Hair diseases in childhood

This paper focuses on four important hair diseases mainly occurring in children. Trichotillomania is the most relevant differential diagnosis of alopecia areata in childhood. Meticulous inspection and lack of telogen hairs in the trichogram from the margin of the lesion usually are sufficient for differentiation. The trichogram also plays a significant role for the diagnosis of the loose anagen hair (loose anagen syndrome), a fairly new, but not rare entity, especially in distinguishing it from telogen effluvium. Five different types of clinical presentation are distinguished in tinea capitis. For the necessary systemic therapy; the new antimycotics terbinafine and itraconazole represent good alternatives to the well-tried griseofulvin. Several effective therapeutic options are also available for head lice, the most frequent parasitary infestation of school age. However, because of its neurotoxicity and the increasing problem of lice resistance lindane should not be used any longer for the treatment of head lice.     

Chronic intestinal inflammatory diseases

In the last years the research on the etiopathogenesis of the inflammatory bowel disease (IBD) is focused around immunological aspects. Many authors consider that the intestinal inflammation is due to an inappropriate immunological response to normally present antigens in the gut. Two aspects must to be considered between IBD: Crohn's disease and ulcerative colitis. IBD's diagnosis is based on the symptomatology, (cramps, liquid feces with mucus and blood, anorexia and weight loss), hemato-clinical tests (ESR, PCR, blood platelet, mucoprotein, sideremia) and radiological tests (tenuis Rx, abdominal echography, fibro endoscophy and scintigraphy). Principal aim of the therapy is the clinical remission. Following the remission starts a maintenance protocol. Parenteral nutrition is used in paediatric and adolescent age. Diets have been used to provide a convenient nutritious contribution with growth improvement and partial remission of activity index of the disease. Pharmacology therapy represents a valid instrument to obtain the remission. Colectomy is performed on unsuccessful medical therapy. Early studies on IBD's pathogenesis bring to the use of biological therapies that show beneficial effects on the disease.     

Transport mechanisms of bestatin in rabbit intestinal brush-border membranes: role of H+/dipeptide cotransport system

Bestatin [(2S,3R)-3-amino-2-hydroxy-4-phenylbutanoyl-L-leucine], a potent inhibitor of aminopeptidase B and leucine aminopeptidase, enhances the immune response to activate the defense mechanism of the living organism and suppresses the growth and metastasis of cancer. Bestatin has been effectively used by p.o. administration, but the mechanisms of intestinal absorption remain to be solved. The present study was undertaken to examine whether bestatin, a dipeptide containing an unusual amino acid, is transported via dipeptide carriers in intestinal brush-border membranes, by using cephradine as a probe for the H+/dipeptide cotransport system. The initial uptake of cephradine in the presence or absence of an inward H+ gradient, driving force, was inhibited by bestatin and this inhibition occurred in a competitive manner (Ki = 0.47 mM). The uptake of cephradine was stimulated by the countertransport effect of bestatin, the definitive criterion for ascertaining a common transport system. These findings indicate that bestatin, as well as cephradine and other p.o. cephalosporins, can be transported via dipeptide carriers in intestinal brush-border membranes.     

Chronic granulomatous diseases of childhood.

Nursing care for the child with chronic granulomatous disease (CGD) is complex and challenging. Understanding the mechanism behind the disease increases the effectiveness of nursing care.