F. Chiarelli - Academia.edu (original) (raw)

Papers by F. Chiarelli

Thyroid, 2000

To study thyroid function in children with perinatal HIV-1 infection retrospectively and determin... more To study thyroid function in children with perinatal HIV-1 infection retrospectively and determine whether thyroid abnormalities are correlated with clinical condition, disease progression, immunological impairment, and viral load. Total (TT4) and free (FT4) thyroxine, total (TT3) and free (FT3) triiodothyronine, reverse triiodothyronine (rT3), thyrotropin (TSH), thyroglobulin (TG), and thyroid binding globulin (TBG) were measured twice in 56 children with perinatal human immunodeficiency virus type 1 (HIV-1) infection. Median age at first determination was 13.5 (range: 0.03-127.0) months; median age at second determination was 66.2 (range 3.42-147.4) months. Antithyroglobulin, antimicrosomal, thyroid peroxidase, and thyrotropin receptor antibodies were also evaluated. Fifty-three healthy children were selected as controls. TT3, TT4, FT4, and TG were significantly reduced and rT3, TBG, and TSH increased in children with HIV-1 infection when compared with controls. Thyroid dysfunction correlated with severe immunosuppression and high viral load early in life preceded the onset of the disease and worsened over time. Autoantibodies were negative in all children with HIV-1 infection in all determinations. Thyroid abnormalities are observed early in the course of perinatal HIV-1 infection; thyroid dysfunction is particularly pronounced in children with severe immunosuppression and high viral load. Modifications of thyroid function precede worsening of clinical course in HIV-1 infected children.

International Journal of Clinical & Laboratory Research, 1999

International journal of immunopathology and pharmacology

In this study, the clinical findings and management of allergic skin reactions induced by the mos... more In this study, the clinical findings and management of allergic skin reactions induced by the most used antiepileptic drugs, Lamotrigine (LMT) and Carbamazepine (CBZ), were evaluated. Lamotrigine is an antiepileptic drug recently released in several countries; it is effective for a variety of seizure types in adults and children, both as an add-on agent and in monotherapy, and it is generally well tolerated. Clinical and epidemiologic evidence suggest serious cutaneous reactions to antiepileptic drugs are more likely to occur during the first 8 weeks and they appear to increase when drugs are administered with other anticonvulsants, such as Valproate (VPA). We selected 10 patients who presented an idiosyncratic skin rash when treated with carbamazepine (8 patients) and lamotrigine (2 patients) administered as monotherapy, and we followed up on these patients for several years. Seven reactions were mild/severe cutaneous eruptions; one Toxic Epidermal Necrolysis, a case of Stevens-Joh...

Minerva pediatrica, 2002

Diabetic angiopathy includes those complications associated with chronic hyperglycaemia. The majo... more Diabetic angiopathy includes those complications associated with chronic hyperglycaemia. The major long-term complications of diabetes can be categorized into two classes: macrovascular (i.e., cardiovascular complications) and microvascular (i.e., nephropathy, retinopathy, and neuropathy). Clinically evident diabetic vascular disease is rare in children and adolescents with type 1 diabetes mellitus: however, the permanent threat of severe vascular organ disease within one or two decades, of early invalidity and limited life expectancy following long-term poor metabolic regulation (which is known to the health professional but only incompletely sensed by the young patient), forces the paediatrician to try to reach from the start the aim of normoglycaemia instead of merely somewhat reduced hyperglycaemia, normal lipid and amino acid patterns and near normal fluctuations of all metabolic parameters. With our present means of intervention, this goal is achieved only temporarily, if at a...

Diabetes, nutrition & metabolism, 2001

The main therapeutic challenge in the treatment of Type 1 diabetes is maintenance of near-normogl... more The main therapeutic challenge in the treatment of Type 1 diabetes is maintenance of near-normoglycaemia in order to prevent long-term complications and avoid hypoglycaemia. This goal is relevant from the onset of the disease and is feasible if physiological models of insulin replacement are used and patients are educated in the strategy of intensive insulin therapy. Although the use of available insulins within a multiple injection regimen has improved, metabolic control it is still far from being optimal. The recent introduction of insulin analogues with a short- and long-acting profile seems promising in improving metabolic control and quality of care. Insulin lispro and insulin aspart, the short-acting insulin analogues offer a better post-prandial profile, while insulin glargine the new long-acting insulin analogue might provide better overnight control. In fact, the theoretical combination of an acute prandial insulin peak with a flat interprandial and overnight plasma profile...

Diabetes, nutrition & metabolism, 1999

Panminerva medica, 1998

Three full term newborns with focal ischemic injury of the middle cerebral artery (MCA) were obse... more Three full term newborns with focal ischemic injury of the middle cerebral artery (MCA) were observed. Diagnosis was suspected by cerebral ultrasonography (US) in the first year of life and then was confirmed by CT-scan and/or MRI. All children had a history of pre-perinatal risk factors of fetal impairment. Neuropsychological outcome, ranging from normal to severe, was evaluated in all three patients; it appears to be related to the type and extension of cerebral injury. In full-term neonates with discrete, moderate or severe neurologic symptoms the possibility of focal ischemic injury in the MCA territory should be considered.

Pediatric Nephrology, 1995

Pediatric Dermatology, 1995

Neurology, 2005

The authors studied 40 epileptic patients treated with valproate and 40 healthy controls for at l... more The authors studied 40 epileptic patients treated with valproate and 40 healthy controls for at least 2 years. At the end of follow-up, 15 epileptic patients (37.5%) had development of obesity. They showed circulating leptin and insulin levels significantly higher and ghrelin and adiponectin levels significantly lower than those of patients who did not gain weight.

Journal of Pediatric Endocrinology and Metabolism, 1999

... Annalisa Blasetti, Alberto Verrotti, Stefano Tumini, Maria Borgia and Francesco Chiarelli ...... more ... Annalisa Blasetti, Alberto Verrotti, Stefano Tumini, Maria Borgia and Francesco Chiarelli ... REFERENCES 1. Deschamps I, Lestradet H, Bonaiti C, Schmid M, Busson M, Benajam A, Marcelli-Barge A, Hors J. HLA genotype studies in juvenile insulin-dependent diabetes. ...

Journal of Pediatric Endocrinology and Metabolism, 1996

Journal of Paediatrics and Child Health, 1997

To assess the effect of long-term treatment of phenobarbital, carbamazepine and sodium valproate ... more To assess the effect of long-term treatment of phenobarbital, carbamazepine and sodium valproate on serum lipids and lipoproteins in epileptic children. One hundred and fourteen (55 male, 59 female) children and adolescents suffering from various types of epilepsy who received different antiepileptic drugs were studied. The patients were subdivided into three groups according to their therapy: (i) carbamazepine (35 patients); (ii) phenobarbital (34 patients); and (iii) sodium valproate (45 patients). One-hundred healthy sex- and age-matched children served as controls. Lipids and lipoprotein profile were evaluated before the beginning of the anticonvulsant therapy and after at least 2.5 years. In the patients receiving phenobarbital, we re-evaluated 12 children (seven male, five female) at the end of therapy. The children receiving phenobarbital showed high levels of serum total cholesterol and low-density lipoprotein (LDL) cholesterol and low levels of triglycerides, while children treated with carbamazepine had high levels of total cholesterol, triglycerides, LDL and high-density lipoprotein (HDL) cholesterol. Children treated with valproate had low triglycerides and LDL cholesterol levels with high levels of HDL cholesterol. The patients treated with phenobarbital showed a normalization of all parameters after the end of therapy. Anticonvulsant drugs significantly modify serum lipids and lipoproteins in epileptic children. The changes due to phenobarbital seem to be transient.

Journal of Child Neurology, 2001

Neuropathy is well recognized as a major complication of insulin-dependent diabetes mellitus in a... more Neuropathy is well recognized as a major complication of insulin-dependent diabetes mellitus in adults, resulting in significant morbidity and possibly an increased mortality. Both the peripheral and autonomic nervous systems can be involved, and adolescents with diabetes can show early evidence of neuropathy. The pathogenesis of diabetic neuropathy remains unclear but is thought to involve various mechanisms. This complication can be traced to the metabolic effects of hyperglycemia and/or other effects of insulin deficiency on the various constituents of the peripheral nerve. The polyol pathway and/or nonenzymatic glycation affecting one or more cell types in the multicellular constituents of the peripheral nerve appear likely to have an inciting role. The role of other factors, such as possible direct neurotrophic effects of insulin and insulin-related growth factors, seems to be relevant. (J Child Neurol 2001;16:389-394).

Hormone Research in Paediatrics, 2010

Introduction: Data concerning final height are completely lacking in human immunodeficiency virus... more Introduction: Data concerning final height are completely lacking in human immunodeficiency virus (HIV)-infected children. Design: Retrospective evaluation of auxological data up to final height in a cohort of patients with perinatal HIV infection. Patients and Methods: In 95 Caucasian patients (57 females and 38 males, median age 17.5 years) the following data were evaluated as standard deviation (SD) score: prepubertal height (PrH), height velocity (HV), final height (FH), target height (TH), FH minus PrH, predicted adult height (PAH), FH minus PAH, and FH minus TH. Results: Patients showed a significantly reduced PrH and FH compared to their TH (p < 0.001), even if no difference was evidenced between PrH and FH. Age at puberty onset displayed a negative significant correlation with PrH (p = 0.002) and CD4+ cell percentage (p < 0.01). Finally, HV displayed a significant correlation with viremia (p = 0.001), but not with CD4+ cell percentage. Conclusions: HIV perinatally infe...

Hormone Research in Paediatrics, 1998

Management methods for quality of diabetes care need new approaches because of the poor metabolic... more Management methods for quality of diabetes care need new approaches because of the poor metabolic control of most of these patients. Poor quality of care generally results from poor instruction and training rather than from misbehaviour of both patients and their families. Structure quality of care (who and where?), process quality (how?, which are the goals, what resolution is taken and what advice for every-day life is given) and outcome quality (which measurements must be done for the evaluation of the progression of the disease and its control) must all be ameliorated and improved. Regional governments and communities should raise funds for the establishment of diabetes centers, giving recognition and economic support to diabetic children and their families and providing for educational programs on diabetic management and care. The educational aspect seems to be crucial for a good metabolic control not only for the practice of treatment (insulin dosage, home blood glucose monito...

Diabetes Research and Clinical Practice, 1999

Diabetes Care, 2006

OBJECTIVE—The aim of the present study was to evaluate serum and urinary nitric oxide (NO) concen... more OBJECTIVE—The aim of the present study was to evaluate serum and urinary nitric oxide (NO) concentrations in children and adolescents with diabetes compared with age-matched healthy control subjects to find out whether Doppler ultrasonography could be used to detect changes in renal resistive indexes (RIs) in children with diabetes and to assess whether there are correlations between these parameters and NO excretion. RESEARCH DESIGN AND METHODS—We studied 42 children with type 1 diabetes and 41 matched healthy control subjects, both divided into prepubertal or pubertal children. Serum and urinary nitrite and nitrate (NO2−+NO3−) concentrations were evaluated as an index of NO production. Doppler ultrasonographic registration of intrarenal RI was performed. RESULTS—Compared with healthy control subjects, children with diabetes had significantly increased concentrations of serum (30.26 ± 6.52 vs. 24.47 ± 7.27 mmol/l, P = 0.001) and urinary NO2−+NO3− (345.07 ± 151.35 vs. 245.86 ± 80.25...

British Journal of Dermatology, 1987