Mario Tumminello, G. Serra, Deborah Bacile, Elisabetta Di Leto, Antonella Gangemi, Melania Guardino, G. Corsello
Neonatal lupus erythematosus (NLE) is a rare immune-mediated disorder due to the pas- sage of maternal anti-Ro/SSA and anti-La/SSB antibodies through the placenta to the foe- tus and newborn. Major manifestations include cardiac anomalies and skin lesions, while hepatic and haematological abnormalities are observed in a minority of cases. The most serious complication is congenital heart block, usually already occurring in the prenatal period (second or third trimester of pregnancy). Cutaneous lupus is the typical manifestation of NLE, characterized by transient and generally photosensitive annular erythematous le- sions, preferentially localized on the face, scalp or periocular region, and less commonly observed on the trunk and extremities. Due to its benign and transient course, no treatment is required. Prophylaxis with hydroxychloroquine in pregnant women testing positive for autoantibodies and/or with a previously affected child may reduce the risk of cardiac and/or cutaneous complications in newborns and infants. The article reports the case of a two-day-old newborn showing a widespread cutaneous rash with erythematous “stepped” patches compatible with annular erythema, localized on their upper and lower limbs, as well as on the anterior surface of their trunk. Obstetric history, which revealed the mother being affected with Sjogren Syndrome and performing hydroxychloroquine prophylaxis, led to the NLE diagnostic suspicion, later confirmed by the detection of specific antibodies (anti-SSA/Ro60 and SSA/Ro52). Although the prognosis of cutaneous NLE is generally favourable, any coexisting and potential life-threatening complications, including haema- tological and cardiological abnormalities, should be ruled out.
{"title":"Manifestazioni cutanee anulari e lupus eritematoso neonatale","authors":"Mario Tumminello, G. Serra, Deborah Bacile, Elisabetta Di Leto, Antonella Gangemi, Melania Guardino, G. Corsello","doi":"10.53126/meb43033","DOIUrl":"https://doi.org/10.53126/meb43033","url":null,"abstract":"Neonatal lupus erythematosus (NLE) is a rare immune-mediated disorder due to the pas- sage of maternal anti-Ro/SSA and anti-La/SSB antibodies through the placenta to the foe- tus and newborn. Major manifestations include cardiac anomalies and skin lesions, while hepatic and haematological abnormalities are observed in a minority of cases. The most serious complication is congenital heart block, usually already occurring in the prenatal period (second or third trimester of pregnancy). Cutaneous lupus is the typical manifestation of NLE, characterized by transient and generally photosensitive annular erythematous le- sions, preferentially localized on the face, scalp or periocular region, and less commonly observed on the trunk and extremities. Due to its benign and transient course, no treatment is required. Prophylaxis with hydroxychloroquine in pregnant women testing positive for autoantibodies and/or with a previously affected child may reduce the risk of cardiac and/or cutaneous complications in newborns and infants. The article reports the case of a two-day-old newborn showing a widespread cutaneous rash with erythematous “stepped” patches compatible with annular erythema, localized on their upper and lower limbs, as well as on the anterior surface of their trunk. Obstetric history, which revealed the mother being affected with Sjogren Syndrome and performing hydroxychloroquine prophylaxis, led to the NLE diagnostic suspicion, later confirmed by the detection of specific antibodies (anti-SSA/Ro60 and SSA/Ro52). Although the prognosis of cutaneous NLE is generally favourable, any coexisting and potential life-threatening complications, including haema- tological and cardiological abnormalities, should be ruled out.","PeriodicalId":39695,"journal":{"name":"Medico e Bambino","volume":"20 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139597415","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}
Equitable access to healthcare is crucial to ensure the fundamental human right to health for all, also for children. However, the possibility to use in appropriate manner medical services (e.g. to access hospital) differs substantially across Italian regions. It is a situa- tion, source of inequality, that has been known for some time and has not found a solu- tion to date. In 2020, the pandemic year, 74.071 hospital admissions occurred for chil- dren and adolescents residing in regions other than that of hospitalization (14.3% of to- tal hospitalizations outside the region of residence). The national flight index was 8.7 ranging from 3.4 of Lazio to 43.4 of Molise. 54.8% of out-region hospitalizations are for patients traveling from one of the regions bordering their residence, in particular to be born. The starting regions with the highest mobility rate and long distance hospitalisation were Calabria, Sardinia, and Sicily with a flight index of 29.0, 11.8 and 11.5 for a to- tal of 11,745 hospitalizations. The main causes of hospitalization in a region far from their own are attributable to psychiatric disorders (43.3% of its Major Diagnostic Cate- gory), epilepsy and cephalalgy care (24.3%), and surgery for the replacement of major joints or reimplantation of the lower limbs with (18.5%). The phenomenon of medical mi- gration undermines the principles of universality, equality and fairness and it is therefore necessary to intervene to guarantee an unfulfilled right in its entirety. Centers of excellen- ce for pediatric care and clinical research are also needed in the southern regions.
{"title":"Minori in viaggio per farsi curare","authors":"R. Campi, M. Bonati","doi":"10.53126/meb43027","DOIUrl":"https://doi.org/10.53126/meb43027","url":null,"abstract":"Equitable access to healthcare is crucial to ensure the fundamental human right to health for all, also for children. However, the possibility to use in appropriate manner medical services (e.g. to access hospital) differs substantially across Italian regions. It is a situa- tion, source of inequality, that has been known for some time and has not found a solu- tion to date. In 2020, the pandemic year, 74.071 hospital admissions occurred for chil- dren and adolescents residing in regions other than that of hospitalization (14.3% of to- tal hospitalizations outside the region of residence). The national flight index was 8.7 ranging from 3.4 of Lazio to 43.4 of Molise. 54.8% of out-region hospitalizations are for patients traveling from one of the regions bordering their residence, in particular to be born. The starting regions with the highest mobility rate and long distance hospitalisation were Calabria, Sardinia, and Sicily with a flight index of 29.0, 11.8 and 11.5 for a to- tal of 11,745 hospitalizations. The main causes of hospitalization in a region far from their own are attributable to psychiatric disorders (43.3% of its Major Diagnostic Cate- gory), epilepsy and cephalalgy care (24.3%), and surgery for the replacement of major joints or reimplantation of the lower limbs with (18.5%). The phenomenon of medical mi- gration undermines the principles of universality, equality and fairness and it is therefore necessary to intervene to guarantee an unfulfilled right in its entirety. Centers of excellen- ce for pediatric care and clinical research are also needed in the southern regions.","PeriodicalId":39695,"journal":{"name":"Medico e Bambino","volume":"53 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139598870","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. Mambelli, Beatrice Gagliardo, M. Minguzzi, Federico Marchetti
Osteoid osteoma is a condition that causes pain and limping in the lower extremity. The- refore, a thorough investigation is necessary in preschool children with prolonged pain and limping. The paper presents the case of a 6-year-old girl with severe nocturnal pain in her tibia. X-ray and MRI did not show any abnormalities, but a technetium bone scan revealed an osteoid osteoma in her femoral neck. CT scan confirmed the diagnosis. The patient underwent ablative treatment with focused ultrasound guided by MRI. When osteoid osteoma is suspected, standard radiology should be the initial diagnostic ima- ging. However, it is important to extend the imaging to the entire femur if the pain radia- tes from the femur to the leg. If the standard x-ray is inconclusive, a CT scan or techne- tium bone scan should be considered.
{"title":"Una bambina molto in gamba...: alla ricerca del suo dolore","authors":"L. Mambelli, Beatrice Gagliardo, M. Minguzzi, Federico Marchetti","doi":"10.53126/meb43045","DOIUrl":"https://doi.org/10.53126/meb43045","url":null,"abstract":"Osteoid osteoma is a condition that causes pain and limping in the lower extremity. The- refore, a thorough investigation is necessary in preschool children with prolonged pain and limping. The paper presents the case of a 6-year-old girl with severe nocturnal pain in her tibia. X-ray and MRI did not show any abnormalities, but a technetium bone scan revealed an osteoid osteoma in her femoral neck. CT scan confirmed the diagnosis. The patient underwent ablative treatment with focused ultrasound guided by MRI. When osteoid osteoma is suspected, standard radiology should be the initial diagnostic ima- ging. However, it is important to extend the imaging to the entire femur if the pain radia- tes from the femur to the leg. If the standard x-ray is inconclusive, a CT scan or techne- tium bone scan should be considered.","PeriodicalId":39695,"journal":{"name":"Medico e Bambino","volume":"54 49","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139599024","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}
La storia e le prospettive che proclamano l'ingresso della comu- nità di Scampia nella rete della cultura, della ricerca, della formazione universitaria, dell'assistenza medica avanzata.
历史和观点宣告斯坎皮亚社区进入文化、研究、大学教育和先进医疗网络。
{"title":"Un sogno per Scampia","authors":"L. Greco, Salvatore Auricchio","doi":"10.53126/meb43061","DOIUrl":"https://doi.org/10.53126/meb43061","url":null,"abstract":"La storia e le prospettive che proclamano l'ingresso della comu- nità di Scampia nella rete della cultura, della ricerca, della formazione universitaria, dell'assistenza medica avanzata.","PeriodicalId":39695,"journal":{"name":"Medico e Bambino","volume":"15 15","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139595501","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}
A typical case of a hypertrophic pyloric stenosis is presented and discussed.
本文介绍并讨论了一个典型的肥厚性幽门狭窄病例。
{"title":"Un vomito di troppo, un'evacuazione di meno","authors":"Micaela Cerreti","doi":"10.53126/meb43052","DOIUrl":"https://doi.org/10.53126/meb43052","url":null,"abstract":"A typical case of a hypertrophic pyloric stenosis is presented and discussed.","PeriodicalId":39695,"journal":{"name":"Medico e Bambino","volume":"13 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139595745","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}
Daniele Zama, Luigi Altimari, Martina Ruscelli, Luca Pierantoni, M. Gennari, F. Toni, Caterina Campoli, Livio Presutti, Marcello Lanari
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.
{"title":"La cellulite orbitaria in età pediatrica: una proposta di gestione diagnostico-terapeuticae","authors":"Daniele Zama, Luigi Altimari, Martina Ruscelli, Luca Pierantoni, M. Gennari, F. Toni, Caterina Campoli, Livio Presutti, Marcello Lanari","doi":"10.53126/meb43017","DOIUrl":"https://doi.org/10.53126/meb43017","url":null,"abstract":"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.","PeriodicalId":39695,"journal":{"name":"Medico e Bambino","volume":"9 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139598321","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}
Il riemergere del morbillo in alcuni contesti internazionali ripropone il tema delle coperture vaccinali con due dosi e della possibilità di eliminazione di questa malattia infettiva. Ci siamo vicini anche in Italia ma occorre un ulteriore sforzo coordinato.
{"title":"Morbillo: una battaglia da fare in tempo di pace","authors":"R. Russo","doi":"10.53126/meb43015","DOIUrl":"https://doi.org/10.53126/meb43015","url":null,"abstract":"Il riemergere del morbillo in alcuni contesti internazionali ripropone il tema delle coperture vaccinali con due dosi e della possibilità di eliminazione di questa malattia infettiva. Ci siamo vicini anche in Italia ma occorre un ulteriore sforzo coordinato.","PeriodicalId":39695,"journal":{"name":"Medico e Bambino","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139596209","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}
Con quella faccia un po' così, quella statura un po' così, che abbiamo noi con una cardiopatia...
脸有点像，身材有点像，这就是我们的心脏病....。
{"title":"La sindrome di Poland","authors":"Michele Abramo, A. Selicorni","doi":"10.53126/meb43043","DOIUrl":"https://doi.org/10.53126/meb43043","url":null,"abstract":"Con quella faccia un po' così, quella statura un po' così, che abbiamo noi con una cardiopatia...","PeriodicalId":39695,"journal":{"name":"Medico e Bambino","volume":"9 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139596330","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 case of a 12-year-old girl presenting with poor exercise tolerance, muscular cramps and CPK high levels is described.The diagnosis of McArdle disease was eventually made due to the classic “second wind” sign.
{"title":"Crampi muscolari, ipercpkemia e fenomeno \"Second wind\": la malattia di McArdle","authors":"Martha Caterina Faraguna, Silvia Barzaghi, Viola Crescitelli, Roberta Pretese, Annamaria Fornari, Serena Gasperini","doi":"10.53126/meb43053","DOIUrl":"https://doi.org/10.53126/meb43053","url":null,"abstract":"The case of a 12-year-old girl presenting with poor exercise tolerance, muscular cramps and CPK high levels is described.The diagnosis of McArdle disease was eventually made due to the classic “second wind” sign.","PeriodicalId":39695,"journal":{"name":"Medico e Bambino","volume":"120 16","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139596488","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}
Francesca Banditelli, Laura Pisanu, Antonella Gagliano
The aim of the present work is to summarize recent advances in the field of clinical pedi- atric sleep medicine and to give tools for clinical assessment and treatment of paediatric insomnia in children with neurodevelopmental disorders, especially ASD and ADHD. Bedtime problems and night awakenings are common cause of paediatric and neuropsy- chiatric consultation and have an impact on quality of life of both child and family. Epi- demiology, pathophysiology, clinical evaluation, sequelae and treatment are described. Clinical tools for assessment, behavioural and pharmacological treatment are presented.
{"title":"L’insonnia nei disturbi del neurosviluppo: ADHD e ASD","authors":"Francesca Banditelli, Laura Pisanu, Antonella Gagliano","doi":"10.53126/meb43037","DOIUrl":"https://doi.org/10.53126/meb43037","url":null,"abstract":"The aim of the present work is to summarize recent advances in the field of clinical pedi- atric sleep medicine and to give tools for clinical assessment and treatment of paediatric insomnia in children with neurodevelopmental disorders, especially ASD and ADHD. Bedtime problems and night awakenings are common cause of paediatric and neuropsy- chiatric consultation and have an impact on quality of life of both child and family. Epi- demiology, pathophysiology, clinical evaluation, sequelae and treatment are described. Clinical tools for assessment, behavioural and pharmacological treatment are presented.","PeriodicalId":39695,"journal":{"name":"Medico e Bambino","volume":"15 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139596076","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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