1U.O.C. Neuropsichiatria Infantile AULSS 10 “Veneto Orientale” San Donà di Piave, Veneto
2Dip.to del Farmaco, Istituto Superiore di Sanità, Roma
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Key words: ADHD, Prevalence, Multimodal treatment, Register
Objective: to assess the prevalence of ADHD in the Italian paediatric population and to evaluate the rate of exposition to pharmacological treatment in children and adolescents affected by ADHD.
Method: observational post-marketing study, 4th phase. Assessment of the drugs prescribed to children and adolescents aged between 6-18 with ADHD in child psychiatry unit of San Donà di Piave.
Results: the population aged 6-18 years amount to 24,000 inhabitants. 2,503 (10.8%) were examined in 2007 for suspected developmental disorders and 286 (1.2%) were diagnosed positive for ADHD. 20 out of 286 (7.0%) patients had received the multimodal treatment and 186 the behavioural treatment alone. In 2010, the subjects suffering from ADHD were 263 (1.1 %) on a population aged 6-18 of 24,650 individuals. 44 (16.7 %) were in multimodal treatment and 153 received behavioural treatment.
Conclusions: the survey was carried out in a small population. Nevertheless this cohort is quite representative of Italian paediatric population. The observed prevalence of ADHD corresponds to that expected on the basis of the data of previous epidemiological Italian surveys but considerably lower than the one reported in international literature. The rate of exposure to pharmacological treatment is similar to that of other European countries.
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1Scuola di Specializzazione in Pediatria, Ferrara; 2UOC di Pediatria e Neonatologia, Azienda Ospedaliera di Ravenna; 3Pediatria di Libera Scelta, AUSL di Ravenna; 4UO di Ortopedia e Traumatologia Pediatrica, Istituto Ortopedico Rizzoli, Bologna
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Key words: Thalasso-drepanocytosis, Mild anaemia, Osteonecrosis, Case report
The paper describes the case of an 8-year-old Moroccan girl who presented with recurrent multi-focal bone pains associated with negative flogosis indexes and standard radiological exams. The magnetic resonance exam of her thighbones showed a multi-focal inflammation; bone biopsy showed that the inflammation was aseptic and secondary to an osteonecrosis caused by vaso-occlusive crisis. After the haemoglobin electrophoresis performed in consideration of the persistent evidence of a mild microcytic anaemia with anisocytosis, the diagnosis was of thalasso-drepanocytosis. Thalasso-drepanocytosis is one of the sickle cell syndromes characterised by heterozygosis associated with thalassemic haemoglobinopathy. It can be clinically similar to homozygote drepanocytosis and therefore it needs the same therapeutic approach and follow-up. The case highlights the importance of thinking about sickle cell crisis, also in absence of important anaemization, when foreign patients coming from world’s endemic areas for thalassemic haemoglobinopathy present with recurrent bone pains.
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