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Biomedical subjects

S Bernasconi

Publications and source records attributed to S Bernasconi.

At least 199 records · Page 11Linked to original sources

Short stature, brachydactyly, small ears, and a pattern of minor anomalies in brother and sister born to consanguineous parents: a hitherto unreported syndrome?

A 13-year-old boy and his 28-year-old sister had short stature, obesity, and a pattern of minor anomalies including a sloping, narrow forehead; small ears; a narrow nose with prominent bridge and long septum; short upper lip; receding mandible; and short limbs with brachydactyly and clinodactyly of little fingers. The boy also had hypoplastic external genitalia and elevated FSH. Both are of normal intelligence. There is remote consanguinity of the (normal) parents. The 2 sibs probably represent a hitherto un-recognized syndrome of possibly autosomal recessive inheritance.

Adolescent↗

Biotransformation of alkyl and aryl carbonates. Microbial degradation.

An enriched mixed culture was successfully grown on model alkyl and aryl carbonates. These compounds were degraded by microorganisms at different rates. P-Chlorophenyl-2-octyl carbonate and p-nitrobenzyl-2-octyl carbonate were metabolized through the formation of p-chlorophenol and p-nitrobenzyl alcohol respectively. A strain of Acinetobacter calcoaceticus isolated from the mixed culture utilized phenyl-2-octyl carbonate by an intracellular hydrolase to phenol and 2-octanol which were further metabolized.

Acinetobacter↗

Pulsatile growth hormone release in Turner's syndrome and short normal children.

To determine whether the quantitative and qualitative aspects of GH secretion in girls with Turner's syndrome are similar to those of short-normal children we studied the 24-h GH secretion of 10 patients with Turner's syndrome and 9 short-normal children with comparable auxological features. GH profiles, obtained by 30-min sampling, were analysed by the Pulsar programme. The pulsatile GH release over the 24 h in Turner's syndrome was similar to that in normal children. However, when the GH release over the 12 day and night hours were separately analysed, only normal children showed a night-time increase in the sum of peak amplitudes. Moreover, patients with Turner's syndrome had significantly decreased number and frequency of peaks in the night-time compared with short children. In short-normal children but not in Turner's syndrome, height velocity was related to the 24-h integrated concentration of GH, area under the curve over zero-line and over baseline, sum of peak areas, and amplitudes. Night-time GH area over zero-line and over baseline, mean peak amplitude, height area, sum of peak area and amplitudes were positively correlated with height velocity in short children, whereas in Turner's syndrome height velocity was related to daytime parameters only. In conclusion, girls with Turner's syndrome have a discrete pattern of pulsatile GH release. However, the relation of GH secretion to growth in these patients, is uncertain.

Body Height↗

Thyroid function tests in children with congenital hypothyroidism on L-thyroxine treatment.

The plasma levels of thyroxine (T4), triiodothyronine (T3), free T4 (FT4), free T3 (FT3), reverse T3 (rT3) and immunoradiometrically assayed thyrotropin (IRMA TSH) have been measured in 28 L-T4-treated children with congenital hypothyroidism as well as in a control group (group C). The patients were subdivided into 2 groups according to the nonsuppressed (group A) or suppressed (group B) TSH response to TSH-releasing hormone (TRH). Basal IRMA TSH correlated with the TSH increment after TRH and it was significantly lower in group B vs. groups A and C, while no difference was present between groups A and B in regard to T4, FT4 and rT3, all higher than in group C. FT3 levels were similar in the 3 groups. In children, as in adults, basal IRMA TSH seems to be a reliable index in monitoring overtreatment.

Adolescent↗

Adrenal steroid, cortisol, adrenocorticotropin, and beta-endorphin responses to human corticotropin-releasing hormone stimulation test in normal children and children with premature pubarche.

To determine whether CRH affects adrenal androgen, beta-endorphin (B-E), and ACTH secretion in normal children during sexual maturation, 17-hydroxyprogesterone (17-OHP), androstenedione (D4-A), dehydroepiandrosterone (DHEA), DHEA sulfate (DS), cortisol, B-E, and ACTH were measured after an iv injection of 1 microgram/kg human CRH. Children with premature pubarche were similarly analyzed to establish whether this condition is accompanied by altered hormonal responses to CRH. CRH produced consistent increases in ACTH, B-EP, and cortisol blood levels, which were comparable at all age intervals in all groups. 17-OHP increased after CRH injection, but its response linearly with age. D4-A levels were not influenced, while DHEA and DS levels were only partially influenced by CRH. The stimulated D4-A to 17-OHP ratio increased with sexual maturation, whereas ratios of cortisol to 17-OHP and D4-A to DHEA remained constant. Children with premature pubarche had hormonal responses similar in magnitude to those of prepubertal children of comparable age. In conclusion, an increase in 17,20-desmolase efficiency occurs with postnatal maturation after CRH challenge. Moreover, CRH does not appear to play an important role in premature pubarche.

17-alpha-Hydroxyprogesterone↗

Absent B-endorphin response to clonidine in obese children.

Plasma B-Endorphin (B-EP), Growth Hormone (GH) and cortisol response to 100 mcg/m2 b.s., i.v. clonidine (an alpha 2-adrenergic agonist) were evaluated in 17 normal weight children (8 prepubertal and 9 pubertal) and in 15 children with simple exogenous obesity (7 prepubertal and 8 pubertal, weight excess ranging from 29% to 97%). All the hormones were measured by radioimmunoassay either directly in the plasma (GH and cortisol) or after extraction and chromatography (B-EP). Obese prepubertal and pubertal children showed basal B-EP levels significantly higher than in controls and no differences were found in GH and cortisol levels. While in controls clonidine stimulated a significant release of plasma GH and B-EP in obese patients, irrespective of pubertal development, no changes were found. Cortisol levels decreased in both groups. These data suggest an impaired adrenergic control of GH and B-EP secretion in children with simple exogenous obesity.

Child↗

Effect of GnRH administration on blood polyamines and LH levels in normal and obese children.

Blood polyamines (spermidine and spermine) and LH levels have been studied after acute GnRH injection both in obese and normal weight children. In both groups LH values significantly increased after stimulation but reached higher peaks in normal children than in obese ones (P less than 0.05). On the contrary, polyamine levels increased significantly only in the normal weight children. LH peaked at 30 min and polyamines at 60 min after GnRH injection. On the basis of the proposed role of polyamines in hormone action and of our results, we suggest that polyamines may play a pivotal role in hormone responsiveness of hypothalamic-hypophyseal axis.

Adolescent↗

Impairment of the opioidergic control of luteinizing hormone secretion in Turner's syndrome: lack of effect of gonadal steroid therapy.

We studied the activity of endogenous opioid peptides in regulating LH secretion in patients with Turner's syndrome. To do so, we determined the LH secretory response to opiate receptor blockade by naloxone (0.08 mg/kg BW, iv) in 17 patients (age range, 9-23 yr). Eight patients were untreated (3 of whom had had spontaneous menarche), and 9 patients were taking ethinyl estradiol/medroxyprogesterone acetate treatment (5 of these patients were also studied before treatment). In addition, the plasma LH responses to GnRH (50 micrograms, iv) and placebo were determined in the patients as well as in 13 age-matched normal girls (6 prepubertal and 7 pubertal). Naloxone did not increase plasma LH levels in the amenorrheic untreated and treated patients with Turner's syndrome. However, in the 3 patients who had had spontaneous menarche and in normal pubertal girls naloxone increased plasma LH levels. GnRH was effective to the same extent in the patients and normal subjects. These results indicate that in patients with Turner's syndrome the opioidergic inhibition of LH secretion is impaired and is not restored by gonadal steroid replacement therapy. Moreover, the normal plasma LH responses to naloxone in the spontaneously menstruating patients with Turner's syndrome indicate both the clinical variability of this syndrome and the participation of endogenous opioid peptides in the regulation of normal menstrual function.

Adolescent↗

Impaired beta-endorphin response to human corticotropin-releasing hormone in obese children.

In order to evaluate the secretion of beta-endorphin in obese children and adolescents, we measured plasma beta-endorphin, ACTH and cortisol levels before and following administration of CRH (1 microgram/kg). Fourteen normal weight and 22 obese subjects (weight excess ranging from 30 to 98%) were studied. Plasma hormone levels were measured by radioimmunoassay directly in plasma (cortisol, ACTH) and after silicic acid extraction and Sephadex G-75 column chromatography (beta-endorphin). Basal beta-endorphin levels in obese children were significantly higher than in controls (14.7 +/- 1.8 vs 6.0 +/- 0.6 pmol/l; mean +/- SEM). No differences were found in basal ACTH and cortisol levels. CRH administration significantly increased beta-endorphin, ACTH and cortisol levels in normal subjects and ACTH and cortisol levels in obese subjects. Plasma beta-endorphin levels in obese children and adolescents did not show any significant increment. These data confirm the higher than normal beta-endorphin plasma levels in obese subjects in childhood and demonstrate that CRH is unable to increase beta-endorphin levels, suggesting an impairment of the hypothalamo-pituitary control mechanisms or an extra-anterior pituitary source.

Adolescent↗

Final height in a group of untreated children with constitutional growth delay.

We retrospectively evaluated the growth of 41 children with constitutional growth delay followed till adulthood and never treated with growth-promoting therapies. Final height has been correlated with prepubertal height, genetic target and height prediction calculated in both prepuberty and puberty. All patients showed a significant improvement of their height standard deviation score (HSDS) from prepuberty to adulthood, and the great majority of them achieved a final height above the 3rd percentile. Moreover, we found a good correlation between final height and both genetic target and height prediction, even if the latter overestimated final height in 25% of the patients. In conclusion, our data confirm that constitutional growth delay is a normal variant of growth. Therefore, caution should be paid in considering pharmacological treatment of this condition.

Adolescent↗

Plasma adrenocorticotropin, cortisol, and dehydroepiandrosterone response to corticotropin-releasing factor in normal children during pubertal development.

The adrenocorticotropin (ACTH), cortisol, and dehydroepiandrosterone responses to synthetic human corticotropin-releasing factor (CRF) were studied in 28 endocrinologically healthy children (age 1-16 yr) and in six adult volunteers (age 24-42 yr). CRF was given as an intravenous bolus (1 microgram/kg body weight) between 0900 and 1000 hr. Significant increments in ACTH and cortisol levels after CRF were observed in all subjects, with an ACTH peak value of 48.2 +/- 3.4 pg/ml at 10 min (p less than 0.001). The ACTH and cortisol response patterns after CRF did not change with age or pubertal maturation and did not differ in children and in adults. In contrast, the dehydroepiandrosterone response to CRF clearly was related to the stage of pubertal development. The peak value after CRF significantly increased from puberty stage 1 to puberty stage 5 (164 +/- 18 versus 779 +/- 86 ng/100 ml, p less than 0.001). In adults, the mean dehydroepiandrosterone peak value after CRF did not differ from that of P5 children. These results show that CRF can be given safely to children. The absence of age-dependent ACTH and cortisol responses and a dehydroepiandrosterone response changing with pubertal maturation points to the existence of factors involved in the control of adrenal androgen production other than ACTH.

Adolescent↗

Combination of mitomycin, vindesine, and cisplatin in the treatment of head and neck squamous cell carcinoma.

Thirty patients with squamous cell carcinoma of the head and neck were treated with a combination of mitomycin (10 mg/m2, Day 1), vindesine (3 mg/m2, Days 1 and 8), and cisplatin (60 mg/m2, Day 1), repeated every 28 days. Seven patients were previously treated by surgery, radiotherapy, or chemotherapy, and 23 had untreated advanced tumors. Objective responses were seen in 17 of 27 evaluable patients (63%), with three (11%) complete remissions. Moderate myelosuppression was the main toxic effect. Considering the advanced tumor staging (54% N3 tumors), this chemotherapeutic regimen appears as effective as other cisplatin-based chemotherapies.

Adult↗

Plasma endorphins in Rett syndrome: preliminary data.

Plasma levels of beta-endorphin (beta-EP) and prolactin (PRL) were measured in 5 girls with Rett syndrome and in a control group before and after giving 10 mg metoclopramide i.v. beta-lipotropin (beta-LPH) was only measured in basal conditions. Basal values of beta-EP and beta-LPH were lower than in control individuals. The responses of plasma beta-EP to metoclopramide in Rett syndrome patients were less intense than in control individuals, while the PRL increase in girls with Rett syndrome was significantly higher than in control subjects. These preliminary data suggest a derangement of the dopaminergic system.

Adolescent↗

Infantile cystinosis and insulin-dependent diabetes mellitus.

A 13-month-old infant was admitted to our Institution because of difficult metabolic control of diabetes mellitus. Clinical and laboratory findings revealed that the child was affected by both insulin-dependent diabetes mellitus and nephropathic cystinosis. Treatment with indomethacin was associated with growth improvement at an early stage of renal insufficiency, but not in more advanced renal failure.

Cystinosis↗

Effects of intravenous TRH on growth hormone and cortisol serum levels in children and adolescents with insulin dependent diabetes mellitus.

The effects of an iv thyrotropin releasing hormone (TRH) bolus on serum growth hormone (GH) and cortisol levels were evaluated in 59 children and adolescents with insulin dependent diabetes mellitus (IDDM) and in 24 healthy, age-matched control subjects. In the IDDM group GH baseline levels sharply rose within 30 min after TRH and successively normalized. On the contrary, TRH injection failed to affect GH serum concentrations in the control group. The GH increase after TRH in IDDM patients was positively correlated to age, but unrelated to other variables, such as sex, pubertal stage, duration of disease, glycemia, glycosylated hemoglobin, thyrotropin and T4 concentrations. Twenty-one out of 59 diabetics and only 1/24 controls exhibited a paradoxical GH response to TRH, arbitrarily defined as a precocious increase (within 30 min), of more than 100% with respect to the baseline value, associated with a GH peak greater than 10 ng/ml. Eighteen IDDM patients underwent a second TRH test 12 to 24 months later and substantially exhibited the same GH pattern documented the first time. The mechanism responsible for such anomalous GH responsiveness to TRH in IDDM is unclear. However, it cannot be attributed to a nonspecific stress reaction, as proven by the lack of a concomitant increase of cortisol serum levels in the same subjects.

Adolescent↗

Naloxone-induced luteinizing hormone secretion in normal, precocious, and delayed puberty.

The aim of the present study was to evaluate the activity of opiate receptors involved in the control of LH secretion during pubertal development, as determined by the LH response to naloxone. Normal children (n = 28) of both sexes, subdivided according to breast (girls) or testicular (boys) development, and patients with idiopathic precocious puberty (n = 7), delayed puberty (n = 8), or hypergonadotropic hypogonadism (n = 4) were studied. Plasma LH levels were measured after the administration of naloxone (NLX; 0.08 mg/kg BW, iv), GnRH (50 micrograms, iv) or placebo. In healthy subjects, NLX significantly increased plasma LH levels only in girls and boys at the most advanced stage of gonadal maturation. NLX was ineffective in prepubertal and early pubertal children, and it did not significantly alter LH levels in children with delayed puberty or hypogonadism or in most of the children with precocious puberty. GnRH injection consistently increased plasma LH levels in healthy subjects as well as in the children with pubertal disturbances. These results indicate that the LH response to NLX occurs only at the most advanced stages of pubertal maturation when normal or precocious and is absent in early puberty or in children with pubertal disturbances. Furthermore, the results suggest that opioid regulation of LH secretion in humans changes during puberty, reaching an adult-like functional state with maturation of the hypothalamus-pituitary-gonadal axis.

Adolescent↗