Rivista di formazione e di aggiornamento professionale del pediatra e del medico di base, realizzata in collaborazione con l'Associazione Culturale Pediatri
Gli articoli pi� visti nel mese di Luglio 2020
1) Problemi non correnti - Settembre 1997
APEC: esantema periflessurale asimmetrico
- M. Cutrone
- 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.
114 kB2) Specialità - Novembre 1997
Il prurito atopico
- E. Bonifazi
- 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.
3) Rivista sfogliabile - Giugno 2020
Rivista sfogliabile on line
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4) Aggiornamento - Giugno 2020
Artrite idiopatica giovanile
- L. Lepore, S. Pastore, A. Taddio
- Juvenile idiopathic arthritis is the most frequent rheumatic disease in childhood. Its diagnosis is still clinical and recently new classification criteria have been proposed. Over the past twenty years, there have been significant improvement in understanding the pathogenetic mechanisms leading to the implementation of targeted therapies. Indeed, the introduction of biological drugs has changed the quality of life of these children, with a rapid control of the disease activity and a reduction in the complications related to the disease and to the use of steroids, which is today very limited. The way of evaluating patients has also changed: joint ultrasound has become a fundamental tool of the daily practice of the paediatric rheumatologists. This article aims to highlight the new discoveries that have changed the management and prognosis of patients affected by juvenile idiopathic arthritis.
7) ABC - Giugno 2020
Il deficit di IgA
- C. Guiducci, F. Marchetti
- IgA deficiency (D-IgA) in the paediatric population is often an occasional finding during tests performed for other reasons in children in whom an immunodeficiency disorder is not suspected. D-IgA is the most common primary immunodeficiency with a variable prevalence according to ethnicity, estimated on 1 case/600 in the Caucasian population. IgA should be dosed twice in a child > 4 years of age to confirm the deficiency, which is defined by the presence of serum IgA < 0.07 g/l. The other classes of immunoglobulins should always be dosed. Most patients with D-IgA will not require any treatment or follow-up (85% are asymptomatic), apart from screening for coeliac disease, which is 10 to 20 times more frequent in patients with D-IgA. In the case of a child with D-IgA with recurrent infections (mainly affecting the respiratory and, less commonly, the gastrointestinal tract), signs and symptoms of alarm must always be sought and valued for other types of primary immunodeficiency (especially the common variable immunodeficiency), which, although rarely, can be associated with D-IgA. Patients with D-IgA, in particular adolescents and adults, have a higher risk than the general population of developing autoimmune diseases. The family should be informed of this possible occurrence, but specific laboratory evaluations are not necessary. Four clinical cases are presented: an occasional finding of D-IgA in a healthy child, the association with coeliac disease, the association with juvenile idiopathic arthritis, and IgA deficiency in a patient with an immunodeficiency disorder (ataxia-telangectasia).
10) Problemi correnti - Gennaio 1999
La valutazione dello sviluppo psicomotorio nel primo anno di vita
- G. Rapisardi
- 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.