[Diagnosis and management of acute pharyngotonsillitis in the primary care pediatrician's office]. / Diagnosi e gestione della faringotonsillite acuta nell'ambulatorio del pediatra di famiglia.

Acute pharyngotonsillitis is one of the most frequent causes of visits in the primary care pediatrician'office. Group A b-hemolytic streptococci (GABHS) or Streptococcus pyogenes causes 15-30% of cases of acute pharyngotonsillitis in pediatric age. Children with pharyngotonsillitis due to GABHS commonly present sore throat, fever more than 38 °C, tonsillar exudate, and tender cervical adenopathy, but the severity of illness ranges from mild throat pain to classic exudative tonsillitis with high fever. The McIsaac criteria is a clinical scoring system to predict the likelihood of streptococcal infection among children. This score is based on 5 clinical criteria: age 3-14 years, fever more than 38°C, tonsillar swelling or exudate, tender and enlarged anterior cervical lymph nodes, and absence of cough, but none of these findings is specific for GABHS pharyngotonsillitis. Culture of a throat swab on a blood agar plate (BAP) remains the gold standard for the diagnosis of acute streptococcal pharyngotonsillitis. Because of the major disadvantage of culturing throat swabs on BAP culture is the delay in obtaining the results (at least 1 day), in the past decades rapid antigen detection test (RAD) were introduced for the rapid identification of GABHS directly from throat swabs. Accurate diagnosis and treatment of GABHS pharyngotonsillitis provides positive benefits, including prevention of complications, such as acute rheumatic fever and peritonsillar abscess and reduce the acute morbidity associated with the illness. Conversely, improper diagnosis may result in negative consequences, including unnecessary antibiotic prescriptions that confer increased health care costs and contibute to the development of bacterial resistance.

Cell-cycle molecules in mesothelioma: an overview.

Cell cycle progression is mediated by a group of proteins named cyclins that activate a highly conserved family of protein kinases, the cyclin-dependent kinases (CDKs). CDKs are also regulated by related proteins called cdk inhibitors, grouped into two families: the INK4 inhibitors (p16, p15, p19 and p18) and the Cip/Kip inhibitors (p21, p27). Moreover, several tumour suppressor genes (such as Retinoblastoma gene and p53 gene) are implicated in the regulation of the molecular mechanism of cell division. Several studies report the importance of cell cycle regulator proteins in the pathogenesis and the prognosis of mesothelioma. This article will review the most recent data from the literature about the expression and the diagnostic and prognostic significance of cell cycle molecules in mesothelioma.

Biphasic pulses enhance bleomycin efficacy in a spontaneous canine perianal tumors model.

Perianal tumors (adenoma and carcinoma of the hepatoid glands) are frequently reported in veterinary literature. They are locally aggressive tumors with a low tendency to metastatic spread. An hormonal ethiology has been identified for the development of perianal adenomas in male dogs, while the carcinomas are free from hormonal influence. Standard treatments include surgery, cryotherapy or, in selected cases, radiation therapy. In this article we describe the outcome of a small cohort of canine patients with perianal tumors treated with bleomycin selectively driven by trains of biphasic pulses (electrochemotherapy). Twelve canine patients, eight with adenoma and four with carcinoma of the perianal glands, entered the study and received two sessions of ECT under sedation. The pets had local injection ofbleomycin at the concentration of 1.5 mg/mg and five minutes after the chemotherapy, trains of 8 biphasic electric pulses lasting 50 + 50 micros each, with 1 ms interpulse intervals, were delivered by means of modified caliper and needle array electrodes or, for difficult districts, through paired needle electrode. The overall response rate was 91% with a 83% of complete response (10/12); one dog had a PR that lasted 12 months and another had progressive disease. Electrochemotherapy appears as a safe and efficacious modality for the treatment of perianal tumors and warrants further investigations.

Hemolytic-uremic syndrome as a presenting form of acute lymphocytic leukemia.

We report an 8-year-old girl who presented with hemolytic-uremic syndrome (HUS) as the onset manifestation of acute lymphocytic leukemia (ALL). The patient was admitted to the hospital for renal failure, thrombocytopenia, and anemia during a HUS outbreak. She was discharged 2 weeks later with normal renal function. One month later the girl presented with clinical and laboratory signs consistent with a diagnosis of ALL. The short time interval between HUS and ALL suggests that HUS was probably an early manifestation of acute leukemia.

[The use of electropherogram in a clinical setting (author's transl)]. / L'elettroferogramma in clinica.

The AA. have spent several years working on the correlation between EPG patterns and diagnosis upon discharge. They then attempted to codify those abnormalities which were statistically related to different illnesses. This codification should not be considered definitive; however, it can be suggestive of further studies especially for those hospitals equipped with a computer which can correlate EPG patterns with the initial diagnosis or the diagnosis on discharge.