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Biomedical subjects

G Saggese

Publications and source records attributed to G Saggese.

At least 145 records · Page 8Linked to original sources

Role of antecedent mumps and reovirus infections on the development of type 1 (insulin-dependent) diabetes.

Type 1 diabetes mellitus is thought to derive from organ-specific autoimmune reactions, probably triggered by environmental factors. In view of the possible involvement of mumps virus and reoviruses in the pathogenesis of autoimmune endocrine disease, serum antibody levels to these viruses were measured in newly-diagnosed diabetic patients aged 5 to 25 years and in matched control subjects. Diabetic patients showed a significantly lower prevalence and reduced titers of antibodies to mumps and reoviruses. By contrast, the antibody response to measles virus (a non-diabetogenic agent) was remarkably similar in the two groups. It is suggested that individuals with an impaired humoral response to some viral agents are at increased risk of developing diabetes when exposed to pancreotropic viruses.

Adolescent↗

Circadian rhythm in gonadotropin secretion in children with constitutional stature delay.

Plasma levels of luteinizing and follicle-stimulating hormones were measured for 24 hours in six subjects affected by constitutional stature delay associated with sexual maturation delay. The children in pubertal stage exhibited fluctuating plasma concentrations of these hormones which significantly increased during sleep, as in healthy pubertal subjects. Thus in this type of delayed puberty, the synchronization of augmented gonadotropin secretion with sleep develops later in chronologic age but it is strongly related to bone age.

Adolescent↗

Bone mineralization and calciotropic hormones in children with hyperthyroidism. Effects of methimazole therapy.

We studied bone mineralization and calcium homeostasis in two children with hyperthyroidism before and during 3 yr of methimazole therapy in order to evaluate the effects of thyrotoxicosis and its therapy on mineral metabolism. Case 1, female, 4.1 year old with hyperthyroidism from 6 months. Biochemical data: increased thyroid function, phosphate and osteocalcin, decreased 1,25(OH)2D levels. X-ray: severe osteoporosis; bone mineral content (BMC) -23.0%, BMC/BW -25.1%. Case 2, female, 7.4 year old with hyperthyroidism from 9 months. Biochemical data: thyroid function, ionized calcium and osteocalcin were increased, 1,25(OH)2D and intact PTH were decreased. X-ray: severe osteoporosis: BMC -32.8%, BMC/BW -36.0. After the patients were euthyroid, they showed an increase of 1,25(OH)2D and intact PTH into normal values and a fall in calcium and phosphate. Osteocalcin levels returned in normal range one yr after first evaluation. Bone mineral analysis showed no variation of BMC and BMC/BW in the first 6 months of therapy and an increase in the following 6 months. In the following two years BMC and BMC/BW rose to normal range. Our study provides further evidence that in hyperthyroidism an altered mineral homeostasis is present with a reversible disturbance in vitamin D metabolism. We found that the return to euthyroidism was associated with a normalization of mineral homeostasis and with a recovery of bone mineralization. Osteocalcin assay may be an useful index to monitor bone metabolism in hyperthyroidism.

Absorptiometry, Photon↗

Assessment of thyroidal "C" cell secretion in osteoporotic girls with Turner's syndrome. Basal and calcium-stimulated levels of total calcitonin, extractable calcitonin and katakalcin.

Osteoporosis is a common finding in Turner's syndrome. To test the hypothesis that calcitonin deficiency may contribute to bone mineral loss in Turner's syndrome, we studied basal and calcium-stimulated (2 mg/kg body weight in 5 min) levels of total calcitonin, extractable calcitonin and katacalcin in 15 girls with Turner's syndrome and osteoporosis. Fifteen age-matched healthy girls were studied as controls. Both basal calcitonin (total and extractable) and katacalcin values were not significantly different in patients with Turner's syndrome in comparison with those of the controls. The calcium stimulation test showed a similar "C" cell secretory reserve in both groups. The calculation of delta CT/delta iCa of total and extractable calcitonin and delta KC/delta iCa, which accounts for individual variations in serum ionized calcium increases, did not show any significant difference between girls with Turner's syndrome and controls. We conclude that calcitonin deficiency is not a causative factor of osteoporosis in girls with Turner's syndrome and that in this syndrome long-life estrogen deficiency does not impair "C" cell secretory activity.

Adolescent↗

Final height outcome in both untreated and testosterone-treated boys with constitutional delay of growth and puberty.

The present retrospective study is based on a historical follow-up of 49 boys with constitutional delay of growth and puberty (CDGP) who went into puberty spontaneously (27 cases) or induced by depotestosterone treatment, 50 mg/ month for 6 months (22 cases). At the time of puberty the two groups of boys were similar in bone age, height deficiency, target height (TH) and had similar predicted final heights (FH). Their FH was measured and compared with TH calculated from measured parents' heights. FH did not significantly differ between the untreated boys and those treated. In the two groups of patients FH was similar and corresponded to both TH and height predicted at puberty onset. This study confirms that most boys with CDGP spontaneously attain a FH within the target range (24/27 cases). A short-term and low dose course of depotestosterone can be used without adverse effects on FH. The Bayley-Pinneau method can be generally considered accurate for predicting FH in CDGP, although significant discrepancies between FH and predicted height have been recorded in a fair number of both untreated and treated boys.

Adolescent↗

McCune-Albright syndrome: a longitudinal clinical study of 32 patients.

We report the diagnostic clinical features and their long term evolution in 32 patients with McCune-Albright syndrome. Patient data are made up of two periods: the first, classified as personal history, is from birth until the time when the diagnosis of McCune-Albright syndrome was made; the second, classified as clinical observation, is from the first observation until the end of follow up. The total duration of these two periods was 9.6+/-2.9 yr; mean age at first observation was 5.7 yr (range 0.7-11 yr). The probability of manifesting main clinical signs according to age was calculated: almost all had skin dysplasia at birth, 50% probability of peripheral precocious puberty in females at 4 years and 50% of bone dysplasia at 8 years of age were found. Other clinical signs had diagnostic relevance when preceding the main signs leading to diagnosis of McCune-Albright syndrome even without specific genetic investigation. The most important clinical manifestations have different evolutions: skin lesions increase in dimensions according to body growth; precocious puberty in females evolves rapidly but periods of regression can be seen in some patients; bone dysplasia in most patients evolves with an increase both in the number of affected bones and in the severity of lesions.

Child↗

Osteoporosis in children and adolescents: diagnosis, risk factors, and prevention.

Bone mass acquired during childhood and adolescence is a key determinant of adult bone health. Peak bone mass, which is achieved in late adolescence, is a main determinant of osteoporosis in adulthood. Therefore, any factor adversely impacting on bone acquisition during childhood or adolescence can potentially have long-standing detrimental effects on bone health predisposing to osteoporosis and fracture risk. Thus, osteoporosis can well have its origin in childhood and adolescence. Pediatricians should be playing an active role in osteoporosis diagnosis and prevention. It is increasingly recognized that osteoporosis may occur in some disorders of children and adolescents. In this paper we review the diagnostic criteria of osteopenia/osteoporosis by densitometric assessment of bone mineral density, the contributing factors, and the mechanisms whereby several disorders may affect the acquisition of bone mass in children and adolescents. Finally, some recommendations to optimize peak bone mass in order to prevent osteopenia/osteoporosis are suggested.

Adolescent↗

[Hormonal treatment of cryptorchism: indications and limitations].

Cryptorchidism is the most frequent anomaly of male genitalia. The major concerns of cryptorchidism are on psychological problems in childhood and infertility and increased cancer risk in adulthood. Medical treatment with various hormones has been used in the last 70 years to induce testicular descent, but some discrepancy exists in the various reports. In this paper, the efficacy on testicular descent, the effect on adult fertility and the inferences on risk of malignancy of the various hormonal strategies are reviewed and briefly discussed. From the literature data, a practical approach to the hormonal treatment of cryptorchism is suggested.

Child↗

[Thyroid and thyrotropin functions in subjects with pituitary nanism treated with growth hormone].

We have evaluated thyroid and thyrotropin functions before the beginning and during Growth Hormone (GH) treatment for a 2-6-year period in a group composed of 21 children (age: 6.6 +/- 1.1 years, m +/- SD) suffering from classic GH deficiency. Circulating levels of thyroxine, and basal thyroid-stimulating hormone (TSH) always resulted in the normal range. TSH response to thyreotropin-releasing hormone administration showed in some subjects (one out of 21 before the start of treatment, 2 out of 16 after 2 years, 3 out of 12 after 4 years and 2 out of 10 after 6 years) a delayed (after 90-120 minutes) and higher peak in comparison to that of normal subjects. All these high and delayed values have been showed in only one occasion by different children, with the exception of a child who has presented the higher values in two occasions. Growth response to GH treatment has not been modified by the change in thyrotropin response, as subjects with high TSH peak have had a height velocity similar to that of the other children in the corresponding periods of study.

Child↗