Relationships between IGF-I and weight Z score, BMI, tricipital skin-fold thickness, type of feeding in healthy infants in the first 5 months of life.

AIM: To determine the concentration of insulin-like growth factor-I (IGF-I) in exclusively breast-fed (BF) and formula-fed (FF) infants in the first 5 months of life and to study the relationship between the IGF-I level and Z score for weight, body mass index (BMI) and tricipital skin-fold thickness. METHODS: We performed a cross-sectional study in order to evaluate serum IGF-I in 97 age-matched healthy term infants: 50 FF and 47 BF. RESULTS: FF infants showed higher values of IGF-I (38.9 +/- 12 ng/ml) when compared to BF infants (26.7 +/- 11.6 ng/ml; p < 0.05). A positive correlation was found between IGF-I values and Z score for weight (p < 0.001), BMI (p = 0.014), tricipital skin-fold thickness (p = 0.043) and age (p = 0.02). CONCLUSION: These results show that the IGF-I serum concentration is higher in FF infants. The observed association between IGF-I and Z score for weight, BMI, tricipital skin-fold thickness confirms the effect of different infant feeding on body size.

Breast-fed infants have higher leptin values than formula-fed infants in the first four months of life.

BACKGROUND: Leptin is a hormone present in breast milk, which regulates food intake and energy metabolism. AIM: To investigate whether leptin levels are different in breast-fed (BF) or formula-fed (FF) infants in the first months of life. METHODS: We evaluated serum leptin by radio-immunoassay and anthropometric parameters in 51 infants at the average age of 62.8+/-30 days, 25 exclusively BF and 26 exclusively FF. RESULTS: Leptin serum values were higher in BF (7.1+/-10.4 ng/ml) than in FF (3.7+/-3.87 ng/ml) infants (p <0.05). Leptin values were higher in females (6.9+/-9.87 ng/ml) than in males (3.5+/-3.88 ng/ml) (p <0.05). No differences were found in anthropometric measurements and body mass index. CONCLUSION: The kind of feeding might be a factor affecting serum leptin concentration in term infants. The long-term consequences of this difference between BF and FF infants and leptin's role in promoting obesity later in life are unknown.

Infant nutritional recommendations from pediatricians. Epidemiologic survey of feeding recommendations for the first year of life in Piedmont.

AIM: Timing the introduction of solids and milk formulas in infants' diet varies throughout the world. The aim of the present study was to assess the modalities of weaning, suggested by pediatricians in Piedmont, Italy, and to compare them to current scientific guidelines. METHODS: The survey was conducted using data recording forms sent to the pediatricians of our area (both practitioners and hospital physicians) from September 2000 to January 2001. Pediatricians were asked to fill in a questionnaire about the time of solid food introduction in the 1st year of life. The study was supported by 168 pediatricians, of these 105 practitioners, 53 hospital doctors and 9 university physicians. RESULTS: The mean age of weaning was 4.5 months. The 1st beikost was vegetable soup with rice flour, meat and parmesan in 65.4%; in 73.8% it was given with a spoon. In 94.6% no salt was added, in 84.5% no sweetener was added. Homogenized fruit was introduced at a mean age of 4.4 months: apple was the 1st fruit to be introduced (4.5 months), followed by pear (4.8 months) and banana (5.6). Lyophilised meat was introduced at 5 months, homogenized meat was introduced at 6.2 months, and minced meat was introduced at 8.2 months. Vegetables (potatoes, carrots, courgettes) were introduced between 5.2 to 5.4 months of age. Parmesan was introduced at 5.3 months; gluten at 6.2 months. Egg yolk was the 1st to be introduced (mean age = 8.9 months), while albumen was introduced at a mean age of 11.6 months. Fish was given at a mean age of 8.2 months. Cow's milk was introduced at 9 months. CONCLUSION: Paediatricians give indications about the introduction of solid foods according to scientific guidelines, with the exception of cow's milk which is introduced too early.

"Minor" feeding problems during the first months of life: effect of a partially hydrolysed milk formula containing fructo- and galacto-oligosaccharides.

BACKGROUND: Colic, regurgitation and constipation are common feeding problems in formula-fed infants that might benefit from dietary treatment. A formula containing fructo- and galacto-oligosaccharides, partially hydrolysed proteins, low levels of lactose and palmitic acid in the beta position and higher density has been tested to reduce the occurrence of these symptoms. The aim of this prospective study was to describe the effects of such a formula in infants with minor gastrointestinal disorders. METHODS: An observational prospective trial involving practising Italian paediatricians was performed. Formula fed-infants up to 90 d of age with minor gastrointestinal problems such as infantile colics and/or regurgitation and/or constipation were enrolled in the study from January 2001 to May 2001. The study was completed within 14 d of treatment. On days 1, 7 and 14 the infants were visited by the paediatricians. Parents were given a structured diary to record daily episodes of colic, regurgitation and type and number of stools. RESULTS: Of the 932 infants enrolled, 604 completed the study. Of the 214 infants with colic, 169 (79%) demonstrated a reduction in frequency of colic from 4.1 +/- 2.0 per day at the beginning of the study to 2.0 +/- 1.8 at the end of the study (I.C. 95%: 1.72-2.39; p < 0.005). A reduction in the number of episodes of colic of 1.8 per day at the beginning of the study (I.C. 95%: 1.49-2.11; p < 0.05) was recorded between day 1 and day 7, and of 0.26 (I.C. 95%: 0.15-0.37; p < 0.05) between day 7 and day 14. Of the 201 infants with regurgitation problems, 141 (70%) demonstrated a reduction of frequency of the symptoms from 4.2 +/- 2.0 per day at the beginningof the study to 2.1 +/- 2.2 at the end of the study (I.C. 95%: 1.75-2.35; p < 0.005). A reduction of 1.87 in the number of regurgitation episodes was reported between day 1 and day 7 (I.C. 95%: 1.57-2.16; p < 0.05) and of 0.18 (I.C. 95%: 0.06-0.31; p < 0.05) between day 7 and day 14. Of the 232 infants with constipation, 147 (63%) demonstrated an increase in the daily number of stools of 0.42 (I.C. 95%: 0.5-0.3; p < 0.005). An increase in stool frequency of 0.41 (I.C. 95%: 0.51-0.23; p < 0.05) was reported between day 1 and day 7, and of 0.04 (I.C. 95%: 0.22-0.14; p = ns) between day 7 and day 14. Parents' evaluation of the formula was 7.9 +/- 1.8 (score 0-10); 550 parents (91%) gave a positive judgement (score > 6). The evaluation by the paediatricians of the improvement in symptoms after the treatment was 8.2 +/- 1.5; 574 (95%) a positive effect (score > 6). CONCLUSION: This study shows that the majority of infants followed by paediatricians for minor gastrointestinal symptoms improve within 2 wk of feeding with this new formula. Further double-blind, controlled studies are needed to confirm whether the amelioration of symptoms observed in this trial is in fact due to the new formula.

The role of laparoscopic myomectomy in women of reproductive age.

Laparoscopic surgery has gained wide popularity for the treatment of uterine fibroids in women of reproductive age. The aim of this study is to evaluate the safety of the present surgical technique in order to preserve fertility and to achieve a satisfactory uterine repair so as to obtain an uncomplicated, full-term pregnancy. Between March 1988 and April 2001, 1170 uterine myomata were laparoscopically removed in 635 patients. The number of myomata removed from each patient varied from one to nine. The main steps of the surgical technique are described. No serious complication occurred. All the myomata proved to be benign. A second look was performed in 121 patients, and in two cases adhesions were found. A total of 105 patients achieved pregnancy (one triplet and three twin) and 91 delivered. No uterine rupture or scar dehiscence was observed. Out of 148 patients who were infertile with one or more myomata larger than 30 mm, 74 achieved pregnancy, 63 spontaneously and 11 after IVF.

[Vaginal echography: a new diagnostic approach in gynecology]. / L'ecografia vaginale: un nuovo approccio diagnostico in ginecologia.

In the last few years ultrasonography has achieved a very important role in Obstetrical and Gynecological diagnosis. The introduction of vaginal probes has substantially improved the quality of the images. The Authors, after a review of the literature, briefly consider the physical basis of this improvement, show the advantages and emphasize its operative possibilities.

Hysteroscopy in an IVF-ER program. Clinical experience with 360 infertile patients.

Three hundred and sixty patients underwent hysteroscopy before entering the IVF program. The procedure was successful in 332 patients; obstructive tubal disease was present in 247 (70%); 148 showed uterine abnormalities (44.5%) such as endometrial polyps, adhesions, hypoplasia, malformations, or severe cervical stenosis; 114 patients had normal hysterographic findings, in whom hysteroscopy revealed a false-negative rate of 36.8%. In 281 patients (84.6%) hysteroscopy was carried out under general anesthesia, in most cases associated with laparoscopy. There were no anesthetic complications, uterine perforations or other significant problems. In an IVF program, hysteroscopic evaluation can reduce the failure rate due to intra-uterine abnormalities. Hysteroscopy, which permits one to optimize an IVF attempt, becomes an essential procedure before introducing a patient into an IVF program.