ABSTRACT
AIM: The aim of this article is to analyze the epidemiological and clinical features of migraine in a pediatric headache center. METHODS: A retrospective study was performed over six years. Hospital record databases were screened for the diagnosis of migraine with aura (MA) or without aura (MO), based on the ICHD-II criteria. STATISTICAL ANALYSIS: Fisher's test or Mann-Whitney U test, significance at p < 0.05. RESULTS: Migraine was diagnosed in 495 children (29.7% MA, 70.3% MO). The majority of diagnoses were made between ages 9 and 14 years. After stratification for age into five groups, we observed an increase of diagnoses in females, with a peak after the age of 15 years, and an increase of MA. In both groups, the attacks were usually severe, infrequent (<1-3/month) lasting <2 hours, and associated with nausea/vomiting, photophobia, phonophobia (more frequent in MO). Osmophobia was reported in 24.7% of the patients with MO. Dizziness was more frequent in patients with MA. Visual auras were the most common occurrence (87.1%). Confusional state was observed in 10.88% of the patients. A positive family history of headache was observed in >88% of the patients. CONCLUSION: We describe the characteristics of pediatric migraine based on the ICHD-II criteria, showing a likely significant loss of diagnoses using the ICHD-III beta. The incidence of migraine increases with age. MO occurs more commonly and shows more frequent attacks and a higher prevalence of associated symptoms, in particular osmophobia. Although males are prevalent in the entire sample, the proportion of females is higher among patients with MA in all of the age groups. Phenotype and sexual prevalence of migraine acquire adult characteristics and become more frequent in females from the onset of puberty.
Subject(s)
Migraine Disorders/epidemiology , Adolescent , Age Distribution , Child , Child, Preschool , Female , Humans , Incidence , Italy/epidemiology , Male , Prevalence , Retrospective Studies , Sex DistributionSubject(s)
Disease Outbreaks , Food Contamination , Foodborne Diseases/diagnosis , Meat/poisoning , Methemoglobinemia/diagnosis , Nitrates/poisoning , Adolescent , Animals , Cattle , Child , Female , Foodborne Diseases/ethnology , Foodborne Diseases/etiology , Humans , Italy/epidemiology , Male , Methemoglobinemia/ethnology , Methemoglobinemia/etiology , RomaABSTRACT
The paper reports a case of a 6-year-old boy affected by visceral leishmaniasis. In addition to clinical and anamnestic findings, diagnosis was made on the basis of the rapid increase in the titer of anti-Leishmania antibodies (16-fold), while the marrow smear was negative. A complete recovery was obtained using antimonial drugs.
Subject(s)
Leishmaniasis, Visceral/diagnosis , Adult , Child , Family Health , Humans , Leishmaniasis, Visceral/drug therapy , MaleABSTRACT
Variation of serum immunoglobulin (Ig) levels and increased frequency of selective IgA deficiency are frequently associated with autoimmune diseases. In insulin-dependent diabetes mellitus (I.D.D.M.) pathogenesis autoimmunity is known to play a causative role. Aim of the present study was to evaluate serum major immunoglobulin subclasses levels and frequency of IgA selective deficiency in juvenile onset I.D.D.M. IgG, IgA, IgM concentrations were determined in 191 insulin-dependent children and adolescents (100 males, 91 females; mean age 10.6 divided by 4.8 yrs; mean duration of I.D.D.M. 5.7 divided by 3.9 yrs) and in 180 age-matched healthy controls. Mean Ig levels were comparable among both group. Duration of I.D.D.M. did not affect mean serum Ig levels. Selective IgA deficiency was found in 7 on 191 diabetics: this gives a prevalence of the defect of 1:27, which is higher than in the Italian pediatric population (1:500). HLA typing evidenced 2 DR3 positive patients, 2 DR4, 1 B8-DR3 and 1 B8-DR3/DR4. The significance of selective IgA deficiency in I.D.D.M. is discussed.
Subject(s)
Diabetes Mellitus, Type 1/immunology , IgA Deficiency , Adolescent , Child , Child, Preschool , Diabetes Mellitus, Type 1/etiology , Female , Humans , Immunoglobulin A, Secretory/analysis , Immunoglobulin G/analysis , Immunoglobulin M/analysis , Male , Saliva/immunology , Skin Tests , T-Lymphocytes/classification , T-Lymphocytes/immunologyABSTRACT
1. Intracellular Na+ concentration [Na+]i and Na+ extrusion catalysed by sodium potassium-activated adenosine triphosphatase (Na+, K+-pump) were evaluated in erythrocytes from 21 obese children and 20 normal weight- and age-matched controls. 2. Obese children showed a significantly decreased Vmax. for Na+, K+-pump-mediated Na+ efflux (5638 +/- 338 vs 7597 +/- 335 mumol h-1 litre-1 of cells mean +/- SEM, P = 0.01), while [Na+]i (9.3 +/- 0.3 vs 9.1 +/- 0.5 mmol/litre of cells, mean +/- SEM, NS) and Na+ efflux in fresh cells (2380 +/- 153 vs 2533 +/- 180 mumol h-1 litre-1 of cells, mean +/- SEM, NS) were similar in both groups. 3. Mean diastolic blood pressure was significantly higher in obese children than in controls, although both groups were normotensive (73.8 +/- 1.3 vs 66.2 +/- 1.9 mmHg, mean +/- SEM, P = 0.009). 4. Abnormal Na+, K+-pump activity is present in individuals with idiopathic obesity. 5. The possible link between obesity and blood pressure regulation may be mediated through modifications in Na+,K+-pump activity.
