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Biomedical subjects

G Chiumello

Publications and source records attributed to G Chiumello.

At least 217 records · Page 12Linked to original sources
PubMedDate not supplied

Measurement of urinary iodine excretion to reveal iodine excess in neonatal transient hypothyroidism.

This study was undertaken to confirm the importance of iodine excess in neonatal transient hypothyroidism. In 30 transient hypothyroid newborns at screening we measured urinary iodine excretion and TSH. They were divided into two groups: group A consisted of 21 newborns who had been exposed to iodine; group B of 9 non-exposed newborns. The two groups were significantly different only for median urinary iodine excretion (p = 0.001). In 61.5% of newborns of group A, iodine exposure caused iodine excess (urinary iodine excretion higher than 185 micrograms/l); this correlated with a higher prevalence of prematurity and a lower mean gestational age. Clinical records should reveal iodine exposure, but only urinary iodine excretion shows iodine excess. We suggest that evaluation at birth of urinary iodine excretion in every newborn with high TSH could help in predicting a good prognosis, since hypothyroidism due to the Wolff-Chaikoff effect is always spontaneously reversible, even if treatment may be suggested.

Female↗
PubMedDate not supplied

Prednisone treatment in newly diagnosed type I diabetic children: 1-yr follow-up.

Thirty-one children suffering from type I diabetes mellitus were arranged at onset of the disease in two different groups. Group 1 was treated with oral prednisone (60 mg X m-2 X day-1 for 14 days, 30 and 15 mg X m-2 X day-1 for 7 days). Group 2 matched the control group. All patients were treated with continuous subcutaneous insulin infusion for the first 15 days of treatment, and then with two daily injections of a mixture of intermediate- and fast-acting insulin. All subjects were followed for 1 yr. Group 1 required more insulin than group 2 after 30 days (1.5 +/- 0.3 vs. 0.6 $ 0.2 U X kg-1 X day-1, P less than .001) and after 60 days (0.8 +/- 0.1 vs. 0.5 +/- 0.06 U X kg-1 X day-1, P less than .001). After 3 mo, both groups reached the lowest mean stable HbA1 level (8.4 +/- 0.4 and 8.3 +/- 0.4% group 1 and 2 respectively). Between the 2nd and 9th mo of follow-up, mean postbreakfast C-peptide concentration increased in both groups. The highest levels of fasting C-peptide were reached by group 1 after 90 days (0.77 +/- 0.32 nM) and group 2 after 60 days (0.34 +/- 0.09 nM). The largest partial remission (C-peptide 0.3 nM, insulin requirement less than 0.5 U X kg-1 X day-1 and no glycosuria) was observed in group 1 after 180 days (5 of 16 patients) and in group 2 after 60 days (5 of 15 patients).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Measuring the mineral content of the distal radius in the age of growth].

A study was carried out to characterize in the growing skeleton the absorptiometric measurement of the ultradistal radial epiphysis where the trabecular bone is higher than at proximal scanning planes. The study showed that a radius scan, 1 to 1.4 cm proximal to the ulnar tip, and consequently 4 to 6 mm proximal to the growing plate, gives reproducible informations in infants aged 6 years or more when the BMC, and not the BMC/BW, is considered, as the measurement error is 3.5% and 5.7%, respectively.

Adolescent↗
PubMedDate not supplied

[Use of echocardiography for diagnosing anomalies of sex differentiation].

Real-time ultrasonography of pelvic organs is a useful tool in diagnosing disorders in sexual development. US has proved to be rapid, accurate, non invasive method to visualize normal and pathologic pelvic structures and its role in intersex disorders lies in the capacity of demonstrate the anatomy of the genital and urinary tracts. The sonographic finding of feminine internal genitalia and bilateral enlargement of the adrenal glands in a newborn is suggestive for congenital adrenal hyperplasia (CAH) and allows to prevent the symptoms of a salt-losing syndrome.

Adrenal Hyperplasia, Congenital↗
PubMedDate not supplied

[Male hypogonadism in children and adolescents: diagnostic assessment and therapy indications].

Testicular hormones, produced by hypothalamic-pituitary-gonadal axis activation, induce male development during embryogenesis and sexual maturation at puberty. As a consequence, any lesion at different levels of the axis is responsible for different clinical alterations, depending on the phase of life in which it develops, from early gestation to adult life. The evaluation of a hypogonadic male is complex and often diagnostic procedures only discriminate the level of damage but not the cause. Standardized and widely accepted therapies for specific forms of hypogonadism are briefly exposed. Three cases of hypogonadotropic hypogonadism are reported.

Adolescent↗
PubMedDate not supplied

[Growth and puberal development in males with adreno-genital syndrome].

Growth patterns of eleven male subjects affected by congenital adrenal hyperplasia (CAH) due to 21 hydroxylase deficiency were studied and correlation with treatment was evaluated. All patients had completed their growth and were divided into two groups according to the age of diagnosis; group A: treated before 6 months of age (5 patients), group B: treated after 3 years of age (6 patients). Besides the pattern of growth, mean parental age, genetic target, onset and completion of puberty were considered. Regardless of the age at diagnosis, the patients of both groups had an anticipated and stunted final height vs. general population, but correlated with mean parental height. In all patients pubertal spurt failed and height velocity slowed down after twelve years of age. We conclude that pattern of growth of patients with CAH is deeply influenced by genetic and constitutional factors and by negative effects of glucocorticoid therapy. Actually an excellent glucocorticoid treatment of CAH is not available as yet and careful clinical and laboratory evaluations are necessary to minimize negative influences on growth.

Adrenal Cortex Hormones↗
PubMedDate not supplied

Nephrocalcinosis in children and adolescents: sonographic evaluation during long-term treatment with 1,25-dihydroxycholecalciferol.

In order to study the presence of possible renal damage, 12 patients who had been chronically treated with 1,25-dihydroxycholecalciferol therapy, 1,25(OH)2D3, for hypoparathyroidism, pseudohypoparathyroidism, and hypophosphatemic rickets were examined by renal ultrasound. Two patients had normal values while 10 subjects showed nephrocalcinosis (NC) of mild, medium, or severe degree. The echographic results have been related to some calcium-phosphorus metabolism and therapeutic parameters. In those subjects with medium to severe NC, the age at the beginning of therapy was significantly younger and the dose of 1,25(OH)2D3 was significantly higher, than in the other patients. Laboratory data were not predictive of NC. Renal ultrasound is, therefore, a useful means of screening to detect even early stages of NC; its use in the follow-up is also recommended.

Adolescent↗
PubMedDate not supplied

[Changes of the lipid and protein profile in the obese child in diet therapy (with and without added fiber)].

Considering the overcoming importance that cholesterol levels and lipoprotein pattern presents as atherosclerosis risk factor, the Authors have performed lipoprotein analysis in two groups of obese children (weight excess over 50% of the ideal weight). The patients were hospitalized and treated by dietetic therapy and moderate exercise for 15 days. In group 1 the diet was daily supplemented by fibres. In both groups a weight drop as well as reduction of total cholesterol and LDL cholesterol was observed, while serum triglycerides and VLDL cholesterol and HDL cholesterol remain substantially unchanged.

Adolescent↗
PubMedDate not supplied

[Cortico-adrenal-genital syndrome. Diagnosis, therapy, follow-up].

Recently new advances are achieved in the diagnosis of CAH, by discovering clinical forms different from the classical one: the late-onset and the cryptic-CAH. While the diagnosis of classical form mainly depends on dosing 17-OH-progesterone levels in all newborns, the detection of non-classical form requires measurement of adrenal steroids in basal conditions and after ACTH stimulation. The Authors recommend a careful follow-up of treated patients by frequent clinical and hormonal evaluations in order to prevent slightly unsuitable therapy that could compromise the achievement of adequate adult height. It is necessary to evaluate not only the daily total amount, but also the pattern of administration and which adrenal preparation is preferable.

17-alpha-Hydroxyprogesterone↗
PubMedDate not supplied

Unusual renal involvement during diabetic ketoacidosis (DKA) in a newly diagnosed type I diabetic child.

A 10-year-old boy, in a precomatose state, was admitted to our Endocrine Unit for diabetic ketoacidosis. It took unusually long to reequilibrate the acidosis despite a bicarbonate drip. On the 4th day the patient suddenly complained of an acute abdominal pain associated with macrohematuria and oliguria; ankle edema was evident. No radio-opaque image was detected along the urinary tract. An intravenous pyelogram (IVP) showed an almost totally silent left kidney. Ten days later a control IVP showed complete normality of both kidneys. We postulated that the serious and protracted dehydration might have resulted in the formation of a blood clot along the renal tract and that the rehydration may have subsequently removed it.

Acute Kidney Injury↗
PubMedDate not supplied

[Male pseudohermaphroditism].

After a brief recall of male sexual differentiation, main features of different etiopathogenetic forms conditioning male pseudohermaphroditism (MPSH) are considered. Procedures for an early and exact identification are illustrated in order to formulate an appropriate prognosis. Hormonal treatment and corrective surgery are discussed; in case of severe malformations, a gender reassignment may be evaluated.

3-Oxo-5-alpha-Steroid 4-Dehydrogenase↗
PubMedDate not supplied

Etiology, diagnosis, and prevention of renal involvement in insulin-dependent diabetes mellitus.

Overt diabetic nephropathy is a well-established clinical picture characterized by macroproteinuria and irreversible decline of glomerular function. The first phase of renal involvement has been widely investigated in the last decade in the hope to individuate early lesions. Five stages of glomerular damage have been identified by morphological abnormalities and clinical tests. Although renal hypertrophy, hyperfiltration, and microalbuminuria are present in all diabetics at onset, subsequent evolution shows different patterns: some patients may present no further progression, while others show a rapid and irreversible decline of kidney function. This suggests that other factors, i.e., risk factors, may play important roles in the renal involvement in diabetics. The predictive role of microalbuminuria and of hyperfiltration was investigated, and, so far, only an albumin excretion rate above 30 micrograms/min had been proved to be associated with a decline of renal function. Actually no practical hints can be given to prevent the disease apart from persistent strict glycometabolic control during the course of diabetes. Antihypertensive treatment can slow glomerular damage when overt diabetic nephropathy and hypertension are present. Aggressive treatment in the early phases of renal involvement might change the natural history of the disease.

Adolescent↗
PubMedDate not supplied

[Late reattribution of sex: a clinical example].

A female patient affected by congenital adrenal hyperplasia, has been brought up as a male till five and half year old. After exact diagnosis has been made, a complete psychological evaluation has suggested the possibility of a change in the rearing sex. We briefly summarize the psychological, medical, legal aspects of this late sexual reattribution. After a five-years follow up, results may be considered satisfactory.

Adrenal Hyperplasia, Congenital↗
PubMedDate not supplied

[Follow-up and prognosis of congenital hypothyroidism].

Neonatal screening of congenital hypothyroidism has been recently extended to the most of North America, Australia, Europe, and to several Italian areas. Before screening programs, several Authors reported neurological defects and behavioral disturbances also in patients whose treatment has been precocious, thus stressing the importance of an antenatal thyroidal defect. We have therefore setted up a follow-up program to evaluate the prevalence and to treat such disturbances in hypothyroid children. In this report we describe the program, present the most significant preliminary data and discuss the prognosis of hypothyroid patients detected by screening programs.

Adolescent↗