[Nicolau syndrome caused by penicillin preparations: review of the literature in search for potential risk factors]. / La sindrome di Nicolau da preparati di penicillina: analisi della letteratura alla ricerca di potenziali fattori di rischio.

The Authors, who in 1977 published the first Italian case report of the Nicolau syndrome (N.S.) from penicillin preparations in the pediatric field, accomplished a thorough search for similar reports in the world literature finding a total of 102 cases, of whom 80 were less than 12-year old. They made a detailed analysis of each case in that series in order to identify or better define potential risk factors or predisposing circumstances worth being taken in consideration for preventive purposes. Indeed, the possible occurrence of N.S., which may include devastating complications such as limb gangrene, paraplegia, or death and have medico-legal implications, is still largely underrated or unrecognised by both physicians and nurses. It is unfortunate in particular that no acknowledgement of that syndrome is available in the teaching programs and textbooks used in professional nurse schools; in addition physicians are not enough zealous in discouraging unqualified lified people as well as patient's relatives from performing intramuscular injections, mainly using certain kinds of drugs such as crystalline suspensions. On the basis of the findings of their analysis as well as of an overall review of the relevant literature the Authors conclude their paper by making a series of specific recommendations and/or proposals addressed to the various operators involved in the matter (prescribing physicians, managers of nursing schools, nurses, pharmaceutical companies, Regulatory Health Authority), with special emphasis on the precautionary measures to be taken in doing intramuscular injection of long-acting penicillins or other drugs in crystalline suspension.

[N.B.T. - PABA screening test for exocrine pancreatic function in healthy children. Preliminary investigation in 60 normal children]. / N.B.T. - PABA-test: screening diagnostico della funzione pancreatica esocrina. Indagine preliminare su 60 soggetti sani.

The theoretical bases of PABA test as a diagnostic screening test of exocrine pancreatic insufficiency, its mode of execution and the findings obtained in 60 healthy subjects ranging in age from 2 to 14 years are reported. Those conditions related to extra-pancreatic disorders or to other factors that may interfere with the test and reduce its reliability are also discussed.

Three cases of ring chromosome 2, one derived from a paternal 2/6 translocation.

Two cases of primary ring chromosome 2 and one case of a ring secondary to a paternal 2/6 translocation are described and compared with a fourth case of ring 2 from the literature. The breakpoints in two cases are identical and the same as the breakpoint on chromosome 2 in the composite 2/6 ring. The three primary rings have a number of symptoms in common, but other cases are needed to identify a possible deletion syndrome. The levels of the enzyme MDH-1 were within the normal range in Cases 1 and 2. Thus we localised the locus for MDH-1 to segment 2p23 leads to p25; this had previously been localised to segment p23 leads to pter.

Pulmonary alveolar microlithiasis. A case report with a discussion of differential diagnosis.

The rare disease of pulmonary alveolar microlithiasis is characterized by innumerable microscopic stones, mainly of tribasic calcium phosphate, within the pulmonary alveoli. In a 13-year-old boy an earlier radiological examination showed diffuse lung opacity. The main differential diagnoses taken into consideration were sarcoidosis, idiopathic hemosiderosis, diffuse interstitial fibrosis and alveolar proteinosis. The correct diagnosis was made after a lung biopsy which showed intra-alveolar microliths. The radiological findings are in agreement with the reports in the literature. The specific X-ray features of pulmonary alveolar microlithiasis are calcified opacities, nodules, hilifugal trabeculations and pleural striae. These radiological signs are sufficiently diagnostic to restrict lung biopsy to particularly difficult cases. The disease is resistant to all therapeutic measures.