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Biomedical subjects

R Lorini

Publications and source records attributed to R Lorini.

122 records · Page 7Linked to original sources
PubMedDate not supplied

Anticardiolipin antibodies in first-degree relatives of type 1, insulin-dependent, diabetic patients.

First-degree relatives (FDRs) of diabetic patients are at risk of IDDM, and frequently present several autoantibodies. We detected anticardiolipin antibodies (aCL) in 42 FDRs, aged 12.4 +/- 4.2 years and in 52 controls. aCL (IgG and IgM) were measured by ELISA and their results expressed in arbitrary units. All FDRs underwent islet cell antibodies (ICA) measurement, intravenous glucose tolerance test and HbA1c levels. HLA typing and HLA-DQ molecular analysis were performed in all FDRs. Positive levels of aCL-IgG were observed in 8/42 FDRs and no control subject (p = 0.04); aCL-IgM values were similar in FDRs and controls. No correlation was found between aCL levels and chronologic age or HbA1c levels. No association was observed between aCL frequency and immunologic (ICA), metabolic or genetic (HLA) parameters. No FDR showed any feature of antiphospholipid syndrome. aCL-IgG presence in FDRs is suggestive of a need to carry out a follow-up study to establish the significance of these antibodies.

Adolescent↗
PubMedDate not supplied

Normal values of overnight albumin excretion rate in a sample of healthy Italian children and adolescents.

The aim of this study was to define normal values of albumin excretion rate (AER) in young people. We measured overnight timed AER (tAER, microgram/min) by a double-antibody radioimmunoassay in 281 healthy Italian children and adolescents (160 M and 121 F), aged 7-19 years. The frequency distribution of tAER deviated from normality, therefore percentiles were used: median and 95th percentile were 2.3 and 6.9 micrograms/min respectively. Log transformed tAER was not related to age or pubertal stage. "Borderline" AER refers to AER higher than normal 95th percentile in non-diabetic subjects but lower than microalbuminuria threshold level. Incipient nephropathy, expressed as "borderline" AER, has been reported in adult IDDM patients, and can be reversed by improving metabolic control. Because incipient diabetic nephropathy may be present in young IDDM patients without microalbuminuria, screening for AER should be recommended for pediatric diabetic patients, also before puberty, in order to detect early renal damage and the "borderline" AER state.

Adolescent↗
PubMedDate not supplied

Phenotype/genotype correlation and cystic fibrosis related diabetes mellitus (Italian Multicenter Study).

BACKGROUND: A genotype/phenotype correlation between early onset cystic fibrosis related diabetes (CFRD) and the N1303K mutation of the CF gene was previously identified in a small series of 28 CFRD patients, out of 313 CF patients. PATIENTS AND METHODS: In order to confirm the observation, data of 141 CFRD patients out of 1,229 CF patients attending 14 Italian CF centers were collected. All patients were older than 10 years and had been genotyped. RESULTS: DeltaF508 was the most frequent mutation (147/282 alleles: 52%) and N1303K the second most frequent mutation (18/282 alleles: 6.3%) in CFRD patients, without significant difference as compared with CF patients without DM (52% vs 48.6% and 6.3% vs 5.1%, respectively). W1282X was the third most frequent mutation in CFRD patients, more frequent than in CF patients without DM (5.3% vs 2%; p<0.001). CONCLUSIONS: Unlike the previous study, we did not find a higher frequency of the N1303K mutation in CFRD patients; moreover, data from this large CF series showed a significant correlation between the W1282X mutation and CFRD.

Adolescent↗
PubMedDate not supplied

Endocrine autoimmunity in young patients with juvenile chronic arthritis.

OBJECTIVE: The aim of our study was to investigate the coexistence of autoimmune diseases (autoimmune thyroid disease and type 1 diabetes mellitus, T1DM) in patients affected by Juvenile Chronic Arthritis (JCA). METHODS: We studied 66 patients affected by JCA, 42 females and 24 males: 42/66 patients had a pauciarticular form of JCA, 13/66 had a polyarticular form and 11/66 had a systemic form. All the patients underwent autoimmune thyroid screening through determination of anti-thyroglobulin (TgA) and anti-peroxidase (TPOA) autoantibodies. Patients with TgA and/ or TPOA, underwent thyroid sonography. T1DM screening included determination of anti-glutamic acid decarboxylase (GADA), anti-insulin (IAA), anti-tyrosine phosphatase-like protein (IA-2A) and anti-islet cell (ICA) autoantibodies. Oral glucose tolerance test (OGTT) was performed only in patients with autoantibody positive values. HLA typing for risk of T1DM was performed in 43 patients. RESULTS: Nine female patients (14%) showed anti-thyroid autoantibodies, in particular: TgA in 3 cases, TPOA in 5, TgA and TPOA in only 1. In 3 of these patients, ultrasound examinations showed thyroid abnormal pattern, suggesting Hashimoto's thyroiditis. As regards T1DM, only 2 patients showed positive levels of GADA. As regards HLA typing, one or more T1DM susceptibility heterodimers were detected in 20 patients (46%) (13 with 1 heterodimer, 7 with 2 heterodimers). CONCLUSION: Our study showed that anti-thyroid autoantibody frequency (9/66, 14%) was higher in JCA than in the general population, while T1DM markers (islet autoantibodies and genetic markers) were not frequent. These results suggest to investigate specific markers of thyroid autoimmunity in patients with JCA, in particular in females with JCA pauciarticular form.

Adolescent↗
PubMedDate not supplied

[The use of highly purified glucomannan-based fibers in childhood obesity].

To evaluate the effectiveness of highly purified glucomannan in childhood obesity a study has been carried out in 23 obese children (12 boys and 11 girls, aged 5.2-15.8 years), with excess weight of 51 +/- 16%, treated with 2-3 caps twice a day of glucomannan fibres (DICOMAN 5:2-3 gr/die), and in 30 obese children (aged 5-18 years) with excess weight of 51 +/- 10%, studied as controls. After a three-days food recall, a balanced diet with adequate caloric intake was provided to all obese children. In all patients before and 2-4 months after the auxological data (weight, height, weight excess) and laboratory data (serum levels of cholesterol, HDL, triglycerides, glucose, fructosamine, glycosylated hemoglobin, RBC, WBC, hemoglobin, iron, calcium, Cu and Zn) have been determined. Excess weight and triglycerides levels were significantly decreased in treated obese patients than in obese controls 4 months after the beginning of the study. A decrease of cholesterol levels was also observed in treated obese patients, but not in controls, whereas serum iron, calcium, copper and zinc persisted unchanged. No important side-effects were observed in treated patients. On the basis of our results highly purified glucomannan fibres may be employed with effectiveness in obese and dyslipidemic children together with diet.

Adolescent↗
PubMedDate not supplied

[Progressive spinal amyotrophy. Nosographic problems].

After a bibliographical revue on progressive spinal amyotrophy the nosographical aspects of the various forms are discussed, above all the proximal ones. Considering personal observations, the conclusion is that a definite differences is the various forms of proximal spinal amyotrophy does not exist and today they are different expressions of the same illness.

Adolescent↗
PubMedDate not supplied

[Experience in diet therapy of child obesity].

During the last 14 years 1620 children and adolescents, 806 boys and 814 girls, aged 2-20 yrs, were referred for overweight as outpatients to the Pediatric Endocrine Center of the University of Pavia. On first admission 170 (10%) of the 1620 subjects had a percent overweight of less than 20% referred to ideal weight for height; 350 (22%) patients with overweight ranging from 25 to plus 100 were lost to follow up. We report our dietary management on 1100 children with percent overweight between 25-120, treated for a period of at least 3 months to a maximum of 7 years (mean 3 yrs). All patients were provided with a physiological diet with an adequate or slightly reduced caloric intake for their height (P 15%, F 25%, C 60%). A regular physical activity was recommended to our patients. Before they started the diet patients kept a daily food diary for three days, which included recording information about what food was eaten, how it was prepared and the time at which it was consumed. Food recalls showed a higher caloric intake for height and age with fat and protein excess, especially of animal origin. A lot of snacks, particularly sweets, and soft drinks were consumed during the day.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Hyperthyroidism in children (author's transl)].

The present paper analyzes the causes, signs and symptoms of hyperthyroidism in children and the problems, complications and results associated with the various therapeutic regimes. Childhood hyperthyroidism is usually due to Grave's disease, an autoimmune thyroid disease. Genetic factors are also involved in its development. The diagnosis and in particular the differential diagnosis with Hashimoto's thyroiditis are discussed. Treatment of Graves' disease is controversial, but medical therapy is commonly accepted as the treatment of choice. Some dosage schedules of antithyroid drugs are considered, and some techniques for predicting remission status and relapse of disease are reported. Both the minor and more serious complications of medical therapy are examined. Careful follow-up for the development of hypothyroidism is advocated, especially in patients treated with radiation or surgery. Autonomous hyperfunctioning thyroid adenoma is rare, but occurs even in childhood, and can degenerate into carcinoma.

Adolescent↗
PubMedDate not supplied

Clinical and neurophysiological study in diabetic children and adolescents.

We investigated 82 unselected insulin dependent diabetes mellitus children and adolescents by clinical and electrophysiological evaluation to assess the frequency of diabetic neuropathy and to relate the results to age and height of patients, duration of illness and degree of metabolic control. Clinical abnormalities were found in about 1/3 of patients: these signs of diabetic neuropathy were related to the age and the duration of diabetes but not to the degree of metabolic control. Neurophysiological study showed alterations, especially of sensory nerve conduction. These results were seen to be related to height and age of patients and duration of illness but not to the degree of metabolic control, probably due to the young age of the patients. Our study confirms that diabetic neuropathy is a heterogeneous disorder that may be caused by the interaction of host susceptibility and vascular, metabolic and perhaps environmental components also in diabetic children.

Adolescent↗
PubMedDate not supplied

Normal values of first-phase insulin response to intravenous glucose in healthy Italian children and adolescents. The Prediabetes Study Group of the Italian Society for Pediatric Endocrinology and Diabetology (SIEDP).

This study reports the first-phase insulin response (FPIR) calculated on a wide pediatric population. 138 non-obese, ICA- and GAD65 antibody-negative subjects, without family history of IDDM, were tested in 21 Italian Pediatric Diabetic Centers, according to a standardized protocol. After an overnight fast, 0.5 g/kg body weight of 25% dextrose (maximum 35 g) was infused over 2.5-3 minutes. Blood samples were taken at -10, 1, 3, 5 and 10 minutes after dextrose infusion for determination of insulin levels by radioimmunoassay. A significant positive relationship was observed between FPIR and pubertal stage groups (p = 0.0043), suggesting a progressive rise of FPIR throughout puberty. These results have to be taken into consideration in evaluating early abnormalities of carbohydrate metabolism in pubertal subjects. According to Tanner's stage the first percentile was 53 microU/ml for stage I, 53.6 microU/ml for stages II-III and 76.6 microU/ml for stages IV-V.

Adolescent↗