Prediction of the therapeutic response to simvastatin by pretreatment lipid concentrations in 2082 subjects.

2082 hypercholesterolemic subjects were treated with simvastatin for 12 weeks. In 530 patients the dose was increased after 6 weeks from 10 to 20 mg because of persistently high cholesterol concentrations. Total cholesterol (TC) in the 1552 patients taking 10 mg fell by 1.61 mmol.l-1 (18.4%), LDL cholesterol (LDLC) by 1.53 mmol.l-1 (25.2%), and triglycerides (TG) by 0.13 mmol.l-1 (5.5%); HDL cholesterol (HDLC) significantly increased by 0.05 mmol.l-1 (3.6%). In the 530 patients taking 20 mg TC fell by 1.89 mmol.l-1 (19.9%), LDLC by 1.78 mmol.l-1 (26.0%), and TG by 0.13 mmol.l-1 (5.5%); HDLC increased by 0.05 mmol.l-1 (3.7%). The reductions in TC, LDLC, and TG were positively correlated and the increase in HDLC negatively correlated with their respective baseline values. There were independent significant correlations of the fall in LDLC with sex (MANOVA), baseline TG, and adherence to a lipid-lowering diet. The falls in TG significantly correlated with baseline fructosamine concentrations and dietary adherence. There were 571 adverse events in 16.6% of the patients but no case of myopathy. These results show that simvastatin is usually well tolerated and that its effects on TC and LDLC depend on their baseline concentrations.

The crystal structure of fructose-1,6-bisphosphate aldolase from Drosophila melanogaster at 2.5 A resolution.

The structure of fructose-1,6-bisphosphate aldolase from Drosophila melanogaster has been determined by X-ray diffraction at 2.5 A resolution. The insect enzyme crystallizes in space group P2(1)2(1)2(1) with lattice replacement with rabbit muscle aldolase as a search model has been employed to solve the structure. To improve the initial phases real space averaging, including phase extension from 4.0 to 2.5 A, has been applied. Refinement of the atomic positions by molecular dynamics resulted in a crystallographic R-factor of 0.214. The tertiary structure resembles in most parts that of the vertebrate aldolase from rabbit muscle. Significant differences were found in surface loops and the N- and C-terminal regions of the protein. Here we present the first aldolase structure where the functionally important C-terminal arm is described completely.

Pharmacokinetics of pirprofen and its pyrrol metabolite in elderly patients.

Plasma concentrations of pirprofen and of its pyrrol metabolite were assessed in 9 elderly patients (3 males, 6 females; mean age 76 years) suffering from chronic degenerative disease. Pirprofen 400 mg in 4 ml was administered i.m. and the pharmacokinetic profile of the drug and the metabolite was calculated. The AUC, Cmax and t1/2 of pirprofen were similar to those found in previous studies, and, as expected, those parameters for the pyrrol metabolite were lower (Cmax = 2.8 micrograms/ml-1; tmax = 6.4 h; AUC(0-32) = 56.5 micrograms.h.ml-1). One patient (n = 8) showed different pharmacokinetic behaviour, which is discussed. The data suggest that age has little influence on the pharmacokinetic of pirprofen, although unpredictable responses should always be considered in clinical practice.

[The relationship between thyroid surgical operations and blood calcium]. / Sul rapporto tra interventi chirurgici tiroidei e calcemia.

The behaviour of calcemia was studied in a group of patients subjected to surgical operation of varying extent on the thyroid (enucleoresection, hemithyroidectomy, subtotal and total thyroidectomy). Average calcaemia was found to be diminished in all groups of operated cases, in relation to the extent of the operation. Surgery interferes by significantly modifying the variability of calcaemia in the different groups. The frequency of cases with pre-operative calcaemia higher than the average and retaining a postoperative level higher than the minimum of the controls is roughly inversely proportional to the extent of the surgery. A comparison between calcaemia after subtotal thyroidectomy for nodular struma and for Graves' disease did not evidence any statistically significant differences.

Adipose tissue cellularity and weight reduction forecastin.

Seventy-six obese female outpatients underwent controlled 1000 kcal diets (50% carbohydrate, 25% fat, 25% protein). Prior-to-treatment data underwent "step-wise" multiple regression analysis to investigate the possibility of predicting body weight after 6 months of treatment (y), Body weight can be forecast using a linear regression function. This function, based on initial weight (x1) and adipose cell weight (x2), uses the equation y = 9.75 + 0.87x1 - 8.41x2 (F = 696.53; P less than 0.001; R2 = 0.95). Afterwards, patients were subdivided into three groups according to the difference between 6th and 12th month body weights: weight loss, weight stable, and weight increase groups. Weight gaining patients showed a significantly higher mean fat cell number, weight lossers had a higher mean adipose cell weight than the other two groups.

[Knowledge and use of contraceptive methods by university physicians and medical students]. / Conoscenza ed utilizzazione delle metodiche contraccettive da parte di medici universitari e studenti in medicina.

PIP: A survey by questionnaire was carried out at 3 Italian University Hospitals, one in northern, one in central, and one in southern Italy, to study contraceptive knowledge and practices among physicians and medical students. 76.6% of respondents used a contraceptive method, but only 40.5% used a modern method. The pill was used by 36.7% of modern contraceptives users, the IUD by 4.1%, and the diaphragm by 1.1%. The condom was still used by 23.6% of respondents, especially students, and the rhythm method by 13.7%, especially among physicians. Coitus interruptus seemed to be still very popular in the south. Motivation for choice of method used was not so much effectiveness of the method, as simplicity of use. Only 5% of respondents were using a method recommended by a specialist. In general, knowledge about specific contraceptive methods, especially the modern ones, was very poor, especially in the southern university. However, as compared to preceding surveys, practice of modern contraceptive methods is on the increase.^ieng

[Behavior of calcemia in breast malignancy. Note I (author's transl)]. / Sul comportamento della calcemia nelle neoplasie della mammella. (Nota 1).

The authors report a statistical investigation conducted in 95 patients with mammary carcinoma, designed to show the behavior of calcemia in the course of this malignancy. The data were analyzed statistically by the binomial test, the scatter of values (F test of Snedecor), and the t test of Student. The authors confirmed the existence of a statistically significant alteration of calcemia only in the group of patients with metastasis to bone versus control subjects; conversely there was no significant difference of distribution in the various groups in regard to values beyond those given as normal.