[Neuroradiological and electroencephalographic clinical considerations on a case of encephalo-trigeminal angiomatosis (Sturge-Weber disease)].
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Biomedical subjects
Publications and source records attributed to A Paci.
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A case of empyema of the gallbladder in a eight year old child is reported. The child presented simptoms relatively constant in the hydrops of the gallbladder, nomely abdominal pain usually confined to the right upper quadrant and or epigastrium, fever, nausea, vomit, dehidratation; a tender abdominal mass was palpable. As usually occurs in childhood, the acute distension of the gallbladder followed in this report, to preceding focus of infection (angina and cervical lymphadenopathy). Ultrasonography permitted to address the correct diagnosis. This was later confirmed at surgery and from histopathologic study.
The collection of urine by the use of adhesive plastic bags even if simple is not unfailing procedure for making diagnosis of urinary tract infection (U.T.I.) because of contamination with bacteria located on the external genitals. This is particularly true in the case of the premature baby. Therefore this method of urine's collection has been considered not enough satisfactory in symptomless cases since an early diagnosis of U.T.I. in this premature babies is extremely important. The Authors suggest that after a first positive test response by urine's collection with adhesive plastic bags is extremely important to collect the urine with a catheter specimen in the females and with sterile test tube in the males. Using these criteria, satisfactory results have been obtained. To prevent possible bladder urine contamination by catheter use, antibiotic treatment had been applied for few days after specimen collection. The non catheter specimen collection of the urine remains of course, one of the most important test to detect pyuria during U.T.I.
82 children (47 male and 35 female), aged between 2 and 12 years, with signs and symptoms consistent with spasmophilia, were investigated with an emg technique to better define boundaries of tetanic syndrome. In all subjects an ischaemic test was performed to the upper limb and the spontaneous emg activity from thenar eminence was recorded both during and after ischaemia. Moreover a clinical examination, with particular attention to objective signs of spasmophilia, were performed and serum electrolytes determined. Electromyographic spontaneous activity was noticed in 46 children (24 female, 22 male), 31 of them were hypocalcemic. The frequency of the various clinical manifestations is reported and correlated with emg and humoral findings. Significant difference between sexes in the incidence of tetanic syndrome where not noticed. More frequent symptoms for spasmophilia are tensive headache and cramps, abdominal spasms, psycomotos instability and anxiety; Chvostek's sign is frequent but no specific. The other symptoms assume relevance only if present in association. The role of electromyographic criteria in the detection of tetanic syndrome is stressed.
Of 144 cases of enuresis we have studied the distribution according with the age in which the subjects have been treated by a doctor for a first consultation, the clinical form (only night, only day, mixed), the sex. We have examined the familiarity, the associated pathology (encopresis, anorexy), the spontaneous evolution and after therapy. Authors have followed a therapeutic scheme that provides for "conditio sine qua non" a practice in the child to reduce, until suspension, the swallowing of liquids during and after the evening meal and in the previous hours, for the whole period of treatment. Cures employed: a preparation with atrapine, ephedrine (Noxenur) and a preparation of dry extract of rear hypophysis (Disipidin), given in series. Another group of subjects has been treated with mipramine. Authors have reached satisfying results by these means, they employ in any case of enuresis on condition to be over 7 years old, because, at this age, there is a more effective and constant collaboration by the subject. Presented the results of EEG and EMG, too.
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The etiopathogenetic bases of atopic dermatitis are still much discussed and controversial. Nevertheless most of the Authors agree upon the pathogenetic role of an IgE mediated hypersensitivity mechanisms with respect to many alimentary and/or environmental allergens. We have looked for the IgE mediated sensitization to the house dust mites by means of skin tests (prick) and/or haematic dosage of specific IgE (F.A.S.T.) in a group of 40 children aged less than 6 with atopic dermatitis. We have divided the examined children into three groups according to their age and found out a high percentage of dust mites sensitization in the children of the oldest age group. This datum could give credit to the hypothesis of a pathogenetic role developed by the allergy to dust mites in the keeping of eczematous lesions. From the anamnestic search emerge both the leading role developed by dust mites on the development of allergic breathing pathology in the subjects with atopic dermatitis and the finding out of a settled exordium of breathing manifestations due to dust mites at an older age in comparison with the age in which the cutaneous disease manifests itself. These observations lead us to recommend a very accurate environmental cleaning since the first manifestations of atopic dermatitis prescinding from the checking of a demonstrated IgE mediated house dust mites hypersensitivity.