[Intestinal intussusception in children]. / Invaginazione intestinale nel bambino.

Enteric intussusception is one f the most frequent causes of acute abdomen in early childhood, with an incidence of 1.3-2/1000 children born and higher frequency from the third to the twelfth month. Primary intussusception is related to predisponsing factors such as peristalsis disorders or Peyer's patch hypertrophy induced by viral infection. Secondary intussusception is due to organic injury in the intestinal wall. The most involved sites are the terminal ileum and the ileocecum, the most frequent type is ileocolic intussusception. Many clinical forms exist, including acute enteric intussusception with its pathognomonic triad intermittent abdominal pain, emesis and rectal bleeding and the atypical form with a neurological presentation, where sopor, myosis and muscular atonicity are dominating, Intussusception can also present in a subacute or chronic form with a slow and apsecific onset. In a retrospective investigation we examined 30 cases of intussusception in children hospitalized at the Pediatric Clinic of Pisa from the 1960s up to today. Our patients (16 males and 14 females) were aged between one month and two years. Clinical presentations resulted in; typical forms (60%), atypical forms (16%), subacute forms 13%) and recurrent forms (10%). Clinical suspicion was confirmed either by the presence of blood observed during rectal exploration, which is a pathognomonic sign, or by the opaque enema which led to recovery by means of hydrostatic reduction in 40% of the cases. The remaining patients (60%) underwent surgery.(ABSTRACT TRUNCATED AT 250 WORDS)

[Selenium in celiac disease]. / Il selenio nella malattia celiaca.

Statistically significant lower levels of selenium (p less than 0.001) have been found both in 37 celiac subjects at free diet and in 36 at gluten-free diet with respect to controls. In patients at free diet the deficit of selenium can be attributed to malabsorption, while in patients at gluten-free diet it may be due to the diet itself. Recently low serum levels of selenium have been observed in several neoplasias; furthermore it's known that celiac patients show an increased incidence of gastrointestinal tumors related to known levels in standard population. Long term monitoring is therefore necessary to integrate diet with selenium in patients showing persistent deficit of this element.