1,721,016 research outputs found
Vaccine administration and the development of immune thrombocytopenic purpura in children
No full textThe most important reasons cited by the opponents of vaccines are concerns about vaccine safety. Unlike issues such as autism for which no indisputable documentation of direct relationship with vaccine use is available, immune thrombocytopenic purpura (ITP) is an adverse event that can really follow vaccine administration, and may limit vaccine use because little is known about which vaccines it may follow, its real incidence and severity, the risk of chronic disease, or the possibility of recurrences after new doses of the same vaccine. The main aim of this review is to clarify the real importance of thrombocytopenia as an adverse event and discuss how it may interfere with recommended vaccination schedules. The available data clearly indicate that ITP is very rare and the only vaccine for which there is a demonstrated cause-effect relationship is the measles, mumps and rubella (MMR) vaccine that can occur in 1 to 3 children every 100,000 vaccine doses. However, also in this case, the incidence of ITP is significantly lower than that observed during the natural diseases that the vaccine prevents. Consequently, ITP cannot be considered a problem limiting vaccine use except in the case of children suffering from chronic ITP who have to receive MMR vaccine. In these subjects, the risk-benefit ratio of the vaccine should be weighed against the risk of measles in the community
Catheter-related infections in pediatric patients with cancer.
No full textCentral venous catheters (CVCs) are essential in the management of pediatric patients receiving antineoplastic therapy or bone marrow transplants, and have significantly improved their quality of life, but CVC-related infectious complications are a major source of morbidity. It has been estimated that 14–51 % of the CVCs implanted in children with malignancies may be complicated by bacteremia, and that the incidence of infections is 1.4–1.9 episodes per 1,000 CVC days. However, there are few recent data concerning the epidemiology of CVC-related
infections, the prevalence of antimicrobial resistance in their etiology, or the main factors associated with an increased risk of infection by type of catheter, patient age, the type of cancer, or the presence of neutropenia. Moreover, although various new strategies have been proposed in an attempt to reduce the risk of CVC-related infections, such as catheters impregnated with antiseptics/antibiotics, lock antibiotic prophylaxis, the use of ointments at the exit site, and antithrombotic prophylaxis, their real efficacy in children has not yet been demonstrated. The management of CVC-related infections remains difficult, mainly because of the number of still open questions (including the choice of optimal antimicrobial therapy because of the increasing isolation of multiresistant bacterial strains, treatment duration, whether catheters should be removed or not, the feasibility of guidewire exchange, and the usefulness of antibiotic lock therapy)
and the lack of studies of children with cancer. Only well-designed, prospective clinical trials involving pediatric cancer patients can clarify optimal prevention and treatment strategies for CVC-related infections in this population
Eventi tromboembolici in età pediatrica: aspetti epidemiologici ed istituzione del registro italiano delle trombosi infantili
No full textManagement and investigation of neonatal thromboembolic events: Genetic and acquired risk factors
No full textNewborns comprise the largest group of children developing thromboembolic events (TEs), due to the peculiarities of their developmental hemostatic system. Moreover, in the sick newborn, especially preterm, numerous acquired perinatal and iatrogenic conditions might result in a disturbance between coagulation and fibrinolysis, leading to thrombus formation.
Nevertheless, the contribution of acquired prothrombotic disorders in the pathogenesis of thromboembolic disease in newborns remains poorly defined. Few data are currently available regarding the influence of maternal or fetal genes on thrombotic risk in the fetus and neonate. Ongoing National and International registries are partially answering these questions.
The purpose of this review is to evaluate the current knowledge about the role of inherited, acquired perinatal and maternal prothrombotic risk factors in neonatal cerebral nervous system (CNS) thrombotic events and non-CNS thrombotic events
The sdq in Italian clinical practice: evaluation between three outpatient groups copmpared
No full textLo scopo del nostro studio è valutare l’efficacia del Strength and Difficulties Questionnarie (SDQ) come
strumento di screening per i problemi emotivi e comportamentali in tre diverse popolazioni a rischio. Metodi. L’SDQ è
un breve questionario di screening che indaga la presenza di problematiche emotive e comportamentali in bambini e adolescenti.
Abbiamo esaminato 497 questionari compilati dai genitori di bambini afferenti alle cliniche di Neuropsichiatria Infantile,
Endocrinologia Pediatrica e Oncologia Pediatrica. Risultati. I risultati indicano una maggiore presenza di disturbi psicopatologici
nei pazienti della Neuropsichiatria rispetto a quelli dell’Oncologia e dell’Endocrinologia. Inoltre, i pazienti dell’Oncologia
hanno più problematiche emotive e comportamentali rispetto a quelli dell’Endocrinologia. Discussione. I risultati
supportano l’uso del questionario SDQ per la valutazione di problematiche emotive e comportamentali in queste popolazioni
a rischio. Quindi l’SDQ potrebbe essere utilizzato dai clinici per individuare precocemente disturbi psicopatologici in
bambini con diversi tipi di patologie organiche croniche
NORMAL VALUES OF TRANSIENT ELASTOGRAPHY (FIBROSCAN) IN CHILDREN WITHOUT EVIDENCE OF LIVER DISEASE: COMPARISON OF ADULT VERSUS PEDIATRIC PROBE
No full textNormal values of transient elastography (Fibroscan) in children without evidence of liver disease: Comparison of adult versus paediatric probe
No full textLangerhans cell histiocytosis in a pediatric patient with thrombocytopenia-absent radius syndrome and 1q21.1 deletion: case report and proposal of a rapid molecular diagnosis of 1q21.1 deletion.
No full textWe describe a child with thrombocytopenia-absent radius (TAR) syndrome in whom a refractory Langerhans cell histiocytosis (LCH) developed at 9 years. Recently, it has been demonstrated, in a large cohort of patients with TAR syndrome, that microdeletion on chromosome 1q21.1 is the characteristic genetic alteration. This genetic alteration was found in the affected son and in maternal lineage. Our data confirm the role played by the 1q21.1 microdeletion in the pathogenesis of TAR syndrome proposing a panel of polymorphic markers for a rapid and low-cost screening of 1q21.1 microdeletion. We do not know if the occurrence of two rare diseases as of TAR syndrome and LCH could be considered a chance association; at our knowledge, a genetic link does not seem to be present between the diseases. Descriptions of additional cases of LCH in patients with TAR syndrome are necessary before a cause and effect relationship can be proven
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