1Cattedra di Pediatria, Università Magna Graecia di Catanzaro
2Assessorato Sanità Regione Calabria
Indirizzo per corrispondenza: email@example.com
Key words: South-north migration, Passive mobility, Hospital discharge records, Hospital admission, Children
Background - South-north migration (passive mobility) for medical
care is a social phenomenon still relevant in the Italian scenario.
Aim - The aim of the present work was to study the paediatric migration (0-16 year of age) from Calabria to other Italian regions for medical reasons.
Methods and material - The hospital discharge records from Calabria Region Health Department on hospital admissions in and out of the Region from 2004 to 2008 was analysed. Diagnoses were codified for medical specialty using 2002 ICD- 9-CM. The information acquired was compared to ACP (Associazione Culturale Pediatri) inquiry performed in 1982 and 1996.
Results - In the examined period of time the numbers of admissions in Calabria were 182,183 concerning 28,351 patients; outside the Region the total hospital admissions were 34,647 concerning 6,190 patients (19% of total admissions): 2,256 in Emilia Romagna, 1,950 in Tuscany, 8,309 in Sicily, 8,526 in Bambino Gesù Hospital, 3,039 in Lombardy, 911 in Puglia, 2,901 in Liguria, 77 in Marche, 40 in Trentino, 2,978 in Lazio, 208 in Umbria, 145 in Friuli Venezia Giulia, 616 in Piedmont, 554 in Veneto, 114 in Abruzzo, 22 in Molise, 1,057 in Campania, 923 in Basilicata, 13 in Sardinia and 8 in Valle d’Aosta. Out of these 6,190 patients, 940 were admitted only outside the Region and 5,250 were admitted in and out of the Region. Costs of 2004-2008 passive mobility were 61 millions of euros. Comparing the obtained results to the previous ACP studies (1982 and 1996) a reduction of the migration rate by 36% to 19% was observed.
Conclusions - Migration for medical care in paediatric patients has been reduced in the last few years; however, it still remains an important Calabria social problem.
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1Pediatra di famiglia, Ragusa
2Scuola di Specializzazione in Pediatria, Università di Catania
Indirizzo per corrispondenza: firstname.lastname@example.org
Key words: Precocious pubarche, Accelerated growth, Growth charts, Non-classical congenital adrenal hyperplasia
Non-classical congenital adrenal hyperplasia (NC CAH) is an autosomal recessive disease that appears during childhood with hyperandrogenic symptoms (premature pubarche, accelerated growth, advanced bone age, penile enlargement, and hypertrophy of clitoris). The case of a 8-year-old boy that showed abnormal statural growth at the annual health check-up is reported. Pubic hair was present but the parents had never noticed this sign before. The advanced bone age and the detection of 17OHP high levels led to the suspicion of NC CAH. The patient was sent to the Reference Centre where NC CAH was diagnosed and molecular analysis of the CYP21A2 gene was started to identify the genotype of the child and his parents. Although the diagnosis must be made by the Centre, a careful examination and a proper interpretation of growth charts are sufficient to the paediatrician to suspect this disease and measure the 17OHP serum concentration.
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