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A prospective study of group B Streptococcus colonization in 939 pregnant women from Vicenza and its region, disclosed an overall rate of 9.58% of genital colonization. Only two cases of group B streptococcal infant disease occurred in the study period (0.21%). No statistically significant difference between culture-positive and culture-negative pregnant women was found in mean age, parity, place of residence, blood group, presence of clinical disease during pregnancy, type of delivery and gestational age, birth weight and presence of any clinical disease over five days from birth of the newborn infants. The Authors make some recommendations based upon the best understanding of the epidemiology of group B streptococci available at this time.

A case of temporary congenital hypoaldosteronism with normal production of other hormones of the adrenal is described. During early infancy the patient showed low blood aldosterone levels, increased ACHT and Hyponatraemia. Replacement therapy needed sodium chloride and mineralcorticoid drug administration (Florinef) until the baby was 9 month old. Later, spontaneous recovery occurred, confirmed by laboratory tests.

The authors report a typical case of JHF. The complete review of the literature shows that no more than 20 cases have been so far described. The clinical, pathological and electron microscopic features are stressed and the main clinical and pathological differential diagnoses are considered. The disease, formerly thought to be due to an abnormal composition of collagen fibers, seems to be nowadays, thanks to Japanese authors, related to an error in glycosaminoglycans metabolism.

A case of unusually large subdural chronic effusion is described in a child 3 years old with severe developmental retardation, without obvious symptoms of increased intra-cranial pressure. Diagnosis was made by angiography. The child underwent to a Pudenz-shunt. An intensive physical and educational care program is performed. Behavior improvement and partial integration in social structure are obtained.

This paper reports the results of the treatment of continuous bronchial asthma in children, 7-14 years old, by means of biofeedback and the counter-conditioning. We observed the remission of the symptomatology in all the cases, with a statistical significance.

An unusual case of stillborn fetus with imperforate anus and left lower limb malformation is described. The principal features were: femoral duplication, muscular atrophy below the knee, heel malformation with absence of calcaneous bone, presence of nine toes of the left foot associated with imperforate anus and with presence of cutaneous tag on the left buttock. No similar case reports are known by the Authors at the present time.

Infants of diabetic mothers have an increased morbidity and mortality in the perinatal period. Nevertheless, there are differences in opinions about the exact incidence of malformations, metabolic disturbances, fetal macrosomia and respiratory distress syndrome. This study was designed to investigate the incidence of embriofetopathy in those of mothers with gestational diabetes. The incidence was highest in the group of mothers on insulin at the time of conception. Major fetal malformations of the cardiovascular and central nervous system were over-represented.

Authors describe importance of anatomical and functional factors in ethiopatogenesis of G.E.R., diagnostic iter and methods. Importance of 24-hour computerized pH-metry in pediatric age is particularly stressed out. Medical and surgical therapeutic procedures are emphasized.

Continuous Negative Pressure (CNP) was utilized as sole form of respiratory assistance in the treatment of 40 newborn infants with Respiratory Distress Syndrome (RDS). The average duration of CNP therapy was less than 7 days in all cases. 38 of these infants survived without sequelae (95%); an infant developed severe bronchopulmonary dysplasia (2.5%); another infant died from intracranial hemorrhage (2.5%). CNP appears to be an effective respiratory support in the treatment of neonatal RDS, when used early in spontaneously breathing infants weighing greater than 1500 grams.

The purpose of this study was to assess the influence of prolonged phototherapy on plasmatic levels of Anti Diuretic Hormone (ADH) in jaundiced newborns. 13 hyperbilirubinemic, otherwise healthy full-term newborns submitted to the phototherapy, were compared to 12 healty, full-term nursery newborns as a control group. No statistical difference was found in ADH levels in 3rd day of life between jaundiced and normal newborns. ADH levels before and after phototherapy do not present any statistical difference, in the jaundiced neonates receiving adequate water and caloric intakes. There was no positive correlation between ADH and bilirubin levels neither in 3rd nor in 5th day of life. Prolonged phototherapy, constant covering of the eyes, deprivation of the day-night rhythm, in absence of gross environmental alterations or of pathological findings, are lacking of effect on the ADH levels in hyperbilirubinemic neonates.

The Authors describe a case of renal tubular acidosis (type I or distal type) with neural deafness in a male child. The condition is inherited as an autosomal recessive trait. Addition of NaHCO3 and potassium to diet allowed normal growth without sequelae. Speech development was retarded because of the neurosensorial deafness, partially corrected by hearing aids.

Thyroxine-binding globulin deficiency is a well-known condition transmitted as a X-linked dominant trait or as autosomal dominant trait. This condition is benign and hypothyroidism is never associated. Values of T4 in the serum are abnormally low, TSH values are normal, RT3U values are high. TBG deficiency probably are much more diffuse than we believed in past. Therefore it's possible to detect this deficit through screening programs for neonatal hypothyroidism. In this paper we describe two cases of TBG deficit. Thyroid function and TBG levels in babies and in their families are studied. In our sample of three years the incidence is I:3170 newborns, The presumable inheritance pattern are both X-linked dominant and autosomal dominant. Neither in affected babies nor in their relatives thyroid function is abnormal.

It is known that, particularly in Nordic States, many patients undergoing antiepileptic therapy with Phenobarbital and Phentoin present disorders of the phospho-calcium metabolism, both clinical and biochemical. For what concerns the mediterranean area, few are the papers written concerning this subject in these last years. In this paper we attempt to provide a "case study" contribution (100 cases) to enable us to study the above-mentioned alteration focusing on an area half way between Central and Southern Europe. The Authors discuss the possible mechanism implicated in this affection.

We have studied plasma levels of Anti Diuretic Hormone (ADH) and its relationship to mode of delivery in 21 mothers and in their newborns. On the basis of the mode of delivery, mothers were divided into three subgroups: vaginal delivery before administration of oxytocin; vaginal delivery after administration of oxytocin; caesarean section. The infants are divided into two subgroups: neonates born by vaginal delivery (14 cases); neonates born by caesarean section (7 cases). ADH levels were determined at birth and in third day of life in the neonates. ADH determination was made by Radioimmunoassay (RIA). A noticeable rise in hormone levels was found in infants born by vaginal delivery, but not in neonates born by caesarean section. In third day of life ADH levels were comparable in all neonates. No significant difference was encountered in ADH levels among the subgroups of mothers. There was no correlation between ADH levels and: maternal age, placental weight, duration of labor, period of gestation of the mothers; neonatal weight, gestational age, body weight in 3rd day of life of the neonates; plasma sodium and osmolality both of the mothers and of the neonates. High levels of ADH in neonates delivered vaginally may contribute to increase the blood flow to the placenta and to other vital structures of the fetus during labour.

This report presents the clinical, radiographic, and autopsy findings in a newborn infant with thanatophoric dysplasia and cloverleaf skull who died soon after birth. The possible genetic mechanisms of transmission of both malformations are discussed.

Two cases of amniotic band disruption complex are described: in both newborns severe craniofacial defects are associated with limb defects. The quality of survival may be satisfactory when surgical correction of limbs and craniofacial defects is possible, like in the newborn less severely affected. Recurrence risk is very low, with respect to the sporadic nature of this disorder. A more accurate diagnosis may be done through placenta and fetal sac studies.

A male infant with profound anemia and liver and spleen enlargement was affected by visceral Leishmaniasis. Diagnostic tests and therapeutical approach to this parasitic infection, very rare in our Region, are discussed.

Part I - A case of acrocephalosyndactyly (ACS) type V, or Pfeiffer Syndrome, is described in a 2-year-old male child. This syndrome is characterized by acrocephaly, partial syndactyly of toes, broad thumbs and great toes, with normal intelligence. Our patient, instead, shows a middle degree of psychomotor delay. The family pedigree confirms an autosomal dominant inheritance mode. Diagnostic separation of the Pfeiffer Syndrome from the other craniostenosis and acrocephalosyndactyly syndromes is discussed. Neurosurgical assessment is mandatory in order to avoid cerebral and ocular damage due to chronically increased intracranial pressure. Part II - The Authors present some concepts on the surgical treatment of the craniofacial stenosis. A great importance is given to an early diagnosis and surgical treatment: to make this possible it is necessary to have some Hospital Centers really very specialized. The treatment of a child affected by Syndrome of Pfeiffer is described, giving more evidence to the operative technique and to its reasons.

High doses of gammaglobulin intravenously have been found useful in controlling thrombocytopenia of a neonate born to a mother who developed acute idiopathic thrombocytopenic purpura during pregnancy. Administration of 0.4 gm/kg/day of intact gammaglobulin intravenously for five days was followed by dramatic rise of platelet count without any side-effect. After 1 month the platelet count was still normal. Passively-acquired immune thrombocytopenia of the newborn consequently is another indication for intravenous gammaglobulin therapy.

The Authors present the study and results in 180 cases of infantile enuresis, treated with a new bell alarm associated to conditioning psychological treatment (toilet training, token economy, motivational counseling, urine stop exercises, etc.). The cases have been subdivided into the type of enuresis, age and sex. 140 (77.8%) subjects aged from 6 years to 16 years with primary enuresis, and 40 (22.2%) aged from 6 years to 15 years with secondary enuresis have been treated. The following results were obtained in the primary enuresis with this type of treatment after a follow-up of 6-12 months: permanent recovery in 85.71% of the cases, relapse after 6 months in 11.42%, improvement in 5% and failures in 9,29% of the cases. In secondary enuresis the following results were obtained: permanent recovery after 12 months in 75% of the cases, relapse after 6 months in 10%, improvement in 7.5% and failures in 17.5% of the cases. The differences in the results between the two types of enuresis with respect to the age of the cases up to 12 years are proved and relatively less with respect to the average time of treatment for the total remission. Regarding the sex of the cases no significant therapeutic answer was noted neither in the final results nor in the time of treatment in both types of enuresis. Finally, it is not the substitution of symptoms which are proved but the benefits of a general and psychological level.

In newborn infants with compromised clinical conditions, it is frequently necessary to improve the perfusion of the vital organs, and the choice often falls on sympathomimetic drugs. However their appropriate use is still discussed and the difference of the opinions about their choice is partially due to scarcity of controlled clinical studies. The purpose of this study is to supply, on the basis of the present knowledges, the opportunity of a rational choice and use of the sympathomimetic drugs in the neonate. The Authors consider the development of the cardiovascular sympathetic innervation and the different responsiveness to sympathomimetic drugs of the human foetus, compared to those of the animal foetuses. Then they discuss the pharmacological characteristics of some of the most important sympathomimetic drugs: adrenaline, isoproterenol, dopamine, dobutamine, indicating choice, and clinical use of them.

Bronchopulmonary Dysplasia (BPD) rarely occurs in newborn infants with RDS ventilated using CNP devices. In this paper we describe a case of BPD following respiratory therapy with CNP in a preterm baby affected by hyaline membrane disease (HMD). Probably the rarity of BPD after CNP treatment is related either to less severe HMD in newborns weighing less than 1500 g, or to the low diffusion of CNP respirators in Neonatal Care Centers.

An infant with E.E.C. Syndrome (a genetic condition characterized by: Ectrodactyly, Ectodermal dysplasia, Cleft Lip-Palate) and delayed psychomotor development was found to have chronic hypernatremia and absence of thirst. Computerized brain tomography revealed abnormal lateral ventricles, agenesis of corpus callosum, calcified cortex. His plasma Anti Diuretic Hormone (ADH) levels were inappropriately low relative to his high values of plasma osmolality, whereas ADH responsiveness to nonosmotic stimuli was normal. E.E.C. Syndrome in this baby is characterized by: ectrodactyly of the feet, syndactyly of the 3rd and 4th finger of the hands, bilateral cleft lip and cleft palate, bilateral microtia, lacrimal ductular stenosis. To our knowledge, this is the first report of a case of chronic hypernatremia in conjunction with normal ADH stores, congenital abnormalities of brain structures, and E.E.C. syndrome.

We describe a case of camphor and balsamic oil poisoning observed in a 1-month-old infant. Because of toxic effects of camphor and volatile oils on central nervous system, these compounds show no therapeutical usefullness in children.

Since June 1977 to June 1980 screening program for neonatal hypothyroidism was carried out in the area of Vicence. 6.340 newborns were screening, in the fifth day of life, primarily by measuring T4 levels, later by measuring both T4 and TSH levels in the blood serum. Three babies were proved to have neonatal hypothyroidism: two cases showed athyreotic hypothyroidism, and one case was due to familial thyroid dyshormonogenesis. The incidence of this condition in our area is much higher than 1:3.000 newborns. Two cases of familial deficit of thyroxine-binding globulin and two subjects with partial enzymatic deficiency were also detected.