Plasma atrial natriuretic hormone in hyperthyroidism.

In 22 hyperthyroid patients, atrial natriuretic hormone (ANH) levels (71.91 +/- 21.03 pg/ml), measured during a 3-h-Holter, were found to be significantly higher (p < 0.001) than those in 20 age-matched normal subjects (37.22 +/- 8.73 pg/ml). We have demonstrated that the presence of tachiarrhythmias does not influence ANH release. The positive and significant correlation of FT3 with both ANH and heart rate confirms the hypothesis of a direct action of thyroid hormones on ANH release.

[Cigarette smoking and hormonal changes in the course of the menstrual cycle]. / Fumo di sigaretta e modificazioni ormonali nel corso del ciclo.

ACTH, cortisol and PRL plasma levels were determined on day 7, 14, and 21 of the menstrual cycle in 20 females with hypertrichosis of whom 10 were smokers and 10 non-smokers. Significantly raised levels of all hormones considered were found in smokers throughout the cycle. These findings suggest a possible relationship between objective symptoms (hypertrichosis) and nicotine, mediated by complex changes in the endocrine pattern and presumably also due to the action of nicotine on the central nervous system.

Serum angiotensin converting enzyme in diabetic retinopathy.

Serum levels of angiotensin converting enzyme (SACE) were measured in 118 diabetic patients divided into the following four groups: 44 insulin-treated diabetic patients with severe retinopathy, 38 non insulin-treated diabetic patients with severe retinopathy, 18 diabetic patients, including both insulin-treated and non insulin-treated subjects with background retinopathy, 18 diabetic patients, insulin-treated and non insulin-treated without signs of retinopathy. Nineteen retinopathic patients non diabetic were also studied in order to verify whether SACE levels are altered when retinopathy is present independently from diabetes. The control group was composed of 44 normal subjects. When the data from the above six groups of subjects were submitted to statistical tests (one-way ANOVA, T-test of Bonferroni and test of Student-Newman-Keuls), the study yielded the following results: i) a remarkable difference between the SACE levels in healthy subjects and those in the three groups of diabetic retinopathic patients considered; ii) a non statistically significant difference of SACE levels between normal subjects and diabetic patients without retinopathy; iii) a non statistically significant comparison of SACE levels of normal subjects versus non diabetic retinopathic patients. Therefore, we concluded that while primitive diseases of the retina are not associated with an increase of SACE levels, yet when diabetes and retinopathy coexist, the SACE levels increase remarkably (in rather an independent way from the type of diabetes, the age of subjects, the stage of retinal disease and the daily average insulin dose), suggesting that most of the enzyme's increase originates from the endothelium of peripheral vasa, widely involved in most of the retinopathic diabetic patients.

[Behavior of serum angiotensin converting enzyme in hyperthyroidism correlated to that of TSH]. / Il comportamento del serum angiotensin converting enzyme nell'ipertiroidismo correlato a quello del TSH.

The study examined the relations between serum levels of angiotensin-converting enzyme and those of thyroid-stimulating hormone in a group of hyperthyroid patients, and the respective therapy. The study continued for 12 months, from the onset of disease until remission. From an analysis of the results it was seen that levels of SACE and TSH during the first 4 months were significantly different to those in normal subjects: levels of SACE were increased, whereas TSH levels had fallen. This difference gradually diminished over the course of the following 8 months, and SACE and TSH values returned to within normal limits. The increment of SACE may depend on the presence of damage to the vascular endothelium within and surrounding the thyroid, in addition to intense vasodilation caused by the hyperthyroid state. The correlation between increased SACE levels and the course of disease is further confirmed by the fact that levels returned to within normal values during thyrostatic therapy; this was also observed in the case of TSH.

Acquired factor VIII inhibitor in a patient with adenocarcinoma of the colon-rectum.

The presence of a circulating inhibitor of factor VIII was observed and described in several pathological conditions. In the present study we describe the case of a patient with a severe haemorrhagic syndrome caused by the presence of a circulating inhibitor of factor VIII discovered following abdominal surgery for an adenocarcinoma of the colon rectum. The haemorrhagic syndrome evolved independently from the course of the neoplastic disease.

Haemodynamic and metabolic effects of ketanserin in dyslipidaemic hypertensive subjects.

Eighteen dyslipidaemic patients affected with moderate hypertension were studied before and after short-term treatment with ketanserin (40 mg/die) on hypocaloric (22-25 kcal/kg/die) and normosodic-normopotassic diet. Student's t test applied to the determinations revealed a significant reduction of systolic and diastolic blood pressure (SBP, p less than 0.001, DBP p less than 0.001), total cholesterol (p less than 0.001) and triglycerides (p less than 0.006). The results suggest that ketanserin is an effective hypotensive drug and its association with a hypocaloric diet promotes a decrease in plasma lipids.

[Tubercular Addison's disease with high titers of microsomal thyroid antibodies and reduced thyroid function reserve]. / Morbo di Addison tubercolare con elevato titolo di anticorpi antimicrosomiali tiroidei e ridotta riserva funzionale della tiroide.

This case reports deals with a male patient, white, aged 51, bricklayer, tobacco smoker. At 43 years old a tubercular epididimite was surgically treated with orchiectomy. Recently, the reports marked weakness, weight loss, headache, vertigo, hypotension. On admittance to the hospital, hyperpigmentation was also present. Previous therapy (cortisone acetate 40 mg/die), was suspended, clinical investigations showed impaired adrenal and thyroidal functions; antimicrosomal antibodies were also present. Therefore therapy with cortisone acetate (25 mg x 2/die, 9-alpha-fluorohydrocortisone 0.1 mg/die and L-thyroxine 100 mcg/die) was instituted with marked improvement of the patient's conditions. This case reports highlights the importance of proceeding with complete investigations on the system, even when dealing with a tubercular Addison's disease.

[Effect of smoking on the hypophyseo-adrenal axis]. / Effetto del fumo sull'asse ipofisi-surrene.

Plasma concentrations of adrenocorticotrophin (ACTH) and cortisol were measured during insulin-induced hypoglycemia and lysin-8-vasopressin (LVP) test in 60 healthy subjects, non-smokers and habitually smokers of 10 or more cigarettes/24 hours. A marked and statistically significant rise of both hormones was found in non-smoker subjects, whereas smokers showed poor and not significant modifications. These results suggest that continuous chronic inhalation of nicotine may act as a powerful stimulus on the hypothalamo-hypophyseal structures that control the hypothalamic CRF and/or ACTH production and release. Central nervous mechanisms of hormonal regulation may become less sensitive and efficient when an acute rise of ACTH is required, as during stimulating tests. Our investigation confirms that cigarette smoking is heavily responsible of endocrine disorders, in particular of hypophyseal-adrenal axis.

[Changes in the levels of ACTH and cortisol after passive exposure to cigarette smoke in smokers and non-smokers]. / Modificazioni dei livelli di ACTH e cortisolo dopo esposizione passiva al fumo di sigaretta in fumatori e non fumatori.

Plasma ACTH and cortisol levels were studied in smokers and non smokers, (exposed or not to smoke of the environment), after passive exposure to cigarette smoking. Non smokers, usually not exposed to smoke, show a rise in both hormones, whereas smokers and non smokers commonly exposed to smoke don't show any change in ACTH and cortisol levels. These data suggest that nicotine acts as an acute stimulus on the hypophysis-adrenal axis even passively inhaled.

[Oral administration of nicotine and plasma levels of ACTH and cortisol in smokers and non-smokers]. / Somministrazione orale di nicotina e livelli plasmatici di ACTH e di cortisolo in fumatori e non fumatori.

Plasma ACTH and cortisol levels after oral administration of nicotine (chewing gum containing nicotine 2 mg) in short and long time (10 and 45 min) were studied in smokers and non smokers. Non smokers after short time administration showed significant rise in ACTH and cortisol. No modifications were seen in the other groups of subjects. These data confirm that nicotine stimulates hypophysis-adrenal axis in non smokers and that this effect is connected with nicotine contents of cigarettes rather than other volatile substances.

[ACTH and cortisol after cigarette smoke exposure during the dexamethasone suppression test in smokers and non-smokers]. / Studio dell'ACTH e del cortisolo dopo fumo di sigaretta, nel corso della prova di inibizione con desametasone, in fumatori e non fumatori.

In this research the effect of nicotine, (smoke of cigarette), was studied in smokers and non smokers during dexamethasone inhibitory test (1 mg h 23.00). ACTH and cortisol plasma levels, physiologically suppressed at 08.00, increased, after 30 min from smoking, only in group of non smokers. These data suggest that nicotine, in non smokers, could induce a maximum stimulus on diencephalic structures, so to overcome the inhibition of dexamethasone.

[Cutaneo-cerebral bullous syndrome in patients with type II diabetes mellitus]. / Sindrome bollosa cutaneo-cerebrale in soggetto con diabete mellito tipo II.

This study deals with a case of non-insulin dependent diabetes mellitus complicated by a diffuse giant vesicular dermatosis in combination with an irreversible coma caused by encephalopathy with hypodense areas on the CT scan. The coma, unlike the known diabetic comas and unrelated to infectious, toxic and cerebrovascular noxae, was interpreted as due to bullous lesions of the brain comparable to the cutaneous vesicles.

[Treatment with deflazacort associated with a thyrostatic therapy in a case of juvenile Basedow's ophthalmopathy. Clinical and hematochemical evaluation of therapeutic results]. / Trattamento con deflazacort associato a terapia tireostatica in un caso di oftalmopatia basedowiana giovanile. Valutazione clinica ed ematochimica dei risultati terapeutici.

In this brief report we describe a case of juvenile Basedow disease associated which exophthalmus and treated with deflazacort and methimazole on the basis of its immune origin (as confirmed by the presence of high levels of antimicrosomal antibodies). After only two months of therapy, we already noted a definite reduction of the exophthalmus and normalization of the thyroid hormone parameters with disappearance of the antimicrosomal antibodies.

[Influence of administration of pyridoxine on circadian rhythm of plasma ACTH, cortisol prolactin and somatotropin in normal subjects]. / Influenza della somministrazione di piridossina sul ritmo circadiano dell'acth, del cortisolo, della prolattina e del somatotropo plasmatici nei soggetti normali.

The influence of vitamin B6 in a dosage of 300 mg X 2 in 24 hrs, on circadian rhythm of plasmatic ACTH, cortisol, prolactin and somatotropin have been studied in 10 normal women. After vitamin B6 24 hrs pattern of ACTH and cortisol is unchanged; prolactin levels are slightly lower, in a statistically unsignificant proportion the night peak of growth hormone is higher in a statistically significant proportion (p. 0.05). The effect of vitamin B6 is likely to me mediated by dopaminergic receptors at hypothalamic level as previous studies by other Authors appear to prove.