[School difficulties in adolescence]. / L'adolescente con difficoltà scolastiche.

Loss, failure and desertion are those words, which better describe the most frequent difficulties incurred by teenagers, and their relation to the school environment, and indicate, as well, the lack of connection between individual aspirations and school achievements obtained. Despite the likelihood of school difficulties throughout the entire educational career, from the kindergarten to the college, we are able to recognize certain specific "disturbances" which come out during the adolescence, basically relating to the school experiences. School failure, school desertion and school abandonment are, in fact, issues mainly discussed in coincidence with the beginning of the adolescent age and the attending of the high school. The aetiopathogenesis of school discomfort is mostly determined by more than only one factor: psychological, physical, cognitive and environmental aspects, all together, contribute in various ways, to the rise and persisting of the above described problems. Suggesting a univocal characterization of the adolescent with school difficulties, is indeed a hard task, since school failure is not an exclusive feature of only one kind of personality or the expression of only one type of conflict. Once identified the individuals more subject to risk, and the warning signs of actual uneasiness, it is important therefore to intervene timely and in different ways in order to avoid the worsening or the excessive extension of the school difficulties and of their frequent and serious consequences on the teenagers' individual and domestic well-being. Such type of prevention definitely belongs to the Adolescent Medicine, and must be developed on different levels, by involving not only the teenagers, but also their families, the school, and the whole social environment in which the teenagers live and with which they interact.

[Legal and medico-legal issues in adolescent medicine. A critical review of the present regulation and legislation]. / Aspetti giuridici e medico-legali della pratica adolescentologica. Riflessioni sulla normativa e legislazione vigenti.

During the last years the Italian Government has taken many different initiatives to protect the adolescents rights to benefit from physical, psychical and social well-being. In particular, various projects concerning the promotion and the support of the school, the family, sport, mass-media, judicial and medical infrastructures, have been organised, promoted and financed. However, it is not always possible to assure a real safeguarding of teenagers rights; this especially happens because the problem concerning the autonomous capacity of minors to consent (or non consent) to the medical treatment is much debated. However, many contradictions still persist about the effective duration of the pediatric age. All the same, it must be noted that the Legislator apparently realised that not only the physical, psychological and social maturity proceed by steps, but also the legal capacity.

[The use of FSH in adolescents and young adults with idiopathic, unilateral, left varicocele not undergoing surgical intervention. Preliminary study]. / Uso del FSH in adolescenti e giovani adulti affetti da varicocele idiopatico monolaterale sinistro, non sottoposti ad intervento chirurgico. Studio preliminare.

BACKGROUND: To study gonadal function in young patients suffering from left varicocele. DESIGN: prospective study. SETTING: university laboratory and clinical services. PATIENTS: 20 boys (age range: 15-20 yrs; mean +/- DS: 17.9 +/- 1.48 yrs), affected by left idiopathic varicocele. INTERVENTION: high purified urinary FSH s.c. (Metrodin HP 75, Ares-Serono), three times every week, for three months. MAIN OUTCOME MEASURES: seminal fluid examination before and after therapy (WHO). RESULTS: At the end of the study period a statistically increase of sperm density/ml (38.45 x 10(6) vs 49.10 x 10(6), total sperm number/ejaculate with forward motility (37.41 x 10(6) vs 48.52 x 10(6)) and a decrease of atypical forms (54.35% vs 49.60%) has been observed; the increase of the total sperm number/ejaculate after FSH treatment greater than 50% compared with basal values allows to define 9 patients as responders. CONCLUSIONS: In this study the FSH treatment in young people with varicocele leads to a statistically significant increase in the seminal fluid parameters and may characterize a group of patients who may have a better prognostic outcome regarding the tubular gonadal function and thus the fertility potential in adult life.

[The use of FSH in adolescents and young adults with left idiopathic varicocele, not submitted to surgery. Preliminary study]. / Uso del FSH in adolescenti e giovani adulti affetti da varicocele idiopatico monolaterale sinistro, non sottoposti ad intervento chirurgico. Studio preliminare.

BACKGROUND: To study gonadal function in young patients suffering from left varicocele. DESIGN: prospective study. SETTING: university laboratory and clinical services. patients: 20 boys (age range: 15-20 yrs; mean +/- DS: 17.9 +/- 1.48 yrs), affected by left idiopathic varicocele. INTERVENTION: high purified urinary FSH s.c. (Metrodin HP 75, Ares-Serono), three times every week, for three months. MAIN OUTCOME MEASURES: seminal fluid examination before and after therapy (WHO). RESULTS: At the end of the study period a statistically increase of sperm density/ml (38.45 x 10(6) vs 49.10 x 10(6)), total sperm number/ejaculate with forward motility (37.41 x 10(6) vs 48.52 x 10(6)) and a decrease of atypical forms (54.35% vs 49.60%) has been observed; the increase of the total sperm number/ejaculate after FSH treatment greater than 50% compared with basal values allows to define 9 patients as responders. CONCLUSIONS: In this study the FSH treatment in young people with varicocele leads to a statistically significant increase in the seminal fluid parameters and may characterize a group of patients who may have a better prognostic outcome regarding the tubular gonadal function and thus the fertility potential in adult life.

[Height percentiles of children at 6 to 11 years of age in the area of Lazio]. / I percentili della statura di bambini laziali da 6 a 11 anni.

BACKGROUND: In this paper we present growth height standards obtained by an auxological study on a primary school population of central Italy (Lazio), in the 1991-1992 and 1992-1993 school-years. METHODS: 4,175 children were included in the study: 2,024 females and 2,151 males, aged from 6 to 11 years. The sampling rate corresponds to more than 98% of the total primary school-population of the areas mentioned. The statistical analysis of the collected data was carried out by the Dipartment of Statistics of the University of Rome, using the widely available statistics packages STAT-GRAPHICS and SAS. RESULTS AND CONCLUSIONS: The analysis of height mean and standard deviation showed an increasing trend of height related to age, without significant differences by sex. The mean heights for females and males were practically the same in each age class. Height variance increases with age, too. This fact necessitates the use of the weighted regression technique to evaluate the functions that express the height growth trend. The relationship between height and age is linearlike and almost coincides for the two sexes. The height percentiles were calculated and the relative curves were developed, based on the distribution of normalized residuals. The centile curves confirm that there are no significant differences in the growth trends for both sexes and therefore the lines are overlapping. Substantial differences exist only in the end centiles (3th and 97th) and age extremes (6 and 11 years), possibly because of the small number of subjects.

[Clinico-epidemiologic considerations on 533 jaundiced newborn infants treated with phototherapy]. / Considerazioni clinico-epidemiologiche su 533 neonati itterici sottoposti a fototerapia.

The authors have conducted a clinical and epidemiological study on 533 newborn infants with marked jaundice treated with phototherapy. They have considered the incidence of jaundice in relation to sex, etiology, gestational age and weight at birth. The authors have also evaluated the minimum, maximum and mean duration of phototherapy of different groups of newborn infants with hyperbilirubinemia. Finally an estimation of initial, peak and final serum bilirubin concentration has been conducted together with an estimation of hourly increases and decreases of this concentration during phototherapy.

[Right of the adolescent to health protection according to Italian legislation]. / Il diritto alla tutela della salute dell'adolescente nell'ordinamento giuridico Italiano.

PIP: A comprehensive study on the rights of the adolescent to the protection of his health according to existing Italian legislation is carried out. After a full examination of international law, the author carefully evaluates all specific articles of the Italian Constitution and all the civil and penal code articles regarding rights and duties of minors. The juridical figure of the adolescent in labor legislation is also examined together with regulations for the healthcare of drug-addicted adolescents and regulations allowing abortion or use of contraception in minor adolescents. After the general overview of the existing legislation, the author discusses the possibility of a proper management in Italy of the Centers for Clinical Adolescentology, as has already been done in other countries. This, however, implies a pressing demand for appropriate modifications of existing legislation to fill all the existing gaps and remove the more obvious contradictions. (author's modified)^ieng