[Multiple sclerosis and acute disseminated encephalomyelitis in children: a difficult diagnostic differentiation. Report of a young boy with early onset of the disease]. / Sclerosi multipla ed encefalomielite acuta disseminata: una diagnosi differenziale difficile. In merito ad un caso clinico con esordio molto precoce.

We report the case of an eight year old boy who developed suddenly acute left-sided hemiparesis syndrome. Brain magnetic resonance imaging (MRI) showed multiple white matter lesions. Therefore we considered in the differential diagnosis multiple sclerosis (MS) and acute disseminated encephalomyelitis (ADEM). The patient received intravenous immunoglobulin (IVIG), 1 g/kg/d over 2 days with complete regression of clinical symptoms. No relapses occurred within six months, although brain magnetic resonance imaging studies found new white matter lesions, suggesting multiple sclerosis with very early onset.

[Cystic dysplasia of the testis: report of a case and review of the literature]. / Displasia cistica del testicolo: descrizione di un caso e revisione della letteratura.

Cystic dysplasia of the testis (CDT) is a rare, benign and congenital lesion causing scrotal mass in pediatric population that can mimic testicular cancer. This lesion consists of cystic dilation of the rete testis and it is frequently associated with renal or genitourinary tract anomalies as renal agenesis and multicystic dysplasia of the kidney. This frequent presentation suggests that testicular cystic dysplasia is associated with a defect of the metamesonephric system in particular with a defect in the connection between the efferent ducts derived from the mesonephros and the rete testis tubules derived from the gonadoblastoma. The role of ultrasound is of primary importance for clinical diagnosis and follow-up of untreated forms. The sonographic appearance of CDT consists of multiple cysts in the mediastinum testis. The cysts range in size from microscopic to several millimetres and may involve the whole testicular parenchyma or have a focal aspect. If the cysts are tiny, the ultrasound must be able to distinguish between CDT and testicular microlithiasis, a potential premalignant condition. Today it is possible thanks to high frequency 7.5 to 10 mHz probes. In the past orchiectomy has been considered as the treatment of the choice for CDT. Today, non operative management of CDT represents an effective alternative option in these patients and the primary benefit of this approach is the preservation of endocrine function and spermiogenic activity. However, the natural history of untreated CDT and its effect on normal testicular tissue are still unknown, therefore long-term follow-up is recommended.

[Practice guidelines to manage children admitted in a general pediatric department with very mild or mild acute infective diarrhea]. / Linee comportamentali di fronte al bambino affetto da diarrea acuta infettiva di lieve o moderata gravità ricoverato in una Divisione di Pediatria.

A clinical-anamnestic card is proposed to gather the main minimal parameters which allow to monitor the course of children with severe or mild acute infective diarrhoea admitted to a pediatric department. This method has been verified through a back-evaluation of the data collected in our clinical-anamnestic cards throughout a period of seven months, and found it useful and appropriate. This case-record includes very mild or mild acute infective diarrhoea (corresponding to a loss lower than 10% of total body weight) in pediatric age children hospitalized in a general pediatric department. The clinical-anamnestic card is divided into five parts coinciding to five different clinical stages of the disease; during each stage, the essential anamnestic and/or clinical data necessary to a correct medical and nursing approach to the children affected with infective acute diarrhoea are recorded. The use of this card is also a good way to engage physicians, nurses and children's parents too, to pay attention to the substantial factors necessary for a correct management of the disease. The evaluation of these clinical-anamnestic cards led to the following general conclusions:--to keep body weight unmodified from the day of admission to the day of discharge--to use very seldom milk without lactose--to keep children on a very short term diet in order to quickly restore intestinal function, to increase body weight and to discharge children in few days.

[Screening of cholesterol levels in middle school students at the Community of Lainate (Milan)]. / Studio osservazionale sui livelli di colesterolo in alunni frequentanti le Scuole medie del Comune di Lainate (Milano).

An example of good integration of territorial sanitary services with hospital services. An observational study that pointed out cholesterol disorders in a pre-adolescent population of a little city next to Milan.

[The beta-hemolytic Streptococcus group A carrier state]. / Stato di portatore di Streptococco beta emolitico gruppo A.

In this study we describe the group A streptococcal upper respiratory tract carrier state, following a clinical method based on two main elements: the presence or the absence of symptoms and the result of throat swab. Through this method we are able to decide how to face each individual clinical case.

[Therapy of Helicobacter pylori infections in children]. / La terapia dell'infezione da Helicobacter pylori in età pediatrica.

We consider Helicobacter pylori treatment in children, giving some indications about the necessity of the treatment, the drugs to use, the duration and the results of therapy. We give importance to the choice of some specific drugs and to the follow-up.

[Diagnosis of food allergy and IgG4]. / Diagnosi di allergia alimentare e IgG4.

We compared specific IgG4 levels in a group of children with food allergy and in an healthy control group. The results show no significant differences in the values of specific IgG4 levels between the two groups of children.

[Urokinase in a premature infant: its use in a case of right atrial thrombosis secondary to catheterization of the umbilical vein]. / Urochinasi nel prematuro: utilizzo in un caso di trombosi atrial destra secondaria a cateterizzazione della vena ombelicale.

Newborns with vascular catheters must be investigated by echocardiogram for intracardiac thrombosis. We report the use of urokinase to treat an asymptomatic right atrial thrombus in a 31 weeks' gestation newborn; the thrombosis occurred after placement of a catheter in the umbilical vein. We obtained a safe and successful thrombolysis using urokinase 4000 U/kg/h in continuous infusion.

[Evaluation of the compliance of thalassemic patients at a structured ambulatory day hospital]. / Valutazione della compliance in pazienti talassemici afferenti ad un ambulatorio D.H. strutturato.

The institution of a self-constructed Ambulatory where both pediatric and adult patient can be assisted with Day-Hospital, gains novelty and new characteristics when four different physicians (Medical, Pediatrician, Hematologist and Psychologist) structured part-time, contribute to functionality with equal participation. Compliance was investigated through a computerized way.

[Polythelia as a sign of other congenital malformations: a clinical example]. / La politelia come spia di altre malformazioni congenite: un esempio clinico.

The authors describe the clinical history of a girl with severe chronic constipation due to anterior ectopic anus, associated with supernumerary nipples. The authors underline the importance of possible associations between supernumerary nipples and other congenital anomalies.

[Cough and vomiting association in an infant: where does the vicious circle start?]. / Associazione tosse/vomito in un lattante: dove inizia il circolo vizioso?

The Authors describe the clinical history and diagnostical problems of a premature twin with the three classical symptoms cough-vomiting-growth retardation in the first year of life. Is the diagnostic route required to stabilize whether this condition is primarily gastroenterological or pulmonary?