The incudo-malleolar and incudo-stapedial joints are true diarthroses and therefore may be subject to the same rheumatic lesions as any other articulation in the body. The existence of this involvement in rheumatoid arthritis (RA), however, is highly controversial. The present study investigates modifications of the mechanical properties of the middle ear in a group of subjects with RA by evaluating the resonance frequency obtained with multiple-frequency tympanometry (MFT). Thirty patients with RA, aged 20 to 68 years (mean age: 45.8 +/- 12.4 years), participated in the investigation. Their data were compared with those obtained in a control group of 48 age-matched subjects. Results obtained in both ears were examined in all subjects. The two groups displayed almost equal hearing levels with mean air conduction thresholds ranging from 10 to 22 dB HL. None of the subjects displayed an air-bone gap greater than 5 dB. Normal resonance frequency, calculated at the 95th percentile from the control group, ranged from 900 to 1250 Hz. Twelve rheumatoid arthritis patients (40 per cent) displayed abnormal resonance values. These findings were monolateral in 9 patients and bilateral in 3. Eleven out of 15 ears with abnormal multiple-frequency tympanometry data were characterized by an increase in resonance and 4 by a decrease. A correlation between abnormal resonance values and more aggressive RA was established. The results of this study suggest that rheumatoid arthritis may involve the incudo-malleolar and incudo-stapedial joints, altering the ossicular mechanics in response to static air pressure modifications. This does not impair sound conduction through the middle ear, but might reduce the protective mechanisms of the middle ear towards high static pressures.

Acoustic Impedance Tests↗

PubMedDate not supplied

Lipid anomaly in a child with partial duplication 3p.

The authors report a case regarding a 7-year-old girl affected by short height, bone growth delay, lipidic alterations (hypercholesterolemia, hypertriglyceridemia and high apolipoprotein B values) and by a partial duplication of the short arm of the third chromosome: 46,XX, dup(3)(p26-pter). This chromosomal alteration appears "de novo", as the parent's karyotypes are normal and none of the patient's next of kin showed evidence of lipidic anomalies. The patient's short height and slight frontal bossing were the only features that could be described as typical of the dup3p syndrome.

Child↗

PubMedDate not supplied

Biphasic waveforms for automatic external defibrillation in human: a review.

Ventricular fibrillation is the principal cause of sudden cardiac arrest and the electrical defibrillation is often the only effective therapy. A very interesting question is represented by the electric parameters of defibrillation shock. Today, monophasic waveform is widely used in Europe and in the United States, but, recently, the Food and Drug Administration grants approval for an automatic external defibrillator (AED) producing a biphasic pulse. In this review we discuss about the effectiveness and the safety of biphasic waveform, by examining a series of human studies between 1982 and 1999. We have found that available data are often incomplete, unclear, dishomogeneous and, consequently, difficult to compare. Furthermore, among the authors there is no concordance about the meaning of "safety", "effectiveness", "success", "equivalence" and "superiority" of biphasic versus monophasic shock: however, biphasic shock, that uses a lower energy level, seems to reduce post-defibrillation heart damage. Due to the lack of homogeneous studies it is not possible to state which kind of signal is more reliable, even if some clinical reports and experimental data seem to tribute to the biphasic waveform a better therapeutic effectiveness and safety. By examining the current scientific literature, we conclude that further studies have to be performed to definitively validate the use of biphasic shock.

Electric Countershock↗

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[Benign recurrent intrahepatic cholestasis. Description of a clinical case].

We present the clinical case of an 8 years old boy affected by episodes of severe recurrent jaundice, preceded by intense itching with clinical and biochemical signs of cholestasis, diagnosed as benign recurrent intrahepatic cholestasis (B.R.I.C.), or Summerskill's syndrome. This was first described by this author in 1959. The syndrome appears as a rare form of cholestatic jaundice of unknown pathogenesis, which in 80% of cases shows up before the age of 20. Its clinical characteristics are episodes of severe jaundice preceded by intense itching with biochemical signs of cholestasis which rise with no apparent cause and which recover spontaneously and are intervalled by asymptomatic periods which last months or years. During this time there is also a regression of the chemical and histological evidence of cholestasis. The diagnosis of B.R.I.C. can be made after having excluded the other congenital or acquired causes of intrahepatic cholestasis according to the recurrent character of the jaundice and to the hepatic biopsy.

Child↗

PubMedDate not supplied

Intracerebral lesion in a chronic granulomatous disease child with aspergillus chest infection.

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Amphotericin B↗

PubMedDate not supplied

[Neurological complications of Mycoplasma pneumoniae infection. Description of a case of meningitis with clear cerebrospinal fluid].

Mycoplasma pneumoniae (M.p.) is generally responsible of upper and lower respiratory tract infections in children in school age; in about 2% of cases can be also considered the cause of a NS infection: meningitis, encephalitis, cerebellitis, transverse myelitis and ascending polyradiculitis. The authors describe a case of meningitis following an acute otitis media in a 6 years old child. This patient presented also a fourfold or greater decrease in titer of complement fixing antibodies to M.p. The authors suggest a systematic research of M.p. in patients with clear CSF meningitis.

Acute Disease↗

PubMedDate not supplied

[Turner syndrome. Cytogenetic analysis of 165 patients with Turner syndrome. 1st report].

Results are reported of a cytogenetic study on 165 patients with Turner syndrome, based on sex chromatin and karyotype tests. We found that the karyotype 45,X is present only in 54.54% of the cases in homogeneous form and in about 14% of the cases in mosaic form associated with a normal clone 46,XX or, rarely, also with a clone 47,XXX; in the other cases X structural anomalies and different kinds of mosaic forms are present. We also found 5 pregnancies in 2 patients: only 2 daughters were born and alive, the first was normal and the second presented the same karyotype and clinical picture of her mother.

Chromosome Aberrations↗

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[Extrapyramidal type collateral effects of the administration of metoclopramide to children].

Metoclopramide (M.) is a neurolectic drug used with good results in digestive tracts disorders. Even in minimum doses Metoclopramide may cause side effects to children. The most frequent are: localized hypertonia, oculogyric fits, trismus, cervical, oral and lingual dyskinesias, tremors and agitations. Symptoms seem to be serious but it is sufficient to stop the cure that all signs fade away. Manufactures show three personal side-effects' remarks by M. and advise to administer the drug to children with more caution since they are very sensitive to the substance.

Adolescent↗

PubMedDate not supplied

Psoriatic arthritis.

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Arthritis, Psoriatic↗