Roberto Toraldo
University of Naples Federico II
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Nutrition Research | 1995
Antonio Marotta; Nicola Todisco; Antonino Di Toro; Roberto Toraldo; Giuseppe Ponte; L. Perrone
Abstract Thirty-three obese children (5 – 15 years of age) and 15 lean controls (5 – 8 years of age) were included in the study. Zinc content in cell subsets of lymphomonocytes (LMs) and polymorphonuclear cells (PMNc), in plasma and erythrocytes was evaluated. Cell populations were separated by density gradient technique. In obese children the mean level of LMs zinc content was significantly lower than in controls (1.59±0.53 vs 2.18±0.61 nmol/mg of proteins respectively). No significant difference in the zinc content of PMNc, plasma and erythrocytes was found between groups. A significant inverse correlation between LMs zinc content and degree of obesity (percent of overweight and arm-fat area) was observed. The low zinc content in lymphomonocytes may be of relevance as an index of zinc deficiency in obese children. However, the relationship between the zinc content in lymphomonocytes and the immune response still requires further investigation.
Journal of Pediatric Gastroenterology and Nutrition | 1992
Michele D'Avanzo; Christa Cobbaert; Carlo Tolone; Roberto Toraldo; Gianfranco Canino; Francesco Vetrano; Raffaele Santinelli; Ferdinando Iafusco
In macroamylasemia, a macromolecular complex consisting of amylase linked to immunoglobulins circulates in the plasma and usually causes benign hyperamylasemia with low or normal amylasuria. Macroamylasemia is extremely rare in pediatric patients as it has been described in only four patients. We report herein the case of a 5-year-old girl with abdominal pain and macroamylasemia. To recognize macroamylase, we used agar gel electrophoresis, PEG precipitation, and fast protein liquid chromatography (FPLC). In our case, FPLC was found to be the most reliable method for the identification of the macromolecular complex. Macroamylasemia is merely a biochemical abnormality that is not associated with any kind of pathology. Its identification is therefore essential in order to avoid a wrong diagnosis, i.e., pancreatitis, with consequent inappropriate therapies.
Acta Paediatrica | 1992
Roberto Toraldo; Carlo Tolone; P. Catalanotti; R. Ianniello; Michele D'Avanzo; G Canino; F. Galdiero; Ferdinando Iafusco
Adherence, metabolic burst and chemotaxis of polymorphonuclear neutrophils (PMNs) were examined in 15 children before and seven days after measles‐mumps‐rubella vaccine administration. In all children, PMN functions were significantly reduced on the seventh day. Adherence, metabolic burst and chemotaxis tested in three subjects one month after vaccination had returned to normal values. Only two children presented transient hyperpyrexia. We conclude that measles‐mumps‐rubella vaccine administration suppresses PMN functions without clinical consequences. This is probably because attenuated strains of vaccine viruses do not replicate in lymphoid tissues as extensively as do wild‐type strains.
British Journal of Haematology | 1988
Michele D'Avanzo; Vito Pistoia; Carlo Tolone; Roberto Toraldo; Raffaele Santinelli; Ferdinando Iafusco
The association of congenital hypoplastic anaemia and triphalangeal thumbs was first described in two male siblings by Aase & Smith (1969). To our knowledge, only eight patients (five males and three females) have been reported in the literature (Pfeiffer & Ambs, 1983). Here we describe an additional case. The patient was a female infant who achieved a prolonged clinical remission upon corticosteroid treatment. A female infant was delivered at full term. Her weight was 2.8 kg and length 49 cm. Physical examination at 3 months revealed growth retardation (weight 3.35 kg: length 53 cm), cleft soft palate, micrognatia and triphalangeal right thumb. There was no family history of haematological disease or hand deformity. The haemoglobin concentration was 8.2 g/ dl, the red cell count 2.4 x 10l2/1, reticulocytes 3%. MCV 91 fl. The white cell count was 1 2 . 4 ~ 10y/l with 38.7% neutrophils, 48.4% lymphocytes, 7.3% monocytes, 2.4% eosinophils and 1.1% basophils. The platelet count was 1020 x 1 Oy/l. The serum iron concentration was 14.7 pmol/ 1. Fetal haemoglobin concentration was determined on one occasion and was in the normal range. Chromosome studies on cultured lymphocytes showed a normal 46 XX karyotype. Dermatoglyphic analysis showed distal displacement of palmar triradii. The severe anaemic state prompted a transfusion with packed red cells. Subsequent examination revealed a slow pattern of growth that persisted until the age of 8 months (weight 3.48 kg; length 56 cm). No evidence for intestinal malabsorption was obtained. Subsequently the physical condition of the patient improved. At the age of 18 months s8he had reached 10.2 kg and her height was 72 cm. Throughout this period haemoglobin values consistently ranged between 8.5 and 9.5 g/dl. Sixteen months later, the patient was weak, looked very pale and her haemoglobin was 3.3 g/dl. The red cell count was 0.97 x 10IL/l, haematocrit 10%. retiiculocytes 3%. the WBC count 6.3 x 10y/l, platelets 430 x 1OY/1. Direct and indirect Coombs tests were negative. Glucose-~5-phosphate-dehydrogenase activity was in the normal range. No pathologic haemoglobins were found. The bone marrow aspirate showed hypoplasia of the erythroid series with normal numbers of immature cells of the other lineages and absence of infiltrating mononuclear cells. Throughout the clinical history of the patient MCV varied between 87 and 97 fl the latter value being when anaemia had reached its nadir (Hb 3.3 g/dl). This trend to macrocytosis may indicate the occurrence of dyserythropoiesis. Neutropenia was. however, never observed. The patient was transfused with packed red cells and the haemoglobin rose to 7.6 g/dl. She was subsequently treated with the corticosteroid Deflazacort (2 mg/kg/d) for 1 month. A prompt reticulocytosis (6%) was observed and the haemoglobin value increased to 11 g/dl. Anaemia recurred when the drug was discontinued but responded readily to a second course of Deflazacort (2 g/kg/d). Two months later Deflazacort was tapered to 1 mg/kg/d. Treatment with this schedule has been continued. The patient is now 4 years old and haemoglobin levels consistently range from 10 to 11 g/dl. Macrocytosis has almost completely disappeared. Mononuclear cells (MNC) were isolated from heparinized bone marrow samples by centrifugation on Fycoll-Hypaque density gradients. 1 x lo5 MNC were suspended in 1 ml of a mixture containing 0.8% methylcellulose (Dow Chemical Company, Midland, Michigan), alpha-medium (Gibco, Grand Island Biological Company, New York), 30% heat-inactivated fetal calf serum (Gibco), 10 -4 M alpha-thyglycerol, 1 % penicillin-streptomycin, and 2 IU erythropoietin (Connaught Labs, Ontario, Canada). Plates were incubated at 3 7OC in 5% C02 and scored for colony forming unit erythroid (CFU-E) after 7 d and for burst forming unit erythroid (BFU-E) after 14 d. Only benzidine-positive colonies comprised at least of eight cells for CFU-E and 50 cells for BFU-E were enumerated (Pistoia et al, 1985). 1 x lo5 bone marrow MNC were resuspended in 1 ml of a mixture containing 0.3% agar, alpha-medium, 10% heatinactivated FCS, non-essential aminoacids, L-glutamine, sodium pyruvate, and the conditioned medium of the GCT cell line (Gibco), at the final concentration of 10% (Pike & Robinson, 1980). In some experiments, the source of colony stimulating activity (CSA) was the conditioned medium of T lymphoma cell line MO (Golde et al, 1978), used at 37°C in 5% COz and scored for colonies after 14 d. A colony was defined as an aggregate containing more than 50 cells. All the above cultures were set up in triplicate: results are means fSE. Culture of bone marrow MNC from the untreated patient gave rise to 223f30x lo5 cells BFU-E 1 3 0 f 10 x lo5 cells and 2 19 f 35 x lo5 cells colony forming unit granulocyte-macrophage (CFU-GM). The numbers of CFU-GM colonies obtained with the GCT and the MO cell line conditioned media were superimposable. The above values fell into our normal range, determined by culturing control marrows from haematologically normal individuals aged between 3 months and 35 years: BFU-E 100-275 x lo5 cells: CFU-E 50-260 x lo5 cells; 14 d CFU-GM 70-230 x lo5 cells. The coexistence of congenital hypoplastic anaemia with triphalangeal thumb in the patient herein reported suggested the diagnosis of Aase-Smith syndrome. The absence of chromosomal fragility, leucopenia, and thrombocytopenia helped to rule out Fanconis syndrome. Likewise, the presence of a triphalangeal thumb in our case was monolateral similarly to that reported by Pfeiffer & Ambs (1983). The
Pediatric Hematology and Oncology | 1994
Michele D'Avanzo; Vito Pistoia; Raffaele Santinelli; Carlo Tolone; Roberto Toraldo; Anna Corcione; Cianfranco Canino; Ferdinando Lafusco
Here we report two children with Aase-Smith syndrome (triphalangeal thumbs and congenital red cell plasia). In vitro growth of erythroid colonies was normal in the first patient and totally absent in the other. In both patients, treatment with glucocorticoids induced remission of anemia. Our results suggest that the different growth patterns of erythroid colonies observed in the two patients could reflect the defect of erythroid differentiation occurring at discrete maturational levels.
The Journal of Pediatrics | 1991
Michele D'Avanzo; Roberto Toraldo; Antonio Fazzone; Maria L. Papa; Raffaele Santinelli; Carlo Tolone; Ferdinando Iafusco
gested that the factor VIII response to DDAVP is a useful test for diagnosing NDI and for identifying carriers. Subsequently, Ohzeki et al., 2 however, showed strong FVIIIC and FVIIIR:Ag responses after DDAVP stimulus of a neonate with NDI. We studied the increase in the levels of FVIIIR:Ag and FVIIIC after DDAVP stimulation in two NDI patients, respectively aged 2 and 5 years, and their obligate carrier mothers. DDAVP (0.30 #g/kg; maximum dose, 24 ~g) was diluted to a final concentration of 0.5 ~g/ml in physiologic saline solution and infused intravenously for 20 minutes. Venous blood samples were collected just before and 1 hour after infusion. FVIIIR:Ag was assayed by quantitative immunoeleetrophoresis with commercial monospecific antiserum (Clottimmune, aggregated human 3,-globulin-associated protein, Behringwerke, Marburg, Germany). FVIIIC was assayed in fresh samples by a one-stage method based on the partial thromboplastin time, with factor VIII-deficient plasma (Instrumentation Laboratories, Lexington, Ky.) used as substrate. Factor VIII responses were compared with mean _ 2 SD for the control group (z score). As shown in the Table, after DDAVP stimulation the first patient had no marked increase in either FVIIIC or FVIIIR:Ag levels; the second patient had a normal increase in the FVIIIC level but no FVII1R:Ag response. In the two obligate carriers, as in the second patient, there was a normal increase of FVIIIC after stimulus but no increase of FVIIIR:Ag. Our results partially differ from those of Kobrinsky. A high response of FVIIIR:Ag and FVIIIC to DDAVP stimulus was also found in the patient reported by Ohzeki. In the obligate carriers whom we studied, the FVIIIC response to DDAVP did not significantly differ from that of control subjects, but the FVIIIR:Ag response was significantly reduced in the first carrier (10% of reference values) and was completely absent in the second. On the basis of these results, one can assume NDI to be a heterogeneous illness, at least regarding the FVIII response to DDDAVP stimulus. Caution should therefore be exercised in using the test for identifying carriers or diagnosing the illness.
Acta Paediatrica | 1989
Carlo Tolone; Roberto Toraldo; P. Catalanotti; R. Ianniello; Michele D'Avanzo; F. Galdiero; Ferdinando Iafusco
ABSTRACT. The adherence of polymorphonuclear neutrophils was examined in 16 children affected by enteritis, pneumonia, hepatitis and infectious mononucleosis. The results were compared with those obtained in 30 healthy adult volunteers and in 15 healthy children of the same age. Adhesiveness was significantly higher in adults than in healthy children, and significantly higher in healthy children than in children with viral infection. In 7 patients tested one month after regression of the disorder, PMN adhesiveness had returned to normal.
Best Practice & Research Clinical Endocrinology & Metabolism | 2018
Anna Grandone; A. Di Sessa; Giuseppina Rosaria Umano; Roberto Toraldo; E. Miraglia del Giudice
The treatment of childhood obesity represents a greater challenge for pediatricians. To date, it is multidisciplinary, including behavioral, dietary, pharmacological, and surgical options. Given the limited efficacy of available treatments, scientific research on finding new solutions is very active. Several drugs comprising Metformin, Glucagon-like peptide- 1 receptor agonists, Naltrexone-bupropion, Phentermine-Topiramate, and Lorcaserin have been studied as pediatric antiobesity agents. Findings from clinical trials showed a modest but significant effect of these drugs on weight loss, but long-term studies are needed to better define their exact role. Bariatric surgery is also promising for extremely obese adolescents. Moreover, a novel approach to treat obesity might be represented by compounds inducing browning of white adipose tissue, a complex process involved in body energy homeostasis, but at present evidence in humans is lacking. We aimed to review the current knowledge regarding the available new options for pediatric obesity treatment.
Pediatric Research | 2018
Anna Grandone; Pierluigi Marzuillo; Caterina Luongo; Roberto Toraldo; Michela Mariani; Emanuele Miraglia del Giudice; Laura Perrone
BackgroundBasal levels of androgens, in particular 17-hydroxyprogesterone (17OHP), are widely debated as predictors of non-classical congenital adrenal hyperplasia (NCCAH) among patients with precocious pubarche (PP). Many authors have recommended the use of adrenocorticotropic hormone (ACTH) stimulation test in children with PP. The aim of our study was to identify clinical and biochemical predictors of NCCAH in children with PP.MethodsWe conducted a prospective study of 92 patients with PP undergoing an ACTH stimulation test. We tested the association of basal clinical and biochemical parameters with NCCAH diagnosis. Patients were suspected to have NCCAH if their stimulated 17OHP plasma levels were >10 ng/mL. In these patients, the diagnosis was confirmed by genetic test.ResultsSeven (7.6%) patients resulted having NCCAH. The best basal biochemical predictor for NCCAH was 17OHP level >2 ng/mL. In fact, a basal 17OHP level >2 ng/mL had 100% (95% confidence interval (CI), 59.04–100) sensitivity and 93% (95% CI, 85.3–97.37) specificity. The area under the receiver-operating characteristic curve for 17OHP was 0.99 (95% CI, 0.98–1.007).ConclusionsBasal 17OHP cut-off of 2 ng/mL was very effective in predicting NCCAH among our patients with PP. Assay-specific cut-off would probably be the best strategy to avoid unnecessary ACTH test.
Pediatric Diabetes | 2018
Pierluigi Marzuillo; Giulia Bellini; Francesca Punzo; Anna Di Sessa; Stefano Guarino; Giuseppina Rosaria Umano; Roberto Toraldo; Emanuele Miraglia del Giudice; Francesca Rossi
The non‐classical HLA‐class I molecule‐g (HLA‐G) gene shows a deletion/insertion (del/ins) polymorphism of a 14‐base‐pair sequence (14 bp) in the exon 8 at the 3′ untranslated region. The presence of the 14 bp insertion allele has been associated to lower soluble HLA‐G protein production, a protein with anti‐inflammatory activities. So far, no studies have investigated the relationship between HLA‐G 14 bp del/ins polymorphism and metabolic features of obese children and adolescents. We aimed to assess if the HLA‐G ins/del polymorphism, and in particular the HLA‐G ins/ins genotype determining lower sHLA‐G production, is associated to insulin resistance (evaluated by homeostasis model assessment [HOMA]) in a population of obese children.