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Biomedical subjects

F Zacchello

Publications and source records attributed to F Zacchello.

At least 109 records · Page 6Linked to original sources
PubMed1991

Somatosensory pathway dysfunction in uremic children.

Neurophysiological studies have shown defects in peripheral conduction in up to 75% of adults with end-stage renal disease (ESRD), though abnormalities of central conduction seem more variable. There are no comparable pediatric data. We therefore measured median nerve somatosensory evoked potentials (SEPs) in 10 children with ESRD, maintained by hemodialysis, who had no neurological signs or symptoms, and compared the results with those for age-matched controls. The latencies of N9, P14, N20 and P22, and interpeak latencies, N9-N20, N9-P14 and P14-N20, were not significantly different between the two groups (Student's t test). However, the children with ESRD were significantly retarded in growth and when arm length was taken into account, a significant difference in peripheral conduction was revealed. There was no correlation with other indexes of disease severity (parathormone, aluminium, Hb, Na, K, Cl, BUN and creatinine). SEPs appear to reflect subclinical changes in peripheral conduction in sensory pathways in children with ESRD which are not correlated with other measures of disease severity.

Adolescent↗
PubMed1991

Development of language in 18-30-month-old HIV-1-infected but not ill children.

Thirty-six children (age range, 18-30 months) born to HIV-1-infected mothers were studied for speech development by matching 18 infected with 18 non-infected subjects for age, sex and socioeconomic status. All the children were in good health. Each child was given three comprehension and three production tasks. In addition, each child's mean length of utterance (MLU) was obtained by observation of natural child-parent interactions. The development quotients (DQ) were assessed by Brunet-Lézine's tests. Infection significantly affected children's MLU, the infected children being less advanced than those non-infected. Both infected and non-infected children progressed in language acquisition from the second to the third year of age, but infected children had significantly greater production difficulty than non-infected children in the second year of life. The matched subjects design adopted gives some strength to the conclusion that HIV-1 infection impairs the genesis rather than the later development of language in infected but not ill children.

Analysis of Variance↗
PubMed1990

Effect of inhaled disodium cromoglycate and albuterol on energy cost of running in asthmatic children.

The purpose of this study is to evaluate the effect of disodium cromoglycate and albuterol on energy cost of running, gas exchange, and ventilation during maximal exercise in children with exercise-induced asthma (EIA). Twelve children (7.1-15.5 years old) with a history of mild to moderate asthma and EIA performed three maximal exercise tests on a treadmill: 1) test A, without premedication; 2) test B, after premedication with inhaled disodium cromoglycate (DSCG) (40 mg); 3) test C, after premedication with inhaled albuterol (200 micrograms). The energy cost of running was calculated at each minute of exercise. None of the children were limited by dyspnea during the run. The post-exercise fall in FEVi after test A was greater than 20% for each child, the mean fall being 32.8 +/- 11.6%, in comparison with 12.6 +/- 8.9% after test B (P less than 0.001) and 2.5 +/- 5.3% after test C (P less than 0.001). There was no difference in the baseline oxygen uptake for the three tests. Maximum oxygen uptake (VO2 peak) decreased from 43.9 +/- 7.7 mL/min/kg in test A to 37.7 +/- 6.0 mL/min/kg in test B (P less than 0.01) and 39.1 +/- 7.2 mL/min/kg in test C (P less than 0.05). Ventilatory anaerobic threshold in tests B and C was significantly lower than in test A (P less than 0.01). Ventilation (L/min) and energy cost of running (O2 mL/kg/m) were significantly lower in tests B and C than in test A at comparable times. Running time was longer in B and C (P less than 0.05) with respect to A.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Inhalation↗
PubMed1990

Exercise tolerance after anaemia correction with recombinant human erythropoietin in end-stage renal disease.

The aim of this study was to evaluate the effect of correction of chronic anaemia on the physical performance and the cardiovascular response to effort in children with end-stage renal disease (ESRD) maintained by haemodialysis. Seven patients (mean age 13.9 years) underwent triangular-type treadmill exercise testing before [haemoglobin (Hb) 6.3 +/- 0.9 g/dl] and after (Hb 11.2 +/- 1.2 g/dl) anaemia correction with recombinant human erythropoietin (rHuEPO). After treatment, the work-load reached, the peak oxygen uptake and average ventilatory anaerobic threshold (VAT) values were significantly increased (P less than 0.01, P less than 0.001, P less than 0.05 respectively). VAT values, expressed as a percentage of normal values, increased from 55.7 +/- 16.6% to 82.4 +/- 21%. This improvement correlated well with the increase in Hb (r = 0.79). Oxygen pulse also increased significantly, when tested after anaemia correction. In conclusion, these data demonstrate that when the anaemia of children with ESRD is corrected with rHuEPO, there is a clear improvement in aerobic work capacity and effort tolerance.

Adolescent↗
PubMed1990

Partial biotinidase deficiency associated with Coffin-Siris syndrome.

Coffin-Siris syndrome is an infrequent condition characterised by mental retardation, nail hypoplasia or absence with fifth digit involvement and feeding problems. In addition, sparse scalp hair and chronic intractable eczema has been described in this syndrome. We report a 26-month-old girl with the disease and partial biotinidase deficiency.

Alopecia↗
PubMed1990

Benefits and risks of anemia correction with recombinant human erythropoietin in children maintained by hemodialysis.

Ten children with renal failure (age range 2 years 6 months to 18 years 9 months; median 11 years 10 months), maintained by long-term hemodialysis, had successful correction of their anemia after intravenous administration of recombinant human erythropoietin in a dosage escalating every 2 weeks (75 to 150 to 300 to 450 IU/kg/wk). Mean hemoglobin concentration increased from 6.4 +/- 0.9 to 11.5 +/- 1.0 gm/dl. Blood cell counts used to evaluate the correction of anemia were done after dialysis; this was especially important for children less compliant with water restriction. The higher hemoglobin concentration resulted in improvement of the quality of life, a greater tolerance for physical effort (exercise tolerance doubled and the ventilatory anaerobic threshold increased significantly), correction of some subclinical central nervous system abnormalities detected by evoked potentials testing, and reduction of bleeding time. Few side effects were noted; severe hypertension developed in one patient when postdialysis hematocrit was only 28%, and there were two episodes of hypertransaminasemia with no other evidence of liver dysfunction. We conclude that in children with renal failure the use of recombinant human erythropoietin to correct anemia is safe and strongly advisable, because of the resolution of many of the symptoms correlated with anemia.

Adolescent↗
PubMed1990

Pediatric HBsAg chronic liver disease and adult asymptomatic carrier status: two stages of the same entity.

Unlike adults (greater than 60% of cases), it is rare to find the chronic hepatitis B virus (HBV) carrier status with normal transaminases among children. The aim of this study was to investigate whether this status would depend on the duration of HBV infection, that is, whether chronic hepatitis in childhood would lead to the asymptomatic carrier status in later life. We reexamined all of our patients with chronic HBV infection of greater than 10 years' duration and with histologically documented chronic hepatitis during childhood. This was a group of 36 adolescents and young adults. All subjects were screened for tumor using alpha-fetoprotein assay and hepatic ultrasound. Eight patients with cirrhosis underwent esophageal fiberoptic endoscopy. All patients were in good general condition, with no clinical signs of liver failure. Only two patients had abnormal transaminase levels, both of whom had evidence of delta infection. All but one patient became anti-HBe positive. Five cases had HBsAg clearance. (Seventy-one percent of patients were HBeAg positive and 14% anti-HBe positive at the onset of the disease.) Hepatic ultrasound revealed no tumors in any of the subjects, and fiberoptic endoscopy demonstrated no esophageal varices. This study suggests that (a) chronic hepatitis and asymptomatic carrier status may be subsequent stages of the B virus infection; and (b) chronic hepatitis in childhood is generally benign and may evolve into an asymptomatic carrier status. The main problem with the chronic carrier status is probably the increased risk of hepatocellular carcinoma.

Adolescent↗
PubMed1990

A placebo-controlled crossover trial of nimodipine in pediatric migraine.

An 8-month, double-blind, placebo-controlled crossover trial was carried out on the use of nimodipine in migraine prophylaxis in 37 patients aged 7 to 18 years old. After a 4-week medication-free run-in period, 19 subjects (Group 1) received a placebo while 18 (Group 2) received nimodipine (10-20 mg t.i.d., according to body weight), for 12 weeks. After a 4-week wash-out period, the groups switched therapy for a further 12 weeks. 30 patients completed the trial and the number of dropouts was comparable in the 2 groups. The only side-effect during nimodipine treatment was mild abdominal discomfort (3 cases). The treatments were evaluated on the basis of frequency and duration of attacks. There was a significant reduction in both parameters during the first period of treatment. During the second period of treatment, nimodipine proved to have a significantly greater effect than the placebo with regard to frequency, whereas the response was similar with the placebo as regards duration of attacks. The latter parameter shows a significant decrease during the treatment periods, regardless of type of therapy.

Adolescent↗
PubMed1990

Exercise tolerance in end-stage renal disease.

The cardiorespiratory and metabolic response to exercise was evaluated in children with end-stage renal failure maintained on haemodialysis. Eight patients (haemodialysis group), 4 boys and 4 girls, with a mean age of 13.4 +/- 3.6 years (range 9.4-18.6 years) and haemoglobin levels ranging from 5.3 to 7.6 g/dl and 16 healthy children (control group) performed a progressive exercise testing on a treadmill. Gas exchange was simultaneously monitored. The mean ventilatory anaerobic threshold of the haemodialysis group, expressed as a percentage of the reference values, was 59.1 +/- 18.2%, and their maximum work load (29.9 +/- 19 W) was about one fourth of that reached by the control group (113.3 +/- 51.6 W). Ventilatory anaerobic threshold values in the haemodialysis group significantly correlated with blood haemoglobin levels, but not with creatinine and parathyroid hormone concentrations. We, therefore, conclude (1) that children maintained on chronic haemodialysis have a marked reduction in aerobic working capacity and (2) that the major cause for this limitation appears to be the reduced haemoglobin concentration.

Adolescent↗
PubMed1989

Gas exchange during exercise in obese children.

Twenty-three obese children, aged 9 to 14 years, ranging in percentage overweight from 26% to 83% (median 51.6% +/- 16.3%), and 37 normal-weight children, matched for sex, age and height, performed a maximal exercise test on a treadmill. Cardiorespiratory performance was assessed by determination of the ventilatory anaerobic threshold (VAT) expressed in ml O2/min per kg and as a percent of maximal oxygen uptake (% VO2max). VAT and VO2max related to body weight were significantly lower (P less than 0.01) in the obese than in the normal-weight children. VAT % VO2max was similar in the two groups. A significant correlation was found between VAT and VO2max both in the obese (r = 0.85) and in the control groups (r = 0.79). The habitual level of physical activity was lower in the obese subjects compared to the control subjects (P less than 0.001). In conclusion our study shows that physical fitness of overweight children is quantitatively lowered and that it can be assessed by VAT. VAT does not require a maximal test and is particularly useful in the ergometric study of subjects with exercise intolerance.

Adolescent↗
PubMed1989

A comparison of two noninvasive methods in the determination of the anaerobic threshold in children.

Seventy children, ranging in age from 7 to 14 years, performed a maximal exercise test on a treadmill with determination of the anaerobic threshold (AT) by two methods: (1) with the gas exchange method the ventilatory anaerobic threshold (VAT) was identified by the increase in the ventilatory equivalent for O2 uptake without a concomitant increase in the ventilatory equivalent for CO2 output and (2) with the method proposed by Conconi, the AT was taken at the point beyond which the increase in work intensity exceeded the increase in heart rate and the linearity of the work rate/heart rate relationship was lost. The AT values measured with the two methods were correlated (r = 0.80, P less than 0.001). This result confirms, also in children, the validity of the simple Conconi method: It can be used particularly for the determination of the individual optimal intensity of training.

Adolescent↗