Juvenile Rheumatoid Arthritis is a heterogeneous disease currently divided into different subtypes based on clinical characteristics. Significant alterations in frequencies of HLA-A, B and DR antigens have been described previously in children with pauciarticular onset Juvenile Rheumatoid Arthritis. We report the results of a study on 42 italian children with pauciarticular onset Juvenile Rheumatoid arthritis that partially confirm the literature data.

Arthritis, Juvenile↗

PubMedDate not supplied

[Evaluation and treatment of the enuretic child: eight years' experience].

Enuresis is a common functional problem among children which is defined as a complete involuntary voiding of urine at an age which control should be present. Bed wetting generally resolves with increasing age, but the restriction in social life and the psychological secondary problems, so frequent in older patients, justify an appropriate treatment of the problem in the child over seven. At children's Hospital of Florence University an enuresis service exists since 1983, and during these years 541 children applied to the structure. 326 children completed the treatment, among these there were 202 boy and 124 girls with age between 6 and 19. All the patients have been initially helped only with conversation (motivational counseling) and 76 among them (23% of the whole) obtained permanent cure. The remaining 250 children were treated with the conditioning alarm system, always associated to periodic conversation, urine stop exercises and other psychological support (token economy, etc). There were 161 boys and 89 girls: 220 children had nocturnal primary enuresis and 30 secondary. The family history was positive in 77%. The results obtained of this kind of treatment after a follow-up of 6 months, were permanent recovery in 211 children (84%) and failure in 39 patients (16% of the cases). There have been 35 relaxes. Regarding the sex, no significant difference was noted. These positive results with the conditioning devices favor the view that the etiology of primary enuresis is mainly biologic. The bell alarm represents the most effective treatment for nocturnal enuresis included more than seven.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMedDate not supplied

[Influence of iron metabolism on the efficacy of r-HuEPO (recombinant human erythropoietin) treatment of anemia in children on hemodialysis].

Recombinant Human Erythropoietin (r-HuEPO) is efficient in the treatment of anaemia in terminal renal failure under dialysis. Five pediatric patients, who were under periodic hemodialysis, were treated and the interaction between the metabolism of iron and the response to r-HuEPO was studied in particular. In two patients it was noticed that a significant reduction of hematic ferritin levels occurred, while an efficient erythropoietic activity was maintained. On the contrary, three patients showed iron deficiency characterized by a reduced percentage of total transferrin saturation in the plasma, in the presence of high levels of ferritin in the blood. Also discovered was a missing increase or even a fall of the hemoglobin values that were obtained till now. In these cases, the increase of the hormone dose didn't lead to an improvement, that could only be obtained by the oral or parenteral administration of iron. The Authors in conclusion affirm that iron deficiency is the first cause to be searched for and to be corrected in the presence of missing hemoglobin increase even with adequate doses of r-HuEPO.

Adolescent↗

PubMedDate not supplied

[A multicenter study of child poisonings. Preliminary epidemiological results].

The project of a multicentre study of poisoning in children planned by 4 Italian pediatric departments to get epidemiologic and clinic information is presented. The study is carried out retrospectively on admissions during 1975-90 and prospectively during 1991-92. Poisonings are classified as not-confirmed, asymptomatic because of early treatment or symptomatic. In the latter group three degrees of severity are assessed. Diagnostic-therapeutic protocols will be elaborated and quality of the hospital care evaluated according to peer review methodology. Preliminary data on changing pattern of poisoning over the time and on main toxic agents involved in younger children are also reported. The first topic has been studied taking into account 1831 patients aged 0-13 years, admitted during 1977-79 and 1987-89. A decrease of exposures to drugs and an increase of poisonings under the age of 3 years have been observed in more recent period. On the other hand household products resulted to be the main poisoning agents in 1044 children under the age of 5 years during 1984-86. Lack of infant supervision by parents and possible influence of compulsory child resistant containers only for drugs are stressed. The findings suggest the need of health education campaigns in general population as well of safety devices for some domestic harmful products.

Age Factors↗

PubMedDate not supplied

[Juvenile rheumatoid arthritis].

Juvenile rheumatoid arthritis (JRA) is the most common rheumatic disease in children. It is one of the more frequent chronic illnesses of childhood and an important cause of disability. Authors review the literature about JRA.

Arthritis, Juvenile↗

PubMedDate not supplied

[Changes in the ambulatory arterial pressure of normotensive obese children].

Obesity represents an important risk factor for cardiovascular disease and in children it is often associated to the future development of essential hypertension. To evaluate the early hemodynamic alterations in obese normotensive children, ambulatory monitoring was performed in 18 obese children aged 9.6 +/- 2.9 and in 33 controls of equivalent age by ICR 5200 (Spacelabs, USA). Blood pressure daily curves in the two groups were compared by MANOVA. Basal blood pressure did not differ in the two groups (115 +/- 17 mmHg and 79 +/- 7 mmHg respectively systolic and diastolic in controls and 115 +/- 12 mmHg and 79 +/- 6 mmHg in obese children). On the contrary ambulatory monitoring showed higher systolic values in obese children when compared to controls (112 +/- 7 versus 107 +/- 7, p less than 0.04) (MANOVA test, p less than 0.03). The difference was observed both during the day time (115 +/- 6 vs 111 +/- 7, p less than 0.03) and during the night (107 +/- 9 vs 102 +/- 8, p less than 0.5). No differences in diastolic pressure and in heart rate were observed. Those findings indicate that in obese children blood pressure alterations unrecognized at usual blood pressure checks are detectable by ambulatory 24 hour monitoring.

Blood Pressure↗