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
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.
186 kB2) 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.
3) Aggiornamento - Ottobre 2007
La splenomegalia
- M. Rabusin, F. Patarino
- The spleen in infants and children is involved in a wide variety of pathological conditions. Splenic disorders may be isolated like splenic cysts or, more frequently, due to multiorgan or systemic disease including hepatic diseases, malignancy, hemoglobinopathy, infectious diseases and storage diseases. The Authors review the role of the laboratory test, the ultrasonography and the peripheral blood smear in orienting the differential diagnosis. Invasive procedure as bone marrow aspiration, lymph node biopsy, hepatic biopsy or fine needle splenic biopsy are often warranted to estabilish the cause of splenomegaly.
4) 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.
5) Farmacoriflessioni - Aprile 2007
La terapia del croup
- F. Marchetti, P. Salierno
- Viral croup is the most common cause of upper airway obstruction in children from 6 months to 6 years of age. Parainfluenza virus accounts for the majority of cases. More than 80% of children have mild symptoms and in approximately 60% to 95% of children, the symptoms disappear within 2 and 5 days, respectively. Based on the results of systematic review, glucocorticoid treatment was associated with an improvement in the Westley score at 6 hours and at 12 hours. Fewer return visits and/or (re)admissions occurred in patients treated with glucocorticoids (relative risk 0.50; 0.36 to 0.70). The setting, severity of croup, route of administration (oral or nebulised) and dose, and study quality, did not influence the effectiveness of treatment. Nebulised adrenaline should be reserved for patients with moderate to severe croup. Simultaneous administration of glucocorticoid and adrenaline reduces the rate of intubation in patients with severe croup. Mist/humidified air provides no additional symptom improvement.
6) Aggiornamento - Maggio 2024
L’otite esterna acuta: dalla diagnosi al trattamento
- Lavezzo G, Pietrolati G, Iacono A, Marchetti F.
- Acute otitis externa (AOE) is an infection of the external auditory canal with peak incidence between 5 and 9 years of age. Predisposing factors are the summer period, water sports and duct injuries (e.g. cotton buds). The diagnosis is clinical and the responsible agents are mainly bacteria (Pseudomonas Aeruginosa followed by Staphylococcus Aureus). The therapy involves the local use of acidifiers and/or antiseptics for mild forms while for moderate forms topical antibiotics (in monotherapy or in combination with cortisone and/or anaesthetics). The use of systemic antibiotics should be reserved only for severe forms or those not responsive to topical therapy.
7) L'angolo dell'immunologo - Ottobre 2001
Quando sospettare un’immunodeficienza
- A. Tommasini, A. Insalaco, C. Perez, A.R. Soresina, A. Plebani
8) Linee guida - Ottobre 2020
La prima infezione urinaria febbrile in bambini di età compresa tra 2 mesi e 3 anni
- Gruppo di lavoro sulle infezioni delle vie urinarie della Società Italiana di Nefrologia Pediatrica (SINePe)
- The aim was to update the recommendations for the diagnosis, treatment and follow-up of the first febrile urinary tract infection in young children, which were first published in 2012 and endorsed by the Italian Society of Paediatric Nephrology. The Italian recommendations were revised on the basis of a review of the literature published from 2012 to October 2018. An ad hoc evaluation of the risk factors, which were published in the previous recommendations, was carried out to identify children with high-grade vesicoureteral reflux or renal scarring. When evidence was not available, the working group held extensive discussions during various meetings and through email exchanges. Four major modifications have been introduced. The method for collecting urine for culture and its interpretation has been re-evaluated. The algorithm that guides clinical decisions to proceed with voiding cystourethrography has been reformulated. The suggested antibiotics have been revised and further restrictions of the use of antibiotic prophylaxis have been recommended. These updated recommendations have now been endorsed by the Italian Society of Paediatric Nephrology and the Italian Society for Paediatric Infectivology. They can also be used to compare other available recommendations, as a worldwide consensus in this area is still lacking.
9) Aggiornamento - Giugno 2024
Il bambino che ritorna perché ha sempre la febbre: capire, sapere e saper fare
- De Nardi L, Insalaco A, De Benedetti F.
- Fever is a very common symptom in children, mostly due to infections. It is a physiological body defence mechanism against damage. However, when it is recurring, it is difficult to understand which are the underlying causes. Recurrent fever is most commonly due to trivial infections of the 1st infancy. However, it can seldom be the expression of inborn errors of immunity, monogenic periodic fevers, neoplasm, or other rheumatologic conditions. What comes with the fever (i.e. specific accompanying signs and symptoms) is essential to distinguish between such different diseases. This paper aims to provide an overview on the causes of recurrent fever in paediatrics, providing a practical guide to assist the paediatrician who needs to disentangle between different diagnoses.
10) Linee guida - Maggio 2024
La gestione della piastrinopenia immune acuta in età pediatrica
- Parodi E, Russo G. a nome del GdL AIEOP
- This report summarizes the most relevant issues of the document that the Working Group on Coagulation Disorders of the Italian Association of Paediatric Haematology and Oncology (AIEOP) developed to gather shared expert opinions on the management of newly diagnosed idiopathic thrombocytopenic purpura (ITP), updating previous guidelines and providing recommendations to paediatricians. These recommendations are not intended to be standards or fixed rules but rather a tool to support paediatricians in the management of the diagnostic work-up and treatment of children with newly diagnosed ITP.
11) Aggiornamento - Aprile 2008
L'ipertensione arteriosa in età pediatrica: dall'inquadramento diagnostico alla terapia
- A. de Cunto, M. Maschio, M. Pennesi, A. Benettoni
- The epidemic of childhood obesity, the risk of developing left ventricular hypertrophy, and evidence of the early development of atherosclerosis in children would make identification and treatment of hypertension an important focus of physicians caring for children. Secondary hypertension is more common in preadolescent children, with most cases caused by renal disease. Primary or essential hypertension is an emerging condition in adolescents and has multiple risk factors, including obesity and a family history of hypertension. Evaluation involves a thorough history and physical examination, laboratory tests, and specialized studies. Lifestyle modifications are advised for all patients and can be tried solely for those with blood pressures between the 95th and 99th percentiles. Drug therapy is indicated in children with blood pressures greater than the 99th percentile, secondary hypertension, coexisting diabetes, left ventricular hypertrophy, or those who fail a trial of non pharmacologic treatment.
12) La pagina gialla - Giugno 2024
a cura di Alessandro Ventura13) Editoriali - Aprile 2024
14) Aggiornamento - Settembre 2024
Ematuria e proteinuria
- Scaramuzzino F, Burlo F, Delcaro G, et al.
- Proteinuria and haematuria are common findings in children. However, they are indicative of a renal or urinary condition only in a minority of cases. The probability of an underlying disease causing haematuria and /or proteinuria increases when they are associated and in the presence of symptoms that suggest kidney damage, such as oedema, hypertension, or kidney failure. Transient and orthostatic proteinurias are benign conditions that do not require further investigations. Proteinuria should always be investigated when constant or heavy. If patients present with nephrotic syndrome, oedema and hypoalbuminemia, proteinuria is always pathologic. Tubular proteinuria should always be ruled out, in particular in male subjects with persistent proteinuria. Haematuria can be glomerular or non-glomerular and may present as gross haematuria or can only be detected microscopically. Macroscopic haematuria should always be investigated as it may be associated with benign conditions (fever, exertion, dehydration, nutcracker syndrome), but also with several conditions such as glomerular diseases or urolithiasis. The urine colour, the urinary sediment, the morphology of red blood cells, kidney function, the presence of proteinuria and the medical history help in the differential diagnosis. On the other hand, microscopic haematuria should be investigated only when persistent or if there is a positive family history. This paper presents 5 illustrative cases to highlight the above points.
15) Linee guida - Gennaio 2022
Le nuove linee guida ESPGHAN 2020 per la diagnosi di celiachia: passo dopo passo
- Mandile R, Auricchio R.
- In 2020 new guidelines for the diagnosis of paediatric coeliac disease were published by the ESPGHAN Society. Just one algorithm is indicated for both symptomatic and asymptomatic patients, HLA haplotype typing is no more suggested and anti-tissue transglutaminase antibodies are identified as the best test for screening for all ages. The present article explains how to manage critically this new diagnostic protocol for coeliac disease in children.
17) Problemi correnti - Dicembre 2007
Orticaria acuta post-infettiva
- M.P. Pilia, R. Meneghetti, G. Longo
- Acute urticaria related to infections is a benign manifestation in children, especially in infancy and early childhood. It typically happens at the same time or at the end of, or after, a viral infection. The eruption is self-limited, and episodes usually resolve within some days or few weeks; the presence of annular, polycyclic or geographic wheals are characteristic, and acral and facial angioedema and dermatographism are frequently observed. It is a very common disease; however, few reports concern this kind of urticaria and frequently they use different definitions as “acute annular urticaria”, “urticaria multiforme”, “acute urticaria of infancy and early childhood”, and more rarely as “infectious urticaria” or “urticaria in relation to infections”. The aim of this study was to review the literature available and shortly define the main clinical characteristics that differentiate this condition from other kinds of urticaria and from other reactions that can be misdiagnosed with it. A correct diagnosis may prevent unwarranted life-long dietary and drug restrictions and may reassure on the benign clinical course.
18) Problemi correnti - Novembre 2024
Infezioni delle vie urinarie: dalla diagnosi alla terapia
- De Pra S, Benvenuto S, Pennesi M.
- Urinary tract infections (UTIs) are a common occurrence in the paediatric population and are often paucisymptomatic in children under two years of age. A definitive diagnosis is obtained through urine culture, which should be collected using invasive methods or midstream urine. Intravenous (IV) therapy is indicated for infants under two months of age, in cases of complicated UTIs, or when there is a suspicion of poor therapeutic adherence. The effectiveness of oral antibiotic therapy (OS) has not shown to be inferior to that of IV therapy in other cases. Two large studies have shown that the effectiveness of a 5-day antibiotic therapy is not inferior to a 10-day one. The addition of corticosteroids, although it is safe, does not show solid evidence regarding its benefit and remains at the clinician's discretion. After a first episode of UTI, a renal ultrasound should always be performed to rule out underlying conditions such as vesicoureteral reflux or renal hypodysplasia. Other diagnostic investigations, such as voiding cystourethrography and renal scintigraphy with MAG3 or DMSA, should be performed only as a second step if specific abnormalities are detected on ultrasound or if there are specific clinical findings. UTIs rarely result in renal scarring, which is more often associated with congenital conditions. Moreover, unilateral renal scars are very rarely correlated with a decline in renal function. The usefulness of antibiotic prophylaxis in VUR (vesicoureteral reflux) has been questioned by numerous studies, which have demonstrated its limited effectiveness in reducing the recurrence of UTIs and its ineffectiveness in preventing renal scars, both in children with low-grade and high-grade VUR.
19) Editoriali - Marzo 2024
Atlante dermatologico pediatrico: 10 anni... e non li dimostra
- Fusco F, Sambugaro D
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.
2) 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.
3) Aggiornamento - Maggio 2024
L’otite esterna acuta: dalla diagnosi al trattamento
- Lavezzo G, Pietrolati G, Iacono A, Marchetti F.
- Acute otitis externa (AOE) is an infection of the external auditory canal with peak incidence between 5 and 9 years of age. Predisposing factors are the summer period, water sports and duct injuries (e.g. cotton buds). The diagnosis is clinical and the responsible agents are mainly bacteria (Pseudomonas Aeruginosa followed by Staphylococcus Aureus). The therapy involves the local use of acidifiers and/or antiseptics for mild forms while for moderate forms topical antibiotics (in monotherapy or in combination with cortisone and/or anaesthetics). The use of systemic antibiotics should be reserved only for severe forms or those not responsive to topical therapy.
4) Aggiornamento - Giugno 2024
Il bambino che ritorna perché ha sempre la febbre: capire, sapere e saper fare
- De Nardi L, Insalaco A, De Benedetti F.
- Fever is a very common symptom in children, mostly due to infections. It is a physiological body defence mechanism against damage. However, when it is recurring, it is difficult to understand which are the underlying causes. Recurrent fever is most commonly due to trivial infections of the 1st infancy. However, it can seldom be the expression of inborn errors of immunity, monogenic periodic fevers, neoplasm, or other rheumatologic conditions. What comes with the fever (i.e. specific accompanying signs and symptoms) is essential to distinguish between such different diseases. This paper aims to provide an overview on the causes of recurrent fever in paediatrics, providing a practical guide to assist the paediatrician who needs to disentangle between different diagnoses.
5) Linee guida - Maggio 2024
La gestione della piastrinopenia immune acuta in età pediatrica
- Parodi E, Russo G. a nome del GdL AIEOP
- This report summarizes the most relevant issues of the document that the Working Group on Coagulation Disorders of the Italian Association of Paediatric Haematology and Oncology (AIEOP) developed to gather shared expert opinions on the management of newly diagnosed idiopathic thrombocytopenic purpura (ITP), updating previous guidelines and providing recommendations to paediatricians. These recommendations are not intended to be standards or fixed rules but rather a tool to support paediatricians in the management of the diagnostic work-up and treatment of children with newly diagnosed ITP.
6) La pagina gialla - Giugno 2024
a cura di Alessandro Ventura7) Aggiornamento - Settembre 2024
Ematuria e proteinuria
- Scaramuzzino F, Burlo F, Delcaro G, et al.
- Proteinuria and haematuria are common findings in children. However, they are indicative of a renal or urinary condition only in a minority of cases. The probability of an underlying disease causing haematuria and /or proteinuria increases when they are associated and in the presence of symptoms that suggest kidney damage, such as oedema, hypertension, or kidney failure. Transient and orthostatic proteinurias are benign conditions that do not require further investigations. Proteinuria should always be investigated when constant or heavy. If patients present with nephrotic syndrome, oedema and hypoalbuminemia, proteinuria is always pathologic. Tubular proteinuria should always be ruled out, in particular in male subjects with persistent proteinuria. Haematuria can be glomerular or non-glomerular and may present as gross haematuria or can only be detected microscopically. Macroscopic haematuria should always be investigated as it may be associated with benign conditions (fever, exertion, dehydration, nutcracker syndrome), but also with several conditions such as glomerular diseases or urolithiasis. The urine colour, the urinary sediment, the morphology of red blood cells, kidney function, the presence of proteinuria and the medical history help in the differential diagnosis. On the other hand, microscopic haematuria should be investigated only when persistent or if there is a positive family history. This paper presents 5 illustrative cases to highlight the above points.
8) Linee guida - Gennaio 2022
Le nuove linee guida ESPGHAN 2020 per la diagnosi di celiachia: passo dopo passo
- Mandile R, Auricchio R.
- In 2020 new guidelines for the diagnosis of paediatric coeliac disease were published by the ESPGHAN Society. Just one algorithm is indicated for both symptomatic and asymptomatic patients, HLA haplotype typing is no more suggested and anti-tissue transglutaminase antibodies are identified as the best test for screening for all ages. The present article explains how to manage critically this new diagnostic protocol for coeliac disease in children.
10) Problemi correnti - Novembre 2024
Infezioni delle vie urinarie: dalla diagnosi alla terapia
- De Pra S, Benvenuto S, Pennesi M.
- Urinary tract infections (UTIs) are a common occurrence in the paediatric population and are often paucisymptomatic in children under two years of age. A definitive diagnosis is obtained through urine culture, which should be collected using invasive methods or midstream urine. Intravenous (IV) therapy is indicated for infants under two months of age, in cases of complicated UTIs, or when there is a suspicion of poor therapeutic adherence. The effectiveness of oral antibiotic therapy (OS) has not shown to be inferior to that of IV therapy in other cases. Two large studies have shown that the effectiveness of a 5-day antibiotic therapy is not inferior to a 10-day one. The addition of corticosteroids, although it is safe, does not show solid evidence regarding its benefit and remains at the clinician's discretion. After a first episode of UTI, a renal ultrasound should always be performed to rule out underlying conditions such as vesicoureteral reflux or renal hypodysplasia. Other diagnostic investigations, such as voiding cystourethrography and renal scintigraphy with MAG3 or DMSA, should be performed only as a second step if specific abnormalities are detected on ultrasound or if there are specific clinical findings. UTIs rarely result in renal scarring, which is more often associated with congenital conditions. Moreover, unilateral renal scars are very rarely correlated with a decline in renal function. The usefulness of antibiotic prophylaxis in VUR (vesicoureteral reflux) has been questioned by numerous studies, which have demonstrated its limited effectiveness in reducing the recurrence of UTIs and its ineffectiveness in preventing renal scars, both in children with low-grade and high-grade VUR.
11) Aggiornamento - Maggio 2023
Vasculiti facili e difficili: cosa deve sapere e saper fare un pediatra
- De Nardi L, Petrone MI, Benvenuto S, et al.
- Vasculitis is defined by a state of inflammation of the blood vessel walls. It can result in formation of either aneurysms or stenosis with ischemia and necrosis. The heterogeneity of clinical presentation depends on the type and size of the vessels involved, which leads to different patterns of organ damage. The skin is usually involved but not necessarily as a first manifestation of disease. Indeed, significant organ damage may occur at any time in the disease course and may precede other symptoms with significant morbidity and mortality, especially in case of diagnostic delay. The most common vasculitides in childhood are IgA-associated vasculitis (Schönlein-Henoch purpura) and Kawasaki disease. Other vasculitides are much rarer, often arising with insidious symp- toms that make them life-threatening. This paper aims to review the literature on paediatric vasculitides providing a practical guide to disentangle between different diagnoses. It also provides an overview that underlines the key differences in vasculitis presentation, management and follow-up.
12) 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.
13) Problemi correnti - Ottobre 2024
L’enuresi notturna: inquadramento e gestione
- Renzullo AM, Benvenuto S, Nait G, Pennesi M.
- Enuresis is the involuntary discharge of urine during sleep. It is a fairly common problem in paediatric age: approximately 1 child out of 5 is affected at 5 years of age, with a potential significant impact on their quality of life and family. Pathogenesis is multifactorial, resulting in a combination of genetic factors, delayed maturation of the central nervous system, night-time anti-diuretic hormone deficiency and, in case, coexisting conditions such as sleep and behavioural disorders. Adequate diagnosis and management can speed up resolution, which usually occurs spontaneously, and identify those cases underlying an organic cause. Diagnosis is clinical. Instrumental investigation (such as ultrasound or urodynamic tests) is reserved to selected cases. Treatment mainly involves behavioural approach alongside, in those in which this approach fails, nocturnal alarm and/or pharmacological therapy. Assessment of associated comorbidities is crucial (ex. constipation, sleep and behavioural disorders).
14) 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).
15) Lettere - Maggio 2024
Quando la pertosse riemerge: si discute del noto e non noto
- Parisi M, Marchetti F.
16) Aggiornamento - Ottobre 2024
Assistenza ventilatoria non invasiva: dalla teoria alla pratica
- Grigoletto V, Cognigni M, Badina L, et al.
- Noninvasive respiratory assistance strategies are becoming part of everyday life for paediatricians, both in hospitals and territorial settings. In the acute condition, a timely and correct use of noninvasive respiratory support can improve the outcome of acute respiratory failure, decreasing the need for invasive mechanical ventilation. An increasing number of chronic patients can benefit from appropriate treatment with home ventilators. Respiratory assistance may be performed using High Flow Nasal Cannula (HFNC), Continuous Positive Airway Pressure (CPAP) or NonInvasive Ventilation (NIV), depending on the primary cause of respiratory failure. Understanding the working mechanisms of the different techniques and the golden rules to use them is crucial for a satisfying outcome.
17) Editoriali - Settembre 2024
18) Problemi correnti - Giugno 2023
Faringotonsillite da streptococco, tempi di risposta all’antibiotico e implicazioni per la pratica corrente
- Iacono A, Mambelli L, De Nardi L, Marchetti F.
- An increase in Group A Streptococcal (GAS) infections higher than seasonally expected levels has been recently reported. Since GAS infections and correlated bacterial diffusion always start from an index case, adopting public health strategies based on ready isolation and treatment of GAS cases has become a relevant problem in the disease management. A systematic review recently published in Eurosurveillance aimed to estimate the pooled proportion of individuals who remained GAS throat culture-positive at set intervals after initiation of antibiotics. It was shown that antibiotic therapy acts on GAS leading to both clinical and microbiological recovery within 24 hours. This was confirmed for all the proven antibiotics, with amoxicillin remaining the drug of choice. Consequently, the child can return to school as early as the day after the beginning of the antibiotic therapy, without risks of infection for the community. About the 10% of children can maintain a positive swab after the start of antibiotic therapy: they are the asymptomatic GAS carriers and they are not to be chased. Furthermore, to avoid mistakes, asymptomatic children should not undergo GAS throat swab so as not to receive further and useless antibiotic therapies.
19) Lettere - Marzo 2024
Faringite e rivalutazione dello score di McIsaac
- Salvatore B, Marchetti F.
20) La Pediatria sulla Grande Stampa - Supplemento 2023
La pediatria sulla Grande Stampa 2023
- Alessandro Ventura
-
Eccoci qua come ogni anno con un po’ di recensioni della Pediatria sulla grande stampa: una selezione un po’ disordinata di novità, conferme, revisioni della letteratura, studi sperimentali usciti durante il 2023. E come al solito anche
di casi clinici, che rappresentano sempre un modo facile e vivo di tenersi aggiornati: si tratti di casi scolastici, promemoria di una realtà ben nota, o si tratti invece di qualcosa che ancora non abbiamo mai visto ma che già domani
potremmo incontrare nella nostra pratica (e quante volte ci è capitato proprio di vedere in ambulatorio il caso appena
letto?!).
La vera novità di quest’anno (novità che speriamo gradita e utile) sono i tre messaggi che precedono le recensioni di ogni specialità evidenziati graficamente dallo sfondo grigio: messaggi di esperti della materia che in poche parole ci indicano quale per loro sia stata la novità più importante dell’anno, quale l’errore che non si dovrebbe più fare e quale infine sia la loro personale raccomandazione a tutti noi.
C’è anche un assaggino minuscolo, un paio di recensioni, che riguardano articoli sull’intelligenza artificiale e i modi con cui potrebbe già da ora, e in concreto, venirci in aiuto. Poco, troppo poco per un argomento che, c’è poco da fare, ci dovrebbe trovare oggi più attenti e impegnati a conoscere e capire: consapevoli dello smisurato progresso, ma anche dei rischi disumanizzanti, che l’intelligenza artificiale porta con sé. Proprio come, e non può essere un caso…, ci ha tempestivamente esortato a fare il presidente Mattarella nel suo luminoso discorso di fine d’anno. Vedremo dunque (spero tutti insieme) di far meglio il prossimo anno.
Buona lettura, dunque. Se di leggere questo speciale avrete voglia. E come sempre Buon Anno per quel che resta dell’anno!
Alessandro Ventura
Consulta la versione sfogliabile.
-
Eccoci qua come ogni anno con un po’ di recensioni della Pediatria sulla grande stampa: una selezione un po’ disordinata di novità, conferme, revisioni della letteratura, studi sperimentali usciti durante il 2023. E come al solito anche
di casi clinici, che rappresentano sempre un modo facile e vivo di tenersi aggiornati: si tratti di casi scolastici, promemoria di una realtà ben nota, o si tratti invece di qualcosa che ancora non abbiamo mai visto ma che già domani
potremmo incontrare nella nostra pratica (e quante volte ci è capitato proprio di vedere in ambulatorio il caso appena
letto?!).