Adherence to antiretroviral therapy and its determinants in children with human immunodeficiency virus infection: a multicentre, national study.

AIM: To investigate rates and determinants of adherence to antiretroviral therapy in Italian children infected with the human immunodeficiency virus (HIV). METHODS: An observational, cross-sectional multicentre study was performed through a structured interview with the caregivers of HIV-infected children. The interview included quantitative information on adherence in the 4 d before interview. Sociodemographic, clinical and psychosocial characteristics of children were recorded. RESULTS: 129 children (median age 96 mo) were enrolled, of whom 94 were on highly active antiretroviral therapy (HAART). Twenty-one (16%) omitted more than 5% of total doses in 4 d and were considered non-adherent. However, only 11% of caregivers reported that therapy had been administered at the correct times. No significant difference was found between age and the stage of HIV infection. Children aware of their HIV status were less adherent. Individual drugs showed a broad adherence pattern and children who received HAART were more adherent. Children receiving therapy from foster parents were more adherent than those receiving drugs from biological parents or relatives. CONCLUSIONS: Adherence is a major problem in children. Psychological rather than clinical or sociodemographic features and types of drug are major determinants of adherence.

[Bilobectomy in a brazilian infant suffering from extensive monolateral pulmonary TBC] / Bilobectomia in un divezzo brasiliano affetto da estesa tubercolosi polmonare monolaterale.

As there has recently been a significant increase in childhood tuberculosis, we considered an important contribution the clinical case of an infant from Brazil, who underwent right bilobectomy to treat a previously poorly cured enlarged pulmonary tubercular infiltrate.

Gas chromatographic detection of class I pesticide residuals in olive oil. Preliminary data for a project on food pollution and children's health.

The data are preliminary findings in order to study the possible pollution of fresh olive oil with Class I Pesticides, often misused by olive farmers, and it's effect on children's health. The oil produced from the olives of 8 farms in a small town of Southern Italy was collected at the mill in 1992, with no previous notice to the farmers, and was analyzed by Head Space Gas Chromatographic technique. The research for organophosphates and chlorinated pesticides was negative. The Kreis test excluded oil rancidity and the index of refraction confirmed the oils being fresh olive oil. The fact that the oil samples resulted free of pesticide residuals, however, might be explained by the unusual season weather not favourable to the olive parasites and the consequent reduced amounts of pesticides used by the farmers. The work will be repeated in 1993 and completed by a dietary semiquantitative questionnaire and epidemiologic evaluations on the children's health.

In vitro effects of conalbumin on iron transport by rat intestinal mucosa.

The possible effects of conalbumin (a glycoprotein closely resembling lactoferrin) on iron transport across the brush border of intestinal cells of the rat were evaluated in vitro. Iron influx was measured in proximal and distal tracts of small intestine from either normal or iron-deprived rats, both in the presence of 1 or 10 mg/ml conalbumin and in its absence. Conalbumin did not affect iron uptake at any concentration and in any intestinal segment, either in normal or in iron-deprived animals. It was concluded that the luminal presence of conalbumin, even at a relatively high concentration, does not interfere with iron intestinal transport.

[Assay of brain and liver DNA, determination of body growth and of some blood parameters in rats subjected to protein malnutrition during fetal and post-natal development]. / Dosaggi del DNA cerebrale ed epatico, determinazione degli accrescimenti ponderali e di alcuni parametri ematici in ratti sottoposti a malnutrizione proteica durante lo sviluppo fetale e post-natale.

The Authors studied the effects of proteinic malnutrition when it occurred at various periods in the life of rats: the last 10 days of fetal life; nursing (the first 3 weeks of life); after weaning (up to 42 day). The results show that:--the growth in weight of the animals was severely restrained when protein deficiency occurred in post-natal life;--in any case, the blood levels of hematocrit, hemoglobin and proteins were significantly lowered;--organ functions and development were greatly compromised if malnutrition occurred during the period of their cell division. In fact, a brain damage, estimated by protein and DNA modifications, is the result of protein deficiency in pre-natal and, particularly, in nursing period. The hepatic damage, instead, becomes more evident in post-natal life and specially after weaning since the cell division in the liver continues for a much longer period of time.

[Values of a number of blood parameters and body growth of rats subjected to fetal and post-natal protein malnutrition]. / Valori di alcuni parametri ematici ed accrescimento corporeo di ratti sottoposti a malnutrizione proteica fetale e post-natale.

Nests of rats, generated by mothers receiving synthetic diets of different protein content during gestation and in post-pregnancy phase, have been kept under observation during suckling and after weaning care being taken that offspring received the same diet as characterised maternal feeding. It was found that in the animals receiving hypoproteic diet (6% proteins), early induced malnutrition extended up to the 40th day of life, namely the term for the cellular subdivision of almost all organs, cuts body growth by about 80% compared to control rats, and is accompanied by a remarkable drop in packed-cell volume and haemoglobin value. In parallel, the electrophoretic pictures of hypoproteic rats were characterised by a drop in serous albumin, offset by a marked rise in beta and gamma globulin, Finally, evaluation of the weigh ratios between the brain and other organs of vital importance, underlines the preferential growth of the cerebral mass in rats receiving an inadequate protein supply.

[Effect of diet with different protein content on rats during gestation: repercussion on pregnancy development and litter size. Preliminary note]. / Effetto di diete con differente contenuto proteico nelle ratte in fase di gestazione: ripercussioni sull'evoluzione della gravidanza e sul numero delle nascite. Nota preliminare.

Pregnant rats, Wistar strain, were treated from day 11 of gestation with synthetic diets containing different amounts of protein. The Group of rats fed a severely deficient protein diet (4% of casein, 2% of lactalbumin) showed reduced hematocrit, hemoglobin, total protein and an expressive increase of gamma globulins compared with rats treated with normal or elevated protein levels. Weight gain during pregnancy was higher for rats which received a larger amount of protein; on the contrary those that were subjected to malnutrition had no weight gain and bore prematurely with high percent of foetal mortality.