Gli articoli più visti nel mese di Febbraio 2017
|Editoriali - Gennaio 2017|
|Le vaccinazioni tra persuasione e coercizione|
l progetto su un “nuovo modo di comunicare in tema di vaccinazioni” rappresenta una complessiva sfida per i prossimi anni.
|Trattamento del vomito da gastroenterite:
quando il bisogno clinico chiama e la ricerca risponde|
Quando la ricerca indipendente, ben disegnata, riesce a dare delle risposte a problemi clinici, anche correnti (vedi Ricerca).
|Per una pediatria basata sull'evidenza - Giugno 2000|
|Varicella e aciclovir|
Chicken pox is still a common disease, usually with a favourable course. Complications are rare (2-3/100.000) in immunocompetent patients. The Authors review the published experience regarding treatment with acyclovir and conclude that the advantage is marginall (25% reduction of the duration of symptoms), while there is no reduction in the rate of complications. Acyclovir should be used in immunocompromised patients including primary immune deficiencies, patients treated with steroids or long-term salycilates, patients affected by chronic lung diseases, eczema, diabetes and heart diseases.
|Ricerca - Gennaio 2017|
|La reidratazione orale e l’uso dell’ondansetron
e del domperidone nella gastroenterite|
Uno studio clinico randomizzato che risponde ad alcuni dei quesiti ancora aperti sulla gestione della gastroenterite.
Background - Vomiting limits the success of oral rehydration in children with acute gastroenteritis (AGE). A double-blind randomized trial was conducted to compare the efficacy of ondansetron and domperidone for the symptomatic treatment of vomiting in children with AGE who have failed oral rehydration.
Methods - After failure of initial oral rehydration administration, children aged 1-6 years admitted for gastroenteritis to the paediatric emergency units of 15 hospitals in Italy were randomized to receive one oral dose of ondansetron (0.15 mg/kg) or domperidone (0.5 mg/kg) or placebo. The primary outcome was the percentage of children receiving nasogastric or intravenous rehydration.
Results - 1313 children were eligible for the first attempt with oral rehydration solution, which was successful for 832 (63.4%); 356 underwent randomization: 118 to placebo, 119 to domperidone, and 119 to ondansetron. Fourteen (11.8%) needed intravenous rehydration in the ondansetron group vs 30 (25.2%) and 34 (28.8%) in the domperidone and placebo groups, respectively. Ondansetron reduced the risk of intravenous rehydration by over 50%, both vs placebo (RR 0.41, 98.6% CI 0.20-0.83) and domperidone (RR 0.47, 98.6% CI 0.23-0.97). No differences for adverse events were seen among groups.
Conclusions - In a context of emergency care, 6 out of 10 children aged 1-6 years with vomiting due to gastroenteritis and without severe dehydration can be managed effective- ly with the administration of oral rehydration solution alone. In children who fail oral rehydration, a single dose of oral ondansetron reduces vomiting and facilitates oral rehydration and may thus be well suited for use in the emergency department. Domperidone was not effective for the symptomatic treatment of vomiting during acute gastroenteritis.
|Farmacologia - Gennaio 1997|
|Adrenalina: tante vie per tante indicazioni|
In recent years, new indications for adrenaline have been added to the most timehonored ones, such as anaphylaxis and cardiopulmonary resuscitation: Alternative routes of administration have also been evaluated. For anaphylaxis, nebulised adrenaline is very effective if administrated at an early stage and has the advantage of allowing a quick and easy administration, thus preventing the progress of anaphylactic reactions. Findings from recent studies show that both subcutaneous and nebulized adrenaline are effective in the treatment of acute bronchiolitis in infants and toddlers. Nebulized adrenaline is now an accepted indication in croup. Most of the studies in croup and bronchiolitis were made with racemic adrenaline, but there is evidence that the laevorotatory form is equally effective and does not produce cardiac effects even at relatively high dosages (0.1 mg/kg in croup and 0.25 mg/kg in bronchiolitis).
|Problemi correnti - Gennaio 1999|
|La valutazione dello sviluppo psicomotorio nel primo anno di vita|
A neurodevelopmental assessment is proposed, based largely on Milani Comparetti’s concepts, and enriched by certain neonatal neurobehavioral items of Brazelton and Als and the Prechtl’s general movements (GMs) assessment in the first four months of life. It privileges the observation of spontaneous motor and interactive behavioral activity at four different phases during the first year of life, according to the stages of the separation-individuation process. Three main parameters are assessed: a) autonomic stability, focused on the first trimester; b) motor activity, divided into the non-functional spontaneous movement repertoire and adaptive functional motor activity; c) behavioral modulation, interpersonal and with the environment and objects. It is a simple, non intrusive method intended to be included in routine pediatric assessment. The overall main goal is to enable the pediatrician, through the assessment of normality, to reveal any deficit needing referral for specialistic investigation.
|Osservatorio - Maggio 2006|
|Cartoline dalla scienza a cura dell'Immaginario Scientifico|
|Grafi di reti sociali|
|Cartoline dal mondo a cura di Giorgio Tamburlini|
|Le nuove curve di crescita dell'OMS|
Nuovi percentili, virtuali e virtuosi
|Schede di neurologia - Febbraio 1997|
|La paralisi di Bell o paralisi idiopatica del nervo faciale|
|Aggiornamento monografico - Novembre 2000|
Enuresis is a very frequent complaint: its prevalence is 10% in 6-year old children. Primary nocturnal enuresis is a multifactorial condition, where an unbalance between urine production and bladder functional capacity is associated with arousal problems. The diagnostic approach is mainly clinical and includes laboratory and instrumental investigations are necessary only when other day symptoms such as incontinence urgency, poliuria or dysuria. Treatment options include behavioural approaches (alarm systems and bladder training) and drugs. Behavioural treatment is usually effective and desmopressin can be associated to it or used to control enuresis in specific situations.
|Problemi non correnti - Settembre 1997|
|APEC: esantema periflessurale asimmetrico|
The paper describes a new entity, the Asymmetric Periflexural Exanthem of Childhood (APEC), first described in 1962 and recently recognized as a separate clinical entity by many Authors. It is characterized by scarlatiniform or papular rash which develops usually from a periflexural (axillary or inguinal) area to the thoracic area but with a clear monolateral preference. Respiratory or gastrointestinal symptoms may accompany the eruption. Occasionally moderate pruritus and regional lymphoadenopathy are present. The course is self-limited. This entity is believed to be caused by a virus but no single agent has been identified as a causal agent sofar. The Authors observed 4 cases of APEC over a period of four months in 18 to 24-month old children. It is probable that APEC can be diagnosed more often if increased attention is payed by paediatricians.
|La Pediatria sulla Grande Stampa - Supplemento 2016|
|La pediatria sulla grande stampa 2016|
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