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Biomedical subjects

A Legido

Publications and source records attributed to A Legido.

At least 55 records · Page 3Linked to original sources
PubMed1988

Significance of basal ganglia calcification on computed tomography in children.

We reviewed 6,428 head computed tomography (CT) scans performed on 4,283 children at our institution over a 3-year period and found basal ganglia calcification (BGC) in 48 (1.1%) of the patients. Their mean age at the time of detection was 5.3 years (range: 0.5-20 years); 16 (33%) patients had cancer, 14 (29%) had tuberous sclerosis or congenital infection and 18 (38%) had other medical conditions. All patients with cancer had been treated with radiation therapy, receiving a mean dose of 4,583 cGy (range: 1,800-5,500 cGy) to the diencephalon, and calcifications first became apparent at a median of 10 months after treatment. Other medical conditions included neonatal asphyxia (3), metabolic disease (3) (Kearns Sayre, MELAS, Krabbe's), congenital anomalies (3), meningitis (2), Fahr's disease (1) and others (6). Neurologic symptoms were common in children of all groups, but could not be correlated to BGC changes. Calcium and phosphorus metabolism was evaluated in 19 patients and was abnormal in 1. We conclude that BGC on CT in childhood occur primarily as an aftermath of the cancer treatment or in children with generalized neurologic dysfunction. Many children with BGC are delayed in their development, but calcifications are not directly related to specific forms of neurologic dysfunction. Rather, ther appear to serve as markers for more extensive brain damage.

Adolescent↗
PubMed1987

Relationship of body fat distribution to metabolic complications in obese prepubertal girls.

The purpose of this study is to assess the relative effects of body fat distribution and obesity "per se" on serum glucose, insulin, and insulin resistance. Seventeen obese and nine nonobese control prepubertal girls were studied. Biceps, triceps, subscapular, and suprailiac skinfold thickness were measured. Percentage of body fat (% BF) and total body fat (TBF) were calculated. Body fat distribution was assessed by analyzing the central (suprailiac, subscapular)/peripheral (biceps, triceps) ratios. Oral glucose tolerance test was performed. Serum glucose and insulin were measured and insulinogenic index (insulin/glucose) was calculated. Body fat anthropometric data and body fat distribution indexes were significantly higher (p less than 0.001) in the obese group. The obese population presented significantly elevated values of glucose, insulin, and insulinogenic indexes (p less than 0.01-p less than 0.001). In the obese group, insulin showed significant positive correlations (p less than 0.05-p less than 0.001) with biceps, subscapular, and suprailiac skinfolds, % BF and TBF, whereas the insulinogenic index had positive correlations with suprailiac skinfold and TBF (p less than 0.05). Obese girls showed positive correlations between the body fat distribution indexes and insulin or insulinogenic indexes (p less than 0.05-p less than 0.001). In prepubertal girls obesity is of the centripetal (central) type. This pattern has an important role in determining the alterations in the glucose-insulin homeostasis that characterize the childhood nutritional obesity.

Adipose Tissue↗
PubMed1987

Adrenal androgen response to metyrapone, adrenocorticotropin, and corticotropin-releasing hormone stimulation in children with hypopituitarism.

We determined the adrenal steroid responses to metyrapone, ACTH, and CRH in 12 ACTH-intact and 5 ACTH-deficient hypopituitary children to determine the mechanisms that control adrenal androgen secretion. Serum adrenal androgen concentrations [dehydroepiandrosterone (DHEA) and delta 4-androstenedione (delta 4-A)] rose in response to oral administration of metyrapone (450 mg/m2 X dose, every h for 7 doses) in ACTH-intact hypopituitary children with multiple or isolated pituitary hormone deficiencies [mean postmaryrapone level: DHEA, 225 ng/dL (range, 27-566); delta 4-A, 313 ng/dL (range, 105-651)], except in 2 young children in whom DHEA did not rise. These adrenal androgens did not rise in all ACTH-deficient hypopituitary children [mean postmetyrapone level: DHEA, 11.0 ng/dL (range, 3-16); delta 4-A, 6.2 ng/dL (range, 3-10)]. The increases in both serum cortisol and adrenal androgens, including DHEA sulfate, in response to short term ACTH infusion (40 U in 6 h) in ACTH-intact hypopituitary children were normal or above normal, while these steroid responses were significantly (P less than 0.05-0.01) lower in ACTH-deficient hypopituitary children compared to normal values. However, prolonged administration of ACTH (40 U/day, or im) for 6 days to 2 ACTH-deficient hypopituitary children resulted in normal DHEA responses to the 6-h ACTH stimulation test (DHEA levels after the first test, 14 and 30 ng/dL, after priming, 80 and 50 ng/dL). Furthermore, CRH administration to 4 ACTH-deficient patients caused a rise in serum DHEA and cortisol in patients with a normal ACTH response, while those with a poor ACTH response had a lesser rise in DHEA and cortisol. These data suggest that ACTH is the major tropic hormone for adrenal androgen secretion.

Adolescent↗
PubMed1985

[Use of skull radiography in craniocerebral injuries in childhood].

Authors review the usefulness of radiographic skull examination in childhood head injury. Two hundred and forty-two patients assisted at the emergency area were prospectively recorded during one year. Data of filiation and epidemiology and symptoms and signs posed by Leonidas as "high risk criteria" to have a skull fracture, were registered. AP and L X-Ray skull were performed in all patients. Thirteen (5.37%) of them had a fracture. Blood discharge from the ear and skull depressed fracture were more frequently found in the fracture group with statistically significant difference (p less than 0.05 and p less than 0.01, respectively). The probability of positive finding was 8.8 for blood discharge from the ear, 17.6 for skull depressed fracture and 4.4 for bilateral black eyes. Because of no correlation between clinical and radiological findings, the radiographic skull examination must be systematically performed in every head injury if the purpose is to diagnose a fracture.

Adolescent↗
PubMed1983

Human pituitary chronoendocrinology: repetitive stimulation with LRH/TRH at different times of the day.

To determine whether human pituitary is characterized by a circadian periodicity in response to repetitive injection of hypothalamic hormones, 8 healthy subjects were challenged iv with a triple stimulation with 50 micrograms of LRH and 100 micrograms of TRH in a single bolus at 0, 90 and 180 min, receiving the first pulse of hypothalamic hormones either at 02.00 h (02.00 h test) or at 09.00 h (09.00 h test). In addition, a placebo was injected instead of LRH/TRH to evaluate the spontaneous hormonal changes during the 02.00 h test. The LH, FSH, Prl and TSH basal levels were similar in the two phases studied. The mean LH, FSH and TSH peaks after each injection of LRH/TRH were similar among them. The mean Prl peak responses to the third pulse of LRH/TRH, in both the 02.00 h and the 09.00 h tests, were lower (P less than 0.05) than those after the first pulse of LRH/TRH. Placebo did not significantly change circulating LH, FSH, Prl or TSH during nocturnal sampling. The mean LH, FSH and Prl levels after LRH/TRH during the 02.00 h test were similar to those during the 09.00 h test. The mean TSH levels 15 min after the second and third pulses of LRH/TRH during the 02.00 h test were higher (P less than 0.05) than those of the 09.00 h test. Thus, thyrotropes responsiveness to pulsatile stimulation with LRH/TRH is greater during the night than in the morning, while LH, FSH and Prl responses remain constant at the two phases studied.

Adult↗
PubMed1983

[Wolfram syndrome or DIDMOAD syndrome].

The authors report a case of Wolfram's syndrome and discuss the evolution of the symptoms in relation with the data in the literature. The possibility of an association of Wolfram's syndrome with the HLA system is suggested. The use of carbamazepine in the treatment of the diabetes insipidus present in this syndrome is discussed.

Carbamazepine↗
PubMed1980

Stimulatory effect of clebopride on human prolactin secretion.

Serum levels of prolactin (PRL), luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were measured in normally cycling women and normal men before and after oral admiministration of 1 mg of clebopride, a derivative of procainamide used in the treatment of gastrointestinal diseases. Clebopride produced a significant increase (P < 0.001) in serum PRL to a 6-fold peak as compared with basal levels. After 240 minutes the levels remained significantly higher (P < 0.05) than the mean basal level at -30 and 0 minutes. No significant effects of clebopride were noted upon the circulating levels of LH and FSH. The peak PRL response to clebopride was unaffected by pretreatment with 100 mg of nomifensine, although the secretory area from 120 to 210 minutes after clebopride was greater (P < 0.05) in the nomifensine-treated group than in the control experiment. When 5 mg of bromocriptine were given before clebopride, the PRL response was completely abolished as compared with the control experiment (P < 0.001). Our data provide new evidence that dopaminergic receptors of the adeylate cyclase system are involved in the regulation of PRL secretion, acting at the pituitary level rather than acting on the hypothalamus. The PRL-releasing activity of clebopride could be the explanation for the occasional menstrual disorders and galactorrhea registered in some cases of long-term treatment.

Adult↗
PubMedDate not supplied

Expression of somatostatin and GABA immunoreactivity in cultures of rat hippocampus.

Somatostatin (SOM) synthesis and release were studied with radioimmunoassay and immunocytochemical techniques in rat fetal hippocampal neurons maintained in monolayer tissue culture. SOM immunoreactivity increased from undetectable to over 4,000 pg/ml in media and over 2,500 pg/culture in neurons by 3 to 5 weeks. After 3 weeks, approximately 11% of the neurons stained for SOM. Gamma-aminobutyric (GABA) immunoreactivity was present in hippocampal neurons from 1 day to 5 weeks with 40-50% of the neurons staining for GABA by 5 weeks in vitro. Costaining neurons for SOM and GABA revealed that 63% which were positive for SOM also stained for GABA.

Animals↗
PubMedDate not supplied

Recent advances in the diagnosis, treatment, and prognosis of neonatal seizures.

Current knowledge about the diagnosis, treatment, and prognosis of neonatal seizures is reviewed. The pitfalls in establishing the diagnosis are emphasized and the usefulness of new electrodiagnostic techniques is discussed. A protocol for treating neonatal seizures is suggested. Finally, the clinical and electroencephalographic variables which are relevant in determining neurologic outcome are discussed.

Anticonvulsants↗
PubMedDate not supplied

The exact ictal and interictal duration of electroencephalographic neonatal seizures.

The temporal behavior of neonatal seizures caused by diverse acute encephalopathies in 42 patients with 487 seizures was studied. All 487 seizures were confirmed by typical ictal electroencephalogram (EEG) patterns. Neonatal seizures are relatively brief events, which usually last about 2 min. They are recurrent and are separated by interictal recovery periods of variable duration, on the average, about 8 min. Solitary prolonged seizures are rare and do not represent the usual behavior of neonatal seizures.

Brain↗
PubMedDate not supplied

Occult neonatal seizures.

Forty-one infants with neonatal seizures frequent enough to be captured by randomly recorded routine EEG examinations were studied to determine how often their electrographic seizures were occult (subclinical) and to examine the effects of seizure duration and mental status on their clinical visibility. Seizures were the result of diverse etiologies and most infants had received one or more antiepileptic drug prior to the EEG recordings. The majority of electrographic seizures were occult: only 84 of 393 (21%) were accompanied by distinctive clinical seizure activity; the remaining 79% were occult. There was no significant difference between the duration of EEG seizures with distinctive clinical signs and those without. There was no significant difference in the proportion of occult seizures in neonates with preserved consciousness compared with lethargic or comatose infants. We conclude that unaided visual inspection of infants seriously underestimates true seizure frequency. Long-term EEG monitoring may be necessary in many infants to determine their real seizure frequency and to judge the adequacy of antiepileptic drug treatment.

Anticonvulsants↗
PubMedDate not supplied

Postnatal epilepsy after EEG-confirmed neonatal seizures.

We examined infants whose neonatal seizures were confirmed by randomly recorded ictal EEG tracings to determine the types and frequency of postnatal epilepsy (PNE)--unprovoked, recurring postnatal seizures. Perinatal and postnatal clinical and EEG variables were also examined for their relevance to PNE. Forty infants with EEG-documented neonatal seizures of diverse etiologies were studied. The 27 survivors were followed for a mean of 31 months. PNE developed in 56% (15 of 27) of the cohort. The first seizure appeared at a mean-corrected age of 12.7 months and occurred despite ongoing antiepileptic medication in 60% (9 of 15) of the group. Seizures were classified as infantile spasms or minor motor (7 patients), complex partial (4 patients), or generalized tonic-clonic (4 patients). Perinatal variables that significantly correlated with PNE included the presence of coma but not the age at seizure onset, the estimated gestational age, or Apgar scores. PNE occurred in 68% (13 of 19) of patients with moderately or markedly abnormal EEG backgrounds but in only 25% (2 of 8) without (p = 0.035). There was a strong trend for PNE to develop in patients with greater than 10 electrographic seizures per hour but in only 45% (9 of 20) of infants with fewer seizures (p = 0.058). Several postnatal variables were significantly related to PNE--the presence of cerebral palsy (CP), mental retardation (MR), CP with MR, and follow-up EEGs. PNE occurred in only 27% (3 of 11) of patients without spikes or sharp waves on postnatal EEGs performed at age 3 months but in 100% (3 of 3) of patients with spikes or sharp waves (p = 0.022).(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMedDate not supplied

[Prevention of epilepsy].

OBJECTIVE: To review the preventive and prophylactic aspects of epilepsy. DEVELOPMENT: The description of the prevention of the causes of epilepsy includes the measures to prevent epilepsy and epileptic seizures. The concept of antiepileptogenesis is discussed according to the available information about the role that both the classic and new antiepileptic drugs (AEDs) play in this process. Neuroprotection is discussed in the context of the mechanisms of action of the AEDs and of the mechanisms of neuronal lesion produced by the causes of epilepsy or by the seizures themselves. Among the new therapeutic modalities the current knowledge about the vagus nerve stimulator and the surgical treatment is summarized. The potential future therapeutic modalities include alternative medicine, pharmacologic treatment of the epileptogenic focus, genetic treatment and vaccination. CONCLUSIONS: The first step in preventing epilepsy is to avoid the causes or the risk factors. Some classic AEDs have demonstrated to be effective in the prophylaxis of provoked seizures (acute, symptomatic) but not of unprovoked seizures (epileptic). The best knowledge of the pathogenesis and the molecular and biological basis of epileptogenesis secondary to lesional causes, suggest that antioxidant and neuroprotective agents, including the new AEDs, may prevent epilepsy. There is a need to design studies with the goal of demonstrating their antiepileptogenic and/or neuroprotective activity at different ages in life. New and future therapeutic modalities may offer additional preventive options.

Anticonvulsants↗
PubMedDate not supplied

[Cerebral palsy: new pathogenetic concepts].

OBJECTIVE: To review the current knowledge pertaining to the new pathogenetic aspects of cerebral palsy (CP). DEVELOPMENT: CP is a group of static, heterogeneous clinical syndromes, characterized by abnormal postural mechanisms and motor activities. Its prevalence in industrialized countries is 2 2.5/1000 newborns. CP should be differentiated from certain genetic or metabolic conditions with which it can be mistaken. Some cases of CP have a genetic basis and they are inherited following a mendelian pattern or are determined by specific isolated genes. Recently, the elevation of certain coagulation factors (i.e., Leiden factor V mutation) and cytokines (i.e. interleukins, a tumor necrosis factor) and interferons have been related to CP pathogenesis. Hypocapnia with PaCO2< 35 mmHg represents a risk for periventricular leukomalacia (PVL) in premature infants. PVL pathogenesis is complex and includes a series of mechanisms that interact among them: fetal/maternal infection, immuneinflammatory reaction, prematurity, intraventricular hemorrhage/iron, ischemia/reperfusion, free radical production, maturational sensitivity of oligodendrocytes, and glutamate effect. Neuroradiological and neuropathological data have demonstrated a cortical anatomical substrate for the intellectual deficits associated with PVL in premature infants. CONCLUSIONS: Current knowledge about CP pathogenesis opens the possibility of early diagnosis and development of new treatments, both therapeutic and preventive.

Brain↗