307 research outputs found
Lack of effect of intravenous metformin on plasma concentrations of glucose, insulin, C-peptide, glucagon and growth hormone in non-diabetic subjects
No full textA study was carried out to evaluate the acute effect of an intravenous injection of metformin on the fasting plasma concentrations of glucose, insulin, C-peptide, glucagon and growth hormone in 15 non-diabetic subjects. Metformin (1 g) was administered as a bolus in a peripheral vein and blood was sampled 2, 5, 10, 15 and 30 minutes after the drug injection. No significant change in fasting concentration of glucose nor in C-peptide, insulin, glucagon and growth hormone fasting levels was noticed. It is concluded that metformin does not possess an acute direct hypoglycaemic effect in non-diabetic subjects and does not acutely affect the basal activity of endocrine pancreas and pituitary gland in releasing insulin, glucagon and growth hormone
Lack of effect of intravenous metformin on plasma concentrations of glucose, insulin, C-peptide, glucagon and growth hormone in non-diabetic subjects.
No full textA study was carried out to evaluate the acute effect of an intravenous injection of metformin on the fasting plasma concentrations of glucose, insulin, C-peptide, glucagon and growth hormone in 15 non-diabetic subjects. Metformin (1 g) was administered as a bolus in a peripheral vein and blood was sampled 2, 5, 10, 15 and 30 minutes after the drug injection. No significant change in fasting concentration of glucose nor in C-peptide, insulin, glucagon and growth hormone fasting levels was noticed. It is concluded that metformin does not possess an acute direct hypoglycaemic effect in non-diabetic subjects and does not acutely affect the basal activity of endocrine pancreas and pituitary gland in releasing insulin, glucagon and growth hormone
Neonatal arterial iliac thrombosis in type-I protein C deficiency: a case report
No full textAbstract A male infant born by caesarean section at 38 weeks of gestational age (B.W. 4055 g; Apgar 9-10), in the first two hours of life his right leg became hypovascularizated. Normal values of leukocities, red cells, haematocrit, hemoglobin, platelets. C-Reactive Protein negative. Electrolytes and coagulation tests were normal. Normal vitamin K coagulation proteins levels. Serological tests for TORCH (IgM) and Parvovirus (IgG and IgM) were negative. Sonography showed a reduced blood flow in the iliac artery and reported a 1 cm long vessel thrombosis. From 8 hours of life we administred an intravenous infusion of unfractionated heparin (UFH) 75 UI/Kg for the first 10 minutes then 28 UI/Kg/h. On the 2nd day tests were performed to assess absence of inhibiting-clot factors. The dosage of homocysteine, protein S and antithrombin was normal. FV Leiden and antiphospholipid antibodies were negative. The mapping of G20210A prothrombin's gene resulted normal, whereas the concentration of Protein C was lower than normal: activity 46% (68-150%), antigen 35% (70-150%). The same deficiency was also found in the father. The mother showed normal concentrations. No episodies of thrombosis events were documentated in the family. The intravenous unfractionated heparin (UFH) therapy was replaced after 64 hours by subcutaneous nadroparin 600 UI twice/day, which was stopped 5 days later when the vessel sonografic images were completely normal. During the hospitalization the infant didn't show bleeding. The child was followed-up yearly until 4 years of age: he was well and had a normal body and mental development. The final diagnosis is likely to be of a permanent protein C deficiency in heterozygous form. Our case is interesting because the first manifestation was an important thrombosis of large vessel that occurred within a few hours of life in absence of perinatal risk factors, as if it was a homozygous disease, but the patient had a heterozygotic form. In literature few cases are reported of heterozygous forms that became symptomatic, but only in old age. After a severe first manifestation, a normal and asymptomatic development is uncommon without new thrombotic episodes. In our patient the neonatal thrombosis was the sole event in his life.</p
Ampullary neuroendocrine neoplasms: surgical experience of a rare challenging entity.
No full textAbstract
PURPOSE:
Ampullary neuroendocrine neoplasms (NENs) account for < 0.3% of gastrointestinal NENs. Surgical options include transduodenal ampullectomy/tumour excision or pancreaticoduodenectomy (PD). We report the experience of two high-volume pancreatic surgical centres of ampullary NENs.
METHODS:
Clinical records of patients who underwent surgery for ampullary NENs (January 2007-November 2017) in the study centres were retrieved retrospectively. We evaluated clinical-pathological features, post-operative outcome and follow-up (FU).
RESULTS:
Eighteen patients (9 M/9 F, averaging 62 years) were enrolled. All but one were non-functioning NENs; four (22%) patients presented with jaundice. Seven (39%) of the patients underwent ampullectomy/excision (median tumour size 1.5 cm), and 11 (61%) patients underwent PD (median tumour size 2.4 cm). The median operation time of ampullectomy/excision was 221 min with operative blood loss of 75 ml (vs. 506 min and 425 ml in PD). The median hospital stay was 10 days in both groups. Overall surgical morbidity was 33%, due to four biochemical leaks, one pancreatic fistula and one abdominal haemorrhage. No reoperations were needed. The median tumour size was 1.8 (range 0.5-6.7) cm. All G2-G3 NENs were N1 (vs. 1/7 in G1 NENs). Three (17%) cases were mixed exocrine/G3 NECs. After a median FU of 45 (up to 124) months, recurrence occurred in four G3 NEC (31%) patients (median disease-free survival 14 months) after an R0 PD. Disease-related survival was 93, 77 and 66% at 1, 3 and 5 years, respectively.
CONCLUSION:
Ampullary NENs are mostly G1-G2 neoplasms. Lymph node metastases rarely occur in G1 NENs < 2 cm in size, which may be treated with ampullectomy/excision. Survival is 66% 5 years after surgery
Un caso di corio-capillarite segmentaria acuta (Epiteliopatia a placche posteriore multifocale acuta E.P.P.M.A)
No full text13q deletion syndrome associated with retinoblastoma and clinical anophthalmos of the opposite eye. Letter to the editor
No full text
Il crocifisso in mistura del Museo Diocesano di Palermo: il contributo delle indagini scientifiche nella conoscenza della tecnica esecutiva e nella valutazione dello stato di conservazione
No full textCHLAMYDIA TRACHOMATIS CAUSING NEONATAL CONJUNCTIVITIS: WHAT KIND OF PREVENTION?
No full textAIMS
Chlamydia trachomatis is one of the most common sexually transmitted agents. Infants born vaginally to infected mothers may present with conjunctivitis (20-50%) and/or pneumonia (5-20%) [1]. Chlamydia spp. is a frequent identifiable cause of neonatal conjunctivitis, in association with S. aureus, E. coli, N. gonorrhoeae. Topical eye drops such as silver nitrate 1% effectively prevent gonococcal neonatal conjunctivitis; however, antibiotic topical agents are commonly used in the clinical practice in the attempt to prevent also chlamydial infections.
METHODS
Topical ocular prophylaxis with fusidic acid was instituted early after birth. Data about new cases of chlamydial conjunctivitis from September 2011
to August 2012 were recorded. Data included length and course of pregnancy, maternal diseases, delivery method, newborn weight, postnatal course.
RESULTS
Two cases of isolated chlamydial conjunctivitis were recorded. Both infants (one male, one female) were born by vaginal delivery. They were full
term, healthy infants,without ocular malformations, whose mothers were treated with neither systemic nor local antibiotics near delivery. Birth weight:
3,400 and 2,380 g respectively. Pregnancy courses are unknown. Both infants received antibiotic prophylaxis in each eye 20 minutes after delivery.
The age of presentation for conjunctivitis was between day 10 and 12 of life. Infants presented with hyperemic conjunctiva, mucopurulent
discharge and swollen eyelids. The male infant also had blood-stained eye discharge. Ophthalmological examinations showed follicular conjunctivitis.
Definite diagnosis was made by detection of Chlamydia DNA by PCR on specimens obtained by swabbing the conjunctiva. Both infants were treated
with systemic Clarithromycin at 10 mg/kg/day in 2 doses for 14 days, after an electrocardiogram was performed. No long-term ocular sequelae were
found.
CONCLUSIONS
In addition to the typical features of chlamydial conjunctivitis, a follicular conjunctivitis was demonstrated at ophthalmological examination in
both our neonates. Prophylaxis with fusidic acid did not prevent all cases of chlamydial neonatal conjunctivitis.
In the absence of information about pregnancy, screening for Chlamydia spp. may be an effective practice to prevent neonatal infection and related
complications
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