PubMed Health⌕ Search

Biomedical subjects

A Verrotti

Publications and source records attributed to A Verrotti.

At least 127 records · Page 7Linked to original sources
PubMed1996

Premature thelarche: a long-term follow-up.

The differentiation between premature thelarche and idiopathic central precocious puberty is essential for both long-term prognosis and therapeutic approach but, until now, there have been insufficient data to predict the future of the girls with premature thelarche. We studied 46 girls with premature thelarche longitudinally. The girls were subdivided into two groups according to the time of onset of thelarche: Group A consisted of 26 girls who presented thelarche before the second year of life (mean +/- SD 14.7 +/- 5.2 months) and Group B contained 20 girls who showed breast enlargement after the second year of life (5.7 +/- 3.1 years). The mean basal follicle-stimulating hormone (FSH) level of the patients as a whole was significantly higher than normal values (2.1 +/- 0.05 vs. 0.7 +/- 0.9 mIU/ml, p < 0.01) and the luteinizing hormone (LH) level was not significantly different from that in healthy control subjects (0.8 +/- 0.6 vs. 0.6 +/- 0.7 mIU/ml). After gonadotropin-releasing hormone test the FSH response was significantly higher than normal prepubertal values (12.9 +/- 2.1 vs. 3.9 +/- 2.9 mIU/ml, p < 0.001) whereas the LH response did not differ significantly (1.8 +/- 0.6 vs. 1.7 +/- 0.9 mIU/ml). After a follow-up time ranging from 5.1 to 7.8 years (mean +/- SD 5.9 +/- 1.9) we observed a greater percentage of disappearance in the girls in Group A than in those in Group B. The present data show that the percentage of girls who developed precocious puberty was significantly higher when they presented thelarche after the age of 2 years than before; the age of onset of thelarche can be useful to distinguish patients at risk of progressing towards precocious puberty.

Adolescent↗
PubMed1995

Influence of puberty on lipids and lipoprotein profile in children with type 1 diabetes mellitus.

In order to assess whether or not the lipoprotein profile worsens throughout puberty in children with type 1 diabetes mellitus and if this change is related to dietary compliance, we studied 46 (20 female, 26 male) children. At the beginning of the study, the mean age (+/- SD) was 10.9 +/- 1.1 years; all the children studied had reached a pubertal stage of P1, G1. The mean duration of diabetes (+/- SD) was 4.9 +/- 1.8 years. The diet and the lipoprotein profile of diabetic children were analysed at the beginning of the study and after 6 years. The quality of metabolic control of subjects studied had not changed significantly at the end of the study (haemoglobin HbA1c 7.6% +/- 2.1% vs 7.9% +/- 2.0%; NS). After puberty, the diabetic patients received more energy from carbohydrate and less from lipids. Total serum cholesterol and triglycerides and levels of low-density lipoproteins were significantly higher and of high-density lipoproteins lower in the diabetic patients after puberty than before (4.47 +/- 0.7 mmol/l vs 5.99 +/- 0.6, P < 0.01; 0.90 +/- 0.02 mmol/l vs 1.45 +/- 0.03, P < 0.01; 2.2 +/- 0.3 mmol/l vs 2.8 +/- 0.5, P < 0.01; 1.5 +/- 0.2 vs 1.1 +/- 0.2, P < 0.01, respectively). These results suggest a detrimental effect of puberty on lipoproteins; probably, dietary compliance plays a role in this worsening. Dietary education should be intensified during adolescence in order to present these changes.

Child↗
PubMed1995

Glomerular hyperfiltration increases the risk of developing microalbuminuria in diabetic children.

An elevated glomerular filtration rate (GFR) is frequently detectable in type 1 diabetic children and adolescents and in those without any other evidence of incipient diabetic nephropathy. In 1982 we detected 23 patients with hyperfiltration (GFR > 140 ml/min per 1.73 m2), aged 9-15 years, with diabetes for longer than 4 years; 23 age- and sex-matched patients with diabetes of a similar duration and without hyperfiltration served as controls. Both groups were followed until March 1992, by assessing GFR every 12 months, albumin excretion rate every 6 months, blood pressure and glycated haemoglobin (HbA1) every 3 months. Dietary protein intake was similar in patients with hyperfiltration and in controls. No other drug except insulin was used throughout the study. The insulin regimen was similar in the two groups. There was no significant difference between the two groups regarding albumin excretion, blood pressure and HbA1 at the beginning of the study. Of the 23 patients with hyperfiltration, 7 developed persistent microalbuminuria (defined as an overnight albumin excretion rate > 30 micrograms/min per 1.73 m2 on at least 5 consecutive measurements); 2 of these patients had overt proteinuria. Only 1 of the diabetics with normal GFR developed persistent microalbuminuria. The positive predictive value for microalbuminuria of an initial GFR > 140 ml/min per 1.73 m2 was 63%; the negative predictive value of an initial GFR < 140 ml/min per 1.73 m2 was 94%. The increase of albumin excretion rate into the microalbuminuric range precedes the elevation of both systolic and diastolic blood pressure.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1995

Colour vision and persistent microalbuminuria in children with type-1 (insulin-dependent) diabetes mellitus: a longitudinal study.

In an attempt to elucidate colour vision in children with type 1 (insulin-dependent) diabetes mellitus without fluorescein angiographic signs of retinopathy, we studied a group of 50 patients of mean age + or - SD 10.27 + or - 2.89 (range 8.1-13.0 years). Results were compared with a sex-and age-matched control group. The Farnsworth-Munsell 100-hue test showed a significantly higher value in total error score (TES) in diabetics than in controls (64.07 + or - 18.32 and 54.27 + or - 12.87, respectively: P = 0.0004). Diabetic patients were divided in two groups as regards presence of persistent microalbuminuria and followed for 7 years. The HbAlc values of the two groups were: normoalbuminuric 7.10 +/- 2.92%, microalbuminuric 9.79 + or - 1.41 (P = 0.004). Microalbuminuric patients showed a significantly higher TES than normoalbuminuric subjects both at the beginning (94.79 + or - 13.98 vs. 58.10 + or - 11.98) and end of the study (103.07 + or - 14.61 vs. 61.04 + or - 13.36: P < 0.0001), and after follow-up they had a worse TES than at the beginning of the study (P = 0.01); no change in TES was found in normoalbuminuric patients during the study. The results suggest that a deficit in colour vision occurs in diabetic children before the onset of fluorescein angiographic signs of retinopathy. Our follow-up shows that microalbuminuric patients present a significant worsening of colour vision. When a patient shows persistent microalbuminuria, colour vision must be carefully evaluated, also in subjects without fluorescein angiographic signs of retinopathy.

Adolescent↗
PubMed1995

Autonomic neuropathy in diabetic children.

OBJECTIVE: Evaluate the presence of cardiovascular autonomic nerve dysfunction in children and adolescents with insulin-dependent diabetes mellitus. METHODOLOGY: We studied 110 patients (54 male, 56 female) and 100 healthy sex and age-matched children. Autonomic nerve function was assessed by standard cardiovascular reflex tests: (1) Fall in systolic blood pressure in response to standing. (2) Heart rate in response to standing. (3) Beat-to-beat rate variation during deep breathing. (4) Quotient of heart rate during and after Valsalva manoeuvre. (5) Change in blood pressure response to sustained handgrip. The coefficient of variation of heart rate was determined from 150 systoles using a microcomputer-based technique. The lower limits of normal were defined according to statistical analysis taking into account the relationship between heart rate variability and age. RESULTS: Forty-seven of the 110 diabetic children and adolescents studied showed one or more abnormal tests for cardiovascular autonomic dysfunction; many patients had an abnormality in more than one test. Twenty-two patients showed early involvement, 18 patients had definite and 7 severe involvement. No correlation was found between sex, glycaemic control, duration of diabetes or presence of retinopathy and persistent microalbuminuria and the autonomic nerve function. CONCLUSIONS: In the paediatric age group also, autonomic nerve dysfunction can be present in asymptomatic diabetic patients. Heart rate variation during Valsalva manoeuvre and maximum/minimum 30:15 ratio are the most sensitive indices to detect autonomic abnormalities in children.

Adolescent↗
PubMed1995

Necrobiosis lipoidica diabeticorum in children and adolescents: a clue for underlying renal and retinal disease.

The prevalence of persistent microalbuminuria, retinopathy, and peripheral and autonomic neuropathy was assessed in 18 children and adolescents with type 1 (insulin-dependent) diabetes mellitus (IDDM) who suffered from necrobiosis lipoidica diabeticorum (NLD) and in 40 diabetics without NLD, matched for sex, age, duration of disease, and metabolic control. The mean +/- SD age of the patients was 15.1 +/- 8.6 years (range 7.9-23.9 yrs) and their duration of IDDM was 10.9 +/- 8.1 years (range 7.1-21.0 yrs). Their mean glycosylated hemoglobin level was 9.9 +/- 5.0% (7.3-16.6%) and their fructosamine level was 274 +/- 180 mumol/L (199-466 mumol/L). Patients with NLD had a higher frequency of persistent microalbuminuria (p < 0.001) and retinopathy (p < 0.001) than those without NLD. Our study suggests that children as well as adult diabetics with NLD can be at high risk for nephropathy and retinopathy; NLD can be a clue for diabetic nephropathy and retinopathy.

Adolescent↗
PubMed1995

Visual field defects in diabetic children without retinopathy. Relation between visual function and microalbuminuria.

The effects of diabetes on retinal function before the onset of clinically detectable retinopathy have been investigated with several methods. Our aim is to evaluate the usefulness of computerized perimetry in early diagnosis of retinal sensitivity impairment in lack of fluorescein angiographic signs of diabetic retinopathy. Seventy diabetic children and adolescents, 39 normoalbuminuric and 31 microalbuminuric patients, and 70 normal subjects were investigated with static computerized perimetry. Normoalbuminuric patients showed functional parameters similar to those of controls, while microalbuminuric patients had a significant reduction of mid-peripheral light sensitivity in comparison with both normoalbuminuric children and controls. Our data suggest that an impaired light sensitivity, in mid-periphery of the visual field, is present in diabetic patients with persistent microalbuminuria.

Adolescent↗
PubMed1995

Bone mineral content in girls with precocious puberty treated with gonadotropin-releasing hormone analog.

In order to evaluate the effects of gonadotropin-releasing hormone (GnRH) analogs on calcium metabolism, we studied 12 girls with central precocious puberty (CPP) who were treated with the GnRH agonist D-Trp6-GnRH every 28 days. The patients' mean age +/- SD was 5.9 +/- 2.1 years. The patients were studied before commencement and after 6 and 12 months of treatment. We also studied 12 age-matched healthy girls who served as controls. Bone mineral content was measured by dual-photon densitometry with 125I, in the distal third of the left radius. We evaluated the serum levels of calcium, phosphate, magnesium, parathyroid hormone, calcitonin, 25-hydroxy-vitamin D and the 24-h urinary excretion of calcium, phosphate and magnesium. All of these parameters were found to be normal before and during the treatment in both groups. At the beginning of the study, the patients with CPP had significantly higher bone mineral content than controls (0.51 +/- 0.12 g/cm2 vs. 0.39 +/- 0.09, p < 0.001); after 6 months contents were 0.42 +/- 0.11 vs. 0.41 +/- 0.05, p < 0.01; and after 12 months 0.44 +/- 0.11 vs. 0.44 +/- 0.05, NS, for treatment and control groups, respectively. This difference remained after 6 months of treatment, while after 12 months no significant difference between patients and controls was found. Our study shows that girls with CPP have an increased bone mineral content and that GnRH analogs modify bone density with a consequent reduction, it seems, that is not related to any of the calcium parameters studied.

Absorptiometry, Photon↗
PubMed1995

Effectiveness of nedocromil sodium in preventing exercise-induced asthma in children.

Exercise-induced asthma is a well-known phenomenon, particularly affecting children, with an important social impact. In order to assess the usefulness of nedocromil sodium in the prevention of exercise-induced asthma, we studied 49 (15 females, 34 males) children who suffered from asthma; their mean +/- SD age was 9.2 +/- 3.0 (range: 3.3-19.1) years. On the first day respiratory function was evaluated by spirometry, basally and after 6 minutes. The inhalation of nedocromil sodium had a great influence on post-exercise lung function measurements; in fact on the day of nedocromil sodium pretreatment, our patients showed an increase of respiratory function, significantly different from the parameters recorded during the first day. Our findings suggest that nedocromil sodium is effective in the prevention of exercise-induced asthma, in pediatric age.

Adolescent↗
PubMed1994

Fetal encephalopathy with cerebral calcifications: a case report.

The authors report a case of a newborn with severe encephalopathy and cerebral calcifications. The newborn was admitted to Neonatal Intensive Care Unit in Chieti at 2 days of age suffering from continuous generalized seizures. He was the child of healthy first-degree cousins. Cerebral ultrasonography showed bilateral ventricular dilatation and an intrathlamic hyperechoic image. Computed tomography and magnetic resonance imaging showed ventricular and corpus callosus hypoplasia, pachygyria, widespread delayed myelination areas, and basal nuclei and periventricular calcifications. All serum and urine analyses showed normal results. In particular, all demyelinizing metabolic diseases were excluded. Based upon these findings, we speculate that this infant may be suffering from fetal encephalopathy with cerebral calcifications.

Brain↗
PubMed1994

Genetic predisposition to hypertension (as detected by Na+/Li+ countertransport) and risk of diabetic nephropathy in childhood diabetes.

In order to evaluate whether insulin-dependent diabetes mellitus patients with incipient nephropathy have an overactivity of erythrocyte sodium-lithium countertransport (Na+/Li+ CT), 82 diabetic children and 38 healthy age-matched control subjects and their parents and grandparents were studied. The children were divided into two groups according to the presence of persistent microalbuminuria (MA). Diabetic children with MA had Na+/Li+ CT activity higher than normoalbuminuric diabetics and healthy controls. The parents and grandparents of microalbuminuric patients showed higher Na+/Li+ CT than parents and grandparents of normoalbuminuric diabetics and of the controls. This study demonstrates that predisposition to hypertension, as indicated by increased Na+/Li+ CT activity in erythrocytes, is more frequently detectable in patients with persistent microalbuminuria than in diabetics without persistent microalbuminuria or in healthy controls. Overactivity of Na+/Li+ CT is present also in parents and grandparents of diabetic children with MA. This study suggests that genetic predisposition to hypertension is more frequent in patients at risk of developing diabetic nephropathy, as well as in their parents and grandparents.

Adolescent↗
PubMed1994

Diabetic retinopathy. Relationship with nephropathy in pediatric age.

In order to evaluate the relationship between diabetic retinopathy and diabetic nephropathy we studied 55 (25 females, 30 males) retinopathic diabetic children and adolescents: their age ranged from 9.0 to 17.3 (mean +/- SD 13.9 + 3.8) years and the duration of disease from 4.8 to 10.0 (6.9 +/- 3.1) years. The mean glycosilated haemoglobin (HbA1c) was 10.4 + 2.7%. Patient distribution in relation to retinal grading showed that the greatest number of patients (34: 61.82%) were in 14-20 retinopathy level (with minimal signs of retinopathy), 9 patients showed 31 retinopathy level (16.36%) and 12 (21.82%) were in the other classes. Comparison between retinal grading of retinopathy and presence/absence of microalbuminuria showed a significant difference between the evaluated subgroups (p < 0.0001). In fact, only 6 patients out of 34 (17.64%) in class 14-20 retinopathy level, 8 patients out of 16 (50%) in 31-41 retinopathy level and 5 patients out of 5 (100%) in 51 retinopathy level had microalbuminuria. Our study shows that the presence of persistent microalbuminuria is an important risk factor for diabetic retinopathy. In conclusion, we suggest that when diabetic children have persistent microalbuminuria, the eye should be carefully examined, in order to prevent a deterioration of the eye function.

Adolescent↗
PubMed1994

[West syndrome. Clinical, diagnostic and therapeutic aspect].

The authors review the main clinical-electro-encephalographical and therapeutic aspects of the West syndrome (infantile spasms), underlying the problems related to long-term prognosis. The authors describe its clinical variants which, sometimes, can create some difficulties for differential diagnosis. Moreover, the difference between idiopathic and secondary (to pre- and peri-natal) problems syndrome is discussed.

Adrenocorticotropic Hormone↗
PubMed1993

Anti-epileptic therapy and behaviour disturbances in children.

In order to evaluate the effects on behaviour of some anti-epileptic drugs, we studied 300 children treated with phenobarbital and other drugs; their age ranged from 3.1 months to 15.9 years. The children were divided into two groups: group A: 197 (116 male and 81 female) children, mean age +/- SD 5.3 +/- 2.8 years, treated with phenobarbital; group B: 103 (66 male and 37 female) children, mean age 6.4 +/- 3.1 years, treated with anti-epileptic drugs other than phenobarbital. In all patients hyperactivity, irritability, disturbances of sleep, and drowsiness were investigated. The parents of patients completed a questionnaire with seven items. In group A, 150 (76.1%) children showed one or more behaviour disturbances, while in Group B a smaller number of patients 32 (31%) had such disorders. There was a significant difference between the two groups (P < 0.0001). The most frequent disorder was hyperactivity. The results of this study suggest that anti-epileptic drugs, in particular phenobarbital, can cause behaviour disturbances.

Anticonvulsants↗