1,721,065 research outputs found
Correspondence to Levetiracetam in Neonatal Seizures as First-Line Treatment
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Liver Fibrosis in Patients with chronic liver diseases: are laboratory tests useful to diagnosis?
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Opening interrupter technique in pre-school children with chronic respiratory diseases: a perspective case-control study in the diagnosis of airway hyperesponsiveness.
No full textBackground: Optimal treatment for pediatric respiratory diseases is strictly related to follow-up evaluations of lung function. The aim of our study was to show the efficacy of the Opening Interrupter Technique in diagnosing the presence of airway obstruction in pre-school children.
Materials and methods: Our study was a prospective case-control study, evaluating 82 patients affected by asthma and/or cystic fibrosis (CF) and 50 healthy pre-school children, as control group. All patients were 3- to 5-years old and they were followed by our Pediatric Department, University of Catania, Italy, from February 2011 to June 2012. Measurements of respiratory resistance (o-Rint) by the opening interrupter technique were made with the MasterScreen PFT device, Jaeger GmbH, Würzburg, Germany, during quiet breathing. The presence of airway obstruction was detected as a value of o-Rint higher than two standard deviations (SD) compared with the theoretical data.
Results: We found higher values of o-Rint in asthmatic patients than in the control group, with a high statistical difference (p < 0.0001). The same results were found when we compared patients with CF and the control group (p < 0.0001). Nevertheless, we did not find any significant statistical difference between respiratory resistances measured in asthmatic and patients with CF (p > 0.05). There was a significant inverse correlation between o-Rint and height only in asthmatic and patients with CF, but not in healthy controls (p < 0.05).
Conclusions: In our study, the opening interrupter technique was efficient in detecting the presence of obstruction in chronic patients affected by asthma and CF
Recurrent febrile infections and neutropenia in a child with silent celiac disease
No full textBackground: Today it is known that celiac disease (CD) may be silent or present with atypical extraintestinal symptoms (silent/atypical CD).
Case report: The authors report the case of a 3-year-old child in whom the diagnosis of CD was made after several admissions to hospital for recurrent febrile infections and persistently moderate neutropenia. After the beginning of a gluten-free diet, we observed a remission of febrile infections and an increase in neutrophil count until it reached normal ranges.
Conclusions: We suggest that recurrent febrile infections and moderate neutropenia be included in the diagnostic workup for atypical/silent CD in the general population
Evaluation of Helicobacter Pylori eradication in pediatric patients by triple therapy plus lactoferrin and probiotics compared to triple therapy alone.
No full textBACKGROUND: To evaluate whether the addition of a probiotic could improve Helicobacter pylori (H.P.) eradication rates and reduce the side effects of treatment in children.
METHODS: Between July 2008 and July 2011 all patients with a clinical, laboratory and endoscopic diagnosis of H.P. positive gastritis referred to our Unit were included in the study. Patients suffering from allergy to any of drugs used in the study, with previous attempts to eradicate H.P. and those who received antibiotics, PPIs or probiotics within 4 weeks were excluded from the present study. Patients were randomized into two therapy regimens (group A and B): both groups received standard triple treatment (omeprazole, amoxicillin and clarithromycin) while only group B patients were also given a probiotic (Probinul - Cadigroup). Patients compliance was evaluated at the end of the treatment. Successful eradication was defined as a negative 13 C-urea breath test (C13-ubt) result four weeks after therapy discontinuation.
RESULTS: A total of 68 histopathologically proven H.P.-infection children (32 male and 36 females) were included in the study. All of the patients in both groups used more than 90% of the therapies and no patients were lost at follow up. All side effects were selflimiting and disappeared once the therapy was terminated. Epigastric pain was observed in 6 (17.6%) group A vs 2 (5.8%) group B patients (P<0.05), nausea in 3 (8.8%) group A vs 1 (2.9%) group B patients (P<0.05); vomiting and diarrhea were observed in 2(5.8%) and 8 (23.5%) group A patients, respectively and never in group B (P<0.05). There was no significant difference between the two groups in terms of constipation (5.8% in group A and B). Four weeks after the completion of therapy, 56/68 patients (82.3%) tested negative for H.P. on C13-ubt. H.P. was eradicated in 26 patients (76.4%) in group A and in 30 patients (88.2%) in group B. There was no significantly difference in the rate of H.P. eradication between group A and group B (p=0.1), although the success rate for H.P. eradication was higher in group B than in group A.
CONCLUSION: The addition of a probiotic formula to triple therapy significantly decreased the frequency of epigastric pain, nausea, vomiting and diarrhea
NRXN1 Deletion in Two Twins' Genotype and Phenotype: A Clinical Case and Literature Review
No full textIn the literature, deletions in the 2p16.3 region of the neurexin gene (NRXN1) are associated with cognitive impairment, and other neuropsychiatric disorders, such as schizophrenia, autism, and Pitt-Hopkins-like syndrome 2. In this paper, we present twins with deletion 2p16.3 of the NRXN1 gene using a comparative genomic hybridization array. The two children had a dual diagnosis consisting of mild cognitive impairment and neurodevelopmental delay. Furthermore, they showed a dysmorphic phenotype characterized by facio-cranial disproportion, turricephalus, macrocrania, macrosomia, strabismus, and abnormal conformation of both auricles with low implantation. The genetic analysis of the family members showed the presence, in the father's genetic test, of a microdeletion of the short arm of chromosome 2, in the 2p16.3 region. Our case report can expand the knowledge on the genotype-phenotype association in carriers of 2p16.3 deletion and for genetic counseling that could help in the prevention and eventual treatment of this genetic condition. Newborn carriers should undergo neurobehavioral follow-ups for timely detection of warning signs
The immunomodulatory effect of probiotics beyond atopy: an update
No full textBackground: In the past decades, the theory of "allergen avoidance" was considered the standard treatment for preventing the onset of allergic diseases. Recently, the concept of "immune tolerance" has replaced this old theory, and induction of tolerance by exposure is actually considered the appropriate method for preventing atopic diseases and other immunomediated pathologies. On the other hand, it is obvious that for public health reasons, abandoning current medical and hygienic practices is not desirable; therefore, safe alternatives, such as probiotics, have been suggested for providing necessary microbial stimulation.
Objective: The purpose of our review is to describe the immunomodulatory and anti-inflammatory properties of probiotics, reporting literature data on their effect when used for the treatment of immunomediated diseases.
Materials and methods: Articles reporting the evidence on the use of probiotics in immunomediated diseases, such as atopy, cow's milk allergy and rheumatoid arthritis (RA), and in inflammatory diseases, such as inflammatory bowel diseases (IBDs), with or without statistical meta-analysis, were selected in three different search engines: (1) MEDLINE via PubMed interface, (2) Scopus and (3) Google Scholar for all articles published from inception to July 2013. Titles and abstracts of identified papers were screened by two independent reviewers to determine whether they met the eligibility criteria of interest to develop our review. Subsequently, full texts of the remaining articles were independently retrieved for eligibility by the two reviewers.
Results and discussion: The recent literature is focusing its interest towards the immunologic properties of relatively harmless organisms, including lactobacilli and bifidobacteria, helminths and saprophytic mycobacteria that may skew immune responses towards immunoregulation by inducing Treg cells, rather than eliciting a pro-inflammatory immune response. For this reason, recent researches have been addressed on the use of probiotics to promote immunoregulation in atopic diseases, such as atopic/eczema dermatitis syndrome and food allergy, as well as in inflammatory-based diseases such as IBDs, RA and bronchial asthma
La spirometria ed i test di broncoreversibilità in età pediatrica.
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Anti-leukotrienes in the treatment of allergic conjunctivities and comorbidities in children: an update
No full textThe term “Allergy” actually includes a variety of different diseases (rhinitis, conjunctivitis, asthma, urticaria, and dermatitis) with a common pathological basis linked to the release of chemical mediators such as histamine, platelet-activating factor, arachidonic acid metabolites, and chemotactic factors secreted by mastocytes, basophils, and eosinophils. The key-role of leukotrienes (LTs) as mediators in allergic and inflammatory response justifies possible therapeutic use of leukotriene antago-nists in other allergic diseases beyond asthma. LTs modifiers reduce asthma symptoms, short-acting beta2-antagonist (SABA) use, and asthma exacerbations, and improve all indexes of pulmonary function, as measured by the increases in forced expiratory flow at one second (FEV1), peak expiratory flow (PEF), quality of life, and indices of bronchial inflammation (blood eosino-phils, inflammatory cells in the bronchial mucosa, exhaled nitric oxide, substance P, neurokinin A, eosinophil cationic protein, and serum myeloperoxidase). Anti-LTs have also been successfully used by some authors to control allergic diseases such as rhinitis, atopic dermatitis, chronic urticaria and allergic conjuncitivitis. Moreover, recently, new reports have been published concerning other conditions (migraine prophylaxis, sleep disorders, inflammatory bowel disease, and nasal polyposis) that broaden the future range of clinical applications. Topical ocular montelukast can be a potential therapeutic drug with a new route of administration that can be used for treatment of allergic conjunctivitis
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