[Allergy to beta-lactam antibiotics in childhood. Diagnostic problems]. / Allergia agli antibiotici beta-lattamici in età pediatrica. Problemi diagnostici.

This study reports about 126 children with an age ranging from 12 months to 12 years having RA to beta-lactamase. More children with an age ranging from 7-12 years (59.5%), and more male (65.9%) than female subjects were studied. 76 patients (60.3%) showed a familial anamnesis of allergic diseases or similar diseases and a personal anamnesis of allergic diseases (45.2%). Among the RA responsible substances the more frequent were semisynthetic penicillin (44.6%) followed by cephalosporin and penicillin. Most clinical manifestations (87.3%) were cutaneous reactions and in smaller number of cases it was possible to observe gastroenteric or respiratory reactions. In 121 patients cutaneous tests were undertaken (Prick tests and intradermoreactions), patch tests, employing: PPL, MDM, Penicillin, Ampicillin, Cephaloridine. 5.8% of the studied subjects showed an allergy. Particularly 2.4% showed a "early" positivity. RAST was carried out in 92 patients and 3 of them showed a positive result (3.2%). This study stresses the opportunity to carry out allergologic tests within 6 months since the beginning of RA. In fact especially in children this test result can soon become negative. Furthermore the reduced percentage of positive allergologic tests can be due to the inclusion in other studies of patients with "coincidental reactions". A certain number of RA can be caused by additive to "per os" products. Finally it will be possible to use "tests dose" even in selectioned cases. These tests can frequently exclude the etiopathogenetic responsibility of beta-lactamic substances.

T-cell subpopulations in pediatric healthy children: age-normal values.

Assessment of the percentage and absolute number of T cells as well as of their main subpopulations is presently a routine procedure for the diagnosis and follow-up of a wide array of pediatric immunologic disorders. For several clinical applications (severe immunodeficiencies or leukaemias) the diagnostic usefulness of their enumeration does not require close comparison with age normal values, while in other circumstances such as follow-up of immunomodulating or immunosuppressive treatments or detection of minor immune defects, the expected changes of T cell subsets are more subtile and they are likely to be detected only by comparison with well-defined age normal values. In the present study CD3, CD4 and CD8 positive cells were enumerated in a group of 410 healthy children of age ranging from 30 days to 9 years. No significant changes in percentage or absolute number were observed during infancy and childhood. Furthermore the sum of CD4 and CD8 positive cells was close to the percentage of CD3 positive cells, suggesting a phenotype maturity of T cells from infancy.

[Variations of the immunological parameters and the clinical response in 25 children treated with thymopentin]. / Variazioni dei parametri immunologici e risposta clinica in 25 bambini trattati con timopentina.

We studied the effects of thymopentin on 25 children aged between 15 months and 11 years, suffering from relapsing herpes, malnutrition and recurrent infections of respiratory tract. None of these children had previously received vaccines or immunostimulating drugs. Our purpose was to test thymopentin efficacy on various pathologies. We carried out a series of blood tests before, during and after drug administration in order to evaluate the variations of immunological parameters (IgA, IgG, IgM, IgAs, C3, C4 and cellular immunity), as well as changes in weight and height. Thymopentin was administered at a dose of 0.5 mg/Kg three times a week for three weeks. Seric IgA (Tab. 2) were also affected by thymopentin. As far as cellular immunity is concerned we observed a progressive increase of CD3 and CD8 during thymopentin treatment. Tolerability was excellent. Only one child had a slight fever that disappeared at the end of treatment. No hematological disorders were reported.

[Dehydrated child]. / II bambino disidratato.

Dehydration, in childhood as in adulthood, may origin from an inadequate water ingestion or an excessive water elimination. Causes may be found in fever, vomiting, scalds, pulmonary hyperventilation, diabetes. Water loss during acute diarrhea in children can be even 6-7 times higher in comparison with an healthy child. Together with water, electrolytes are lost. We differentiate dehydration in isonatremic d. (70% of cases), hyponatremic d. (10%) and hypernatremic d. (20%) basing on Sodium loss. Important dehydration causes severe clinical symptoms as shock, renal and cardiocirculatory failure, convulsion, coma. Symptoms at the central nervous system level derivate both from hyperosmolarity in brain cells and from thrombosis or hemorrhages in subdural sites. Dehydration, following acute diarrhea, is slight when weight loss is lower than 5%. The child health conditions still remain good. Dehydration become moderate if weight loss reaches 5% and the child starts suffering. When the weight loss reaches 10%, dehydration is now severe and circulatory deficiency becomes evident. When it is higher than 10%, prognosis is very severe and shock and coma may be observed. In the present work, we illustrate the different ways of rehydration after acute diarrhea. Initially, oral rehydration must be established with one of the oral solutions, differing each other for amount of electrolytes and glucose. Recently, a new solution, "supersolution", has been presented differing from the other ones for electrolytes concentration and for the presence of rice starch instead of glucose. In most cases of diarrhea, oral rehydration appears adequate but sometimes an intravenous rehydration becomes necessary, e.g. in case of vomiting, CNS depression and in any case of severe gastroenteric symptomatology.(ABSTRACT TRUNCATED AT 250 WORDS)

[Comparison of an oral rehydration solution (ORS 90) and a "supersolution" during acute infantile diarrhea]. / Confronto tra una soluzione reidratante orale (ORS 90) ed una "supersoluzione" in corso di diarrea acuta infantile.

As acute diarrhoea gives rise to a loss of water and electrolytes, the most effective therapy results the oral rehydration. Harrison and Darrow tried this way first. Only in the years '60 we began to use oral rehydration commonly. Usually, solutions contain glucose, Na, K, Cl, Bicarbonate in various concentration. When glucose is replaced by rice starch or when amino acid are added, then we have a "supersolution". Nutrients intake provides more calories and increases absorption Na-depending. We used one of these new "supersolutions". Two groups of children, hospitalised for acute diarrhoea, were treated with different rehydration solutions. The first one (Dicodral Forte), prepared according to the WHO, contains glucose and electrolytes as we know. The second one (Amidral) has rice starch instead of glucose and presents a lower concentration of Na and Cl. The present study looked over: A) Weight increase from the first to the third day of hospitalisation in our department. B) Duration of diarrhea. C) Number of stools. D) Haematological values before and after rehydration. All the patients ingested the same amount of solution. Children which received WHO's solution presented diarrhea longer than others (2.55 +/- 2.06 vs 2.2 +/- 1.1 days). Number of stools was below average too (3.05 +/- 2.64 vs 2.8 +/- 1.5). Refeeding was done employing the same milk used in former times. AMIDRAL was used to dilute the milk when it was possible. Most important result is the increase of weight we had using this "supersolution". 15/20 children which received AMIDRAL showed an increase of their weight as shown in Tab. 1.

[Comparison between 2 types of feeding in acute diarrhea in childhood]. / Confronto tra due tipi di rialimentazione nelle diarree acute dell'infanzia.

134 infants under three years of age suffering from severe diarrhoea are related. 57 of these had quite serious dehydration and 77 presented protracted diarrhoea (less than or equal to 15 days). 50% were treated with a milk with reduced content of lactose. Other 50% with a diet lactose-free for a day followed by the same milk used before diarrheal disease. Results obtained, few relapses and quick normalization of stool are supporting the use of a milk with reduced contents of lactose.