Microalbuminuria is a marker of left ventricular hypertrophy but not hyperinsulinemia in nondiabetic atherosclerotic patients.

Microalbuminuria predicts cardiovascular events in diabetic and nondiabetic patients. For a better understanding of the physiopathological importance of microalbuminuria in atherosclerotic disease, we evaluated the relation between urinary albumin excretion and arterial blood pressure, left ventricular mass, insulin, and lipid levels. The studies were conducted in patients with atherosclerotic peripheral vascular disease. Urinary albumin excretion (studied by nephelometry; an average of triplicate collections from 8 PM to 8 AM), causal blood pressure, echocardiographic left ventricular mass index and wall thickness, plasma immunoreactive insulin and C-peptide (both basally and after a 75-g oral glucose load), blood lipids, and fibrinogen were studied in eight normal subjects and 20 nonobese, nondiabetic male patients with angiographically documented atherosclerotic peripheral vascular disease and preserved renal function, 12 of whom were either hypertensive or on antihypertensive treatment. Eight patients were microalbuminuric (urinary albumin > 20 micrograms/min) and 12 were not. Ankle-arm index and calf and foot transcutaneous oxygen tension were reduced in comparison with normal control subjects but superimposable between the two patient groups to indicate a comparable clinical progression of the vascular disease. In the microalbuminuric subjects, left ventricular mass index was greater, interventricular septum was thicker, and cardiac hypertrophy was more frequent than in nonmicroalbuminuric patients. The prevalence of hypertension tended to be greater and systolic blood pressure values were higher in the presence of microalbuminuria. Overall, a highly significant relation existed between urinary albumin excretion and left ventricular mass. Systolic blood pressure was greater and a history of arterial hypertension was more frequent among microalbuminurics, whereas diastolic blood pressure values showed a statistically significant correlation with both variables.(ABSTRACT TRUNCATED AT 250 WORDS)

Effects of stress on adrenal steroidogenesis blockade by aminoglutethimide.

After one week of AG-treatment, the adrenal cortex reveals a marked storage of lipids and cholesterol, as well as a decrease in haematic corticosterone and progesterone levels. On the contrary, when AG-treatment is associated with stress, an increase in plasma corticosterone and progesterone levels occurs, together with a less evident lipidic storage in the adrenal cortex. These results seem to indicate the possibility that, during stress, hypothalamo-hypophysis axis activation is able to remove, at least partially, the adrenal biosynthesis blockade operated by AG-administration.

Platelet activation in outpatients undergoing esophagogastroduodenoscopy.

To evaluate the influence of emotional stress on platelet function, we have measured by radio-immunoassay in plasma two platelet-secreted proteins, beta-thromboglobulin and platelet factor 4, in a series of outpatients undergoing esophagogastroduodenoscopy for upper digestive complaints. The plasma levels of beta-thromboglobulin and platelet factor 4, determined just before the instrumental examination, were significantly more elevated as compared to basal values, checked a week later. These results provide evidence of enhanced in vivo platelet release reaction during emotional stress.

[A case of Crohn's disease associated with ankylosing spondylitis and digital hippocratism]. / Considerazioni su di un caso di morbo di Crohn associte a spondilite anchilosante ed ippocratismo digitalico.

Some comments are made on the association of chronic intestinal inflammatory conditions and articular manifestations on the basis of a case of Crohn's disease associated with ankylosing spondylitis and digitalic hippocratism. The clinical case is described and the literature on associations observed during Crohn's disease reviewed. Special attention is paid to associations involving ankylosing spondylitis, enteropathic synovitis and hypertrophic osteopathy, particularly as regards the presence of clubbed fingers.

Progressively elevated levels of biologically active (free) cortisol during pregnancy by a direct radioimmunological assay of diffusible cortisol in an equilibrium dialysis system.

The measurement of free cortisol would be preferable with respect to the total hormone content, since it yields more reliable information about the plasma levels of the biologically active cortisol. We have developed a new method for the determination of the apparent free plasma cortisol concentration (AFCC) by means of direct radioimmunological measurement of dialyzed cortisol. The AFCC was measured in 23 plasma pools obtained from normal pregnant women at various gestational times and in 18 nonpregnant women. The mean AFCC was 19.5 +/- 7.1 ng/ml in pregnant women and 9.0 +/- 6.2 ng/ml in nonpregnant women (p less than 0.005). The percent of free cortisol (%FC) showed a progressive increase during pregnancy reaching the lower limits of the normal range at the third trimester. However, the mean of %FC was significantly lower (p less than 0.005) in pregnant women than in nonpregnant women. Our data show a progressive increase of biologically active cortisol during pregnancy.