Prolonged follow up of seven patients affected by hepatosplenic granulomata due to cat-scratch disease.

This study is a retrospective analysis of seven patients with hypoechogenic lesions in the liver and/or spleen due to Bartonella henselae, who were followed from 1998 through to 2005 by the Department of Pediatrics, Turin University. In addition to showing constitutional symptoms, four children had skin lesions suggestive of injuries inflicted by cats, and one child had a history of exposure to cats. The origin of the infection remained undefined in the other two patients. Humoral tests enabled a precise diagnosis in all children. Treatment with macrolides or combinations of two active antibiotics for at least 2-3 weeks led to the definitive clearance of infection, although residual intraparenchymal lesions persisted in five patients for several months or years. Conclusion B. henselae serology allows an easy diagnosis of multiple hepatosplenic granulomata, a clinical picture that appears to be under-recognized. Macrolides or a combination of two active antibiotics for 2-3 weeks leads to a rapid clinical response and a definitive clearance of infection.

[Development of a multiple PCR method for the identification of Ureaplasma parvum and Ureaplasma urealyticum]. / Desarrollo de un método de PCR-múltiple para la identificación de Ureaplasma parvum y Ureaplasma urealyticum.

Ureaplasma parvum and Ureaplasma urealyticum, also known as biovar parvum and biovar T960, respectively, could be associated with several disorders in men, women, and mainly, in newborn children with under weight. Several methods have been developed in order to identify the species or biovars of ureaplasmas. We developed a Multiplex-PCR method using the UPS-UPSA and UUS2-UUA2 primers, specific for U. parvum and U. urealyticum, respectively. This Multiplex-PCR method was used to identify cultures of clinical positive samples to Ureaplasma spp. by the "MYCOFAST Evolution-2" Kit. Of 56 positive cultures to Ureaplasma spp. from newborn children, 70% were U. parvum and 30% U. urealyticum; in 76 positive samples in women, 83% corresponded to U. parvum and 17% to U. urealyticum, while in 63 positive samples of men, 76% identified U. parvum and 24% U. urealyticum. The PCR-multiplex method showed specificity for the identification of the biovars or species of ureaplasmas of clinical interest.

Desarrollo de un método de PCR-múltiple para la identificación de Ureaplasma parvum y Ureaplasma urealyticum / [Development of a multiple PCR method for the identification of Ureaplasma parvum and Ureaplasma urealyticum]

Ureaplasma parvum and Ureaplasma urealyticum, also known as biovar parvum and biovar T960, respectively, could be associated with several disorders in men, women, and mainly, in newborn children with under weight. Several methods have been developed in order to identify the species or biovars of ureaplasmas. We developed a Multiplex-PCR method using the UPS-UPSA and UUS2-UUA2 primers, specific for U. parvum and U. urealyticum, respectively. This Multiplex-PCR method was used to identify cultures of clinical positive samples to Ureaplasma spp. by the [quot ]MYCOFAST Evolution-2[quot ] Kit. Of 56 positive cultures to Ureaplasma spp. from newborn children, 70

were U. parvum and 30

U. urealyticum; in 76 positive samples in women, 83

corresponded to U. parvum and 17

to U. urealyticum, while in 63 positive samples of men, 76

identified U. parvum and 24

U. urealyticum. The PCR-multiplex method showed specificity for the identification of the biovars or species of ureaplasmas of clinical interest.

Desarrollo de un método de PCR-múltiple para la identificación de Ureaplasma parvum y Ureaplasma urealyticum. / [Development of a multiple PCR method for the identification of Ureaplasma parvum and Ureaplasma urealyticum]

Ureaplasma parvum and Ureaplasma urealyticum, also known as biovar parvum and biovar T960, respectively, could be associated with several disorders in men, women, and mainly, in newborn children with under weight. Several methods have been developed in order to identify the species or biovars of ureaplasmas. We developed a Multiplex-PCR method using the UPS-UPSA and UUS2-UUA2 primers, specific for U. parvum and U. urealyticum, respectively. This Multiplex-PCR method was used to identify cultures of clinical positive samples to Ureaplasma spp. by the [quot ]MYCOFAST Evolution-2[quot ] Kit. Of 56 positive cultures to Ureaplasma spp. from newborn children, 70

were U. parvum and 30

U. urealyticum; in 76 positive samples in women, 83

corresponded to U. parvum and 17

to U. urealyticum, while in 63 positive samples of men, 76

identified U. parvum and 24

U. urealyticum. The PCR-multiplex method showed specificity for the identification of the biovars or species of ureaplasmas of clinical interest.

[Antigen detection in stools as a first choice for laboratory diagnosis of Helicobacter pylori disease]. / La ricerca dell'antigene nelle feci può essere proposto come test di prima diagnosi della malattia da Helicobacter pylori.

BACKGROUND: Several techniques have been suggested for Helicobacter pylori infection diagnosis, invasive (histology) and not invasive (Urea Breath Test C13, or serological assays). An enzyme immunoassay able to detect Helicobacter pylori antigen directly in stool specimens was recently developed. A study was carried out in order to evaluate the sensibility and the specificity of this test comparing it with the Urea Breath Test C13 and histology. The patients studied are all in pediatric age, and great are the advantages of a non-invasive method to detect infection. METHODS: In this study 60 patients were enrolled. In 34 of them Helicobacter pylori infection was diagnosed by Urea Breath Test C13, all confirmed by histology. In all the 60 patients studied the fecal antigen was researched by an immunoenzymatic method (Premier Platinum HpSA, Meridian Diag.). RESULTS: The detection of Helicobacter pylori in stool shows a sensibility of 100% and a specificity of 97%. CONCLUSIONS: Sensibility and specificity, considering also the low cost of the examination, the short time to perform it and the very easy technique, allows us to propose the test as the first choice in the diagnosis of Helicobacter pylori disease.

[Indwelling central venous catheters after discontinuation of therapy and risk of infection in children with cancer]. / Permanenza del catetere venoso centrale dopo la sospensione della terapia e rischio infettivo in bambini affetti da neoplasia.

In this retrospective study we report the incidence of CVC-related infections in a pediatric oncology population during the off therapy period. We analysed 128 children with oncologic diseases (solid tumors and leukemia), 78 boys and 50 girls, aged 1 to 21 years, who maintained the CVC in situ at least 6 months after the cessation of chemotherapeutic protocols. Seventy-eight patients had a single lumen Broviac-Hickman CVC, 8 patients had a double lumen Broviac-Hickman and 42 a implantable port device. The permanence of CVC in situ after discontinuation of treatment varied between 6 and 24 months. CVC was removed in 5 patients that presented a CVC-related infection, respectively 6, 6, 6, 7 and 10 months from discontinuation of therapy, in 85 patients because was considered no more necessary. 38 patients are still with CVC in situ; in this group 11 patients relapsed more than 6 months after discontinuation of the therapy and were analysed until the time of relapsed. The result of our study show that the incidence of CVC related infections in patients off therapy is very low. Considering the discomfort that frequent blood withdrawals cause to children and the relapse risk, we think that CVC may be maintained in situ more than 6 months after discontinuation of the therapy without risks for the patients.

[Long lasting conjunctivitis: research of etiological factors]. / Congiuntiviti a lenta risoluzione: ricerca degli agenti etiologici.

Forty children with long-lasting or recurrent conjunctivitis were included in this etiological study. It is well known that purulent conjunctivitis is mainly bacterial, with a major source of infection from Chlamydia; recently, however, a greater percentage of viral forms, with the exception of conjunctivitis without secretion, has been reported. The authors focused their attention on the clinical symptoms and on bacteriological studies of the forms of Chlamydia and Mycoplasma conjunctivitis, highlighting their marked sensitivity to antibiotics and the clinical response and recommending the importance of an etiological study in all cases in which conjunctivitis does not resolve within a short period of time.

[Anti-Chlamydia psittaci antibodies in a healthy pediatric population]. / Anticorpi anti Chlamydia psittaci nella popolazione sana infantile.

Psittacosis or ornithosis is a bird disease caused by Chlamydia psittaci which can be transmitted to man. Little is known of the epidemiology of the disease in this region, but occasional cases which have been brought to the authors' attention have prompted an epidemiological study on the subject. The preliminary results indicate a surprising percentage, over 8%, of antibodies in infants and children. This percentage varies little in relation to place of residence, rural or urban, or the presence of animals, but confirms the high risk in parrot-owning households where anti-Chlamydia antibodies are found in 37.5% of children.

[A case of histiocytosis X with primary localization in the mandible]. / Su di un caso di istiocitosi X a primaria localizzazione mandibolare.

A personally observed case of histiocytosis X triggers a discussion of the prognostic aspects and therapeutic prospects for this disease.

[Changes in lactate dehydrogenase levels in acute articular rheumatism, chorea minor and the Schönlein-Henoch syndrome in childhood]. / Variazioni del tasso della latticodeidrogenasi nel R.A.A., corea minor e sindrome di Schönlein-Henoch in età pediatrica.

Changes in serum LDH in AAR, Sydenham's chorea and purpura rheumatica and their significance were investigated in 103 cases observed at the 1st Paediatrics Clinic, University of Turin. A search was made for relation between such changes and the laboratory parameters in rheumatism. The data showed that blood LDH can be profitably determined in the diseases considered.

[Psoriatic polyarthritis in childhood. Clinico-nosological study]. / Poliartrite psoriasica nell'infanzia. Studio clinico-nosologico.

The nosological independence of psoriatic arthritis is discussed in the light of the literature. The clinical and laboratory pictures of infantile psoriasis and PCP are described. Three cases of infantile psoriatic polyarthritis are presented and attention is drawn to the difficulty of diagnosing this condition in children. Longitudinal assessment of the possibility of early onset on the part of forms becoming evident during adulthood is envisaged.

[Erythema nodosum in childhood. Nosographical classification and case studies]. / L'eritema nodoso nell'infanzia. Inquadramento nosografico e contributo casistico.

A survey of the relevant literature, with particular attention to clinical and immunological studies propounding pathogenetic theories, is followed by the presentation of 32 cases of erythema nodosum observed in infants examined at the Turin Paediatrics Clinic and Regina Margherita Hospital. The clinical laboratory data showed that streptococcal infection was hardly less significant than T. B. as the cause of this condition.