[The use of ondansetron in acute gastroenteritis. Its impact in a pediatric emergency department]. / L'impiego dell'ondansentron nella gastroenterite acuta e la sua efficacia in un pronto soccorso pediatrico.

BACKGROUND: Ondansentron is in consideration in literature for its use in vomiting secondary to acute gastroenteritis in children. OBJECTIVE: To evaluate its usefulness in children with acute gastroenteritis referred to a paediatric emergency department. METHODS: A retrospective study considered 967 children treated with ondansetron (0,06 mg/kg IM) plus oral rehydration, with a control group of 286 children who received only oral rehydration. RESULTS: The time spent into the short-stay observation unit and the total emergency department stay were significantly reduced in children receiving ondansentron. No adverse reactions to the drug were recorded.

[The use of ondansetron in acute gastroenteritis. Its impact in a pediatric emergency department]. / L'impiego dell'ondansentron nella gastroenterite acuta e la sua efficacia in un pronto soccorso pediatrico.

BACKGROUND: Ondansentron is in consideration in literature for its use in vomiting secondary to acute gastroenteritis in children. OBJECTIVE: To evaluate its usefulness in children with acute gastroenteritis referred to a paediatric emergency department. METHODS: A retrospective study considered 967 children treated with ondansetron (0,06 mg/kg IM) plus oral rehydration, with a control group of 286 children who received only oral rehydration. RESULTS: The time spent into the short-stay observation unit and the total emergency department stay were significantly reduced in children receiving ondansentron. No adverse reactions to the drug were recorded.

[The short-stay observation unit: an experience of the Pediatric Department in Modena]. / Osservazione breve intensiva (OBI) in pediatria: l'esperienza del Policlinico di Modena.

The use of a short-stay observation unit (OBI) in a pediatric department has reduced the number of admissions. Significant cost savings and a better care for children and their families have been also achieved. During the year 2003 in our department 1759 children received OBI. 226 (12.8%) were then admitted. 1553 (87.2%) were discharged after a nine-hour mean stay. Descriptive statistics are used to outline the sample of patients and used treatments.

New evidence on the tool-assisted hunting exhibited by chimpanzees (Pan troglodytes verus) in a savannah habitat at Fongoli, Sénégal.

For anthropologists, meat eating by primates like chimpanzees (Pan troglodytes) warrants examination given the emphasis on hunting in human evolutionary history. As referential models, apes provide insight into the evolution of hominin hunting, given their phylogenetic relatedness and challenges reconstructing extinct hominin behaviour from palaeoanthropological evidence. Among chimpanzees, adult males are usually the main hunters, capturing vertebrate prey by hand. Savannah chimpanzees (P. t. verus) at Fongoli, Sénégal are the only known non-human population that systematically hunts vertebrate prey with tools, making them an important source for hypotheses of early hominin behaviour based on analogy. Here, we test the hypothesis that sex and age patterns in tool-assisted hunting (n=308 cases) at Fongoli occur and differ from chimpanzees elsewhere, and we compare tool-assisted hunting to the overall hunting pattern. Males accounted for 70% of all captures but hunted with tools less than expected based on their representation on hunting days. Females accounted for most tool-assisted hunting. We propose that social tolerance at Fongoli, along with the tool-assisted hunting method, permits individuals other than adult males to capture and retain control of prey, which is uncommon for chimpanzees. We assert that tool-assisted hunting could have similarly been important for early hominins.

[Experimentation and clinical analysis of the interrelationships between dental damage and celiac disease]. / Sperimentazione ed analisi clinica dei rapporti intercorrenti tra il danno dentale e la malattia celiaca.

Celiac disease is characterized by gluten-dependent atrophy of the intestinal tufts. Aetiologically the genetic "habitus" of the subject has particular importance and, as rear as the pathogenesis is concerned, many theories, among which the most accredited one is "immunopathological", exist. According to what this last one provides, the cell-mediated immunity component is to be considered the true mediator of intestinal injury, whereas the antibody-mediated component and, in particular, anti-gliadin antibodies (AGA) and anti-endomysium antibodies (EMA), has a particular and pre-eminent diagnostic role. Just from this point of view the celiac disease appeared, with the progress of the studies, to be more and more fleeting, because of growing symptomatologic diversification. It is then interesting to take into account that the celiac disease seems to be able to maintain itself asymptomatic for the greatest part of life, perhaps, forever, configuring the appearance of silent celiac disease and contributing to specify the outline of the above-mentioned celiac "habitus". Recently, besides, close associations have been found between many different diseases and celiac disease. Even for such reasons we relied upon the indication of the ESPGAN in order to achieve a sure and standardized diagnosis of celiac disease. Early diagnosis of celiac disease is very important because it allows a normal psychophysical development and it avoids the strong incidence of lymphomas and other neoplasms of the gastrointestinal tractus which can characterize the natural story of celiac patients. From a more specifically odontological point of view, interesting manifestations exist in the ambit of celiac disease. This last may in fact appear associated particular signs, such as recurrent aphthae or plainly autoimmune diseases with even oral verification. There, however, a more frequent association between celiac disease and some lesions of the tooth enamel which occur in the period of the two stages of histodifferentiation and mineralisation, and they are, respectively, hypoplasias and opacities. Alteration of the enamel, in such stages, both in deciduous and in permanent sets of teeth may be caused by different "noxae"; hence it will be necessary to know how to distinguish between the dental lesions typical of celiac disease and the others. It is helpful the fact that the dental lesion, observed in the course of celiac disease, remembers conceptually the Chronologic Hypoplasia of the enamel. This pathologic form damages the enamel which is depositing, and evolving contemporaneously to the local or systemic "noxa" which is its remote cause.(ABSTRACT TRUNCATED AT 400 WORDS)

[High prevalence of hepatitis C virus infection in patients with non-Hodgkin's lymphoma at the onset. Preliminary results of an Italian multicenter study]. / Elevata frequenza della infezione da virus dell'epatite C nei pazienti con linfoma non-Hodgkin all'esordio. Risultati preliminari di uno studio multicentrico italiano.

143 patients with non-Hodgkin lymphoma (NHL) at the onset entered this perspective study on NHL-associated risk factors. They were 87 males and 56 females with a mean age of 52.3 years (range 14.6-82.3). An associated hepatitis C virus (HCV) infection was found in 16 of the 143 NHL cases (11.2%; 95% CI 6.5-17.5). They were 11 males and 5 females [mean age 59.9] year with disseminated (13/16) or localized NHL disease (3/16)]. The NHL histological subgroup was low grade (6/16), intermediate grade (2/16) or high grade (8/16). The cell origin was B in 15/16 cases and B cell-T cell rich in 1/16. The discovery of HCV infection was contemporary to lymphoma diagnosis in 6/16 cases but preceded the NHL onset in the other 10 patients. In these 10 patients the median time between HCV infection diagnosis and NHL onset was 3.6 years (range 1-14.5). These data confirm that in Italy the prevalence of HCV infection in patients with NHL (11.2%) is significantly higher than expected in the general population (1.3-3.2%). The finding that, in most cases, HCV infection was definitely antecedent to NHL onset, usually by years, adds evidence to the possible causative role of the HCV in lymphomagenesis.

[Chromium and atherosclerosis]. / Cromo e aterosclerosi.

The authors report numerous experimental and clinical studies relating deficiency of chromium in the organism and atherosclerosis. They hope new researches to compute the pool of chromium in the organism and the validity and possibility to utilize this oligoelement in prevention of atherosclerosis.

[Intestinal flora in children with celiac disease]. / La flora intestinale nel bambino celiaco.

The variations of duodeno-jejunal bacterial flora are evaluated. 26 celiac children aged 2 to 7 years were divided in three groups. First group: 8 children in active phase of disease on a free diet; Second group: 10 children kept since one year on a gluten-free diet; Third group: 8 children challenged with gluten for some months. As the same time of the jejunal biopsy, a sample of duodenal juice was obtained for bacteriological examination; for this purpose were used the following culture media: Fluid thioglycollate medium (FTM), Blood-agar, Bile Esculin Azide Agar (BEAA), SF, selective for enterococcus, and MacConkey Agar. The results are: The number of bacterias in the first and third group is significantly higher (p less than 0.001 and p less than 0.05 respectively) than the second group with normal intestinal mucosa. Particular variations in bacteriological species in the three groups are not demonstrated. The excessive growth of bacterias in active phase of celiac disease could worse the absorption of lipids, vitamins, iron, and others substances and it could facilitate the local inflammatory processes in the small intestine.

[High-dose oral bacteria-therapy for chronic non-specific diarrhea of infancy]. / Batterioterapia orale ad alte dosi nella diarrea cronica aspecificia del bambino.

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.

[Immunostimulating therapy in chronic non-specific diarrhea]. / Terapia immunostimolante nella diarrea cronica aspecifica.

The authors describe 9 children affect by chronic aspecific diarrhea treated with levamisole; the drug was effective in reducing diarrhea episodes during the period of administration in respect to the untreated group. Follow-up of 3-5 months did not show auxological or nutritional differences in the two groups.

[Clinical study on the efficacy of a sustained-release theophylline-based preparation in infants with chronic asthma]. / Studio clinico sull'efficacia di un preparato a base di teofillina a cessione controllata in lattanti con asma cronico.

Authors describe 9 infants aged between 3 and 17 months, affected by recurrent episodes of bronchial asthma (at least one crises even month for three following months) and treated with sustained-release theophylline. During the 6 months of follow-up a total of 8 episodes of bronchial asthma in 7 subjects were observed. Seven out of 8 of these episodes occurred during the period of suspension of the therapy with the sustained-release theophylline. In each subjects, after 6 hours from the drug administration on average of 4-8 determinations of the theophylline blood levels were performed. More than 70 percent of the theophylline blood values has been found within the normal therapeutic range (6-20 micrograms/ml).

[Cow's milk protein intolerance: evaluation of immunological markers. A preliminary study]. / Intolleranza alle proteine del latte vaccino: valutazione di alcuni marcatori immunologici. Studio preliminare.

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)

[Continuous intraesophageal pH monitoring in the study of gastroesophageal reflux (GER) in children. Influence of age on the considered parameters]. / La pH-metria intraesofagea di lunga durata nello studio del reflusso gastroesofageo (RGE) del bambino. Influenza dell'età sui parametri considerati.

Gastroesophageal reflux is a very common event in children; it is studied using 24-hour intraesophageal pH-monitoring, which has a large sensitivity and specificity, but in the literature is not clear if the age of the children could have influence on the parameters considered in the pH-monitoring. The aim of our study is to assess if the age of our small patients could modify the results of pH-monitoring. During 3-year period from 1991-1993 continuous intraesophageal pH-monitoring of 45 children (29 males and 16 females), divided in three groups on the bases of age, homogeneous for number, sex and clinical symptoms, with pathologic reflux time (> 4% of 24 hours) has been evaluated. In our cases the pathologic total reflux time in 24 hours doesn't seem change with age. It has been noted that under two years of age the pH-monitoring measures are homogeneous with a tendency of reflux longer than children over two years. This older group has more after lunch refluxes; that is the number of total refluxes is larger in older children but the number of refluxes with length higher than five minutes is more in younger. These data are discussed in relation to the anatomical and functional gastroesophageal characteristics of the different age of the child.

[Atrophy of the duodeno-jejunal mucosa in cow's milk protein intolerance. Importance of cell-mediated immunologic factors]. / Atrofia della mucosa duodeno-digiunale nella intolleranza alle proteine del latte vaccino. Importanza dei fattori immunitari cellulo-mediati.

Cow's milk sensitive enteropathy has been described several times but in spite of that, it is still a problem concerning the pathogenesis. Our study involves the children hospitalized from 1974 to 1984 in the First Department of Pediatrics, University of Modena. Patients were suffering from chronic diarrhea and malabsorption. At the first biopsy each child showed atrophy of the small intestinal mucosa. All patients had been fed fed with gluten. We have followed the protocol for Celiac Disease's diagnosis; we found proved 85% of cases, excluded 15%. These last cases may be considered as cow's milk sensitive enteropathy. We catamnestically considered all the clinical and laboratory data of the two groups in the purpose of selecting significative parameters for a differential diagnosis. The data meaning fully different between the two groups resulted: family history of allergy, recurrent infections, positive occult blood in the stools, eosinophils in blood greater than 400/mm3 serum IgE value greater than 97 degrees P X (p less than 0.01). On the ground of recent studies the involvement of the cell-mediated immunity in cow's milk sensitive enteropathy is supposed.

[Coexistence of cystic fibrosis and celiac disease. Description of a clinical case and review of the literature]. / Compresenza di fibrosi cistica e malattia celiaca. Descrizione di un caso clinico e revisione della letteratura.

A 14-month-old female infant with chronic diarrhea, recurrent respiratory infections and stunted growth was diagnosed as celiac disease with AGA detection and a positive intestinal biopsy. A gluten-free diet was introduced with a poor response. A sweat test was positive and heterozygosis for mutation of CFTR gene (both F508 and G542X) was found, demonstrating an association in the infant between cystic fibrosis and celiac disease. Fifteen cases of such association have been previously described in literature, but only three have been genetically studied. The co-existence of cystic fibrosis and celiac disease in the same subject has to be considered till now a casual finding, but are also discussed hypothesis of a non-casual linkage, formulated by some authors.

[Celiac disease and lymphoma]. / Malattia celiaca e linfoma.

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.

[Unusual cause of ileal occlusion: a coconut bezoar]. / Una causa insolita di occlusione ileale: un bezoario da noce di cocco.

A coconut phytobezoar was detected in the distal ileum of a 4-year-old boy, admitted for suspected appendicitis. While persimmon or citrus fruit ingestion has been previously reported as cause of phytobezoar intestinal occlusion, it is the first time that coconut pulp is described to cause ileal obstruction in children. No predisposing factor as previous gastric surgery or Meckel's diverticulum was present. The bezoar was successfully milked past the ileocecal valve into the right colon.

[Atherosclerosis: a childhood problem]. / Aterosclerosi: un problema infantile.

The project "Precursors of Atherosclerosis (ATS) in Children" following the protocol of WHO started in Modena in 1981/82. A total of 527 schoolchildren of 6, 9, 12 and 15, living in the area around Modena, Emilia Romagna Region, were examined, sampled from whole schools or classes. Each group exceeds the minimum of 100 children with the exception of the group including subjects of 15. The population sampled is fairly homogeneous. There are no immigrants to the area and the intra-population differences due to social-classes are minimal. The standard of life is very high: the rate of income is one of the highest in Italy and the incidence of ATS manifestations is very high. The children will be reexamined each year for three years at the same season and the study will be over in 1984. A questionnaire with family story has been filled by the parents and the parents were directly examined about: height, blood pressure, cholesterolemia, triglyceridemia, smoking habit. Following the protocol in each child are determined: height, weight, Quetelet's index (kg/m2), skinfold thickness, blood pressure, cholesterolemia, triglyceridemia, sexual maturity and smoking habit. The statistical elaboration methods of data are chosen in cooperation with the "Centro di Calcolo" of the University of Modena, and elaborated with the Statistical Package for the Social Science (SPSS) method.