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Biomedical subjects

D Greco

Publications and source records attributed to D Greco.

At least 37 records · Page 2Linked to original sources
PubMed1996

Saethre-Chotzen syndrome: a clinical, EEG and neuroradiological study.

Saethre-Chotzen syndrome is a form of acrocephalosyndactyly with autosomal dominant inheritance, characterized by craniosynostosis, facial asymmetry, palpebral ptosis, deviated nasal septum, partial cutaneous syndactyly, and various skeletal abnormalities. We studied in detail the neurological, EEG, and neuroradiological features of a group of 11 (6 male, 5 female) patients with Saethre-Chotzen syndrome. Four subjects were affected by seizures; they had paroxysmal EEG abnormalities, and gross neuroimaging revealed destructive brain lesions or malformations. Our findings suggest that CNS involvement in Saethre-Chotzen syndrome might be more severe than previously reported and support the wider use of neurophysiological and neuroimaging techniques in the study of children with this syndrome.

Acrocephalosyndactylia↗
PubMed1996

Serum uric acid, insulin secretion and resistance in nonhyperuricemic and hyperuricemic obese female subjects.

In order to study the relationships between obesity, serum uric acid, insulin secretion and insulin resistance in female subjects, we evaluated serum C-peptide and glucose-induced insulin utilization (euglycemic hyperinsulinemic clamp) in 16 obese (8 nonhyperuricemic and 8 hyperuricemic) and 10 nonobese control subjects. Baseline C-peptide levels were significantly higher in hyperuricemic compared to both nonhyperuricemic obese subjects and controls (P < 0.001). M values, a measure of glucose disposal and insulin sensitivity, were significantly lower in hyperuricemic obese compared to nonhyperuricemic obese subjects and controls (P < 0.001) and, for all subjects were inversely correlated with the serum uric acid values (r = -0.821, P < 0.001). In conclusion, in this group of subjects the serum uric acid values were directly related to insulin resistance independently of age, sex, excess body weight, fat distribution and blood pressure.

Adult↗
PubMed1996

Predicting the accrual rate in a vaccine clinical trial: an a posteriori evaluation of the feasibility study.

To estimate the expected accrual rate in a double blinded controlled randomized trial of the absolute clinical efficacy of three anti-pertussis vaccines in infants, we performed a series of surveys among mothers and physicians in the areas to be considered for participation in the trial. In this paper, we compared the predicted enrollment with the actual enrollment achieved at the end of the recruitment phase of the trial. The predicted enrollment rate was 27%, while the observed rate was 26%. Results from the feasibility study were highly predictive of actual enrollment rate. In the local health units (USL) where such assessments were carried out, the accrual rate, was higher than those not participating in the feasibility phase.

Adult↗
PubMed1995

Transcription factor AP-2 regulates expression of the dopamine beta-hydroxylase gene.

Expression of the gene encoding the neurotransmitter biosynthetic enzyme dopamine beta-hydroxylase (DBH) is regulated in a tissue-specific pattern, and transcription is influenced by environmental stimuli. Using the promoter proximal region of the rat DBH gene and nuclear extracts from SHSY-5Y neuroblastoma cells, a DNA-protein complex was identified that is competitive with oligonucleotides containing the recognition site of transcription factor AP-2. DNase footprint analysis identified an AP-2 binding site between -136 and -115 of the DBH promoter. Mutation of that AP-2 site results in a sevenfold reduction of basal reporter gene expression, but second messenger-stimulated activity is retained. Cotransfection of an AP-2 expression vector and a DBH promoter-reporter construct into cultured cells results in a sixfold stimulation of reporter gene expression, demonstrating the ability of AP-2 to trans-activate the DBH promoter. These results identify a new regulatory element on the rat DBH gene and suggest that the AP-2 site plays a role in maintaining basal levels of DBH transcription.

Base Sequence↗
PubMed1995

Heteroduplex mobility assay and phylogenetic analysis of V3 region sequences of human immunodeficiency virus type 1 isolates from Gulu, northern Uganda. The Italian-Ugandan Cooperation AIDS Program.

We analyzed peripheral blood mononuclear cells from 19 asymptomatic seropositive pregnant women from the district of Gulu in northern Uganda. A 700-bp fragment of the human immunodeficiency virus type 1 (HIV-1) env gene, including the V3-V5 region, was successfully amplified by PCR from 10 samples (52.6%) and was subsequently subjected to both a heteroduplex mobility assay for genetic screening and subtyping and DNA sequence analysis (approximately 300 bp) for nucleotide comparison and phylogenetic studies. The results show the presence of HIV-1 A and D subtypes (or clades) in this rural area, with the prevalence of the A subtype (8 of 10) being greater than that of the D (2 of 10) subtype, which is unlike what was previously reported for Uganda. By pairwise comparison analysis, the percentage of sequence divergence among samples within each subtype is low (the average intrasubtype divergence is 15.8%), but it is significantly higher between the two subtypes (the average intersubtype divergence is 23%). At the amino acid level, the two HIV-1 subtypes show distinct tetramers at the apex of the V3 loop and, in particular, GPGQ in clade A and GPGR in clade D. In addition, 10 of the 19 viral samples (52.6%) have been isolated in vitro. Nine of the samples have been classified as rapid/high, which reflects a high in vitro replication capacity for the HIV-1 field isolates from this country, even for those obtained from seropositive asymptomatic individuals. These observations, despite being made on the basis of a limited sample size, show a modest degree of genetic divergence among samples isolated in the last 4 years in this country by comparison with those based on the 1990 data on HIV-1 isolates from Kampala. The results reported here are, therefore, extremely relevant for Uganda, which is one of the selected World Health Organization field sites for future HIV-1 vaccine evaluation programs.

Amino Acid Sequence↗
PubMed1995

HIV-related knowledge and risk behaviors of street youth in Belo Horizonte, Brazil. The Street Youth Study Group.

Individual interviews were conducted with 379 youth who work and/or live on the streets of a large Brazilian city to assess HIV-related knowledge, sources of information, risk behaviors, and prevention beliefs and strategies. Respondents demonstrated high levels of factual knowledge about HIV transmission (84% correct) coupled with high levels of misconceptions about casual transmission (53% correct) and intermediate levels of knowledge about prevention (64% correct). Only 54% of the respondents had heard about AIDS recently, and 37.5% said they talked to someone about AIDS. The most common sources of information about HIV/AIDS were the mass-media and friends. Over half the sample reported taking precautions to reduce their risk of HIV infection; however, the proportion of youth taking effective precautions was low. Among the 247 youth (65% of the sample) who had initiated sexual activity, lifetime condom use was reported by 18%, and condom use at last intercourse by 10%. Youth with higher levels of knowledge were more likely to report behavior changes to avoid HIV infection. These findings underscore the urgent need for prevention programs tailored to street youth in developing countries.

Acquired Immunodeficiency Syndrome↗
PubMed1995

[Hyperinsulinism/insulin resistance: cause, effect or marker of essential arterial hypertension?].

Essential hypertension is often accompanied by metabolic abnormalities which commonly include hyperinsulinemia/insulin resistance. Even in the absence of these metabolic disorders, high blood pressure tends to be associated with insulin resistance. These observations raise two orders of questions: 1) whether hyperinsulinemia and insulin resistance are simply innocent bystanders or are causally involved in the initiation and/or promotion of hypertension; 2) whether blood pressure elevation is eventually caused by excess of insulin or whether it is a manifestation of the complex metabolic state responsible for insulin resistance. The purpose of this paper is to survey the clinical, epidemiological and experimental data that have led to the above generalizations and to address the potential significance of this coexistence. First, it could be argued that the relationship between high blood pressure and the associated metabolic defects is incidental. In this case, insulin resistance and hypertension may represent two independent consequences of a same metabolic disorder. On the other hand, there is evidence that suggests that insulin resistance (by itself or by insulin) may play a role in the etiology and/or the clinical course of hypertension. Although insulin has complex actions on the circulation (including a vasodilator effect), plausible mechanisms by which insulin might raise blood pressure include stimulation of the sympathetic nervous system, alteration of ion transport kinetics, increase of renal sodium retention and stimulation of vascular smooth cells growth. The pathways that could link insulin resistance, through hyperinsulinemia, with essential hypertension are based on the concept that a defect of insulin action on glucose utilization, does not imply that all other effects of insulin are equally blunted. However, in patients with insulinoma, hypertension has not been associated, and the acute administration of insulin does not cause an increase in blood pressure. It is also possible, on the contrary, that hypertension may be the cause of insulin resistance, but in various forms of secondary hypertension, impaired insulin sensitivity has not been found. It is probable that insulin resistance may represent, in a subgroup of individuals characterized by genetic predisposition (ethnicity, familiarity, etc.), simply a marker for susceptibility to hypertension. Hyperinsulinemia, in these subjects, may directly contribute to a raise in blood pressure by several mechanisms. In conclusion, despite the clinical importance of this association the nature of the relationship between insulin resistance and blood pressure remains obscure. Since hypertension does not develop in all insulin resistant subjects and hyperinsulinemia does not always cause a raise in blood pressure, the relationship must be modulated by other genetic or environmental factors.

Biomarkers↗
PubMed1995

[Obesity and arterial hypertension. Relation between insulin secretion, peripheral insulin resistance and pressure indices].

The association between obesity and hypertension has been well documented. Both conditions are often linked to an insulin resistance state. In a group of homogeneously obese hypertensive subjects, the presence of a significant correlation between degree of insulin resistance and severity of hypertension was found. These results confirm that, independently of obesity and insulin secretion, equally present in all the subjects, high blood pressure is inversely correlated to hormone sensitivity.

Adult↗
PubMed1995

Blood pressure, insulin secretion and resistance in nonhypertensive and hypertensive obese female subjects.

OBJECTIVE: To study the relationships between blood pressure, insulin secretion and insulin resistance in obese female subjects. DESIGN: Evaluation of insulin-secretion and resistance respectively by blood C-peptide determination and glucose clamp technique in nonhypertensive and hypertensive obese female subjects. SETTING: Outpatient clinic of University Hospital. SUBJECTS: 12 female obese subjects, six of whom were nonhypertensive, and six hypertensive; and nine nonobese nonhypertensive subjects as control. MEASUREMENTS: Baseline and during OGTT blood C-peptide as insulin secretion index; M, MCR and M/I ratio evaluated by euglycemic hyperinsulinemic clamp as expression of insulin resistance. RESULTS: No difference is shown in C-peptide levels, between the two groups of obese subjects; the M, MCR and M/I values are significantly lower in hypertensive obese vs nonhypertensive obese subjects and controls (P < 0.001). Considering all the subjects, the same parameters are significantly inversely correlated with mean blood pressure values (P < 0.001). CONCLUSION: In the groups of considered obese subjects, homogeneous for age, sex, body weight excess, fat distribution and glucose tolerance, blood pressure values are directly related to insulin resistance but not to insulin secretion.

Adult↗
PubMed1995

A homeodomain protein selectively expressed in noradrenergic tissue regulates transcription of neurotransmitter biosynthetic genes.

In order to characterize the specificity of expression of the neurotransmitter biosynthetic gene dopamine beta-hydroxylase (DBH), the identification of proteins that interact with the DB1 enhancer was initiated. A homeobox-containing cDNA was isolated from a PC12 expression cDNA library screened with the DB1 enhancer. The homeodomain is a member of the paired-like class, and is encoded by several nonidentical cDNAs. The cDNAs contain the same sequence in the homeodomain and 3' coding and noncoding sequences, but diverge in sequence 5' to the homeodomain. This family of homeobox-containing cDNAs is named Arix. Arix mRNA transcripts are found only in noradrenergic, DBH-positive tissues, and in cell lines derived from those tissue. The DB1 enhancer contains two binding sites for the Arix homeodomain, and both sites contribute to basal activity of the DBH promoter. When introduced into tissue culture, Arix regulates the transcriptional activity from the DBH promoter, and also from the promoter of the tyrosine hydroxylase gene, encoding the initial enzyme of the catecholamine biosynthetic pathway. The pattern of expression of the Arix transcripts, the presence of the homeodomain, and the transcriptional regulatory properties suggest that this family of proteins may be involved in the specificity of expression of the catecholamine biosynthetic genes.

Amino Acid Sequence↗
PubMed1995

[Health education and the prevention of HIV infection in schools].

This review describes the HIV prevention strategies adopted since 1990 by the Italian Ministry of Health and Ministry of Education, coordinated by the National Health Institute, for use in Italian schools. It sets out reasons for believing that action in schools is essential in containing the spread of the HIV epidemic and presents teaching materials prepared for school use. An analysis is made of the IV national HIV information campaign, in which the Ministry of Health trained 4,000 middle and senior schools principals. The prospects for continuing the work with these 4,000 principals in the V information campaign, are also reported.

Adolescent↗
PubMed1994

AIDS-associated Kaposi's sarcoma and non-Hodgkin's lymphomas reporting in Italy: a linkage study.

To evaluate the completeness and accuracy in the reporting of AIDS-associated Kaposi's sarcoma (KS) and non-Hodgkin's lymphomas (NHL) in Italy, a linkage study of the notifications to the Italian AIDS Registry (RAIDS--the national compulsory AIDS surveillance system) and the clinical and pathological records of the Italian Cooperative Group on AIDS-related tumors (GICAT--a nationwide voluntary reporting system for HIV-infected individuals who develop cancer) was carried out. A total of 288 cases of KS and 258 cases of NHL fulfilling the AIDS definition criteria, histologically diagnosed by the GICAT centers between January 1987 and March 1992, were matched with the 16,860 AIDS cases reported to the RAIDS up to March 1993. The linkage procedure, based on name, gender, and date of birth, identified 276 cases of KS (96%) and 241 cases of NHL (93%) present in both files ("linked" cases). The diagnosis of KS did not appear among the clinical manifestations of AIDS in the RAIDS file in 67 out of the 276 linked KS (24%), either with coincident dates of KS diagnosis and of case notification (19 cases) or when the KS diagnosis followed by > or = 2 months the case notification to RAIDS (48 cases). Of the 241 linked NHL, 84 (33%) had no such neoplastic complications of AIDS listed in the RAIDS file, 23 with coincident dates of NHL diagnosis and of case notification and 61 with the NHL diagnosis made > or = 2 months after the notification. A noteworthy discrepancy in the classification of the three histologic subtypes of NHL emerged between the GICAT and the RAIDS. The degree of underreporting of AIDS-associated cancers that emerged from the present study suggests that augmentation with other sources of oncological information is important to better estimate the burden of AIDS-related tumors and to study the interaction between HIV infection and cancer.

Acquired Immunodeficiency Syndrome↗
PubMed1994

Social networks and daily activities of street youth in Belo Horizonte, Brazil. Street Youth Study Group.

Social networks and daily activities of children and adolescents living and/or working on the streets of a large Brazilian city were examined. Drawing on data collected through structured surveys, in-depth interviews, focus group discussions, and field observations, we described street youths' family situation, social resources, institutional experiences, survival activities, and problem behaviors and investigated differences attributable to age, gender, and living situation (at home or on the street). Youngsters who lived at home and worked on the street appeared to be experiencing orderly development despite their impoverished circumstances. Youngsters who lived on the street showed hallmarks of psychological and physical risk, including parental loss, diminished social support, substance abuse, and early onset of sexual activity. Possible implications of these contextual differences for development are discussed, and directions for future research are suggested.

Activities of Daily Living↗