Gli articoli più visti nel mese di Ottobre 2017
|Ricerca - Ottobre 2017|
|Diagnosi precoce dei disturbi dello spettro autistico|
Una sorveglianza dello sviluppo da parte del PdF consente di fare una diagnosi precoce e di intervenire efficacemente.
Background - Early diagnosis combined with an early intervention programme, such as the Early Start Denver Model (ESDM), can positively influence the early natural history of autism spectrum disorders. This study evaluated the effectiveness of an early ESDM-inspired intervention, delivered at low intensity by the Italian Public Health System.
Materials and methods - Thirty-five toddlers at risk for autism spectrum disorders, aged 20-36 months, received 3-5 hours/wk of one-to-one ESDM-inspired intervention by trained therapists, combined with parents’ and teachers’ active engagement in ecological implementation of treatment. The mean duration of treatment was 15 months. Cognitive and communication skills, as well as severity of autism symptoms, were assessed by using standardized measures at pre-intervention (Time 0 [T0]; mean age =27 months) and postintervention (Time 1 [T1]; mean age =42 months).
Results - Children made statistically significant improvements in the language and cognitive domains. Regarding severity of autism symptoms, younger age at diagnosis was positively associated with greater improvement at post-assessment.
Conclusion - The results of the study are consistent with the literature that underlines the importance of early diagnosis and early intervention, since prompt diagnosis can reduce the severity of autism symptoms and improve cognitive and language skills in younger children. Particularly in toddlers, it seems that an intervention model based on the ESDM principles, involving the active engagement of parents and nursery school teachers, may be effective even when the individual treatment is delivered at low intensity. Furthermore, the present study supports the adaptation and the positive impact of the ESDM entirely sustained by the Italian Public Health System.
|Vaccinare - Dicembre 1997|
|Reazioni avverse lievi e gravi (rare) ai vaccini: una revisione|
Adverse reactions to vaccine vary from trivial to severe. Mild reactions include systemic symptoms (fever after DTP vaccine or rash after live measles vaccine) or local flogosis after DTP. Sterile abscesses may occur after immunization with a variety of killed vaccines and may be caused by the inadvertent subcutaneous administration of a vaccine intended for intramuscolar use. Rare, serious consequences of vaccine use that result in severe sequelae or death can also occur impredictably. Examples are paralytic polio after live polio vaccine or hypersensitivity reactions to vaccine components such as bovine or suine collagen, neomycine, mercury. Egg allergy does not represent a contraindication to vaccines containing egg proteins. Health professionals should know the specific reactions that may be associated with the administration of the most commonly used vaccines.
|L'angolo dell'immunologo - Ottobre 2001|
|Quando sospettare un’immunodeficienza|
|Aggiornamento monografico - Febbraio 2001|
|Le microcitosi nel bambino: classificazione e approccio diagnostico|
The Authors provide an overview of microcytic anemias. Causes of microcytic anemia include a wide variety of diseases, the most common being iron-deficiency, impaired haemoglobin synthesis, sideroblastic anemias and anemias due to chronic disease. Other less common causes are copper deficiency, lead poisoning and haemosiderosis. A classification of the main microcytic anemias is provided and a diagnostic approach to microcytosis, with and without anemia, based on RDW and MCV is suggested.
|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.
|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).
|Speciale - Settembre 2017|
|PATOLOGIA OSTEOARTICOLARE NEL
LA GRANDE TRASFORMISTA
|Editoriali - Ottobre 2017|
|Psicopatologia del tempo presente|
Si delinea l’idea di un mondo governato da persone dagli evidenti tratti psicopatologici. Capire è il primo passo per cambiare.
|Antibiotici, resistenze e durata della terapia |
La durata del trattamento antibiotico: occorre completare l’intero ciclo previsto per ridurre le resistenze antimicrobiche? Forse è l’esatto contrario (vedi anche il Focus).
|Focus - Ottobre 2017|
|STEWARDSHIP ANTIMICROBICA NEL NEONATO E NEL PICCOLO LATTANTE. Perché e come praticarla|
Antimicrobial resistances are increasing worldwide, due to the misuse of antibiotic therapies in humans as well as in animals. It is expected that within a few decades multi-resistant pathogens will become the leading cause of death worldwide. The misuse of antibiotics in the neonatal period depends on the lack of predictive diagnostic tests and the peculiarity of symptoms of sepsis, which frequently are vague and unspecific at the time of presentation. Policies to prevent the emergence of antimicrobial resistances rely on a judicious use of antibiotics, on protocols and additional measures shared by health care providers. This document summarizes recent indications issued in the Emilia-Romagna subsequent to a review of the literature.
CASI CLINICI: COSA DEVE FARE IL PEDIATRA PER AZZECCARE GLI ANTIBIOTICI…
|È davvero indispensabile fare
la rachicentesi ai neonati
senza segni neurologici?|
|Ma tutti questi antibiotici sono
davvero necessari nei lattanti gravi?|
Un lavoro significativo che si propone di migliorare l’outcome clinico dei pazienti; originale nel metodo oltre che nei contenuti.
|ABC - Aprile 1999|
|La sesta malattia e l’infezione da HHV-6|
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