[Therapy with arginine chlorohydrate in children with short constitutional stature]. / Terapia con arginina cloridrato nella bassa statura costituzionale (BSC).

It is common knowledge that the administration by mouth of chlorhydrate arginine in children with BSC is followed by an increase of plasma levels of Growth Hormone and Insulin as well as an improvement of statural growth. In order to confirm or disprove this observation we have administrated chlorhydrate arginine for six months in children affected by BSC. We have treated 20 prepubertal children (14 males, 6 females) affected by BSC (13 constitutional growth delay, and 7 familiar short stature) with chronological age ranged from 4.75 to 12.55 years, and bone age from 3 to 12 years, with height < 10 degrees centile. The chlorhydrate arginine was administered by mouth at a daily dosage of 4 g (1 phial/2) for 6 months. Height was controlled 6 months before treatment ("off" period) at the start, and after 6 months of treatment ("on" period). Before the start of treatment GH release was assessed with 3 pharmacological tests (arginine, insulin and clonidine) at last of treatment has been made only arginine test in order to investigate GH and insulin response. We have compared the "off" with "on" period and we have observed a substantial improvement (p < 0.01) of the height velocity (HC), worded in SDS-HC (standard deviation score of height velocity) that changed from -1.21 +/- 0.40 to -0.30 +/- 1.37 with a positive difference of +0.91 +/- 0.47 between the two periods. As for as GH release is concerned we have observed, after therapy, a significant increase of mean almost twice that see in the "off" period and the difference is significant p = 0.012).(ABSTRACT TRUNCATED AT 250 WORDS)

Decrease in serum IgE associated with limited restriction in energy intake to treat toddler's diarrhea.

Toddler's diarrhea may be an allergic disease and its recurrences can be avoided with education to "internal spontaneity" in feeding, i.e., by education to a limited and reproducible decrease in eating incentives at the onset of meals. Serum IgE was thus investigated in 16 experimental children in a random comparison with 16 controls, all aged 1 to 4 years, before and after seven months' dietary treatment. Compliance was measured with a seven-day written diary, while serum IgE was measured by PRIST, before and after dietary treatment. A 21% decrease in energy intake (p less than 0.05) and about five times increase in fruit and nonstarchy vegetable intake amount was seen in treated children. A decrease in serum IgE level of 13.9 +/- 43.5 U/ml was found in the "internal spontaneity" group, as opposed to an increase of 33.2 +/- 50.5 U/ml in the control one (p less than 0.01). The differences between examinations were significantly correlated to the increase in NSV acceptance in all children plotted together (r = .51, p less than 0.005). The overall NSV effect on the changes of the 2 muscle areas, 2 symptoms, and 2 percent growth, 15 nutritional, 5 immune and 3 hepatic indices was significant with MANOVA (p less than 0.01). The education to "internal spontaneity" may be a useful tool for prevention of overeating, diarrhea recurrences and IgE increase in the second/third year of life.

Evaluation of GH secretion.

The Authors analyse the main body of somatotropin function test: insulin hypoglycemia; arginine; ornithine; I-dopa; clonidine; galanin; GH-RH; physical exercise; sleep; combined stimuli; spontaneous GH secretion of varying duration. The advantages and disadvantages of the different tests are pointed out and some recent contradictory findings concerning the newest prolonged techniques are reported. The Authors claim priority for the clinical/auxological examination, with measurement of bone age and growth velocity and suggest the procedure for GH deficit diagnosis to be followed, also in the light of their personal experience.

[Arterial blood-gases and acid-base balance in acute diseases of the lower respiratory tract in infancy (author's transl)]. / Gas respiratori ed equilibrio acido-base nelle broncopneumopatie acute nel lattante.

A group of 31 infants, aged 1 month to 13 months, recovered at the Pediatric Institute of the University of Florence for acute diseases of the lower respiratory tract, were analyzed for paCO2, paO2, pH and BE. Samples of arterial blood were obtained in the first, second, fourth and eighth day of recovery. Hypoxia occurred in all the infants and metabolic acidosis was found in almost every case. The paCO2 value resulted high in some of the babies, normal in others and below normal in the remaining. pH showed a lower value in patients affected with metabolic and respiratory acidosis. paCO2 returned to normal value on the eighth day in all the infants, while pH remained slightly below normal value, due to persisting metabolic acidosis. paO2 registered only a small increase during the stay, remaining on the eighth day still below normal level.

Oral clonidine: an effective provocative test of growth hormone release.

The authors tested the efficiency of clonidine as a stimulant for growth hormone (GH) release in a group of 31 undersized children aged from four to fourteen years. The efficacy of clonidine was compared with insulin-induced hypoglycaemia, which has so far been considered the most valid test for somatotropic function measurement. The average GH peak after clonidine was 13.7 +/- 1.9 ng/ml, while after insulin it was only 7.0 +/- 0.9 ng/ml. The number of patients responding to clonidine and insulin reacting with GH values below 5, between 5 and 8, and higher than 8 ng/ml were reported, and the difference between the two sets of values was found to be statistically significant (p less than 0,01) in favour of clonidine.