[Glycopeptides and the newborn infant's kidney]. / Glicopeptidi e rene del neonato.

The aim of this paper was to evaluate glycopeptide nephrotoxicity in the newborn. The exact mechanism of nephrotoxicity has not been defined. Basal mechanism of vancomycin nephrotoxicity seems related to the energy-dependent tubular transport of the drug from blood to tubular cell across the basolateral membrane. Moreover a tubular reabsorption is probably involved, but it is not relevant for nephrotoxicity. Considering the widespread use of this antibiotic, the question of nephrotoxic side effects in humans is of great importance. However, the results of studies published to date are controversial. Results differ considerably depending on the period considered and on the sensitivity of the methods used to indicate renal damage. In paediatric patients (including neonates) the nephrotoxicity of vancomycin appears to be less than that in adults, thus confirming a number of experimental observations. It is commonly suggested that pharmacokinetic monitoring of doses in children should minimize nephrotoxicity. The most important risk factors for the development of the nephrotoxic action of vancomycin are: pre-dose values > 10 mg/l, prolonged therapy (> 21 days), and concomitant treatment with aminoglycosides. In most cases nephrotoxicity associated with vancomycin is reversible, even after high doses. In conclusion it could be speculated that vancomycin nephrotoxicity relates to the combined effect of a large area under the concentration-time curve and duration of therapy. Teicoplanin is a new glycopeptide that is effective in the treatment of both children and neonates and offers the advantages of once daily administration, choice of administration route (intramuscular or rapid intravenous bolus) and lack of requirement for routine therapeutic drug monitoring. Finally it seems less nephrotoxic than vancomycin. In the neonatal age bracket, none of the 173 patients treated presented abnormalities of traditional kidney function parameters.

[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.

The effect of cetirizine on the integrin-dependent respiratory burst of normodense eosinophils.

It has been proposed that cetirizine inhibits eosinophil migration and adherence. We evaluated the possible effect of cetirizine on integrin-induced eosinophil proinflammatory activation. Normodense eosinophils were triggered with monoclonal antibodies to integrins in the presence of different concentrations of certirizine. Proinflammatory activation was measured by evaluation of O2- production. Only at high concentrations (250 micrograms/ml) and in the first 15 min did certirizine significantly inhibit (p < 0.02) the eosinophil respiratory burst. No effect was shown for lower concentrations (50 and 100 micrograms/ml) or after 15 min. These data suggest that, only at very high concentrations, cetirizine may induce a transient inhibition of the integrin-induced eosinophil respiratory burst.