Area variations in birthweight- and cause of death--specific neonatal mortality rates in Italy.

The neonatal mortality rate in Italy is intermediate between the United States and the Northern European countries, but important regional differences exist within the country. On the basis of national data recorded by the Italian National Statistical Institute, birthweight- and cause of death-specific neonatal mortality rates were calculated for the whole country and for Northern, Central, and Southern Italy. The incidence of very low birthweight (500 to 1499 gm) and moderately low birthweight (1500 to 2499 gm) infants is similar in the three areas, whereas the risk of dying in the first month of life is highest in Southern and lowest in Northern Italy. Respiratory distress syndrome/immaturity is the main cause of neonatal death because of very high percent and component rates among very low birthweight infants and (to a lesser extent) among moderately low birthweight infants. Congenital disorders, which mainly affect normal weight newborns, are the second cause of neonatal death. Infants born in Southern Italy run a significantly higher risk of dying in the neonatal period than infants born in Northern Italy in almost all birthweight/cause of death subgroups, with the largest differences for moderately low birthweight infants. A similar but smaller difference is seen when infants born in Central Italy are compared with their Northern counterparts.

[Blood sugar control in children and young diabetics during an educational summer camp]. / Controllo glicemico in bambini e giovani diabetici durante un soggiorno educativo estivo.

UNLABELLED: The aim of the study was to evaluate the impact of educative summer camp on the glycemic control in two different age-groups of young diabetic patients. METHODS: 54 patients (36 M, 18 F, age 10-27 years, duration of diabetes 2-19 years), treated with 0.81 +/- 0.2 UI/kg/day of insulin and with HbA1c mean levels of 8.25 +/- 1.35 g% were followed by an equip of 8 medical doctors, 4 nurses and 1 dietician for a week during an educative summer camp. RESULTS: 34 children, group 1 (20 M, 14 F, 10-14 years aged, mean duration of the disease 4.52 years, range 2-12 years) and 20 young adults, group 2 (16 M, 4 F, age 16-27 years, mean duration 10.21 years, range 2-19 years) were evaluated. Insulin doses and HbA1c levels were 0.82 +/- 0.21 UI/kg/day vs 0.80 +/- 0.22 U/kg/day and 9.54 +/- 1.5% vs 7.6 +/- 0.6%, p < 0.02 in group 1 and 2 respectively. Glycemic levels at 8 a.m. and 11 p.m. were significantly higher in group 1 than in group 2 (180 +/- 87 mg% vs 219 +/- 77 mg%, p < 0.05 and 164 +/- 84 mg% vs 201 +/- 81 mg%, p < 0.05). Hypoglycemic/patient/episodes were 1.82 vs 0.72, p < 0.05 in group 1 and group 2 respectively. CONCLUSIONS: 1. Glycemic control was unsatisfactory in both groups and it was significantly worse in the group of youngs, though in this group HbA1c level was significantly lower. 2. The risk of hypoglycemia was significantly higher in group 1, though in this group insulin doses were significantly decreased.

[Nutritional and acute phase proteins in preterm newborns: reference standards and interrelations]. / Proteine nutrizionali e della fase acuta nel neonato pretermine: standard di riferimento ed interrelazioni.

The serum concentrations of 5 "nutritional" and 5 "acute phase" proteins were prospectively studied in 3 groups of newborns with nephelometric methods. Group A: 22 healthy breast fed term newborns aged 4 days; group B: 28 healthy enterally fed preterm newborns (mean gestational age 33.3 weeks); group C: 49 preterm newborns (mean gestational age 29.5 weeks) on parenteral nutrition (PN). Infants with surgical procedures, sepsis and liver or renal diseases were excluded. The serum concentrations of almost all proteins were similar or only slightly different among the 3 groups and never related to the weight and chronological or post-conceptional age. Only prealbumin, apolipoprotein A and B and C4 levels were significantly different between term and preterm newborns. Enterally fed preterm infants had lower concentrations of alpha 1 acid glycoprotein and higher albumin, transferrin and apolipoprotein A than PN fed infants. Since the observed differences were usually quite small, we suggest that--at least in clinical practice--common serum reference values of these proteins should be adopted for all healthy growing newborns, whether preterm or at term, enterally or parenterally fed. The inter-relationships between different proteins were studied. Four of the five nutritional proteins were highly correlated one with another and the same was observed for the 5 acute phase proteins. Nutritional proteins as a group did not correlate with acute phase proteins, with the only exception of alpha 1 acid glycoprotein and apolipoprotein A. Thus, the 2 groups of proteins seem to be regulated by different metabolic systems.