Symptomatic hypercalcemia in the first months of life: calcium-regulating hormones and treatment.

Neonatal hypercalcemia is a rare condition often of unclear pathogenesis. If unrecognized and untreated it may result in central nervous system and renal damage. We studied three infants with symptomatic neonatal hypercalcemia pointing out pathogenetic and therapeutic aspects. One infant was found to have transient hyperparathyroidism with high intact parathyroid hormone (iPTH) levels. One infant had an incomplete form of Williams syndrome with hypercalcemia and an elfin facies. The pathogenesis is unclear in this case. A reduced secretion of calcitonin or an hypersensitivity to vitamin D might be the underlying defect. The third case was found to have subcutaneous fat necrosis and hypercalcemia associated with high 1,25(OH)2D levels and suppressed iPTH levels. These findings suggest an unregulated extrarenal 1,25(OH)2D production. These infants were treated with hydratation, furosemide, corticosteroids and low calcium diet. Symptomatic neonatal hypercalcemia should be treated promptly. However blood has to be taken before starting treatment to study calcium-regulating hormones and clarify pathogenesis.

Impact of pesticides to groundwater resources in an alluvial plain using a geographical information system.

A methodology to evaluate the impact of pesticides to drinking water resources in an agricultural region has been applied in an Italian alluvial plain using a Geographical Information System (GIS). With this technology it is possible to store, process and represent geographical data and update them according to the environmental characteristics. The studied area, covering a surface of 500 km2, is located immediately south of Milan, in the alluvial plain of the Po river. The DRASTIC model (1) has been utilized in order to evaluate the intrinsic vulnerability of aquifers, DRASTIC is a quantitative method proposed by EPA to identify pollution potential especially referred to pesticides in USA. The application of this model, combined with data of land use has provided maps identifying areas at risk for groundwater pollution. Information derived from risk maps is of primary importance in territorial planning such as: selection of areas to be monitored, identification of areas to be protected, correct management of agricultural practices and use of pesticides. These maps should provide an useful instrument for agricultural and territorial management.