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Biomedical subjects

R Lala

Publications and source records attributed to R Lala.

36 records · Page 2Linked to original sources
PubMed1986

Teenage pregnancy in an urban hospital setting.

Recent research suggests that adverse consequences of teenage pregnancy are largely a function of social background factors and adequacy of prenatal care. This study examines the situation of young mothers with new babies in a low income, urban environment. The study explores the relationship between age and ethnicity and various life circumstance and life style differences which might effect long term developmental outcome. 475 Hispanic and black mothers were interviewed using a structured questionnaire. The majority are poorly educated, single parents. Educational attainment is higher for blacks than for Hispanics and for older mothers than for younger. Older mothers are more likely to be living with the father, to be married, and to have received adequate prenatal care. Hispanic parents are more likely than Blacks to be planning to live together. Hispanic mothers are more likely than blacks to be planning to be the primary caretaker for their babies. Adequacy of prenatal care is related to both prematurity and low birth weight. The implications of these findings are discussed in relation to pregnancy prevention and parenting education programs.

Adolescent↗
PubMed1975

The Feulgen reaction after glutaraldehyde fixation.

A technique is described for performing the Feulgen reaction for DNA on cells and tissues fixed in glutaraldehyde. Blockade free aldehydes by reducing them with fresh 0.5% NaBH4 in 1% NaH2PO4 for 1 hr at room temperature, then rinse in water. Follow by a Feulgen reaction (hydrolysis at room temperature in 6 N HCl for 20 min, Schiff's reagent for 60 min.). Controls assure the completeness and irreversibility of the borohydride blockade. Cytophotometry shows that the DNA content per nucleus is unaffected by the blockade procedure.

Aldehydes↗
PubMedDate not supplied

HLA haplotypes and hormonal studies in 25 Italian families of patients with classical and non-classical 21-OH deficiency.

To investigate the genetic polymorphisms of the HLA region and the molecular defect of the P450c21B gene in congenital adrenal hyperplasia (CAH) due to 21-hydroxylase deficiency, we studied 89 individuals from 25 families of CAH patients (14 classical forms, 11 non-classical forms). The following immunogenetic and hormonal investigations were performed: HLA-A and B typing, restriction fragment length polymorphism (RFLP) analysis of 21-hydroxylase A and B genes, and serum 17-OH-progesterone values determined basally and 60 min after ACTH stimulation. In the patients affected by the classical form, RFLP analysis revealed 5 deletions and 1 gene conversion in 6 haplotypes and no molecular defect in the others, who probably carry point mutations. In the patients with non-classical form we found P450c21A duplication in 11/18 haplotypes; 9 of the 11 patients shared the HLA-B14 allele. Utilizing both hormonal and genetic data we identified two cryptic forms; hormonal data alone failed to differentiate heterozygous from normal individuals.

17-alpha-Hydroxyprogesterone↗
PubMedDate not supplied

Sonographic appearance of ovaries and gonadotropin secretions as prognostic tools of spontaneous puberty in girls with Turner's syndrome.

We evaluated the possibility of anticipating spontaneous puberty in peripubertal Turner girls, in order to plan substitutive estrogen treatment. In the 24 patients studied, spontaneous puberty was seen in 4/11 girls with 45 XO karyotype, 5/5 with mosaicisms, 1 out of 2 with structural aberrations of the X chromosome and 0 out of 6 with Xq isochromosomes. When considering sonographic findings, the 6 girls with normal ovaries and 4/9 of those with intermediate ovarian appearance showed spontaneous puberty; the remaining 5 with intermediate ovaries and 9 with streak gonads did not undergo spontaneous puberty. Gonadotropin secretion was normal in girls with normal ovaries, moderately elevated in patients with intermediate ovarian appearance, and very high in those with streak gonads. The prognostic value of sonography and gonadotropins is particularly important in girls with intermediate ovaries. Therefore these evaluations should be performed at peripubertal age in patients with Turner's syndrome to elucidate the degree of ovarian insufficiency.

Child↗
PubMedDate not supplied

[The medical treatment of cryptorchism in early childhood].

To evaluate the efficacy of early treatment of cryptorchidism, we studied 154 children, 133 with unilateral and 21 bilateral cryptorchidism, between the ages of 6 months and 6 years. Only fullterm newborns without other pathological signs were selected for treatment which was undertaken only after the sixth month of life, when the time of late spontaneous testicular descent has been passed. By clinical evaluation, cryptorchid testes were classified as not palpable, inguinal and prescrotal. Patients were treated by LHRH nasal spray 200 mcg in each nostril 3 times a day (total 1.2 mg/day) for 4 weeks. In the case of failure, HCG (500 I.U. im. 3 times a week for 3 weeks) was further administered. We considered as therapeutic success testicular descent into the lower half of the scrotum. By LHRH treatment 36 testes (20.5%) reached the scrotum, when HCG was added in unsuccessful cases 47 other gonads (26.8%) descended. Total descent rate by LHRH + HCG was 47.3% (table 1). Uni- and bilateral forms of cryptorchidism responded to therapy without any significant difference (table 2). Abdominal testes failed to descend into the scrotum, 28.7% of inguinal testes and 81.3% prescrotal testes descended. Scrotal descent was dependent only by position of cryptorchid testes and not by age of patients (table 3). Higher descent rates obtained at older ages were due to higher incidence of milder forms of cryptorchidism (table 3). Side effects of combined therapy were light. In our experience, medical treatment by LHRH + HCG started after the first 6 months of life causes testicular descent in about one half of testes; it can place into the scrotum gonads with better fertility prognosis.

Administration, Intranasal↗
PubMedDate not supplied

[Cryptorchidism].

Cryptorchidism is the most frequent anomaly of an endocrine gland; it entails risks of infertility and testicular cancer. Its pathogenesis is thought to be multifactorial including anatomical and mechanical together with endocrine causes. In the last decades most Authors favoured the hypothesis that some degree of androgen insufficiency during fetal life may play a role in determining testicular maldescent. Morphological alterations have been demonstrated in cryptorchidism testes since birth; both tubular and interstitial damage already can be found in the first months of life. A critical phase in germinal development occurs during the third month when gonadotropin and testosterone postnatal surge induces the first maturational step in germ cells development. In cryptorchid infants, gonadotropin insufficiency at this time reduces germ cells differentiation, leading to progressive germinal decline, which becomes manifest after 12 months of life. In the opinion of some Authors, germinal alteration can be partially reversed by early scrotal reposition of the cryptorchid testes. Hormonal therapy with human chorionic gonadotropin (HCG) and luteinizing hormone releasing hormone (LHRH) has been used in the past decades with variable results. A combination of the two hormones has had a greater effect in inducing testicular descent compared to single hormone treatment. Although some surgeons already treat cryptorchid patients during childhood, an increasing number of pediatric surgeons believe that early treatment, performed during infancy is preferable, when considering the early and progressive histological damage seen in cryptorchid gonads. In our opinion, also hormonal treatment performed during the first year of life seems preferable since it can at the same time induce scrotal descent of cryptorchid testes and substitute postnatal gonadotropin insufficiency.

Adolescent↗
PubMedDate not supplied

Auxological and biochemical parameters in assessing treatment of infants and toddlers with congenital adrenal hyperplasia due to 21-hydroxylase deficiency.

We studied height velocity (HV), bone age progression (delta BA/delta CA), urinary pregnanetriol (PT) and plasma 17-hydroxyprogesterone (17-OH-P) during the first years of life in 12 patients with 21-hydroxylase deficiency, treated by cortisone acetate. In the well-controlled phases normal growth rate (SDS between -1 and +1), satisfactory bone age progression (delta BA/delta CA < or = 1) and no clinical sign of poor treatment were found; in the undertreatment phases enhanced growth rate, rapid bone age progression and, in some instances, signs of virilization were found; in the overtreatment phases, reduced growth rate was the only sign of poor treatment. Hormonal values were only weakly correlated to therapeutic control. Therefore, growth rate evaluation can represent the best method of monitoring treatment in very young patients with 21-hydroxylase deficiency.

17-alpha-Hydroxyprogesterone↗