Gli articoli più visti nel mese di Dicembre 2017
|Per una pediatria basata sull'evidenza - Giugno 2000|
|Varicella e aciclovir|
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.
|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.
|Ricerca - Ottobre 2017|
|Diagnosi precoce dei disturbi dello spettro autistico|
Una sorveglianza dello sviluppo da parte del PdF consente di fare una diagnosi precoce e di intervenire efficacemente.
Background - Early diagnosis combined with an early intervention programme, such as the Early Start Denver Model (ESDM), can positively influence the early natural history of autism spectrum disorders. This study evaluated the effectiveness of an early ESDM-inspired intervention, delivered at low intensity by the Italian Public Health System.
Materials and methods - Thirty-five toddlers at risk for autism spectrum disorders, aged 20-36 months, received 3-5 hours/wk of one-to-one ESDM-inspired intervention by trained therapists, combined with parents’ and teachers’ active engagement in ecological implementation of treatment. The mean duration of treatment was 15 months. Cognitive and communication skills, as well as severity of autism symptoms, were assessed by using standardized measures at pre-intervention (Time 0 [T0]; mean age =27 months) and postintervention (Time 1 [T1]; mean age =42 months).
Results - Children made statistically significant improvements in the language and cognitive domains. Regarding severity of autism symptoms, younger age at diagnosis was positively associated with greater improvement at post-assessment.
Conclusion - The results of the study are consistent with the literature that underlines the importance of early diagnosis and early intervention, since prompt diagnosis can reduce the severity of autism symptoms and improve cognitive and language skills in younger children. Particularly in toddlers, it seems that an intervention model based on the ESDM principles, involving the active engagement of parents and nursery school teachers, may be effective even when the individual treatment is delivered at low intensity. Furthermore, the present study supports the adaptation and the positive impact of the ESDM entirely sustained by the Italian Public Health System.
|Specialità - Novembre 1997|
|Il prurito atopico|
Atopic dermatitis is the most frequent skin disease characterized by severe itching. The treatment of atopic itching should start from the evaluation of its severity. An itching score based on the number of crises during daytime, the period of waking up during the night and the extension of scratch marks is suggested. The parents must be trained to prevent the crises of itching and to stop them as soon as possible. Finally, the indications and effectiveness of symptomatic treatments of pruritus such as emollients, corticosteroid creams and oral antihistamines are reviewed.
|Vaccinare - Dicembre 1997|
|Reazioni avverse lievi e gravi (rare) ai vaccini: una revisione|
Adverse reactions to vaccine vary from trivial to severe. Mild reactions include systemic symptoms (fever after DTP vaccine or rash after live measles vaccine) or local flogosis after DTP. Sterile abscesses may occur after immunization with a variety of killed vaccines and may be caused by the inadvertent subcutaneous administration of a vaccine intended for intramuscolar use. Rare, serious consequences of vaccine use that result in severe sequelae or death can also occur impredictably. Examples are paralytic polio after live polio vaccine or hypersensitivity reactions to vaccine components such as bovine or suine collagen, neomycine, mercury. Egg allergy does not represent a contraindication to vaccines containing egg proteins. Health professionals should know the specific reactions that may be associated with the administration of the most commonly used vaccines.
|Farmacologia - Gennaio 1997|
|Adrenalina: tante vie per tante indicazioni|
In recent years, new indications for adrenaline have been added to the most timehonored ones, such as anaphylaxis and cardiopulmonary resuscitation: Alternative routes of administration have also been evaluated. For anaphylaxis, nebulised adrenaline is very effective if administrated at an early stage and has the advantage of allowing a quick and easy administration, thus preventing the progress of anaphylactic reactions. Findings from recent studies show that both subcutaneous and nebulized adrenaline are effective in the treatment of acute bronchiolitis in infants and toddlers. Nebulized adrenaline is now an accepted indication in croup. Most of the studies in croup and bronchiolitis were made with racemic adrenaline, but there is evidence that the laevorotatory form is equally effective and does not produce cardiac effects even at relatively high dosages (0.1 mg/kg in croup and 0.25 mg/kg in bronchiolitis).
|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.
|L'angolo dell'immunologo - Ottobre 2001|
|Quando sospettare un’immunodeficienza|
|ABC - Aprile 2000|
|Gengivostomatite erpetica e dintorni|
|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.
La riproduzione senza autorizzazione è vietata. Le informazioni di tipo sanitario contenute in questo sito Web sono rivolte a personale medico specializzato e non possono in alcun modo intendersi come riferite al singolo e sostitutive dell'atto medico. Per i casi personali si invita sempre a consultare il proprio medico curante. I contenuti di queste pagine sono soggetti a verifica continua; tuttavia sono sempre possibili errori e/o omissioni. Medico e Bambino non è responsabile degli effetti derivanti dall'uso di queste informazioni.
Unauthorised copies are strictly forbidden. The medical information contained in the present web site is only addressed to specialized medical staff and cannot substitute any medical action. For personal cases we invite to consult one's GP. The contents of the pages are subject to continuous verifications; anyhow mistakes and/or omissions are always possible. Medico e Bambino is not liable for the effects deriving from an improper use of the information.