Gli articoli più visti nel mese di Gennaio 2019
|Linee guida - Giugno 2015|
|Le nuove Linee Guida sulla bronchiolite|
Questo numero è in gran parte dedicato alla corretta gestione della bronchiolite. Gli Autori commentano le LG dell’AAP e il documento di Consensus della SIP che ci richiamano a una essenzialità diagnostica e terapeutica ancora largamente disattesa. Convinciamoci di questo, una volta per tutte.
Bronchiolitis is the leading cause of lower respiratory tract infection and hospitalization in children less than 1 year old. The American Academy of Pediatrics (AAP) and the Italian Pediatric Society (SIP) have recently published new guidelines for the diagnosis, management and prevention of bronchiolitis. Indications in the two documents are similar, but bronchiolitis management is still debated. In particular pharmacological treatments are not supported by enough evidence, whereas support therapy with oxygen, hydration and nutrition seems the only useful option. The aim of the present work is to summarise these new guidelines, adding a brief comment to each recommendation, in order to produce a useful and practical everyday guide for the paediatrician.
|Domande e risposte - Settembre 2001 |
|Ricerca - Dicembre 2018|
|La bronchiolite: aderenza alle linee guida|
I farmaci non servono, ma tanti continuano a usarli. La condivisione di un protocollo assistenziale può ottimizzare le risorse ed evitare trattamenti inutili e potenzialmente dannosi.
Background - Bronchiolitis is the most common infection of the lower respiratory tract during the first year of life. The American Academy of Pediatrics (AAP) guidelines and the Italian Society of Paediatrics (SIP) Consensus underline that the diagnosis of bronchiolitis is based on the clinical history and the objective examination and that the key points of the treatment are mainly to guarantee a proper nutrition/hydration and to administer oxygen where necessary.
Objectives - To assess the compliance with international and national guidelines in hospital settings before and after sharing and discussing a care protocol.
Materials and Methods - Two groups consisting of 27 patients each affected by bronchiolitis were studied. The children of the first were hospitalised in 2014-2015 and were managed without complying with the unit protocol and those of the second group were hospitalised in 2015-2016, after the protocol sharing. Treatment modalities and the incidence of complication were compared.
Results - Following the sharing of the clinical protocol a trend towards the decrease in the use of the antibiotic therapy and steroids was observed. A larger use of nebuliser therapy with hypertonic solution was observed with respect to the sole physiological solution or the steroidal one. The duration of hospitalisation was similar in the two considered periods. No major complications were observed in both the above two periods.
Conclusions - The present study, though it considers a low number of samples, shows that the sharing of an internal protocol for the management of paediatric patients can allow resources to be optimised as well as ineffective and potentially dangerous treatments to be avoided.
|Editoriali - Dicembre 2018|
|Quando il neuropsichiatra dovrebbe sporcarsi le mani...|
Il neuropsichiatra è centrale in un progetto di rete integrata che deve rispondere a bisogni sempre più emergenti.
|L’insensata vergogna del Decreto Sicurezza|
Molti di questi bambini e di queste donne li abbiamo incontrati nei luoghi di cura e assistenza. Sono meritevoli di tutto questo?
|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.
|L'angolo dell'immunologo - Ottobre 2001|
|Quando sospettare un’immunodeficienza|
|Problemi non correnti - Settembre 1997|
|APEC: esantema periflessurale asimmetrico|
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.
|L'angolo degli specializzandi - Dicembre 2018 a cura di Sara Lega|
|Tutto sull’ingestione di corpi estranei|
Intervista al dott. Luigi Dall’Oglio.
|Rubrica iconografica - Giugno 1999|
|Una calvizie troppo precoce|
|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.
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