RESUMEN
Three cases of visceral leishmaniasis are presented: two children who got the disease in Florence and the imported case of a girl coming from Albania with her disease in act. The diagnosis was made showing Leishmania in bone marrow specimen. Therapy with melglumine antimonate was effective and well borne, leading the three children to a complete healing. In the province of Florence visceral leishmaniasis is very rare, but such protozoa and the sand flies are present as shown by the high number of dog with leishmaniasis.
Asunto(s)
Leishmaniasis Visceral/diagnóstico , Adolescente , Animales , Anticuerpos Antiprotozoarios/análisis , Antimonio/uso terapéutico , Médula Ósea/parasitología , Niño , Preescolar , Diagnóstico Diferencial , Femenino , Técnica del Anticuerpo Fluorescente Indirecta , Humanos , Leishmania infantum/inmunología , Leishmania infantum/aislamiento & purificación , Leishmaniasis Visceral/tratamiento farmacológico , MasculinoRESUMEN
BACKGROUND: Infections in intensive care unit are nowadays well documented. As no recent papers about catheter related infections in cardiological intensive care units were found, we decided to approach them during a period of six months with a surveillance study including a clinical, nursing and microbiological protocol. METHODS: The microbiological protocol the semiquantitative Maki cultural evaluation of the tips, the interior of the hubs and the skin around the catheter insertion point. In addition, all the samples were additionally cultured in liquid media. A total of 432 biological samples were analysed, from 125 patients entered into our cardiological intensive care unit: 144 from catheter tips, 144 from the hubs and 144 from the skin around the catheter insertion. RESULTS: Three hundred and eighty-four biological samples (88.9%) were completely negative. Thirteen tips resulted positive (27.1% of the 48 total positive biological samples): 92.3% (12/13) of the positive catheters were infected from internal origin, hub and skin resulting culture negative. Of the 144 catheter tips 12 were colonized (C.F.U. < 15) while only 2 resulted infected (C.F.U. > or = 15). Only one patient was infected with an exogenous infection presenting tip, hub and skin positivity. The overall positivity was of 214 microorganisms mainly represented (93.5%) by gram positives; 87% of them were coagulase-negative staphylococci (C.N.S.). In addition, the tip detection of a Candida guillermondii strain in a pacemaker patient is a relevant finding. CONCLUSIONS: The very low number of cutaneous contaminations (1.3%) and patient's infections (0.69%) showed the good sensibilisation of the medical and nursing teams in the infection control and surveillance.
Asunto(s)
Cateterismo Venoso Central/efectos adversos , Unidades de Cuidados Coronarios , Infección Hospitalaria/etiología , Vigilancia de la Población , Bacterias/aislamiento & purificación , Cateterismo Venoso Central/enfermería , Infección Hospitalaria/microbiología , Infección Hospitalaria/enfermería , Microbiología Ambiental , Contaminación de Equipos , Humanos , Factores de Tiempo , Recursos HumanosRESUMEN
Toddler's diarrhea may be an allergic disease and its recurrences can be avoided with education to "internal spontaneity" in feeding, i.e., by education to a limited and reproducible decrease in eating incentives at the onset of meals. Serum IgE was thus investigated in 16 experimental children in a random comparison with 16 controls, all aged 1 to 4 years, before and after seven months' dietary treatment. Compliance was measured with a seven-day written diary, while serum IgE was measured by PRIST, before and after dietary treatment. A 21% decrease in energy intake (p less than 0.05) and about five times increase in fruit and nonstarchy vegetable intake amount was seen in treated children. A decrease in serum IgE level of 13.9 +/- 43.5 U/ml was found in the "internal spontaneity" group, as opposed to an increase of 33.2 +/- 50.5 U/ml in the control one (p less than 0.01). The differences between examinations were significantly correlated to the increase in NSV acceptance in all children plotted together (r = .51, p less than 0.005). The overall NSV effect on the changes of the 2 muscle areas, 2 symptoms, and 2 percent growth, 15 nutritional, 5 immune and 3 hepatic indices was significant with MANOVA (p less than 0.01). The education to "internal spontaneity" may be a useful tool for prevention of overeating, diarrhea recurrences and IgE increase in the second/third year of life.
Asunto(s)
Diarrea/dietoterapia , Metabolismo Energético/fisiología , Hipersensibilidad a los Alimentos/dietoterapia , Inmunoglobulina E/metabolismo , Apetito/fisiología , Preescolar , Diarrea/inmunología , Ingestión de Energía/fisiología , Conducta Alimentaria/fisiología , Hipersensibilidad a los Alimentos/inmunología , Humanos , Hambre/fisiología , Lactante , VerdurasRESUMEN
The Authors analyse the main body of somatotropin function test: insulin hypoglycemia; arginine; ornithine; I-dopa; clonidine; galanin; GH-RH; physical exercise; sleep; combined stimuli; spontaneous GH secretion of varying duration. The advantages and disadvantages of the different tests are pointed out and some recent contradictory findings concerning the newest prolonged techniques are reported. The Authors claim priority for the clinical/auxological examination, with measurement of bone age and growth velocity and suggest the procedure for GH deficit diagnosis to be followed, also in the light of their personal experience.
Asunto(s)
Hormona del Crecimiento/metabolismo , Animales , Hormona del Crecimiento/fisiología , HumanosAsunto(s)
Bronconeumonía/etiología , Hiperpotasemia/etiología , Tos Ferina/complicaciones , Humanos , LactanteRESUMEN
Two cases are reported of neonatal meningitis caused by Enterobacter cloacae. The two patients are alive; one is perfectly well, the other resulted in hydrocephalus. Both children came from the same neonatal Unit where the were given phototherapy. The importance of nosocomial infections is outlined and different aspects related to the etiology, the environment and the host (particularly immunologic deficits) are briefly reviewed.