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We report the case of an eight year old boy who developed suddenly acute left-sided hemiparesis syndrome. Brain magnetic resonance imaging (MRI) showed multiple white matter lesions. Therefore we considered in the differential diagnosis multiple sclerosis (MS) and acute disseminated encephalomyelitis (ADEM). The patient received intravenous immunoglobulin (IVIG), 1 g/kg/d over 2 days with complete regression of clinical symptoms. No relapses occurred within six months, although brain magnetic resonance imaging studies found new white matter lesions, suggesting multiple sclerosis with very early onset.

Cystic dysplasia of the testis (CDT) is a rare, benign and congenital lesion causing scrotal mass in pediatric population that can mimic testicular cancer. This lesion consists of cystic dilation of the rete testis and it is frequently associated with renal or genitourinary tract anomalies as renal agenesis and multicystic dysplasia of the kidney. This frequent presentation suggests that testicular cystic dysplasia is associated with a defect of the metamesonephric system in particular with a defect in the connection between the efferent ducts derived from the mesonephros and the rete testis tubules derived from the gonadoblastoma. The role of ultrasound is of primary importance for clinical diagnosis and follow-up of untreated forms. The sonographic appearance of CDT consists of multiple cysts in the mediastinum testis. The cysts range in size from microscopic to several millimetres and may involve the whole testicular parenchyma or have a focal aspect. If the cysts are tiny, the ultrasound must be able to distinguish between CDT and testicular microlithiasis, a potential premalignant condition. Today it is possible thanks to high frequency 7.5 to 10 mHz probes. In the past orchiectomy has been considered as the treatment of the choice for CDT. Today, non operative management of CDT represents an effective alternative option in these patients and the primary benefit of this approach is the preservation of endocrine function and spermiogenic activity. However, the natural history of untreated CDT and its effect on normal testicular tissue are still unknown, therefore long-term follow-up is recommended.

A clinical-anamnestic card is proposed to gather the main minimal parameters which allow to monitor the course of children with severe or mild acute infective diarrhoea admitted to a pediatric department. This method has been verified through a back-evaluation of the data collected in our clinical-anamnestic cards throughout a period of seven months, and found it useful and appropriate. This case-record includes very mild or mild acute infective diarrhoea (corresponding to a loss lower than 10% of total body weight) in pediatric age children hospitalized in a general pediatric department. The clinical-anamnestic card is divided into five parts coinciding to five different clinical stages of the disease; during each stage, the essential anamnestic and/or clinical data necessary to a correct medical and nursing approach to the children affected with infective acute diarrhoea are recorded. The use of this card is also a good way to engage physicians, nurses and children's parents too, to pay attention to the substantial factors necessary for a correct management of the disease. The evaluation of these clinical-anamnestic cards led to the following general conclusions:--to keep body weight unmodified from the day of admission to the day of discharge--to use very seldom milk without lactose--to keep children on a very short term diet in order to quickly restore intestinal function, to increase body weight and to discharge children in few days.

An example of good integration of territorial sanitary services with hospital services. An observational study that pointed out cholesterol disorders in a pre-adolescent population of a little city next to Milan.

In this study we describe the group A streptococcal upper respiratory tract carrier state, following a clinical method based on two main elements: the presence or the absence of symptoms and the result of throat swab. Through this method we are able to decide how to face each individual clinical case.

We consider Helicobacter pylori treatment in children, giving some indications about the necessity of the treatment, the drugs to use, the duration and the results of therapy. We give importance to the choice of some specific drugs and to the follow-up.

We compared specific IgG4 levels in a group of children with food allergy and in an healthy control group. The results show no significant differences in the values of specific IgG4 levels between the two groups of children.

Newborns with vascular catheters must be investigated by echocardiogram for intracardiac thrombosis. We report the use of urokinase to treat an asymptomatic right atrial thrombus in a 31 weeks' gestation newborn; the thrombosis occurred after placement of a catheter in the umbilical vein. We obtained a safe and successful thrombolysis using urokinase 4000 U/kg/h in continuous infusion.

The institution of a self-constructed Ambulatory where both pediatric and adult patient can be assisted with Day-Hospital, gains novelty and new characteristics when four different physicians (Medical, Pediatrician, Hematologist and Psychologist) structured part-time, contribute to functionality with equal participation. Compliance was investigated through a computerized way.

The authors describe the clinical history of a girl with severe chronic constipation due to anterior ectopic anus, associated with supernumerary nipples. The authors underline the importance of possible associations between supernumerary nipples and other congenital anomalies.

The Authors describe the clinical history and diagnostical problems of a premature twin with the three classical symptoms cough-vomiting-growth retardation in the first year of life. Is the diagnostic route required to stabilize whether this condition is primarily gastroenterological or pulmonary?

56 very low-birth-weight (less than or equal to 1500 gm) infants were admitted in our Neonatal Intensive Care Unit between january 1978 and december 1981. Mortality of these infants in the first year of life decreased from 50% in 1978 to 32% in 1981. Our study confirms that mortality is significantly higher in transported infants. As to those born in our Hospital, mortality is markedly higher for breech delivery than for cephalic delivery or caesarian section. The amelioration of intensive care techniques, i.e. continuous transcutaneous PaO2 monitoring, orotracheal intubation at birth and improved respiratory care, markedly reduced the percentage of children with neuromotor pathology (from 43% in 1978 to 0% in 1981 in 16 survivors). Neurological follow-up was performed by serial controls until at least 2 years of age; Apgar scores and blood gas values are reported along with follow-up results to evaluate prognostic significance. Duration of orotracheal intubation, isolette requirement and feeding schedules are briefly discussed.

13 preterm infants (gestational age 34 weeks or below; birth weight under 1500 g.) with severe respiratory distress, were admitted for intensive care in our Unit between 1980 and 1981. Factors affecting the onset of BPD (bronchopulmonary dysplasia) in these subjects are evaluated by retrospective studies. Diuresis in the third day of life, expressed as a percentage of administered fluids appeared particularly significant. It resulted significantly lower in subjects developing BPD than in non-affected controls. Therefore, along with a PDA and a high fluid input favouring interstitial oedem, the inability of preterm infants to remove fluid overload must be considered. A reduced clearance of interstitial fluid in the lung enhances circulatory status and ventilatory damage and increases the risk of BPD.