Giovanni Lavezzo, Gina Pietrolati, Alessandra Iacono, Federico Marchetti
Acute otitis externa (OEA) is an infectious of the external auditory canal with peak inci- dence between 5 and 9 years. 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.
{"title":"L’otite esterna acuta: dalla diagnosi al trattamento","authors":"Giovanni Lavezzo, Gina Pietrolati, Alessandra Iacono, Federico Marchetti","doi":"10.53126/meb43289","DOIUrl":"https://doi.org/10.53126/meb43289","url":null,"abstract":"Acute otitis externa (OEA) is an infectious of the external auditory canal with peak inci- dence between 5 and 9 years. 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.","PeriodicalId":39695,"journal":{"name":"Medico e Bambino","volume":"26 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Reti costituite da soggetti diversi per ottenere risultati nelle politiche, nei programmi e negli interventi a favore dell’infanzia e delle famiglie.
不同行为者为在儿童和家庭政策、计划和干预措施方面取得成果而建立的网络。
{"title":"Le reti per l'infanzia","authors":"G. Tamburlini","doi":"10.53126/meb43324","DOIUrl":"https://doi.org/10.53126/meb43324","url":null,"abstract":"Reti costituite da soggetti diversi per ottenere risultati nelle politiche, nei programmi e negli interventi a favore dell’infanzia e delle famiglie.","PeriodicalId":39695,"journal":{"name":"Medico e Bambino","volume":"91 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141101289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background - The emergency department (ED) is an important site of care in which inappropriate antibiotic prescribing and the consequent impact of antibiotic-resistant bacteria can be reduced. Objective - The aim of this retrospective study was to investigate the pattern of antibiotic prescriptions for upper respiratory tract infections in children examined in 3 different ED located in Azienda Ospedaliera Bergamo-Est and to highlight the possibilities for a reduction and a more appropriate use of this class of drugs, overprescribed in paediatric age. Methods - A retrospective observational study was performed on children younger than 18 years of age, who were examined in a general hospital near Bergamo from January 2020 to September 2022. The proportion and type of antibiotic prescription according to demographic, clinical, laboratory and imaging data were determined. Results - 4,731 children were included in the study and 894 (18.9%) received an antibiotic prescription. The prevalence of antibiotic prescription varies with age, with a peak at 1-5 years (21.7%), and depending on the diagnosis, from 2.5 % in children with influenza to 78.4% in children with otitis. Amoxicillin/clavulanate was the most prescribed antibiotic (47% of antibiotic prescriptions), while the percentage of amoxicillin prescription was low (36%). In patients examined for pharyngotonsillitis, amoxicillin was prescribed to 43% of those treated with antibiotics. Conclusions - This study supports the need for a new comprehensive approach to ensure successful antibiotic stewardship. A guide to the use of new diagnostic tests (molecular biology, genome sequencing and immunoenzymatic assays) in a “diagnostic stewardship” perspective may be helpful; however, clinical evaluation remains of fundamental and central importance.
{"title":"Prescrizione di antibiotici in Pronto Soccorso pediatrico","authors":"Ilaria Pacati, C. Ghitti, Antonio Clavenna","doi":"10.53126/meb43297","DOIUrl":"https://doi.org/10.53126/meb43297","url":null,"abstract":"Background - The emergency department (ED) is an important site of care in which inappropriate antibiotic prescribing and the consequent impact of antibiotic-resistant bacteria can be reduced. Objective - The aim of this retrospective study was to investigate the pattern of antibiotic prescriptions for upper respiratory tract infections in children examined in 3 different ED located in Azienda Ospedaliera Bergamo-Est and to highlight the possibilities for a reduction and a more appropriate use of this class of drugs, overprescribed in paediatric age. Methods - A retrospective observational study was performed on children younger than 18 years of age, who were examined in a general hospital near Bergamo from January 2020 to September 2022. The proportion and type of antibiotic prescription according to demographic, clinical, laboratory and imaging data were determined. Results - 4,731 children were included in the study and 894 (18.9%) received an antibiotic prescription. The prevalence of antibiotic prescription varies with age, with a peak at 1-5 years (21.7%), and depending on the diagnosis, from 2.5 % in children with influenza to 78.4% in children with otitis. Amoxicillin/clavulanate was the most prescribed antibiotic (47% of antibiotic prescriptions), while the percentage of amoxicillin prescription was low (36%). In patients examined for pharyngotonsillitis, amoxicillin was prescribed to 43% of those treated with antibiotics. Conclusions - This study supports the need for a new comprehensive approach to ensure successful antibiotic stewardship. A guide to the use of new diagnostic tests (molecular biology, genome sequencing and immunoenzymatic assays) in a “diagnostic stewardship” perspective may be helpful; however, clinical evaluation remains of fundamental and central importance.","PeriodicalId":39695,"journal":{"name":"Medico e Bambino","volume":"7 49","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
L’obiettivo non può essere solo di avere più nati, ma di poter crescere bambine e bambini nella pienezza del loro potenziale di sviluppo e salute.
我们的目标不能仅仅是多生孩子，而是要能够养育女孩和男孩，充分发挥他们在发展和健康方面的潜力。
{"title":"Nascere non basta","authors":"G. Tamburlini","doi":"10.53126/meb43279","DOIUrl":"https://doi.org/10.53126/meb43279","url":null,"abstract":"L’obiettivo non può essere solo di avere più nati, ma di poter crescere bambine e bambini nella pienezza del loro potenziale di sviluppo e salute.","PeriodicalId":39695,"journal":{"name":"Medico e Bambino","volume":"9 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141101093","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Quando la pertosse riemerge: si discute del noto (come prevenirla) (vedasi anche News Box e Pagina Gialla) e del non noto (la difficoltà nel trattarla)
{"title":"Lettere","authors":"Federico Marchetti","doi":"10.53126/meb43284","DOIUrl":"https://doi.org/10.53126/meb43284","url":null,"abstract":"Quando la pertosse riemerge: si discute del noto (come prevenirla) (vedasi anche News Box e Pagina Gialla) e del non noto (la difficoltà nel trattarla)","PeriodicalId":39695,"journal":{"name":"Medico e Bambino","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141101261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Leone, Maria Chiara Consentino, Maria Grazia Pappalardo, Roberta Leonardi, Federica Scarlata, Chiara Nannola, T. Timpanaro
The authors describe a case of idiopathic autoimmune thrombocytopenia characterized by the onset of visual disturbances due to macular haemor- rhage in the left eye.
作者描述了一例特发性自身免疫性血小板减少症病例，其特点是左眼黄斑出血导致视力障碍。
{"title":"Una presentazione atipica della porpora trombocitopenica immune","authors":"G. Leone, Maria Chiara Consentino, Maria Grazia Pappalardo, Roberta Leonardi, Federica Scarlata, Chiara Nannola, T. Timpanaro","doi":"10.53126/meb43330","DOIUrl":"https://doi.org/10.53126/meb43330","url":null,"abstract":"The authors describe a case of idiopathic autoimmune thrombocytopenia characterized by the onset of visual disturbances due to macular haemor- rhage in the left eye.","PeriodicalId":39695,"journal":{"name":"Medico e Bambino","volume":"76 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141101744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Una terapia che ha tutte le potenzialità per rivoluzionare il modo in cui affrontiamo le malattie oncologiche ma anche alcune patologie immunomediate. Imprescindibile la conoscenza del progresso
{"title":"Cellule CAR T: universo in espansione","authors":"Alex Moretti, Andrea Biondi","doi":"10.53126/meb43309","DOIUrl":"https://doi.org/10.53126/meb43309","url":null,"abstract":"Una terapia che ha tutte le potenzialità per rivoluzionare il modo in cui affrontiamo le malattie oncologiche ma anche alcune patologie immunomediate. Imprescindibile la conoscenza del progresso","PeriodicalId":39695,"journal":{"name":"Medico e Bambino","volume":"68 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141101490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Arianna Traunero, Simona Basilicata, L. Badina, M. Maschio, S. Ghirardo, A. Amaddeo
The paper presents the case of a 14-month-old child with a persistent respiratory distress with wheezing and diffuse crackles on chest auscultation. Symptoms appeared after a viral pneumonia caused by Adenovirus. The recent history, the clinical manifestations and the lung CT (Computed Tomography) scans, which showed a diffuse mosaic pattern, with air trapping, bronchiectasis and peribronchial inflammation, led to the diagnosis of Post-infectious Bronchiolitis Obliterans (PIBO). PIBO is a rare chronic paediatric pulmonary disease characterized by irreversible fibrotic narrowing of the small airways. It can present with a broad severity spectrum, and the evolution of this condition is not predictable in the single patient. Adenovirus is by far the most common cause of this lung pathology, and during the post Covid-19 pandemic an unprecedented rise in PIBO cases triggered by Adenovirus lower respiratory infections was observed. The treatment of PIBO is empirical, and a defined protocol does not exist yet. Therapeutic approaches range from nil to methylprednisolone pulse therapy, which would seem effective especially if performed early and if peribronchitis is found on imaging. Some studies evaluated the administration of intravenous immunoglobulins, while in more advanced cases showing fibrotic transformation of the parenchyma, the use of antifibrotic drugs (hydroxychloroquine, nintedanib) may be tried
{"title":"Bronchiolite obliterante post-infettiva (PIBO), chi è costei?","authors":"Arianna Traunero, Simona Basilicata, L. Badina, M. Maschio, S. Ghirardo, A. Amaddeo","doi":"10.53126/meb43317","DOIUrl":"https://doi.org/10.53126/meb43317","url":null,"abstract":"The paper presents the case of a 14-month-old child with a persistent respiratory distress with wheezing and diffuse crackles on chest auscultation. Symptoms appeared after a viral pneumonia caused by Adenovirus. The recent history, the clinical manifestations and the lung CT (Computed Tomography) scans, which showed a diffuse mosaic pattern, with air trapping, bronchiectasis and peribronchial inflammation, led to the diagnosis of Post-infectious Bronchiolitis Obliterans (PIBO). PIBO is a rare chronic paediatric pulmonary disease characterized by irreversible fibrotic narrowing of the small airways. It can present with a broad severity spectrum, and the evolution of this condition is not predictable in the single patient. Adenovirus is by far the most common cause of this lung pathology, and during the post Covid-19 pandemic an unprecedented rise in PIBO cases triggered by Adenovirus lower respiratory infections was observed. The treatment of PIBO is empirical, and a defined protocol does not exist yet. Therapeutic approaches range from nil to methylprednisolone pulse therapy, which would seem effective especially if performed early and if peribronchitis is found on imaging. Some studies evaluated the administration of intravenous immunoglobulins, while in more advanced cases showing fibrotic transformation of the parenchyma, the use of antifibrotic drugs (hydroxychloroquine, nintedanib) may be tried","PeriodicalId":39695,"journal":{"name":"Medico e Bambino","volume":"10 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141100073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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
{"title":"La gestione della piastrinopenia immune acuta in età pediatrica","authors":"Emilia Parodi, G. Russo","doi":"10.53126/meb43313","DOIUrl":"https://doi.org/10.53126/meb43313","url":null,"abstract":"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","PeriodicalId":39695,"journal":{"name":"Medico e Bambino","volume":"18 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The diagnosis of biliary atresia was ultimately made in an infant who still presented with jaundice after his first month of life and had previously been misdiagnosed with breast milk jaundice.The authors underline that biliary atresia should always be suspected in an infant with persistent jaundice after the third week of life.
作者强调，在婴儿出生后第三周出现持续黄疸时，应始终怀疑其患有胆道闭锁。
{"title":"L'ittero di un lattante","authors":"Marzia Moras, G. Tanzi, Paola Melli, P. Cogo","doi":"10.53126/meb43331","DOIUrl":"https://doi.org/10.53126/meb43331","url":null,"abstract":"The diagnosis of biliary atresia was ultimately made in an infant who still presented with jaundice after his first month of life and had previously been misdiagnosed with breast milk jaundice.The authors underline that biliary atresia should always be suspected in an infant with persistent jaundice after the third week of life.","PeriodicalId":39695,"journal":{"name":"Medico e Bambino","volume":"1 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141101188","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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