[Arterial hypertension in childhood. Study of a school population]. / L'ipertensione arteriosa in età pediatrica. Studio di una popolazione scolastica.

Most Authors fix the upper limits of normal blood pressure at 90 degrees percentile according to age. Nevertheless in their investigations different instruments were used and they often didn't relate in detail the position of the subject during the measurement. Other factors, influencing blood pressure values, have been often left out: relation with meals, room temperature, pain, drugs, stress, etc. The prevalence of hypertension in pediatric age in literature is 0,6 - 12,4% with several intermediate values. The first very important research concerning the hypertension in pediatric age was carried out by Londe et Coll., conducted among 1593 children (785 males and 798 females); they estimated mean values and percentiles according to age and sex. In the present study the A.A. saw 346 children (161 females and 185 males), 11-15 years old, observed at school, in a comfortable room. Pressure measurement was done twice in the same morning with half an our interval. Systolic pressure, 4 degrees and 5 degrees Korotkoff tones, was noticed. 11% of the children had systolic pressure values under 50 degrees percentile, 35,3% between 50 degrees and 90 degrees percentile and 43,1% had values equal or greater than 90 degrees percentile at the first measurement. The third group went down to 30,6% (106 cases) at the control (after an half an hour). This reduction shows the importance of the emotional factors in the P.A. variations. The 106 children who had systolic and/or diastolic values equal or greater than 90 degrees percentile were controlled again after a week. 92 maintained the same values. They were called for the third sitting 1-6 months later. 45 subjects agreed to our invitation and it was possible to point out that high blood pressure values persisted in 31 children (that is 8,9% of all examined cases). Following correlations were observed: body weight-blood pressure values (either systolic or diastolic ones) and so cutaneous plica-pressure values (p less than 0,01); moreover 50% of the 31 hypertensive children had hypertensive parents; the most frequent subjective symptom (13 cases) was cephalalgia. None of the studied school children showed either clinic or biochemical abnormal data, so that it was possible to define their hypertension as "essential".

[Correlation between plasma IgE and IgA in infant nephrosis and nephrotic syndrome]. / Correlazioni fra IgE e IgA plasmatiche nella nefrosi infantile e nella sindrome nefrosica.

A study on IgE - IgA plasmatic level has been carried out in the acute phase and in remission of minimal changes nephrosis (MCN) and in glomerulonephritis with nephrotic syndrome (NS). The results obtained are the following: 1) Mean values of Ig classes were impaired in comparison with the normal values of children of the same age, both in MCN and in NS. 2) IgE were increased, particularly in children over 6 years in the MCN acute phase; the values decreased within normal after the remission was achieved. 3) IgA, on the contrary, were decreased in the subjects over 6 years, in the MCN acute phase. 4) No significant correlation was found between the two Ig classes. 5) The modifications of the Ig plasmatic level during the remission, after corticosteroid therapy was characterized by IgE reduction; IgA were only slightly, but not significantly, decreased in the same phase.

[Asymptomatic microhematuria]. / La microematuria asintomatica.

Microscopic haematuria is an urinary finding more and more frequently observed in routine analysis in childhood; the diagnostic problems, most of which unresolved, are yet the principal questions of concern. We have studied 123 patients during five years from 1975 to 1980, and followed them for 1-8 years (mean 4 years). Our experience allowed us to consider "normal" or without remarkable pathologic significance a urinary finding less than or equal to 5.000 RBC/m' at the Addis count. Such findings were pointed out in 55 cases (44%); 27 patients (22%) had 5-10.000 RBC/m', 34 cases (27,6%) presented 10-50.000 RBC/m' and 7 cases (5,7%) had more then 50.000 RBC/m'. The familiar background, the clinical, biological and immunological data, the roentgenographic investigations and the renal biopsy carried out in the 4 groups of patients, led us to the following conclusions: 1) 26% of the 123 cases had a "unexplained;; microscopic haematuria with complete lack of anamnestic data, symptomatology and with normal biological findings. 2) in 65,8% of the cases it was possible to discover frequent upper respiratory tract infections (and allergy in 5,6% of them). 3) in 26% of the patients we discovered a previous or actual genito-urinary (10,5% and 15,5% respectively) infection: 9,4% of 96 urography demonstrated a variable degree of nephro-urological abnormalities. 4) 23 children (18,7%) was selected for renal biopsy, primarily by the hypocomplementemia and positive anti-DNA ab. test, and secondly by elevated degree of microhematuria. The histological and immunohistochemical studies demonstrated the presence of mesangial proliferation glomerulonephritis with IgG-IgA-C3 deposits in 7 cases (30% of the cases biopsied and 5,6% of the total), 69,6% of the cases had only minimal charges with negative immunofluorescence. 5) A mean follow-up of 4 years in two groups of patients (less than or greater than 6 years of age) has demonstrated that microscopic haematuria remains unchanged in 18-19% of both groups. A more marked improvement or normalization has been documented in the children more than 6 years aged (p less than 0,001) while a worsening has been observed in the children less than 6 years aged (p less than 0,005), with a statistically significant difference between the two groups considered.

[Medical and dietetic management of congenital and inherited nephropathies (author's transl)]. / Il trattamento medico e dietetico delle nefropatie congenite ed ereditarie.

The management of the congenital and inherited nephropathies is, still today, almost exclusively symptomatic. The authors relate the most important drugs and the dose used for the principal complications of these nephropathies: hypertension, hypo-dysprotidoemia, oedema, anemia, metabolic acidosis, polyuria, hypoevolutism, recurrent urinary infections. Particular care must be taken in order to provide an adequate caloric-protein allowance principally when the renal insufficiency is reached.