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OBJECTIVE: To provide centiles for birth weight (BW) according to gestational age (GA) and sex for infants born in Italy. METHODS: We used records of the whole neonatal population of Tuscany, a region in Italy, from July 1991 to June 2002 as resulting from the database of the cystic fibrosis neonatal screening program (n=290129). We excluded as unlikely for GA those BW that were more than two interquartile ranges above the 75th centile or below the 25th centile for each GA and gender group. RESULTS: We present the 3rd, 10th, 25th, 50th, 75th, 90th and 97th centiles of BW for GA from the 24th to 43rd week of gestation for male and female Italian neonates, as both tables and smoothed curves. CONCLUSIONS: The large size of the examined population allows us to provide up-to-date, reliable BW for GA centiles for Italian newborns, especially for lower GAs.

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Knowledge of the microbiology of pulmonary infections is critical for treatment of cystic fibrosis because sickness and mortality in this disease are mainly due to relapse occurring in the respiratory tract. The microbiology of pulmonary infections presents several singular aspects. Respiratory tract infections are caused by bacteria such as Staphylococcus aureus in the early years of life and Pseudomonas aeruginosa and Burkholderia cepacia thereafter. The patients, who are not immune compromised, are predisposed to chronic colonization and highly transmissible bacterial strains can cause cross-infections. Bacterial also develop resistance mechanisms which make them difficult to treat. Until recently the relationship between genetic defects and a predisposition to colonization was not noted, but recent studies have allowed us to form some interesting hypothesis. The present work analyzes the principal mechanisms of antibiotic resistance, with particular reference to classic cystic fibrosis pathogens, and looks at future prospects of respiratory tract infection treatment.

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Cerebral venous thrombosis is an infrequent cause of childhood stroke. It is reported most frequently in the setting of acute dehydration, cyanotic congenital heart disease, or the nephrotic syndrome and it is commonly found in patients with hereditary coagulation or immunologic disorders. Thrombotic tendencies may also occur in children with iron deficiency anemia. We describe a 11-months old boy with cerebral venous thrombosis likely attributable to dehydration and iron deficiency anemia by intestinal chronic blood loss, caused by food allergy.

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Rotavirus is an important cause of acute gastroenteritis in infants. Gastroenteritis has been reported in association with a variety of other disease conditions, such as respiratory infections and CNS involvement. A case of a child, thirteen months old, presenting afebrile seizures during a rotavirus gastroenteritis is described.

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Cardiac beriberi is a rare cause of heart failure in infancy and the diagnosis is often very difficult. We describe the case of a 4-year-old girl admitted to our Hospital with symptoms of heart failure and diagnosis of myocarditis. In children with acute cardiac failure and suggestive history and signs of peripheral neuropathy, thiamine deficiency should be suspected.

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Multiple hepatic hemangioendothelioma are vascular lesions of the liver that generally appear in the infancy with hepatomegaly, high output congestive heart failure and cutaneous hemangiomas. Many plans for management (steroid, radiation, hepatic artery ligation, embolization, cyclophosphamide) have been proposed. We report a case in two months old boy of hepatic hemangioendothelioma with arteriovenous shunts and heart congestive failure, successfully treated with steroid.

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BACKGROUND: Congenital arteriovenous malformations represent a rare cause of heart failure in neonates. MATERIALS: Four neonates with arteriovenous malformations (cerebral in one, hepatic in two and pulmonary in one) are reported. RESULTS: In the first three cases Color Doppler echography was able to image the arteriovenous malformations, to identify the afferent and efferent vessels and to quantify the arteriovenous shunt. In the neonate with pulmonary malformation, a cardiac cause of heart failure was excluded by echocardiography, and the diagnosis was stated by selective angiography. The neonate with cerebral great arteriovenous malformation died at 4th day of life. The two neonates with hepatic malformations improved both with medical therapy; in the last neonate, with multiple arteriovenous pulmonary fistulae, selective embolization was performed, but the child died a few months later. CONCLUSION: Congenital arteriovenous malformations are rare, and an early diagnosis is the base for a correct therapy; Color Doppler echography represents the gold standard for cerebral and hepatic malformations, while selective angiography should be reserved to patients who might profit of embolization or surgical resection.

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The classification of chest alterations in Cystic Fibrosis (CF) and related score proposed by Chrispin and Norman has been widely adopted in Europe and is still applied (although slightly modified) in most European Centres. Brasfield classification instead has been mostly used in the USA. Lately, however, to revise both classifications, the need has been felt, for a more precise correlation to anatomo-radiological data as well as for inclusion of headings which have not been taken into account so far. In 1980 one of the Authors (Vichi) worked out a new scoring system for the chest alterations of CF. Results are reported from a follow-up of 15 patients with CF carried out at the FC Centre of Meyer Ospedale in Florence from the late 1981 to 1985. The patients underwent periodic checkings including determination of clinical scoring system-according to Shwachman and Kulczychi modified by Doershuk-respiratory function tests, chest X-rays evaluated by three radiologists separately, following both Chrispin and Norman and Vichi scoring systems. The latter system has proved to be well correlated to clinical data and to the ordinary pulmonary function tests but it mainly presents a high observer reproducibility.

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The pharmacokinetics of oral theophylline at steady-state were comparatively investigated in 13 asthmatic patients and in 10 patients with cystic fibrosis (CF). In all patients, the drug was administered twice daily as slow-release tablets. The total daily dose of theophylline ranged from 10.8 to 29.4 mg/kg/day. For each patient, the time-course of theophylline steady-state plasma levels was studied after the morning dose. Six serial plasma samples were drawn at 0, 2, 4, 6, 8, and 12 h after dosing. Model-independent methods were used for calculating the pharmacokinetics parameters (area under the curve and clearance). The clearance values (mean +/- SD) calculated in the two patient groups were significantly different (asthmatic patients: clearance = 61.2 +/- 15.6 ml/h/kg; CF patients: clearance = 86.3 +/- 22.8 ml/h/kg; P = 0.007). It has previously been shown that the clearance of theophylline after single dose is increased in CF patients. Our study confirms this finding under steady-state conditions and demonstrates that higher theophylline doses are on the average required to treat patients with FC.

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