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 Aprile 2025
1) Aggiornamento - Marzo 2025
Glomerulonefriti acute: tre facce della stessa medaglia
- Iacono A, Cunsolo M, Spallino E, et al.
- The phenotypic variability of a single pathology complicates the diagnostic and therapeutic approaches, particularly for its more complex and less common forms. The paper describes three clinical cases of post-infectious glomerulonephritis, all presenting with macrohaematuria but evolving with different outcomes, ranging from clinical-laboratory findings to varying therapeutic management, including supportive therapies and the use of immunosuppressive treatments. Although acute post-infectious glomerulonephritis is typically a self-limiting condition, the third clinical case presented with rapidly progressive renal failure accompanied by a sudden clinical deterioration, requiring both haemodialysis and immunosuppressive therapy. The discussion of these three clinical cases - different sides of the same medal - aims to emphasise the extreme phenotypic variability of a single disease and the importance of early diagnostic and therapeutic evaluation.
440 kB2) La pagina gialla - Marzo 2025
a cura di Sara Lega3) News box - Marzo 2025
a cura di Federico Marchetti
4) Aggiornamento - Gennaio 2024
La cellulite orbitaria in età pediatrica: una proposta di gestione diagnostico-terapeutica
- Zama D, Altimari L, Ruscelli M, et al.
- The incidence of orbital cellulitis in the paediatric age is around 1.6/100,000 cases per year. Most cases are mild and limited to the preseptal space; however, severe and complicated cases are possible. Paediatricians should be able to recognize high-risk adverse outcome conditions that require prompt intervention. Clinical evaluation supported by laboratory workup is the key for the diagnosis. Intraorbital and intracranial complications may be ruled out through diagnostic imaging. Depending on the extension of the infection, clinicians may choose between conservative treatment with antibiotic therapy or surgical drainage at first. The paper proposes an algorithm to aid clinicians in the management of paediatric orbital cellulitis through the description of three emblematic clinical cases observed in the Paediatric Emergency Room.
5) Aggiornamento - Ottobre 2007
La splenomegalia
- M. Rabusin, F. Patarino
- The spleen in infants and children is involved in a wide variety of pathological conditions. Splenic disorders may be isolated like splenic cysts or, more frequently, due to multiorgan or systemic disease including hepatic diseases, malignancy, hemoglobinopathy, infectious diseases and storage diseases. The Authors review the role of the laboratory test, the ultrasonography and the peripheral blood smear in orienting the differential diagnosis. Invasive procedure as bone marrow aspiration, lymph node biopsy, hepatic biopsy or fine needle splenic biopsy are often warranted to estabilish the cause of splenomegaly.
6) Neonatologia - Marzo 2025
Infezioni herpetiche invasive neonatali
- Valencic I, Moratti M, Conti F, Nanni N, Ancora G.
- Herpetic infection is a condition with high rates of neonatal morbidity and mortality; to date, there is no universally recognized strategy for the perinatal management of the risk of Herpes Simplex Virus (HSV) transmission based on the prognostic value attributed to maternal risk factors. Starting from the analysis of a clinical case of neonatal herpes meningoencephalitis, a literature review was conducted concerning the management of herpetic infection during pregnancy and in the neonatal period in terms of prevention and early diagnosis. The paper describes a case of a newborn with neonatal herpes meningoencephalitis transmitted by a mother with recurrent herpetic infection without clinically evident genital lesions at birth, despite the correct application of gynecological-neonatal protocols stratified by risk categories. An integrative model to the current guidelines should consider the following prophylactic strategies: performance of serological screening for HSV between the 24th and 28th week of pregnancy; provision of counseling regarding the main maternal-fetal and neonatal transmission risk factors for HSV; administration of antiviral prophylaxis with acyclovir to seropositive pregnant women starting from the 36th week of gestation; expansion of neonatal HSV-related screening tests even in cases where primary or recurrent genital lesions are present within ninety days before delivery. The diagnosis of neonatal herpetic meningoencephalitis suggests an underlying congenital error in innate immunity, related to an alteration in the TLR3/IFNα-β-λ axis, which presents with minimal/absent alterations in the immunological balance of I/II level, associated with infectious susceptibility to a restricted spectrum of viral pathogens, and deserves early immunological specialist evaluation.
9) Casi indimenticabili - Marzo 2025
Anche il fegato ha i suoi binomi
- Maggiore G.
- The paper describes the case of a 20-month-old girl hospitalized for acute liver failure, later diagnosed with progressive familial intrahepatic cholestasis (PFIC). Jaundice is often a fundamental clinical sign that is frequently overlooked, not only in the strictly neonatal period. The uniqueness of this case lies in the rarity and early onset of the clinical presentation of PFIC.
9) Casi indimenticabili - Marzo 2025
Famiglie tossiche
- Faleschini E.
- The paper highlights that families characterized by violence, ignorance and a lack of rules, along with the failure to consult a paediatrician, contributed to worsen psychophysical condition in adolescents.
9) Casi indimenticabili - Marzo 2025
Enuresi da sempre... e valvole dell'uretra posteriore
- Menotti MG, Pugliese P.
- The Authors describe the case of 9-year-old child with a urological problem underestimated even by the family. Investigations reveal bladder overactivity with vesicoureteral reflux secondary to posterior urethral valves.
10) Aggiornamento - Aprile 2008
L'ipertensione arteriosa in età pediatrica: dall'inquadramento diagnostico alla terapia
- A. de Cunto, M. Maschio, M. Pennesi, A. Benettoni
- The epidemic of childhood obesity, the risk of developing left ventricular hypertrophy, and evidence of the early development of atherosclerosis in children would make identification and treatment of hypertension an important focus of physicians caring for children. Secondary hypertension is more common in preadolescent children, with most cases caused by renal disease. Primary or essential hypertension is an emerging condition in adolescents and has multiple risk factors, including obesity and a family history of hypertension. Evaluation involves a thorough history and physical examination, laboratory tests, and specialized studies. Lifestyle modifications are advised for all patients and can be tried solely for those with blood pressures between the 95th and 99th percentiles. Drug therapy is indicated in children with blood pressures greater than the 99th percentile, secondary hypertension, coexisting diabetes, left ventricular hypertrophy, or those who fail a trial of non pharmacologic treatment.