Acromegaly is associated with increased cancer risk: A survey in Italy

It is debated if acromegalic patients have an increased risk to develop malignancies. The aim of the present study was to assess the standardized incidence ratios (SIRs) of different types of cancer in acromegaly on a large series of acromegalic patients managed in the somatostatin analogs era. It was evaluated the incidence of cancer in an Italian nationwide multicenter cohort study of 1512 acromegalic patients, 624 men and 888 women, mean age at diagnosis 45 \uc2\ub1 13 years, followed up for a mean of 10 years (12573 person-years) in respect to the general Italian population. Cancer was diagnosed in 124 patients, 72 women and 52 men. The SIRs for all cancers was significantly increased compared to the general Italian population (expected: 88, SIR 1.41; 95% CI, 1.18-1.68, P < 0.001). In the whole series, we found a significantly increased incidence of colorectal cancer (SIR 1.67; 95% CI, 1.07-2.58, P = 0.022), kidney cancer (SIR 2.87; 95% CI, 1.55-5.34, P < 0.001) and thyroid cancer (SIR 3.99; 95% CI, 2.32-6.87, P < 0.001). The exclusion of 11 cancers occurring before diagnosis of acromegaly (all in women) did not change remarkably the study outcome. In multivariate analysis, the factors significantly associated with an increased risk of malignancy were age and family history of cancer, with a non-significant trend for the estimated duration of acromegaly before diagnosis. In conclusion, we found evidence that acromegaly in Italy is associated with a moderate increase in cancer risk

DEFICIT OF GALANIN-LIKE IMMUNOSTAINING IN THE MEDIAN-EMINENCE OF ADULT HYPOTHYROID RATS

In this paper we describe the modification of the galanin (GAL)-like immunostaining in the hypothalamus of rats, which were made hypothyroid at 52 days after birth. On 21st day after the surgical ablation of the thyroid gland, the staining of the GAL-immunoreactive fibers in the median eminence decreased and on the 84th day disappeared almost totally. The GAL-immunoreactive distribution in other areas of the hypothalamus, e.g. the anterior hypothalamus and the dorsomedial nucleus, is only slightly affected by the absence of thyroid hormones, whereas the GAL-staining of medulla oblongata (vagal complex) is equal in both control and hypothyroid rats. In hypothyroid colchicine-treated rats, we were unable to stain GAL-immunoreactive neurons in the paraventricular nucleus (PVN). Oxytocin- and vasopressin-like material was present in the magnocellular neurons and the staining pattern in hypothyroid rats was the same as that of control animals. Our data show a marked reduction in the expression of the GAL-like immunoreactivity of the PVN and median eminence of adult hypothyroid rats. The possible role of this deficit in the pathogenesis of the GH secretion impairment that is observed in hypothyroid rats is discussed

Le Sindromi da Insufficienza Corticosurrenalica

Vengono illustrate l'eziologia, la patogenesi, le caratteristiche cliniche, la prognosi e la terapia del Morbo di Addison e delle insufficienze surrenaliche croniche di origine iatrogena o congenita.Vengono trattate le diverse forme di insufficienza surrenalica acuta e l'ipoaldosteronismo

Le Sindromi da Ipersecrezione degli Ormoni Corticosurrenalici

Gli autori dopo aver illustrato la biositesi degli ormoni surrenalici descrivono l\u2019eziologia, la patogenesi e le manifestazioni cliniche delle principali patologie legate all\u2019 aumentata produzione di ormoni corticosurrenalici, soffermandosi sui procedimenti necessari per arrivare alla diagnosi e sulle pi\uf9 opportune procedure terapeutiche

Primary Pituitary Lymphoma

Primary central nervous system lymphoma (PCNSL) is an uncommon neoplasm, representing 1% of primary brain tumors. PCNSL represents 3% of intracranial neoplasms in patients with AIDS. The aim of this paper will be to review the clinical case reports so far available of pituitary lymphomas in order to depict with the most updated information the clinical syndrome correlated. We report 17 cases of primary pituitary lymphoma (PPL) and 12 cases of secondary localization. The clinical presentation of PPL may be similar to the pituitary invasive macroadenomas. As many as 50% of patients showed evidence of anterior pituitary hipofunction. Of the patients with anterior pituitary failure, 5 had diabetes insipidus; 3 had hyperprolactinemia; 63% had diffuse B cell-large lymphoma. PPL seems to have a better prognosis with respect to all PCNSLs (70% of the examined patients had survived quite long). The data reported suggest that PPLs represent the final presentation of different processes with either hypophyseal or extrahypophysealorigin. Neurosurgical intervention or biopsy are at this point considered crucial for early diagnosis of the tumor

INFLUENCE OF EXERCISE ON DEHYDROEPIANDROSTERONE SULFATE AND DELTA-4-ANDROSTENEDIONE PLASMA-LEVELS IN MAN

To study the involvement of adrenal cortex in prolonged physical exercise, we measured plasma dehydroepiandrosterone sulphate (DHEAS), DELTA-4-androstenedione (DELTA-4-A) and cortisol (C) levels in 20 moderately trained men one hour before and 5-10 min after one-hour-swimming. Mean plasma DHEAS and DELTA-4-A pre-exercise levels increased significantly with respect to post-exercise levels. Cortisol levels moderately increased, but showed no significant modifications after the exercise. These results suggest that in this physical exercise there is an independent activation of the cortical zona reticularis as to that of the zona fasciculata

Cardiovascular and catecholamine response to clonidine in obese subjects

OBJECTIVE: To investigate central alpha-2 adrenergic activity, one of the main inhibitory factors affecting norepinephrine secretion, in human obesity. DESIGN: Cardiovascular and catecholamine responses to clonidine (300 mu g per os) were evaluated in a group of obese subjects. SUBJECTS: 10 obese men (OM) and 14 obese women (OW). MEASUREMENTS: Mean arterial pressure, pulse rate, plasma norepinephrine (NE) and epinephrine (E) before and 120', 130', 140' after clonidine (CL) administration. RESULTS: The mean arterial pressure decreased after CL administration in obese patients (from 92 +/- 12 to 79 +/- 2 mmHg; P < 0.001) with no significant differences between OM and OW. The values of pulse rate were reduced in obese patients after clonidine (60 +/- 1 b/min vs 65 +/- 1 b/min before clonidine; P < 0.01) with no differences between OM and OW. Plasma E was not affected by the administration of clonidine and no sex related differences were found in the basal (OM: 0.23 +/- 0.03 vs OW: 0.15 +/- 0.03 nmol/L; P = NS) and in the post-CL E levels (OM: 0.22 +/- 0.02 vs OW: 0.14 +/- 0.03 nmol/L; P = NS). Basal plasma NE values were not different between OM (1.32 +/- 0.15 nmol/L) and OW (1.03 +/- 0.11 nmol/L; P = NS). Plasma NE decreased after CL in obese patients (from 1.20 +/- 0.10 to 0.59 +/- 0.08 nmol/L; P < 0.001) and a significant difference was found in the post-CL values between OM and OW (0.74 +/- 0.11 vs 0.40 +/- 0.06 nmol/L respectively; P < 0.01). The decrease in plasma NE was strongly correlated with the basal value of NE (r = 0.70; P < 0.001). The sex-related differences in plasma NE responses to clonidine in obese subjects did not differ with those previously observed in control subjects (P = NS). CONCLUSION: The cardiovascular and catecholamine response to CL in obese patients were similar to that previously observed in normal subjects, indicating a normal alpha-a adrenergic activity. The sex related difference in the NE response to CL, previously reported in normal subjects, was maintained in obese patients

Increased cardiovascular response to caffeine in perimenopausal women before and during estrogen therapy

Perimenopause and menopause may be associated with an increased risk of cardiovascular disease, so we have investigated the cardiovascular and catecholamine response to caffeine in perimenopausal women compared to young cycling premenopausal subjects. Caffeine (250 mg per os) was administered to nine perimenopausal women and nine premenopausal women, The perimenopausal women repeated the test after 4 months of percutaneous estrogen replacement therapy. Systolic and diastolic blood pressure, pulse rate, plasma norepinephrine, epinephrine, glucose, insulin and free fatty acids were determined at 0, 15, 30, 45, 60, 90 and 120 min after caffeine administration, No differences were found in the basal values of systolic blood pressure, diastolic blood pressure, pulse rate, norepinephrine, epinephrine, insulin, glucose and free fatty acids between perimenopausal women, both before and after therapy, and premenopausal women. Caffeine induced a higher increase of systolic (F = 4.9; p < 0.05) and diastolic blood pressure (F = 4.7; p < 0.05) in perimenopausal women before and during estrogen therapy as compared with premenopausal women. Pulse rate increased significantly only in perimenopausal women before therapy (F = 6.5; p < 0.03). These data show that perimenopause either before or during short-term estrogen therapy is associated with enhanced cardiovascular reactivity to caffeine. This phenomenon is not due to increased adrenergic and metabolic responses

DAILY CHANGES OF NEUROPEPTIDE-Y-LIKE IMMUNOREACTIVITY IN THE SUPRACHIASMATIC NUCLEUS OF THE RAT

We found that in 12-h-dark and 12-hlighith housed rats the NPY-like immunoreactive innervation of ventro-lateral part of the SCN shows a 24 h rhythm with values rising gradually during the light phase and falling during the dark phase.these results confirm the physiological role of NPY in tyht timimg of the circadian activity of the SCN