Nutritional Status and Selected Adipokines in Children with Irritable Bowel Syndrome.

BACKGROUND: The aim of this study was to assess the nutritional status and serum concentrations of adipokines in children with irritable bowel syndrome (IBS) and healthy controls. We also sought to evaluate their relation to metabolic parameters. METHODS: We studied 33 IBS patients (11 girls, 22 boys) aged 5-17 years and 30 healthy age-matched controls (11 girls, 19 boys). The analysis included anthropometric measurements, body composition parameter measurements using bioimpedance, and biochemical tests and measurements of serum concentrations of leptin, adiponectin, chemerin, and omentin-1. RESULTS: The results of the anthropometric measurements were comparable between the patients and the controls. The patients had higher triglycerides, HOMA-IRs, and chemerin concentrations than the healthy subjects. The HDL cholesterol and omentin-1 levels were lower than in the controls. Leptin and adiponectin did not differ significantly between the groups. An analysis of the receiver operator curves (ROCs) showed that serum concentrations of chemerin ≥ 232.8 ng/mL had 30% sensitivity and 87% specificity when they were used to differentiate between children with IBS and healthy subjects. In the case of serum omentin-1 concentrations ≤ 279.4 ng/mL, the sensitivity and specificity were 60% and 80%, respectively. CONCLUSIONS: The nutritional status of children with IBS did not differ from that of the healthy controls. We found significant differences in serum chemerin and omentin-1 concentrations between IBS patients and healthy children. These adipokines could be used as IBS biomarkers as they demonstrate good specificity and moderate sensitivity. The serum concentrations of chemerin and omentin-1 in IBS patients were related to nutritional status and insulin resistance.

Evaluation of the frequency of ADIPOQ c.45 T>G and ADIPOQ c.276 G>T polymorphisms in adiponectin coding gene in girls with anorexia nervosa.

INTRODUCTION: Anorexia nervosa (AN) is a serious chronic psychosomatic disorder, the essence of which are attempts by the sufferer to obtain a slim silhouette by deliberate weight loss (restrictive diet, strenuous physical exercise, provoking vomiting). The aetiology of this disorder is multifactorial. Genetic factors that influence the predisposition to AN have been sought. A broad meta-analysis points to a strong genetic correlation between AN and insulin resistance. Adiponectin (ADIPO) increases insulin sensitivity. In our pilot study we demonstrated that the TT genotype in locus ADIPOQ c.276 G>T of the ADIPO gene and a higher concentration of ADIPO in blood serum occurred significantly more frequently in 68 girls suffering from AN than in 38 healthy girls. The objective of this study was to evaluate the frequency of the occurrence of ADIPOQ c.45 T>G and ADIPOQ c.276 G>T in the ADIPO gene in a larger cohort of girls with AN and healthy girls, as well as an analysis of correlations between variants of the aforementioned polymorphisms and the levels of ADIPO in blood serum. MATERIAL AND METHODS: The study covered 472 girls (age: 11-19 years): 308 with the restrictive form of AN (AN) and 164 healthy girls (C). The level of ADIPO in blood serum was determined by means of the ELISA method on a Bio-Vendor, LLC (Asheville, North Carolina, USA). The DNA isolation was carried out by means of Genomic Mini AX BLOOD (SPIN). The PCR reaction was carried out in a ThermoCycle T100 thermocycler. 80-150 ng of the studied DNA and relevant F and R starters were added to the reaction mixture. The reaction products were subjected to digestion by restriction enzymes and separated on agarose gels (RFLP). RESULTS: The distribution of genotypes in the polymorphic site ADP c.45 of the ADIPO gene and ADP c.276 was similar in both groups. In both groups the T allele was most frequent in locus ADIPOQ c.45 and the G allele in locus ADIPOQ c.276. In all the study subjects collectively (AN and C) a statistically significant negative correlation between the levels of ADIPO in blood serum on one hand and body weight (r = -0.46; p < 0.0001) and BMI (r = -0.67; p < 0.0001) on the other was demonstrated. Exclusively in the AN group a significant correlation between the level of ADIPO in blood and the distribution of TG, TT, and GG alleles in loci ADIPOQ c.45 and ADIPOQ c.276 was demonstrated (p = 0.0052 and p < 0.0001, respectively). CONCLUSIONS: The genotype in loci ADIPOQ c.45 and ADIPOQ c.276 of the ADIPO gene seems to have no effect on the predisposition to AN. Girls suffering from AN with the TT genotype in loci ADIPOQ c.45 and ADIPOQ c. 276 may demonstrate higher insulin sensitivity because they have significantly higher levels of ADIPO than girls suffering from AN with other genotypes. This may be suggestive of their better adaptation to the state of malnutrition, and it has a potential effect on treatment results.

Evaluation of the frequency of RETN c.62G>A and RETN c.-180C>G polymorphisms in the resistin coding gene in girls with anorexia nervosa.

INTRODUCTION: Anorexia nervosa (AN) is a serious psychosomatic syndrome, classified as an eating disorder. AN patients strive to lose weight below the normal limits defined for a specific age and height, achieving their goal even at the expense of extreme emaciation. AN has a multifactorial aetiology. Genetic factors are believed to be significant in the predisposition to the development of AN. In girls suffering from AN significantly lower levels of resistin (RES) in blood serum are observed as compared to healthy girls. These differences may lead to a thesis that functional genetic polymorphisms in RES coding genes can be responsible for this phenomenon. In our pilot study we demonstrated significant differences in the distribution of genotypes in the locus RETN c.-180C>G of the RES gene in 67 girls with AN and 38 healthy girls. It seems reasonable to compare the frequency of polymorphisms of RETN c.62G>A and RETN c.-180C>G in the RES gene in girls with AN and in healthy subjects in a bigger cohort and to analyse correlations between individual variants of the polymorphisms referred to above and the RES levels in blood plasma. MATERIAL AND METHODS: The study covered 308 girls with the restrictive form of AN (AN) and 164 healthy girls (C) (aged 11-19 years). The RES levels in blood serum were determined by means of the ELISA method on a Bio-Vendor machine from LLC (Asheville, North Carolina, USA). The DNA isolation was carried out by means of Genomic Mini AX BLOOD (SPIN). The PCR reaction was carried out on a ThermoCycle T100 thermocycler. 80-150 ng of the studied DNA and relevant F and R starters were added to the reaction mixture. The reaction products were subjected to digestion by restriction enzymes and separated on agarose gels (RFLP). RESULTS: The average RES level in blood serum in the AN group was significantly lower (p < 0.0001) than in the C group. The distribution of genotypes in the locus RETN c.62 of the RES gene was similar in both groups. A significant difference was demonstrated in the distribution of genotypes in the polymorphic site RETN c.-180 of the RES gene between AN and C (p = 0.0145) and in the distribution of the C and G alleles in the locus RETN c.-180 (p < 0.0001). The C allele occurred significantly more frequently than the G allele in the C group as compared to the AN group. In all the study subjects jointly (AN and C) a significant positive correlation between the blood RES levels on one hand and the body mass (r = 0.42; p < 0.0001) and BMI (r = 0.61; p< 0.0001) on the other was observed. There was no correlation between the concentration of RES in blood serum and the distribution of genotypes in the loci of the resistin gene referred to above. CONCLUSIONS: The CG genotype in the locus RETN c.-180 C>G of the RES gene may constitute one of the factors predisposing to the development of AN in girls. The genotype in the loci RETN c.62 G>A and RETN c.-180 C>G of the resistin gene has no influence on the levels of this hormone in blood in AN patients.

Rare case of nephrocalcinosis in a 14-year-old girl: Questions.

A 14-year-old Caucasian girl with a history of primary hypoparathyroidism and unstable calcium and phosphorus levels and on ongoing treatment was admitted to the Department of Pediatric Nephrology because of the onset of nephrocalcinosis and difficulties achieving normocalcemia. Coexistence of hypoparathyroidism, oral candidiasis, dental enamel hypoplasia, and subclinical Hashimoto's disease was strongly suggestive for autoimmune polyglandular syndrome (APS) type I. One of the clinical implications of this diagnosis is the high probability of future occurrence of adrenal insufficiency and hence the importance of maintaining a high level of suspicion in case of the onset of symptoms like weakness, fainting, hypotonia, or hyperkaliemia. Addison's disease would, in fact, be quite challenging for the future management of this patient.This clinical quiz highlighted the importance of careful evaluation of all multiorgan symptoms occurring in a patient to prevent further complications.

Evaluation of serum chemokine RANTES concentration as a biomarker in the diagnosis of early-onset severe infections in neonates.

OBJECTIVE: Only a few studies on improving the early diagnosis of severe neonatal infections have focused on the role of serum RANTES concentration (sRC). The aim of the study was to establish sRC in neonates with early-onset infections, according to their gestational age, sex, birth asphyxia, mode of delivery and value of some biochemical and hematological parameters. MATERIAL/METHODS: The analysis comprised 129 neonates, including 89 infected (52 preterm, 37 full-term; 43 with sepsis, 39 with congenital pneumonia, 7 with severe urinary tract infection) and 40 healthy (control group, 25 full-term, 15 preterm). The sRC in peripheral vein blood was measured by the ELISA method using Quantikine Set (R & D systems, USA). RESULTS: The sRC in infected neonates ranged from 10.83 to 122.55 µg/ml, in full-term neonates from 18.28 to 122.55 µg/ml, and in preterm from 10.83 to 118.24 µg/ml. The mean sRCs in full-term septic neonates (73.95±25.99 µg/ml) and with organ infections (58.43±29.24 µg/ml) were significantly higher than healthy ones (28.25±14.06 µg/ml). The mean sRCs in septic preterm neonates (59.17±28.29 µg/ml) and those with organ infections (50.86±28.16) were significantly higher than in healthy preterm neonates (25.61±8.29 µg/ml). Positive correlations between sRC and CRP value (r=0.3014, p=0.004) and between sRC and band cell count (r=0.2489, p=0.019) were found in all infected neonates. CONCLUSION: The significant increase of serum RANTES concentration in early-onset infections in neonates, regardless of their gestational age, sex and birth asphyxia, not only proves the presence of an active immunological process but also may be a useful biomarker for diagnosis of severe neonatal infections.

Chemerin serum levels in girls with anorexia nervosa.

BACKGROUND: The regulatory function of chemerin (CHEM) in the process of adipogenesis and the metabolism of adipocytes has been confirmed. Data from several studies have shown higher serum CHEM in obesity. To date, there are no available studies on serum CHEM concentrations in patients with anorexia nervosa (AN), which is recognized as a good biological model of the chronic atrophy of adipose tissue and energy metabolism disorders in humans. OBJECTIVES: The aim of the study was to assess serum CHEM concentrations in girls with AN in comparison to healthy and obese subjects and determine its relationship with body mass, BMI and insulin. METHODS: CHEM serum concentrations were evaluated using commercially available ELISA kit in 65 Polish girls with restrictive AN, in 39 healthy controls (H) and 64 girls with simple obesity (OB). RESULTS: The mean serum CHEM concentration in the AN group was significantly lower than in the H and OB groups. After adjusting for BMI, CHEM concentrations in the AN group were significantly lower than in the H group, but statistically higher than in the OB group. Significant correlations between serum CHEM and body mass (r=0.77), BMI (r=0.82), Cole index (r=0.81) and serum insulin (r=0.78) were observed.

Quality of life in transition phase in adolescents and young adults with severe and partial growth hormone deficiency.

BACKGROUND: Transition is a term used to describe the period of adolescence after which the final adult height during growth hormone (GH) treatment is achieved. According to re-evaluation results in insulin tolerance test (ITT) patients with severe and partial growth hormone deficiency (GHD) may be distinguished. OBJECTIVES: The aim of the study was to assess QoL in patients with different degrees of GHD in transition phase. METHODS: QoL was evaluated in 76 subjects aged 16-25 years with severe (SGHD, n=26), partial GHD (PGHD, n=22) and normal GH secretion (NGH, n=28) using SF-36 v.2™ Health Survey and the Quality of Life Assessment of Growth Hormone Deficiency in Adults (QoL-AGHDA) questionnaires. RESULTS: Physical Component Score (PCS), Physical Functioning (PF) and General Health (GH) results were significantly lower in patients with SGHD than in NGH group. SF-36 v.2™ Health Survey scores in PGHD were similar as in NGH patients. There were no statistically significant differences in QoL-AGHDA scores between the examined groups. We found positive correlations between peak GH in ITT and PF (r=0.29; p=0.02) or Role Emotional (r=0.37; p=0.002) scores. CONCLUSIONS: We demonstrated that the QoL in adolescents and young adults with severe GHD in transition period is disturbed mainly in terms of physical health and emotions. These changes were detected only by generic SF-36, but not by disease-specific QoL-AGHDA questionnaire. Therefore AGHDA-QoL assessment may not be applicable in GHD patients in transition period. QoL in the patients with partial GHD is unchanged in comparison to growth hormone sufficient subjects.

Assessment of serum visfatin levels in girls with anorexia nervosa.

OBJECTIVE: Visfatin (VISF) is a recently described peptide regulating the process of adipocyte differentiation. Only one pilot study of VISF expression in the fat tissue and its circulating concentrations in a small group of patients with anorexia nervosa (AN) have been published, yet. DESIGN AND PATIENTS: Cross-sectional assessment of VISF serum concentrations in 195 girls aged 11-18·9 years with AN (n = 87), eating disorders not otherwise specified (NOS; n = 17), simple obesity (OB; n = 30), and healthy controls (H; n = 61). MEASUREMENTS: Blood samples were collected during the fasting state between 7:00 am-8:30 am. VISF serum concentrations were determined using enzyme immunoassay. Comparisons of VISF levels between groups were performed. RESULTS: Mean serum VISF concentrations in girls with AN and NOS were significantly lower than those in the H and OB groups. Serum VISF concentrations were higher in the OB than in the H groups. When were calculated per body mass index (BMI), VISF concentrations were significantly lower in the AN, NOS, and OB groups than in healthy controls. Among participants with a normal BMI, serum VISF concentrations correlated positively with BMI (r = 0·27; P < 0·05). In the OB group, a significant, negative correlation between BMI and VISF levels (r = -0·38; P = 0·04) was observed. CONCLUSIONS: Compared with healthy girls, serum VISF concentrations are decreased in girls with AN. Conversely, obese girls have elevated VISF levels. When calculated per BMI (VISF/BMI), the results in AN and OB groups were lower than in healthy participants.

Androgens concentrations and second-to fourth-digit ratio (2D:4D) in girls with congenital adrenal hyperplasia (21-hydroxylase deficiency).

OBJECTIVES: Excessive hyperandrogenism, though proper hydrocortisone supplementation is a frequent clinical problem in girls with congenital adrenal hyperplasia (CAH). This may result from autonomic regulation of androgen production established in prenatal life. It has been suggested that the length of the second finger relative to the length of the fourth finger (2D;4D ratio) is negatively related to prenatal testosterone concentration. DESIGN AND SETTING: The retrospective study aimed to establish the relationship between the level of androgenization in utero determined using 2D:4D ratio and serum androgen concentrations in treated girls with CAH (21-OH deficiency) has been performed on 19 girls with CAH (21-OH deficiency) at the age of 3.7-19 years (mean 13.8 ± 4.07 years). All subjects were adequately treated with hydrocortisone (10-19 mg/m2; mean 13.81 ± 4.07 mg/m2). Anthropometric measurements of digits length were performed in all girls on X-rays obtained for bone age estimation. Apart from it, serum androgens concentrations (testosterone, androstenedione, s-DHEA) and 17-OH-progesterone (17-OHP) were assayed. RESULTS: Mean androgens serum concentrations in examined group were: testosterone 150.21 ± 155.44 ng/ml; androstenedione 4.15 ± 5.32 ng/ml, s-DHEA 70.39 ± 85.52 µg/dl. Mean 2D:4D ratio was 0.96 ± 0.04. Analysis of correlation showed positive linear correlations between testosterone, s-DHEA and 2D:4D ratio (r=0.53, p=0.023 and r=0.53; p=0.019, respectively). CONCLUSIONS: 2D:4D ratio parameter may be a simple test in indentification of female CAH patients prone to excessive androgen secretion despite proper treatment. The autonomization of adrenal androgens production in foetal life may cause its elevated levels in female patients with CAH although treated adequately.

Assessment of serum levels resistin in girls with anorexia nervosa. Part II. Relationships between serum levels of resistin and thyroid, adrenal and gonadal hormones.

OBJECTIVES: Thyroid, adrenal glands and gonadal hormones play a role in maintaining metabolic homeostasis of the body via the receptors located in the adipose tissue. The correlations between serum resistin (RES) and function of other hormonal axes in patients with AN have not been established, yet. Therefore, the aim of this study is: 1) assessment of concentrations of thyroid hormones (FT4, TSH), adrenal hormones (ACTH, cortisol), sex hormones (LH, FSH, estradiol, testosterone); 2) establishing their relationship with BMI and 3) analysis of correlations between examined hormones and RES serum concentrations in adolescent female patients with AN. DESIGN AND SETTING: Serum RES (ELISA) and fT4, TSH, ACTH, LH, FSH, estradiol and testosterone (ECLIA) concentrations have been assayed in 195 adolescent girls: 87 with restrictive AN, 17 with not otherwise specified eating disorders (NOS), 30 with simple obesity (OB) and 61 healthy (H) subjects. RESULTS: Mean serum FT4, LH and estradiol concentrations were significantly lower (p=0.015; p<0.0001; p<0.0001, respectively) in AN than in OB group, and cortisol increased (p<0.001) compared to OB and H subjects. In all examined subjects BMI correlated positively (p<0.0001) with LH (r=0.61) and estradiol (r=0.30), and negatively with cortisol (r=-0.35; p=0.008). Also the significant positive relationship between serum RES and FT4 (r=0.34), LH (r=0.57) as well as estradiol (r=0.28) was observed, whereas serum cortisol correlated negatively with RES (r=-0.40). CONCLUSION: Changes in resistin serum concentrations in eating disorders may be involved in the altered regulation of hypothalamic-pituitary-adrenal, thyroid and gonadal axes.

Assessment of serum levels resistin in girls with anorexia nervosa. Part I. Relationship between resistin and body mass index.

OBJECTIVES: There are only few studies available on blood resistin (RES) levels in patients with anorexia nervosa (AN), which revealed scarce results, however it has been demonstrated that RES mRNA expression in adipose tissue of these patients is increased. The aim of this study is: 1) the evaluation of serum resistin levels in girls with AN and determination a threshold value differentiating these patients from healthy subjects; 2) analysis of the relationship between serum resistin levels and BMI in examined subjects. DESIGN AND SETTING: Serum RES concentration has been assayed using ELISA kit in 195 adolescent girls: 87 with restrictive AN (mean BMI-SDS: -2.65 ± 0.2), 17 with not otherwise specified eating disorders (NOS) (mean BMI-SDS: -1.4 ± 0.68), 30 with simple obesity (OB) (mean BMI-SDS: 6.91 ± 1.23) and 61 healthy (mean BMI-SDS: -0.18 ± 0.54). RESULTS: Mean serum RES concentration in AN (2.8 ± 0.6 ng/ml) and NOS (3.1 ± 0.9 ng/ml) were significantly lower (p<0.0001) than in OB and H groups (4.8 ± 0.5 and 4.1 ± 0.4 ng/ml respectively). After corrected for BMI, RES values in AN were similar as in H subjects, but significantly higher (p<0.005) in comparison to OB group. ROC curve analysis revealed that 3.87 ng/ml is the threshold value of RES serum concentration differentiating AN from H girls (specificity 100%, sensitivity 80%). No significant correlations between BMI and serum resistin concentration are found in AN group, although a significant positive correlation has been established for all examined subjects. CONCLUSION: Additional adaptive mechanisms may be involved in regulation of RES levels in adolescent girls with AN.

Assessment of serum apelin levels in girls with anorexia nervosa.

CONTEXT: Pilot studies in rats have suggested that apelin (APE) is involved in the control of appetite and food intake. APE is secreted in the organs involved in the control of hunger and satiety: the stomach, hypothalamus, and fat tissue. Anorexia nervosa (AN) is an eating disorder that represents a good biological model of chronic fat tissue atrophy in humans. To date, there are no reports of APE expression in the fat tissue and its circulating concentrations in patients with AN. OBJECTIVE: Our objective was to assess serum APE concentrations in girls with AN. DESIGN, PARTICIPANTS, AND SETTING: APE-36 and APE-12 serum concentrations were evaluated in 87 Polish girls with restrictive AN, in 61 healthy (H) controls, 17 girls with no otherwise specified eating disorders (NOS), and 30 girls with simple obesity (OB). RESULTS: Mean serum APE-36 and APE-12 concentrations in patients with AN and NOS were significantly lower than in the H and OB groups. However, no differences between AN, H, and NOS groups were observed when APE concentrations were calculated per body mass index (BMI). In participants with normal BMI, serum APE-36 (r = 0.35) and APE-12 (r = 0.37) concentrations correlated positively with BMI. CONCLUSIONS: We conclude that compared with H controls, serum APE-36 and APE-12 concentrations decreased as a result of fat tissue depletion in patients with AN. Conversely, obese adolescents had elevated APE-36 and APE-12 due to excessive fat mass as well as increased APE production in adipose tissue.

An analysis of factors determining serum leptin concentration in healthy and infected newborns.

OBJECTIVE: The effect leptin on fetal growth in healthy and infected newborns is not well known. This study is aimed at: 1) evaluating serum leptin concentration in full term and preterm, healthy and infected newborns, according to their gender, birth asphyxia, intrauterine and neonatal infections, and 2) assessing the correlation between serum leptin levels and anthropometric parameters among healthy and infected newborns. MATERIALS AND METHODS: The study involved 146 newborns: 73 full-term and 73 preterm, 86 male and 60 female, 56 healthy and 90 infected, aged from 2nd to 4th day of life. Anthropometric parameters, including: birth weight, length, head and chest circumference, and serum leptin concentration were measured in all the subjects. Intrauterine and neonatal infections were diagnosed by the standard criteria. RESULTS: In this study, it was found that both healthy and infected, but full-term newborns had significantly higher mean leptin concentration than the premature ones (p<0.05). Statistically significant (p<0.05), positive correlations were found between serum leptin level and gestational age, birth weight, head and chest circumference, both in healthy, and in infected newborns. CONCLUSIONS: Findings of this study suggest that the serum leptin concentration in full term newborns is higher than in the preterm ones, and in females it is higher than in males, 2) among both healthy and infected newborns, there is a positive, linear correlation between the serum leptin concentration and anthropometric parameters, 3) intrauterine and neonatal infections do not have a significant influence on serum leptin concentration. The role of leptin in fetal growth deserves further research.

Effects of feminizing surgery for ambiguous genitalia - a novel scale for evaluation of cosmetic and anatomical results.

INTRODUCTION: Ambiguous genitalia always present diagnostic and therapeutic problem. Long-term results of feminizing operations are unsatisfactory in some cases and reports from follow-up after feminizing genitoplasty are rare in the literature. Systematic studies are needed to evaluate ultimate function of all girls undergoing feminizing surgery. In our opinion, the lack of worldwide-accepted scale for the assessment of long-term effects of feminizing genitoplasty, enabling the possibility of comparing outcomes between institutions and countries, may contribute to this deficit of reliable data. AIM: The aim of the study was the evaluation of the outcomes of surgical management of masculinization using a novel scale developed by the authors. MATERIAL AND METHODS: We examined 43 patients aged 3-24 years (mean age 15,4 years) operated due to ambiguous genitalia. Most of the patients were females with congenital adrenal hyperplasia (CAH) diagnosed in 38 of subjects (88.4%).The patients were operated at the age from 10 months - 15 years (mean age 4,5 years). Five patients had to be reoperated. The effects of surgical management in ambiguous genitalia were assessed using our own scale. We evaluated five anatomical and cosmetic parameters (general appearance, size of pudendal labia, symmetry of pudendal labia symmetry, size and position of clitoris, size of introitus and position of urethra opening), each of them was scored 0-2 points. RESULTS: In 36 of examined patients the result of the surgery was considered good, in 4 patients - satisfactory and in 3 - poor. The most common complication of feminizing genitoplasty in our patients was stenosed vagina (in 10 patients, 23.8%). Location of urinary coil in anterior wall of vagina was found in 6 patients (13.9%) and in 1 patient it was invisible (2.3%). Post-operational clitoral enlargement was found in 3 cases (6.9%). CONCLUSION: Taking into consideration controversial data about the results of feminizing genitoplasty, a standarized, well-defined and commonly accepted scale enabling comparison between methods and institutions is necessary. In our opinion scoring scale makes the evaluation more precise and the results are more comparable.

Effect of intrauterine infection and perinatal risk factors on serum concentrations of insulin like growth factor (IGF-I) in full-term and preterm newborns.

OBJECTIVES: IGF-I is believed to be a key factor in fetal growth dynamics It is widely known, that serious early-onset infection in the newborn is a risk factor for further developmental disturbances in a child. However, effect of congenital infection as well as an influence of infectious and non-infectious perinatal risk factors on circulating IGF-I concentrations in newborns has not been examined, yet. DESIGN: Thus, the aim of this study was: 1) evaluation of IGF-I venous blood serum concentration in full-term and premature infants considering their sex, occurrence of intrauterine infection and perinatal risk factors; 2) establishing the relationship between IGF-I serum concentrations and chosen anthropometric parameters values in infected and healthy newborns. SETTING: The study involved 112 newborns appropriate for gestational age. Taking into consideration occurrence of early onset infection and gestational age we divided examined children into 4 groups: I group--infected, full-term newborns; II group--infected premature newborns; III group--healthy full-term newborns; IV group--healthy premature newborns. In all infants immediately after birth anthropometric measurements were performed (birth weight, body length, circumference of head and circumference of chest) and serum IGF-I concentration was determined. RESULTS: We demonstrated that full-term infants with intrauterine infection have statistically significantly higher concentration of IGF-I in blood serum than infected premature infants and healthy full-term infants. Analysis of correlation revealed a significant positive linear correlations between IGF-I serum concentration and gestational age and anthropometric parameters values. CONCLUSIONS: We conclude that intrauterine infection increases serum IGF-I concentration in full-term infants, but not in preterm infants, that may be a result of immaturity. We suggest serum IGF-I concentration may be considered an additional element of developmental and nutritional state assessment in infected newborn.

Growth hormone therapy in boy with panhypopituitarism may induce pilomatricoma recurrence: case report.

Pilomatricoma is usually a solitary subcutaneous nodule. Recurrence of the nodule after surgical excision is very rare. Pilomatricoma occurrence in patients with growth hormone (GH) deficiency has not been reported, yet. We report a 14-year-old boy with pilomatricoma and panhypopituitarism. After GH therapy had been started, we observed two relapses of previously completely excised pilomatricoma in the same location and a new pilomatricoma formation on the chin.

Effects of neuroendocrine changes on results of ambulatory blood pressure monitoring (ABPM) in adolescent girls with anorexia nervosa.

OBJECTIVES: Anorexia nervosa (AN) is characterized by marked neuroendocrine and autonomic dysfunctions. In the recent studies using automatic blood pressure monitoring (ABPM), lower BP values and lack of circardian variation of BP in anorectic patients were demonstrated. Unfortunately effects of hormonal changes, that may explain BP abnormalities were not analysed together. DESIGN: The aim of our study was the assessment of ABPM and hormonal status in anorectic girls. SETTINGS: The study was performed on hospitalized 25 female anorectic adolescents aged 12-18 years. Control group was 17 age and height matched girls with normal weight and negative history for hypertension. ABPM was performed between 5 and 7 day of hospitalization, every 30 minutes during active period and every 60 minutes during sleep. Hormones (FSH, LH, estradiol, cortisol and fT4) serum concentrations were also evaluated. RESULTS: Mean systolic BP values were significantly lower in patients with AN in comparison to controls. Maximal diastolic and mean arterial pressure values for the whole day and active period but not for sleep were lower in AN than in controls. Anorectic girls showed tendency to night-time bradycardia. Moreover, there were no physiological circadian variations of BP in AN. CONCLUSIONS: We conclude that hormonal regulation of blood pressure and heart rate in anorectic patients is at least partially preserved. Lower blood pressure values, bradycardia and lack of physiological night fall of BP in anorectic patients may result from altered autonomic system function resulting from hormonal disturbances and other centrally mediated mechanisms.

[Anorexia nervosa in boys and men]. / Jadlowstret psychiczny u chlopców I mezczyzn.

Anorexia nervosa (AN) is thought to appear predominantly in girls and young women. Twenty years ago the incidence of AN was considered as 1 boy to 10-15 girls. Recent data suggest that the girls to boys rate is 4:1. The most frequently AN in boys begins during puberty. Boys and young men reluctantly apply for help to medical professionals trying to hide their symptoms. The diagnosis of AN is established and the treatment is being performed only when they suffer from a marked loss of weight or a severe depression with suicidal thoughts. We report seven male patients with AN and review the differences in a course of this disease between male and female patients.

[Quantitative changes of CD3+, CD4+, CD8+, HLA-DR+, T lymphocytes and CD25+ cells in eutrophic full-term neonates with staphylococcal septicemia]. / Zmiany ilosciowe limfocytów CD3+, CD4+, CD8+ i HLA-DR+ oraz komórek CD25+ u eutroficznych noworodków donoszonych z posocznica gronkowcowa.

OBJECTIVE: Influence of staphylococcal septicemia on changes of share and changes of amount of CD3+ lymphocytes and their subpopulation as well as CD25+ cells in eutrophic full-term neonates. MATERIALS AND METHODS: In 52 full-term neonates, with birthweight ranged from 2900 to 4500 g, including 30 infants with staphylococcal septicemia caused by Staphylococcus epidermidis (19 cases), S. sciuri (2 cases) S. varneri, S. hominis, S. haemolyticus and S. aureus (6 cases) and 22 healthy neonates (control group) the subpopulation of CD3+, CD4+, CD8+, HLA-DR+ lymphocytes in venous blood was estimated using flow cytometer FACScan with monoclonal antibodies of Becton Dickinson. RESULTS: Average percentage of CD3+ (69.2 +/- 5.9%), CD4+ (48.9 +/- 10.7%) and HLA-DR+ (1.8 +/- 0.9%) lymphocytes and average CD4+/CD8+ ratio (2.97 +/- 1.33) in neonates with septicemia did not significantly differ from average values of these parameters in healthy neonates that were: CD3+ (69.1 +/- 9.0%), CD4+ (47.4 +/- 10.6%), HLA-DR+ (1.5 +/- 0.5%) and CD4+/CD8+ (2.29 +/- 1.29). Likewise the average numbers of these lymphocytes were close to the values found in the control group. Whereas the average subpopulation of CD8+ (19.2 +/- 4.6%) lymphocytes in ill neonates was significantly lower (p = 0.007) than in healthy ones (23.6 +/- 6.6%), and the average number of CD25+ cells was essentially (p = 0.01) higher in septicemia neonates (8.5 +/- 2.5) compared to the control group (6.6 +/- 1.3%). Average numbers of these cells in ill neonates did not substantially differ from their average values in control group. CONCLUSIONS: 1. Staphylococcal septicemia significantly decreases the values of subpopulation of CD8+ lymphocytes and increases the number of CD25+ cells in eutrophic full-term neonates. 2. Estimation of lymphocytes, and their subpopulation and CD25+ cells in neonates with staphylococcal septicemia may be useful in assessment of immunological changes in severe infections.