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Background: There are no studies on the use of cetirizine in children under the age of 6., Objective: We compared the efficacy and tolerability of cetirizine in patients with idiopathic chronic urticaria to the more widely used antihistamine, oxatomide., Methods: This double-blind study was performed on 62 patients (38 male and 24 female) with idiopathic chronic urticaria, recruited from four different medical centers of the national territory (Ancona, Cagliari, Catania, and Messina). The children's ages ranged from 2 to 6 years (mean 3.85). The patients were randomly assigned to two treatment groups: one group treated 31 children with cetirizine at a dosage of 5 mg q.d., and a second group treated 31 children for the same amount of time with oxatomide, at a dosage of 25 mg q.d. Sixty-two children began the treatment, but five did not finish the study (three in the cetirizine and two in the oxatomide group). Thus, the clinical study and the statistical evaluation were conducted on 57 children (28 cetirizine and 29 oxatomide). The Student's t test was used to compare severity of the illness and changes in the hematochemical tests., Results: Overall, the effectiveness of the two medications in treating erythema, papules, edema, and itching showed comparable therapeutic activity (P < 0.001). Neither medication produced significant side effects., Conclusions: The results of the present study suggest that cetirizine may represent an effective and safe pharmacologic therapy for chronic urticaria in preschool children. There was no evidence for changes in hematochemical and urinary values, demonstrating the safety and the tolerability of the two antihistamines, even when given to young children.

Background: Many prognostic factors of colorectal cancer are known but their actual clinical validity is still uncertain. The aim of the present study was to verify, on the basis of our experience, the prognostic validy of variables for survival by using survival regression analysis., Methods: From January 1978 to December 1986 the prognostic factors for 192 patients were analysed. These patients had undergone surgical resection for colorectal cancer. The follow up was completed in every patient by the end of December 1992, with a median follow up of 10 years (range 6-14 years). The prognostic factors considered in the statistical analysis were age, sex, size of tumour, site, grade, direct spread, node involvement and stage (according to Astler-Coller and pTNM)., Results: Of the prognostic factors, sex was the only one not to show any prognostic significance. In the survival regression analysis we have used an accelerated failure time model (equivalent to the Cox proportional hazard model); age, grade and stage were significant covariables., Conclusions: Although clinical pathological staging (pTNM) appears as a pre-eminent prognostic factor, and as our analysis shows, it needs a further variable (grading), which has been shown to affect the prognosis in a significant way.

It was recently observed that otitis media with perfusion (OME) occurs in 35-50% of children suffering from allergic rhinitis. The main pathogenetic mechanism was identified as the dysfunction of the eustachian tube (ET) following its impairment during nose allergy infection. As a result of this dysfunction, the tympanic cavity is affected by: accumulated secretion, proliferation of germs and changes of the hypersecretion of the lining mucous. The long-term persistence of these secretions may damage the normal functions of the ossicular chain and thus the transmission of sounds, leading to the onset of hypoacusis which may interfere negatively with the child's mental-physical development.

The allergic inflammation may contribute to the development of otitis media with effusion (OME). For this reason we have examined two groups of children: the first (group A) formed by 12 children with allergic rhinitis, the second (group B) by 15 children with hypertrophic adenoids. We have found respectively: pathologic otoscopy in 75% and 93% of cases; pathologic tympanometry in 83% and in 90%; pathologic audiometry in 60% and in 83%. This values are not significant according to a statistic analysis. Instead, the degree of compromission has been significant: in fact 16% of the children belonging to group A had a retracted and atelectatic eardrum in comparison with 33% of the children belonging to group B. Also tympanometry has confirmed this aspect: in fact 33% of group A showed type C and B tympanograms in comparison with 77% of group B. Besides, audiometry has confirmed the presence of hearing loss in the subjects with tympanometry of type C and B, belonging to both groups. For this reason the allergic rhinitis, because it may cause OME, must be treated in order to limit the negative effects of allergic nasal obstruction on the functionality of the middle ear.

A retrospective epidemiological investigation was conducted on 144 infants in order to discover the connection between breast feeding and the appearance of allergic disease. The data obtained indicate that: mothers' milk offers no such protection and at most may delay the onset of symptoms in respiratory allergic diseases. In contrast, it seems that atopic dermatitis arises earlier in breast fed babies, particularly if the mother is atopic.

Gastroesophageal reflux (GER) may contribute to the persistence of asthma and may be triggered and/or exacerbated by treatment with bronchodilatory and cortisone drugs. For this reason, GER should be suspected in patients with asthma non-responsive to treatment. In fact in this series 24 hour pH monitoring revealed GER in 7 out of 9 (77%) patients with persistent asthma. The use of a personally developed diagnostic protocol permitted the identification of various situations in 4 patients who completed the study: one coincidental association, one GER caused by theophylline and constituting the main cause of the bronchial obstruction.

Bronchial provocation tests (TBP) allow to detect airways hyperreactivity in asthmatics. Twenty asthmatic children and sixteen rhinitics underwent a standard methacholine challenge and a free running exercise test on two separate days. Metacholine challenge pointed out bronchial hyperreactivity in 90% of the asthmatics. An exercise induced bronchospasm occurred in 70% of them. TPB resulted positive also in 18% of the rhinitics. Our study confirms diagnostic usefulness of the TBP and a good correlation between both tests.