[Gastroesophageal reflux and respiratory pathology].

The prevalence of gastroesophageal reflux (GER) in 86 children with respiratory disease (recurrent pneumonia, chronic cough, bronchial asthma) has been evaluated by mean of prolonged (22-24 hours) esophageal pH-monitoring. The following parameters were evaluated: the total percentage of time pH < 4 and the percent time the esophageal pH was < 4 while sleeping. None of the children had gastrointestinal symptoms suggesting GER and no neurological disorder was noted in any of the studied patients.

[Reduced natural killer function in children with recurrent respiratory tract infections].

Respiratory infections are the major cause of disease in childhood in the industrialized areas of the world. This essentially depends on two factors: immunological immaturity and immunological naivety. In most cases a virus has been considered the causative agent in respiratory infection.

[Clinical and cellular studies in a patient with Cockayne syndrome].

Hypersensitivity to the lethal effect of ultraviolet light (UV) and other DNA-damaging agents has been observed in cells from patients affected by Cockayne syndrome, suggesting that this syndrome is deficient in the capability to repair damage in cellular DNA. We report a case showing the main clinical features of Cockayne syndrome in which the clinical and cellular photosensitivity described as typical for Cockayne syndrome is not present. These cytological results suggest that there is considerable clinical and cellular heterogeneity in Cockayne syndrome and that cellular sensitivity to UV might not be as essential for the diagnosis of Cockayne syndrome as previously thought.

[The adolescent celiac].

A group of 81 teenage coeliac patients were recently followed to monitor their compliance with a gluten free diet and also to correlate this with: their general wellbeing, height and weight, antigliadin and antiendomisyal antibody levels and jejunal mucosa patterns. Fifty two patients (64.1%) were on a strict gluten free diet; 18 (22.

[Specific IgA against multiple antigens as expression of immunologic deregulation in HIV-positive children].

B-cell dysfunction in HIV-infected children is reflected by hypergammaglobulinemia and high levels of serum IgA. Little is known about antibody specificity since only a small portion of serum IgA appears to be directed against HIV proteins. In the present study the specificity of IgA antibodies against food, inhalant, bacterial and fungi antigens were evaluated in a population of HIV infected children.

[Changed levels of substance P and somatostatin in HIV-positive children].

Substance P (sP) and Somatostatin (SOM), so as other neuropeptides can modulate neurologic and immunologic functions. sP has been described to enhance both in vitro and in vivo immunoglobulin synthesis. On the contrary, SOM has an inhibitory effect on the same activity.

[Celiac disease and autoimmune thyroiditis. Description of a case].

It has been known that there is a more than fortuitous association between coeliac disease and a whole range of autoimmune conditions. At present there are only very small numbers of cases reported with childhood coeliac disease and thyroiditis. The Authors refer to a seven year old girl with documented coeliac disease who developed an autoimmune thyroiditis with glandular hypofunction, an unusual feature still rarely described.

Monosomy 20 in childhood acute lymphoblastic leukemia.

We report two cases of acute lymphoblastic leukemia (ALL) with loss of chromosome 20 as the only karyotypic abnormality detected in the blast cells. The first patient is a 12-year-old boy studied at diagnosis. He represents the only case of monosomy 20 in our series of 90 pediatric ALL successfully karyotyped at diagnosis.

[The leukemia-lymphoma syndrome with gastrointestinal involvement in childhood. A case report].

The gastrointestinal tract is an uncommon site of presentation for acute lymphoblastic leukemia in children. We report a child who developed a leukemia-lymphoma syndrome with central nervous system and gastrointestinal tract involvement at the diagnosis. The patient received an intensive combination chemotherapy and is currently off-therapy in continuous complete remission 29 months after the diagnosis.

[Chronic diarrhea due to Cryptosporidium in an immunocompetent subject].

The protozoan Cryptosporidium has been described in many cases of acute self-limiting diarrhoea in immunocompetent patients and of more protracted or life threatening diarrhoea in immunocompromised patients. We found the parasite in the stools of a child with chronic diarrhoea and without deficiency of immunity. The test for common causes of chronic diarrhoea were normal.

[The diagnosis of gastroesophageal reflux in childhood: a comparison between echography and pH measurement].

Gastroesophageal reflux (GER) is a very common event in childhood. Therefore we must use an exact and nontraumatizing test to differentiate between physiologic and pathologic conditions. Sonography appears to be a methodology endowed with these particularities.

[Host-microorganism interactions in urinary infections in children].

The authors examine the factors which induce urinary tract infections (U.T.I.

[Hypothyroidism, transitory or congenital. Reflections on a clinical case].

We report one case of congenital hypothyroidism with thyroid agenesis wrongly considered as a transient form of hypothyroidism. The patient came to our attention at 9 months of age, showing an important delay in neuromotor development. Transient hypothyroidism is a situation of brief hormonal deficit with spontaneous resolution in the first weeks of life.

[The usefulness of measuring fructosamine in the cord blood of the newborn infants of diabetic mothers].

The aim of our study was to evaluate the usefulness of fructosamine measurement (Fram) in cord blood as an index of glucose metabolism in the last week of pregnancy in infants of diabetic mothers. In newborns and their respective mothers Fram values were surprisingly greater in N than in IDM and IGDM and neonatal and maternal values appeared to be strictly related. While intrauterine growth was associated with metabolic control indexes of 2nd and 3rd trimester gestation.

[Neonatal common bile duct calculi. Description of a case].

Cholelithiasis as a cause of jaundice in the neonatal period is rare. We are going to describe a case of cholestasis with cholangitis due to calculus of choledochus. None of the causes favouring cholelithiasis described in medical studies proved to be present.

Bone marrow transplantation in childhood: a report from the AIEOP-BMT group registry.

A multicenter cooperative group has been activated in Italy in 1986, with the aim of focusing on the following issues: to standardize perspectively the approach to bone marrow transplantation (BMT) in pediatric centers granting the recommendations of the Associazione Italiana di Ematologia e Oncologia Pediatrica (AIEOP); to study effects and toxicity of preparative regimens to BMT; to evaluate the special features of BMT in children, such as clinical management, care and late effects, as peculiar issues of a pediatric setting. Indeed, one of the major aims of the group is to attempt to address in the most appropriate ways, such as in children only and at a nation-wide level, the most crucial questions about the real role of BMT, taking advantage from the fact that most of the children with cancer undergoing BMT in Italy have been treated homogeneously before transplant, i.e.

Growth acceleration and final height after treatment for delayed diagnosis of celiac disease.

The only presenting clinical feature of diagnosing celiac disease (CD) late may be short stature. At the start of treatment with a gluten-free diet (GFD), celiac children show an accelerated growth rate. The real duration of catch-up growth and influence of diet on the final stature has not yet been defined.

[Late data in pediatric oncology].

This work reviews the most frequent late effects seen in long-term survivors and how they relate to individual therapeutic modalities: a) Growth: severe growth retardation is seen in patients treated by radiation therapy, related to dose, anatomical site and age of patient, along with bony abnormalities (scoliosis, atrophy or hypoplasia, osteoporosis). b) Fertility: chemotherapy, in particular alkylating agents and the methylhydrazine procarbazine, can interfere with gonadal function, especially when administered with abdomen and pelvic irradiation. This effect is often seen in Hodgkin disease.

[Preventive effect of thymomodulin in recurrent respiratory infections in children].

Recurrent respiratory infections (RRI) are a common occurrence in early childhood. Several investigations report the primary role of environmental factors (as early social mixing and passive smoking) in inducing RRI. In RRI children immunological defects, transient and not typical, have been often observed, but it is reasonable to suppose that they are essentially secondary to infections.

Bone mass in young patients with type I diabetes.

We measured bone mineral content (BMC) with single photon absorptiometry in two groups of young patients with type I diabetes: the first group (prospective study) consists of 48 patients followed from onset to the third year of diabetes and the second group (cross-sectional study) consists of 66 long-term diabetics. Bone mineral content at onset of disease was lower than normal in only two cases. After 3 years of diabetes no male revealed BMC below the normal range but two females (6.

The silver-stained proteins of interphasic nucleolar organizer regions as a parameter of cell duplication rate.

The relationship between interphasic silver-stained proteins of the nucleolar organizer regions (Ag-NOR proteins) and cell replication rate has been studied in 13 established neuroblastoma cell lines. The quantity of Ag-NOR proteins was measured in silver-stained cells by means of an automated image analyzer. The results indicated that the amount of Ag-NOR proteins is strictly proportional to the proliferative activity of the cells.