These data suggest that daily consumption of concentrated cranberry juice can significantly prevent the recurrence of symptomatic UTIs in children.

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Background: The first-line drug therapy for patients with nocturnal enuresis (NE) associated with nocturnal polyuria and normal bladder function is desmopressin (dDAVP). Objective: To evaluate if increasing dose of oral desmopressin lyophilisate (MELT) can improve response rates to dDAVP and is useful in enuretic children. Materials and methods: We enrolled a total of 260 children all diagnosed with NE. Enuretic children were treated with increasing MELT at a dose of 120, 180 and 240 mcg a day. Results. We included in our study a total of 237 children, 164 males (69.2%) and 73 females (30.8%) aged between 5 and 18 years (mean age 10.32 ± 2.52 years). Of the 237 patients enrolled in the study and treated with MELT 120 mcg, a full response was achieved in 135 (56.9%). A partial response was achieved in 21 (8.9%) patients, therefore the dose was increased up to 180 mcg, with further improving symptoms (14.3%) or full response (9.5%), and up to 240 mcg, without usefulness. Conclusions: MELT at the dose of 120 mcg resulted efficacy and safety; the increased dose up to 180 mcg resulted poorly efficacy; finally, the further increase up to 240 mcg did not improve the symptoms with the increased risk of side effects.KEY WORDS: Desmopressin; Nocturnal enuresis. ated with nocturnal polyuria and normal bladder function is desmopressin (dDAVP) for a period of 3 months following by withdrawal. dDAVP is associated with a response rate of about 40-60%, however its effect may not be maintained on discontinuing treatment, and symptoms have been found to recur in about 50-80% after stopping treatment (3). The different formulations of dDAVP are an intranasal solution, an oral tablet formulation and the recent oral sublingual lyophilisate (MELT). The aim of this study is to evaluate if increasing dose of MELT (120, 180, 240 mcg/day) can improve response rates to dDAVP in enuretic children. MATERIALS AND METHODSWe enrolled a total of 260 children all diagnosed with NE, between April 2014 and April 2017, at the Paediatric Service of Campus Bio-Medico Hospital in Rome. Inclusion criteria were: age > 5 years and a diagnosis of primary MNE (PMNE) without NE treatment in the last 3 months. Exclusion criteria were the presence of secondary NE, any provided story of urinary infection, nephrogenic diabetes or congenital genitourinary anomalies. The children and their families were asked to participate in the study. This study was conducted in accordance with the regulatory standards of Good Clinical Practice and the Declaration of Helsinki. We carefully evaluated each patients with medical history and physical examination, including monitoring blood pressure, possible sign of spinal dysraphism or polythelia, neurological reflexes and genital examination. During the period of treatment, all patients and their parents were asked to keep a NE calendar depicting the wet and the dry nights and in addition, we educated both child and parents with dietary advices (4). During the follow-up, families were called to verify their adherence and respons...

Drug reaction with eosinophilia and systemic symptoms (DRESS) syndrome is a severe multiorgan hypersensitivity reaction mostly caused by several eliciting drugs in patients with a genetic predisposition. Incidence of DRESS in children is very variable, frome 1:1000 to 1:10.000, and the mortality rate seems to be lower than 10%. Anti-convulsants are the main drugs involved both in adults and in children. The treatment of choice is the prompt withdrawn of the offending drug and using intravenous immunoglobulins and corticosteroids used in synergy. In recent years, emerging studies have outlined the disease more clearly. We present a pediatric case in which the patient developed DRESS syndrome as a result of exposure to lamotrigine before and carbamazepine after and a relapse after exposure to omeprazole. Starting from this case report we provide an overview on DRESS Syndrome.

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