Effects of vitamin D on the growth of normal and malignant B-cell progenitors.

As the effects of vitamin D3, 1,25-dihydroxyvitamin D3 (1,25-(OH)2-D3) (VD, calcitriol) on the proliferation and differentiation potential of normal and leukaemic cells in vitro of myeloid lineage are known, we investigated the response to VD on the growth of both normal and malignant lymphoid progenitors. Effects of vitamin D on normal human lymphoid progenitors and B lineage acute lymphoblastic leukaemia (ALL) progenitors were assessed by using an in vitro cell colony assay specific for either B or T cell lineages. The expression of VDR on B untreated malignant progenitors at diagnosis was investigated by RT-PCR analysis. VD induced a significant inhibition of normal lymphoid cell progenitors growth of both T and B lineage. VD inhibited significantly also the growth of malignant B cell lineage lymphoid progenitors, without inducing cytotoxic effect. As it has been reported that VD effects on activated lymphocytes are mediated by 1,25-(OH)2-D3 nuclear receptor (VDR), we investigated VDR expression on malignant B cell progenitors. We did not detect VDR expression on these cells examined at diagnosis. We demonstrated that VD inhibited in vitro the clonogenic growth of both normal and malignant lymphoid B cell progenitors and that this inhibitory effect on malignant B cell progenitors was not related to VDR. Our work contributes to understanding of the mechanism of action of this hormone in promoting cellular inhibition of clonal growth of malignant lymphoid B cell progenitors, suggesting that the regulation of some critical growth and differentiation factor receptors could be a key physiological role of this hormone.

[The cell-mediated response after measles vaccination]. / Studio della risposta cellulo-mediata dopo vaccinazione anti-morbillosa.

Natural measles virus infection is recognized for causing prolonged abnormalities in immune responses, that contribute to the severe and complicated evolution of the disease. Immunization with live measles virus vaccine could be considered a mild form of the measles infection. Results of investigation of in vitro immune response after measles immunization with live attenuate vaccine have been conflicting. In this work we studied cellular immune parameters in children aged between 3 and 12 years. T cells, CD4+ and CD8+ subsets were analyzed by cytometry. CD3+ cells were significantly reduced compared to controls (p < 0.01) whereas CD4+/CD8+ ratio was normal. The in vitro proliferative response to polyclonal mitogen was significantly reduced (p < 0.01). This study confirms the presence of a mainly functional immunosuppression of cellular response in a cohort of children belonging to a developed area. These findings improve the understanding of the mechanism of immune response to virus measles and provide suggestions for the development of a better approach to immunization, taking account for the strain, vaccine titre, age and environmental conditions of the target population.

[Peutz-Jeghers syndrome]. / La sindrome di Peutz-Jeghers.

An observation of Peutz-Jeghers syndrome, in a 13 year old girl, provides the Authors with the opportunity of reviewing the clinical features, the natural history and the complications of the disease, mainly the malignancies. In recent reviews the occurrence of cancer was further on investigated: gastrointestinal and non gastrointestinal tumors occurred in 22-48% of the patients examined. The surveillance protocols of the subjects at risk and genetic counseling are discussed.

[Catering services in schools for children (critique and operative proposals)]. / A proposito di refezione collettiva nelle scuole per bambini (critiche e proposte operative).

Several protests by pupils' parents against bad-quality of food given in school-meal--widely and minutely reported by local press--advised Autors to give due emphasis on some deficiencies in school-meal administration, rightly denounced by relatives. To cut down health troubles, Authors suggest to commit school-meal's management to catering firms for their great experience in field of collective meal. In fact they have implements and competence to check properly: -education and skill of staff attached to school-meal and distribution; -places, structures, tools used to get meals; -victualling, carriage, storage and condition of food maintenance; -the fancy diets, appropriately diversified by age. Authors think that each school should have places, structures and tools to prepare and take meals and should engage a sole firm both for cooking and serving school-meal.

[Pulmonary infections in children. III. Pneumonia due to Chlamydia trachomatis]. / Infezioni polmonari emergenti nel bambino. III--Polmoniti da Chlamydia trachomatis.

The authors show a scientific literary review on Ch. trachomatis pneumonia. A distinctive syndrome pneumonia has been reported in infants infected by Chlamydia (at 2-3 months of age) in genital-urinary infected mothers. The infection may be preceded by conjunctivitis, in apyrexia followed by attacks of coughing pertussis-like. Blood eosinophilia is present. Although favorable prognosis in infancy, erythromycin is the drug of choice shortening the clinical course erythromycin is also recommended in woman infected prevention.

[Pulmonary infections in children. II - Mycoplasma pneumonia]. / Infezioni polmonari emergenti nel bambino. II--Polmoniti da micoplasmi.

The authors show a literary review on Mycoplasma pneumonia which represents a fifth of human pneumonia. M. pneumoniae is the major cause of illness in school-age children (5-9 years) and young adults and the peak incidence of illness occurs in this age. The infection appears mainly as an interstitial pneumonitis and the onset of illness is gradual, influence-like with few clinical symptoms and typical roentgenographic and bronchoscopic findings. Cold hemagglutinins appear in approximately 50% of patients. A severe prognosis can be associated with extrarespiratory symptoms; Erythromycin (as others macrolides) is the drug of choice.

[Brief analytical review of additional possible mechanisms in the pathogenesis of AIDS]. / Breve revisione analitica dei possibili meccanismi addizionali nella patogenesi dell'AIDS.

It is generally agreed that HIV itself has the primary role in the initiation and propagation of the pathogenic process of the infection. Nonetheless, a number of important issues concerning the pathogenesis of HIV infection remain unresolved. For example, it remains unclear how CD4+ T cells are lost after HIV infection. The low frequency of infected cells seen even in advanced infection implies that a direct cythopathic effect of HIV on infected CD4+ T cells cannot explain their disappearance. Multiple and diverse mechanisms have been proposed as supplements to the HIV in the destruction of CD4+ cells and the pathogenesis of AIDS. However, it is not yet possible to state confidently which additional mechanism(s) is important. Identification of the nature of this supplemental process has become essential for successful, non-harmful intervention. We propose here a short analytical review of the possible supplemental mechanisms of immunological destruction in AIDS in order to emphasize the complexity of the pathogenesis of the disease.

[Pulmonary infections in children. I -- pneumonia due to Legionella pneumophila]. / Infezioni polmonari emergenti nel bambino. I--Polmoniti da Legionelle.

Pneumonia due to L. pneumophila occurs frequently in children even though "legionnaires' disease" in adults in usual. The authors show a literary scientific review of almost one hundred cases, sporadic generally, in childhood. In children legionnaires' disease remembers the adults infection, beginning with bronchiolitis. The extrarespiratory symptoms appears more frequently in adults. Chest roentgenograms obtained early reveal patchy infiltrates that become nodular areas of consolidation bilateral also, with pleural effusion. In children prognosis is poor (exitus in 15 about 97 described cases). The infection responds to erythromycin; it is administered intravenously, but oral treatment may also be used.

[Food allergy in children. Diagnostic difficulties, doubts and digressions]. / Allergia alimentare nel bambino. Difficoltà diagnostiche, dubbi, divagazioni.

It is very difficult to diagnose an alimentary allergy especially because of: the difference among individuals in their physical, psychic and humoral reactions to the environment; weakness and variability of these reactions during the puberty; limited reliability in the results of certain kind of research (i.e. false positiveness and negativeness, discordance between laboratory results and the results of the challenge, neutralization of diagnostic antigenic extracts and/or the presence in these extracts of lectin, etc.); the bad compliance of some therapies and their restricted efficaciousness, particularly in the little children. Moreover: the superimposition of the clinical manifestations of alimentary allergy and pseudoallergy with those of allergy, the possibility of an association between the alimentary and the respiratory allergy, the acquisition on behalf of the allergic child of other kinds of allergy, false polyallergy, the allergy might change its seats and in consequence also its manifestations. The authors, apart a short account of the different diagnostic methods, lay stress on the challenge as the most reliable. They discuss upon the dose of a nourishment that can be given to the patient without risk, besides they suggest to take into account the type and the seriousness of the clinical manifestations in fixing this dose.

[Food contamination: a problem of pediatric interest]. / Contaminanti alimentari: un problema di interesse pediatrico.

The application of technology in the production, processing, preservation and transport of food has led to a well known consequence: the presence in the foods of undesirable substances and chemicals, that is to say "the contaminants of feeding". In this study the authors report the main groups of contaminants as the mycotoxins, nitrates, pesticides, methylmercury, lead, cadmium etc., relating for everyone of them the harmful effects for the health of human being, of which they have come to know mostly for some episodes of acute poisoning occurred in several countries in the world. They relate also the hypothetical effects of a chronic exposure to low levels of contamination, mostly if the fetuses and infants come to be exposed to these contaminants for the peculiar embryo genetic and evolutive situation that characterizes them.

[IgA deficiency in pediatrics]. / Deficit di IgA in pediatria.

To evaluate the IgA deficiency we have considered 368 children, admitted to "Day hospital" for different pathologies: 64 of them had serum IgA levels lower than the normal values for their age according to Ellis and Robbin. The age of the children with this deficiency was included from 4 months up to 8 years: 39 were boys, 25 were girls. In 54 cases the IgA deficiency was "partial" that is: the IgA value found out was lower than the normal for the age, but higher than 5 mg%. In 10 cases the IgA deficiency was "severe" (the IgA value was lower than 5 mg%). Six cases, among the 29 ones with intestinal diseases, had a severe deficiency, whereas among the 22 cases with respiratory diseases 3 had a "severe" deficiency. The 2 patients with urinary disease had a partial deficiency; only one case of the remaining 11 with different pathologies had a "severe" deficiency. Among the carriers of serum IgA deficiency an high incidence of chronic pathology has been found out (83%). Nevertheless the percentage of IgA deficiency extrapolated from the all case histories doesn't differ very much (64 cases among 368 = 17.39%) considering only those patients with chronic relapsing pathology (53 cases among 275 = 18.2%). Therefore it seems that the IgA deficiency could be considered a chronicizing factor in the examinated pathology even if in few cases. Anyway the frequency of IgA deficiency has reached major values (29/54; 45.3%) in the patients with enteric diseases. The frequency of IgA deficiency is smaller but still important in those patients with respiratory diseases (22/64: 34.3%).(ABSTRACT TRUNCATED AT 250 WORDS)

[Short near-fainting in children with or without loss of conscience]. / Malesseri fugaci del bambino con o senza perdita di coscienza.

Short near-faints with or without loss of consciousness have different etiologies and pathogenesis and, according to these, they recur with various frequency. This subject was reported on several publications and here is again examined with the contribute of personal experience and the description of distinct cases. The following causes were examined: vagal hypertonia, digestive troubles (gastroesophageal reflux), metabolic troubles (cyclic ketosis, hypoglycemia and hypocalcemia with peculiar clinic manifestations). Among the neurological causes were examined: epilepsy, benign paroxysmal vertigos and, particularly, the so called breath-holding spells and the migraine, about that were reported a few examples of "migraine accompagnée". Among the cardiovascular causes (ischaemic cerebral crisis), -particular attention was dedicated to orthostatic hypotension syncope. A short hint about hysteria ends the exposition of psychical causes of short near-faints.

[Headache in childhood with special reference to migraine. Discussion of a personal case material of 94 subjects]. / Le cefalee dell'infanzia con particolare riguardo all'emicrania. Discussione di una casistica personale di 94 soggetti.

After having characterized epidemiologically, etiopathogenetically diagnostically, prognostically and psychologically the childhood headache, the A.A. refer data relative to 94 children of age in between 6 and 16 years, of which 51 females and 43 males, suffering for migraine (diagnosed by Bille's criteria). The ratio between migraine and sex, age, relationships, clinical symptomatology, onset time, crisis appearance frequency and causing factors have been studied. The relations between migraine and spasmophilia have been treated with particular remark in our casuistry, since similar studies don't appear in the literature. The work ends with some informations about migraine's common therapy, our particular one and the results that we obtained.

[Therapy of atopic dermatitis in children. Study on the use of a desensitizing preparation]. / Sulla terapia della dermatite atopica nel bambino. Studio sull'impiego di un preparato iposensibilizzante.

Children with Atopic Dermatitis have been treated with Histaglobin (gamma globulin + histamine) applied by hypodermic injections. The patients (42) were divided into three groups: the first one (ten cases) aged between 9 and 5 years; the second one (eight cases) between 5 and 2 years and the third one (twenty four cases) aged less than two years. The trial has been carried out in two phases: the first one consisted of nine injections with increasing doses ranging from 1/3 to 1 ampoule with 4-6 day intervals; the second one, "the maintenance period", was made by nine injections of 1 ampoule with increasing intervals from two up to four weeks. The following four parameters were checked along all the therapy period: prurigo, erythema, exudation, scratching lesions. All the listed symptoms have been observed to decrease of intensity mainly during the first phase, until the complete disappearance of some of them; the residual symptoms continued to have a further improvement during the second phase; in most case disappeared completely. Absolutely no troubles of any kind have been noticed. Consequently the Authors consider the desensitization therapy by Histaglobin on the whole satisfying.

[Herpesvirus simplex disease in the newborn infant. Clinical aspects, diagnosis, prophylaxis, therapy]. / La malattia da HVS nel neonato. Clinica, diagnosi, profilassi, terapia.

Herpes Simplex virus infection (Particularly by HVS2) is one of the most important disease transmitted by mother to newborn because of the seriousness of symptoms and the high incidence of genital infection of pregnants. Transmission of congenital HVS infection occurs usually by contact with infected genital secretions during the birth process, but there is evidence that transplacenter transmission also may occur. Emphasis must be placed then on prophylaxis of genital infection of pregnants and of their partners. Specific Immunoglobulins with high antibody titre are recommended for prophylaxis. An anti HVS2 vaccine without oncogen property os still at experimental stage. This prophylaxis is inadequate for the newborn of infected mother: this one must be treated with newer antiviral agents (Acyclovir), even is absence of herpetic lesion and other symptoms.

[Sinusitis in children. Personal case study]. / Le sinusiti nel bambino. Casistica personale.

The presence of sinusitis has been found out 85 times out of 278 cases of acute relapsing respiratory diseases in children between 4 and 12 years of age. The maxilla sinuses have been those most frequently stricken; the frontal sinuses come next and last at a distance the sphenoidal sinus. A close relationship between the entity of basic respiratory pathology and the presence and seriousness of the sinusitis has been observed. There also seems to be a rather close relationship between the frequency of the presence of sinusitis in children with respiratory pathology either relapsing or chronic and climatic environmental situation. A damp climate with persistent fog together with industrial atmospheric pollution seems to favour the considered pathology in an undisputed way.