Infant nutritional recommendations from pediatricians. Epidemiologic survey of feeding recommendations for the first year of life in Piedmont.

AIM: Timing the introduction of solids and milk formulas in infants' diet varies throughout the world. The aim of the present study was to assess the modalities of weaning, suggested by pediatricians in Piedmont, Italy, and to compare them to current scientific guidelines. METHODS: The survey was conducted using data recording forms sent to the pediatricians of our area (both practitioners and hospital physicians) from September 2000 to January 2001. Pediatricians were asked to fill in a questionnaire about the time of solid food introduction in the 1st year of life. The study was supported by 168 pediatricians, of these 105 practitioners, 53 hospital doctors and 9 university physicians. RESULTS: The mean age of weaning was 4.5 months. The 1st beikost was vegetable soup with rice flour, meat and parmesan in 65.4%; in 73.8% it was given with a spoon. In 94.6% no salt was added, in 84.5% no sweetener was added. Homogenized fruit was introduced at a mean age of 4.4 months: apple was the 1st fruit to be introduced (4.5 months), followed by pear (4.8 months) and banana (5.6). Lyophilised meat was introduced at 5 months, homogenized meat was introduced at 6.2 months, and minced meat was introduced at 8.2 months. Vegetables (potatoes, carrots, courgettes) were introduced between 5.2 to 5.4 months of age. Parmesan was introduced at 5.3 months; gluten at 6.2 months. Egg yolk was the 1st to be introduced (mean age = 8.9 months), while albumen was introduced at a mean age of 11.6 months. Fish was given at a mean age of 8.2 months. Cow's milk was introduced at 9 months. CONCLUSION: Paediatricians give indications about the introduction of solid foods according to scientific guidelines, with the exception of cow's milk which is introduced too early.

Psychological stress, neuroimmunomodulation, and susceptibility to infectious diseases in animals and man: a review.

This article reviews research on the role of psychological stress, personality, social support and other psychosocial factors in bacterial, viral and parasitic infections. After 100 years of research on man and animals, psychological stress is considered as a potential cofactor in the pathogenesis of infectious disease. Psychological stress seems able to alter the susceptibility of animals and man to infectious agents, influencing the onset, course and outcome of certain infectious pathologies. Many experiments have identified in neuroimmunomodulation the principal mediator of the alterations associated with conditions of stress. The development of psychoneuroimmunology has fostered in-depth study of the complex relationship between psychosocial factors, the central nervous system, the immune system and infectious disease. Although antimicrobial drugs have certainly remained the basis of all anti-infective therapy, this type of study has already led some authors to propose and experiment protocols of psychological intervention or psychoimmunotherapy in pathologies such as tuberculosis, or herpes simplex virus or human immunodeficiency virus infections. The psychoneuroimmunological approach to infectious diseases will probably grow in importance in the future not only in the setting of research in psychosomatic medicine but also in that of clinical microbiology.

Systemic reactions to specific immunotherapy in children with respiratory allergy: a prospective study.

The aim of this multi-centre prospective study was to evaluate the prevalence of systemic reactions to specific immunotherapy in children with allergic asthma and or rhinitis. One thousand and fifty-six children (653 boys and 403 girls), median age 8.5 years, were enrolled in this three-year prospective study. All the children were treated with injections of the following allergenic extracts: 689 of house dust mite, 291 of grass, 109 of Parietaria, 13 of Alternaria, 6 of Artemisia and 11 of Olea. Among 1056 treated children, 41 (3.7%) had systemic reactions: 40 children (3.7%) experienced mild symptoms such as asthma and/or urticaria, and only one shock (0.08%). A total of 47,247 injections were administered, and the rate of systemic reactions, according to the number of total injections was only 0.08%. According to the allergenic extract, systemic reactions occurred in 29/689 children (4.2%) treated with house dust mites extract (0.09% of the injections), in 9/291 children (3.1%) treated with grass extract (0.07% of the injections) and in 3/109 children (2.8%) treated with Parietaria extract (0.06% of the injections). The prevalence of systemic reactions was significantly higher (p < 0.0001) in the children treated with house dust mite extract in comparison with those treated with pollen extracts. All the systemic reactions appeared within 30 minutes following the administration of the extract and occurred in 37/41 cases (90.2%) with the same dose, previously tolerated. Most reactions were mild, and were readily controlled by immediate emergency treatment. There was no need for hospitalization.(ABSTRACT TRUNCATED AT 250 WORDS)

[Celiac disease in Piedmont. An epidemiological-clinical study]. / La malattia celiaca in Piemonte. Studio epidemiologico-clinico.

The incidence of coeliac disease (CD) was calculated on 304 patients under eighteen who were born in the city of Turin and its province in the years 1975-1989; the prevalence on 494 patients who live in the Piedmont Region. The mean crude yearly incidence was 0.511/1000 (1:1957 live birth). It varied from year to year, reaching minimum values in the years 1984-1987. In a contemporary epidemiological study, the mean crude incidence of CD in Italy was 1.2/1000 (1:833 live birth) twice the rate observed in Turin. The prevalence of paediatric CD in Piedmont was 113 per million inhabitants. Since CD has a normal life expectancy, its prevalence may be expected to increase. In the provinces of Novara, Alessandria and Asti CD prevalence was lower than in the others. Mean age at onset was 6 mos in 1975 and increased to 34 mos in 1989. Mean age at diagnosis was 15 mos in 1981, and 7 yrs in 1989. Symptoms were more numerous and severe in patients under 12 mos of age, and became fewer and often atypical in older children. We can therefore speculate that the trend towards a decreasing incidence of CD in recent years my be due to delayed diagnosis.

[Anti-Chlamydia psittaci antibodies in a healthy pediatric population]. / Anticorpi anti Chlamydia psittaci nella popolazione sana infantile.

Psittacosis or ornithosis is a bird disease caused by Chlamydia psittaci which can be transmitted to man. Little is known of the epidemiology of the disease in this region, but occasional cases which have been brought to the authors' attention have prompted an epidemiological study on the subject. The preliminary results indicate a surprising percentage, over 8%, of antibodies in infants and children. This percentage varies little in relation to place of residence, rural or urban, or the presence of animals, but confirms the high risk in parrot-owning households where anti-Chlamydia antibodies are found in 37.5% of children.

Changes of polyamine concentrations in infants during the first six months of life.

Polyamines were detected in the blood of infants during the first six months of life. The highest spermidine levels were found at the 2nd and the 4th month after birth. Spermine, on the contrary, does not show significant differences. Different types of diet produced no changes in the polyamine pattern.

Pattern of human blood spermidine and spermine in prematurity.

Blood polyamines have been determined in preterm newborns (24-37 gestation weeks) during the first hours of life and until 20 days after birth. The most elevated polyamine concentrations were found in preterm newborns from the 24th-33rd gestational week. In all preterms, however, polyamine concentrations are higher than in full term newborns. In preterm infants two different patterns of blood polyamines appear in relation to the gestational age: in infants born at 24-34 wk, spermidine reaches the peak at 12 h and spermine shows high concentrations between 12 and 48 h. In infants born at 35-37 wk maximal concentrations of polyamines were reached at 12 h. Successively, in both groups the polyamines progressively decrease up to the 20th day, with some individual variations. Our results may provide a further support to the suggestion of a fetal genesis of polyamines and their involvement in fetal growth.

[Study of serum ferritin in a population of 3-month-old breast feeding children]. / Valutazione della ferritina serica in una popolazione di lattanti al seno all'età di tre mesi.

The evaluation of serum ferritin level in a population of 30 three months old babies is made by the Authors following a radioimmunological method. The reckoned average values reflect exactly the wellknown elements of iron kinetics during the first months of life. The Authors underline that those values show how complete is breast-feeding; moreover they emphasize the importance of a referring value which, together with those already known in subjects of different ages, allows on early diagnosis of syndromes due to iron decrease and subsequent check-up after therapeutic trial.