Plasma protein binding of dicloxacillin: effects of age and diseases.

Dicloxacillin protein binding was investigated in sera from 10 umbilical cords, 20 children (aged between 2 and 21 months) and in the plasma from 8 healthy young subjects, 7 healthy elderlies, 10 patients with liver cirrhosis, 10 patients with renal failure (glomerulonephritis) and 10 chronic uremics maintained on hemodialysis. The percentage unbound fraction (mean +/- SD) of dicloxacillin was 7.3 +/- 0.8 (healthy subjects), 9.8 +/- 0.6 (umbilical cords), 7.4 +/- 2.8 (children), 8.8 +/- 1.0 (elderlies), 11.8 +/- 6.3 (cirrhosis), 10.5 +/- 2.0 (renal failure), 12.7 +/- 2.0 (before hemodialysis) and 11.7 +/- 2.1 (after hemodialysis). Healthy subjects were different from all the groups (0.001 greater than p greater than 0.05) except children (p greater than 0.5) (Student's t-test). Human isolated albumin (45 g/l) bound dicloxacillin at the same degree as the plasma of healthy subjects. The kinetics of dicloxacillin protein binding was studied in three umbilical cord serum, three adult plasma specimens and in human serum albumin. The number of binding sites (n) and the association constant (k) were estimated by Lineweaver-Burk double reciprocal plot.(ABSTRACT TRUNCATED AT 250 WORDS)

[Syndrome of ventricular overdrainage in children with fluid shunts]. / Sindromi da iperdrenaggio ventricolare in bambini portatori di shunt liquorali.

The authors emphasize the possible complications following the surgical operation by ventriculocaval or ventriculoperitoneal shunts in the neonatal hydrocephalus. These complications are mainly caused by the liquoral hyperdrenage which occurs for the differential pressure of the valve system, since this valve is operating by the differential pressure between cerebral ventricles and the receiving cavities and not by the absolute pressure existing in the ventricular cavity. The following late complications are examined: a) chronic subdural haematoma; b) slit ventricle syndrome. Their evolution often is deceitful and severe problems of differential diagnosis with others pathological infantile states arise.

Serum protein binding of furosemide in newborn infants and children.

The protein binding of furosemide was studied in the serum from 8 umbilical cords, in 51 children (aged between 2 weeks and 13.5 years) and in the plasma of 10 volunteers (aged between 28 and 42 years). The drug was added to the buffer to give a final concentration of 2 micrograms/ml. The unbound fraction of furosemide was 2.5 +/- 0.1% (cord serum) and 1.7 +/- 0.7% (adult plasma). These figures are different at a level of 0.001. The unbound fraction of furosemide reached the adult values during the 1st year of life. A correlation (level of significance greater than 0.01) was found between the unbound fraction and the age during the first 6 months of life. The furosemide binding kinetics were studied in 3 cord serum and in 3 adult plasma samples. The concentration of the drug in the buffer ranged between 1 and 16 micrograms/ml. The kinetic constants (mean +/- SEM) were: association constant (K = 10(5) M-1) 2.4 +/- 0.3 (cord serum), 2.0 +/- 0.2 (adult plasma); the number of binding sites per gram protein (n = 10(-6] was 3.2 +/- 0.5 (cord serum) and 3.9 +/- 0.7 (adult plasma). When the concentration of furosemide was increased up to 200 micrograms/ml buffer, the free fraction of the drug increased up to 4.8 +/- 0.2% (cord serum) and 2.9 +/- 0.4% (adult plasma).

[Therapy of atopic dermatitis in children. Study on the use of a desensitizing preparation]. / Sulla terapia della dermatite atopica nel bambino. Studio sull'impiego di un preparato iposensibilizzante.

Children with Atopic Dermatitis have been treated with Histaglobin (gamma globulin + histamine) applied by hypodermic injections. The patients (42) were divided into three groups: the first one (ten cases) aged between 9 and 5 years; the second one (eight cases) between 5 and 2 years and the third one (twenty four cases) aged less than two years. The trial has been carried out in two phases: the first one consisted of nine injections with increasing doses ranging from 1/3 to 1 ampoule with 4-6 day intervals; the second one, "the maintenance period", was made by nine injections of 1 ampoule with increasing intervals from two up to four weeks. The following four parameters were checked along all the therapy period: prurigo, erythema, exudation, scratching lesions. All the listed symptoms have been observed to decrease of intensity mainly during the first phase, until the complete disappearance of some of them; the residual symptoms continued to have a further improvement during the second phase; in most case disappeared completely. Absolutely no troubles of any kind have been noticed. Consequently the Authors consider the desensitization therapy by Histaglobin on the whole satisfying.

[Herpesvirus simplex disease in the newborn infant. Clinical aspects, diagnosis, prophylaxis, therapy]. / La malattia da HVS nel neonato. Clinica, diagnosi, profilassi, terapia.

Herpes Simplex virus infection (Particularly by HVS2) is one of the most important disease transmitted by mother to newborn because of the seriousness of symptoms and the high incidence of genital infection of pregnants. Transmission of congenital HVS infection occurs usually by contact with infected genital secretions during the birth process, but there is evidence that transplacenter transmission also may occur. Emphasis must be placed then on prophylaxis of genital infection of pregnants and of their partners. Specific Immunoglobulins with high antibody titre are recommended for prophylaxis. An anti HVS2 vaccine without oncogen property os still at experimental stage. This prophylaxis is inadequate for the newborn of infected mother: this one must be treated with newer antiviral agents (Acyclovir), even is absence of herpetic lesion and other symptoms.

Effects of development, aging, and renal and hepatic insufficiency as well as hemodialysis on the plasma concentrations of albumin and alpha 1-acid glycoprotein: implications for binding of drugs.

The concentrations of total proteins, albumin, alpha 1-acid glycoprotein (AGP), and nonesterified fatty acids (NEFA) were measured in the serum of 21 newborn infants and 13 children, aged 1-13 months, and in the plasma of 31 volunteers, 25 patients with renal failure, 27 patients with cirrhosis, 39 uremic patients undergoing hemodialysis, and 20 elderly subjects. The concentration of albumin in the volunteers was higher than in all other groups. The concentration of AGP in the volunteers was higher than in newborn infants but lower than in elderly subjects, patients with renal failure, and those with chronic uremia. The concentration of NEFA in volunteers was higher than in newborn infants and patients with renal failure and lower than in elderly subjects and patients with cirrhosis.

[Sinusitis in children. Personal case study]. / Le sinusiti nel bambino. Casistica personale.

The presence of sinusitis has been found out 85 times out of 278 cases of acute relapsing respiratory diseases in children between 4 and 12 years of age. The maxilla sinuses have been those most frequently stricken; the frontal sinuses come next and last at a distance the sphenoidal sinus. A close relationship between the entity of basic respiratory pathology and the presence and seriousness of the sinusitis has been observed. There also seems to be a rather close relationship between the frequency of the presence of sinusitis in children with respiratory pathology either relapsing or chronic and climatic environmental situation. A damp climate with persistent fog together with industrial atmospheric pollution seems to favour the considered pathology in an undisputed way.

Clonazepam serum protein binding during development.

Clonazepam protein binding was investigated in sera from five different umbilical cords, 45 children (aged 2 mo to 12 yr), and five adults (aged 27 to 40 yr). The unbound fraction (means +/- SE) of clonazepam was 17.3% +/- 0.7% in umbilical cord serum and 13.9% +/- 0.2% in adult serum (P less than 0.01). In children, the unbound fraction of clonazepam reached the adult values during the first year of life. The kinetics of clonazepam serum protein binding were studied in three umbilical cord serum and three adult serum specimens. The number of binding sites (n, reported as moles per gram protein) and the association constant (K, reported as M-1) were estimated from double reciprocal plots of 1/r against 1/D (r is the number of moles bound per gram plasma protein; D is the molar concentration of unbound drug). In umbilical cord sera, the mean values (+/- SE) of n and K were 8.4 +/- 0.6 X 10(-7) mol/gm and 8.3 +/- 0.9 X 10(4) M-1. In adult serum samples the corresponding values were 3.0 +/- 0.8 X 10(-7) mol/gm and 2.7 +/- 0.6 X 10(5) M-1, which indicated lower binding capacity but higher affinity for clonazepam of plasma proteins in adults than in children.

[Empyema of the gallbladder in an 8-year old boy]. / Empiema della colecisti in un bambino di 8 anni.

A case of empyema of the gallbladder in a eight year old child is reported. The child presented simptoms relatively constant in the hydrops of the gallbladder, nomely abdominal pain usually confined to the right upper quadrant and or epigastrium, fever, nausea, vomit, dehidratation; a tender abdominal mass was palpable. As usually occurs in childhood, the acute distension of the gallbladder followed in this report, to preceding focus of infection (angina and cervical lymphadenopathy). Ultrasonography permitted to address the correct diagnosis. This was later confirmed at surgery and from histopathologic study.

[Urinary tract infections in premature infants: considerations on the reliability of bladder catheterization and other methods of urine collection for bacteriological study]. / Infezione delle vie urinarie nell'immaturo: osservazioni sulla attendibilità del cateterismo vescicale e di altri metodi di raccolta delle urine per lo studio batteriologico.

The collection of urine by the use of adhesive plastic bags even if simple is not unfailing procedure for making diagnosis of urinary tract infection (U.T.I.) because of contamination with bacteria located on the external genitals. This is particularly true in the case of the premature baby. Therefore this method of urine's collection has been considered not enough satisfactory in symptomless cases since an early diagnosis of U.T.I. in this premature babies is extremely important. The Authors suggest that after a first positive test response by urine's collection with adhesive plastic bags is extremely important to collect the urine with a catheter specimen in the females and with sterile test tube in the males. Using these criteria, satisfactory results have been obtained. To prevent possible bladder urine contamination by catheter use, antibiotic treatment had been applied for few days after specimen collection. The non catheter specimen collection of the urine remains of course, one of the most important test to detect pyuria during U.T.I.