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Biomedical subjects

A Vierucci

Publications and source records attributed to A Vierucci.

221 records · Page 13Linked to original sources

Evaluation of the efficacy of oral cromolyn sodium or an oligoantigenic diet in children with atopic dermatitis: a multicenter study of 1085 patients.

One thousand eighty-five children with atopic dermatitis were enrolled in a multicenter study to evaluate the efficacy of 4 weeks of oral sodium cromoglycate or 4 weeks of a restricted diet. One thousand-eleven children (93%) concluded the study. At the end of the trial there was a significant improvement in skin lesions in the two groups: 61% of the patients in the sodium cromoglycate group and 69% in the restricted diet showed a significant improvement in atopic dermatitis. We concluded that, at least in our experimental design, both sodium cromoglycate and a restricted diet are equally effective in atopic dermatitis.

Administration, Oral↗

[Allergy to latex evaluated at an allergology clinic].

Natural rubber latex allergy is responsible for a wide spectrum of clinical symptoms ranging from rhinoconjunctivitis to severe anaphylaxis both in adults and children. The aim of this study was to investigate the prevalence and clinical significance of latex sensitization in children evaluated for allergic disease. Four hundred fifty three consecutive children evaluated for allergic disease in a university outpatient allergy clinic were screened. A detailed clinical history with particular attention to the past surgical history and the use of natural dummies or pacifiers was obtained. Skin prick tests (SPT) for the more important inhalants and foods were performed on all children. In patients with positive latex SPT, latex challenge and RAST as well as patch test with latex were also done. Ten out 326 atopic children (3%) presented positive skin test to latex, but only five (1.5%) also had a positive clinical history to latex exposure. Latex challenge was positive in 3/9 positive latex SPT children. None of the non-atopic children had positive skin test to latex or symptoms to latex exposure. A history of previous surgery was found in 5/10 positive latex SPT children, in 63/316 negative latex SPT atopic children (p < 0.05) and in 23/127 non-atopic children. The use of natural dummies or pacifiers was similar in atopic (positive or negative latex SPT) and non-atopic children. RAST to latex was positive in 5/10 positive latex SPT children. Latex SPT sensitivity was demonstrated in a moderate proportion of atopic children (3%) even if only half of these patients had a positive clinical history to latex exposure. Latex challenge was positive in 3 out 9 latex SPT positive children. SPT to latex is a safe and simple method to detect sensitive patients and should be included in the routine PT series of inhalant allergens.

Adult↗

[Clinical and physiopathological significance of pneumatocele in pulmonary pathology in children].

Two cases of pneumatocele are reported. As our cases suggest and as the literature reports, the pneumatoceles are almost always benign lesions, whose resolution is only partially influenced by the therapy. On contrary their worrying radiological aspect and their long persistence can induce erroneously to think not efficacious the started therapy and therefore to change it. The etiology and the pathogenesis of pneumatocele are not completely clarified, even if various theory have been proposed.

Child↗

Local nasal immunotherapy with a powder extract for grass pollen induced rhinitis in pediatric ages: a controlled study.

Forty pediatric patients, ranging from 5-13 years of age and suffering from grass pollen rhinoconjunctivitis, were submitted to local nasal preseasonal (12 weeks) immunotherapy, either with a grass pollen extract or with placebo. After 1 year, 15 of these patients (5 previously treated with active product and 10 with placebo) were treated with the grass pollen extract preseasonally for 2 consecutive years. Before and after treatment, serum total IgA and IgE, and specific IgG and IgE were assayed as well as carrying out nasal provocation tests (NPT) with extracts at different concentrations, endpoint evaluations by rhinomanometry and prick tests with different concentrations of extract. After only 1 year, the actively treated patients showed a significant decrease of daily nasal and conjunctival signs and symptoms-as judged by a 1 to 3 score-in comparison with the control group. The placebo group showed the same results after the 3rd year. The improvement was confirmed by a significant increase of the dose threshold in NPT. No immunological alterations were evident.

Administration, Intranasal↗

Chickenpox complications among immunocompetent hospitalized children in Italy. Acyclovir-Chickenpox Italian Study Group.

OBJECTIVE: To evaluate the frequency and clinical spectrum of chickenpox complications among immunocompetent hospitalized children. PATIENTS AND METHODS: Multicentre retrospective study of clinical records of all patients consecutively hospitalized for varicella during the last decade, in ten tertiary care clinical centres of Pediatrics and Infectious Diseases, throughout Italy. RESULTS: Two hundred and nineteen out of 991 patients (22.1%) hospitalized for varicella suffered from a complicated disease (247 complicating events on the whole). Central nervous system (CNS) involvement was prevalent (104 episodes), followed by skin/soft tissue infections, lower respiratory tract involvement, and thrombocytopenia. A complicated disease was significantly associated with the male gender and an elevated incidence of varicella-zoster (VZ) virus infection acquired by household contacts. The involvement of lower respiratory airways and skin/soft tissues seemed to occur at an earlier age, compared with CNS and thrombocytopenia. Moreover, lower respiratory tract and skin/soft tissue infections occurred earlier during disease course than complications interesting the CNS and coagulation system. All subjects with complicated chickenpox showed a favourable outcome within 5-40 days, except two patients developing a lethal cardiomyopathy and Reye syndrome, respectively. Anyway, chickenpox complications led to a prolonged hospitalization, and needed further pharmacologic treatment in all evaluated cases. The administration of anti-VZ virus treatments (i.v. acyclovir or VZ immunoglobulins) did not modify significantly the course of disease in treated patients, when compared with untreated ones. CONCLUSIONS: Although chickenpox is considered a self-limiting, uncomplicated disease in immunocompetent children, when assessing hospitalized patients a considerable incidence and a broad spectrum of complications are observed, requiring prolonged admission and pharmacologic and supportive care. Even though a lethal outcome remains a rare occurrence, it may be of relevant concern when considering the overall incidence of chickenpox in the general population. The role of an early antiviral treatment in reducing the incidence and severity of varicella complications deserves further evaluation.

Acyclovir↗