Enrica Ciccarelli - Academia.edu (original) (raw)
Papers by Enrica Ciccarelli
Journal of Endocrinology, 1997
Sixty cerebral meningioma specimens obtained at surgery from 34 female and 26 male patients were ... more Sixty cerebral meningioma specimens obtained at surgery from 34 female and 26 male patients were examined for the presence of prolactin (PRL) receptors. These were compared with normal arachnoid tissue from which these tumours arise. PRL receptors were detected in 61·7% of meningiomas whereas no PRL binding was found in samples of normal arachnoid tissue. No relationship was found when sex or histological findings were compared with the presence of PRL receptors. Receptor-positive tumours had saturable and high-affinity (Kd, 4·8 ± 0·5 ng/ml) receptors with hormonal specificity for human PRL (hPRL) resembling that of other target tissues of PRL in man. The biological role of these receptors was investigated in primary cell cultures derived from meningioma tissue characterized for PRL receptor. When human PRL was added to the culture medium, in doses ranging from 1 to 200 ng/ml, a dose-dependent stimulation of 3H-thymidine incorporation was observed only in PRL-receptor positive tumou...
Journal of Endocrinological Investigation, 1996
It is widely accepted that, in man, galanin, a neuropeptide, has a clear GH-releasing effect whil... more It is widely accepted that, in man, galanin, a neuropeptide, has a clear GH-releasing effect while its stimulatory influence on PRL secretion is matter of debate. To clarify this point, in 6 normal young women (23-35 yr) in their early follicular phase, we studied the effect of galanin (pGAL, 80 pmol/kg. min infused iv over 60 min) on both basal and arginine (ARG, 0.5 g/kg iv in 30 min), TRH (400 iJg iv as a bolus at 0 min) or metoclopramide (MCP, 10 mg iv as a bolus at 0 min)-stimulated PRL secretion. GAL infusion failed to significantly increase basal PRL levels (peak vs baseline: 12.2±3.6 vs 8.7±1.2 iJg/L) but counteracted the spontaneous PRL decrease observed during saline infusion (AUC: 1216.6±282.1 vs 672.0±94.5 iJg.min/L; p<O.05). GAL infusion clearly enhanced the PRL response to TRH (AUC: 5806.3±743.0 vs 3952.1 ±423.9 iJg.min/L, p<O.05) and ARG (AUC: 3676.8±382.6 vs 2638.9 ± 287.0 iJg.min/L, p<O.05),
Journal of Endocrinological Investigation, 1989
Journal of Endocrinological Investigation, 1996
Dopaminergic system seems to influence the regulation of insulin secretion, although in man confl... more Dopaminergic system seems to influence the regulation of insulin secretion, although in man conflicting data are reported. Furthermore, bromocriptine (BRC), a dopaminergic agonist, has been recently found to inhibit the seasonally occurring hyperinsulinemia and the increase in body weight in the hamster. On this basis, we investigated the effect of BRC on spontaneous and stimulated insulin secretion in human obesity. Six obese (BMI: 33.2±1.6 Kg/m2) underwent the administration of: 1) arginine (ARG, O.S g/Kg iv in 30 min), 2) BRC (2.S mg po), 3) ARG + BRC. In each test plasma glucose and serum insulin, growth hormone (GH) and prolactin levels were determined. BRC did not significantly reduce spontaneous and ARG-induced insulin release. Baseline and stimulated glucose levels were also un
Journal of Endocrinological Investigation, 1987
Recently, a new long-acting form of bromocriptine (Parlodel LA, Sandoz) has been developed and it... more Recently, a new long-acting form of bromocriptine (Parlodel LA, Sandoz) has been developed and it has already been found to be effective in lowering plasma PRL levels in normal volunteers and postpartum women. This work reports the clinical, hormonal and radiological effects of a single 50 mg dose of long-acting bromocriptine in 10 patients with tumorous hyperprolactinemia (2 microprolactinomas, 6 macroprolactinomas, 1 acromegaly and 1 nonsecreting macroadenoma). A rapid and long-lasting (28 days) normalization of PRL levels was observed in patients with microprolactinoma, acromegaly and nonsecreting adenoma. None of the 6 patients with macroprolactinoma underwent normalization of plasma PRL, but the latter was markedly reduced (61-80% of basal levels). A second injection of the drug in 5 macroprolactinoma patients induced a further reduction of plasma PRL levels in 2 ofthem. No changes in the tumor size were observed either after the first or the second injection of long-acting bromocriptine in any of the patients. This injectable form of bromocriptine induced nausea and / or mild hypotension lasting a few h in 4 of the 10 patients and was better tolerated than the oral form as regards both the duration and intensity of the side effects. Thus, as this drug has proved to be efficacious and well tolerated by the patients, this long-acting form of bromocriptine may be a valid therapeutical approach for initiating medical treatment of patients with prolactinoma.
The Journal of Clinical Endocrinology & Metabolism, 1983
The PRL response to nomifensine (Nom), an indirect DA agonist; domperidone (Dom), a DA receptor a... more The PRL response to nomifensine (Nom), an indirect DA agonist; domperidone (Dom), a DA receptor antagonist; and TRH, which directly stimulates the PRL-secreting cells, was evaluated 2-53 months after surgery in 13 patients in whom successful removal of a prolactinoma had resulted in normal serum PRL levels and return of regular menses or libido and potency. In addition, the pattern of TSH secretion in response to Dom and the spontaneous rise in plasma PRL of 6 cured patients during pregnancy were evaluated. Nom induced an inconsistent decrease in basal PRL levels, a pattern contrasting with that in healthy women in whom plasma PRL was markedly suppressed after administration of the drug. Dom and TRH elicited a significant rise of basal PRL levels, but the rise was markedly lower than that occurring in the control group. The TSH increment after Dom treatment was lower than that before surgery, though higher than that in the controls. Evaluation of individual patients showed that only one patient had a normal PRL response to either Nom or Dom, while the TSH response to the latter returned to normal in five of seven patients. During pregnancy, plasma PRL rose inconsistently in the patients, and PRL levels were generally lower than those in normal pregnant women. These results suggest the presence of an abnormality in the dopaminergic mechanism(s) of PRL control before and after adenomectomy or, less likely, the existence of impaired pituitary function or reserve.
The Journal of Clinical Endocrinology & Metabolism, 1989
Cabergoline (CAB) is a new oral dopaminergic compound showing a very long-lasting PRL-lowering ac... more Cabergoline (CAB) is a new oral dopaminergic compound showing a very long-lasting PRL-lowering activity and reported to be well tolerated. The efficacy and tolerability of chronic treatment with CAB in 30 female hyperprolactinemic patients, aged 18-52 yr (6 microadenomas, 3 macroadenomas, and 21 functional hyperprolactinemias), were studied. In a group of 10 patients who received CAB (0.8 mg once weekly or 0.4 mg twice weekly) for 8 weeks PRL levels normalized while on treatment and remained normal (8 patients) or greatly reduced (1 patient) for 1-2 months after discontinuation of the drug. Twenty-six patients underwent chronic treatment (6-12 months) with an initial dose of 0.5 mg once weekly, subsequently increased to 1-2 mg in 10 patients and decreased in the other 2. Due to severe side-effects CAB was discontinued in 3 patients, in 1, 8, and 12 weeks. A significant reduction of PRL levels was already observed after the first week of treatment (mean +/- SEM basal values, 90.1 +/- 13.3 vs. 29.5 +/- 6.3 micrograms/L; P less than 0.001). Twenty-two patients had normal PRL levels in 1-36 weeks (mean, 6 weeks) with 0.5-2 mg CAB. Twenty-two patients resumed regular menses; 2 patients became pregnant after 3-11 months of treatment. Thirteen patients complained of side-effects (nausea, hypotension, headache, gastric pain, dizziness, and weakness) that disappeared with time in 10 of them. The comparison with a previous bromocriptine treatment regimen in 20 patients had shown that the number of patients requiring discontinuation of the latter drug was significantly higher (7 vs. 3 patients; P less than 0.001). However, 2 patients who needed to discontinue CAB were able to tolerate bromocriptine therapy. A computed tomographic scan performed after 12 months of therapy in 7 patients showed a significant reduction (50%) of the adenoma in 5. In conclusion, our results show that CAB is a well tolerated new dopamine agonist with long-lasting activity that represents an advance in chronic medical treatment of hyperprolactinemic conditions.
Growth Hormone & IGF Research, 1999
In situ hybridization and ribonuclease protection assays, together with reverse transcription pol... more In situ hybridization and ribonuclease protection assays, together with reverse transcription polymerase chain reaction (RT-PCR), have been used to localize expression of the GH secretagogue receptor. 5-z In the rat brain, the strongest expression of the GH secretagogue receptor mRNA was detected in the hypothalarnic nuclei, including the arcuate nucleus, ventromedial nucleus, lateral mamillary nucleus, anteroventral pre-optic nucleus, anterior hypothalamic area, suprachiasmatic nucleus, lateroanterior hypothalamic nucleus, paraventricular nucleus, periventricular nucleus, dorsomedial nucleus and the tuberomamillary nucleus. Recently, it has been shown that the GH secretagogue receptor is co-localized with approximately 25% of the GH-releasing hormone (GHRH)
Acta Endocrinologica, 1989
A poor correlation exists between growth hormone levels and the severity of disease in patients w... more A poor correlation exists between growth hormone levels and the severity of disease in patients with acromegaly. It has been suggested that insulin-like growth factor I correlates better with the clinical condition than GH itself, but the presence of a correlation between GH and IGF-I is still a matter of debate. We there
Acta Endocrinologica, 1986
It has been reported that rat growth hormone releasing factor (rat GRF-43), similarly to the two ... more It has been reported that rat growth hormone releasing factor (rat GRF-43), similarly to the two human GRFs (GRF-40 and 44
European Journal of Clinical Investigation, 1997
Medical therapy is frequently needed to normalize growth hormone/insulin-like growth factor I sec... more Medical therapy is frequently needed to normalize growth hormone/insulin-like growth factor I secretion in acromegaly. The aim of this study was to determine the long-term effects of the slow-release (SR) somatostatin analogue lanreotide in 57 acromegalic patients. SR lanreotide (30 mg) was given every 14 days for 12 months. In 33% of patients, the drug dosage was raised to 60 mg and/or the time interval was shortened to 10 days. Two months of clinical evaluation followed drug discontinuation in 47 out of 48 (84%) patients who completed the 12-month period. A drug-related decrease in GH/IGF-I levels was observed. Basal GH/IGF-I levels were significantly (P < 0.001) reduced at 12 months, IGF-I was normalized in 35% of patients and GH levels were < 5 micrograms L-1 in 54%. There was a clinical improvement in patients complaining of joint pain, rachialgias, headache, digital paraesthesias and hyperhidrosis. Soft-tissue changes were documented by significant (P < 0.001) decreases in finger size. In 52 (91%) patients without overt diabetes, a slight but significant increase in integrated glycaemia (P < 0.001) was noted, while integrated insulin levels were reduced (P < 0.001). Of 33 (58%) patients with normal basal ultrasound examination of the gall bladder, three (9%) had developed asymptomatic gall stones or biliary sludge after 12 months. Adverse events were generally mild. They frequently (52%) occurred after the first SR lanreotide administration; only 28% were recurrent and 20% appeared for the first time during therapy. SR lanreotide is an effective treatment in most unselected acromegalic patients. Tolerance towards the drug is high. Subjective benefits seem to override the simple biochemical control of the disease. Glucose homeostasis more than the incidence of gall stones seems to require monitoring on therapy. SR lanreotide is clearly advantageous in improving patient compliance with medical treatment for acromegaly.
Clinical Endocrinology, 1993
We assessed the efficacy and safety of the new, long-acting dopamine agonist drug cabergoline dur... more We assessed the efficacy and safety of the new, long-acting dopamine agonist drug cabergoline during long-term therapy of hyperprolactinaemia. Open, prospective, multicentre study. One hundred and sixty-two females with either a microprolactinoma (n = 100), idiopathic hyperprolactinaemia (n = 54), empty sella syndrome (n = 7) or residual hyperprolactinaemia after surgery for a macroprolactinoma (n = 1). All had previously been treated with cabergoline or placebo for 4 weeks as part of a dose-finding study. Menstrual pattern, adverse symptoms, blood pressure and pulse, serum PRL, blood count, liver and renal function were assessed after one month and subsequently at two-monthly intervals. Treatment was started at doses of 0.25 mg (n = 3), 0.5 mg (n = 8), 1 mg (n = 150) or 2 mg (n = 1) per week, given either as a single weekly dose (n = 8) or divided into twice-weekly doses (n = 154), and was continued for at least 49 weeks in 123 patients. Final treatment doses ranged from 0.25 mg fortnightly to 2 mg twice weekly: most patients finished the study taking 0.5 mg once (n = 31) or twice (n = 77) weekly. Stable normalization of PRL levels was achieved in 138 subjects (85%), in 129 of whom the effective dose was < 1 mg per week. In the subset of 114 patients completing 49 weeks of therapy and having dose adjustments according to the protocol, the biochemical success rate was 92%. Fifty-nine of the 65 previously amenorrhoeic women (91%) and 44 of the 49 (90%) who were previously oligomenorrhoeic resumed regular menses and/or became pregnant during the study. Adverse events were reported in 64 patients (39.5%). In 84% of cases with adverse events, the symptoms were of mild or moderate severity and most occurred during the first few weeks of therapy; five patients (3%) discontinued treatment because of poor tolerance. The most frequent symptoms were dizziness (13% of patients), headache (13%), nausea (10%) and weakness and/or fatigue (10%). Of 27 patients who had previously been poorly tolerant of other dopamine agonists, 17 (63%) did not experience any side-effects and only one was intolerant of cabergoline. No adverse haematological or biochemical effects were detected except for a slight downward trend in haemoglobin which may have been related to the resumption of regular menses in previously amenorrhoeic or oligomenorrhoeic women. A mild hypotensive effect was observed, mean systolic and diastolic blood pressures falling by 5 and 4 mmHg respectively during treatment. The results provide evidence for the long-term effectiveness and safety of cabergoline in the treatment of hyperprolactinaemia. Its ability to normalize PRL and restore gonadal function compares favourably with reported data on reference compounds while its tolerability profile and simple administration schedule offer potential advantages in terms of patient acceptability.
Journal of neurosurgical sciences, 2001
Meningiomas have been found to have receptors for several hormones, such as oestrogen, progestero... more Meningiomas have been found to have receptors for several hormones, such as oestrogen, progesterone, somatostatin, dopamine and recently also for prolactin. To investigate any possible role of prolactin in the growth of those tumours we detected the presence of prolactin-receptors (PRL-R) in 22 meningiomas and we correlated these data with PRL serum levels in patients before surgery. We also studied 13 patients with schwannomas and 7 with other cerebral tumours (4 glioblastomas, 2 ependymomas and 1 astrocytoma). Increased prolactin binding was present in 10 (45.4 percent;) meningiomas, 9 (69.2 percent;) schwannomas and in the patient with astrocytoma. The presence of high PRL levels was present in 6 (27.2 percent;) patients with meningiomas, 8 (61.5 percent;) with schwannomas and in 3 (42.8 percent;) with other tumours. No direct correlation was present between serum PRL levels and PRL binding in all groups. In conclusion we confirmed the presence of PRL receptors in patients with m...
Minerva chirurgica, 2020
BACKGROUND Aim of our study was to investigate the postoperative course of calcium and parathyroi... more BACKGROUND Aim of our study was to investigate the postoperative course of calcium and parathyroid hormone (PTH) levels after total thyroidectomy to define a proper and low cost protocol. METHODS We studied 144 patients who underwent total thyroidectomy between 2007 and 2010. Ionized calcium was determined preoperatively and on day 1 (POD1), day 2 (POD2) and day 7 (POD7) postoperatively; PTH preoperatively and on POD7. Patients with ionized calcium ≤ 1.11 mmol/l were considered hypocalcaemic and treated only if symptoms, ≤ 1 mmol/l were treated in all cases. RESULTS Ionized calcium and PTH declined postoperative in all patients compared to preoperative levels (P=0.000). Ionized calcium increased on POD7 compared to POD1 and POD2 (P=0.000). All hypocalcaemic untreated tirthy patients returned normocalcaemic on POD7. Thirty- eight hypocalcaemic patients were treated but 23 (61%) safely suspended therapy on POD7. We tested PTH and ionized calcium as independent factors of prolongued hy...
L'Endocrinologo, 2012
M. Terzolo, G. Reimondo, I. Chiodini, R. Castello, R. Giordano, E. Ciccarelli, P. Limone, C. Criv... more M. Terzolo, G. Reimondo, I. Chiodini, R. Castello, R. Giordano, E. Ciccarelli, P. Limone, C. Crivellaro, I. Martinelli, M. Montini, O. Disoteo, B. Ambrosi, R. Lanzi, M. Arosio, S. Senni, A. Balestrieri, E. Solaroli, B. Madeo, R. De Giovanni, F. Strollo, R. Battista, A. Scorsone, V.A. Giagulli, D. Collura, A. Scillitani, R. Cozzi, M. Faustini-Fustini, A. Pia, R. Rinaldi, B. Allasino, G. Peraga, F. Tassone, P. Garofalo, E. Papini, G. Borretta
Journal of Endocrinology, 1997
Sixty cerebral meningioma specimens obtained at surgery from 34 female and 26 male patients were ... more Sixty cerebral meningioma specimens obtained at surgery from 34 female and 26 male patients were examined for the presence of prolactin (PRL) receptors. These were compared with normal arachnoid tissue from which these tumours arise. PRL receptors were detected in 61·7% of meningiomas whereas no PRL binding was found in samples of normal arachnoid tissue. No relationship was found when sex or histological findings were compared with the presence of PRL receptors. Receptor-positive tumours had saturable and high-affinity (Kd, 4·8 ± 0·5 ng/ml) receptors with hormonal specificity for human PRL (hPRL) resembling that of other target tissues of PRL in man. The biological role of these receptors was investigated in primary cell cultures derived from meningioma tissue characterized for PRL receptor. When human PRL was added to the culture medium, in doses ranging from 1 to 200 ng/ml, a dose-dependent stimulation of 3H-thymidine incorporation was observed only in PRL-receptor positive tumou...
Journal of Endocrinological Investigation, 1996
It is widely accepted that, in man, galanin, a neuropeptide, has a clear GH-releasing effect whil... more It is widely accepted that, in man, galanin, a neuropeptide, has a clear GH-releasing effect while its stimulatory influence on PRL secretion is matter of debate. To clarify this point, in 6 normal young women (23-35 yr) in their early follicular phase, we studied the effect of galanin (pGAL, 80 pmol/kg. min infused iv over 60 min) on both basal and arginine (ARG, 0.5 g/kg iv in 30 min), TRH (400 iJg iv as a bolus at 0 min) or metoclopramide (MCP, 10 mg iv as a bolus at 0 min)-stimulated PRL secretion. GAL infusion failed to significantly increase basal PRL levels (peak vs baseline: 12.2±3.6 vs 8.7±1.2 iJg/L) but counteracted the spontaneous PRL decrease observed during saline infusion (AUC: 1216.6±282.1 vs 672.0±94.5 iJg.min/L; p<O.05). GAL infusion clearly enhanced the PRL response to TRH (AUC: 5806.3±743.0 vs 3952.1 ±423.9 iJg.min/L, p<O.05) and ARG (AUC: 3676.8±382.6 vs 2638.9 ± 287.0 iJg.min/L, p<O.05),
Journal of Endocrinological Investigation, 1989
Journal of Endocrinological Investigation, 1996
Dopaminergic system seems to influence the regulation of insulin secretion, although in man confl... more Dopaminergic system seems to influence the regulation of insulin secretion, although in man conflicting data are reported. Furthermore, bromocriptine (BRC), a dopaminergic agonist, has been recently found to inhibit the seasonally occurring hyperinsulinemia and the increase in body weight in the hamster. On this basis, we investigated the effect of BRC on spontaneous and stimulated insulin secretion in human obesity. Six obese (BMI: 33.2±1.6 Kg/m2) underwent the administration of: 1) arginine (ARG, O.S g/Kg iv in 30 min), 2) BRC (2.S mg po), 3) ARG + BRC. In each test plasma glucose and serum insulin, growth hormone (GH) and prolactin levels were determined. BRC did not significantly reduce spontaneous and ARG-induced insulin release. Baseline and stimulated glucose levels were also un
Journal of Endocrinological Investigation, 1987
Recently, a new long-acting form of bromocriptine (Parlodel LA, Sandoz) has been developed and it... more Recently, a new long-acting form of bromocriptine (Parlodel LA, Sandoz) has been developed and it has already been found to be effective in lowering plasma PRL levels in normal volunteers and postpartum women. This work reports the clinical, hormonal and radiological effects of a single 50 mg dose of long-acting bromocriptine in 10 patients with tumorous hyperprolactinemia (2 microprolactinomas, 6 macroprolactinomas, 1 acromegaly and 1 nonsecreting macroadenoma). A rapid and long-lasting (28 days) normalization of PRL levels was observed in patients with microprolactinoma, acromegaly and nonsecreting adenoma. None of the 6 patients with macroprolactinoma underwent normalization of plasma PRL, but the latter was markedly reduced (61-80% of basal levels). A second injection of the drug in 5 macroprolactinoma patients induced a further reduction of plasma PRL levels in 2 ofthem. No changes in the tumor size were observed either after the first or the second injection of long-acting bromocriptine in any of the patients. This injectable form of bromocriptine induced nausea and / or mild hypotension lasting a few h in 4 of the 10 patients and was better tolerated than the oral form as regards both the duration and intensity of the side effects. Thus, as this drug has proved to be efficacious and well tolerated by the patients, this long-acting form of bromocriptine may be a valid therapeutical approach for initiating medical treatment of patients with prolactinoma.
The Journal of Clinical Endocrinology & Metabolism, 1983
The PRL response to nomifensine (Nom), an indirect DA agonist; domperidone (Dom), a DA receptor a... more The PRL response to nomifensine (Nom), an indirect DA agonist; domperidone (Dom), a DA receptor antagonist; and TRH, which directly stimulates the PRL-secreting cells, was evaluated 2-53 months after surgery in 13 patients in whom successful removal of a prolactinoma had resulted in normal serum PRL levels and return of regular menses or libido and potency. In addition, the pattern of TSH secretion in response to Dom and the spontaneous rise in plasma PRL of 6 cured patients during pregnancy were evaluated. Nom induced an inconsistent decrease in basal PRL levels, a pattern contrasting with that in healthy women in whom plasma PRL was markedly suppressed after administration of the drug. Dom and TRH elicited a significant rise of basal PRL levels, but the rise was markedly lower than that occurring in the control group. The TSH increment after Dom treatment was lower than that before surgery, though higher than that in the controls. Evaluation of individual patients showed that only one patient had a normal PRL response to either Nom or Dom, while the TSH response to the latter returned to normal in five of seven patients. During pregnancy, plasma PRL rose inconsistently in the patients, and PRL levels were generally lower than those in normal pregnant women. These results suggest the presence of an abnormality in the dopaminergic mechanism(s) of PRL control before and after adenomectomy or, less likely, the existence of impaired pituitary function or reserve.
The Journal of Clinical Endocrinology & Metabolism, 1989
Cabergoline (CAB) is a new oral dopaminergic compound showing a very long-lasting PRL-lowering ac... more Cabergoline (CAB) is a new oral dopaminergic compound showing a very long-lasting PRL-lowering activity and reported to be well tolerated. The efficacy and tolerability of chronic treatment with CAB in 30 female hyperprolactinemic patients, aged 18-52 yr (6 microadenomas, 3 macroadenomas, and 21 functional hyperprolactinemias), were studied. In a group of 10 patients who received CAB (0.8 mg once weekly or 0.4 mg twice weekly) for 8 weeks PRL levels normalized while on treatment and remained normal (8 patients) or greatly reduced (1 patient) for 1-2 months after discontinuation of the drug. Twenty-six patients underwent chronic treatment (6-12 months) with an initial dose of 0.5 mg once weekly, subsequently increased to 1-2 mg in 10 patients and decreased in the other 2. Due to severe side-effects CAB was discontinued in 3 patients, in 1, 8, and 12 weeks. A significant reduction of PRL levels was already observed after the first week of treatment (mean +/- SEM basal values, 90.1 +/- 13.3 vs. 29.5 +/- 6.3 micrograms/L; P less than 0.001). Twenty-two patients had normal PRL levels in 1-36 weeks (mean, 6 weeks) with 0.5-2 mg CAB. Twenty-two patients resumed regular menses; 2 patients became pregnant after 3-11 months of treatment. Thirteen patients complained of side-effects (nausea, hypotension, headache, gastric pain, dizziness, and weakness) that disappeared with time in 10 of them. The comparison with a previous bromocriptine treatment regimen in 20 patients had shown that the number of patients requiring discontinuation of the latter drug was significantly higher (7 vs. 3 patients; P less than 0.001). However, 2 patients who needed to discontinue CAB were able to tolerate bromocriptine therapy. A computed tomographic scan performed after 12 months of therapy in 7 patients showed a significant reduction (50%) of the adenoma in 5. In conclusion, our results show that CAB is a well tolerated new dopamine agonist with long-lasting activity that represents an advance in chronic medical treatment of hyperprolactinemic conditions.
Growth Hormone & IGF Research, 1999
In situ hybridization and ribonuclease protection assays, together with reverse transcription pol... more In situ hybridization and ribonuclease protection assays, together with reverse transcription polymerase chain reaction (RT-PCR), have been used to localize expression of the GH secretagogue receptor. 5-z In the rat brain, the strongest expression of the GH secretagogue receptor mRNA was detected in the hypothalarnic nuclei, including the arcuate nucleus, ventromedial nucleus, lateral mamillary nucleus, anteroventral pre-optic nucleus, anterior hypothalamic area, suprachiasmatic nucleus, lateroanterior hypothalamic nucleus, paraventricular nucleus, periventricular nucleus, dorsomedial nucleus and the tuberomamillary nucleus. Recently, it has been shown that the GH secretagogue receptor is co-localized with approximately 25% of the GH-releasing hormone (GHRH)
Acta Endocrinologica, 1989
A poor correlation exists between growth hormone levels and the severity of disease in patients w... more A poor correlation exists between growth hormone levels and the severity of disease in patients with acromegaly. It has been suggested that insulin-like growth factor I correlates better with the clinical condition than GH itself, but the presence of a correlation between GH and IGF-I is still a matter of debate. We there
Acta Endocrinologica, 1986
It has been reported that rat growth hormone releasing factor (rat GRF-43), similarly to the two ... more It has been reported that rat growth hormone releasing factor (rat GRF-43), similarly to the two human GRFs (GRF-40 and 44
European Journal of Clinical Investigation, 1997
Medical therapy is frequently needed to normalize growth hormone/insulin-like growth factor I sec... more Medical therapy is frequently needed to normalize growth hormone/insulin-like growth factor I secretion in acromegaly. The aim of this study was to determine the long-term effects of the slow-release (SR) somatostatin analogue lanreotide in 57 acromegalic patients. SR lanreotide (30 mg) was given every 14 days for 12 months. In 33% of patients, the drug dosage was raised to 60 mg and/or the time interval was shortened to 10 days. Two months of clinical evaluation followed drug discontinuation in 47 out of 48 (84%) patients who completed the 12-month period. A drug-related decrease in GH/IGF-I levels was observed. Basal GH/IGF-I levels were significantly (P < 0.001) reduced at 12 months, IGF-I was normalized in 35% of patients and GH levels were < 5 micrograms L-1 in 54%. There was a clinical improvement in patients complaining of joint pain, rachialgias, headache, digital paraesthesias and hyperhidrosis. Soft-tissue changes were documented by significant (P < 0.001) decreases in finger size. In 52 (91%) patients without overt diabetes, a slight but significant increase in integrated glycaemia (P < 0.001) was noted, while integrated insulin levels were reduced (P < 0.001). Of 33 (58%) patients with normal basal ultrasound examination of the gall bladder, three (9%) had developed asymptomatic gall stones or biliary sludge after 12 months. Adverse events were generally mild. They frequently (52%) occurred after the first SR lanreotide administration; only 28% were recurrent and 20% appeared for the first time during therapy. SR lanreotide is an effective treatment in most unselected acromegalic patients. Tolerance towards the drug is high. Subjective benefits seem to override the simple biochemical control of the disease. Glucose homeostasis more than the incidence of gall stones seems to require monitoring on therapy. SR lanreotide is clearly advantageous in improving patient compliance with medical treatment for acromegaly.
Clinical Endocrinology, 1993
We assessed the efficacy and safety of the new, long-acting dopamine agonist drug cabergoline dur... more We assessed the efficacy and safety of the new, long-acting dopamine agonist drug cabergoline during long-term therapy of hyperprolactinaemia. Open, prospective, multicentre study. One hundred and sixty-two females with either a microprolactinoma (n = 100), idiopathic hyperprolactinaemia (n = 54), empty sella syndrome (n = 7) or residual hyperprolactinaemia after surgery for a macroprolactinoma (n = 1). All had previously been treated with cabergoline or placebo for 4 weeks as part of a dose-finding study. Menstrual pattern, adverse symptoms, blood pressure and pulse, serum PRL, blood count, liver and renal function were assessed after one month and subsequently at two-monthly intervals. Treatment was started at doses of 0.25 mg (n = 3), 0.5 mg (n = 8), 1 mg (n = 150) or 2 mg (n = 1) per week, given either as a single weekly dose (n = 8) or divided into twice-weekly doses (n = 154), and was continued for at least 49 weeks in 123 patients. Final treatment doses ranged from 0.25 mg fortnightly to 2 mg twice weekly: most patients finished the study taking 0.5 mg once (n = 31) or twice (n = 77) weekly. Stable normalization of PRL levels was achieved in 138 subjects (85%), in 129 of whom the effective dose was < 1 mg per week. In the subset of 114 patients completing 49 weeks of therapy and having dose adjustments according to the protocol, the biochemical success rate was 92%. Fifty-nine of the 65 previously amenorrhoeic women (91%) and 44 of the 49 (90%) who were previously oligomenorrhoeic resumed regular menses and/or became pregnant during the study. Adverse events were reported in 64 patients (39.5%). In 84% of cases with adverse events, the symptoms were of mild or moderate severity and most occurred during the first few weeks of therapy; five patients (3%) discontinued treatment because of poor tolerance. The most frequent symptoms were dizziness (13% of patients), headache (13%), nausea (10%) and weakness and/or fatigue (10%). Of 27 patients who had previously been poorly tolerant of other dopamine agonists, 17 (63%) did not experience any side-effects and only one was intolerant of cabergoline. No adverse haematological or biochemical effects were detected except for a slight downward trend in haemoglobin which may have been related to the resumption of regular menses in previously amenorrhoeic or oligomenorrhoeic women. A mild hypotensive effect was observed, mean systolic and diastolic blood pressures falling by 5 and 4 mmHg respectively during treatment. The results provide evidence for the long-term effectiveness and safety of cabergoline in the treatment of hyperprolactinaemia. Its ability to normalize PRL and restore gonadal function compares favourably with reported data on reference compounds while its tolerability profile and simple administration schedule offer potential advantages in terms of patient acceptability.
Journal of neurosurgical sciences, 2001
Meningiomas have been found to have receptors for several hormones, such as oestrogen, progestero... more Meningiomas have been found to have receptors for several hormones, such as oestrogen, progesterone, somatostatin, dopamine and recently also for prolactin. To investigate any possible role of prolactin in the growth of those tumours we detected the presence of prolactin-receptors (PRL-R) in 22 meningiomas and we correlated these data with PRL serum levels in patients before surgery. We also studied 13 patients with schwannomas and 7 with other cerebral tumours (4 glioblastomas, 2 ependymomas and 1 astrocytoma). Increased prolactin binding was present in 10 (45.4 percent;) meningiomas, 9 (69.2 percent;) schwannomas and in the patient with astrocytoma. The presence of high PRL levels was present in 6 (27.2 percent;) patients with meningiomas, 8 (61.5 percent;) with schwannomas and in 3 (42.8 percent;) with other tumours. No direct correlation was present between serum PRL levels and PRL binding in all groups. In conclusion we confirmed the presence of PRL receptors in patients with m...
Minerva chirurgica, 2020
BACKGROUND Aim of our study was to investigate the postoperative course of calcium and parathyroi... more BACKGROUND Aim of our study was to investigate the postoperative course of calcium and parathyroid hormone (PTH) levels after total thyroidectomy to define a proper and low cost protocol. METHODS We studied 144 patients who underwent total thyroidectomy between 2007 and 2010. Ionized calcium was determined preoperatively and on day 1 (POD1), day 2 (POD2) and day 7 (POD7) postoperatively; PTH preoperatively and on POD7. Patients with ionized calcium ≤ 1.11 mmol/l were considered hypocalcaemic and treated only if symptoms, ≤ 1 mmol/l were treated in all cases. RESULTS Ionized calcium and PTH declined postoperative in all patients compared to preoperative levels (P=0.000). Ionized calcium increased on POD7 compared to POD1 and POD2 (P=0.000). All hypocalcaemic untreated tirthy patients returned normocalcaemic on POD7. Thirty- eight hypocalcaemic patients were treated but 23 (61%) safely suspended therapy on POD7. We tested PTH and ionized calcium as independent factors of prolongued hy...
L'Endocrinologo, 2012
M. Terzolo, G. Reimondo, I. Chiodini, R. Castello, R. Giordano, E. Ciccarelli, P. Limone, C. Criv... more M. Terzolo, G. Reimondo, I. Chiodini, R. Castello, R. Giordano, E. Ciccarelli, P. Limone, C. Crivellaro, I. Martinelli, M. Montini, O. Disoteo, B. Ambrosi, R. Lanzi, M. Arosio, S. Senni, A. Balestrieri, E. Solaroli, B. Madeo, R. De Giovanni, F. Strollo, R. Battista, A. Scorsone, V.A. Giagulli, D. Collura, A. Scillitani, R. Cozzi, M. Faustini-Fustini, A. Pia, R. Rinaldi, B. Allasino, G. Peraga, F. Tassone, P. Garofalo, E. Papini, G. Borretta