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Biomedical subjects

G Morgese

Publications and source records attributed to G Morgese.

178 records · Page 10Linked to original sources
PubMedDate not supplied

Carbamazepine-induced hypersensitivity syndrome in a child with epilepsy.

Carbamazepine is an effective anticonvulsant and is considered the drug of first choice for the treatment of partial and secondarily generalized seizures. Although carbamazepine is well tolerated, many side effects have been reported in the literature. The majority of these adverse effects are transient and do not lead to the discontinuation of the therapy. We present a case of a female child, aged 11 years and 6 months, who showed an anticonvulsant hypersensitivity syndrome induced by carbamazepine. This syndrome is a rare, potentially life-threatening adverse drug reaction. The patient developed a cutaneous nonpruritic rash, associated with high fever, diffuse lymphadenopathy, and arthralgias on the knees and the ankles with local signs of arthritis. Laboratory examination showed a lymphocytosis, mild thrombocytopenia, marked eosinophilia, and high transaminases. Corticosteroid therapy (betametasone 0,5 mg x 3 day) was started and carbamazepine was gradually withdrawn changing to valproic acid, with complete control of the seizures. The fever and the rash reduced gradually, beginning from the face and then disappearing completely after 10 days. Laboratory results showed a clear improvement: after 7 days the patient showed a complete normalization of the above parameters, except for transaminases. The complete normalization of these enzymes was observed after 2 weeks from the disappearance of the skin rash.

Journal Article↗
PubMedDate not supplied

Bone metabolism in children with congenital hypothyroidism--a longitudinal study.

In order to evaluate the effect of thyroid replacement therapy on bone metabolism in congenital hypothyroid children, we studied 23 (10 girls and 13 boys) consecutive patients. Their age ranged from 3 to 8 weeks. One of these patients had familiar dyshormonogenesis, 21 had ectopic glands and one hemiagenesis. As a control group, we studied 46 sex- and age-matched healthy newborns. Before the beginning of therapy, the hypothyroid patients showed higher values of calcium (2.78 +/- 0.04 vs 2.65 +/- 0.07 mmol/l; p < 0.05) and of 1,25-dihydroxy-vitamin D (159.7 +/- 31.6 vs 90.5 +/- 33.1 ng/l; p < 0.01), while they showed lower values of osteocalcin (1.9 +/- 0.8 vs 2.9 +/- 0.9 ng/ml; p < 0.01) than controls. After 3 months of therapy, we found a complete normalization of all these parameters and a progressive increase of osteocalcin. Our data show that in congenital hypothyroid children there are abnormalities in calcium metabolism which seem to be transient and reversible after L-thyroxine replacement therapy.

Bone and Bones↗
PubMedDate not supplied

[Evaluation of nasal eosinophils after specific provocation in the diagnosis of respiratory allergy].

The authors describe the results of a study of a group of children suffering from allergic rhinitis; the Authors evaluated eosinophils, basally and after nasal provocation test. Both clinical and cellular responses were evaluated. The basal results were: presence of eosinophils in 9/17 (52.9%) subjects allergic to Graminacee, in 42/61 (68.3%) subjects allergic to Dermatophagoides and in 3/3 (100%) subjects allergic to Parietaria. The results of the clinical response are the following: Graminacee: positive response in 20/22 (90.9%) tests; Dermatophagoides: 48/63 (76.2%); Parietaria: 6/6 (100%). The results of laboratory response are the following: Graminacee: positive response in 14/18 (77.8%) tests; Dermatophagoides: 45/59 (76.3%); Parietaria: 5/5 (100%). The evaluation of both responses is useful to increase the sensitivity of the nasal provocation test.

Adolescent↗
PubMedDate not supplied

[The families of diabetic children: a 2-year follow-up].

A great amount of clinical and experimental evidence has been accumulated on the role of immunological early events in the development of type 1 diabetes mellitus. In order to try to make a precocious diagnosis of type 1 diabetes mellitus, the Authors have studied all the components of the family in a group of diabetic children. This study is a part of a collaborative International Study called IFS (International Family Study). The Authors describe the scheme of this project in detail. During this study the Authors made a very early diagnosis of diabetes in a child, brother of another diabetic boy. The importance of this approach to the diabetic disease is discussed.

Adolescent↗
PubMedDate not supplied

Plasma renin activity (PRA) in type I diabetes mellitus: PRA and metabolic control in diabetes.

Plasma renin activity (PRA) and aldosterone were evaluated in 39 diabetic children and adolescents and in 39 healthy subjects. The mean values of PRA in the diabetics were higher than in controls not only basal (means +/- SD: 2.7 +/- 1.1 vs. 1.3 +/- 0.6 ng/ml/h) but also after physical exercise (5.2 +/- 3.84 vs. 2.8 +/- 0.7 ng/ml/h). Aldosterone was similar in diabetics and controls (basal: 18.1 +/- 6.6 vs. 16.9 +/- 5.1 pmol/l; after physical exercise: 5.3 +/- 14.1 vs. 39.9 +/- 7.1 pmol/l). There was a significant correlation between HbA1c and PRA after exercise (p less than 0.01). The diabetic children were subdivided into 3 groups according to their stable HbA1c values (group A: less than 8.5%; group B: 8.5-10.9%; group C: greater than 11.0%). A group of diabetics (group C) were re-evaluated after a long period of a good metabolic control. The values of PRA were decreased and similar to the controls (PRA basal values: 1.7 +/- 1.9 ng/ml/h; after exercise: 3.2 +/- 2.9 ng/ml/h). Our study suggests that PRA abnormalities present in diabetic patients can be reversible if a good metabolic control is achieved.

Adolescent↗
PubMedDate not supplied

[Clinical and functional sequelae of bronchiolitis].

The authors carried out a follow-up on twenty-five children, affected with bronchiolitis in the early years of life, at seven years of age, in order to evaluate their clinical status and pulmonary function. Their parents were questioned about diseases of the small airways following to acute bronchiolitis. PRIST and RAST were effected in fourteen children; an evaluation of the pulmonary function with spirometry, flow-volume curve and body-plethysmography was done in every child. Then the flow-volume curve was repeated after bronchial provocation test with exercise (free running). Abnormalities of the pulmonary function at resting significant for small airways' obstruction were observed. A great number of children with bronchial hyperreactivity (60%) was observed after bronchial provocation test with exercise, particularly in those with genetic predisposition; 6/14 (43%) showed sensitization to many inhalant allergens, without correlation with genetic predisposition, clinical sequences and bronchial hyperreactivity.

Airway Resistance↗
PubMedDate not supplied

[Pharmacological prevention of exercise-induced bronchospasm: review of the literature and trial of disodium cromoglycate, fenoterol and ipratropium bromide in a pediatric population].

Exercise-induced bronchospasm (EIB) is an instrumentally-measurable paraphysiologic phenomenon, related to bronchial hyperreactivity in asthmatic children. Therefore EIB is very useful to evaluate airways hyperreactivity and pharmacological treatment in asthmatic child. We have evaluate EIB inhibition and bronchodilator effect of three drugs: Disodiumcromoglycate (DSCG), Fenoterol (F), Ipratropium Bromide (IB), in a group of 27 asymptomatic and therapy-free asthmatic children. The bronchial provocation test was performed by physical exercise (free-running for six minutes) according to criteria stated by Paediatric Bronchopneumology Group of S.I.P. Therefore we have analysed the most recent studies to correlate our results with other's data: our study confirm DSCG and Beta-adrenergic drugs effectiveness; theophylline has a similar validity, but is less useful in clinical practice; anticholinergic drugs and corticosteroids seem less valid; the new drugs (Ketotifen, alpha-blockers and calcium antagonists) need further controlled studies.

Adolescent↗
PubMedDate not supplied

[Kawasaki's syndrome: description of 4 cases].

In this study we present four cases of Kawasaki syndrome; in two of them were present some particular aspects, besides the characteristic signs of the lymphonodal-mucocutaneous syndrome. One little girl showed, during the acute phase of the disease, paralysis of facial nerve, without other signs of neurological involvement; in the second patient, the outcome of the syndrome was quite atypical, because of an osteoarticular involvement; we also observed the presence of immature white blood cells in the peripheral blood. Three of the four cases were treated with acetyl-salicylic acid for almost one year, two of them were also treated with dypiridamol. A four years follow-up, after the acute phase, demonstrated a complete recovery, a normal clinical status and no damage of the cardiocirculatory system.

Blood Cells↗
PubMedDate not supplied

[Physical exercise-induced bronchospasm in asthmatic children. Clinical usefulness of the specific free-running bronchial provocation test].

Exercise-induced bronchospasm (E.I.B.) is frequently observed in children. Here are reported the correlation between E.I.B. and some clinical-anamnestical parameters found in a group of thirty-eight asthmatic children examined by exercise. The aspecific bronchial provocation test was performed with six minutes free-running. The exercise-induced bronchospasm was estimated by bronchial obstruction index (b.o.i.). All the children were tested at 4 p.m., out of attacks, without clinical signs of airway obstruction, with basal pick-flow rate (PEFR) at least 80% of predicted. We have looked for the possible correlations between E.I.B. and the following parameters: sex, exercise-induced asthma, house heating, season, period of clinical remission, length of the disease and number of attacks per year. These results indicate that bronchial provocation test with free-running is useful in asthmatic children to objectify the bronchial hyperreactivity and to follow-up the course of the disease.

Adolescent↗
PubMedDate not supplied

[Bronchiolitis: new pathogenetic aspects and personal cases].

The etiological, epidemiological and pathogenetical features of bronchiolitis and some clinical and biochemical data concerning seventy nine cases were discussed. It has been underlined the possible pathogenetical role of immunoallergic mechanism (immunoreactions type II, III, IV and VI), and of alterations of humoral immunocompetence (rise of IgM and deficit of IgA). Moreover it has been pointed out that hereditary, socioeconomical and environmental factors could play an important role in determining the seriousness of the clinical picture. The relationship between bronchiolitis and the respiratory diseases of the following years have been examinated.

Bronchiolitis, Viral↗
PubMedDate not supplied

Education, knowledge and metabolic control in children with type 1 diabetes.

We studied thirty diabetic patients and we evaluated their knowledge of main topics of diabetes mellitus. The level of the knowledge was evaluated by multiple choice questionnaires. On the basis of score obtained the patients were divided into two groups: Group A, with high knowledge level, Group B, with low knowledge level. All the patients were followed-up for a 12 months period after a careful education. At the end of follow-up, we compared the Group A patients with another group of 14 diabetic children, who have followed an educational programme from the diagnosis of the disease (Group C). We assessed the knowledge score and the principal metabolic parameters in the three groups of patients; during the follow-up, we found a significant increase of these parameters in Group A and B patients, more evident in Group A patients. At the end of follow-up, the Group C patients showed a higher knowledge score and metabolic parameters than the Group A children. This study shows that education of disease is important for the increase of metabolic parameters and its usefulness is higher if is carried out from the onset of the disease.

Adolescent↗