[Fluoroquinolones: pharmacokinetics and clinical use in pediatrics].
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Biomedical subjects
Publications and source records attributed to M Conte.
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The influence of drug addiction in pregnancy on the fetus is in terms of malformation, ponderal and functional development and post-natal psychoneuromotor development. The Authors evaluate the incidence of this complications in 101 drug addicted pregnant patients and the results are shown below.
The results of a randomised prospective study conducted on 40 patients with erosive oesophagitis caused by gastro-oesophageal acid reflux are reported. The patients were divided into two groups and given either ranitidine or a placebo. The clinical and endoscopic evolution confirmed by the histological findings and pH figures demonstrated a significantly better performance in the patients treated with ranitidine. No clinically significant side effects were noted.
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Through a careful examination of the up-to-date literature on the subject, the Authors provide a full account of the present knowledge about the physiopathology of the status asthmaticus; at the same time they draw a practical exhaustive guide to the treatment to be carried out in hospital. The work arises from the considerable increase of mortality rate, due to asthma, recorded in the last few years.
Of 567 children with neuroblastoma diagnosed between November 1984 and May 1993 in 21 Italian institutions, 235 (41%) have been evaluated for MYCN oncogene amplification. The amplification (3 or more copies of the gene) was found in 39 patients (17%) and was more frequent in patients aged more than one year, abdominal primary site of the tumor, advanced stages, normal urinary excretion of vanillylmandelic acid (VMA), and high level of LDH, NSE and ferritin. The five-year survival of the 235 patients (62%) was significantly better in patients with normal copy number of MYCN (69% versus 29%). By correlating genomic amplification with clinical and biochemical characteristics, MYCN amplification was found associated with a worse prognosis even when patients were subdivided for age (under and above one year), disease extension (localized operable, localized but inoperable, and disseminated) with exception for Stage IV-S, VMA and homovanillic acid excretion, serum levels of NSE and ferritin, but not of LDH. These data confirm the unfavourable prognostic meaning of MYCN amplification, but are unable to define if it represents a new independent variable.
Despite the remarkable amount of clinical and biologic information that has been cumulated on neuroblastoma, particularly in the last two decades, this embryonal tumor of early childhood remains one of the major challenges of pediatric oncology. It is now clear that the term encompasses at least two entities characterized by different features and outcome. The favorable entity includes patients with localized disease, infants and stage IV-s. The unfavorable entity refers to patients older than one year at diagnosis with disseminated disease. However, in both entities exceptions exploiting a clinical course different from expected do occur. Molecular biology is presently suggesting that specific genomic alterations may predict unfavorable events. Patients evaluation should thus include the study of biologic features since they may provide us with strongly predictive clues. In this article the Authors describe the main clinical features of the neoplasia and focus on some of its more peculiar patterns. They also refer on the criteria that the International Neuroblastoma Staging System (INSS) has recently designed regarding diagnosis, evaluation of disease extent, and response to therapy, in order to improve the cooperations and the understanding among the major Cooperative Groups. Finally, the treatment outlines of the main forms of clinical presentations are described.