenomas.

Adenoma↗

Pattern VEP alterations in psoriatic patients may indicate a sub clinic optic neuritis.

We examined 44 subject (Group A) of both sexes (27 males and 17 females) aging between 16 and 80 (average: 45+/-16.6), divided into age bands, affected by mild-medium psoriasis with PASI (psoriasis area and severity index) between 1.2 and 48.6 (average: 11.2+/-9.7) without any other disease and we performed pattern transient VEP (Visual Evoked Potential) at the frequencies usually used in clinical experience (73', 36', 18' check size). For a good statistic comparison we choose 55 healthy subjects (group B) divided into age bands on which we performed the same test. Comparison of VEP parameters between psoriatic and healthy subjects, showed in group A 10 normal (22.7%) and 34 pathological (77.3%). In the latter group there are 16 subjects who show only a P100 reduced amplitude (36.3%), 3 with only increased latency (6.8%), 15 with alterations of both values (34%). The achieved data show that more than 3/4 of group A subjects have VEP alterations as index of the presence of a sub clinic optic neuritis with a probably toxic autoimmune origin due to the action of TNFalpha, of IgG, of ECP or of other cytokines (IL6, IL7, etc) that are increased in the blood of this patients. The electro physiologic monitoring of optic nerve seems to represent a good routine test to evaluate the global conditions of psoriatic patients.

Adolescent↗

Long-term follow-up confirms a survival advantage of the paclitaxel-cisplatin regimen over the cyclophosphamide-cisplatin combination in advanced ovarian cancer.

Two independent and consecutive randomized clinical trials, conducted by the American Gynecological Oncology Group and by an European-Canadian Intergroup, have shown superiority, in clinical response rate, progression-free survival, and overall survival, of a cisplatin-paclitaxel regimen over cisplatin-cyclophosphamide given as first-line chemotherapy for women with advanced epithelial ovarian cancer. The results of these studies, published with a median follow-up of about 3 years, have been updated with a 6.5-year follow-up: In each case, an 11% absolute gain in survival favoring the paclitaxel arm is shown; this advantage remains both statistically and clinically significant and supports a role for paclitaxel in frontline chemotherapy for advanced ovarian cancer.

Antineoplastic Combined Chemotherapy Protocols↗