Asthma and allergy in young athletes in Siena Province. Preliminary results.

AIM: The aim of the study was to assess the prevalence of asthma and related respiratory symptoms in a sample of the Siena pediatric population that engages in sport. METHODS: The subjects were 460 young athletes, age 7-14 years, enrolled in 23 sporting clubs in 10 municipalities of Siena Province. Subjects and their parents answered a questionnaire on life style and the children underwent basal spirometric tests at their respective training centers. RESULTS: A total of 352 questionnaires (76.6%) were returned; 80% of responders performed the spirometric test. The lifetime prevalences of asthma, allergic rhinitis and atopic dermatitis were found to be 17.33%, 22.16% and 11.08%, respectively. About 33.2% of subjects had also experienced symptoms compatible with exercise-induced bronchospasm (EIB) during sport and 4.2% of them had had to stop activity at least once. CONCLUSION: The results suggest that EIB is a major phenomenon in our province and that this disorder interferes with, or even limits, physical activity of young athletes.

Neurocutaneous syndrome with mental delay, autism, blockage in intracellular vescicular trafficking and melanosome defects.

We evaluated a 11-year-old male patient with mental delay, autism and brownish and whitish skin spots. The former resembled those of neurofibromatosis, the latter those of tuberous sclerosis. The patient received a complete clinical work-up to exclude neurofibromatosis, tuberous sclerosis, or any other known neurocutaneous disease, with biochemistry, chromosome analysis and analysis of skin specimens. Being all the other tests not significant, two main ultrastructural defects were observed. The first was a blockage in intracellular vescicular trafficking with sparing of the mitochondria; the second an aberrant presence of melanosomes in vacuoles of several cell lines and abnormal transfer of these organelles to keratinocytes. This patient presented with a unique clinical picture distinct from neurofibromatosis or tuberous sclerosis or any other known neurocutaneous disease. The ultrastructural abnormalities suggested a defect in cell trafficking involving several cell lines and compartments.

Occipital intermittent rhythmic delta activity only following eye closure in atypical CNS Salmonellosis.

OBJECTIVE: A statement recently published on the base of a large retrospective analysis, report that the occipital intermittent rhythmic delta activity (OIRDA) "is associated with epilepsy but not acute encephalopathy" [Gullapalli and Fountain. J Clin Neurophysiol 2003;20:35-41]. Our aim is to report, the exception from a child with an intermittent fever, in which the finding of an occipital intermittent rhythmic delta activity (OIRDA) following the eye closure in the EEG recording was the first clinical sign addressing to a CNS involvement. METHODS: To review the record from a five-year-old girl with a normal basal electroencephalogram and OIRDA that only appeared following eye closure. RESULTS: We found OIRDA associated with atypical CNS Salmonellosis. Brain MRI and CSF examination confirmed an acute encephalopathy, which was due to Salmonella infection. The only symptoms of the infection were episodes of nightly fever that had lasted for four weeks, sometimes associated with headache and vomiting. Both OIRDA only induced by eye closing and other symptoms disappeared after starting antimicrobial therapy. CONCLUSIONS: OIRDA only following eye closure is a non-specific abnormality and the present findings, based on a single case, merely indicate that intracranial infection is among the possible causes. SIGNIFICANCE: The new clinical association is certainly worth recording, as the presence of this electrophysiological sign may provoke clinicians to then delve further into a diagnostic work up.

Pediatricians' advices on timing of solid food introduction: two Italian experiences.

AIM: The aim of the study was to evaluate and compare methods of weaning suggested by pediatricians in two Italian regions with different geographical and cultural characteristics, Tuscany and Apulia. METHODS: Questionnaires were sent to 30 pediatricians, 15 in Tuscany and 15 in Apulia. Questions regarded prevalence and duration of breastfeeding, timing and manner of introducing other foods, and use of commercial baby food or food prepared at home. RESULTS: The pediatricians advised beginning weaning between the 4(th) and the 6th months. In Tuscany, 60% of pediatricians advised breastfeeding for 6 months and 40% for 12 months. In Apulia the same figures were 86.7% and 13.3%. All pediatricians advised differentiated introduction of foods. The percentages of Tuscany pediatricians suggesting late introduction of certain foods were 31.70% for eggs, 19.51% for cow's milk, fish and tomato, 4.87% for vegetables and 2.44% for citrus and gluten. Foods introduced with caution by Apulia pediatricians were egg white (41.37%), gluten (31.03%) and fish (27.58%). The percentages of Tuscany and of Apulia pediatricians recommending home cooked food were 77.7% and 31.21%, respectively; 22.3% and 68.75% respectively recommended commercial baby food. CONCLUSIONS: Pediatricians in both regions are aware of the importance of nutritional quality in the first year of life and provide indications about the timing and manner of introducing foods in line with international scientific guidelines.

The FBN1 (R2726W) mutation is not fully penetrant.

The R2726W mutation in the fibrillin 1 (FBN1, Marfan syndrome) gene segregates with isolated skeletal features of Marfan syndrome and/or high stature. Here we report a family in which two out of four individuals, an 18-year-old son and his mother, a 41-year-old woman, had the R2726W mutation of FBN1. Both family members carrying the mutation were of average height. The son had a Marfan-like phenotype, but his mother did not. The FBN1 R2776W mutation, which is associated with skeletal features of Marfan syndrome, appears incompletely penetrant. Consequently, genetic counselling in the presence of this mutation is difficult.

Hypertelorism, ptosis, and myopia associated with drug-resistant epilepsy, mental delay, growth deficiency, ectodermal defects, and osteopenia.

We report a 30-year-old woman with hypertelorism, ptosis, and myopia associated with drug-resistant epilepsy (DRE, Lennox-Gastaut syndrome), mental delay, growth deficiency, ectodermal defects, and osteopenia. To the best of our knowledge, this patient has an unusual combination of symptoms not previously described, associated with severe central nervous system dysfunction. The ectodermal defects were present in a very intriguing form, were difficult to diagnose, and did not conform to any classification or previous description.