Biomedical subjects
R Manna
Publications and source records attributed to R Manna.
[Acute adult respiratory distress in a gram-negative infection. Clinical contribution].
The adult respiratory distress syndrome in major complication of hospitalized patients. The therapeutic role of intravenous albumin, diuretics, corticosteroids and oxygen administration is yet doubtful. The Authors, after a description of pathogenetic, histological and clinical aspects of the syndrome, report a case occurred at their observation; it is showed the important role of intravascular coagulopathy and reversible ECG alterations, and the therapeutic valve of positive end-expiratory pressures (PEEP).
[Ehler-Danlos syndrome (type V) with urethra bifida and polydactyly: an unusual combination].
Ehlers-Danlos syndrome is currently regarded as a connective tissue dysplasia. Its genetic, biochemical, histological and clinical features are described, together with a personal case in a patient who presented the fundamental symptoms, plus polydactyly and bifid urethra. This association had not been hitherto reported in the literature. The case itself is classed as Ehlers-Danlos syndrome type V.
[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.
Adult respiratory distress syndrome.
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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.
Association of retroperitoneal fibrosis, proctitis and rectal stenosis.
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[Clinical aspects and therapy of diabetic coma].
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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.
[Endocrine changes in hepatic cirrhosis].
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[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.
[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.
Somatostatin infusion in liver cirrhosis: glucagon control of glucose homeostasis.
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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.
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.
Effect of preoperative posture and binocular occlusion on retinal detachment.
In an unselected series of retinal detachments a 24-hour period of binocular occlusion and posture with a retinal hole dependent produces some resolution of subretinal fluid in 13% of cases. If only patients with acute, freely mobile detachments and retinal holes above the horizontal meridian were selected the proportion of detachments showing some resolution rose to 30%. In 8% of cases a paradoxical response occurred, the detachment increasing in depth or extending to involve an additional area of retina.
Insulin and glucagon concentrations in portal and peripheral veins in patients with hepatic cirrhosis.
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Glucose, insulin and somatostatin infusion for the determination of insulin resistance in liver cirrhosis.
Twelve patients with liver cirrhosis and ten normal subjects were studied. Using a constant intravneous infusion of glucose, insulin and somatostatin over 2 1/2 hours we determined the stteady state plasma glucose level (SSPG) in order to measure insulin resistance. The results demonstrated that the cirrhotic patients were insulin resistant compared to normals and that plasma glucagon does not account for the insulin resistance in these patients.