Marzo 2011 - Volume XXX - numero 3

Medico e Bambino


Pagine elettroniche ; Ricerca

Vaccinazione anti-rotavirus:
intervento lodevole ma… fa risparmiare il sistema sanitario nazionale?
L’esperienza del Brasile

Chiara Centenari1, Giuseppe Maggiore1, Ricardo Q. Gurgel2,3, Luis E. Cuevas3,4

1Dipartimento di Pediatria, Università di Pisa
2Post-Graduate Nucleus of Medicine, Federal University of Sergipe, Aracaju, Brasile
3Liverpool School of Tropical Medicine, Pembroke Place, L3 5QA, Liverpool, Regno Unito
4Current address: UNICEF/UNDP/World Bank/WHO Special Programme for Research and Training in Tropical Diseases

Indirizzo per corrispondenza: c.centenari@tin.it

ROTAVIRUS VACCINATION: A PRAISABLE INTERVENTION BUT... DOES IT ENABLE THE NATIONAL HEALTH SYSTEM TO SAVE MONEY?

Key words: Vaccine, Rotavirus, Diarrhoea, Cost

The present “budget impact” study assessed the family and health system costs due to diarrhoea in children < 2 years old, before/after the introduction of a rotavirus vaccine in Brazil in 2006. This kind of evaluations plays a crucial role in the assessment of a health intervention and may help reimbursement decision. This is important especially in Countries with low children’s diarrhoea mortality and high morbidity. In these settings the vaccine is mainly introduced to contain the health and economic burden more than to reduce deaths. The study was made possible by an international collaboration involving the University of Pisa (Italy), the Liverpool School of Tropical Medicine (UK) and the Federal University of Sergipe (Brazil). Information on diarrhoea health care costs and morbidity was obtained from the primary health care system, the National Public Health database (2004- 2008) and care-givers. Diarrhoea ambulatory consultations and hospitalisations had a declining trend during the entire period, with additional steeper reductions after vaccine introduction. Therefore, the vaccine was associated with reduced diarrhoea consultations and hospitalization costs and families’ out-of-pocket expenses. Despite these gains, the overall health system costs have increased.

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C. Centenari, G. Maggiore, R.Q. Gurgel, L.E. Cuevas Vaccinazione anti-rotavirus:
intervento lodevole ma… fa risparmiare il sistema sanitario nazionale?
L’esperienza del Brasile. Medico e Bambino 2011;30(3):191 https://www.medicoebambino.com/?id=1103_191.pdf

Pagine elettroniche ; Caso Contributivo

La picnocitosi infantile: una causa rara ma non infrequente di anemia emolitica neonatale severa

Anna Maria Aurino, Rosanna Di Concilio, Giovanna D’urzo, Maria Amendolara, Carmelina Romano, Giulia Attianese, Silvana Mauriello, Cecilia Di Filippo, Giovanni Amendola

Unità Operativa Complessa di Pediatria - TIN, Ospedale “Umberto I”, Nocera Inferiore, Salerno

Indirizzo per corrispondenza: aurinoanna@hotmail.com

INFANTILE PYKNOCYTOSIS: A RARE BUT NOT INFREQUENT CAUSE OF SEVERE NEONATAL HAEMOLYTIC ANAEMIA

Key words: Infantile pyknocytosis, Erythropoiesis, Flow cytometry, Erythropoietin, Haemolytic anaemia

The diagnosis and treatment of six patients with infantile pyknocytosis are reported. The clinical course and the diagnostic work-up are shown. All the patients necessitated therapy: phototherapy in five patients and one red blood cell transfusion in all of them; in two patients, because of the persistence of haemolysis and pyknocytosis with inadequate erythropoiesis, a brief course of erythropoietin treatment was undertaken with an excellent response and no side effects. Infantile pyknocytosis is a rare but not infrequent disease: physicians caring for a neonate with haemolytic anaemia should not forget this disease in the differential diagnosis.

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A.M. Aurino, R. Di Concilio, G. d’Urzo, M. Amendolara, C. Romano, G. Attianese, S. Mauriello, C. Di Filippo, G. Amendola La picnocitosi infantile: una causa rara ma non infrequente di anemia emolitica neonatale severa. Medico e Bambino 2011;30(3):191 https://www.medicoebambino.com/?id=1103_191.pdf


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