Diet and atopic eczema in children.
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Biomedical subjects
Publications and source records attributed to F Longo.
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The antianginal effects of 360 mg/day of diltiazem were evaluated, using intrapatient comparisons, in a double/blind, randomized, placebo/controlled trial in 24 young patients (50 +/- 7 years) and in 16 elderly patients (67 +/- 3 years) with stable effort angina. All patients had angiographic documentation of significant coronary artery disease. An open-labelled, randomized, crossover design was employed. For 1 week prior to beginning the study, the patient was on no medication except sublingual nitrates. The study consisted of an initial 2-week single-blind placebo run-in period followed by a 4-week randomized double-blind crossover between diltiazem, 120 mg t.i.d., and placebo. A diary of chest pain and nitroglycerin usage was kept during this period and run-in. Exercise tests were carried out during the run-in period (2 tests) and at the end of the 4-week treatment. After diltiazem 12 of the 24 young patients stopped the exercise test because of angina. A similar number (9/16) of elderly patients stopped the exercise test because of angina. During diltiazem treatment, weekly angina frequency was significantly reduced in the young patients (1.25 +/- 0.67 vs 3.87 +/- 1.19-run-in, 4.08 +/- 1.24-placebo; p less than 0.01) and in the elderly patients (0.87 +/- 0.71 vs 4.06 +/- 1.48-run-in, 4.12 +/- 1.5-placebo; p less than 0.01). Weekly TNT consumption significantly decreased in both groups of patients.(ABSTRACT TRUNCATED AT 250 WORDS)
The Holter examinations of 111 subjects aged more than 65 who then underwent dynamic ecg were investigated in order to assess the clinical significance of cardiac arrhythmias in geriatric age. Group A was formed of 53 patients with no clinical signs of cardiovascular diseases. Thirty-two patients with clinical evidence of ischaemic cardiopathy made up Group B and 26 with arterial hypertension formed Group C. The Holter examinations were evaluated in accordance with current guidelines, considering the basic rhythm, heart rate, pulse formation and conduction disturbances and supraventricular and ventricular hyperkinetic arrhythmias. Sinus base rhythm was present in most cases whereas atrial fibrillation was noted in a similar percentage in the three groups, whether or not cardiovascular disease was present. Supraventricular and ventricular hyperkinetic arrhythmias were extremely common in the elderly and made no discrimination between patients with ischaemic cardiopathy or hypertension and the clinically healthy; for example, ventricular tachycardia was observed in 10.6% of Group A subjects, in 7.1% of Group B and 8.6% of Group C. To conclude, the clinical significance of heart rhythm changes in the elderly remains obscure because in most subjects they are not related to the presence of cardiovascular disease.
The contribution of secondary infection to severity and tendency to relapse in atopic dermatitis during childhood has been assessed. A total of 57 children aged between 4 months and 14 years were followed for an average of 4.73 months. A secondary infection was diagnosed in 22 (31.4%) of 70 relapses, since the lesions only subsided with antibiotics active on the bacteria isolated from the skin, usually a coagulase-positive Staphylococcus aureus. The eczema was more severe at presentation and hypogammaglobulinemia G more often found in those children who were more susceptible to secondary infections. The hypogammaglobulinemia G was present in 13 out of the 57 patients, but it normalized with age and was not correlated with IgE levels. In the children in whom the relapse or the worsening of the eczema could be attributed to secondary infection because of the positive response to the antibiotic treatment, the lesions had the appearance of pustules or showed more exudation, although in some cases only the worsening of the erythema and itching was observed. A secondary bacterial infection should be considered a likely cause of relapse or worsening of atopic dermatitis. Furthermore it may be that, at least in first year of life, hypogammaglobulinemia G is part of an immunologic impairment of atopic dermatitis which favors the susceptibility to secondary infections.
Salivary IgA were examined in a group of children with recurring respiratory infections (RRI) in order to complete research into the immunological profile of such children. IgA assays were performed in 21 children suffering from RRI both in the remission period (Summer) and during infections (Winter). No children revealed any real disorder in basic salivary IgA. Salivary IgA levels were however about ten times higher in the Winter (the infection period). In a control group of 15 healthy children in the same age range, IgA levels were also high in the winter but still lower than those found in the RRI group. It is therefore concluded that children with RRI do not, as has often been suggested, present any basic disorder in salivary IgA, but that the response of secretory IgA is far more sensitive to infection than the system as a whole.
A novel cytoskeletal element consisting of dense webs of thin (3-14 nm) filaments surrounding the nucleus of the sperm head has recently been isolated and shown to be associated with certain major basic proteins. Using antibodies specific for calicin, a prominent Mr-60,000 cytoskeletal protein of the posterior calyx of bull sperm heads detected in immunoblotting on gel electrophoretically separated polypeptides as well as in immunofluorescence and immunoelectron microscopy, we show that the same--or an immunologically related--polypeptide occurs in sperm heads of other species with greatly different morphology, including human, boar, guinea pig, hamster, rat and mouse. The calicin localization in the various species is described and discussed in relation to the specific sperm morphology.
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A group of 11 female patients (mean age 33.7 +/- 8 years) with a clearly proven primary Raynaud's syndrome of up to five years' duration were subjected to a two-month oral treatment with 3 X 400 mg pentoxifylline per day. The following parameters were studied without and with exposure to cold conditions: hemodynamics (finger photoplethysmography), red cell deformability (filtration test), various clotting variables (prothrombin activity, antithrombin III, plasma fibrinogen, partial thromboplastin time, thrombin time, thrombelastogram), and clinical symptomatology. After treatment 7 of the 11 patients showed a distinct improvement of peripheral blood flow and of symptoms (decrease or removal of asphyxia attacks, pain, color change) under basal conditions, as well as after exposure to cold. Red cell filtration was significantly (p less than 0.05) improved, increasing by 35% under normal conditions and by 30% after exposure to cold. Positive changes were also found in respect to antithrombin III (increase) and plasma fibrinogen (decrease). The thrombelastogram was unchanged. Clinical and instrumental improvements were probably ascribable to better microcirculatory flow due to increased red cell deformability, reduced viscosity, and decreased fibrinogen, all capable of influencing in various degrees the blood flow at the microcirculatory level.
We observed three children, aged 1 year 8 months to 9 years 7 months, in whom herpes simplex blepharoconjunctivitis resolved promptly without treatment. A fourth child, 8 years old, developed probable toxic manifestations from topical vidarabine. These manifestations, as well as the blepharoconjunctivitis, resolved when the medication was discontinued. Herpes simplex ocular infection without corneal involvement in children is usually benign and self-limited.
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Certain non-invasive techniques like Doppler CW and strain gauge plethysmography are highly effective ways of evaluating the natural history of postphlebitic syndrome. 40 patients of both sexes, average age 51.5 +/- 6.9 with a history of deep venous thrombosis (28 documented phlebographically) were subjected to Doppler tests with assessment of venous blood pressure and bilateral strain gauge plethysmography. 34 of the 40 suspected PPS cases were confirmed, though not all cases were at the same stage. Persistent deep venous thrombosis was found in five of the extremities and the last one examined revealed a primary varicose syndrome. A comparison of the Doppler and phlebography results showed both to be highly sensitive techniques (100% accuracy). When the contralateral limbs were examined, the Doppler technique revealed 7 cases of PPS and 21 primary varices. In contrast strain gauge plethysmography identified all 28 cases of increased venous capacitance as primary varices, thus confirming the inability of this technique to distinguish between the various varicose conditions. Assuming the presence of a vascular diagnosis laboratory where both techniques are available, strain gauge plethysmography is recommended as the examination of choice. This technique is simple and fast to perform and can provide extensive information whether at rest (filling and emptying volumes and times; venous tone and distensibility, venous blood pressure at rest) or in movement (venous pressure when standing, muscular pumping index). Hence plethysmography can reveal any canalisation present even in the earliest stages though it cannot pinpoint the precise site of the deep obstruction. The longer, more complex Doppler CW procedure should be reserved for secondary investigations. This technique is preferable to plethysmography when a more accurate assessment of the degree, site and extension of the venous recanalisation is needed. Doppler CW also provides information on any valvar sequelae since it records the direction of the blood flow in the presence of a substitution syndrome (increased venous flow in the surface vessels). Finally if used in a rational manner the two techniques can be combined to eliminate contrast medium techniques, which would only be adopted as a preoperative measure.
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1200 mg/day per os of Pentoxyphyllin administered for 60 day brought about an improvement in symptomatology and photoplethysmographic readouts under base conditions and following the cooling test in 7 out of 11 females suffering from Raynaud's disease. These results may be explained by an improved microcirculation flow resulting from increased erythrocyte filterability and a decrease in fibrinogenemia .
Deep-seated venous thrombosis (DVT) is more common in subjects over 40 and is most frequently found in subjects between 60 and 70 years of age. It is thought that the complaint is brought about by paraphysiological factors connected with aging or conditions frequently encountered in the elderly which are interconnected to varying extents. The flow parameters of 30 female subjects with diagnosed DVT, of which 18 were over 60, and 24 female subjects with a phlebographic diagnosis of Post-phlebocytic syndrome (PPS), of which 14 were over 60, were evaluated using the plethysmographic strain gauge technique. Women over 60 with DVT have longer maximum emptying times and higher venous pressures. For this group, maximum emptying time is slightly lower (although not by a statistically significant amount) than for the younger group. Subjects of advanced age with DVT display significantly higher levels of venous obstruction and patients with PPS display higher levels of venous ectasia. These effects are probably caused by venous circulation miopragia due to aging.
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