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Plasma levels of cyclic nucleotides and catecholamines in hypertension in the aged [Livelli plasmatici dei nucleotidi ciclici e delle catecolamine nella ipertensione arteriosa dell'anziano]
No full textPharmacokinetic profile and effect on bone markers and muscle strength of two daily dosage regimens of calcifediol in osteopenic/osteoporotic postmenopausal women
Full text linkBackground: At present, although cholecalciferol represents the form of vitamin D of choice for the treatment of vitamin D deficiency, there is a growing interest in calcifediol. Aims: This study aimed to evaluate the efficacy and the safety of two different daily doses of calcifediol. Methods: Fifty osteopenic/osteoporotic women with serum levels of 25-hydroxyvitamin D (25OHD) between 10 and 20 ng/ml were randomized to a 6-month treatment with oral calcifediol 20 μg/day (n = 25) or oral calcifediol 30 μg/day (n = 25). In all, we measured the time course of the levels of 25OHD and other biochemical parameters. Moreover, we evaluated handgrip strength and serum levels of myostatin. Results: The peak increase in 25OHD levels was reached after 90 days of treatment in group 1 (59.3 ng/ml) and after only 60 days in group 2 (72.3 ng/ml); thereafter in both groups, the levels of 25OHD showed a tendency towards stabilization. After 30 days, all the patients treated with 30 μg/day had values of 25OHD > 30 ng/ml. Handgrip strength showed a modest but progressive increase which reached the statistical significance in the 30 μg/day group. This latter group also presented a modest and non-significant decrease in serum levels of myostatin. Conclusions: Calcifediol is able to rapidly normalize the vitamin D deficiency, and the 30 μg daily dosage could be suggested in those patients who need to rapidly reach optimal 25OHD levels. Moreover, the 6-month treatment with calcifediol at a dose of 30 μg results in a modest but significant increase in upper limb strength
Plasma levels of catecholamines and cyclic nucleotides during hand-grip in normotensive and hypertensive subjects
No full textCirculating levels of immunoreactive peptides and steroid hormones in bronchogenic carcinoma
No full textPlasma levels of immunoreactive parathormone (iPTH), immunoreactive calcitonin (iCT) and prostaglandins (PGE2) were measured by RIA in 115 patients with bronchogenic carcinoma. In 37 of these cases the following hormones were also assayed: adrenocorticotropic hormone (ACTH), cortisol, plasma renin activity (PRA), aldosterone, prolactin, human growth hormone (HGH), thyroid stimulating hormone (TSH), luteinizing hormone (LH), follicle stimulating hormone (FSH) human chorionic gonadotropin (HCG), progesterone (P), androstenedione (A), testosterone (T), estradiol (E2) and dehydroepiandrosterone sulphate (DHAS). High serum levels of many hormone-like substances and hormones were found and the levels of certain hormones varied in some cases according to the clinical evolution of the disease and the response to therapy
Graphic trace analysis of ultrasound at the phalanges may differentiate between subjects with primary hyperparathyroidism and with osteoporosis: a pilot study
No full textBone loss characterizes both primary hyperparathyroidism (PHPT) and osteoporosis (OP) but with a different histologic pattern, and this could partially explain the different fracture incidence in these two populations. Quantitative ultrasound (QUS), influenced by bone structural parameters other than bone mineral density (BMD), could evidence these differences, opening new perspectives in the evaluation of patients with metabolic bone diseases. The aim of the present study was to investigate the usefulness of QUS graphic trace parameters, assessed at the phalanx, in discriminating between PHPT bone disease and osteoporosis. We studied 34 patients with PHPT (mean age 59.7 +/- 12.7 years), 35 patients with OP (mean age 60.6 +/- 7.1 years) and 34 healthy subjects as controls (mean age 59.1+/- 9.4 years). In all subjects QUS measurements were performed at the phalanx with a Bone Profiler (IGEA, Italy), obtaining the amplitude-dependent speed of sound (AD-SoS), fast wave amplitude (FWA), signal dynamic (SDy), bone transmission time (BTT) and ultrasound bone profile index (UBPI). Moreover, serum calcium, phosphorus, parathyroid hormone (PTH), bone isoenzyme of alkaline phosphatase (B-ALP) and ionized calcium were measured in all subjects in the morning under fasting conditions. In PHPT patients BTT was correlated with PTH, ionized calcium and B-ALP levels (r = -0.47, -0.57 and -0.44, respectively; p < 0.01), whereas FWA, SDy and UBPI correlated only with B-ALP (r = -0.43, -0.46 and -0.50, respectively; p <0.01). Moreover, FWA, SDY and UBPI were significantly (p<0.01) lower and BTT significantly (p<0.001) higher in OP than in PHPT patients. UBPI, BTT, FWA and the BTT/FWA ratio, but not SDy, were able to discriminate between the two groups (area under the curve =0.66, 0.69, 0.67 and 0.81, respectively). Our findings show that ultrasound signal parameters are differently influenced by bone changes characterizing primary hyperparathyroidism or osteoporosis. This suggests that the QUS signal could be a useful instrument in discriminating and studying some of the bone alterations typical of metabolic bone diseases
The influence of ghrelin serum levels on bone mineral density and body composition in patients with Rett syndrome
No full textRett patients, frequently present marked decreases in bone mineral density (BMD) beyond that expected from disuse atrophy. Recent studies indicate that ghrelin, a orexigenic peptide mainly secreted by the stomach, is involved in the regulation of bone growth and metabolism; however no clear evidence is present in the literature about the relationship of circulating total ghrelin with bone mineral density in humans.
This study aimed to investigate whether there is any association between ghrelin levels, body composition and BMD in Rett patients. We studied 83 Rett girls (mean age 13.8 8.4 yrs) and 55 age-matched controls. Serum calcium, bone alkaline phosphatase, parathyroid hormone (PTH), 25-hydroxyvitamin D (25OHD) and ghrelin were measured in both Rett patients and controls. In all subjects bone mineral density at whole body (BMD-WB), at femoral neck (BMD-FN), at total femur (BMD-T) and BMC as well as body composition were measured by using a DXA machine (Hologic QDR 4500).
In Rett patients the values of BMD were significantly lower than in controls at all skeletal sites. In Rett subjects BMD values, expressed as z-scores, were -1.32±2.0; -2.10±1.4 and -2.64±1.4 for BMD-WB, BMD-FN and BMD-T, respectively. The values of ghrelin were lower in Rett girl aged less than 10 years with respect to those aged 11- 20 years and those older than 20 years (1164.7382.7, 995.5413.9 and 927.5349.5 pg/ml, respectively). Ghrelin showed a significative correlations with BMD-WB, BMD-FN and with BMD-F which remained significant after adjustment for age and weight (r= -0.36; p< 0.05, r= -0.43; p< 0.05 and r=-0.44; p<0.01, respectively). Significant correlation were found also between ghrelin and lean mass (r=-0.45; p<0.05) and between ghrelin and fat mass (r=-0.43; p<0.05). Ghrelin showed a significant correlation with 25OHD (r=-0.21; p< 0.05) but not with serum PTH. By dividing the study population in tertiles on the basis of ghrelin values, we observed that fat mass was higher in the lowest with respect to the highest tertile (36.9 8.1% vs 33.3 6.4 %; p<0.050). On the contrary lean mass did not show any significant differences. In conclusion, the results of this study indicate that in Rett patients the influence of serum ghrelin on BMD is mediated by the body composition parameters. Additional studies are necessary to better understand the complex interplay of body composition and ghrelin in determining bone status
Anthropometric, haemodynamic, humoral and hormonal evaluation in patients with incidental adrenocortical adenomas before and after surgery
No full textObjective: To compare clinical and humoral parameters before and after surgery in patients with incidental adrenocortical adenomas. Design: Six patients with subclinical. Cushing's syndrome and nine with non-functioning adenomas were investigated before and 12 months after removal of the mass. Methods: Anthropometric (body weight, body mass index and waist to hip ratio), haemodynamic (blood pressure and heart rate), metabolic (lipids and oral glucose tolerance test (OGTT)), hormonal (cortisol, plasma renin activity, aldosterone, androgens and catecholamines) and bone metabolism (hydroxyproline, parathyroid hormone, osteocalcin and ostase) parameters were evaluated. Results: In the whole group, a significant decrease in body weight (69.7±3.5 vs 70.8±3.5 kg, P < 0.03), in systolic (135.3±5.1 vs 145.6±4.9 mmHg, P < 0.009) and diastolic (83.7±1.9 vs 91.0±3.5 mmHg, P < 0.03) blood pressure and in glucose levels in response to OGTT (106.4±9.6 vs 127.5±6.5 mg/dl, P < 0.05) was observed after surgery. All other parameters examined did not change significantly. This trend was also found in both groups separately. Analytical data showed a high frequency of overweight/obesity (66.6%), hypertension (66.6%) and impaired glucose profile (26.6%) in our patients, with a greater prevalence of these cardiovascular risk factors in the subclinical. Cushing's syndrome group. After surgery, values normalized or improved in eight out of ten hypertensive patients and in three out of four patients with impaired glucose profile. Conclusions: Solid adrenocortical incidentalomas are associated with some cardiovascular risk factors which may be corrected after removal of the mass. Therefore, surgery may be an appropriate choice in patients with subclinical Cushing's syndrome but also in those with solid non-functioning adenomas and coexistent cardiovascular risk factors
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Direct oral anticoagulants in patients affected by major congenital thrombophilia
No full textBackground: Thrombophilia is a condition that predisposes to a higher incidence of venous thromboembolisms (VTE), some also in atypical sites. Direct oral anticoagulants (DOACs) have proven to be effective in the treatment of deep vein thrombosis (DVT). However, their use can be sometimes challenging in particular settings of patients such as those with major thrombophilia - antithrombin, protein C and protein S deficiency, homozygous mutation of Factor V Leiden, homozygous mutation of Factor II G20210A, combined heterozygous mutation of factor V Leiden and Factor II G20210A - carrying a high thrombotic risk. Patients and Methods: At our Center, 45 patients with major thrombophilia were treated with DOACs: 33 after an initial treatment with vitamin K antagonists (VKA) and 12 as first-line therapy for VTE. The median follow-up of DOACs treatment was 29 months. Conclusions: No patient presented hemorrhagic or thrombotic complications during DOAC therapy. DOACs have proven to be effective and safe in this real-life series of patients with major thrombophilia
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