[5 days Cefaclor vs. 10 days amoxicillin/clavulanate in the treatment of childhood streptococcal pharyngitis. Data from a randomized clinical trial]. / Efficacia di Cefaclor 5 giorni vs. amoxicillina-acido clavulanico 10 giorni, nella terapia della faringotonsillite streptococcia del bambino. Risultati di uno studio clinico randomizzato.

AIM: The duration of therapy represents a fundamental aspect in the compliance to the therapy of child pathologies, such as pharyngotonsillitis, treated with oral therapy. Although penicillin and amoxicillin are the first choice antibiotics in the case of a child suffering from pharyngotonsillitis with the proven presence of Group A ß-hemolytic Streptococcus (GAS), the number of orally administered doses and 10 days of therapy, considerably lower the compliance. METHODS: An open phase IV randomized multicenter clinical trial was conducted in parallel groups, involving 49 family pediatrician (FP), distributed over the entire national territory, enrolling 435 children suffering from GAS-FT. 210 children received Cefaclor, 50 mg/kg/day, administered twice daily for five days, whilst 213 children received amoxicillin/clavulanate 40 mg/kg/day administered twice daily for 10 days. RESULTS: The results showed percentages of eradication of 88.4% for the Cefaclor group and 94.3% for the amoxicillin/clavulanate group, and a positive clinical judgement of 92.3% for the Cefaclor group and 96.6% for the amoxicillin/clavulanate group. The two arms of the study did not have any significant statistical differences, neither for the eradication, nor for the clinical judgement nor for the reduction of the Milano Score between the beginning and the end of treatment, with a P=0.042 for amoxicillin/clavulanate for eradication. CONCLUSION: This study confirms that the administration of Cefaclor for five days during GAS-FT has the same efficacy as a 10-day therapy with amoxicillin/clavulanate, with a clearly different compliance.

[Chromium and diabetes. Relationships to serum levels of cholesterol, triglycerides and lipoproteins]. / Cromo e diabete. Relazione con i livelli sierici di colesterolo, trigliceridi e lipoproteine.

The authors examined 91 adult diabetic subjects to evidence any possible correlation between the levels of serum chromium and those of cholesterol, triglycerides and lipoprotein. The calculation of Bravais Galton's correlation coefficient did not reveal any correlation between these parameters. However the authors confirmed that the levels of serum chromium in adult diabetic subjects were significantly lower than in normal subjects, although there was no correlation between rate of glycemia and chromium.

[The behaviour of platelets in some viral infectious diseases in childhood (author's transl)]. / Il comportamento delle piastrine in alcune malattie infettive virali dell' infanzia.

To evidentiate a participation clinically not evident of thrombocytes during viral infections, the Authors performed platelets count in 207 children of age varying 7 months to 12 years from the diagnosis and during the course of the illness. A subclinical thrombocytopenia was revealed in 55% of children affected by measles, in 25% of mumps, in 45% of varicella, in 30% of german measles and in 55% of infectious mononucleosis. In all the cases we didn't observe hemorrhagic manifestations and platelets count has come back to normal and higher levels spontaneously. Previously the Authors discuss pathogenetic ways which may have a role in subclinically thrombocytopenia during viral infectious diseases.

Proteolytic activity of maternal serum on newborn IgD-positive lymphocytes. Study with protease inhibitors.

We studied the effect of maternal serum on the surface IgD of newborn lymphocytes in the presence of protease inhibitors (epsilon-aminocaproic acid and Trasylol). Contact with maternal serum caused a significant reduction (p less than 0.000001) in the percentage of neonatal IgD-positive cells. The addition of either epsilon-aminocaproic acid or Trasylol significantly reduced this action of maternal serum (p l-ess than 0.00001 and p less than 0.0001), without difference between the effects of the two inhibitors (p greater than 0.05). We suggest, therefore, that activity of maternal serum is due, at least in part, to proteolytic enzymes, such as plasmin. The relative role of plasminogen and alpha2-macroglobulin in the incapacity of the newborn serum to reduce the number of IgD-positive lymphocytes is discussed.

Vascular obstruction of the superior renal calyces in children.

The authors describe 5 cases with a pathology peculiar to the superior calyces due to vascular compression, observed from 1969 to 1975 among 938 urographic tests performed in the Pediatric Clinic of Florence. Three of these cases have been checked up to this date. In every patient the urographic tests show clear evidence of a vascular compression at the level of the right upper calyces, associated with stasis and/or ectasis. In two cases there is a symptomatology of abdominal pains; in the remaining 3 patients haematuria is revealed. It is important, particularly in children, to follow the course of the clinical and urographic features, in order to carry out a surgical intervention at the right moment, according to the evolution of the process. The chronic segmental (upper pole) pyelonephritis is the most dangerous evolution.