Relation between redox potential and natural antibody levels in goat kid serum.

The redox potential and the natural antibody (NAb) levels are parameters commonly tested to verify the physiological response to stressful situations determined by farming conditions or research needs. In this paper, the redox potential, assessed by different spectrophotometric methods, was related to NAb levels together with total immunoglobulin (tot-Ig) levels in goat kid serum. Reactive oxygen metabolites (ROMs) and ceruloplasmin (CP) oxidase activity were significantly associated with NAb-IgG and NAb-IgM. Nitric oxide metabolites (NOx) and total thiol levels (TTLs) were significantly related to NAb-IgM and tot-IgM, and with NAb-IgG, respectively. A tendency was shown between ROMs and tot-IgM, and between CP and tot-IgM, where, however, the significance levels were above the cut-off values. Total oxidant status (TOS), total antioxidant activity (TAA), determined by the ABTS-based method, the ferric reducing ability of plasma (FRAP), and free radical scavenging activity (FRSA) were associated with neither NAb nor tot-Ig. The obtained results are discussed in light of the possible linkage between the (anti)oxidant status and the innate immune system in goats.

Accuracy of VirtualTouch Acoustic Radiation Force Impulse (ARFI) imaging for the diagnosis of cirrhosis during liver ultrasonography.

PURPOSE: VirtualTouch is a new technique recently proposed to evaluate liver stiffness during B-mode ultrasonography. The goal of the present study was to analyze the diagnostic accuracy of VirtualTouch in the diagnosis of cirrhosis and its correlation with transient elastography (Fibroscan). MATERIALS AND METHODS: A total of 133 patients with chronic liver disease were enrolled. 90 of 133 underwent VirtualTouch and transient elastography and 70 patients assessed with VirtualTouch were submitted to liver biopsy. Stiffness was assessed by both techniques in the right liver lobe. The diagnostic accuracy for cirrhosis was first assessed in the 90 patients submitted to transient elastography with > 13 kPa (47 % of patients) as diagnostic for cirrhosis values. The best cut-off for cirrhosis with VirtualTouch was then tested in the 70 patients with biopsy (cirrhosis in 38 % of patients). 41 patients were assessed by VirtualTouch by two different operators. RESULTS: The VirtualTouch values in controls, chronic hepatitis and cirrhosis were respectively 113, 147 and 255 cm/sec. The AUROC of liver VirtualTouch for the diagnosis of cirrhosis (reference Fibroscan) was 0.941 with 175 cm/sec as the best cut-off (sensitivity 93.0 %; specificity 85.1 %). VirtualTouch confirmed good performance also in patients with bioptic diagnosis of cirrhosis (AUROC 0.908, sensitivity 81.5 %, specificity 88.4 %,). The correlation of VirtualTouch with transient elastography was strict (r = 0.891) and the correlation in VirtualTouch measurements between two operators was also good (r = 0.874). CONCLUSION: VirtualTouch is able to identify the presence of cirrhosis with good accuracy, shows good interobserver reproducibility and the correlation of its values with those obtained by transient elastography with Fibroscan is good.

Preliminary report on effects of oxcarbazepine-treatment on serum lipid levels in children.

The aim of the present study was to assess serum lipid levels before and after treatment with oxcarbazepine (OXC) in children with epilepsy. We measured total cholesterol (TC), triglycerides (TGs) and high-density lipoprotein cholesterol (HDL-C) in 28 patients whereas only TC levels in 11 patients, during baseline period and at 3 months after the beginning of therapy with OXC. During baseline period, median values were: 4.38 mmol/l (IQR = 4.12-5.03) for TC levels, 1.72 mmol/l (IQR = 1.42-2.01) for HDL-C levels and 1.54 mmol/l (IQR = 1.29-1.96) for TGs levels. At 3 months, median values were: 4.38 mmol/l (4.10-4.95) for TC levels (P < 0.05), 1.57 mmol/l (1.34-1.93) for HDL-C levels (P < 0.005) and 1.8 mmol/l (1.23-2.34) for TGs levels (P < 0.05). Median serum lipid levels remained in the normal range, despite an increasing-trend at 3 months of treatment with OXC. Further studies are necessary to confirm these results.

Open prospective study on oxcarbazepine in epilepsy in children: a preliminary report.

PURPOSE: To evaluate the long-term efficacy, tolerability, and safety of oxcarbazepine (OXC) in children with epilepsy. METHODS: We enrolled 36 patients (median age 7.75) with new diagnosis of partial epilepsy in an open prospective study. All type of epilepsy were included: 25 patients were affected by idiopathic epilepsy, eight by symptomatic epilepsy and three by cryptogenic epilepsy. Patients were then scheduled to come back for controls at 3 months (T1), 12 months (T2) and 24 months (T3) after the beginning of OXC-monotherapy (T0). At each control we evaluated patients through their seizure diary, a questionnaire on side effects, their level of 10-monohydroxy (MHD) metabolite and laboratory analysis. RESULTS: At T1, 21/36 patients (58.3%) were seizure-free, 3/36 patients (8.3%) showed an improvement higher than 50%, 3/36 (8.3%) lower than 50%, while 2/36 worsened (5.6%). In 7/36 (19.5%) patients, no improvement was reported. At T2 13/18 patients (72.2%) were seizure-free, 1/18 showed a response to therapy higher than 50% while 2/18 worsened (11%). In two patients no improvement was reported. A correspondence between MHD plasmatic levels and clinical response (r=0.49; p<0.05) was only registered at T1. An EEG normalization was observed in 25% of cases. Side effects were reported in 25% of cases, but symptoms progressively disappeared at follow-up. CONCLUSIONS: We can therefore conclude that OXC can be considered, for its efficacy and safety, as a first line drug in children with epilepsy.

Final height of patients treated for isolated GH deficiency: examination of 83 patients.

The aim of the present study was to evaluate retrospectively the influence of various auxological and laboratory parameters on final height in a group of GH-deficient children after replacement therapy and to compare their final height with that of a group of short children with normal GH secretion and hence not treated. The final height was evaluated of 83 patients (51 males and 32 females) affected by idiopathic isolated GH deficiency and treated with recombinant human GH (hGH) for 2-7 years. Inclusion criteria at the start of treatment were short stature (mean height for chronological age in standard deviation score (SDS) -2.21) due to idiopathic isolated GH deficiency (GH peak < 8 micrograms/l after two pharmacological tests and/or mean GH concentration < 3.3 micrograms/l during the night) and treatment with recombinant hGH for at least 2 years at a dose of 15-20 U/m2 per week by s.c. injection for 6 or 7 days/ week. Mean chronological age at diagnosis was 12.2 +/- 1.7 years; 35 were prepubertal and 48 pubertal. The final height of 51 untreated short stature (mean height for chronological age in SDS -2.13 at diagnosis) subjects (42 males and 9 females: 29 prepubertal and 22 pubertal at diagnosis with mean chronological age 11.6 +/- 2.4 years) with normal GH secretion was also evaluated. In the treated subjects final height SDS was higher than that of the untreated group (-1.3 vs -1.7 SDS; P = 0.01). Both treated and untreated subjects showed a final height lower than target height, but 39% of the treated subjects vs only 20% of the untreated group (P = 0.035) had a final height greater than target height. In the treated subjects this percentage was higher in the patients improving their height for bone age in the first years of therapy. While treated females showed a positive correlation only between target and final height (P = 0.0001), in treated males final height correlated with the Bayley-Pinneau prediction at diagnosis, height for chronological age and bone age at diagnosis and target height. Patients who started therapy before puberty also showed these correlations with data calculated at the onset of puberty, together with a correlation with chronological age at the onset of puberty. When considering the influence of GH response at tests on final height, the percentage of subjects exceeding target height increased progressively according to the severity of the GH deficiency. There was no difference in height gain between the patients starting therapy before or during puberty. The height gain, however modest, obtained by our treated patients, the number of patients with final height greater than target height and the favourable comparison with the untreated short-stature subjects represent a promising result, which could be improved by personalizing treatment.

Developmental pattern of fetal growth hormone, insulin-like growth factor I, growth hormone binding protein and insulin-like growth factor binding protein-3.

AIMS: To evaluate the developmental pattern of fetal growth hormone (GH), insulin-like growth factor I (IGF-I), GH binding protein (GHBP) and IGF binding protein-3 (IGF-3); to determine the implications for fetal growth. METHODS: Serum GH, IGF-I, GHBP and IGFBP-3 were measured in 53 fetuses, 41 aged 20-26 weeks (group A) and 12 aged 31-38 weeks (group B). Fetal blood samples were obtained by direct puncture of the umbilical vein in utero. Fetal blood samples were taken to rule out beta thalassaemia, chromosome alterations, mother to fetus transmissible infections, and for maternal rhesus factor. GHBP was determined by gel filtration chromatography of serum incubated overnight with 125I-GH. GH, IGF-I and IGFBP-3 were determined by radioimmunoassay. RESULTS: Fetal serum GH concentrations in group A (median 29 micrograms/l, range 11-92) were significantly higher (P < 0.01) than those of group B (median 16.7 micrograms/l, range 4.5-29). IGF-I in group A (median 20 micrograms/l, range 4.1-53.3) was significantly lower (P < 0.01) than in group B (median 75.2 micrograms/l, range 27.8-122.3). Similarly, IGFBP-3 concentrations in group A (median 950 micrograms/l, range 580-1260) were significantly lower than those of group B (median 1920 micrograms/l, range 1070-1770). There was no significant difference between GHBP values in group A (median 8.6%, range 6.6-12.6) and group B (median 8.3%, range 6-14.3). Gestational age correlated positively with IGF-I concentrations (P < 0.0001) and IGFBP-3 (P < 0.0001) and negatively with GH (P < 0.0001). GHBP values did not correlate with gestational age. Multiple regression analysis showed a negative correlation between GH:IGF-I ratio and fetal growth indices CONCLUSIONS: The simultaneous evaluation of fetal GH, IGF-I, IGFBP-3 and GHBP suggests that the GH-IGF-I axis might already be functional in utero. The progressive improvement in the efficiency of this axis in the last part of gestation does not seem to be due to an increase in GH receptors.

Modifications of metabolic control in type 1 diabetic children and adolescents: experience over the last 20 years.

The aim of this retrospective study was to verify whether the daily number of insulin injections could have affected metabolic control in 181 unselected diabetic patients (age 0.66-14.75 yr at onset of diabetes) followed in our clinic from the 1970s to the 1990s. They were evaluated regularly since onset of disease for a mean follow-up period of 6.8 years. The factor with the greatest effect on HbA1c levels was the year of disease onset, which was negatively correlated with HbA1c independently of the daily number of injections and disease duration. Disease duration showed an effect on metabolic control only in the first 5 years of disease. Daily insulin injections affected metabolic control above all as regards 1 vs 2 or more injections. Regarding the change in insulin regimen from 2 to 3-4 injections, there was an improvement in metabolic control in patients with HbA1c > 9% and a worsening in those with HbA1c < 7%/ After the first 5 years of the disease HbA1c levels were higher in adolescent patients than in both younger and older patients. In conclusion, increasing the daily number of injections does not seem in itself capable of eliciting marked improvement in metabolic control, as in our young diabetic patients in the last decade. Multiple insulin injection therapy seems to be mostly indicated for patients with poor control and for adolescents.

Homocysteinemia, serum folate and vitamin B12 in very young patients with diabetes mellitus type 1.

BACKGROUND: Recently a link between hyperhomocysteinemia [HH(e)] and diabetic micro- and macrovascular complications has been reported. However, it is far from clear whether HH(e) is an epiphenomenon or a cause of angiopathic complications. OBJECTIVE: To try to clarify this question we studied adolescents and young diabetic patients without or with only initial complications. SUBJECTS: Plasma levels of basal homocysteinemia [H(e)], folate and vitamin B12 were measured in 76 young diabetic patients (age range 13.6-32.2 yr) and 70 normal volunteers matched for sex and age. In 68 diabetic patients and 53 controls we evaluated the levels of homocysteinemia 2 h after a methionine-loading test. METHODS: Total (free + protein bound) plasma H(e) level was measured by HPLC. RESULTS: Basal or post-load HH(e) occurred in 4.1% of diabetic patients and 12.4% of controls (frequencies not statistically different). In diabetic patients plasma homocysteine values were statistically lower than in controls, but this difference was present only in females. The females showed lower homocysteine values and higher folate levels than males only in the diabetic group. We did not find significant differences in H(e) levels between patients with early complications, late complications or without complications of any type. CONCLUSIONS: Considering very young diabetic patients, the risk of hyperhomocysteinemia does not appear to be greater than in normal controls. Furthermore, our data seem to demonstrate that HH(e) is not a preexisting condition in diabetic patients, even in those predisposed to early complications.

Is statural growth predictable in utero? Follow-up from the second trimester of gestation to the 8th year of life.

BACKGROUND: It is well known that birth weight is related to later childhood growth and adult height. It can therefore be hypothesized that this relationship exists also for fetal size before birth. OBJECTIVE: To verify whether a child's final height can be predicted by sonographic biometry in utero. SUBJECTS: We evaluated in 116 healthy children both ultrasound measurements in utero and postnatal measurements at a mean age of 6.0 +/- 1.4 years. METHODS: The following fetal ultrasound measurements were obtained: crown-rump length in the first trimester; biparietal diameter, head circumference and femur length in the second and third trimester. RESULTS: Midparental height of the children was correlated both with crown-rump length in the first trimester and with femur length (FL) in the second and third trimester. Predicted adult height was correlated both with FL in the second and third trimester, while present height of the child was correlated with FL only at the third trimester. CONCLUSIONS: FL showed a close relationship with postnatal measurements. For the extreme values of FL, it seems possible to make quite an accurate prediction of the limits of future height. We can reasonably speculate, therefore, that the basis for the future growth of the child can be found in utero.

Influence of gender and pubertal stage at diagnosis on growth outcome in childhood thyrotoxicosis: results of a collaborative study.

OBJECTIVE: To evaluate the influence of sex as well as pubertal stage at diagnosis on the growth outcome of childhood thyrotoxicosis. DESIGN: Retrospective, collaborative study. PATIENTS AND METHODS: Longitudinal auxological evaluation in 101 patients (M/F 23/78) for 4.7 +/- 3.1 years subdivided according to pubertal stage at diagnosis into prepubertal (group I) and pubertal (group II). RESULTS: At diagnosis height and bone age (BA) standard deviation score (SDS) were positive both in girls and boys of groups I and II. In boys of group II, height SDS was significantly higher than in girls of the same group (P = 0.007) and in boys of group I (P = 0.026). During the follow-up, in group I, height SDS remained positive without significant differences between boys and girls, and in group II, height SDS remained significantly lower in girls than in boys. The age at onset of puberty and the age at menarche were within the normal range. Final height (FH) was within target height (TH) range in all groups The FH SDS and the height gain (FH-TH) were similar in girls and in boys in group I and significantly higher in boys than in girls (P < 0.05) in group II. The boys of group II showed a mean height gain significantly greater than that found in all the other groups. CONCLUSIONS: Despite the advancement of BA at presentation, there were no adverse effects on subsequent growth and FH; the growth outcome seems to be better in boys than in girls in group II.

[Serotonin distribution between plasma and platelets in clinically healthy children]. / Distribuzione della serotonina nel plasma e nelle piastrine di soggetti in età pediatrica clinicamente sani.

Serotonin distribution between plasma and platelets was examined in 34 clinically healthy children. We measured 5-HT with spectrofluorometric method. We obtained no correlation between plasma and platelets 5-HT. Serotonin is more concentrated in platelets than in plasma. In fact, platelets uptake 5-HT even at low plasma concentration, by an active transport mechanism and store it in granular substructures. 5-HT uptake occurs in similar way both in platelets and in 5-HT neurons. MOreover, the 5-HT receptors react to 5-HT agonist or antagonist drugs as the receptors of some SNC areas (not those with dense 5-HT innervation). Therefore, platelets might be used as indication for 5-HT neurons activity in those SNC regions whose receptors react to drugs as platelets receptors.

Growth and thyroid function in children treated with growth hormone.

We examined the effect of growth hormone (GH) therapy on thyroid function in 57 children with isolated GH deficiency and whether this effect could influence their growth response. Thyroid function and insulin-like growth factor I levels were measured before and after 3, 6, and 12 months of recombinant-GH therapy (20 U/m2 per week, given subcutaneously), after a 1-month withdrawal from therapy, and after a further 6 months of GH administration. The serum concentration of triiodothyronine (T3) and the T3/T4 (thyroxine) ratio increased after 12 months of GH treatment, whereas total T4 and free T4 levels decreased; thyrotropin levels did not change significantly during treatment but increased after a 1-month withdrawal. After a further 6 months of GH therapy, an increase in T3 levels and in the T3/T4 ratio and a decrease in total T4 and free T4 levels were found again, and thyrotropin levels decreased. The increment in growth velocity after 12 months of therapy correlated positively with the T3/T4 ratio and negatively with total T4 and free T4 values. These data confirm in children a GH-induced enhancement of peripheral conversion of T4 to T3. This effect appears to be more evident in children who are most sensitive to GH in terms of growth-promoting activity.

Urinary growth hormone estimation in diagnosing severe growth hormone deficiency.

Urinary growth hormone was measured in 54 children with short stature who had growth hormone deficiency that was initially diagnosed pharmacologically (arginine and L-dopa) and physiologically (mean growth hormone concentration during sleep evaluated twice). Based on the growth hormone response to pharmacological tests the subjects were subdivided into three groups: group A, 20 subjects with normal response (peak concentration > 8 micrograms/l); group B, 20 subjects with response between 4 and 8 micrograms/l; and group C, 14 subjects with response < 4 micrograms/l. In group A four subjects had an abnormally low nocturnal mean growth hormone concentration (< or = 3.3 micrograms/l). In group C seven subjects had multiple pituitary hormone deficiency and abnormal magnetic resonance imaging. All subjects had urine collected from 8.00 pm to 8.00 am for 4-5 consecutive nights. A positive correlation was found between serum nocturnal mean growth hormone values and urinary growth hormone in all subjects. Mean (SD) concentrations of urinary growth hormone were similar in groups A (18.0 (9.5) ng/g creatinine) and B (13.6 (5.9) ng/g creatinine), but significantly higher than that of group C (3.4 (3.7) ng/g creatinine). Considering as abnormal urinary growth hormones below the lower limit of the range in group A, specificity and sensitivity of urinary growth hormone was 100% and 35% respectively. Sensitivity for groups B and C were 5% and 78% respectively. When considering only the subjects of group C with pathological magnetic resonance findings, sensitivity increased to 100%. In the four subjects of group A with mean growth hormone concentration < or = 3.3 micrograms/l, specificity decreased to 80%. It is concluded that urinary growth hormone assay is characterised by a sensitivity too low to be regarded as improving the traditional diagnostic approach to define growth hormone deficiency, unless it is used to identify subjects with the most severe deficiencies.

[Plasma and platelet serotonin in children with essential headache]. / La serotonina plasmatica e piastrinica in bambini con cefalea essenziale.

We examined the haematic concentration of 5 HT in idiopathic headache in children. We observed plasma and platelet 5 HT concentration in 18 migrainous patients free from painful crisis, and we compared the results with a control group of 20 clinically healthy children. No significant variation was noted in plasma 5 HT concentration between the two groups. The data are more difficult to interpret on the platelet because of the slight statistical difference (0.1 greater than p greater than 0.05). However we think suggestive the possible existence of persisting platelet anomalies in migrainous children and this hypothesis can be verified in a larger number of children free from painful crisis.

[Correlation between tryptophan, NEFA and albumins in the nephrotic syndrome]. / Studio delle correlazioni fra triptofano, NEFA e albumina nella sindrome nefrosica.

Many connections were considered between bound and free tryptophan and albumins, NEFA and other aminoacids in 18 proofs in ten subjects of paediatric age affected by nephrotic syndrome. A decrease of total tryptophan and a tendency to increase of free tryptophan were showed in our experience. NEFA, at normal concentrations, should not be responsible for this; and this could suggest that the binding sites on albumins for NEFA and tryptophan are different. Besides there is appearance of a positive correlation between albumins and bound tryptophan and a negative correlation between albumins and free tryptophan. These results can suggest that the reduction of the total tryptophan is due to the loss of the fractions bound to albumins, but urinary tryptophan is not increased in our studies. As the albumins get fewer, there is a lost in linked tryptophan and an increase of free tryptophan. A total reduction of other aromatic aminoacids can also explain, through a reduced intestinal absorption, the decrease of the tryptophan in the nephrotic syndrome.

[Separation of N-acetyl-beta-hexosaminidase isoenzymes. Methological note]. / Separazione degli isoenzimi della N-acetil-beta-esosaminidasi. Nota metodologica.

We examined the activity of total N-acetyl-beta-hexosaminidase and of its isoenzyme forms, that represent different stages of the maturation of the lysosomal hydrolase. In both methods the enzyme catalyzes the separation of 4-methylumbelliferone, a fluorescent substance, from 4-methylumelliferyl-2-acetamido-2-deoxy-beta-D-glucopyranoside. We used Leaback's method for the fluorimetric assay of total enzyme, and Ellis's DEAE-cellulose microcolum chromatography for the assay of its components. We obtained a clear separation of each fraction. We will apply these methods in our further studies of children with renal damage, because hexosaminidase seems to be one of the most sensitive markers of tubular damage.

[Plasma benzylamine oxidase activity. I). Clinically healthy pediatric subjects]. / Attivita' benzilaminossidasica plasmatica - I) soggetti in eta' pediatrica clinicamente sani.

Plasma benzylamine oxidase has been determined in clinically healthy children. No differences exist between females and males. Inhibition by penicillamine and isoniazide shows a close dependency of enzymatic activity by the presence of copper and pyridoxal phosphate.

[Plasma dopamine beta-hydroxylase activity in clinically healthy children]. / Attivita' della dopamina-beta-idrossilasi plasmatica in soggetti in eta' pediatrica clinicamente sani.

Dopamine-beta-Hydroxylase is the enzyme that catalyzes the conversion of dopamine to norepinephrine. Plasma D beta H activity was measured with spectrophotometric method in 60 healthy children of various age groups. Plasma D beta H activity is influenced by age: the means reveal a progressive rise in activity with each successive age group. Also, a great individual variation was found. Therefore, measurement of D beta H activity is not a good indication of the activity of the simpathetic nervous system, except in special pathological conditions. Moreover, the wide range of activities among normal human subjects might indicate important factors in determining the plasma D beta H level. The possibility of a genetic control must be considered.

[Relation among plasma dopamine beta-hydroxylase, monoamine oxidase and Cu++]. / Relazione fra dopamina-beta-idrossilasi, monoaminossidasi e Cu++ nel plasma.

Dopamine-beta-Hydroxylase and Monoamineoxidase are two plasmatic enzymes whose activity is Cu++ dependent. D beta H and Mao activity and Cu++ concentration has been dosed in plasma of 30 different aged subjects, using spectrophotometric methods. The obtained results show the presence of a direct correlation between MAO and Cu++, and an inverse correlation between D beta H and Cu++.

[Urinary guanidinosuccinic acid in uremic children]. / L'acido guanidinosuccinico urinario in soggetti uremici in eta' pediatrica.

Urinary guanidinosuccinic acid (GSA) was measured in pediatric age: six normal subjects, six chronically uremic patients and five with acute renal failure. Urinary GSA was increased in uremic patients as compared to that in normal subjects: our levels was less than in the growth-up people. These differences might be correlated with different protein metabolism in children.