[The effect on breastfeeding rate of regional anesthesia technique for cesarean and vaginal childbirth]. / Influenza sulla frequenza di allattamento al seno delle tecniche di anestesia regionale nel parto cesareo e nel parto per via vaginale.

BACKGROUND: To evaluate the influence of regional techniques of anesthesia and analgesia on breastfeeding rate after cesarean section and vaginal delivery. STUDY DESIGN: prospective, area-based. SETTING: Obstetrics and Pediatrics Department at Aosta Valley Regional Hospital. SUBJECTS: all the mothers and their newborns during a three-year period (1993-1995). Maternal wish to breastfeed was the main inclusion criterion. Data recorded: feeding modality at discharge, anesthesia and analgesia modality, maternal/neonatal socio-demographic and clinical data. RESULTS: 2725 records were examined, among them 1920 vaginal deliveries and 355 cesarean sections were statistically analyzed. chi 2 analysis showed a significant greater incidence of breastfeeding after cesarean section under regional anesthesia (spinal or epidural) versus general anesthesia: 95% vs 85.5%, p = 0.002. Breastfeeding rate was not different after vaginal delivery with epidural analgesia versus delivery without analgesia: 96.5% vs 97.8%. Logistic regression confirmed the positive role of regional anesthesia and few other maternal and neonatal variables on breastfeeding rate after cesarean section. CONCLUSIONS: Regional anesthesia seems to be advantageous for breastfeeding after cesarean section, probably because of a faster neonatal-maternal bonding if compared with general anesthesia. Epidural analgesia for vaginal delivery does not adversely affects breastfeeding if compared with delivery without analgesia.

[Frequency of hereditary neurologic diseases. A clinical study]. / La frequenza delle malattie neurologiche ereditarie. Uno studio clinico.

INTRODUCTION: The nervous system is affected in 30% of hereditary monogenic disorders and as many as 500 single-gene disorders display major neurologic symptoms. We have studied the frequency of hereditary neurological diseases to assess their importance in daily hospital activity. Only single-gene hereditary diseases with central or peripheral nervous system involvement were considered; thus chromosomal diseases and diseases with multifactorial etiology were excluded. METHODS: We surveyed admission to in- and out-patient departments of Neurology, Pediatrics, and Dermatology of the Aosta Regional Hospital for the calendar years 1982-1991, collecting 229 cases, 95 women and 134 men. Out-patient departments held 126 patients, the others came from in-patient departments. Admission to the neurological in-patient department were 1.8% of total neurological admissions in the same period. Each diagnosis was assigned to the code number of the International Classification of Diseases (ICD-IX Revision, 1975). RESULTS: We found 33 different phenotypes. Most frequent diagnoses were: essential tremor (89 patients), hereditary sensory-motor neuropathy (HSMN) type I (28), Huntington's chorea (13), progressive muscular dystrophy limb-girdle type (8), neurofibromatosis type I (9), HSMN type II (9), spinocerebellar ataxia (9), hereditary spastic paraplegia (7), spinal muscular atrophy type IV (5), myotonic dystrophy (5), cerebellar ataxia (4), HSMN type III (4), spinal muscular atrophy type II and III (3), tuberous sclerosis (3). Essential tremor mostly affected persons in the over-50 age groups. On the contrary, the other neurologic monogenic diseases were diagnosed in all ages with the following age-group breakdown: 0-9, 11%; 10-19, 16%; 20-29, 15%; 30-39, 8%; 40-49, 11%; 50-59, 19%; 60-69, 14%, 70+, 7%. Consistently with the general rule, autosomic recessive diseases have the earliest onset and autosomic dominant ones the latest; HSMN, spinal muscular atrophy and Huntington's chorea were the disorders diagnosed in older age group. DISCUSSION: Although the frequency of the single neurologic monogenic disease is low (with the exception of essential tremor), their overall prevalence is higher than the prevalence of multiple sclerosis or the peripheral neuropathies. All age-groups are involved. We separated three groups of diseases: 1) two relatively benign diseases, essential tremor and the HSMN, affecting half of our patients; 2) five severe and more common diseases (Huntington's chorea, progressive muscular dystrophy limb-girdle type, neurofibromatosis type I, spinocerebellar ataxia, hereditary spastic paraplegia), affecting 1/4 of patients; and 3) a group of rare, mostly severe diseases, affecting the remaining 1/4 of patients.

[Traumatic extradural hematoma in a newborn: a case report]. / Ematoma extradurale traumatico precoce: discussione di un caso.

The authors report the case of a twenty-six-day-old patient presenting a traumatic extradural haematoma. The main clinical aspects of this feature are illustrated and the approach to diagnosis and management is discussed.

Deficiency 10p. Report of a case and exclusion mapping of the hexokinase 1 locus to band 10p11.2.

A patient deficient for most of the short arm of one chromosome 10 is described. The clinical picture is similar to those of other published cases but includes agenesis of olfactory bulbs, an uncommon finding, already noted in few 10p- patients. The normal levels of hexokinase 1 found in the fibroblasts of the patient allow a more precise localization of the gene at band 10p11.2. The results obtained for inorganic pyrophosphatase confirm the data available from two other cases.

[The newborn infant of mothers under treatment with anticonvulsants. Description of 5 cases]. / Il neonato da madre in terapia con anticonvulsivanti. Descrizione di cinque casi.

The effects of fetal exposure to the anticonvulsant drugs and their clinical, diagnostic and therapeutic problems have been considered. The authors have reported five cases of newborns from addicted mothers. Particularly discussed are some clinical and pathologic correlations involved in the exposure to the Hydantoin and to the Sodium Valproate.