[Food allergy in asthma. Diagnostic significance of peripheral eosinophils]. / Allergia alimentare nell'asma. Significato diagnostico degli eosinofili periferici.

Thirty one patients with suspicion of asthma due to food allergy (lack of correlation between allergic sensitivity and asthmatic attacks, association of clinical features suggestive of food allergy, no response to the pharmacological treatment) received an elimination diet. A second group (control group) of 51 asthmatic patients were enrolled in the study for a better evaluation of the diagnostic significance of blood eosinophil counts in food-induced asthma. 29-31 patients who took a variable oligoallergenic diet had a baseline blood eosinophilia greater than 600/mm3 (range 600-2100/mm3). Eosinophil count after an appropriate diet showed an early significant fall which preceded the improvement of symptoms. Only 10 patients had not a valuable improvement from the diet. The post diet change of spirometric values was significant. There was no significant difference between subjects with an eosinophil count greater than 1000/mm3 vs. less than 1000/mm3 with regard to both inhalant and food skin prick tests. On the other hand, the group with blood eosinophilia greater than 1000/mm3 had a significant correlation with the presence of persistent asthma (persistent alteration of forced expiratory volumes verified in asymptomatic phases of the disease) as with the anamnestic or actual report of eczema or other clinical manifestations of food allergy. Blood eosinophil count showed to be essential in the management of patients with a suspicion of asthma due to food allergy.

Genetic factors in nonspecific bronchial hyperreactivity. An epidemiologic study.

We tested bronchial reactivity to carbachol in 50 asthmatics, healthy parents of 40 asthmatic children, and 70 healthy subjects with no personal or family history of asthma. Stepped doses of carbachol (0.1%) aerosol were given until a 50% drop in forced expiratory flow rate from 25% to 75% was observed, or until the subject had inhaled 80 of his or her own vital-capacity equivalent volumes of the aerosol. The area under the dose-response curve was computed. Histograms of the carbachol reactivity showed a bimodal distribution: 10% of normal subjects and 50% of nonasthmatic parents had values in the asthmatic range. In 85% of parent couples at least one of the two parents had bronchial reactivity without being asthmatic. Our findings suggest that bronchial reactivity to a cholinergic bronchoconstrictor indicates an autosomal-dominant pattern of inheritance.

[Multicenter study on bronchopneumonia treated in a hospital environment in Friuli-Venezia Giulia: 1) Epidemiology]. / Indagine policentrica sulle broncopolmoniti trattate in ambiente ospedaliero in Friuli-Venezia Giulia: 1) Epidemiologia.

Results are presented of a vast analysis into Bronchopneumonia (B.P.) conducted in North East Italy as activity of the Regional Section of the Italian Paediatric Society. The survey of the 14 Paediatric Centres in the Friuli Venezia Giulia Region, produced a total of 536 cases of B.P. in the period January-December 1982. Some significant connections between the several epidemiologic parameters investigated, with special interest in length of hospitalization, are commented. Bed occupancy, short vs. long stays, efficient management are discussed having also in consideration specific possible necessities of some local communities.

[Multicenter study on bronchopneumonia treated in a hospital environment in Friuli-Venezia Giulia: 2) Antibiotic therapy]. / Indagine policentrica sulle broncopolmoniti trattate in ambiente ospedaliero in Friuli-Venezia Giulia: 2) Antibioticoterapia.

An analysis of a year's admissions for Pneumonia in all the Paediatric Department of the Region Friuli Venezia Giulia is presented. The study was conducted as activity of the Regional Section of the Italian Paediatric Society. The survey of the 14 Paediatric Centres produced a total of 536 cases of Pneumonia in the period January-December 1982 and was focused on antimicrobial therapy adopted pre and after hospitalization. General and specific therapeutic choices are discussed. Drawing the attention on the differences among centres.

A two-year survey of mucocutaneous lymph node syndrome in northeastern Italy. Epidemiological and clinical findings.

A two-year retrospective survey of cases of mucocutaneous lymph node syndrome (MLNS, Kawasaki disease) was conducted by a collaborative research group in Northeastern Italy (Friuli Venezia-Giulia) by reviewing the records of all patients admitted in the paediatric wards of this area from January 1, 1981 to December 31, 1982. 19 cases of MLNS were identified representing an overall incidence in the two-year period of 14.7 cases per 100,000 children younger than 5 years of age. Seasonal clustering of cases was observed, 17 out of 19 cases occurring either in spring or autumn (P = 0.0004, binomial distribution) and 11 out of 19 cases occurring in spring alone (P = 0.0023). No evidence for direct contact between cases or common source exposure emerged, and no risk factors were identified. The clinical spectrum of the disease was similar to that described elsewhere, carditis, uveitis, arthritis and urethritis being the most frequent complications. One infant died, and in this case coronary artery aneurysms were demonstrated by two-dimensional echocardiography. In the remaining cases recovery was complete without sequelae. This study suggests that MLNS is more frequent than expected and that the real incidence of the disease is probably underestimated. The evidence of seasonal clustering of cases strongly suggests the presence of a yet unidentified exogenous factor playing a role in the etiology of the disease.

[Chronic asthma in children: comparison between a delayed-action theophylline preparation and a prompt-release aminophylline preparation]. / Asma cronica del bambino: confronto fra un preparato di teofillina ritardo ed un preparato di aminofillina a cessione pronta.

Data from 34 patients were included in the analysis of this open group comparative study comparing a controlled release theophylline given twice daily with immediate release aminophylline given four times daily. The treatment period was of eight weeks duration. There was no significant difference between treatments in clinical assessments of asthma severity or pulmonary function tests. Similarly there were no significant differences between treatments in diary card assessments of asthma symptoms or PERF. Serum theophylline levels were measured prior to the morning dose of test treatment and 2 or 5 hours later, respectively for patients taking immediate release (IR) or controlled release (CR) preparations, at each clinic visit. There was no significant difference between treatments in serum theophylline levels fluctuations, although the dosing interval (12 hours) was twice as long for CR formulation. Six patients reported unusual symptoms, two in the CR group (headache, gastric discomfort) four in the aminophylline group (three headache, one headache and vomiting).

[Treatment of essential headache in developmental age with L-5-HTP (cross over double-blind study versus placebo)]. / Trattamento della cefalea essenziale in età evolutiva con L-5-HTP (Studio in doppio-cieco "cross over" verso placebo).

Thirty patients (mean age: 10.38 years) affected by primary headache were selected for a double-blind cross-over clinical trial. The patients were randomized into 2 homogeneous groups of 15 and treated for 12 weeks with L-5-HTP (100 mg/day) and placebo as per the following design: placebo - L-5-HTP (group A) and L-5-HTP - placebo (group B). Evaluation was carried out every 3 weeks by the Migraine Index supplying a general assessment of the attacks, i.e. severity, duration and frequency. The decrease in mean score values was directly proportional to L-5-HTP treatment, and statistical significance (Wilcoxon's test) was observed only for L-5-HTP in both groups, from 0.05 to 0.01. Improvement, as evaluated by CGI on percentage distribution of the patients, was homogeneous in both groups.