Mild cutaneous reactions to drugs

Adverse reactions to drugs are not frequent in childhood. Cutaneous reactions are the most frequent in this age group. Mild cutaneous reactions are immediate or delayed adverse reactions that do not seriously compromise the clinical condition of children. The patients usually early improve and recover the state of health. Although it is difficult to define the prevalence accurately, we could affirm that the rate adverse reaction to drugs are often over estimated by both the families and the physicians. Therefore, children may be prone to loss of school days and inappropriate or sub-optimal treatments. However, the identification of a true adverse reaction to drugs allows adequate treatment and alert to further exposure to harmful drugs.

Mechanisms of hypersensitivity reactions induced by drugs

Adverse drug reactions include drug hypersensitivity reactions (DHRs), which can be immunologically mediated or non-immunologically mediated. The high number of DHRs unconfirmed and/or self-reported is a frequent problem in daily clinical practice, with considerable impact on future prescription choices and patient health. It is important to distinguish between hypersensitivity and non-hypersensitivity reactions by adopting a structured diagnostic approach to confirm or discard the suspected drug, not only to avoid life-threatening reactions, but also to reduce the frequent over-diagnosis of DHRs. (www.actabiomedica.it)

Cytogenetic damage in lymphocytes of healthy and thyroid tumor-affected children from the Gomel region (Belarus)

During 1994, 19 thyroid tumor-affected children and 17 healthy children from the Gomel region, one of the areas most polluted by the Chernobyl fallout, were analysed for (i) the presence of in their urine and (ii) chromosome aberrations (CA) in circulating lymphocytes. They were compared with 35 healthy children from Pisa, Italy. Tumor-affected children showed significantly (p<0.05) higher levels in their urine as compared to healthy controls from the Gomel region. No radioactivity was found in urine from the Pisa controls. CA frequency was significantly higher in tumor-affected children compared to the Gomel controls, but was not significantly different between Gomel and Pisa controls. However, dicentric chromosomes were found in a significantly (p<0.01) greater proportion in both affected and healthy Gomel children (3.4 and 1.3/1000 cells, respectively) as compared to the Pisa controls (0.4/1000 cells). Multiple regression analysis showed that the proportion of cells with acentric fragments, dicentric and ring chromosomes was significantly correlated (p<0.05) with the amount of excreted in their urine. These findings suggest that children from the Gomel region were still being exposed to radionuclides, which makes it possible to study a dose-effect relationship.

Embryology of the urinary tract and prenatal diagnosis of congenital obstructive anomalies

Fetal malformations within the urinary tract are frequently detected during sonographic examination in the second and third trimester of pregnancy. Detection has been facilitated by a continued evolution of new technological equipment and by increased knowledge regarding the existence of direct sonographic patterns (kidneys) and/or indirect sonographic patterns (amniotic fluid volume). A wide range of variability and severity of such malformations has been noted, from the so-called "functional" types which disappear spontaneously after birth, to those requiring postnatal surgery, as well as those with fatal prognosis. Due to the complexity of the embryological development of the fetal urinary system, the pathogenesis of such malformations is still not well known. The main stages of development of the urinary tract in the embryo were studied in 156 cases involving urinary tract obstructions. Follow-up was strictly adhered to until the postnatal outcome. Sonographic patterns representative of this pathology were studied in order to verify if a correct diagnosis and an accurate definition of the prognosis could be arrived at using the data.