Based on the assumption that faecal and urinary coproporphyrin excretion is closely dependent on biliary function, coproporphyrin excretion was investigated in severe cholestatic diseases in infants and adults. The following subjects were investigated: biliary atresia (5), neonatal hepatitis (3), normal infants (11), adults with biliary obstruction (5) and normal adults (18). Urinary and faecal coproporphyrin concentrations were determined by solvent partition methods, and the isomers (I and III) were separated by thin-layer chromatography with direct spectrofluorometric scanning. The results showed a significant increase in urinary coproporphyrin in biliary atresia and neonatal hepatitis and in adults with biliary obstruction. All the cholestatic diseases showed the same marked increase in urinary isomer I. In biliary atresia and neonatal hepatitis there was a significant decrease in faecal coproporphyrin and a concomitant increase in isomer III (of bacterial origin) which was related to the extent of the biliary defect. Determination of urinary and faecal coproporphyrin, and particularly of the isomer distribution, may be a sensitive tool for diagnosis.

Adult↗

PubMedDate not supplied

Which treatment for children with hepatitis B surface antigen-positive chronic active hepatitis?

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Child↗

PubMedDate not supplied

[Helicobacter pylori. I. Morphology, biochemistry, antigenic profile and correlated diseases].

Infection by Helicobacter pylori (HP) occurs all over the world and is related to the socio-economic development of the subject's country of residence and age. Various strains of HP can be identified on the basis of the microbiological characteristics of the bacterium and, in particular, or its antigenic profile, while the virulence factors are responsible for the damage that HP can cause. The virulence factors include components (flagellum and adhesin) and substances produced by bacterium (enzymes and cytotoxins), the most important among which are urease and the cytotoxins, CagA and VacA. It is the association of these virulence factors that is responsible for the different pathologies to which HP-positive subjects are prone. The link between HP and gastritis, peptic ulcer and gastric cancers (adenocarcinoma and lymphoma) is now proven. Whether there is a link between HP and RAP in young children is still a matter for debate; some Authors claim that there is, while others refute it.

Adult↗

PubMedDate not supplied

[Nutritional status and dietary habits of children in the Province of Modena].

Under the auspices of the "Food and health" project, research was undertaken (Nutritional Diagnosis) to evaluate the state of nutrition and health of a sample of the population of the Province of Modena. 155 children of an average age of 10 +/- 2 years were studied. These children, resident in the Local Health Areas 15 (Mirandola), 16 (Modena) and 18 (Pavullo), took part in a questionnaire comprising specific items. A general examination was carried out checking BMI, arterial pressure and pubertal development. Biohumoral examinations were also carried out which, as far as the average haematic lipids were concerned, showed no significant difference between the various Health Areas for CHT, LDL, and TGT, while for HDL there were significant difference (p < 0.01) for Area 16 with respect to Areas 15 and 18. Extremely high values of CHT and LDL were noted in the three areas and low values of HDL, particularly in Area 16. Case histories obtained while completing the questionnaire showed that the children's knowledge of the normality or not of bodily development was fair, since their replies to the question "how is your weight?" had a correlation of r = 0.6 with respective BMI. The prevalence of allergic illness in the three areas is 34.8% with significant differences for some zones and no significant difference for sex. With regard to physical activity, the evidence is disturbing: 31% of the children did not engage in any form of physical recreation whatsoever, which, given the average age of the target group (10 years), is serious. The findings for fatty acids and haematic lipids reflects the findings of an unbalanced diet. It is clear from the findings and observations reported that a study such as this should give rise to primary preventive strategies aimed particularly at young children, to prevent incorrect lifestyles as far as feeding and motor activity are concerned. Bad habits, once established, are difficult to eradicate and lead to obesity and hypercholesterolaemia, sure risk factors for ATS.

Child↗

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[Celiac disease and lymphoma].

Celiac disease (CD) has been acknowledge as being responsible for numerous secondary pathologies, in particular autoimmune and neoplastic diseases. Whether CD is more prevalent in patients with non-Hodgkin's lymphoma (NHL) than in the normal population is not known. Accordingly, we carried out a study of 86 patients hospitalized in the Section of Oncology, Haematology and Internal Medicine of the Department of Medical, Oncological and Radiological Sciences of the University of Modena and Reggio Emilia and who, between 1988 and 1995 had been diagnosed as affected by NHL. On diagnosis, and before the beginning of antitumour therapy, all the patients were tested for antigliadin (AGA IgA and IgG) and antiendomysium (EMA) antibodies together with total class IgA antibody levels. Our findings showed that none of the 86 patients had an IgA deficit, while one tested positive for AGA IgA (43.9% v.n. < 7.5). The same patient also tested positive for EMA. The extremely high sensitivity and specificity of the AGA IgA and EMA led us to conclude that the patient was affected by CD, although his early death precluded confirmation by biopsy. The presence of one celiac patient among 86 NHL patients examined at the onset of the disease would suggest that CD is not infrequent in NHL. The numbers involved in our study are insufficient for statistical purposes, and we are therefore awaiting the results of a SIGEP multi-centre study into the connection between CD and lymphomas.

Adolescent↗

PubMedDate not supplied

[Helicobacter pylori. Part II. Epidemiology, diagnosis, and treatment].

In recent years, the diagnosis of Helicobacter Pylori (HP)-mediated infection has become increasingly important not only in adults but also in children. Factors such as residence in a country with low social and economic standards and the presence of HP-positive family members underscore the widely-acknowledged fact that the incidence of HP infection tends to increase with age both in children (where the increase is roughly 1% per year) and in adults, where it reaches values of 50% in the industrialized nations and 80% in developing countries. This has led to research aimed at developing more accurate and less invasive diagnostic techniques that can be used in children as well. Also, the development of simple, cost-effective diagnosis is all the more important given the widespread occurrence of HP infection, particularly in the developing countries. The techniques employed range from the classical histological and culture examination, which involves esophagogastroduodenoscopy (a rather invasive technique), to serology and the Urea Breath Test with 13C. Also, the feasibility of tracing HP antigens in the faeces, a non-invasive and simple technique, is under investigation. As for therapy, there is as yet no unanimous agreement about when to start treatment, about which antibiotics (beta-lactams, macrolides and nitro-imidazoles) to use in association, about their effect on the gastric mucosa, nor, indeed, about the treatment routines to be followed in adults and children.

Child↗

PubMedDate not supplied

[The potential risks from an excess of hygiene in the home].

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Disinfectants↗

PubMedDate not supplied

[Asthma due to Dermatophagoides in children. Peroral desensitization].

At present current knowledges on OIT are controversial. We studied the effectiveness and the possible immunological mechanisms of this therapy. We followed a group of 56 children affected by allergic asthma due to Dermatophagoides during their treatment with OIT. Many clinical parameters were investigated and also immunoallergological and spirometric values in a subgroup. We observed a particularly satisfying clinical and respiratory improvement, while immunoallergological parameters did not suffer significant changes.

Allergens↗

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Antitransglutaminase enzyme-linked immune-adsorbed assay in coeliac disease diagnosis: evaluation of a diagnostic algorithm.

BACKGROUND: Tissue transglutaminase is the major autoantigen recognized in the sera of coeliac patients. An enzyme-linked immune-adsorbed assay based on tissue transglutaminase was recently used to measure serum tissue transglutaminase immunoglobulins A for coeliac disease diagnosis. OBJECTIVES: To determine the sensitivity, the specificity, the positive and negative predictive values of an immunoenzymatic assay based on guinea pig tissue transglutaminase, to compare antititransglutaminase immunoenzymatic assay to the antiendomysium immunofluorescent assay, and to define a cost-effective sequence to execute serum antibody determination in coeliac patients. METHODS: We assessed for coeliac disease antibodies 91 pediatric patients with symptoms suggestive of coeliac disease, and 23 patients with coeliac disease on a gluten-free diet as controls. RESULTS: Antitransglutaminase immunoglobulins A showed 93.1% sensitivity, 93.6% specificity, 87.1% positive and 96.7% negative predictive values. Antitransglutaminase immunoglobulins A were significantly higher in antiendomysium positive subjects. Correlation between antitransglutaminase immunoglobulins A and antigliadin immunoglobulins A was not significant. DISCUSSION: Our results show that antitransglutaminase immunoenzymatic assay represents a cost-effective strategy for patients' serological evaluation and it could substitute EMA determination, which could be considered a second level evaluation.

Adolescent↗

PubMedDate not supplied

[High-dose oral bacteria-therapy for chronic non-specific diarrhea of infancy].

The Authors evaluate the effectiveness of oral bacteriotherapy using a combination of anaerobe fecal Lactobacilli for chronic non specific diarrhea of infancy. A double blind study was carried out in a total of 40 children treated with low and high doses of bacteria. The results confirm the importance of fecal flora in this disease and support the hypothesis that oral bacteriotherapy can improve clinical and laboratory presentation especially when given at high doses.

Administration, Oral↗

PubMedDate not supplied

[Cow's milk protein intolerance: evaluation of immunological markers. A preliminary study].

Cow's milk protein intolerance (CMPI) is recognised as an important cause of protean symptoms in infants. There are no tests with enough specificity and sensibility to set up a diagnostic assay. We carried out preliminary study on children suffering from CMPI with the following aims: a) to ascertain the importance of the variation in circulating antibodies to cow's milk proteins in CMPI, b) to establish a useful screening tool to diagnose CMPI. Seventy-four subjects (s.) were studied and divided into four diagnostic groups as follows: Six s. (3 M, 3 F) suffering from CMPI mean age 4.8 +/- 3.9 months, assuming a diet containing cow's milk: I group. Eleven s. (O M, 7 F) suffering from CMPI mean age 7.8 +/- 4.6 months, assuming a cow's milk free diet, for several months (mean 4.5 +/- 1.5): II group. Nine s. (5 M, 4 F) suffering from enteropathies not cow's milk correlated, mean age 18.5 +/- 10.6 months, assuming a diet containing cow's milk: III group. Fourty-eight healthy s. (24 M, 24 F), mean age 10.5 +/- 4.3 months, assuming a diet containing cow's milk.(ABSTRACT TRUNCATED AT 250 WORDS)

Caseins↗

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[A new and original therapy for seborrheic dermatitis].

The AA describe the results of an original therapy for seborrhoic dermatitis in both localized and spread forms (Leiner's Disease). Due to similarity of seborrhoic dermatitis in the two forms with acrodermatitis enterophatica and considering that this last disease reacts positively after Zinc administration, the AA stated the validity of such therapy also for seborrhoic dermatitis and discuss its possible mechanism of action.

Administration, Oral↗

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[Growth, skeletal and dental age in chronic diarrhea in childhood].

Chronic diarrhea is a common disease in children; several etiological agents and pathogenetic mechanisms are responsible for causing the illness. In order to evaluate the long term effects of chronic diarrhea on growth, dental and bone age the authors have examined 111 children in a 7 years follow-up for coeliac disease (49 cases) and a 5 years follow-up for chronic diarrhea caused by different agents (62 cases). All the coeliac diseases show a good clinical and auxological evolution, whereas aspecific chronic diarrhea shows important changes in growth, in dental and bone age. Clinical progress of the disease is therefore strictly related to the accuracy of the diagnosis, while the duration of the illness is of little importance. Our study does not show any correlation between changes in auxological tests or in dental and bone age and the length of symptoms (r = -0.150 N.S.). The authors stress the importance of the evaluation of dental age together with bone age and auxological parameters in monitoring children with chronic diarrhea; in all observed cases dental and bone age retardation showed a positive correlation both with chronic diarrhea (r = 0.608; p less than 0.03) and coeliac disease (r = 0.411; p less than 0.02).

Age Determination by Skeleton↗

PubMedDate not supplied

[Validity of antigliadin antibodies in the diagnosis of celiac disease].

Antibodies to gliadin, detected by immunofluorescence (IFL-AGA) and ELISA (ELISA-AGA), have been found in 68 of 71 (96%) sera from children with active celiac disease. AGA of IgA class were confined to celiac disease on normal diet and after gluten challenge, as all the antibodies, found in children on gluten free diet (40%) and in control gastroenterological diseases (20%), were of IgG class. Sera from 175 first-degree relatives of our celiacs were also screened for AGA. IFL-AGA were positive in 13 (7%) and ELISA-AGA in 27 cases (15%). Antibodies were of IgA class in 13 relatives (7%). A celiac's asymptomatic sister, selected for jejunal biopsy only on the basis of IgA AGA positivity, showed subtotal villous atrophy. Although AGA cannot replace jejunal biopsy in the diagnosis of celiac disease, they can be regarded as useful tools in the screening of gluten sensitive enteropathy. Moreover, as a positive IgA AGA test is closely related to the active phases of celiac disease, their research can be useful both to evaluate the effect of gluten free diet and to establish when a new biopsy is appropriate after gluten challenge.

Adolescent↗