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Biomedical subjects

G Morgese

Publications and source records attributed to G Morgese.

At least 127 records · Page 7Linked to original sources

Fetal encephalopathy with cerebral calcifications: a case report.

The authors report a case of a newborn with severe encephalopathy and cerebral calcifications. The newborn was admitted to Neonatal Intensive Care Unit in Chieti at 2 days of age suffering from continuous generalized seizures. He was the child of healthy first-degree cousins. Cerebral ultrasonography showed bilateral ventricular dilatation and an intrathlamic hyperechoic image. Computed tomography and magnetic resonance imaging showed ventricular and corpus callosus hypoplasia, pachygyria, widespread delayed myelination areas, and basal nuclei and periventricular calcifications. All serum and urine analyses showed normal results. In particular, all demyelinizing metabolic diseases were excluded. Based upon these findings, we speculate that this infant may be suffering from fetal encephalopathy with cerebral calcifications.

Brain↗

Genetic predisposition to hypertension (as detected by Na+/Li+ countertransport) and risk of diabetic nephropathy in childhood diabetes.

In order to evaluate whether insulin-dependent diabetes mellitus patients with incipient nephropathy have an overactivity of erythrocyte sodium-lithium countertransport (Na+/Li+ CT), 82 diabetic children and 38 healthy age-matched control subjects and their parents and grandparents were studied. The children were divided into two groups according to the presence of persistent microalbuminuria (MA). Diabetic children with MA had Na+/Li+ CT activity higher than normoalbuminuric diabetics and healthy controls. The parents and grandparents of microalbuminuric patients showed higher Na+/Li+ CT than parents and grandparents of normoalbuminuric diabetics and of the controls. This study demonstrates that predisposition to hypertension, as indicated by increased Na+/Li+ CT activity in erythrocytes, is more frequently detectable in patients with persistent microalbuminuria than in diabetics without persistent microalbuminuria or in healthy controls. Overactivity of Na+/Li+ CT is present also in parents and grandparents of diabetic children with MA. This study suggests that genetic predisposition to hypertension is more frequent in patients at risk of developing diabetic nephropathy, as well as in their parents and grandparents.

Adolescent↗

Diabetic retinopathy. Relationship with nephropathy in pediatric age.

In order to evaluate the relationship between diabetic retinopathy and diabetic nephropathy we studied 55 (25 females, 30 males) retinopathic diabetic children and adolescents: their age ranged from 9.0 to 17.3 (mean +/- SD 13.9 + 3.8) years and the duration of disease from 4.8 to 10.0 (6.9 +/- 3.1) years. The mean glycosilated haemoglobin (HbA1c) was 10.4 + 2.7%. Patient distribution in relation to retinal grading showed that the greatest number of patients (34: 61.82%) were in 14-20 retinopathy level (with minimal signs of retinopathy), 9 patients showed 31 retinopathy level (16.36%) and 12 (21.82%) were in the other classes. Comparison between retinal grading of retinopathy and presence/absence of microalbuminuria showed a significant difference between the evaluated subgroups (p < 0.0001). In fact, only 6 patients out of 34 (17.64%) in class 14-20 retinopathy level, 8 patients out of 16 (50%) in 31-41 retinopathy level and 5 patients out of 5 (100%) in 51 retinopathy level had microalbuminuria. Our study shows that the presence of persistent microalbuminuria is an important risk factor for diabetic retinopathy. In conclusion, we suggest that when diabetic children have persistent microalbuminuria, the eye should be carefully examined, in order to prevent a deterioration of the eye function.

Adolescent↗

[Body mass index, weight and height in school children in central Italy].

AIM: To study the pattern of distribution for body-mass index, weight and height in children of the Abruzzo region and to compare them with commonly used standards. STUDY DESIGN: Weight, height and body-mass index (BMI, weight/height2) were reported from 2858 school children (6 to 14 years old) of a town of Central Italy (Pescara). Data were detected in 1991. The conventional percentiles were calculated. Then we considered the first (25%), the median (50%) and the third (75%) quartile of all obtained data. Those of the BMI were superimposed on France (Rolland-cachera MF, Eur J Clin Nutr 1991;45:13) and USA (Hammer LD, Am J Dis Child 1991;145:259) standards. Those of weight and height were superimposed on the respective Tanner standards (Tanner JM, Arch Dis Child 1966;41:613). RESULTS: The percentiles are shown. The central point of distribution (quartiles) appear slid over. The nearer standard for BMI to our sample seems to be represented by France standards, in front of which our values result slid quite exactly of one quartile over. The comparison with USA standards shows an increase of our findings, but the slope of the curves is different (overall in the advanced ages). Both weight and height, compared with Tanner standards, show an increase of values. CONCLUSIONS: 1) Different growth patterns are observed in the studied sample; 2) to calculate the prevalence of wasting and fattening conditions using values of cutoff points from not own standards could load to not appropriate estimates.

Adolescent↗

Hyperinsulinism as a marker in obese children.

OBJECTIVE: To determine the relationship between insulin and the metabolic profile and eventual weight loss in obese children. DESIGN: We first attempted to define the metabolic profile for 18 obese children; we then studied weight loss in this group longitudinally. SETTING: Department of Pediatrics in a university hospital. PARTICIPANTS: Eighteen randomly selected, young, obese male subjects from 5 to 16 years of age. INTERVENTIONS: (1) Metabolic screening at the outset, including insulinemia and glycemia after the oral glucose tolerance test and plasma levels of total cholesterol, high-density lipoprotein cholesterol, and triglycerides, and (2) weight loss treatment. RESULTS: We divided the sample into "normoinsulinemic" and "hyperinsulinemic" groups, similar for all the variables tested except for weight loss and plasma triglyceride levels. A direct relationship between weight loss results and duration of treatment was found for the entire group. The "hyperinsulinemic" group had a lower percentage reduction in excess weight, and the results in this group were not dependent on the duration of treatment. CONCLUSIONS: The effort to keep "normoinsulinemic" obese children in treatment may be useful; it is advisable to study "hyperinsulinemic" children more in depth.

Adolescent↗

Anti-epileptic therapy and behaviour disturbances in children.

In order to evaluate the effects on behaviour of some anti-epileptic drugs, we studied 300 children treated with phenobarbital and other drugs; their age ranged from 3.1 months to 15.9 years. The children were divided into two groups: group A: 197 (116 male and 81 female) children, mean age +/- SD 5.3 +/- 2.8 years, treated with phenobarbital; group B: 103 (66 male and 37 female) children, mean age 6.4 +/- 3.1 years, treated with anti-epileptic drugs other than phenobarbital. In all patients hyperactivity, irritability, disturbances of sleep, and drowsiness were investigated. The parents of patients completed a questionnaire with seven items. In group A, 150 (76.1%) children showed one or more behaviour disturbances, while in Group B a smaller number of patients 32 (31%) had such disorders. There was a significant difference between the two groups (P < 0.0001). The most frequent disorder was hyperactivity. The results of this study suggest that anti-epileptic drugs, in particular phenobarbital, can cause behaviour disturbances.

Anticonvulsants↗

Prediabetes: genetic, immunological and metabolical aspects.

There is mounting evidence from experimental animal diabetes and from human epidemiological studies that a long period of "prediabetes" precedes the clinical onset of type 1 (Insulin Dependent) Diabetes Mellitus. In this review, the authors evaluate the main informations concerning the genetic, immunological and metabolic aspects of this phase of prediabetes and the relationship of prediabetes with the onset of the disease. Prediabetes is a long period; in this period the destruction of beta cells can be caused by many factors and by many pathogenetic mechanisms. Nowadays, we begin to understand some of these mechanisms and the central role of the activation of the immune system; this activation results in various humoral and cellular abnormalities detectable in the prediabetic phase. These abnormalities, together with metabolic ones, have been reported in many studies. Consequently, we have at our disposal some genetic, immunological and metabolical markers which can be useful in the detection of the person at risk of developing diabetes mellitus.

Animals↗

[Immunologic changes in diabetic ketoacidosis].

We studied 13 children and adolescents during diabetic ketoacidosis; the duration of diabetes ranged from 1.4 to 6.0 years. A group of 13 diabetic sex, age and duration of disease-matched children served as control. Patients in ketoacidosis showed important abnormalities of T subset percentages (OKT3: 63.4 +/- 1.87% vs 72.1 +/- 3.4; p less than 0.001. OKT4: 37.18 +/- 1.85% vs 44.6 +/- 3.9; p less than 0.01. OKT8: 28.5 +/- 6.51% vs 28.1 +/- 1.9; p less than 0.04) and impaired neutrophil chemotaxis (53.10 +/- 3.3 vs 88.1 +/- 7.2; p less than 0.001). The patients showed normal levels of all classes of immunoglobulins. No correlation was observed between these abnormalities and the degree of ketoacidosis or glycaemia. When the patients were re-evaluated out of ketoacidosis, the values of the immunological parameters were normal and similar to those of the control group.

Chemotaxis, Leukocyte↗

Controlled study in diabetic children comparing insulin-dosage adjustment by manual and computer algorithms.

A controlled trial of a new microprocessor device for insulin-dosage adjustment was undertaken in two matched groups of a priori well-controlled diabetic children. A prospective study design with three equal 8-wk periods was used. In the first period, both groups used manual methods for insulin-dosage adjustment after manual criteria. In the second period, one group of children adjusted insulin dosage by computer algorithms, whereas the other continued to use manual methods. In the third period, both groups again adjusted insulin by traditional methods. Mean premeal glycemia and glycosylated hemoglobin levels did not change in either group throughout the study. During the second period, episodes of hypoglycemia were more frequent in children without the computer than in those who used the device. In keeping with the latter outcome, the group that used the microprocessor device was given less insulin in the second period than the first (0.88 +/- 0.02 vs. 0.94 +/- 0.02 U.kg-1.day-1, P less than 0.0001) and in comparison to the control group of patients who concurrently were given an increased insulin dose in the second period compared with the first. This study showed that insulin treatment through specific computer-mediated dosage-adjusting algorithms was safe and minimized hypoglycemia by effectively accommodating seasonally changing insulin requirements. We recommend the device to help diabetic children and their families in the care of insulin-dependent diabetes.

Algorithms↗

Long-term therapy in childhood asthma: clinical and auxological effects.

The authors studied the effect of different therapeutical regimens on the growth of children suffering from asthma. These patients were subdivided into four groups of ten patients according to their therapeutic regimens: Group A = ketotifene (1 mg, two times/day), Group B = diproprionate beclomethasone + salbuthamol (100 + 200 mcg, 3 times/day), Group C = ketotifene + diproprionate beclomethasone, Group D = disodiumcromoglycate (20 mg, 3 times/day). The patients were followed for at least 1 year. Our study has shown that all the children treated with the four different regimens had a normal growth and growth velocity.

Adolescent↗

Effects of ketoacidosis and puberty on basal and TRH-stimulated thyroid hormones and TSH in children with diabetes mellitus.

Basal and TRH-stimulated thyroid hormones and TSH were evaluated in two groups of prepubertal and pubertal diabetics: group B - 45 children without ketoacidosis; group C - 16 children with ketoacidosis. The diabetic patients showed no signs of diabetic microangiopathy. Fifty-three healthy subjects served as controls (group A). T4, T3, FT4 and FT3 serum levels were reduced in diabetics, particularly in ketotic ones; T4 and T3 values were lower in pubertal than in prepubertal non-ketotic diabetics and in pubertal than in prepubertal controls, while no significant difference was observed between pubertal and prepubertal ketotic patients. Moreover, no difference in rT3 serum concentrations was found between group A, B and C, but non-ketotic and ketotic pubertals showed a significant rT3 reduction if compared with non-ketotic and ketotic prepubertals and with healthy pubertals. TBG was lower in group B and group C diabetics than in controls. After TRH stimulus, T3 levels showed a significant increase both in controls and in non-ketotic diabetics, while no variation was observed in ketotic children; furthermore, at 120 minutes T3 values were lower in diabetic than in healthy children, particularly in ketotic ones. Basal TSH serum concentrations were reduced in ketotic diabetics, while no difference was found between nonketotic and control subjects. After TRH stimulus, TSH peak was higher in pubertal non-ketotic diabetics than in pubertal controls, while no difference was found between prepubertal and pubertal diabetics, both in non-ketotic and in ketotic status.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗