Showing papers by "Casa Sollievo della Sofferenza published in 1983"

The adrenergic contribution to glucose counterregulation in type I diabetes mellitus. Dependency on A-cell function and mediation through beta 2-adrenergic receptors.

Abstract: In order to assess the adrenergic contribution to hypoglycemie glucose counterregulation in type | diabetes mellitus and to determine whether the adrenergic contribution is mediated through beta1- or beta2-adrenergic receptors, hypoglycemia was induced by an i.v. insulin infusion (30 mU/m2 · min) for 60 min in 11 insulin-dependent diabetic patients (IDDM), 5 with normal plasma glucagon responses and 6 with blunted responses, and also in 7 age-weight-matched nondiabetic subjects. Rates of plasma glucose decrease and postnadir increase, as well as plasma concentrations of free insulin and of counterregulatory hormones, were measured when insulin was infused alone, and when insulin was infused along with propranolol (a beta1- and beta2-adrenergic receptor antagonist) or metoprolol (a selective beta1-antagonist). Postnadir plasma glucose recovery was decreased in IDDM with blunted plasma glucagon responses (21 ± 0.8 µmol. L−1 min−1, P < 0.001), but was normal in patients with normal plasma glucagon responses (30 ± 0.4 versus 33 ± 0.5 μmol · L−1 · min−1 in nondiabetic subjects, P = NS). Postnadir plasma glucose recovery was not affected by either propranolol or metoprolol in normal subjects and in IDDM with normal glucagon responses. However, in IDDM with blunted plasma glucagon responses, postnadir plasma glucose recovery was further decreased by propranolol (14 ± 0.6 µmol. L−1 min1, P < 0.01), but was unaffected by metoprolol (22 ± 0.9 μmol. L 1 min1, P = NS). These results demonstrate that, as in normal man, adrenergic mechanisms are not essential for normal plasma glucose recovery from hypoglycemia in IDDM with normal plasma glucagon responses. However, in IDDM with blunted plasma glucagon responses, adrenergic mechanisms become important for glucose counterregulation although they do not fully compensate for the blunted plasma glucagon responses. Since propranolol delayed plasma glucose recovery from hypoglycemia in IDDM with blunted glucagon responses but metoprolol had no effect, the adrenergic contribution to glucose counterregulation appears to be mediated through beta2-adrenergic receptors.

Candida Overgrowth in Gastric Juice of Peptic Ulcer Subjects on Short- and Long-Term Treatment with H2-Receptor Antagonists

Abstract: Candida overgrowth in gastric juice of peptic ulcer subjects under therapy with H2-receptor (H2-R) antagonists has been detected in 21.4 and 53.8% of cases after short- and long-

Differential effects of a dopaminergic drug (piribedil) on pituitary hormone release in normal men and women.

Abstract: Six normal women, in the follicular phase of their menstrual cycle, and 6 normal men received orally 40, 60 and 100 mg doses of piribedil, a dopamine receptor agonist, or placebo. The effects of piribedil on anterior pituitary hormone release was evaluated. In normal women a dose-related decrease in Prl levels was observed, while in men the Prl decrement was not related to the dose employed. In women an increase in serum hGH occurred after administration of the lowest (40 mg) dose of piribedil. In normal men, on the contrary, a modest hGH stimulation was present after administration of all doses of the drug. No consistent changes in serum TSH, LH and FSH concentrations were observed and no side effects were reported. The results from this study indicate that piribedil can exert differential effects on hypophyseal trophic hormone release and that these effects are sex-related. It is possible that the differences observed in men and women after the administration of piribedil are due to a different endogenous dopaminergic tone, induced by the different sexual steroid environment.

Serum Trypsinlike Immunoreactivity in Cystic Fibrosis: An Aid in Assessing Progressive Involvement of the Pancreas

Abstract: • Serum trypsinlike Immunoreactivity (TLI) was measured in 42 children with cystic fibrosis (CF) and related to age and steatorrhea. The mean TLI value in 106 age- and sex-matched control subjects was 22 ± 7.2 ng/mL. In patients with CF, TLI showed a widespread distribution (range, 0.3 to 214 ng/mL), and an exponential inverse correlation between TLI and age was found. The same trend in the decline in TLI values with increasing age was evident in patients who were followed up. Reduced TLI concentrations were associated with fat malabsorption, but in younger patients with CF, normal or elevated TLI values did not exclude steatorrhea. Elevated serum TLI levels in patients with CF at an early age might reflect pancreatic ductal obstruction. Tendency for TLI to decrease with advancing age and in patients who are followed up can reflect ongoing degenerative destruction within the pancreatic gland. Serum TLI estimation in patients with CF should be used to monitor the progression of pancreatic impairment. ( Am J Dis Child 1983;137:167-170)

Dose-related effect of bombesin on serum cationic trypsinogen levels.

Abstract: The present study has been addressed to study the serum cationic trypsinogen (CT) response after the ingestion of a mixed meal and following the infusion of caerulein and bombesin. On the first day of study a mixed meal was administered to 12 normal volunteers. On the following day 6 of these subjects received bombesin infusion in stepwise increasing doses (18.7, 37.5, 75 and 150 pM/kg/h) every 30 min, while the remaining 6 subjets received caerulein infusion (18, 37, 75 and 150 ng/kg/h). The time course of the serum CT response to bombesin (150 pM/kg/h) was also studied in 6 patients with distal gastrectomy. Serum CT levels did not vary after the ingestion of the meal or the infusion of caerulein. Bombesin infusion was followed by a dose-related increase on serum CT levels, but it had no effect on serum amylase and isoamylases. The CT concentrations peaked 30 min after starting the infusion and remained unchanged as long as bombesin was administered. It is suggested that the bombesin action on the pancreatic acinar cells may be direct and not mediated through cholecystokinin or gastrin release.

Arterial hypertension with hypopotassemia and hypochloremic metabolic alkalosis caused by abuse of a nasal spray

Abstract: The case of a young woman, using a nasal spray containing corticosteroids, presenting hypertension systodiastolic, hypokalemia and hypochloremic metabolic alkalosis is presented. Clinical findings, similar to hyperfunction of the adrenal cortex, recovered quickly after discontinuation of the drug. The principal causes of hypertension associated with hypokalemia and hypochloremic metabolic alkalosis, are discussed and the importance of nasal spray, containing glucocorticoids and sympathetic agonists, as a cause of high blood pressure syndromes with different clinical expression and of difficult diagnosis is stressed. The importance of systemic absorption of drugs administered by nasal route is also emphasized.