Neurorretinitis bilateral y nefritis lúpica membranosa: dos manifestaciones infrecuentes en el lupus juvenil / Bilateral neuroretinitis and membranous lupus nephritis: 2 infrequent manifestations in juvenile lupus

Joven de 15 años, previamente sana, se presentó con dolor abdominal, vómitos, diarrea, eritema malar, edema palpebral y en miembros inferiores, artralgias, rigidez matinal y visión borrosa bilateral. Estudios de laboratorio y por imágenes junto con la clínica permitieron realizar el diagnóstico de síndrome nefrótico secundario a lupus eritematoso sistémico. Al examen oftalmológico se constató 8/10 de visión en ambos ojos y edema de papila bilateral con estrella macular parcial, hallazgos compatibles con una neurorretinitis bilateral. La biopsia renal estableció el diagnóstico de nefritis lúpica membranosa. Se inició tratamiento inmunosupresor, con mejoría clínica gradual. Si bien el lupus eritematoso sistémico con nefritis lúpica membranosa y neurorretinitis es una asociación muy infrecuente, frente a un paciente con neurorretinitis bilateral debemos considerar el lupus eritematoso sistémico dentro de los diagnósticos diferenciales (AU)

Fifteen-year-old female patient, previously healthy, referred to our center for presenting abdominal pain, vomiting, diarrhea, malar erythema, palpebral and lower limb edema, arthralgia, morning stiffness and bilateral blurred vision. Laboratory and imaging studies together with the clinic allowed the diagnosis of nephrotic syndrome secondary to systemic lupus erythematosus. Ophthalmology examination revealed a visual acuity of 8/10 in both eyes and bilateral disc edema with partial macular star, findings compatible with bilateral neuroretinitis. Renal biopsy established the diagnosis of membranous lupus nephritis. Immunosuppressive treatment was started, obtaining gradual clinical improvement. Although systemic lupus erythematosus with membranous lupus nephritis and neuroretinitis is a very infrequent association, when faced with a patient with bilateral neuroretinitis, we must consider systemic lupus erythematosus within the differential diagnoses (AU)

Bilateral neuroretinitis and membranous lupus nephritis: 2 infrequent manifestations in juvenile lupus.

Fifteen-year-old female patient, previously healthy, referred to our center for presenting abdominal pain, vomiting, diarrhea, malar erythema, palpebral and lower limb edema, arthralgia, morning stiffness and bilateral blurred vision. Laboratory and imaging studies together with the clinic allowed the diagnosis of nephrotic syndrome secondary to systemic lupus erythematosus. Ophthalmology examination revealed a visual acuity of 8/10 in both eyes and bilateral disc edema with partial macular star, findings compatible with bilateral neuroretinitis. Renal biopsy established the diagnosis of membranous lupus nephritis. Immunosuppressive treatment was started, obtaining gradual clinical improvement. Although systemic lupus erythematosus with membranous lupus nephritis and neuroretinitis is a very infrequent association, when faced with a patient with bilateral neuroretinitis, we must consider systemic lupus erythematosus within the differential diagnoses.

Comorbidity in specific language disorders and early feeding disorders: mother-child interactive patterns.

OBJECTIVE: This empirical study has its main object in highlighting the role of mother-child interactive experiences in the development of affective and communicative exchanges in infancy. METHODS: The study analyzed four groups of mother-child couples with children who presented a Specific Language Disorder (SLD) the first, a Feeding Disorder (FD) the second, the third an association of SLD and FD, and a fourth non clinical group. Diagnostic assessments were done through: a specific linguistic protocol, the Italian version of the Feeding Scale-Observational Scale for Mother-Infant Interactions during Feeding, specific psychodiagnostic questionnaires for mothers and children. CONCLUSION: A distortion in the communication area can significantly weigh upon the quality of infant-caregiver relationship: our data on mothers of children with a SLD/FD comorbidity confirm this finding by describing their children as prone to isolation and withdrawal, thus directing their efforts and worries to a specifically communicative and relational factor.

Feeding disorders in infancy: an empirical study on mother-infant interactions.

AIM: The objective of this paper is an empirical analysis of mother-infant feeding interactions through an observational instrument (Feeding Scale), which is applied to the videotape of a feeding session. METHODS: Three samples of mothers and their children have been examined (104 couples with children ranging in age from 2 to 36 months: a first group in which children presented a feeding disorder on organic and functional base (food intolerances and/or gastroesophageal reflux), a second group in which the disorder was not due to a medical condition and a third group of control. The Authors meant to test three hypotheses: 1) the presence of developmental changes in mother-infant interactional patterns during the course of the first three years of life; 2) higher degree of dysfunction of mother-infant interaction in those dyads in which the feeding disorder had not organic causes; 3) dysfunctional interactions in the couples of mothers and children in which the feeding disorder was on an organic base. RESULTS: The results of the statistic analyses have confirmed the hypotheses, providing different elements of reflection. CONCLUSIONS: The Authors underline the importance of a multidimensional, global and integrated approach in the clinical assessment and treatment, which evaluates the possible interconnections among organic, psychogenetic and relational factors in the origin and course of feeding disorders in infancy and early childhood.

[Cancer of the appendix. A report of 2 cases]. / Il ca. dell'appendice. Osservazione di due casi.

The paper reports two cases of adenocarcinoma of the appendix. Following a review of the literature on this neoplasia, it concludes that prognosis is poor on account of the early spread of the disease, the low ratio of suspected disease, and difficulties of diagnosis prior to surgery. The preferred surgical treatment is right hemicolectomy which consents a 5-year survival rate of 50% in comparison to 20% achieved with appendectomy alone. The authors also stress the importance of carrying out histological tests after any type of appendectomy.

Piribedil and platelet aggregation.

Piribedil at high concentrations inhibits in vitro ADP and thrombin aggregation effect on the rabbit PRP.