Biomedical subjects
Publications and source records attributed to F Valli.
A 5 months old infant having "granuloma gluteale infantum" (G.G.I.) is reported. One or more tumorous red-purple nodules on gluteal or on genitocrural area are the usual cutaneus injuries of G.G.I. The histologic aspect resembles pyogenic granulomas. The exact pathogenesis of G.G.I. is still to be defined; nevertheless the use of plastic diaper covers and topical fluorinated steroid preparations seems to have great influence.
Among hemorrhagic disorders affecting infants and depending on a vessel increased permeability, Seidlmayer "cockade purpura" is characteristic for its typical cutaneous manifestations. Owing to the rarity of this disease, we report a recently observed case.
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In the second part of the Authors work, they report the results obtained in the treatment of 85 female children with recurrent non malformative urinary tract infections. The first group of 15 female children had been treated with phenoxybenzamine and urinary chemyotherapycs with little satisfaction. The other two groups, both of which consisted of 35 children, one group was treated with only chemyotherapycs and the other with chemyotherapycs associated to oxybutynin chloride. The best results were obtained in the last group regarding the improvement of the symptoms and earlier and higher incidence of sterilization of the urine. At the same time in this group the maximum cystometric capacity and vesical compliance were brought back to normal and the detrusorial instability disappeared.
In the second part of the present work the data which was obtained through questionnaires and interviews with 130 families with children affected by spina bifida is presented. Presented first are the immediate sociopsychological aspects of the family when they are informed about the malformation, the derived psychological effects and the preoccupations relating to the life of their child. Then the aspects of the successive social and psychological problems of these parents are presented, and finally the expectations and demands of the same parents following the psychological operations carried out at the centre to the benefit of the children and their families.
Acute hydrops of the gallbladder is described in a patient who had mucocutaneous lymph node syndrome. Diagnosis was readily made with gray-scale ultrasound. Serial sonograms were obtained to follow the resolution of the hydrops once supportive medical therapy was started. The role of surgery in acute hydrops of the gallbladder is for complications of the hydrops and not for distension alone.
The authors report a typical case of hyperthyroidism with alopecia in a 5 years old female child with family precedents. We punctualize the present etiopathogenetic theory and the therapeutical possibilities.
A male infant with profound anemia and liver and spleen enlargement was affected by visceral Leishmaniasis. Diagnostic tests and therapeutical approach to this parasitic infection, very rare in our Region, are discussed.
Following a brief description of the clinical and radiological features of cleidocranial dysplasia (see Table), two patients are presented who respectively exemplify the classic and the incomplete form of this syndrome. The morphologic appearance of the bone segments involved may suggest a diagnosis of cleidocranial dysplasia even through occasional radiologic examinations, specially in the pediatric age. The patients suffering from this condition, which in itself is not incapacitating, should be serially observed so that appropriate therapeutic measures can be adopted, mainly in the presence of hip dysplasia or when the thoracic cage or the spine are severely involved.
Infants of diabetic mothers have an increased morbidity and mortality in the perinatal period. Nevertheless, there are differences in opinions about the exact incidence of malformations, metabolic disturbances, fetal macrosomia and respiratory distress syndrome. This study was designed to investigate the incidence of embriofetopathy in those of mothers with gestational diabetes. The incidence was highest in the group of mothers on insulin at the time of conception. Major fetal malformations of the cardiovascular and central nervous system were over-represented.
Authors describe a case of Hypohidrotic Ectodermal Dysplasia in a female carrier. This report give rise to a review of the clinical spectrum of the syndrome. An appraisal of diagnostic methods, associate abnormalities and mode of inheritance is detailed.
A case of acute idiopathic oedema of the scrotum in a 6-year old child is described. The patients presenting with this condition are often misdiagnosed as suffering from torsion of spermatic cord and then submitted to surgery. The clinical features and the presumed pathogenesis of this unusual disease are discussed.
In a period of over 18 years the prominent medical bibliographic marks with regard to definition, diagnosis and examinations of coeliac disease (CD) have been compared and as far as possible reproduced. The results confirm the remarks derivating from wider statistics. From the beginning of 1975 to the first six months of 1993 in Merate Hospital Pediatric Division, 323 patients were submitted to a first jejunal peroral biopsy in 133 cases (41.2%) CD was diagnosed. Since 34 children (25.6%) concluded the ESPGAN diagnostic iter with 3 consecutive biopsies, the reasons why the other patients didn't finish or respect the programs are here examined. Since 1987 a specific anti-gliadin (IgA and IgG) antibodies titrimetry has been available either in the investigation of suspect symptomatology or like control mark during the assessment or after a sure CD diagnosis. Since october 1992 antiendomysium antibodies (EMA or AEA IgA) have been determined only in selected patients. From the examination of 24 subjects now checked with AGA IgA/IgG and EMA and with a first positive biopsy, it is possible to point out that only one jejunal biopsy (or at the most a second one as a control during the gluten challenge) with the guarantee of haematologic patterns doesn't raise doubts about a CD diagnosis. Analogous considerations mainly refer to the atypical CD "late onset" when a constant lack of AGA and EMA during gluten free diet (GFD) or their changes in a non compliance or in gluten challenge, can exclude a following hystological confirmation. By this experience it follows that a specific antigliadin and antiendomysium antibodies investigation is indispensable to the shortening of diagnostic times, to the reduction of an often unwelcome invasive diagnostic method and to the discovery of the "CD iceberg".