Biomedical subjects
Publications and source records attributed to G Saggese.
The authors report plasma substance P levels in obese children and healthy controls. Obese children showed significantly higher substance P values in comparison with controls. A positive correlation was found between substance P levels and percentage of weight increment.
Three children with tuberculosis and hypercalcemia are reported. Before antitubercular treatment 1,25-dihydroxyvitamin D serum levels and urinary calcium excretion were elevated for age in all patients; vitamin D and 25-hydroxyvitamin D were in normal range whereas serum intact parathyroid hormone concentrations were suppressed. Low calcium diet and antitubercular treatment caused a normalization of serum calcium levels and urinary calcium excretion; 1,25-dihydroxyvitamin D concentrations returned in normal range after three months of antituberculosis therapy. When 1,25-dihydroxyvitamin D was normal, a reintroduction of a diet with normal calcium content did not determine new hypercalcemic episodes. These data suggest that an abnormal 1,25-dihydroxyvitamin D production sustains the hypercalcemia of children with tuberculosis. An ectopic and unregulated synthesis of 1,25-dihydroxyvitamin D by macrophages of granulomatous tissue is proposed.
In juvenile type 1 diabetes a computer-aided orthoclinostatic test, giving information on central autonomic reactivity, shows a significant difference, vs control subjects, only in the ortho-to-clino transition (not in clino-to-ortho), while no differences emerge in peripheral autonomic functions. The correlations between the mean values of heart rate in lying and standing positions seem to indicate a different response of the baroceptor reflex in the two groups.
The available information regarding the possible relevance of viruses in the pathogenesis of insulin-dependent diabetes is reviewed. Experimental studies in animals, clinical cases, histopathologic findings as well as epidemiologic and family studies provide circumstantial evidence that at least some cases of the disease are triggered by infection. Moreover, since it is widely accepted that autoimmunity plays a key role in diabetogenesis, the possible relationship between viruses and the induction of autoimmune responses to pancreatic islets is discussed. In view of recent developments in our comprehension of several chronic "idiopathic" diseases, the role of persistent viral infections and virus-induced immunopathology deserve further consideration in the etiology and pathogenesis of diabetes.
A 7-year-old male with the Aarskog Syndrome is described. This observation is the seventh of the italian literature. The child had the typical findings of the syndrome: short stature, abnormal facies, short fingers with interdigital webbing, unusual scrotal folds encircling the penis ventrally, cryptorchidism and mild mental retardation. Endocrinological study showed only a reduction of Testosterone secretion attributable to malposition of the testis. The presence of minor abnormalities in the mother is compatible with a "X-linked" recessive transmission or with inheritance of an autosomal gene, dominant in males and recessive in females (sex controlled).
Sotos syndrome is a rare disorder of statural overgrowth in children. Peculiar facies, pre- and post-natal overgrowth and advanced bone age are the main clinical findings; developmental delay may be present. The Authors report a case of Sotos syndrome followed until adult height and describe the pattern of growth. The girl showed the typical findings of the syndrome together with premature pubarche and premature pubertal development. Since precocious puberty determines an increase of growth during childhood, the Authors suggest that Sotos syndrome should be considered and excluded in girls with premature pubertal development.
In this study the authors examined 14 subjects with "classic" growth hormone (GH) deficiency and 40 with "non classic" GH deficiency treated with GH for a period of 6-36 months. Height velocity (HV) and plasma Somatomedin C (SmC) levels have been evaluated every 6 months during GH therapy. Both HV and SmC significantly increased (p < 0.001) during GH therapy in comparison to pretreatment values, but without any difference between the two groups; furthermore no significant difference was present among each six-monthly value of SmC. During GH treatment the following correlations resulted between SmC and HV: at time 0, r = 0.494 (p = 0.0004); after 6 months, r = 0.779 (p < 0.0001); after 12 months, r = 0.660 (p = 0.0001); after 18 months, r = 0.657 (p = 0.0001); after 24 months, r = 0.593 (p = 0.0038); after 30 months, r = 0.550 (p = ns); after 36 months, r = 0.465 (p = ns). Furthermore, mean value of SmC (y) correlated with mean value of HV (x) during GH treatment: r = 0.697, p < 0.0001; regression equation: y = 242x + 576. Finally no correlation was present among six-monthly SmC values, including those pre-treatment, and HV values in each of following periods. In conclusion, during GH treatment in subjects with GH deficiency plasma SmC levels correlate with HV, but have not a predictive value of the growth response to GH treatment itself.
In 116 short children (height < -1.6 SDs), the authors examined GH secretion over 24 hours, by taking blood samples every 20 min and performing an electroencephalographic sleep control. The following GH parameters were evaluated: 24-h mean GH concentration (MGHC); maximum GH peak during the initial cycle of sleep (iMGHP), the nocturnal 12 h (nMGHP) or diurnal 12 h (dMGHP), the number of GH pulses over 24 h (NP), or nocturnal 12 h (nNP) or diurnal 12 h (dNP), the mean pulse amplitude over 24 h (MPA), or nocturnal 12 h (nMPA) or diurnal 12 h (dMPA). The subjects were divided into 3 groups: group 1, 12 subjects with low responses to provocative tests and MGHC < 3 ng/ml; group 2, 36 subjects with normal responses to provocative tests and MGHC < 3 ng/ml; group 3, 68 subjects with MGHC > 3 ng/ml. MGHC was highly correlated (p < 0.001) with iMGHP (r = 0.80), nMGHP (r = 0.82), dMGHP (r = 0.59), MPA (r = 0.85), nMPA (r = 0.86), dMPA (r = 0.56), NP (r = 0.70), nNP (r = 0.68), dNP (r = 0.46). By the analysis of the regression equations, the values corresponding to 3 ng/ml for MGHC were 11.08 ng/ml for iMGHP, 11.66 ng/ml for nMGHP, 5.21 ng/ml for dMGHP, 7.29 ng/ml for MPA, 8.40 ng/ml for nMPA, 4.25 ng/ml for dMPA, 3.2 for NP, 2.41 for nNP and 0.78 for dNP. By using these values as cut-off points, the diagnostic accuracy yielded 83.6% for iMGHP, 84.5% for nMGHP, 69.8% for dMGHP, 92.2% for MPA, 90.5% for nMPA, 81.9% for dMPA, 80.2% for NP, 77.6% for nNP, 71.5% for dNP. In conclusion, we found a strong correlation between mean GH secretion over 24 h and the number or amplitude of pulses: particularly, nocturnal pulsatile GH parameters show a higher correlation in comparison with diurnal pulsatile GH parameters, so that the examination of GH values during nocturnal hours may be considered a reliable index of GH secretory status.