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The effect of cimetropium bromide, a new potent antimuscarinic compound, on caerulein-induced gall bladder emptying in 8 male volunteers was studied by real time ultrasonography. During saline infusion, caerulein (10-40 ng.kg-1.h-1) induced dose-dependent emptying of the gall bladder. There was a significant linear correlation between the dose of the peptide and the reduction in gall bladder size. A continuous infusion of cimetropium bromide (5 mg.h-1) significantly inhibited the contracting effect of caerulein on the human gall bladder, by 74% in response to the lowest dose and by 45% and 22%, respectively, to the two higher doses. The data confirm that the contracting effect of CCK-like peptides on the human gall bladder is at least partly cholinergically mediated, and they demonstrate the relaxing activity of cimetropium previously shown in animals. Provided its antispasmodic activity is also evident in disease, cimetropium should be regarded as a potentially useful agent for the treatment of biliary colic and spasm of the biliary tree.

The aim of our investigation was to evaluate thyroid function by a follow-up study in 45 polytransfused thalassemic patients, since endocrine abnormalities are frequent consequences of iron overload in thalassemia major. Significant changes of thyroid function have been revealed in the time elapsing the observation, despite unchanged haematological parameters; at the end of the present study five patients were affected by overt hypothyroidism and 15 patients by subclinical hypothyroidism. Ultrasound thyroid volume in 13 randomly selected patients was greatly reduced, while thyroid Magnetic Resonance Imaging (MRI) was not able to detect tissue alterations. Inversely, liver MRI was markedly reduced in 14 patients and negatively related to ferritine levels (P< 0.01). We conclude that polytransfused thalassemics are frequently affected by thyroid disfunction; haepatic haemosiderosis due to iron overload seems influence hormonal peripheral metabolism, although the patients display a moderate compliance with iron chelation therapy. Therefore, periodic thyroid investigation should be carried out in thalassemic subjects in order to detect patients who need hormone replacement therapy.

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