Rivista di formazione e di aggiornamento professionale del pediatra e del medico di base, realizzata in collaborazione con l'Associazione Culturale Pediatri
Gli articoli più visti nel mese di Dicembre 2019
1) Per una pediatria basata sull'evidenza - Giugno 2000
Varicella e aciclovir
- E. Neri, I. Bruno, C. Salvatore, F. Braida, E. Barbi
- 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.
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5) Problemi correnti - Giugno 2000
Trattare la mononucleosi?
- M. Fontana
- Symptoms are usually mild in young children, but in older children and adolescents systemic and pharingeal complains can be more severe, sometimes with significant airway obstruction. Only supportive care is usually recommended. This paper reports the risults of a recent meta-analysis reviewing the use of acyclovir in IM. This review concludes that acyclovir is effective when administred whithin the first seventytwo hours from the onset of the disease and recommends acyclovir for immunocompromised patients. Pros and cons of steroids treatment is also discussed and the authors conclude that the risks outweigh the benefits.
6) Consensus - Novembre 2019
La sindrome nefrosica in età pediatrica
- Consensus della Società Italiana di Nefrologia Pediatrica (SINePe)
- In Italy are not guidelines for the management of idiopathic nephrotic syndrome (NS) in paediatric age. The choice of a treatment with steroids has always been based on the clinical experience of each centre. The present Consensus of the Italian Paediatric Nephrology Association, updated as an overview of the literature in August 2015, aims to provide a multidisciplinary review on the diagnosis and treatment of NS at the onset by proposing a shared therapeutic protocol for both hospital and family paediatricians. The Consensus gives recommendations on the early recognition and treatment of complications (oedema, hypovolemia, infections and thromboembolic events) as well as on the definition of cortico-resistance and indications on the performance of kidney biopsy.
8) Farmacoriflessioni - Dicembre 2019
Soluzioni ipertoniche in aerosol? Anche no, grazie
- L. Anfossi, R. Calzedda
- Nebulised hypertonic saline (HS) - usually 3% - has become part of paediatric practice for the management of respiratory diseases such as bronchiolitis and preschool wheezing. Acute bronchiolitis is a common disorder in infancy and often results in hospitalisation. No therapy has been shown to influence the course of the disease, other than supportive care. The quality of evidence of studies on positive effects of 3% nebulised saline is low to moderate and new analyses show no benefit. Prospective blinded studies concerning HS use in preschool children with acute viral wheezing are limited. Moreover, HS can induce bronchonconstriction and worsening of cough and should be used with caution especially in patients with bronchial hyperresponsiveness. Other drugs too are used for nebulisation (i.e. mucolytics) despite their unknown physical properties. The hypertonicity-induced bronchospasm can be prevented with the concurrent use of salbutamol.
9) Problemi correnti - Gennaio 1999
La valutazione dello sviluppo psicomotorio nel primo anno di vita
- G. Rapisardi
- 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.