Simultaneous Diagnosis of Acute Crohn's Disease and Endometriosis in a Patient Affects HIV.

This is the case report of a 45-year-old woman affected by HIV, who was hospitalized for diffuse abdominal pain, constipation, and weight loss present for over one month. A colonoscopy showed the presence of a nontransitable stenosis of the ascending colon. A right hemicolectomy was performed. The histological examination reports CD with outbreaks of endometriosis. CD and the HIV infection may coexist in the same individual and it seems that HIV reduces the relapse rate in IBD patients. CD and intestinal endometriosis can also occur simultaneously. The diagnosis is often only made after surgical resection of the diseased segment. These patients were more likely to have stricturing CD but endometriosis does not seem to impact the natural history of CD.

Rectal localization of metastatic lobular breast cancer: report of a case.

The incidence of extrahepatic gastrointestinal metastases from breast cancer is reported in the literature only as necroscopy studies (6-18 percent); they usually originate from lobular or a mixed ductal-lobular subtype. Nonspecific presenting symptoms, death of the patients caused by other more frequent metastases, and variable radiographic features mimicking primary neoplasms cause a clinical underestimation of this pathology. We report here a case of rectal metastasis from a lobular carcinoma eight years after mastectomy.

Association of multiple granular cell tumors and squamous carcinoma of the esophagus: case report and review of the literature.

This report describes the case of a man who underwent subtotal esophagectomy for the concomitant presence of a multifocal esophageal squamous carcinoma and a granular cell tumor (GCT); he had been previously affected by another metachronous esophageal GCT excised endoscopically. This is the sixth case described in the literature detailing other cases of a combination of malignancies involving additional organs. We emphasize the need for a prolonged surveillance of patients with multiple GCTs in order to promptly recognize the possibility of associated neoplasms.

Cow's milk and intestinal blood loss in late infancy.

OBJECTIVES: Young infants commonly show occult intestinal blood loss when fed cow's milk, but in older infants blood loss may be less common. This study examined intestinal blood loss in response to cow's milk feeding in normal 7(1/2)-month-old and 12-month-old infants. STUDY DESIGN: Infants (n = 62) were fed formula for 1 month and then pasteurized cow's milk for 2 months. Stools were collected for quantitative determination of hemoglobin. Iron nutritional status was assessed. RESULTS: Infants fed cow's milk from 7(1/2) months of age showed a significant increase in guaiac-positive stools and in stool hemoglobin concentration. These effects were largely limited to those infants who had been breast fed early in life. Infants fed cow's milk from 12 months of age at baseline had greater stool hemoglobin concentrations than 7(1/2)-month-old infants, but cow's milk produced no significant increase. In neither age group did cow's milk affect iron nutritional status. CONCLUSION: The response to cow's milk is attenuated in infants aged 7(1/2) months compared with younger infants. By 12 months of age, the response has disappeared entirely. We conclude that the gastrointestinal tract of healthy infants gradually loses its responsiveness to cow's milk.

[Prevalence of HCV antibodies and vertical transmission of hepatitis C virus]. / Prevalenza dell'anti-HCV e trasmissione verticale del virus C.

HCV infection is one of the most frequent causes of hepatitis in man. There are numerous means of infection, not all of which can be documented. In infancy HCV infection occurs particularly in children that have been multitransfused or are on dialysis. Vertical transmission of HCV infection is rare, and the times and means of occurrence are not as yet well defined. The present study sets out to establish the prevalence of HCV-Ab carriers within a population of 4,242 pregnant women in Verona (Italy). It also aims to assess the incidence of vertical transmission of HCV infection in a sample of newborns examined over a 15-months follow-up. Of the 4,242 pregnant women subjected to screening, 45 (1.06%) were HCV-Ab positive. In only 74% of the cases it was possible to identify an HCV infection risk factor. On the 45 children of the HCV positive mothers, at present 25 have completed the 15 months follow-up. Only one of these children has contracted the infection: the incidence of transmission is therefore 4%.

[Obesity in pediatrics: statistical analysis of school performance of obese children]. / L'obesità in Pediatria: analisi statistica del rendimento scolastico dei bambini obesi.

We examined the school performance of 936 normal children (431 males, 434 females) and 71 obese children (39 males, 32 females) aged between 8 and 13 years (mean 11 years and 6 months +/- 1 year) attending 2 primary school in a district of our town characterized by a good socio-cultural level. In total the subjects studied were 1007. Results showed that: 1) females had a school performance significantly higher than males (p < 0.005); 2) obese patients (both males and females) had a school performance significantly higher than normal children (p < 0.001). This observation may be explained by the consideration that good school attendance implies: a) stress inducing a compensatory mechanism of hyperalimentation; b) lower physical activity. Another interpretation may also be suggested: children already obese attend the school more diligently in order to be better accepted and to counterbalance their negative self-image.

[A case of slowly resolving enteritis caused by Clostridium difficile]. / Un caso di enterite a lenta risoluzione da Clostridium difficile.

Clostridium difficile is considered as the most important cause of severe antibiotic-associated diarrhea and pseudomembranous colitis. We describe the case of an one year old boy presenting C. difficile chronic diarrhea without previous antibiotic treatments.

Latex allergy in a child with banana anaphylaxis.

Allergy to latex and to banana is probably uncommon. Cross-reactivity between these two antigens has been recently demonstrated, but the clinical association of allergic reactions to latex contact and banana ingestion is extremely rare. We report a 3-year-old boy who developed an anaphylactic reaction following banana ingestion and who presented an associated immediate hypersensitivity to latex.

[Gastroesophageal reflux and respiratory pathology: a study comparing radiology and intraesophageal pH measurement]. / Reflusso gastroesofageo e patologia respiratoria: studio comparativo fra radiologia e pH-metria intraesofagea.

From November 1st, 1992 to August 31st, 1993 45 children with respiratory symptoms of gastroesophageal reflux (GER) were tested with barium esophagogram and 24 h intraesophageal pH-monitoring to determine their sensitivity in detecting gastric acid reflux and to document their usefulness as a prognostic indicators. Results showed that thirty-seven of these patients had GER on esophagograms and that 24 h intraesophageal pH monitoring was positive in thirty-nine patients. However, we found a high incidence of false-negative results of the upper gastrointestinal series when the pH monitoring was positive.

Ki67 immunohistochemical evaluation in colorectal cancer and normal colonic mucosa. Possible clinical applications.

Cell proliferation was evaluated by Ki67 monoclonal antibody in 33 colorectal adenocarcinomas and in the normal colonic mucosa. Immunoreactivity was assessed independently by two observers in two subsequent evaluations with a semiquantitative method, by counting at least 2000 cells in two distinct neoplastic specimens (central and peripheric section). There was an excellent intra-inter observer agreement in Ki67 score for each specimen. The tumor score range from 7 to 70% (median 48.8), without any significant correlation with sex and age of the patient and location, size, staging and grading of the neoplasm. Tumor Ki67 score was almost identical in central (46.96%) and in peripheral section (49.24%), and always higher than in normal mucosa. There was no distinction in Ki67 score in normal mucosa at various distances from the tumor. In our experience, Ki67 provides a reliable and reproducible method for assessment of proliferative activity; its clinical applications need further studies.

[Cooperation between the occupational health department and the technical assistance office to confront the problem of pollution by anesthetics]. / Collaborazione fra servizio di medicina del lavoro e ufficio tecnico per affrontare il problema dell'inquinamento da anestetici.

In the past years the problem related to occupational exposure to anaesthetic gases in operating rooms has been dealt with in different ways by each hospital administration, and frequently with little cooperation between the health departments involved. At the Spedali Civili of Brescia in the five year period, 1987-1991, a monitoring activity of nitrous oxide (N2O) and halogenated anaesthetics was performed in 30 operating rooms. This lead to a noticeable reduction of environmental concentrations of these substances. Favourable results have been achieved principally by maintenance and/or substitution of anesthesiological machine parts. In order to organize and facilitate this program a close collaboration was accomplished between the Medical Direction of the Hospital and the Occupational Health Department, with the support of the Technical Assistance Department.