Paolo Montaldo

Second University of Naples, Caserta, Campania, Italy

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Publications (10)24.33 Total impact

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    ABSTRACT: BACKGROUND: Previous studies reported that children with neural tube defects, but without any history of intrinsic renal diseases, have small kidneys when compared with age-matched standard renal growth. The aim of this study was to investigate the possible causes of small renal size in children with spina bifida by comparing growth hormone deficiency, physical limitations and hyperhomocysteinemia. METHODS: The sample included 187 newborns with spina bifida. Renal sizes in the patients were assessed by using maximum measurement of renal length and the measurements were compared by using the Sutherland monogram. According to the results, the sample was divided into two groups-a group of 120 patients with small kidneys (under the third percentile) and a control group of 67 newborns with normal kidney size. Plasma total homocysteine was investigated in mothers and in their children. Serum insulin-like growth factor-1 (IGF-1) levels were measured. RESULTS: Serum IGF-1 levels were normal in both groups. Children and mothers with homocysteine levels >10 μmol/l were more than twice as likely to have small kidneys and to give to birth children with small kidneys, respectively, compared with newborns and mothers with homocysteine levels <10 μmol/l. An inverse correlation was also found between the homocysteine levels of mothers and kidney sizes of children (r = - 0.6109 P ≤ 0.01). CONCLUSIONS: It is highly important for mothers with hyperhomocysteinemia to be educated about benefits of folate supplementation in order to reduce the risk of small renal size and lower renal function in children.
    Clinical and Experimental Nephrology 03/2013; 18(1). DOI:10.1007/s10157-013-0802-z · 1.71 Impact Factor
  • Luisa Montaldo, Paolo Montaldo
    Tobacco control 07/2012; 21(4):384. DOI:10.1136/tobaccocontrol-2012-050584 · 3.85 Impact Factor
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    ABSTRACT: Study Type - Therapy (case series) Level of Evidence 4 What's known on the subject? and What does the study add? The desmopressin analogue to antidiuretic vasopressin is an evidence-based therapy but conflicting results are provided regarding the initial dose of oral desmopressin. Previous studies report the use of a combined therapy with desmopressin and oxybutynin to treat desmopressin-resistant monosymptomatic nocturnal enuresis. These studies show promising results, but they suffer from lack of randomization and lack of a placebo-controlled patient group and are of small sample size. In addition to this, no predictive factors of response to the combined therapy have been considered. This study showed no significant difference between either a 120 µg or a 240 µg desmopressin initial dose with regard to degree of response. The study is the first randomized, double-blinded, placebo-controlled trial showing the efficacy of combination therapy with desmopressin plus oxybutynin for monosymptomatic nocturnal enuresis. Furthermore, bladder volume and wall thickness index, nocturnal polyuria and voiding latency were assessed as predictive factors of response to the therapy. •  To assess the efficacy of desmopressin plus oxybutynin and compare two starting dosages of desmopressin (120 and 240 µg) in a randomized, double-blinded, placebo-controlled trial for children with monosymptomatic nocturnal enuresis (MNE) resistant to desmopressin. •  The predictive factors of children with MNE responsive to desmopressin and combination therapy were also evaluated. •  Our sample included 206 patients aged between 6 and 13 (mean age 10.6 ± 2.9 years), 117 males. All patients were required to have MNE. •  The patients were randomly divided into two groups: the first group was given oral melt 120 µg and the second group 240 µg, for 2 weeks. •  All patients who had experienced failure of treatment with sublingually administered desmopressin alone were given either desmopressin plus 5 mg oxybutynin or desmopressin plus placebo in a randomized, double-blinded trial for 4 weeks. •  As predictive factors, bladder volume and wall thickness index, nocturnal polyuria and voiding latency were considered. •  There was no significant difference between the 120 µg and 240 µg patients in terms of response. •  The oxybutynin group showed a higher rate of full and partial responses (45% success) compared with the placebo group (17% success), P < 0.01. •  The responders to combined oxybutynin and desmopressin had significantly lower bladder volume and wall thickness index than the other patients. •  Our findings highlight that anticholinergic agents may play an important role for a subset of children with enuresis who have a restricted bladder capacity and thickened bladder wall. •  Ultrasonography-measured bladder variables can provide useful predictive clues for MNE. •  Predictive factors can help to differentiate treatment subtypes and guide clinical management in primary nocturnal enuresis.
    BJU International 02/2012; 110(8 Pt B):E381-6. DOI:10.1111/j.1464-410X.2011.10918.x · 3.13 Impact Factor
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    ABSTRACT: Exposure to secondhand smoke (SHS) is a serious public health threat and represents a preventable cause of morbidity among children. Sleep bruxism is characterised by teeth grinding or clenching movements during sleep and may begin in adulthood as well as in childhood. To investigate the association between SHS exposure and sleep bruxism in children. Sleep bruxism was investigated in 498 children (mean age: 9.2±1.9). Family members were interviewed and asked whether they smoked in the presence of their children. Children were classified according to their exposure to SHS into heavily, moderately, lightly and occasionally exposed. Children with sleep bruxism and exposed to SHS were randomly divided into two groups: children in group 1 were not exposed to SHS for 6 months, whereas children in group 2 were. Thirty-one per cent of the children under investigation suffered from bruxism. Among them, 116 children (76%) were exposed to SHS. Exposed children showed a higher risk of sleep bruxism (p<0.05). After 6 months, sleep bruxism was found in 38% and in 90% of children, in the first and in the second group, respectively, this difference was statistically significant (p<0.05). In group 1, changes were statistically significant in those who were heavily and moderately exposed (p<0.05) but not in those lightly and occasionally exposed (p>0.05). In group 2, changes were not statistically significant (p>0.05). The findings showed that high and moderate exposure to SHS is associated with sleep bruxism in children.
    Tobacco control 01/2012; 21(4):392-5. DOI:10.1136/tobaccocontrol-2011-050217 · 3.85 Impact Factor
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    ABSTRACT: Several studies have determined the effects of non-nutritive sucking habits on malocclusions, but provided conflicting results. To analyse the influence of infant feeding In the presence of non-nutritive sucking habits in children after the first year of life and to assess the effects of non-nutritive sucking habits on occlusion in mixed dentition. Data were collected by self-reported questionnaire and confirmed by personal interview. Parents of 1451 children (aged 7-11) were asked about their children's infant feeding and non-nutritive sucking habits. A clinical evaluation of dental arches included classification of molar relationship (Angle classification), presence or absence of crossbite and open bite. Children with bottle or complementary feeding showed a higher risk of acquiring non-nutritive sucking habits after the first year of life (P < 0.01). Non-nutritive sucking habits are associated with a greater risk of crossbite, open bite, Class II molar relationship (P < 0.01). Parents should be educated about benefits of the exclusive breast feeding in the first 6 months of age on mixed dentition. The activity of non-nutritive sucking should be diagnosed in a timely manner in order to reduce the development of posterior crossbite, anterior open bite, and Class II molar relationship.
    International Journal of Paediatric Dentistry 01/2011; 21(1):68-73. DOI:10.1111/j.1365-263X.2010.01092.x · 1.54 Impact Factor
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    ABSTRACT: 2649 negative predictive value.1 It should be noted that plasma levels of imatinib in patients given high doses of the drug exceed those of the no ­ effect level in the study of rat fertility. We also disagree with the specific reservations expressed by the correspondents. The time relationship was rea­ sonable, with oligomenorrhea occurring a few months after the increase in the dose of imatinib. There were no other exposures, and no alterna­ tive causes were found on routine investigation of amenorrhea. Finally, the hypothesis of an etiolog­ ic link between imatinib and ovarian insufficiency is biologically plausible, since pathways involving kinases targeted by imatinib appear to play criti­ cal roles in the survival and maturation of folli­ cles and oocytes.2-4
    Journal of Cardiovascular Medicine 01/2011; 12(1):5. DOI:10.2459/JCM.0b013e328341aed3 · 1.41 Impact Factor
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    ABSTRACT: To assess oral status in a sample of Type 2 diabetic patients before and after therapy with saliva substitutes and oral status in a control group of diabetic patients who were not given saliva substitutes. Salivary flow rate was determined in 134 patients (mean age 47.9 ± 2.9 years) with Type 2 diabetes. Mean salivary rate was significantly low compared with a healthy control group. The sample of 134 patients was randomly divided into two groups of 67 people each. One group was given immunologically active salivary substitutes for 6 months, the other group was given nothing. Each patient of the two groups underwent a dental and periodontal examination at the beginning of the study and 6 months later. As regards carious teeth and teeth loss, there was no statistical difference between the first group after 6 months of treatment with salivary substitutes and the control group (P>0.01). Salivary substitutes did not significantly reduce the periodontal disease (P>0.01). In the group treated with salivary substitutes, after 6 months of therapy, the average dental plaque index decreased from 2.3 ± 0.73 to 1.6 ± 0.56, patients with gingivitis decreased from 66 to 43% and patients with positive yeast counts decreased from 60 to 37%. These differences were statistically significant (P<0.01). In Type 2 diabetes, in the case of hyposalivation, a therapy with immunologically active saliva substitutes can be of help in reducing the amount of plaque, gingivitis and positive yeast counts.
    Diabetic Medicine 11/2010; 27(11):1280-3. DOI:10.1111/j.1464-5491.2010.03063.x · 3.24 Impact Factor
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    ABSTRACT: Large facial haemangiomas have a high rate of complications and can be associated with neurological, ophthalmological and cardiac abnormalities (PHACE syndrome; Posterior fossa malformations, Haemangiomas, Arterial anomalies, Coarctation of the aorta and cardiac defects, and Eye abnormalities). However, a thorough clinical examination is absolutely necessary. In fact, even in the absence of a PHACE syndrome, large haemangiomas can induce important complications. In the present brief report we describe a case of left ventricular dilatation in a 6-month-old girl due to a giant facial haemangioma. Left ventricular dilatation has been evaluated by two-dimensional echocardiography. Studies to identify other major arteriovenous malformations were negative. Medical therapy with diuretics, angiotensin-converting enzyme (ACE) inhibitors and steroids was able to halt the progression towards left ventricular dysfunction, avoiding an early surgical approach for a disease that very often is self-limiting.
    Journal of Cardiovascular Medicine 09/2010; 11(9):692-4. DOI:10.2459/JCM.0b013e328332e861 · 1.41 Impact Factor
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    ABSTRACT: To demonstrate a relationship between enuresis and nocturia. The study investigated 250 mothers (average age 34.6 +/- 3.3 years) whose children attended the Department of Pediatrics of the Second University of Naples because they suffered from enuresis. Data were collected by self-reported questionnaire and personal interview. All women provided written informed consent with guarantees of confidentiality. Both the presence of nocturia in adulthood and enuresis in childhood were taken into account. The overall prevalence of nocturia was 38% (n = 95). There was a history of childhood bedwetting in eight mothers (5%) without nocturia and in 61 mothers (65%) with nocturia; the difference was significant (chi(2) p < 0.01). Moreover, among the 110 enuretic children of nocturic mothers, 69 (62%) suffered from non-monosymptomatic nocturnal enuresis (NMNE), and 34 (56%) of their mothers suffered from NMNE in childhood. Nocturic mothers suffering from non-monosymptomatic enuresis during their childhood had offspring with a higher risk of developing non-monosymptomatic enuresis (odds ratio 4.3 95%, confidence interval 2.6-7.1, p < 0.01). These findings enabled a close connection between nocturia in adulthood and enuresis in childhood to be hypothesized. Furthermore, this analysis provided evidence of the link between suffering from nocturia, and previously from enuresis, and having children affected by enuresis.
    Scandinavian Journal of Urology and Nephrology 03/2010; 44(2):101-5. DOI:10.3109/00365590903510737 · 1.06 Impact Factor
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    ABSTRACT: To compare urodynamic (UD) and ultrasonography (US)-based measurements for the diagnosis and follow-up of patients with non-monosymptomatic primary nocturnal enuresis (NMPNE). The study included 455 enuretic children (282 boys and 173 girls, mean age 9.58 years) with daytime voiding symptoms and with more than one void per night. In healthy children the upper limits for US-measured bladder wall thickness are 3 and 5 mm for a full or empty bladder, respectively. In 419 children the results showed urodynamic signs of an overactive bladder (OAB) and the US-measured bladder wall was thickened. After 6 months of antimuscarinic treatment, we re-assessed the children with US and UD; the relation between UD and US measurements was confirmed. After analysing these data, we considered the use of a new diagnostic assessment for patients with NMPNE. In children with a significant US measurement, i.e. a bladder wall with a thickness of >3 mm (full bladder) and >5 mm (empty bladder), the diagnostic assessment was concluded and therapy was started. We restricted the UD examination exclusively to those patients who either had severe intractable symptoms or did not respond to treatment. This new management was applied to 453 patients with NMPNE. After the first 6 months of therapy all the patients were assessed with a new US study. In all, 343 patients (75.7%) were full-responders, with a normal bladder wall thickness; 82 (18.1%) were partial responders but with no normalization of bladder wall thickness; only 28 (6.2%) were classified as nonresponders with a persistent thickened bladder wall. We favour a more conservative management: the UD study should be limited to the very few patients who either have severe intractable symptoms or do not respond to treatment. In our experience, the US study, which is not invasive, is useful for the diagnosis and follow-up of NMPNE and it is preferable to the UD study, which is invasive and often traumatic for children.
    BJU International 08/2009; 105(1):108-11. DOI:10.1111/j.1464-410X.2009.08735.x · 3.13 Impact Factor