Oral immunoglobulins for treatment of acute rotaviral gastroenteritis.

OBJECTIVE: Preliminary evidence has been reported on the antirotavirus effect of human serum immunoglobulin administered orally. The aim was to see whether such treatment might be effective in rotavirus acute gastroenteritis. METHODS: A prospective, double-blind, placebo-controlled study was performed. Ninety-eight children admitted with acute gastroenteritis were enrolled and randomly assigned to groups A (treated) and B (control). Children in group A received a single oral dose of 300 mg/kg body weight of human serum immunoglobulin. Parameters of efficacy were clinical condition, frequency and consistency of stools, duration of diarrhea, duration of viral excretion, and length of hospital stay. Antirotaviral activity was determined in the immunoglobulin preparation by a specific neutralization assay. RESULTS: Seventy-one of the 98 children enrolled had rotaviral gastroenteritis; 36 belonged to group A. Children who received immunoglobulin had significantly faster clinical improvement of clinical condition and stool pattern than control children. Mean total duration of rotaviral diarrhea was 76 hours in group A and 131 in group B (P < .01). Viral excretion lasted 114 and 180 hours, respectively (P < .01). Hospital stay was significantly reduced in children in group A. Neutralizing antibodies against rotavirus were detected in the immunoglobulin preparation. CONCLUSION: Oral administration of immunoglobulin is associated with a faster recovery from acute gastroenteritis and should be given to children hospitalized with this illness.

[Proposal of a surgical technique to avoid deformities after conservative treatment of T1 tumors of centroinferior quadrants of the breast]. / Proposta di tecnica chirurgica per evitare deformità dopo trattamento conservativo dei tumori T1 dei quadranti centro-inferiori della mammella.

An important aim of breast surgery is to perform a conservative treatment in which both oncological and cosmetic purposes are fulfilled. This is achieved for the T1 tumors of the upper quadrants by means of the elliptical radial quadrantectomy. In the central or inferior quadrants the cosmetic results performing the same technique are poor. We have recently published a new technique called Centroinferior Hemimastectomy for the treatment of T1 breast cancer with which both the aims are respected. We report the data obtained from thirty-three consecutive Centroinferior Hemimastectomies performed from January 1989 until June 1993. The tumors were removed as described and for those centrally located also the nipple areola complex was removed. The reconstruction was carried out by immediate reimplantation of the nipple (10 cases) or later by tattooing (16 cases). For the tumors located in the inferior quadrants, the nipple-areola complex was made to emerge through the circular skin incision and sutured separately (7 cases). The oncological follow-up (range 3-42 months, mean 16 months) did not show local or systemic relapses. The cosmetic evaluation of the patients was subjectively and objectively very good. Thus the technique can be considered a research progress offering a better quality and quantity of life.