Serum eosinophil cationic protein in children with atopic dermatitis.

BACKGROUND: Eosinophil cationic protein (ECP) is a cytotoxic agent secreted by activated eosinophils during allergic and inflammatory processes. The aim of the study was to determine the ECP level, absolute and relative eosinophil count and IgE antibodies in children with atopic dermatitis (AD) compared with those of nonatopic children, and to assess the correlation of these laboratory parameters with the clinical severity of AD. METHODS: This prospective study comprised 70 children. There were 49 children with AD aged 3-36 months, and the control group comprised 21 children with a negative personal and family history for atopic diseases. Detailed history, serum ECP levels (UniCAP FEIA), relative and absolute eosinophil counts and total serum IgE antibodies were determined in both groups. In the children with AD, skin involvement was measured by the SCORAD index. RESULTS: The calculated SCORAD index was between 16 and 83. IgE antibodies, relative and absolute eosinophil counts showed a significantly wider range of values and a statistically higher median (P < 0.001) in the patients with AD compared with the control group. These laboratory parameters did not correlate with the severity of AD. The serum ECP median level, in the children with AD, was 16.2 microg/L (range 3.01-65.30) compared with 5.92 microg/L (range 2.76-21.90) in the control group. Correlation of the total SCORAD index and the serum ECP levels was negative, weak (r = -0.065) and statistically not significant (P > 0.05). The same was found for the correlation of serum ECP and intensity of skin changes (r = -0.095) and serum ECP and subjective symptoms (r = -0.045). The correlation was positive, but weak and statistically not significant for the serum ECP and extent of the skin lesions (r = 0.079, P > 0.05). CONCLUSION: Elevated levels of ECP, relative and absolute eosinophil counts, as well as IgE antibodies were determined in the patients with AD. As these laboratory findings did not correlate with the severity of AD, they can be considered only as additional methods in the evaluation of patients with AD.

[The frequency of urinary tract infections in hospitalized infants]. / Ucestalost uroinfekcija u hospitalizirane dojencadi.

The authors present the frequency of urinary tract infections in hospitalised infants. A retrospective study of infants hospitalized during a five year period, from 1979-1983 was made. The average frequency for the mentioned period was 12%, all of which were bacterial infections. In 70.7% of patients we diagnosed cytopyelonephritis. Girls prevailed among the patients with urinary tract infections, even in the neonatal period. Vesicoureteric reflux was confirmed in 36.5% children. The results of this study show that the symptoms of urinary tract infections in infancy are not specific. As the frequency of cytopyelonephritis and vesicoureteric reflux was high it emphasizes the significance of early diagnosis. In every febrile child, diagnosis of urinary tract infections should be suspected.

[The status of care of abused and neglected children in Zagreb at the end of the 20th century]. / Stanje zastite djeteta od zlostavljanja i zanemarivanja u Zagrebu krajem XX. stoljeca.

In this paper, the data on some medical, social and legal aspects of abuse and/or neglect of children in Zagreb are presented which, at least, partially illustrate this societies' care of mistreated children at the end of the 20th century. We reviewed questionnaires that were administered to 44 health institutions involved in the childrens' health control and/or treatment and to 14 social work services and analyzed cases of child mistreatment reported to the Zagreb Public Prosecution Office and final court judgements for 1987 to 1988. We conclude that all these institutions encounter cases of child abuse and/or neglect but that medical institutions identify only 10% of cases detected by social work services and that judicial system sentences with imprisonment about 30% of abusers. Underdetection of child mistreatment in Zagreb, in addition to poor coordination of services, are the possible reasons for insufficient concern for these children. Up to now, only mass media and scientific publications have spoken more loudly about this problem. The authors emphasize the need and obligation of all those professionals concerned with children and of the entire community to undertake relevant measures to protect abused and/or neglected children.