Successful weaning from mechanical ventilation after Serratus Anterior Plane block in a chest trauma patient.

Objectives: Chest trauma is associated with severe pain, which can hamper normal breathing. Serratus Anterior Plane block (SAPB) is a novel technique, which provides analgesia for chest wall surgery. We describe an interesting clinical case about the use of SAPB to improve pain and pulmonary function in a patient with severe chest trauma.

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.

[Cigarette smoking and hormonal changes in the course of the menstrual cycle].

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.

[Behavior of serum angiotensin converting enzyme in hyperthyroidism correlated to that of 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.

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.

[Tubercular Addison's disease with high titers of microsomal thyroid antibodies and reduced thyroid function reserve].

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.

[Cutaneo-cerebral bullous syndrome in patients with type II diabetes mellitus].

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.

[Effect of smoking on the hypophyseo-adrenal axis].

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.

[ACTH and cortisol after cigarette smoke exposure during the dexamethasone suppression test in smokers and non-smokers].

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.

[Oral administration of nicotine and plasma levels of ACTH and cortisol in smokers and non-smokers].

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.

[Changes in the levels of ACTH and cortisol after passive exposure to cigarette smoke in smokers and non-smokers].

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.

[Treatment with deflazacort associated with a thyrostatic therapy in a case of juvenile Basedow's ophthalmopathy. Clinical and hematochemical evaluation of therapeutic results].

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].

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.

[Behavior of circadian rhythm of ACTH and cortisol in 16 normal subjects after a balanced normocaloric diet and after a high protein diet (Cosinor mean method)].

In 16 normal subjects the circadian rhythm of ACTH has been studied during normal calories diet and after a 15 days period of high protein content diet (2 g/Kg body weight). The statistical study, according Cosinor method, has shown a significant increase of the mesor and of the amplitude, but has not shown any change of the ACTH and Cortisol rhythm, after hyperproteic diet. Data advise the increase of the tonic and fasic secretion of both hormones and shown the mantained acrophase.

[The influence, in normal subjects, of a high-protein normocaloric diet on the response of cortisol, ACTH, GH, and PRL to insulin hypoglycemia].

A protein rich diet causes a remarkable increment of plasma cortisol, corticotropin and somatotropin concentration, but does not modify the plasma prolactin level; this diet, moreover, is followed by a more vivacious response to the Lysin-8-Vasopressin test. In 10 healthy voluntary subjects we have studied the hormonal behaviour during the insulin-induced hypoglycemia test in course of equilibrated diet and after 15 days of protein-rich diet. In these two experimental conditions the insulin-induced hypoglycemia test has promoted a similar increment of the four hormones.