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Gli articoli più visti nel mese di Maggio 2019

		Per una pediatria basata sull'evidenza - Giugno 2000
1	38 kB	Varicella e aciclovir E. Neri, I. Bruno, C. Salvatore, F. Braida, E. Barbi Abstract 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.

		Editoriali - Aprile 2019
2	44 kB	Perché abbiamo paura di prescrivere bene gli antibiotici? F. Marchetti Il Rapporto dell’AIFA riporta dati molto deludenti sulla prescrizione degli antibiotici (vedi News box). Quali le ragioni e le possibili soluzioni?

		ABC - Febbraio 2004
3	213 kB	Leggere l’emocromo I. Bruno

		Problemi non correnti - Settembre 1997
4	114 kB	APEC: esantema periflessurale asimmetrico M. Cutrone Abstract 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.

		Aggiornamento monografico - Febbraio 2001
5	84 kB	Le microcitosi nel bambino: classificazione e approccio diagnostico A. Sciotto, V. Furia, S.E. Munda Abstract 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.

		Aggiornamento monografico - Febbraio 1997
6	193 kB	I disturbi del sonno nel bambino F. Cordelli Abstract The author syntetizes current knowedge on sleep physiology, particulary regarding REM and non REM sleep. There are many physiological motor and autonomic phenomena related to sleep such as gestual activity, modifications of hearth rate, respiratory rate and temperature. They should not be seen as abnormalities. When evaluating the child with insomnia, paediatricians should take into account the different sleep requirements at different ages, as well as environmental factors such as rituals utilized to induce sleep, fears, and stress. In infants, insomnia may be caused by allergy. Airway obstruction due to hypertrophic tonsils or adenoids may cause severe sleep disturbances, and negatively affect the child during the day. Pharmacological treatment of sleep disorders should be limited to cases not-responders to behavioural approaches or to elimination diet. Ipersomnias (narcolepsia, catalepsia, ipnagogic allucinations) are very rare in children and differential diagnosis with epilepsia may be diffucult. Parasomnias (iactatio capitis, spasmus rutans, pavor nocturnus, sonnambulism, bruxism) are easy to recognize and need just reassurance.

		Problemi correnti - Gennaio 1999
7	51 kB	La valutazione dello sviluppo psicomotorio nel primo anno di vita G. Rapisardi Abstract 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.

		L'angolo dell'immunologo - Ottobre 2001
8	71 kB	Quando sospettare un’immunodeficienza A. Tommasini, A. Insalaco, C. Perez, A.R. Soresina, A. Plebani

		Problemi correnti - Giugno 2000
9	19 kB	Trattare la mononucleosi? M. Fontana Abstract 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.

10	26 kB	Domande e risposte - Settembre 2001 G. Longo

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