Our study underscores the fact that lactose malabsorption often occurs in patients with systemic sclerosis. Furthermore, our findings highlight the fact that lactose breath test is a helpful, noninvasive method, by identifying the group of patients with systemic sclerosis with symptomatic lactose malabsorption that may benefit from a reduction in lactose intake.
Summary: Automatic sleep EEG analysis was performed on infants from 2 to 11 months of age. Partial power spectra of 1>, e, Ct, and 131 bands were studied as function of sleep stages, age, and time of the night. 131' Ct, and 1> power spectra are significantly lower in paradoxical sleep (PS) than in quiet sleep (QS) whatever the age; but theta is lower in PS than in QS only after 5 months of age. 1>, e, and Ct power increase with age in QS. Only 1> and e are greater in the first half of the night than in the second half. 131 power does not differ significantly in stages 2 and 3 of QS, during the course of the night or as a function of age. Thus 1>, e, Ct may be the best spectral parameters for the maturation of quiet sleep EEGs during the first year of life. Key Words: Automatic analysis-Sleep EEG-Infants.We have previously developed and reported a system of automatic computerized analysis of sleep in infants (1,2), which is valid for full-term infants aged 2-11 months. U sing data from these subjects we studied the development of different EEG frequency bands as a function of sleep stage and course of the night during the first year of life. SUBJECTS AND METHODSTwenty infants younger than 5 months of age and 23 infants aged 5 -11 months were recorded during sleep (Table O. The younger group was recorded during the day (morning sleep), the older group during the first half of the night. Eighteen other infants aged 3-11 months had all-night recordings. These 61 full-term infants were either control subjects, with no serious neurological or medical pathology, receiving no medication, or siblings of infants who had died of Sudden Infant Death Syndrome (SIDS). Sterman et aI. (3) have found only a few minor differences in SIDS siblings as compared with normal subjects at 4 and 8 weeks of age. All of the infants in our study were older than 8 weeks of age, and no differences were found by Sterman et al. in these older babies. Data from the 18 children who had full-night recordings were used for a com-
Aldosterone, produced by the adrenals and under the control of plasma angiotensin and potassium levels, regulates hydromineral homeostasis and blood pressure. Here we report that the neuropeptide substance P (SP) released by intraadrenal nerve fibres, stimulates aldosterone secretion via binding to neurokinin type 1 receptors (NK1R) expressed by aldosterone-producing adrenocortical cells. The action of SP is mediated by the extracellular signal-regulated kinase pathway and involves upregulation of steroidogenic enzymes. We also conducted a prospective proof-of-concept, double blind, placebo-controlled clinical trial aimed to investigate the impact of the NK1R antagonist aprepitant on aldosterone secretion in healthy male volunteers (EudraCT: 2008-003367-40, ClinicalTrial.gov: NCT00977223). Participants received during two 7-day treatment periods aprepitant (125 mg on the 1 st day and 80 mg during the following days) or placebo in a random order at a 2-week interval. The primary endpoint was plasma aldosterone levels during posture test. Secondary endpoints included basal aldosterone alterations, plasma aldosterone variation during metoclopramide and hypoglycaemia tests, and basal and stimulated alterations of renin, cortisol and ACTH during the three different stimulatory tests. The safety of the treatment was assessed on the basis of serum transaminase measurements on days 4 and 7. All pre-specified endpoints were achieved. Aprepitant decreases aldosterone production by around 30% but does not influence the aldosterone response to upright posture. These results indicate that the autonomic nervous system exerts a direct stimulatory tone on mineralocorticoid synthesis through SP, and thus plays a role in the maintenance of hydromineral homeostasis. This regulatory mechanism may be involved in aldosterone excess syndromes.
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