[Depressive symptoms and low self-esteem in obese children and adolescents]. / Sintomi depressivi e bassa autostima in bambini e adolescenti obesi.

AIM: The aim of th study was to assess the prevalence of depressive symptoms and low self-esteem (SE) in a clinical sample of obese children and adolescents; to examine whether Body Mass Index (BMI) or age are correlated to scores of depression and SE. METHODS: Fifty-five obese patients, aged 9-16 years, completed 2 questionnaires: the Children's Depression Inventory (CDI) and the Multidimensional Self Concept Scale (MSCS), which assesses global SE and 6 specific domains of SE (Social, Competence, Affect, Academic, Family and Physical). RESULTS: The prevalence of depressive symptoms and low global SE was not significantly different from normative data of the general pediatric population. The mean overall scores on CDI (8+/-4.69) and MSCS (96.6+/-11.54) fell within the normal range (0-19 and 85-115, respectively). The lowest scores in specific domains of MSCS were obtained in Physical SE (94.42+/-12.64). The scores on questionnaires were not significantly correlated to BMI or age. A significant negative correlation between Physical SE scores and CDI scores was found (r=-0.43; p<0.05). CONCLUSIONS: Obese children and adolescents, as a whole, did not present more depressive symptoms and lower SE than the general pediatric population. However, some obese patients may be at higher risk for psychopathology. In this study, the degree of obesity (BMI), age and sex were not risk factors for psychopathology. The relative low scores on Physical SE and their correlation to CDI scores suggest that body image dissatisfaction may be a risk factor for psychopathology in a subgroup of obese patients.

[Pilot studies on the effect of desmopressin on the personality of enuretic children]. / Studio pilota sugli effetti della desmopressina sulla personalità di bambini enuretici.

The aim of this paper was to establish if there is a correlation between desmopressin administration and modification of psychological experience in enuretic children. 22 enuretic children (18 treated with desmopressin, 4 not treated) were enrolled in the study. They underwent a complete psychological examination, differentiated on the basis of chronological age, before the beginning and at the end of the treatment (duration 4 months). The psychologist was not informed if they were treated or not. In the 17 of 18 treated children with basal psychological problems, 14 became normal, 2 demonstrated a significative amelioration and 1 remained pathologic at the end of the treatment. No modification was observed in not treated patients, all presenting psychological problems. 6 emblematic cases with psychological findings and paintings are presented. The results seem interesting, despite the low number of children enrolled.

[Inferences drawn from communication in a neonatal pathology ward]. / Inferenze sulla comunicazione in un reparto di patologia neonatale.

The general process of communication is reviewed in order to ascertain how neonatologists should approach not-verbal, not intentional messages coming from premature newborns, which ask suitable answers from a therapeutic and educational point of view. The author recalls the Als Synactive Theory that enables to understand the signals coming from the newborn allowing all the care-gives to reply coherently to expressed physical and physiological needs.

Vocal cord dysfunction in an asthmatic child: case report.

Acute functional narrowing of the glottis frequently leads to an inappropriate diagnosis of asthma. Only 2 cases have been reported of patients with asthma and concomitant vocal cord dysfunction. We present the case of an adolescent boy with asthma, who exhibited a worsening of wheezing and a reduction in peak expiratory flow rate out of proportion to symptoms due to a vocal cord dysfunction.

Progressive myoclonic encephalopathy in X-linked hypogamma-globulinemia. Case report, review of the literature and its relationship with progressive encephalopathy in children with A.I.D.S.

A 7-year-old boy suffering from X-linked hypogammaglobulinemia and progressive myoclonic encephalopathy is reported. The onset of neurological disturbances is at four years of age with ataxic gait and myoclonic jerks. The EEG shows a progressive slowing of background activity, bilateral diffuse and repetitive, pseudoperiodic, high amplitude slow waves, myoclonic jerks polygraphically documented. The CT-scan shows generalized cerebral atrophy, white matter hypodensity--principally in the frontal regions -, multiple nodular calcifications, also in the basal ganglia. Two years after the onset of neurological signs, the boy is completely bedridden, spastic, dement and blind; the myoclonic jerks persist. Finally the relationship is discussed with both the previously reported patients with the same affection, and with similar progressive encephalopathy in children suffering from A.I.D.S.

Biotin-responsive infantile encephalopathy: EEG-polygraphic study of a case.

A case of an infant suffering from progressive lethargy, sparse scalp hair, autistic-like behavior, myoclonias, and drug-resistant generalized seizures is reported. Laboratory investigations revealed, in the absence of metabolic acidosis, an increased urinary excretion of 2-ketoglutaric acid and a small peak of 3-hydroxyisovaleric acid. The serum biotinidase activity was 0.15 nmol min-1 ml-1 (normal range 5.2 +/- 0.9) in the propositus and 0.310 and 0.420 in her father and mother, respectively. The interictal EEG showed multifocal abnormalities; numerous seizures were recorded, with the pattern of true tonic-clonic fits, exceptional in infancy. Also myoclonias, auditory myoclonus, and repetitive startles were documented. Because of dramatic improvement of all symptoms and signs after starting biotin (5 mg twice daily), the authors suggest a therapeutical trial in all drug-resistant infantile seizures.