Paradoxical effect of dopamine-agonists on IGF-1 in patients with prolactinoma: the role of weight.

PURPOSE: An increase of IGF-1 has been reported during therapy with dopamine agonists (DA) for prolactinomas; in such cases a correct diagnosis is pivotal to avoid an unnecessary reduction or withdrawal of DA, which are needed to maintain normal prolactin levels. This study was aimed to measure IGF-1 levels, at baseline and during follow-up, in a cohort of patients with prolactinoma, treated with cabergoline, stratified by body mass index. METHODS: We retrospectively enrolled 35 patients (15 F/20 M; age m ± SD, years: 43.4 ± 13.7) with prolactinoma (21 microadenomas and 14 macroadenomas) who were followed-up at the Endocrinology Unit, in Siena, and with available pituitary hormone assessment at baseline and during follow-up (m ± SD, years: 2.74 ± 0.55). RESULTS: IGF-1 increased in the whole cohort, but remaining within normal range, except two patients, in whom acromegaly was ruled out with oral glucose tolerance test. After dividing patients by weight, this trend was confirmed only in subjects with overweight and obesity (OV/OB) (p = 0.04). Interestingly, the reduction of prolactin levels was significantly greater in the OV/OB compared to normal-weight patients (median decrease of 97.5% versus 88.2%, p = 0.04). CONCLUSIONS: Since DA and normalization of prolactin are known to improve insulin sensitivity, we speculated they have favored the increase of IGF-1 in OV/OB. Our results should be confirmed and the hypothesis proven by further studies.

Analysis of stable low molecular weight (LMW) RNA profiles of hydrocarbon metabolizing bacteria by staircase electrophoresis.

Staircase electrophoresis (SCE) in polyacrilamide gels was used to analyze the stable low-molecular weight (LMW) RNA profiles of several propane and butane oxidizing bacteria belonging to different species and genera. Differences in the number and distribution of the RNA bands in these profiles allowed us to differentiate among them. Congruent results were found between the established classification of these bacteria and results obtained by LMW RNA profiling and moreover, some misclassified strains can be assigned to the correct genus and species using this technique. LMW RNA profiling by staircase electrophoresis, which makes possible the analysis of a large number of strains in a short time, permits rapid identification of hydrocarbon metabolizing species when compared with LMW RNA profiles of reference strains.

A phase II study of combination chemotherapy in advanced ovarian carcinoma with cisplatin and cyclophosphamide plus reduced glutathione as potential protective agent against cisplatin toxicity.

AIMS AND BACKGROUND: The clinical use of cisplatin (CDDP), one of the most active agents in advanced ovarian cancer, is limited by nephrotoxicity and cumulative neurotoxicity. In preclinical studies, reduced glutathione (GSH) demonstrated a protective action against CDDP nephrotoxicity. We treated 20 patients with advanced ovarian carcinoma, with polychemotherapy containing CDDP + GSH, to assess the protective action of GSH against CDDP nephrotoxicity. METHODS: Between January 1988 and December 1989, 20 patients, with advanced ovarian carcinoma (St. III-IV-FIGO), not pretreated received CDDP: 45 mg/m2 i.v., on day 1-2, + cyclophosphamide (CPA): 900 mg/m2 i.v. on day 2 + GSH 2500 mg i.v. in normal saline 100 ml (in 15 min), before CDDP, every 21-28 days. RESULTS: A pathologic complete response rate (PCR) of 55% (11/20) was observed (7/14 patients with bulky disease). Median survival was 26.5 months and 5 patients were still alive and disease free at 35 months. Toxicity was limited, without any case of nephrotoxicity. CONCLUSIONS: On the basis of our previous experience with the same regimen without GSH, this study suggests that also in the clinical setting, GSH has no negative interference on CDDP activity and that GSH might improve the therapeutic index of CDDP. However, our data need to be confirmed by large randomized clinical studies.

[Results of neonatal vaccination against hepatitis B in Frosinone]. / Risultati della vaccinazione neonatale antiepatite B a frosinone.

Neonates born to HBSAg-positive mothers are at increased risk of HBV, mainly because of perinatal exposure. Since 1985 the HBV Regional prevention and control program of Latium recommends prophylaxis both with HBIG and HBV vaccine at birth for all infants born to HBaAg-positive mothers. From 1-1-80 to 1-5-88 89 neonates (52 males, 37 female) from Local Health Units (U.S.L.) FR 2, 3, 4, 5, 6, 7, 8, 9 have been examined at the Centre for Vaccination against HBV of Frosinone. Prophylaxis was accomplished both by HBIG 1 ml. I.M.) at birth and HBV vaccine (5.5 ml. I.M. of HBVAX) at birth, and at 1 and 6 months. All injections were given in the gluteal muscle. Antibody titer to HBsAg (antiHBs) detectable by RIA was tested 1 month after or by the time of the third injection of vaccine. Non-responders (anti HBs less than 10 mUI/ml) were given an extra dose of vaccine (0.5 ml I.M.). 85 neonates accomplished vaccination receiving three injections of HBVAX; 4 neonates received only one dose as their parents refused to continue vaccination. Two neonates (non-responders) out of 85 required another dose of vaccine, but only one seroconvertion appeared. No serious side effects have been seen: one case of anorexia and one case of low-grade fever, with no need to interrupt or modify immunization schedule. In the present study the prophylactic efficacy of HBV vaccine has been demonstrated providing 98.6% of cases with antiHBs titer greater than or equal to 10 mUI/ml, and 84% of cases with antiHBs titer greater than or equal to 150 mUI/ml.(ABSTRACT TRUNCATED AT 250 WORDS)

[Adenomyosis: trans-myometrial biopsy]. / Contributo allo studio dell'adenomiosi: le biopsie trans-miometriali.

Myometrial biopsies were taken on 45 women less than 40 years old either by laparoscopy or laparotomy, searching for adenomyosis "in vivo". A positive response of 5 cases (11.11%) may prove adenomyosis to affect significantly young women too and not to be closely connected with the usually reported pathogenetic factors.