Biomedical subjects
G Arcese
Publications and source records attributed to G Arcese.
Role of allogeneic bone marrow transplantation for the treatment of myelodysplastic syndromes in childhood. The European Working Group on Childhood Myelodysplastic Syndrome (EWOG-MDS) and the Austria-Germany-Italy (AGI) Bone Marrow Transplantation Registry.
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Evaluation of hypoallergenic milk.
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Immunogenicity of a so-called hypoallergenic formula in at-risk babies: two case reports.
The clinical and immunologic findings of two breast-fed babies who experienced anaphylaxis after a feeding with a partially whey hydrolysate formula (PWHF) are reported. Sensitization to this formula seems to have occurred in the first days of life in the Maternity Hospital where the babies were fed the same formula. These two case reports suggest that PWHF may be immunogenic in the IgE system. This data is in agreement with previous studies which showed intact fragments of cow's milk (CM) proteins in PWHF.
Evaluation of hypoallergenic milk.
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Food allergy, atopic dermatitis and superficialism in medicine.
Although the essential immunology underlying atopic diseases is now being clarified, there are still few accountable diagnostic tests. Therefore the recognition and treatment of these diseases continues to be based mainly on clinical skill and, in particular, on the taking of a careful history. This means that the observer bias can be a significant factor, and so whether or not the diagnosis is made may dependent on a clinician's preconceptions. Furthermore, the general interest in the subjects has tended to divided the medical consensus between believers and nonbelievers. In infancy, food allergy has protean manifestations and is provoked by many different food allergens. In addition to the lack of really useful diagnostic tests, there is the difficulty of easily and reliably conducting double-blind challenges in general pediatric practice. Thus it is crucial that a scientific, and critical, approach is adopted and that doctors attentively record the case history and observe the response to elimination diets and challenges. True science has nothing to do with superficialism.
[Prevention of atopic diseases: recent findings and personal data].
Prevention of IgE-mediated diseases relies on the skill necessary to overcome the natural forces unceasingly working to sensitize humans to produce IgE antibodies. The phenotypic expression of allergic disease ensues from an elaborate inter-relationship between the atopy-prone genetic constitution of a child and the experienced environment surrounding it. Prevention of atopy could potentially by met by selectively interfering with the genetic and environmental factors that appear to be responsible in concert for the final phenotypic expression of atopy. As no ideal cow's milk substitute exists, and all the suggested formulas could cause allergy, the currently available foods for children are soy milk, hydrolyzed protein, and home-made meat-based formulas. From a nutritional point of view, soy milk formulas are adequate, however in IgE mediated forms and atopic dermatitis reactions to hydrolyzed protein are more common. Although no long-term studies on the nutritional value of hydrolyzed protein are available, some formulae have shown a satisfactory growth rate in short term clinical trials. Meat-based formulas, such as the home-made lamb formula are well accepted and economical.
Cord blood mononuclear leukocytes of neonates at risk of atopy have a deficiency of arachidonic acid.
Essential fatty acids and their delta-6-desaturated derivatives are major components of cellular membrane phospholipids, contributing to their stability and functions. They are also precursors of inflammation mediators such as prostaglandins and leukotrienes, and are involved in cellular immunoregulation. Recent studies have stressed the importance of essential fatty acids in various diseases. Patients with atopic dermatitis have altered essential fatty acids levels in plasma and a clinical improvement has been shown after oral administration of essential fatty acids. The aim of our study was to investigate the distribution of essential fatty acids in the membranes of cord blood mononuclear leukocytes of newborns at risk of atopy, and to correlate the levels of essential fatty acids at birth with total IgE values and with the onset of atopic disease. Newborns at risk of atopic disease have a significant reduction in arachidonic acid in the membranes of cord blood mononuclear leukocytes. Our data show a significant decrease in arachidonic acid in neonates at risk of atopy, suggesting that the abnormality of essential fatty acids is a primary phenomenon associated with atopic status.
Anaphylaxis induced by peanuts is a dangerous king of food allergy.
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[Effectiveness of a test for verification of the presence of acari in house dust for the prevention of respiratory allergies in children].
Respiratory allergy and bronchial asthma in particular can be serious afflictions in younger as well as in older children. Therefore interest has been focused on methods for the prevention of atopy. The role and allergenic importance of Dermatophagoides pteronyssinus (Dpt) in house and other environments have been identified. This mite provokes asthma in children at an earlier age than pollens. However the most under-valued area of asthma prevention is environmental control. The steps may seem difficult at first, but the results will be well worth the efforts and the sacrifices. We report on the high effectiveness of the guanine detection test (Acarex) based on the colorimetric quantification of allergen sources in house dust (mattresses, pillows, upholstered furniture, carpets, moquettes, etc), which can be treated with house dust mite extermination products such as benzyl benzoate. The eradication measures will allow the parents to reduce the allergen exposure, to be monitored at 3-6 month intervals. The guanine detection test performed in our Division on house dust samples assembled by the patents of children with house dust mite induced asthma (study group) or pollen asthma (control group) yielded highly significant statistical differences.
A three-year prospective study of specific immunotherapy to inhalant allergens: evidence of safety and efficacy in 300 children with allergic asthma.
The effectiveness and safety of specific immunotherapy (SIT) in allergic diseases such as asthma have increasingly come under question. Some authors advocate eliminating SIT as a therapeutic option for allergic patients, since the risks associated with this form of asthma may outweigh its positive effects. However, in a review of twenty-nine controlled studies in 2077 children and an equal number of controls, 27 (93.1%) have shown the effectiveness of SIT in pediatric age for the treatment of asthma due to inhalant allergens (p < 0.0001). The scope of this study was to ascertain whether this form of therapy is safe and effective in pediatrics. 300 children (median age 4.4 years) with asthma due to pollen or house dust mite were prospectively followed for three years. They were randomly divided into two groups: the study group and control group, being almost equal in number of children and clinical characteristics such as sex and age. No child suffered severe reactions due to SIT. Children receiving SIT had significantly greater reductions in days (p = 0.0001) and nights (p = 0.0005) without asthma and drug usage (p = 0.0003), compared with drug-treated children. In addition, the number of asthma attacks (p = 0.0001), and the quality of life were significantly improved in the study group (p = 0.0001). These findings suggest that if suitable allergen extracts are used with close observation of therapeutic indications, and children are followed by their doctors as frequently as required, SIT is effective in the treatment of pediatric asthma, with few adverse effects.
Specific immunotherapy in children is safe and effective.
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