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Biomedical subjects

A Spagnolo

Publications and source records attributed to A Spagnolo.

At least 19 recordsLinked to original sources
PubMed2006

Rhabdomyolysis due to severe hypokaliemia in a Crohn's disease patient after budesonide treatment.

Patients with Crohn's disease may experience several non-digestive complications, including muscle disorders. Rabdomyolysis has rarely been reported in patients with inflammatory bowel disease, however a number of factors may cause muscular damage in this setting. We report the case of a young woman with Crohn's disease who developed a severe, symptomatic skeletal muscle damage associated with severe hypokaliemia. Reversal of the potassium levels to normal ranges led to clinical resolution. The possible causes that might have lead to hypokalemia development and subsequent rhabdomyolysis are discussed with special emphasis for the potential causative role of medical treatment, especially budesonide for which similar side effects have been previously reported. Physicians should be aware that hypokalemia is possible in the setting of Crohn's disease and muscle damage can present as a complication.

Adult↗
PubMed2005

Receptor-independent actions of PPAR thiazolidinedione agonists: is mitochondrial function the key?

Agonists of the peroxisome proliferator activated receptor gamma (PPAR(gamma)) are currently used for treatment of type 2 diabetes due to their insulin sensitizing and glucose metabolism stabilizing effects. More recently some of these same agonists were shown to exert anti-inflammatory and anti-proliferative effects as well. Although PPAR(gamma) agonists can operate via receptor-mediated events occurring at the genomic level, thereby causing long lasting changes in gene expression patterns, recent studies demonstrate non-genomic as well as genomic actions, and receptor-dependent as well as receptor-independent effects of the thiazolidinedione (TZD) class of PPAR(gamma) agonists. In this review we will summarize data describing some of these novel, receptor independent actions of TZDs, review evidence that TZDs directly influence mitochondrial function, and attempt to reconcile how changes in mitochondrial function could contribute to other receptor-independent actions of these drugs.

Animals↗
PubMed2004

[Hypertension in schoolchildren: research carried out in a secondary school in Rome and observations on dietary patterns].

AIM: The aim of this research was to evaluate the incidence of hypertension in adolescents by assessing their anthropometric measurements and diet, since recent literature data suggest that 30% of obese adolescents are hypertensive. METHODS: The 293 schoolchildren engaged in the study were aged 11-14 years and 54% were male. They attended a Secondary School in Rome with a middle-high class background. Blood pressure, heart rate, weight, height, tricipital and subscapular skinfolds and body mass index (BMI) were measured and dietary patterns assessed through 24-h recall. The findings were then statistically evaluated. RESULTS: The incidence of hypertension was 6.5%, without distinction between sexes. On the basis of the statistical evaluation of the correlations between hypertension and obesity, familial hypertension, weaning with the addition of salt and bottle-feeding from birth, only obesity was found to be statistically significant (p<0.001). Even though the hypertensive adolescents had a high intake of snacks, salt, meat, sausages and cheese in their daily diet, only the excess of proteins was statistically significant (p<0.05). The incidence of obesity (calculated as being 20% over the ideal weight for a given height) was 17.3%. This finding was confirmed by the mean value of the both skinfolds, whereas BMI, for which obesity and overweight were considered together, showed a slight overestimation of this percentage. CONCLUSION: A high number of hypertensive adolescents was found, about 1/3 of the obese adolescents examined. This confirms the findings of an extensive study previously carried out by the Group of Hypertension of the Italian Society of Pediatrics. From a nutritional point of view, the excessive intake of proteins of the 19 hypertensive adolescents was found to be statistically significant. However, a more extensive study could probably provide further data on other nutrients which, in this case, were not quite statistically significant.

Adolescent↗
PubMed2002

A population-based study on the frequency of additional congenital malformations in infants with congenital hypothyroidism: data from the Italian Registry for Congenital Hypothyroidism (1991-1998).

In the last decade a high frequency of other congenital anomalies has been reported in infants with congenital hypothyroidism (CH) detected by neonatal screening. In the present study the occurrence of additional congenital malformations (CM) in the population of CH infants detected in Italy between 1991 and 1998 (n = 1420) was investigated. In Italy all of the centers in charge of screening, treatment, and follow-up of CH adhere to the Italian National Registry of infants with CH. In this study a high prevalence of additional CM (8.4%), more than 4-fold higher than that reported in the Italian population (1-2%), was found in the population of CH infants. Cardiac anomalies represented the most frequent malformations associated with CH, with a prevalence of 5.5%. However, a significant association between CH and anomalies of nervous system, eyes, and multiple CM was also observed. In conclusion, the significantly higher frequency of extrathyroidal congenital malformations reported in the CH infants than in the general population represents a further argument supporting the role of a genetic component in the etiology of CH. Investigations of the molecular mechanisms underlying developmental events of formation of thyroid and other organs represent critical steps in the knowledge of CH etiology.

Abnormalities, Multiple↗
PubMed2002

[Computer-based preoperative planning for breast reconstruction in the woman with unilateral breast hypoplasia].

BACKGROUND: Aim of this paper is to describe a computer program which can provide objective and quantitative data useful for the selection of the proper implant in order to obtain the symmetry with the contralateral breast in case of unilateral breast reconstruction by tissue expansion, especially for the surgeon without experience or for the occasional operator. METHODS: Our C++ program provides the final implant volume using the measurements of the semi-circumference and projection of the contralateral breast performed on the supine patient. The aim is the symmetry of the two breasts. RESULTS: According to our experience in breast reconstruction by tissue expanders, this program allows non invasive and simple measurements of the breast volume, useful to obtain the mammary symmetry. CONCLUSIONS: In case of breast reconstruction by tissue expansion, the preoperative evaluation is usually based on the surgeon's experience and on empirical observations without knowing the correct volume to reach. For this reason our program is useful to know the necessary volume for breast reconstruction, and therefore it allows the surgeon to obtain a better plastic result.

Adult↗
PubMed1999

Risk factors for the development of respiratory distress syndrome and transient tachypnoea in newborn infants. Italian Group of Neonatal Pneumology.

Respiratory distress syndrome (RDS) and transient tachypnoea (TT) are the most frequent acute respiratory diseases in the newborn. This study investigated the risk factors for RDS and TT in newborn infants. A population of 63,537 newborns was enrolled in a 12-month survey in Italy, 734 (1.15%) affected by RDS and 594 (0.93%) affected by TT. Multivariate regression analysis of maternal and perinatal data and the calculation of odds ratios (with 95% confidence intervals) were performed. It was demonstrated that gestational age, birthweight, maternal age, elective and emergency caesarean section (CS), and male sex were risk factors for RDS, while gestational age, maternal diseases, twinning, birthweight, operative vaginal delivery, elective and emergency CS, and male sex were risk factors for TT. The data confirm previous reports and demonstrate that advanced maternal age is a risk factor for RDS, while ruling out maternal diseases as independent risk factors for RDS.

Adult↗
PubMed1999

Blood pressure in childhood and adolescence: the Italian normal standards. Study Group on Hypertension' of the Italian Society of Pediatrics'.

OBJECTIVES: To develop a national standard level of blood pressure (BP) for Italian children on the basis of a large sample of the population. DESIGN: We analyzed data available from 21 Italian studies conducted according to the recommendations of the American Task Force between 1988 and 1994. Percentile curves of systolic and diastolic BP were constructed by fitting a third-order polynomial model of BP on age and height using multiple regression analysis. PARTICIPANTS: BP was measured in 11 519 healthy individuals (6258 boys and 5261 girls) aged 5-17 years in various locations throughout Italy. All measurements were performed at school. RESULTS: Percentile curves (5th, 10th, 25th, 50th, 75th, 90th and 95th) of systolic and diastolic BP are reported by age and by height for males and females. CONCLUSIONS: With respect to the American standards, the levels in Italy for the 90th and 95th percentiles were 3-8 mmHg higher for systolic and diastolic BP in both sexes between 5 and 12 years of age, and 2-3 mmHg higher in older males. With respect to Northern Europe, in the lower ages, levels in Italy were quite similar, although slightly higher, whereas in late adolescence, the Northern European levels were much higher, especially in males, with differences of 4-5 mmHg for the mean values and 8-12 mmHg for the 95th percentile.

Adolescent↗
PubMed1998

Acute neonatal respiratory distress in Italy: a one-year prospective study. Italian Group of Neonatal Pneumology.

A prospective multicentre 12-month survey of neonatal respiratory disorders in 63 537 Italian infants was performed to evaluate the incidence of acute neonatal respiratory disorders and of the main related complications. A total of 1427 developed respiratory disorders (2.2%), 208 of whom died (14.6%). The incidence of respiratory distress syndrome was 1.16%, with a case fatality rate (CFR) of 24%; that of transient tachypnoea was 0.93%, with a CFR of 1.3%. The rates of meconium aspiration syndrome, persistent pulmonary hypertension and pneumonia were 0.06%, 0.02% and 0.07%, with CFRs of 10.3%, 38.5% and 21.7%, respectively. The occurrences of the main complications in affected newborns were: bronchopulmonary dysplasia 5.6%, necrotizing enterocolitis 1.7%, patent ductus arteriosus 9.8%, 3 degrees and 4 degrees grade intraventricular haemorrhage 6.8% and air leak 4.9%. It was concluded that the incidence of acute neonatal respiratory disorders and the main related complications was lower than that reported two decades ago and that the CFR of acute neonatal respiratory disorders had increased. These results may be the consequences of (i) progress in the management of high-risk pregnancies, (ii) an increased number of viable infants with extremely low birth weight and (iii) diffusion of antenatal treatment with corticosteroids which, in this series, seemed to reduce the morbidity but not the mortality in the high-risk infants.

Acute Disease↗
PubMed1998

Epidemiology of neonatal acute respiratory disorders. A multicenter study on incidence and fatality rates of neonatal acute respiratory disorders according to gestational age, maternal age, pregnancy complications and type of delivery. Italian Group of Neonatal Pneumology.

A prospective 3-month survey of neonatal respiratory disorders in 17,192 Italian infants born in 65 hospitals, located in 17 Italian regions representative of northern, central and southern Italy, was performed to evaluate the incidence of neonatal acute respiratory disorders and their risk factors. The prematurity rate was 7.3%, while the extremely low birth weight (< 1,000 g) and very low birth weight (< 1,500 g) rates were 0.58% and 0.99%, respectively. Four hundred and ninety-one infants (2.8%) developed respiratory signs. Lethality or specific fatality rate (SFR) for acute respiratory disorders with regard to the overall study population was 0.45%. The male/female ratio of affected infants was 1.3:1. Among affected newborns the case fatality rate (CFR) for respiratory disorders was 15.88% (78/491) and was higher in males than in females (2:1), in infants with a gestational age of < or = 28 weeks (60%) and birth weights of < 1,000 g (50%). Moreover, the SFR was higher (p < 0.05) in the infants of mothers older than 34 years. SFR was 3.0% in intrauterine growth-retarded infants, 3.6% in the first twin and 3.2% in the second twin. An Apgar score of < or = 3 at 5 min was strongly related to the incidence of respiratory disorders (47.1%). The antenatal prevention of neonatal respiratory distress syndrome with maternal corticosteroid treatment was performed in 84% of newborns (< 32 weeks) with respiratory problems in northern Italy, and about 25% and 38% in central and southern Italy, respectively. The CFR was double in southern Italy as compared with northern and central Italy. Prematurity, low birth weight and a low Apgar score (< or = 3) at 1 and 5 min as well as a maternal age of > 34 years are risk factors for acute respiratory disorders.

Acute Disease↗
PubMed1998

[Activity of the Istituto Superiore di Sanitá regarding medically assisted reproduction].

In vitro fertilization and embryo transfer, embryo cryo-preservation, multiple pregnancies, embryo reduction, embryo and gamete donation: each of these questions deserves an articulate ethical and medical discussion. In Italy until this moment we do not have a legislation for the regulation of medically assisted reproduction. One of the most suitable means to monitoring large scale initiatives for medically assisted procreation is through registries that collect standardized information on all treatment cycles performed. In 1992, the Italian national registry on medically assisted procreation was established at the Istituto Superiore di Sanità (ISS, the Italian National Health Institute). The Registry collects data sent voluntarily by centers to the ISS for each cycle of treatment started and for each outcome. The data collected can be used to conduct an adequate statistical-epidemiological analysis and to better evaluate results of specific techniques.

Academies and Institutes↗
PubMed1998

[Study of the health status of subjects born with medical-assisted reproduction: the connexion between epidemiology and bioethics].

The knowledge of the newborns' health status from medical assisted procreation techniques represents the main objective of public health in this field. It is not acceptable, in fact, the use of fertilisation and artificial insemination techniques without a correct evaluation of these newborns' health status. As probable risks exist in medical protocols of treatments (mothers' exposition to hormonal drugs, manipulations of gametes, embryo development in growing coculture with different animal cells, cryopreservation, lack of natural selection of spermatozoa in intracytoplasmatic sperm injection techniques), a check of the results of these techniques is extremely necessary. Newborns' health status must be detected not only at delivery time but also in the following period to evaluate the right physical and psychological development. To estimate infertility risk that these children might run after their mothers' hormonal treatment, it is necessary to follow these subjects till adult age.

Bioethics↗
PubMed1997

Liver inflammation and acute respiratory distress syndrome in a patient receiving hepatitis B vaccine: a possible relationship?

We describe a patient in whom clinical evidence of liver and lung dysfunction developed after he received the second dose of recombinant hepatitis B vaccine, despite no serologic evidence of viral hepatitis. However, liver biopsy specimens demonstrated both surface antigens and core antigens, possibly indicating silent hepatitis B virus infection. A search for an infective etiology for the patient's subsequent clinical deterioration in lung function did not yield pathogens: postmortem examination revealed evidence of immune complex-mediated organ injury in the liver, lungs, and kidneys.

Antigen-Antibody Complex↗
PubMed1997

Clinical approach to the analysis of causes of death in the first two years of life of very-low-birthweight infants in a multicentre setting.

Mortality in the first 2 years of 634 very-low-birthweight infants admitted to eight neonatal intensive care units in Italy, and the factors associated with the net probability of death from each cause, were studied by means of the Cox proportional hazard model. A clinical classification of the causes of death was used. Overall mortality was 33.7% (intercentre range 12.6-52.9%). The highest cause-specific mortality rates were observed for respiratory problems, intra-ventricular haemorrhage (IVH) and infections (14.5%, 6.3% and 5.7% respectively). The leading causes of death were respiratory problems and IVH in the first week of life, infections from the second week up to the end of the first month, and bronchopulmonary dysplasia (BPD) afterwards. Birthweight < 1000 g, gestational age < 30 weeks, absence of spontaneous respiratory activity, unknown body temperature and pH < 7.20 at admission were associated with death from respiratory problems and IVH. Male sex, birthweight < 1000 g and unknown body temperature at admission were associated with death from BPD. Mortality from infections was higher in one centre; no other differences emerged among the eight NICUs. The classification of the causes of death employed and the use of the net probabilities of death appear as practical and useful instruments to study the relationship between specific aspects of medical care and mortality, and to investigate the reasons for differences in performance between neonatal units.

Cause of Death↗
PubMed1996

Spirometric prediction equations for male Italians 7-18 years of age.

The purpose of this study was to develop spirometric predictive equations (SPE) for forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and maximum midexpiratory flow (MMF25-75) derived from a large sample of healthy italian boys and male adolescents. We used the univariate and multiple linear regression models and considered as independent variables age and the following anthropometric measurements: height, weight, chest circumference. The predictive power of multivariate models was slightly higher than that of the univariate model using height as independent variable for FVC, FEV1 and MMF25-75.

Adolescent↗
PubMed1994

Italian multicentre study on very low-birth-weight babies. Neonatal mortality and two-year outcome.

The Italian multicentre study on very low-birth-weight babies is the first collaborative project in Italy on the health status of newborns weighing 500-1499 g at birth: 634 such babies were admitted in 1987-88 to eight Italian NICUs; 424 infants survived and were followed until two years of age, corrected for prematurity. Logistic regression analysis of pre-admission risk factors of in-hospital mortality identified eight statistically significant variables: birth weight, gestational age, sex, antepartum steroids, 1-min Apgar score and, on admission to the NICU, body temperature, pH and absence of spontaneous respiration. Using the equation derived from the logistic model, a theoretical mortality rate was calculated for each centre, predicted on the basis of the local incidence of preadmission risk factors. In no case was the predicted mortality significantly different from the observed one. At two years of age, 8 children were blind and 48 had motor disability. Of these, 46 had cerebral palsy: based on a functional evaluation score 14 had severe (degree 4), 20 intermediate (degree 3) and 12 mild cerebral palsy (degree 2). Among 25 variables entered in a logistic regression as risk factors for cerebral palsy, only periventricular leukomalacia and acidosis were significantly associated with the outcome.

Apgar Score↗