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 Marzo 2024
1) Problemi correnti - Febbraio 2024
Tutta la tosse in una figura
- Longo G.
- Cough is the most common cause of unscheduled paediatric visits. The figure in the article shows the main causes of paediatric coughs differentiated by duration, quality (dry or wet) and night-time coughing. With these few simple key anamnestic elements (and especially if confirmed and reinforced by being able to see, even in a simple video, the child coughing) a diagnosis may be made with reasonable certainty, saving specialist visits and diagnostic tests that are unlikely useful and potentially harmful.
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2) Editoriali - Marzo 2024
Atlante dermatologico pediatrico: 10 anni... e non li dimostra
- Fusco F, Sambugaro D
3) Lettere - Marzo 2024
Faringite e rivalutazione dello score di McIsaac
- Salvatore B, Marchetti F.
4) Aggiornamento - Marzo 2024
Allergia agli antibiotici beta-lattamici: i miti da sfatare e le azioni pratiche da adottare
- Badina L, Marchetti F, Fontijn S, Berti I.
- The penicillins (amoxicillin) are among the most effective and safe antibiotics for many common bacterial respiratory infections in paediatric age and should be avoided only when a true allergy is highly suspected. Severe true antibiotic allergies are rare and allergies are often overestimated. In high-income countries, 5-15% of patients report a penicillin allergy. However, in most cases (> 95%), these patients do not have a true immunologically mediated allergy and they may very likely tolerate the antibiotic upon a new exposure. All patients defined as allergic should be carefully evaluated and their levels of antibiotic allergy risk determined. In cases of suspected penicillin allergy (e.g. those with cutaneous manifestations), skin tests are not necessary before prescribing a beta-lactam antibiotic (amoxicillin) and direct oral administration can be performed in low-risk phenotypes carefully selected according to simple protocols that do not always require a specialist evaluation. The article, based on the recommendations of the WHO Aware Manual, provides current evidence and practical guidance, and fosters a correct interpretation and management of an overestimated problem that does not promote an optimal and judicious antibiotic use.
5) 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.
6) Aggiornamento monografico - Gennaio 2009
La porpora di Schönlein-Henoch
- L. Calligaris, L. Calligaris, F. Marchetti, E. Barbi, E. da Dalt, E. Panontin, L. Lepore, A. Ventura
- Henoch-Schönlein purpura (HSP) is the most common vasculitic disease of childhood. HSP is a multisystem immunoglobulin A-mediated vasculitis with a self-limited course usually affecting the skin, joints, gastrointestinal tract, and kidneys. HSP occurs most often in children before the age of 10 years, and classically presents with a unique distribution of the rash to the lower extremities and the buttocks. One third of these patients will have one or more recurrences of symptoms, usually within 6 weeks, but they may occur as late as 18 months later. The overall prognosis in HSP is excellent, but the long-term morbidity depends mainly on the renal involvement. In our opinion, actually, there are no data to recommend the routine use of corticosteroids in the management of uncomplicated HSP, in both the acute and chronic settings.
8) La pagina gialla - Febbraio 2024
a cura di Alessandro Ventura9) Aggiornamento - Settembre 2023
Sindrome da ipersensibilità dei recettori della tosse (SIRT): “la tosse che fa tosse”
- Longo G.
- Dry cough usually accompanies the first few days of each “cold” (Upper Respiratory Tract Infection: URTI), but in some children, it always recurs with a particular intensity that “prevents sleep” and puts the whole family to the test. This cough is recognized to have an etiopathogenetic factor of an exaggerated sensitivity of cough sensory receptors. In the year 2000, the “Medico e Bambino” journal coined the acronym SIRT (Sindrome da Ipersensibilità dei recettori della Tosse - Cough Receptors Hypersensitivity Syndrome) to label this phenotype of cough. Today, this diagnosis is made more frequently especially by Italian family paediatricians who have learned to understand and recognize it. However, in the paediatric literature, SIRT still lacks recognition and an adequate description of its peculiar clinical characteristics. It is conceivable that SIRT corresponds to the persistent cough during the most acute phase of URTIs. The mechanisms by which viral infections induce the dysregulation of the cough reflex are now well understood, but why it remains unchanged over time in only certain individuals is still unknown. In adulthood, cough due to cough receptor hypersensitivity (Cough Receptor Hypersensitivity, CRH) has received much more attention, becoming an “umbrella” diagnosis for all “chronic” coughs of undefined cause. CRH recognizes the same mechanisms and causes at all ages, but there is a significant clinical difference that, in children, due to the high frequency of URTIs, it is characterized by recurrent episodes of acute cough, while in adults, CRH primarily manifests as a “chronic” cough induced by micro environmental stimuli (thermal, mechanical, chemical).