Publications (2)1.57 Total impact
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Article: Favorable clinical heart and bone effects of anti-thyroid drug therapy in endogenous subclinical hyperthyroidism.
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ABSTRACT: Although subclinical hyperthyroidism (SCH) has been associated with increased risk of osteoporosis and cardiac arrhythmias, its treatment is still controversial. This study was designed as a prospective, randomized, intervention, control-study with a 1-year follow-up in order to investigate whether normalization of serum TSH in SCH using methimazole has favorable bone and heart clinical effects. Fourteen patients with endogenous SCH (not Graves' disease) were enrolled, 7 (5 women/2 men; group T) were treated with methimazole (2.5-7.5 mg/day), and 7 (5 women/2 men; group C) were followed without treatment; 10 healthy subjects were also included in the study as controls. Serum free-T3 (FT3), free-T4 (FT4) and TSH, thyroid echography, bone stiffness index (SI), as measured by heel ultrasonometry, and 24-h electrocardiography monitoring were obtained. SCH patients exhibited higher systolic and diastolic blood pressure than control subjects. They also had a significantly higher number of both ventricular premature beats (VPB) (mean+/-SEM: 681+/-238 vs 6+/-2 beats/24 h; p<0.02) and atrial premature beats (APB) (mean+/-SEM: 495+/-331 vs 7+/-2 beats/24 h; p<0.0001), and a lower SI (66+/-5 vs 96+/-3; p<0.001). Twelve months after normalization of TSH with the use of methimazole, the number of VPB decreased significantly (947+/-443 vs 214+/-109 beats/24 h; p<0.05) while it remained unchanged in untreated SCH patients (414+/-163 vs 487+/-152 beats/24 h; p=ns). An insignificant therapy effect was observed as far as APB were concerned (826+/-660 vs 144+/-75 beats/24 h; p=ns), however their number increased significantly in the untreated group (463+/-49 vs 215+/-46 beats/24 h; p<0.05). The SI increased significantly as a result of therapy in group T (64.1+/-4.8 vs 70.0+/-5.3; p<0.02) and was further reduced in group C at the end of the study (69.1+/-7.3 vs 62.9+/-7.1; p<0.001). No adverse effect was observed in group T. In conclusion, anti-thyroid therapy seems to have favor-able bone and heart clinical effects in subjects with endogenous SCH.Journal of endocrinological investigation 03/2007; 30(3):230-5. · 1.57 Impact Factor -
Article: [Clinical characteristics and therapeutic perspectives of boutonneuse fever. Assessment of a caseload of 39 patients].
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ABSTRACT: Rickettsia conorii is the etiologic agent of Boutonneuse fever, a rickettsiosis of the spotted fever group that is endemic in Southern Italy. Chloramphenicol or tetracyclines are still the treatment of choice for this disease, and recently quinolones have also been utilized with success. In 1994-95, 39 otherwise healthy patients were admitted to our unit for Boutonneuse fever. They were treated, in random order, with quinolones (10 subjects received ciprofloxacin, 500 mg/12 h per os; 8 subjects received intravenous pefloxacin, 200 mg/12 h), or tetracyclines (21 subjects received intravenous rolitetracycline, 275 mg/12 h). Outcome was favorable in all cases and no significant complications were observed. However, in a significant number of cases, increased blood concentrations of glutamic-oxalacetic (68.4%) and glutamic-pyruvic (60.5%) transaminases were found. Above normal blood creatinine values were observed in 29.7% of the cases, and urinanalysis disclosed blood in 35.9% and proteins in 56.4% of the cases. Both tetracyclines and quinolones were well tolerated and effective, with apyrexia achieved after 2.7 +/- 0.1 days (mean +/- SEM). All patients were discharged after an average of 7.1 +/- 0.4 days. Liver and kidney function derangements seem to occur to some extent in the acute phase of Boutonneuse fever. This finding might partially explain the increased mortality rate reported for subjects with simultaneous systemic or organ diseases or when the administration of an effective antibiotic is delayed. Together with chloramphenicol and tetracyclines, quinolones might be considered as first line antibiotics.Annali italiani di medicina interna: organo ufficiale della Societa italiana di medicina interna 12(1):11-4.
