[The follow-up in adulthood of subjects with progressive rheumatic disease in childhood. Considerations of secondary prevention]. / Controllo in età adulta di soggetti con pregressa malattia reumatica nell' infanzia. Considerazioni sulla profilassi secondaria.

We reviewed 57 patients who had previously suffered from rheumatic fever (RF) after an average period of 7.2 (+/- 2.8) years without penicillin prophylaxis. In 24 cases (42%) RF began with carditis and in 9 patients valvular damage remained after hospital discharge. Prophylaxis with retard penicillin every four week was carried out for 5.5 +/- 1.8 years. At present the patients are all asymptomatic. There was in 7 cases mild valvular damage without clinical and instrumental involvement. There was not recurrency after the end of prophylaxis, except for a doubtful case, analysed in the Discussion. Although our cases are not numerous, we believe that a regular prophylactic treatment over 5 or 6 years is sufficient to avoid any recurrency in patients with previous RF. After this period of treatment, only subjects with valvular damage should have further extensive treatment until their 20th year and always for a period not shorter than ten years.

[Behavior of blood folate in children with thalassemia major under transfusion therapy and in thalassemia trait]. / Comportamento della folemia in bambini affetti da talassemia mayor in regime trasfusionale e in portatori di tratto talassemico.

The folic acid plasma level in 12 out of 13 children with thalassemia major was lower than 3 ng/ml. This deficiency is not due to intestinal malabsorption. Folate deficiency should then be provoked by an increased allowance due to the compensatory erythropoiesis and to the lack of. Folic acid level less then 3 ng/ml in 24% and not more then 6 ng/ml in 50% of thalassemic heterozygotic children has been found. Therefore the necessity of folic acid treatment in thalassemic children with a low blood transfusional therapy and in beta-thalassemic heterozygotic children has been recommended.