[Immunological development in asymptomatic HIV infected children]. / Follow-up immunologico di bambini con infezione asintomatica da HIV.

In HIV infected children, CD45+CD4+ T lymph. reconstitution has been related to efficient thymopoiesis. Because human thymus undergoes spontaneous involution at a relatively young age, institution of antiretroviral therapy early in the course of infection has been recommended. 12 HIV vertically infected children aged 4-8 years were investigated T-cell subsets for four years. 7 children were naive for therapy (group NT); 5 experienced nucleoside analogues only (group T). CD45RA+ and CD45RO+ CD4+ values were compared to predicted values of healthy children. The two groups showed similar clinical and immunological baseline characteristics (CDC class N-A). Mean VL at t0 was 4.26 log10 (SD 0.71) in gr. NT and 4.01 log10 (SD 0.57) in gr. T; median CD4 T lymph values were 27% in gr. NT and 23.5% in gr. T. Median CD45RA+ values were 62.8% in gr. NT and 71.3% in gr. T. No differences in VL, CD4+ T lymph., CD45RA+, CD45RO+ were found in between groups or within each group at each time evaluation. Median CD45RA+ values were not different from predicted values of healthy children. None of the children changed CDC class during the study period. Although the number of subjects was small, our study evidenced the possibility of a normal immunological development in HIV-1 vertically infected asymptomatic children naive for HAART during the first decade, even in the presence of significant viremia.

Body composition assessment: an indispensable tool for disease management.

Recent conceptual and technology advancements fostered a rapid development in the field of body composition assessment and provided new and powerful investigative tools. Densitometry, isotopic dilution, bioelectrical impedance, whole-body counting, neutron activation, X-ray absorptiometry, computed tomography, magnetic resonance imaging, and spectroscopy have been the most widely employed methods. The result of this effort is the discovery that body composition at both molecular and cellular or tissue levels is affected by virtually all the pathologic conditions found in medical textbooks. The field is now mature for the clinical translation of this research. Some applications rely on a very solid base and their clinical use has been fully codified. Others still need reference values diversified on a regional and ethnic scale, consensus for interpretation of values, and guidelines for clinical indications. Only after these requirements are satisfied will it be possible to adopt specific practical guidelines, the most reasonable basis for acceptance and accreditation by care providers. Some applications are already being used in several settings. Therefore, establishing the guidelines for clinical application of body composition assessment methods is not only important for physicians and their patients, but is also urgent so as to prevent misuse and to ensure correct communication with the media in this field.

Ramipril treatment in a patient with glycogen storage disease I non-A.

We studied the effect of ramipril on proteinuria and mild hypertension in a 21-year-old patient affected by glycogen storage disease type I non-A. After few months of therapy we obtained a decrease in total urine protein excretion that later re-increased in spite of the high dose of ACE inhibitor. Even if ACE inhibitors are the only effective therapy for GSD I nephropathy, further studies are requested.

Dual-energy X-ray absorptiometry: analysis of pediatric fat estimate errors due to tissue hydration effects.

Dual-energy X-ray absorptiometry (DXA) percent (%) fat estimates may be inaccurate in young children, who typically have high tissue hydration levels. This study was designed to provide a comprehensive analysis of pediatric tissue hydration effects on DXA %fat estimates. Phase 1 was experimental and included three in vitro studies to establish the physical basis of DXA %fat-estimation models. Phase 2 extended phase 1 models and consisted of theoretical calculations to estimate the %fat errors emanating from previously reported pediatric hydration effects. Phase 1 experiments supported the two-compartment DXA soft tissue model and established that pixel ratio of low to high energy (R values) are a predictable function of tissue elemental content. In phase 2, modeling of reference body composition values from birth to age 120 mo revealed that %fat errors will arise if a "constant" adult lean soft tissue R value is applied to the pediatric population; the maximum %fat error, approximately 0.8%, would be present at birth. High tissue hydration, as observed in infants and young children, leads to errors in DXA %fat estimates. The magnitude of these errors based on theoretical calculations is small and may not be of clinical or research significance.

Body composition measurement in highly trained male athletes. A comparison of three methods.

BACKGROUND: The purpose of the present study was to evaluate the differences in the body composition estimate of highly trained male athletes by three different methods: dual-energy X-ray absorptiometry (DXA), bioelectrical impedance analysis (BIA) and skinfold thickness measurement (SFT). METHODS: The study occurred during a non-intensive training period. The measurements were performed at the Human Physiology laboratory. PARTICIPANTS: forty-three male athletes (19 waterpolo, 9 judo, 15 karate) who exercised regularly at least three hours per day, six days per week. MEASUREMENTS: DXA, BIA and SFT measurements of percentage fat mass (%FM) and the amount of fat-free mass (FFM) were performed. STATISTICAL ANALYSES: the different %FM estimates by the three methods were compared using a one-way ANOVA, with posthoc Bonferroni test when values were significantly different. The same test was used to compare FFM values. The coefficient of variation (CV%=100xSD/mean) was calculated for each methods. Methodological differences among the various methods were analysed with the method of Bland-Altman. RESULTS: ANOVA test showed significant differences among the three methods. In particular, DXA significantly (p<0.001) overestimated %FM (12.4+/-4.1%) and underestimate FFM (67.0+/-6.9 kg) respect to SFT (7.8+/-0.9 % and 71.0+/-8.2 kg) and BIA (9.9+/-1.4% and 69.4+/-7.9 kg). Also Bland-Altman comparison among the estimates indicated wide differences between methods. CONCLUSIONS: DXA provides different body composition estimates than those derived from skinfold thickness measurement and BIA, so that the methods should not be used interchangeably.

Anthropometry and methods of body composition measurement for research and field application in the elderly.

Evaluation of body composition is important in the study of human energy and protein metabolism as methods are available for quantifying energy stores and protein content at a single point in time; energy-protein balance can be monitored over time; and dynamic measures of energy and protein metabolism can be referenced to body mass and related measurable components for between-individual comparisons. This review emphasizes the need for considering subject age when developing body composition component prediction models that are applied in elderly populations. An overview of body composition research is provided that emphasizes compartment and level definitions and interrelations. Two broad method categories, mechanistic and descriptive, are then critically examined in relation to their role in energy-protein metabolism and aging research. Our collective review indicates that all major body composition components are now measurable using one or more methods that are based on non age-dependent assumptions. We also found that some methods, particularly descriptive field methods (eg anthropometry), may be based on age-sensitive assumptions and measurements and suggestions for future development of these methods are provided. Lastly, as body composition differences between races, cultures, and countries are now recognized, it would be useful to create international cooperative groups with the aim of developing widely applicable descriptive field methods based on simple available techniques such as anthropometry and bioimpedance analysis.

Comparison between measured and predicted resting metabolic rate in moderately active adolescents.

The aim of this study was to check the validity of predictive equations for the calculation of resting metabolic rate (RMR) in moderately active adolescents. The RMR was measured in a sample of 25 healthy 15.5-18.2-year-old boys practicing soccer. The RMR was assessed by indirect calorimetry for 30 min following an overnight fast. Body composition was estimated from skinfold thickness measurements. Among the available equations to predict RMR, we decided to use those a of Molnar et al., Harris-Benedict, Schofield, and Cunningham. Measured and predicted values were compared by means of a one-way ANOVA. Also the Bland-Altman test was performed in order to evaluate the accuracy of the prediction equations compared to the measured value. The measured RMR was found to be 1834 +/- 160 kcal/day (mean +/- SD), while the Molnar et al., Schofield, Harris-Benedict, and Cunningham predicted values were 1707 +/- 78, 1866 +/- 89, 1779 +/- 84 and 1830 +/- 87 kcal/day, respectively. On average, compared to the measured values only the Molnar et al. equation differed significantly. On an individual basis, all the equations demonstrated considerable variability between measured and predicted RMRs. The predicted values also differed significantly. As regards the moderately active subjects (16-18 years old), we recommend the use of the Schofield equation, based on simple anthropometric parameters and also that of Cunningham, even if the estimation or measurement of fat-free mass may be cumbersome for everyday pediatric use.

Regulation of the human glut4 gene expression in tumor RD18 cell line.

We tested if glut4, the gene for muscle-specific glucose transporter, underwent some variations of expression in neoplastic cells. Our model was a rhabdomyosarcoma cell line (RD18) which retains the ability to differentiate along the myogenic pathway. Any definable changes of expression of glut4 in normal and RD18 cells were revealed by Northern blot analysis. In order to identify the transcriptional regulatory regions of the glut4 gene we performed a deletion analysis of the 5' flanking region. The downregulation which we found in the expression of this gene in RD18 cells could be related with the activity of a negative regulatory element.