Prospective study of the burden of acute gastroenteritis and rotavirus gastroenteritis in children less than 5 years of age, in Padova, Italy

BACKGROUND

Data on the burden of rotavirus gastroenteritis in Europe are needed to help understand the potential impact of introducing new rotavirus vaccines.

MATERIALS AND METHODS

As part of prospective observational study (Rotavirus gastroenteritis Epidemiology and Viral types in Europe Accounting for Losses in Public Health and Society Study, REVEAL) conducted in 2004--2005 in seven European countries, we studied, the characteristics of acute gastroenteritis and rotavirus gastroenteritis in children less than 5 years in primary care, emergency room and hospital settings (Padova, Italy).

RESULTS

A total of 757 children with acute gastroenteritis were included and enzyme-linked immunoabsorbent assay (ELISA) results were available for 725 cases. The overall estimated annual incidence for rotavirus gastroenteritis was 4.7%. Overall, rotavirus gastroenteritis was estimated to account for 43.6% of acute gastroenteritis cases. Among children with acute gastroenteritis (AGE) aged 6-23 months, 61.2% were rotavirus positive. Rotavirus gastroenteritis (RVGE) was responsible for 68.8% of hospitalizations, 61% of emergency consultations, and 33% of primary care consultations. The most prevalent serotype was G9 (84.4%) followed by G1 (11.8%). The relative risk for rotavirus gastroenteritis of being referred to hospital after an initial consultation in primary care was 3.37 (95% CI: 1.77-6.43) and 3.38 (95% CI: 2.28-5.01) for emergency room referral. Children with rotavirus gastroenteritis generally had more severe disease than children with rotavirus-negative gastroenteritis.

CONCLUSION

Rotavirus accounts for a significant proportion of acute gastroenteritis cases in children less than 5 years in Italy, many of whom require frequent primary care consultations, or care in emergency room or hospital settings.

Sodium cromoglycate and carbachol-induced bronchoprovocation in asthmatic children

Ten children with mild bronchial asthma underwent bronchial challenge with carbachol on three consecutive days; using a double-blind technique, they were given inhaled saline placebo on the first day and placebo or sodium cromoglycate (SCG) on the second and third days 15 min prior to the bronchial provocation test with carbachol. We did not find any significant difference between the baseline and placebo values, but we did obtain a statistically significant difference when comparing baseline with post-SCG and placebo with post-SCG values. These results demonstrate a protective effect of SCG on carbachol-induced bronchospasm in asthmatic children.

Bladder Carcinosarcoma: Case Report and Literature Review

The authors report a case of bladder carcinosarcoma, a highly malignant tumour rarely reported in literature. Therapy is purely surgical, since radiation and chemotherapy do not resolve the situation.

Liposarcoma of the spermatic cord: A rare urological cancer

Malignant paratesticular tumours are uncommon. Of these, liposarcoma of the spermatic cord is a rare tumour type with good prognosis, found above all in the elderly. Most have a low level of malignancy and relapses tend to be localised. Choice treatment is radical orchiectomy and patients should be followed closely since local recurrence is not uncommon. This study briefly reviews the literature on spermatic cord liposarcoma and reports an additional case that was treated for a relapse by radical. orchiectomy.

Influence of aeroallergens on bronchial reactivity in children sensitized to grass pollens

Nine children, sensitized to grass pollens, with seasonal rhinitis and mild asthma underwent bronchial challenge with carbachol and EIA test repeatedly either during a pre-seasonal or in seasonal period. We failed to find any significant difference between pre-seasonal and seasonal values in both tests. We believe that atmospheric conditions are an important determinant of our results. It is our hypothesis that a threshold concentration in atmospheric pollen may exist which must be reached before an allergic reaction is evident.

Report on: “Treatment of urolithiasis with extracorporeal shock wave lithotripsy (ESWL)” - Introduction

The author reports some general considerations about urinary stone disease and about therapeutical approaches, and the results of 18 months experience in the Urology Department of Bolzano Hospital in the treatment of urinary stone disease, particularly through ESWL.

Treatment of urinary stones with ESWL: Our experience

During a period of 18 months we treated 469 urinary stones which included 364 ureteral-kidney stones in 340 patients (average = 1.62 treatments per patient). The total percentage of disintegration is 94.7% and 76.47% of the patients are stone free three months after the last treatment.

Modification of bronchial hyperreactivity during pollen season in children allergic to grass

Ten children, sensitive to grass pollens with seasonal rhinitis and mild asthma, underwent bronchial challenge with carbachol in the pre-seasonal, seasonal, and post-seasonal period. According to pollen count, we observed significant differences between pre-seasonal, seasonal, and post-seasonal values. Also basal FEV1 values varied in the same fashion. Seven of the ten children also participated in a previous similar study in 1984, at which time they did not demonstrate significant variations to bronchial challenge. We wish to emphasize the importance of pollen concentration in the atmosphere as well as the existence of a threshold value of grass pollen necessary for a significant modification in bronchial reactivity to occur.

Considerations and conclusion

Also in our experience, ESWL performed with Lithostar Plus has proved its efficacy and low complication rates. It does not need any anesthesia and may often be used as a day-hospital method.