Ottobre 2008 - Volume XXVII - numero 8

Medico e Bambino

Pagine elettroniche ; Ricerca

La consulenza telefonica infermieristica in pronto soccorso pediatrico: esperienze e prospettive

G. Borrelli1, P. Serafini2, E. Rossi3

1Infermiere DEA, Azienda Sanitaria Ospedaliera OIRM - S. Anna, Torino
2Ostetrica Coordinatrice, Corso di Laurea in Ostetricia, Università di Torino
3Pediatra, Direttore Sanitario Azienda Sanitaria Ospedaliera OIRM - S. Anna, Torino

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Key words: Telephone nursing consultancy, Paediatric Emergency Unit, Information request

Background - In the Paediatric Emergency Unit phone nursing consultancy represents an important reference point for the users in case of acute situations and at the same time enables to filter requests. Aim - The present work analyses and evaluates the work burden connected with the activity of telephone nursing consultancy by identifying the reasons that most frequently make the users call the Paediatric Emergency Unit and by defining juridical liabilities. Materials and Methods - For each phone call the general data concerning the child, the output of the phone call and its duration as well as the operator have been recorded in a form. The phone calls have been divided into consultancy and information request. The descriptive perspective study was carried out from May to September 2007. Results - The total number of phone calls was 7,813 of which 5,874 consultancies and 1,939 information requests. The most frequent symptom was fever followed by cutaneous eruption and accidents. Conclusion - Since 75% of the phone calls almost always concerns the same symptoms, it would be useful to draw up protocols for the most frequent questions in order optimize the whole procedure.

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G. Borrelli, P. Serafini, E. Rossi La consulenza telefonica infermieristica in pronto soccorso pediatrico: esperienze e prospettive. Medico e Bambino 2008;27(8):527-529

Pagine elettroniche ; Caso Contributivo

Colestasi neonatale: la grande simulatrice

M. Tufano1, F. Cirillo1, G. Ranucci1, R. Vecchione2, A. Sonzogni3, D. Alberti4, R. Iorio1

1Dipartimento di Pediatria, Università Federico II di Napoli
2Dipartimento di Scienze Biomorfologiche e Funzionali, Università Federico II di Napoli
3Dipartimento di Anatomia Patologica, AO Ospedali Riuniti di Bergamo
4Chirurgia Pediatrica, AO Ospedali Riuniti di Bergamo

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Key words: Neonatal cholestasis, Jaundice, Sclerosing cholangitis, Cholangiography

Early detection and accurate diagnosis of cholestatic jaundice (CJ) are important for successful treatment and favourable prognosis but the rapid and effective recognition of the causes of cholestasis in infants is still challenging also for paediatric gastroenterologist. Here is reported the case of a female infant with CJ who during the observation showed features suggestive of many diseases such as Alagille syndrome, cystic fibrosis, neonatal hemocromatosis, α1- anti-trypsin deficiency (α1-ATD) and biliary atresia. A definite diagnosis was not obtained with a first liver biopsy performed at the age of 58 days which revealed severe lobular hepatitis and signs of cholangitis. An intraoperative cholangiography, performed to exclude biliary atresia, showed signs of sclerosing cholangitis. A second liver biopsy supported diagnosis of sclerosing cholangitis, but also showed signs of α1-ATD. The analysis of phenotype/genotype of α1-ATD excluded this diagnosis. At the end of a challenging diagnostic process, at the age of 75 days, the final diagnosis was of neonatal sclerosing cholangitis, but many doubts persisted. This case confirms that neonatal cholestasis remains a very challenging matter.

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M. Tufano, F. Cirillo, G. Ranucci, R. Vecchione, A. Sonzogni, D. Alberti, R. Iorio Colestasi neonatale: la grande simulatrice. Medico e Bambino 2008;27(8):527-529

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