Local nasal immunotherapy with a powder extract for grass pollen induced rhinitis in pediatric ages: a controlled study.

Forty pediatric patients, ranging from 5-13 years of age and suffering from grass pollen rhinoconjunctivitis, were submitted to local nasal preseasonal (12 weeks) immunotherapy, either with a grass pollen extract or with placebo. After 1 year, 15 of these patients (5 previously treated with active product and 10 with placebo) were treated with the grass pollen extract preseasonally for 2 consecutive years. Before and after treatment, serum total IgA and IgE, and specific IgG and IgE were assayed as well as carrying out nasal provocation tests (NPT) with extracts at different concentrations, endpoint evaluations by rhinomanometry and prick tests with different concentrations of extract. After only 1 year, the actively treated patients showed a significant decrease of daily nasal and conjunctival signs and symptoms-as judged by a 1 to 3 score-in comparison with the control group. The placebo group showed the same results after the 3rd year. The improvement was confirmed by a significant increase of the dose threshold in NPT. No immunological alterations were evident.

[The diagnostic procedure in deep venous thrombosis. The authors' experience]. / Iter diagnostico nella trombosi venosa profonda. Esperienza personale.

Diagnostic flow chart of 101 patients admitted with suspected TVP between 1987 and 1991 is discussed. In all of them Doppler cw and radionuclide venography with pulmonary scanning with albumin Tc 99 were performed. Since the 90's a triplex scanner was employed, usually after Doppler cw examination. Phlebography was considered as a golden backup. Pulmonary embolism was detected in 15% of patients and 2/3 were completely asymptomatic.

[Open abdomen treatment in massive peritonitis. Our experience]. / Trattamento ad addome aperto delle peritoniti massive. Nostra esperienza.

Intractable intra-abdominal sepsis occurring in eight patients was managed by the authors with planned abdomen reexploration. Only the severity of illness can justify such aggressive surgical treatment. Mortality is still high.

Soy sensitivity: personal observation on 71 children with food intolerance.

The controversies on the use of soy milk as a substitute in cow's milk intolerance prompted us to study: the incidence of soy sensitivity in a pediatric population (71 children, mean age 5.9 years, 45 boys and 26 girls) with food intolerance: the influence of a prior soy milk feeding on soy sensitivity: the relationship between soy, cow's milk and seed allergy. The patients were subdivided in two groups, one of atopic patients (50 subjects, 28 of which previously fed soy) and the other of non atopic patients (21 subjects, 12 of which previously fed soy). In the atopic group prick and RAST gave positive results to soy in 46% of case, with no difference between subjects fed soy and not. There was a relationship between any and peanut RAST in 82%; between soy and pea in 70%; between soy and cow's milk in 27% of cases. Soy milk challenge was positive in 10 out of 58 children (6 atopic and 4 non atopic); 4 our of 21 atopic patients with a cow's milk intolerance had a positive soy milk challenge: 3 of 10 non atopic patients with cow's milk intolerance were reactive to soy too. 77% of atopic and 90% of non atopic children were responsive both to seeds and soy. It can be concluded that soy sensitivity is rather rare in patients with food intolerance (17.2% of cases) and is not correlated with cow's milk intolerance while is significantly correlated with seeds allergy; there is no difference between atopic and non atopic subjects and between patients previously fed soy and never fed soy.

Starch gel electrophoresis of fructose-6-phosphate phophoketolase in the genus Bifidobacterium.

Three groups of nomenspecies of the genus Bifidobacterium were distinguished by the different mobility of their fructose-6-phosphate phosphoketolase in starchgel electrophoresis; there is apparently a close relatedness between electrophoretic type of phosphoketolase and habitat.

Soy allergy in atopic children.

BACKGROUND: Although soy is considered a major food allergen (along with milk, egg, peanut, fish, and wheat), the prevalence of soy allergy in the pediatric population is not well defined. OBJECTIVE: To determine the prevalence of soy allergy in atopic children attending the Allergy Clinic at the Pediatric Department of Milan University. METHODS: Seven hundred four patients with allergic signs and symptoms, aged 1 month to 18 years, were recruited between December, 1991 and April, 1992. The subjects with positive skin prick tests to soy were tested using a DBPCFC with powdered soy formula in fruit juice, and rice or corn flour as placebo. In children who refused the liquid challenge, capsules containing dehydrated soy flour or talcum powder as placebo were administered. An age-matched and sex-matched group of subjects with negative skin prick tests to soy were tested using an open challenge with soy formula. RESULTS: A positive skin prick test to soy was found in 148/704 patients (21%); 131 out of 148 children with positive skin prick test (group A) and 131 out of 556 children with negative skin prick test to soy (group B) were challenged with soy: 8/131 (6%) in group A had a positive soy challenge while no clinical reactions were observed in children in group B. A younger median age, a positive past and current personal history of cow milk allergy, and a previous history of soy allergy were found most often in children with positive soy skin prick test and positive soy challenge than in children with positive skin prick test and negative soy challenge. The eight soy-allergic children reacted to the soy challenge mostly with cutaneous and gastrointestinal symptoms; symptoms were immediate in six and late in two children. The eliciting dose of soy was very small in the immediate reaction; higher and repeated doses were necessary for the onset of late reactions. CONCLUSION: The prevalence of clinical soy allergy in our children with positive skin prick tests to soy is 6.1% (8/131), while none of 131 children with negative skin prick test to soy reacted to the challenge.

Ifosfamide in the treatment of malignant epithelial ovarian tumors.

Ifosfamide is one of the best-known alkylating agents. In advanced epithelial ovarian cancer, it has been tested in association with cisplatin, achieving results equal, if not better than cyclophosphamide, with acceptable toxicity. In second-line therapy, it shows remarkable activity, even in patients refractory to cisplatin already treated with cyclophosphamide, with more severe, but always manageable toxicity. In gynecological sarcomas, ifosfamide is, together with doxorubicin, the reference drug for chemotherapy.

Visual evoked potential: a diagnostic tool for the assessment of hepatic encephalopathy.

Visual evoked potential recordings were examined in 45 liver cirrhosis patients with (n = 29) and without (n = 16) encephalopathy, in 15 normal volunteers, and in one patient with an opioid induced stupor state. Visual evoked potential parameters were classified on the basis of EEG recordings. Plasma concentrations of amino acids, octopamine, and ammonia were assayed in order to document the metabolic change of hepatic encephalopathy. Latencies and wave patterns recorded after flash stimulation differentiated the four degrees of the coma one from another according to EEG classification in the 29 patients with encephalopathy. In the group of 16 patients without clinical and EEG evidence of encephalopathy the visual potential recordings discriminated a group of patients (n = 10) in a preclinical stage of encephalopathy. Biochemical parameters and subsequent clinical observation of patients confirmed our judgement of a preclinical stage of encephalopathy. These results suggest that visual evoked potentials are a simple, suitable and objective method for differentiating the degrees of encephalopathy and for identifying the preclinical stage of encephalopathy.