[Evaluation of a rapid and simple ambulatory method for the determination of HbA1c in diabetic children]. / Valutazione di una metodica ambulatoriale rapida e di semplice esecuzione per la determinazione dell'HbA1c nei bambini diabetici.

The aim of this study was to compare a simply and quick outpatient method for the determination of HbA1c (DCA 2000 Bayer) to a laboratory immunoturbidimetric method (B M Hitachi 911). We have determined HbA1c in 139 subjects (120 diabetics and 19 healthy controls, 81 males and 58 females, mean age ( +/- DS) 14.4 +/- 6.41 years, range 2-40) with the two methods at the same time. The HbA1c normal range, determined by DCA 2000 and by laboratory method, were 4-5.2% and 4.5-6% respectively. The HbA1c values determined with both methods were significantly correlated (r = 0.91; p < 0.001). In 16 diabetic patients, chosen for their reliability, the HbA1c values determined by DCA 2000 were significantly correlated to the last two month mean glycemic level preceding the test. In 14 healthy subjects HbA1c was determined simultaneously by DCA 2000 in capillary and venous blood samples. The values were similar. The DCA 2000 method showed to be reliable, simply to use, no traumatic and ideal for pediatric outpatient use.

[Acute carbon monoxide poisoning in children]. / L'intossicazione acuta da monossido di carbonio nel bambino.

Epidemiological and clinical aspects of 233 children below 14 years of age with acute carbon-monoxide poisoning are presented. Patients were recorded in the retrospective part of the M.S.P.C. (Multicentre Study of Poisoning in Children) at Genova, Torino and Trieste pediatric hospitals during 1975/90. Carbon-monoxide poisoning resulted to be a main toxic risk in children by considering its frequency and the severity of symptoms; three cases of death occurred. In particular, differences between symptoms in small children (under the age of 4 years) and adults are emphasised. This poisoning has to be suspected even in the presence of minor symptoms; the blood carboxyhemoglobin assay confirms the diagnosis and is useful to avoid further exposure.

Severity grading of childhood poisoning: the Multicentre Study of Poisoning in Children (MSPC) score.

Scores for severity grading of childhood poisoning may be useful in comparing different causes of poisoning, in order to identify the main risks and their changes over time. The Multicentre Study of Poisoning in Children score is based on four levels of severity (1-mild, 2-moderate, 3-severe, 4-very severe) involving nine target groups: seven relating to organ systems (gastrointestinal, nervous, respiratory, circulatory, renal, hepatic, skin), one to metabolic abnormalities and one to injuries from corrosive substances. Each patient is classified by the highest level attributed to any one of the nine groups. The score has been prospectively tested in 644 symptomatic children, aged 0-13 years, admitted to six pediatric hospitals of Northern Italy from January 1, 1991 to December 31, 1993. Poisoning was categorized as mild (1) in 357 children (53.8%), moderate (2) in 285 (42.9%), severe (3) in 18 (2.7%) and very severe (4) in 4 (0.6%). No deaths occurred. Severity grading according to The Multicentre Study of Poisoning in Children score confirms the prevalence of mild and moderate poisonings in children; the score seems to be an objective method suitable for epidemiological studies in different countries. Its clinical usefulness deserves more investigation.