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Biomedical subjects

P Manzoni

Publications and source records attributed to P Manzoni.

36 records · Page 2Linked to original sources

Relative expansion of extracellular water in obese vs. normal children.

This preliminary communication reports data regarding the distribution between intracellular (ICW) and extracellular (ECW) water compartments in a group of 21 prepubertal young obese children of both sexes in comparison with a group of 18 normal children weight matched for age. Our data indicate that obesity is associated with a highly significant relative expansion of extracellular water (ECW/ICW = 0.61 +/- 0.19 and 0.76 +/- 0.09 in control and obese subjects, respectively; P < 0.0015). This observation, which has been already reported in adult women, suggests that some disturbances of water homeostasis have an early onset and stress the need for an early control of energy imbalance in children. These findings are of great concern also in the field of human body composition, suggesting the opportunity for a critical reevaluation of the assumed constancy of some human body characteristics. Body composition methodologies developed for "normal" populations would require adjustment for use in the obese population, since a considerable error would be introduced.

Body Water↗

Peripheral and abdominal adiposity in childhood obesity.

The aim of this work was to evaluate peripheral and abdominal adipose tissue (AT) content detected by MRI in normal weight and obese children, to compare MRI data with simple anthropometric indexes and to estimate intrabdominal adipose tissue (IAT) influence on cardiovascular risk factors. The subjects were 23 obese and 21 normal weight children aged 10 to 15 years. The following measurements were carried out: MRI analysis at lumbar level with definition of subcutaneous adipose tissue (SAT) area and IAT area; arm fat area (AFA); thigh fat area (TFA) and waist/hip ratio from anthropometry. SAT (353 +/- 94 cm2) was predominant compared with IAT (49 +/- 21 cm2) in obese as well as in controls (SAT: 79 +/- 61 cm2; IAT: 22 +/- 11 cm2). No differences in SAT/IAT ratio were found for sex and puberty, either in obese subjects or in controls. SAT and IAT were significantly related in controls (r = 0.77, P < 0.0001), but not in obese subjects (r = 0.12, P = 0.59). IAT was related to total and LDL cholesterol and triglycerides levels (r = 0.54, P < 0.02, r = 0.60, P < 0.01, r = 0.46, P < 0.04, respectively) in obese children. AFA and TFA from anthropometry significantly underestimated AT compared with MRI in both groups. Methods agreement analysis showed unacceptable results for anthropometry. It was concluded that childhood obesity has a subcutaneous adipose pattern with no differences between the sexes. IAT already begins to have clinical significance since it has a relationship to some cardiovascular risk factors.(ABSTRACT TRUNCATED AT 250 WORDS)

Abdomen↗

[Milk feeding of infants in the Turin district. An epidemiological survey].

A cross section study was performed on 1342 children living in the Turin district to examine the modalities followed for milk-feeding during the first year of life. Children examined had been admitted to the infants' ward of the Pediatric University Clinic of Turin suffering from common illness of early infancy. Mothers were asked to fill in a questionnaire concerning breast-feeding, formula feeding and cow's milk feeding. Data collected show that 75% of infants were exclusively breast-fed at birth, that a large number of infants are already fed cow's milk after the 3rd month of life, that hypoallergenic formulas are overused (18.5% among adapted formulas), and that follow-up formulas are underused. Most of the mothers (74%) say that their dietary choices were made by their physician. These data indicate that infant dietary trends in our district are often not in accordance with scientific recommendations.

Animals↗

[Weaning of infants in the Turin district. An epidemiological survey].

A cross section study was performed on 1060 healthy children living in the Torino district to examine the modalities followed for weaning during infancy. Mothers were asked to fill in a questionnaire which contained questions concerning the family, allergic and metabolic diseases in relatives, type of food given to infants before, during and after weaning, and source of dietary counselling. A score was given for each answer. Data indicate generally correct trends though major fields of error concerns prevention of food allergy and coeliac disease. Scores were correlated with family type and area of origin of the family.

Age Factors↗

[Evolutive aneurysms in type IV Ehlers-Danlos' syndrome].

Ehlers-Danlos syndrome is one of the most frequent hereditary connective tissue diseases. Type 4 or Sack-Barabas syndrome differs by the seventy of arterial complications. The authors report a case of severely progressive aneurysms since thrombosis of the aneurysm of the left hepatic artery, splenic artery, and small aneurysms of the lower pancreatic artery and rapid development of severe ectasia of the coeliac trunk and the commun hepatic artery all occurred over a period of three months.

Adult↗

Congenital hypothyroidism and pericardial effusion.

A group of infants, affected by congenital hypothyroidism diagnosed through the neonatal screening program, was investigated with echocardiography to detect the presence of pericardial effusion. We studied the relationship between the effusion and the etiology of hypothyroidism, established through thyroid scintiscanning. Our data show a high prevalence of effusion in hypothyroid patients, without other clinical signs of cardiac involvement as well as a relationship between the etiology of hypothyroidism and the presence of effusion. This seems to be much more frequent in those forms which can imply a more severe hormonal defect, particularly during fetal life (agenesis/dyshormonogenesis). Furthermore, the high prevalence of pericardial effusion suggests to start the L-T4 replacement therapy with lower dosages as commonly advised, in order to avoid a cardiac involvement.

Congenital Hypothyroidism↗

[Hypothyroidism, transitory or congenital. Reflections on a clinical case].

We report one case of congenital hypothyroidism with thyroid agenesis wrongly considered as a transient form of hypothyroidism. The patient came to our attention at 9 months of age, showing an important delay in neuromotor development. Transient hypothyroidism is a situation of brief hormonal deficit with spontaneous resolution in the first weeks of life. We consider it very important to differentiate this transient condition from a permanent form of thyroid dysgenesis.

Congenital Hypothyroidism↗

Miokamycin penetration into oral cavity tissues and crevicular fluid.

Diffusion of miokamycin into gum, maxillary-mandibular bone and crevicular fluid was studied in human beings. The antibiotic concentrations were determined in specimens at different times after oral administration of 600 mg in a single dose of miokamycin. Peak serum levels (2.32 +/- 0.67 mcg/ml) were found at the first hour after dosage. In healthy gum tissue the highest antibiotic levels (1.44 +/- 0.34 mcg/gr) were observed at the second hour, while in the inflamed gum miokamycin penetrates more rapidly, being, as in serum at the highest levels detectable during the first hour. In the bone of the maxilla or mandible the highest levels of miokamycin (0.88 +/- 0.13 mcg/gr) were detected at the second hour after treatment. In the crevicular fluid miokamycin showed a similar profile as that in serum, since the peak levels were reached at the first hour (2.4 +/- 0.88 mcg/ml, but the decrease of the antibiotic occurred more slowly than in serum. Miokamycin rapidly penetrates into tissues and fluids of oral cavity. A single oral dose of 600 mg guarantees antibacterial levels against susceptible bacteria over six hours.

Administration, Oral↗

Time-domain remarks on the cycle-to-cycle variability in some quantities measured on the vectorcardiogram magnitude.

Traces from five patients with different pathophysiological conditions were considered. For each of them more than ten successive cardiac cycles were observed. In each cycle, fourteen temporal intervals were measured. Diagrams were prepared with all values from many measurements made on the electrocardiogram of a patient. Means, variances and coefficients of variation were also computed. A consistent variability was detected in all measurements on every patient. The causes of such a situation have to be studied in detail. However, the coefficient of variation appears make it possible by itself, to distinguish some pathological cases (infarcts and conduction defects) from all others considered here.

Arrhythmias, Cardiac↗

Italian guidelines for the management of infectious complications in pediatric oncology: empirical antimicrobial therapy of febrile neutropenia.

The Italian Association for Paediatric Haematology and Oncology prepared a guideline document aimed at unifying and rationalising as much as possible the management of febrile neutropenia in children with cancer, because of the potential impact of these procedures on hospital costs and on the development of antibiotic resistance. Before starting anti-infective therapy, at least 2 blood cultures, a throat swab, urine-culture, and cultures from any suspected infected site, should be performed. Routine chest X-rays at onset of febrile neutropenia are probably not necessary, in absence of respiratory signs. At the present time, the safer option probably remains the combination of a beta-lactam and an aminoglycoside, and treating febrile neutropenia outside of hospital should be considered an investigational approach. The choice of the most appropriated regimen for each institution should be based also on the local bacteriological statistics and patterns of bacterial resistance. Antibiotic toxicity and cost should be other important factors. Every subsequent addition or substitution of antibiotics should be based on objective signs of clinical deterioration. The only accepted empirical modification is empirical antifungal therapy, while the empirical addition of a glycopeptide antibiotic cannot be recommended.

Anti-Bacterial Agents↗

Further evidence of cholinergic impairment of the neuroendocrine control of the GH secretion in Down's syndrome.

There are data indicating that cholinergic activity is precociously impaired in Down's syndrome (DS). On the other hand, acetylcholine as well as arginine (ARG) play a major stimulatory role in the neural control of growth hormone (GH) secretion in humans, likely acting via the inhibition of hypothalamic somatostatin release. The aim of the present study was to verify the effects of pyridostigmine (PD, 120 mg p.o.), a cholinesterase inhibitor, and ARG (0.5 g/kg i.v.) on the growth hormone-releasing hormone (GHRH) (1 microgram/kg i.v.)-induced GH rise in 15 adult patients with DS (M/F: 8/7; age 26.5 +/- 2.2 years; body mass index, BMI: 25.7 +/- 1.0 kg/m2) in which the potentiating effect of PD on GH secretion has been reported to be reduced. The results in DS were compared to those in 15 normal subjects (NS) (M/F: 8/7; age: 30.0 +/- 1.3 years; BMI: 21.4 +/- 0.4 kg/m2). Basal GH and insulin growth factor I (IGF-1) levels in DS (1.8 +/- 0.7 and 206.5 +/- 21.0 micrograms/l) were similar to those in NS (1.4 +/- 0.3 and 179.4 +/- 11.0 micrograms/l). The GH response to GHRH alone in DS (526.5 +/- 120.1 micrograms/l/h) was lower (p < 0.05) than that recorded in NS (895.4 +/- 153.7 micrograms/l/h). The GHRH-induced GH rise was potentiated by PD both in DS (1,138 +/- 184.2 micrograms/l/h; p < 0.02 vs. GHRH alone) and in NS (2,213.8 +/- 212.8 micrograms/l/h; p < 0.005 vs. GHRH alone); however, as the percent potentiating effect of PD was similar in both groups (215 and 247%, respectively) the GH response to GHRH + PD in DS was lower (p < 0.005) than that in NS. The GHRH-induced GH rise was also potentiated by ARG in both DS (2,243 +/- 362.4 micrograms/h; p < 0.001 vs. GHRH alone) and NS (2,764.3 +/- 325.7 micrograms/l/h; p < 0.005 vs. GHRH alone). As the percent potentiating effect of ARG in DS was more marked than in NS (425 vs. 308%, respectively), the GH response to GHRH + ARG became similar in both groups. No sex-related difference was found in the GH response to various stimuli both in DS and NS. In conclusion, these data demonstrate that the potentiating effect of PD but not that of ARG is impaired in adults with DS in whom a reduced somatotrope responsiveness to GHRH is present. These findings indicate that in DS the pituitary GH releasable pool is fully preserved while an impairment of the tuberoinfundibular cholinergic pathways could lead to somatostatinergic hyperactivity and low somatotrope responsiveness to GHRH.

Acetylcholine↗

Identification of commercial fish species belonging to the orders pleuronectiformes and gadiformes: library of isoelectric focusing patterns.

Isoelectric focusing in polyacrylamide gel was used to establish an identification archive of fish species belonging to the orders Pleuronectiformes, or flat fish, and Gadiformes, or gadoid fish. The 2 orders include species of different commercial value and interest that are frequently requested in European fish markets, but are susceptible to substitution either because they are morphologically similar or because they arrive on the markets already filleted or sliced. The sarcoplasmic protein profiles are species-specific and reproducible. The use of densitometry and image analysis coupled with a simple computer program overcomes the subjective evaluation of the patterns, making it possible to identify species correctly.

Animals↗

[G-CSF, neutropenia and candidiasis in VLBW patients].

OBJECTIVES: Relationships among Early Onset Neutropenia (EON), i.e. neutropenia in the first week of life, treated with Filgrastim, and subsequent colonization by Candida spp. with eventual systemic fungal infection in ELBW patients are not clear. We tried to analyze these features in a retrospective study on a selected population of a large tertiary NICU. METHODS: By a database search, we identified a group of VLBW patients who were diagnosed a systemic fungal infection (SFI) during their stay in NICU (n=52), and divided them in two subgroups: those who had presented Early Onset Neutropenia (EON) and thus had been treated with a 3-day course of Filgrastim (n=14)(group A), and those who had not presented EON and thus had not undergone Filgrastim therapy (n=38) (group B). We investigated in both subgroups the following variables: neutrophil count monitoring during the first 2 weeks of life, colonization by Candida spp, day of onset of SFI, outcome. Statistical analysis was performed by Chi-square test, ANOVA and T-test using SPSS 8.0 for Windows. RESULTS: Absolute neutrophil number was obviously lower in group A at recruitment (354/mmc vs 2910\mmc, Chi-square = 9.776, p <0.005), but became normal at the end of G-CSF treatment, thus detecting no significant differences between the two groups at day 8 (p<0.12) and 14 (p<0.34). The onset of SFI occurred significantly earlier ( 9.6 dol vs 14.6 dol., p<0.004) in group A neonates. Fungal Colonization rate in the 2nd week of life was significantly higher in previously neutropenic patients (71% vs. 37%, p< 0.005), who had also a significantly higher number of sites involved (p<0.003). CONCLUSIONS: Neutropenia in the first days of life in VLBW neonates, even if adequately and succesfully treated, heavily influences rates and severity of colonization by fungal spp., and is associated with an earlier onset of a SFI.

Candidiasis↗

Prospective study of the prevalence of bronchiectasis in rheumatoid arthritis using high-resolution computed tomography.

A prospective study of the prevalence of bronchiectasis in rheumatoid arthritis was conducted over an 18-month period in 46 patients (34 women and 12 men with a mean age of 60.1 years) meeting 1987 American College of Rheumatology criteria for rheumatoid arthritis. All patients underwent high-resolution computed tomography of the chest, whose results were confronted with a number of clinical, laboratory test and lung function testing parameters. Bronchiectasis or bronchiolectasis was found in 23 patients (50%) and was the most common abnormality detected by high-resolution computed tomography. When the four patients with isolated bronchiolectasis were excluded, the prevalence was 41%. Eighteen of the 23 patients had not been diagnosed with bronchiectasis before the study and 13 were free of respiratory symptoms. No significant differences were found between the 23 patients with and the 23 patients without bronchiectasis for age at onset or duration of the rheumatoid arthritis, extraarticular involvement, positive rheumatoid factors, bony erosions, use of corticosteroids or immunosuppressives, respiratory manifestations, smoking, or spirometry parameters. Patients without bronchiectasis were more likely to have impaired diffusion of carbon monoxide across the alveolar-capillary membrane. Among the patients with bronchiectasis, those with respiratory symptoms (n = 10) were more likely to have a history of lung disease and those without respiratory symptoms (n = 13) were more likely to have a diagnosis of bronchiectasis secondary to rheumatoid arthritis; no other differences were found between these two subgroups. Routine use of high-resolution computed tomography, a technique capable of demonstrating silent bronchiectasis, showed that bronchiectasis was the most common lung change in rheumatoid arthritis in our study. At the time of the study, there was no evidence that presence of bronchiectasis was associated with more severe joint or lung symptoms.

Adult↗