Rivista di formazione e aggiornamento di pediatri e medici operanti sul territorio e in ospedale. Fondata nel 1982, in collaborazione con l'Associazione Culturale Pediatri
Gli articoli più visti nel mese di Ottobre 2025
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3) Aggiornamento - Ottobre 2025
La bronchite eosinofila
- Longo G, Badina L, Berti I, Maschio M, Amaddeo A.
- Eosinophilic bronchitis is a clinical entity characterized by bronchial eosinophilic inflammation that clinically manifests only with chronic, essentially dry cough. Just like asthma, it responds well to inhaled corticosteroid therapy, but it differs in that it is not associated with airflow variability, bronchial hyperreactivity, or response to beta-2 agonists. Because of the absence of these peculiar features of asthma, it is now labelled with the acronym NAEB (“Non-Asthmatic Eosinophilic Bronchitis”). The essential histopathological difference with asthma lies in the location of mast cells: in asthma, they are mainly found in the smooth muscle of the bronchial wall, while in NAEB they are essentially located on the epithelial surface, adjacent to the sensory nerve endings involved in the cough reflex. NAEB is not uncommon and is well described in adults, but it is overlooked or only briefly mentioned in the paediatric literature, probably because of the common habit of paediatricians to think of asthma first in any child with persistent or unexplained cough. Although inhaled corticosteroid therapy proves equally effective, it is important to diagnose eosinophilic bronchitis correctly because of its different therapeutic and prognostic implications.
4) Linee guida - Ottobre 2025
Diarrea emorragica acuta, infezione da Escherichia coli produttori di Shiga tossine e sindrome emolitica uremica
- Documento d’indirizzo inter-societario
- Haemolytic uremic syndrome (HUS) associated with Shiga toxin-producing Escherichia coli (STEC) infection is a major individual and public health challenge and is the leading cause of acute kidney injury in children. In Western countries, HUS complicates about 15% of STEC infections, which usually present with acute bloody diarrhoea (ABD). At least 6-7% of cases of ABD in children (rising to 15-20% during summer) are caused by STEC. The widespread use of molecular microbiology techniques enables the diagnosis of STEC infection before HUS onset in an increasing number of patients and generates a window of preventive and/or therapeutic opportunities. Given the rapid progression of the disease, all children with ABD should be tested as early as possible for Shiga toxin (Stx) encoding genes. Stx-positive patients should then be closely monitored for HUS development by urine dipstick for the development of haemoglobinuria. This proactive diagnostic approach allows the application of measures aimed to prevent or mitigate the severity of HUS among which stands the early and generous fluid administration. Moreover, although antibiotics are not recommended in STEC infections, recent data suggest a promising potential preventive role for bacteriostatic agents (e.g. azithromycin), if administered early during the infection. The aim of the present contribution is to share the approach to ABD and STEC infection as endorsed by the scientific societies actively engaged in this area (AMCLI, SIGENP, SIMEUP, SIN, SIP, SIPPS, SITIP). The goal is to promote the early diagnosis of STEC infection by molecular microbiology of ABDs nationwide, thereby improving the understanding of the mechanisms of disease spreading and hopefully reducing the incidence of HUS and its case fatality rate as well as improving both short- and long-term outcomes.
6) Lettere - Ottobre 2025
La bronchite eosinofila: la riconosci se la conosci
- Thiebat E, Longo G.
8) Problemi speciali - Ottobre 2025
Anche il naso vuole la sua parte: quando l’odore può essere diagnostico
- Candela E, Tagliaferri F, Baldo F.
- The distinctive body smell of a newborn or a child may be the sign of an underlying inherited metabolic disorder, and sometimes even the sole diagnostic key to identify severe genetic conditions in life or death situations (such as a coma). A quick recognition of an inborn error of metabolism may radically change the prognosis and the life of a child by preventing the development of sequelae, especially the neurological ones. This paper is a brief guide to metabolic odours (frequent and rare, dangerous or not) that may be identified by paediatricians, both in the emergency room and in an outpatient clinic.