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Biomedical subjects

C Lenti

Publications and source records attributed to C Lenti.

At least 19 recordsLinked to original sources

Crying abnormalities in congenital hypothyroidism: preliminary spectrographic study.

The aim of this preliminary study was to evaluate the acoustic patterns of the cries of hypothyroid newborns at the time of diagnosis and after the beginning of therapy. Cries were recorded at the nursery of the San Raffaele Hospital, Milan, Italy from 12 full-term subjects (three boys and nine girls) affected by congenital hypothyroidism. Results show that untreated hypothyroid infants at first recording had fewer voiceless and partially voiced cries than normal controls. The percent distribution of this pattern did not change at the second recording after the onset of substitutive therapy. Also, untreated hypothyroid infants had many more cry units showing a vibrato contour than did controls, and this pattern did not change after the onset of treatment. Starting, maximum, minimum, and end frequencies measured on the fundamental were significantly lower in the hypothyroid sample. Four hypothyroid subjects recorded before therapy and within 4 weeks after therapy onset significantly augmented their fundamental frequency parameters; however, in 25% of the sample, sound parameters remained unaltered after 3 or more weeks of treatment. To our knowledge the present preliminary study is the first one performed on follow-up of hypothyroid newborns and indicates that both central and peripheral damage might influence the pattern of crying in untreated hypothyroid infants.

Congenital Hypothyroidism↗

Recognition of emotional facial expressions in depressed children and adolescents.

Of the neurobiological models of children's and adolescents' depression, the neuropsychological one is considered here. Experimental and clinical evidence has allowed us to identify a lateralization of emotional functions from the very beginning of development, and a right hemisphere dominance for emotions is by now well-known. Many studies have also correlated depression with a right hemisphere dysfunction in patients of different ages. The aim of our study was to analyze recognition of different facial emotions by a group of depressed children and adolescents. Patients affected by Major Depressive Disorder recognized less fear in six fundamental emotions than a group of healthy controls, and Dysthymic subjects recognized less anger. The group of patients' failure to recognize negative-aroused facial expressions could indicate a subtle right hemisphere dysfunction in depressed children and adolescents.

Adolescent↗

Serum calcitriol and dietary protein intake in idiopathic calcium stone patients.

In kidney stone patients, high protein intake and calcitriol overproduction are factors leading to hypercalciuria, but there are conflicting reports on the effects of dietary protein on calcitriol production. To investigate the relationships between serum calcitriol, dietary protein intake, and urinary calcium excretion, 33 male idiopathic calcium stone formers (aged 20-60 years), with normal renal function and on unrestricted diet, have been studied. Dietary protein intake was estimated by the protein catabolic rate determination. Abnormally elevated calcitriol levels were found in 16 patients (48.5%) who had similar levels of serum intact parathyroid hormone and phosphate, creatinine clearance, and calcium and phosphate urinary excretion, but lower protein catabolic rate (82+/-16 vs. 97+/-20 g/day, P<0.05) than the patients with normal calcitriol levels. The calcitriol to intact parathyroid hormone ratio was higher in hypercalciuric than in normocalciuric patients (2.4+/-1.1 vs. 1.6+/-0.8, P<0.05). Calcitriol was positively correlated with plasma calcium (r=0.41, P<0.01) and inversely with protein catabolic rate (r=-0.42, P<0.01). Protein catabolic rate was positively correlated with creatinine clearance (r=0.69, P<0.001) and urinary phosphate excretion (r=0.72, P<0.001). No relationship was observed between calcitriol and creatinine clearance. These results confirm the calcitriol overproduction in calcium stone disease and that the high calcitriol to intact parathyroid hormone ratio is the main feature associated with hypercalciuria. Calcitriol serum levels appear to be unrelated to creatinine clearance, whereas there is an inverse relationship with protein catabolic rate. This suggests that low rather than high dietary protein intake may favor the increase of calcitriol synthesis in male calcium stone formers with normal renal function.

Adult↗

Panic disorder or temporal lobe epilepsy: A diagnostic problem in an adolescent girl.

Similarities in the clinical presentation of panic disorder and temporal lobe epilepsy suggest that the two disorders are related and can lead to difficulties in a differential diagnosis. We describe the case of a young girl suffering from paroxysmal anxiety, derealization-depersonalization and autonomic symptoms, lasting from seconds to several minutes; these episodes were very frequent and disabling. The interictal EEGs and MRI were normal. After having diagnosed panic disorder based mainly on the duration of the attacks and the family history, a pharmacological treatment was started.

Adolescent↗

Decoding of emotional expressions in children and adolescents.

The aim of this study was to assess whether different kinds of emotions are decoded in different ways during ontogeny. 151 normal subjects (80 boys; 71 girls) aged 8 to 16 were recruited in primary, secondary (middle), and high schools and 46 slides (3 male; 3 female) from Picture of Facial Affect showing six basic emotions were stimuli. Analysis showed that boys and girls in all age groups did not differ in decoding facial expression; happiness and disgust had the highest percentage scores in all age groups, 99% and 94%, respectively, while sadness and fear had the lowest percentage scores, 69% and 55%, respectively. This was possibly due to the intrinsic unpleasantness of those emotions for children. Competence in discrimination of sadness, fear, and surprise changed across age groups, but this growing competence did not show a linear trend and was not similar for all emotions.

Adolescent↗

Myoclonic encephalopathy and diabetes mellitus in a boy.

We describe an 18-month-old boy with insulin-dependent diabetes mellitus who developed idiopathic myoclonic encephalopathy (dancing eye syndrome) at 26 months of age. The neurological symptomatology (multifocal myoclonus, opsoclonus, ataxia, behavioural disturbance) developed within 10 to 14 days after presentation. Biological, neuroradiological, and scintigraphic examination excluded CNS infectious diseases, intoxication, or tumours. At onset of diabetes mellitus, anti-glutamic-acid decarboxylase (GAD) antibodies were observed, and markedly increased in titre when myoclonic encephalopathy occurred. Corticosteroid treatment resulted in a decrease in anti-GAD autoantibody titres and the disappearance of neurological disturbances. As GAD is expressed both in pancreatic beta-cells and cerebellar Purkinje cells, it is possible that a common autoimmune disorder in this patient may account for both the diabetes and myoclonic encephalopathy.

Autoimmune Diseases↗

Dietary treatment of diabetic nephropathy with chronic renal failure.

Thirty-two patients with diabetes mellitus (22 IDDM and 10 NIDDM, 21 males and 11 females, age 44+/-11.8 years) were followed for 5.2+/-3.8 years after the onset of chronic renal failure, with the aim of evaluating the effect of low protein diets on the rate of decline of the residual renal function. During the 1.8+/-1.6 year follow-up period on free or uncontrolled low protein diet the mean rate of decline of creatinine clearance was 0.9+/-0.6 ml/min/month, significantly greater than that observed during 3.7+/-3.1 years on low or very low protein diets. The reduction of protein intake was followed by a significant decrease in daily urinary protein loss. A better glycaemic control was obtained on the low protein diet, and the daily insulin requirement decreased. The anthropometry, as well as the serum concentrations of rapid turnover proteins, did not change, in spite of the low or very low protein dietary supply for a long duration. The values of mean arterial pressure were quite similar during the follow-up period on free or uncontrolled low protein diet and during the study period on the low protein diet. A good compliance with reduced dietary intake (as demonstrated by the measurement of the daily urea excretion) was obtained in a large number of patients. In conclusion, our study confirms the protective effect on the residual renal function of low protein diets in IDDM and NIDDM patients with chronic renal failure due to diabetic nephropathy, in the absence of any sign of protein malnutrition.

Amino Acids↗

Newborns crying in different contexts: discrete or graded signals?

The aim of this study was to investigate whether human infants' cries show individually and contextually discriminable acoustic parameters. 20 full-term normal human newborns (aged 1 to 4 days) had their cries recorded during routine blood withdrawal (pain context) 30 min. before a scheduled feeding (hunger context) and when subjected to kinetic stimuli during neurological examination (manipulation context). Type of cries, melodic contours, F0 parameters, but not the "macro" trend of the start of the fundamental frequency, indicated a difference in pain cries in the other two contexts. All the acoustic features considered showed an individual specificity. The peak frequencies of voiceless or partially voiced wails had the interesting property of being optimised as long distance signals. We hypothesised that this feature of infants' cries may have evolved in a time window when the infants were left in collective nurseries and not carried on the mothers' backs as maintained by the traditional view.

Acoustics↗

Discordant clinical and neuroradiological features of congenital bilateral perisylvian syndrome in monozygotic female twins.

We here report a case of monozygotic female twins, only one of whom had congenital bilateral perisylvian syndrome (CBPS). The affected girl had all of the essential and some additional diagnostic criteria according to Kuzniecky et al. [1993]; her twin sister was completely normal both clinically and neuroradiologically. This observation may contribute towards our understanding of the etiopathogenetic mechanisms of cortical dysplasia in CBPS: fetal brain ischemia or hypoxia in only one twin seems to be a reasonable explanation in this particular case.

Adolescent↗

IgG2 deficiency in children with febrile convulsions: a familial study.

The IgG subclasses were investigated in children with febrile convulsions (FC) and in their first degree relatives in the search for a selective immunological deficiency associated with FC and its occurrence in the relatives of affected subjects. The results of the study show lower IgG2 concentrations in FC patients than in controls. But it was not possible to demonstrate familial transmission of the IgG2 subclass deficiency, since it was present only in children with FC and tended to normalize in adulthood. The immunoglobulin subclass deficiency might be responsible for the recurrent infections connected with FC.

Adolescent↗

Neuropsychological and neuroradiological study of a case of early-onset Huntington's chorea.

The authors report a case of Huntington's disease in an 11-year-old boy with onset at six years of age. The neurological signs and symptoms were midway between the hyperkinetic and rigid forms of chorea. Intellectual development was characterized by a medium-grade deficit. MRI revealed marked atrophy of the head of the caudate nucleus, with diffuse hyperintensity of the putamen. The most characteristic neuropsychological feature was ideomotor apraxia. Neuropsychological and neuroradiological data are discussed in relation to the role of the basal nuclei and frontal cortex in the organization of movement.

Apraxias↗

Tactile extinction on complex stimulation in normal children.

The Schwartz Quality Extinction Test was administered to 221 normal right-handed children aged 4 to 7 years to find out at what age their ability to perceive complex bimanual simultaneous stimuli stabilizes. Tactile extinction was present in some 4- and 5-yr.-old children and tended to disappear later. We found a significant difference in responses between 5- and 6-yr.-old children but no difference regarding side and sex at different ages. Among the principal theories regarding the pathogenesis of extinction, incomplete maturation of attentional mechanisms seems the one which better explains extinction in younger children.

Age Factors↗

Effects of carbamazepine and valproate on immunological assessment in young epileptic patients.

Serum immunoglobulin levels and peripheral blood lymphocyte subsets were determined in 25 epileptic children treated with anticonvulsant drugs [carbamazepine (CBZ) or sodium valproate (VPA)], 17 untreated patients and 18 healthy subjects. The treated and untreated patients did not differ significantly from the controls with respect to the mean IgA, IgG, IgM values or lymphocyte subsets. The patients on carbamazepine had lower serum concentrations of IgG (though not significantly lower) than the untreated patients and children on valproate. OKT8 subset, in absolute terms and as a percentage of total lymphocytes, was significantly higher in generalized than in partial epilepsy, but this was probably due to the antiepileptic treatment. We found a sex difference in serum immunoglobulins (Ig M, IgG) in the epileptic group. Our data do not seem to argue for major changes in immune status related to clinical type of epilepsy or to VPA or CBZ treatment.

Adolescent↗

Tactile extinction in childhood hemiplegia.

Tactile extinction was investigated by the Quality Extinction Test (QET) of Schwartz in 39 patients, 34 of whom had congenital hemiplegia and five early-acquired hemiplegia. Extinction values were significantly higher in hemiplegia patients than in controls and usually contralateral to the side of brain damage, except for four cases with right hemiplegia. Values were also higher in males than in females. There were no significant differences between patients with left and right hemiplegia, and no correlations between extinction and IQ or the presence of epilepsy. There was a correlation between QET scores and neuroradiologically proven cerebral atrophy. The meaning of extinction in hemiplegic patients and the principal theories regarding the pathogenesis of neglect are discussed.

Adolescent↗