1,721,037 research outputs found
Editorial: Difficult and severe asthma in children, volume II
No full textEditorial on difficult asthma. No abstract availabl
Indagine sulla formazione in pneumologia pediatrica nelle scuole di specializzazione in pediatria
No full textRiassunto Background Sebbene le malattie respiratorie rappresentino uno dei principali motivi di visita pediatrica, nel nostro paese la formazione in quest’ ambito è attuata in maniera disomogenea. Scopo dell’indagine è stato descrivere lo stato dell’arte della formazione in pneumologia pediatrica nelle scuole di specializzazione in pediatria.
Materiali e Metodi: Abbiamo realizzato una survey composta di 25 item e l’abbiamo resa accessibile online per 2 mesi, comunicandone le modalità di accesso a tutti gli specializzandi in pediatria mediante mailing list e newsletter di SIMRI, ONSP (Osservatorio Nazionale Specializzandi Pediatria) e Forum Junior Members SIMRI.
Risultati: Hanno partecipato all’indagine 182 specializzandi da 16 regioni. Nessuno riteneva la propria preparazione in ambito pneumologico ottima. Lezioni e tirocini sono diffusi nelle scuole, a differenza di journal club e discussione di casi clinici. Spesso non è disponibile alcuna attività formativa relativa a radioprotezione (85.2%) e fisioterapia respiratoria (71.4%). Uno pneumologo pediatra è presente nell’83% dei casi. I test più diffusi sono: spirometria (97.8%), test del sudore (94%) e pH-metria (78.6%), ma la relativa formazione è attuata capillarmente solo per la spirometria (87.9%). Solo il 7.7% del campione è molto soddisfatto del piano formativo della propria scuola, mentre il 45.6% lo è abbastanza, il 40.1% poco ed il 6.6% per niente. L’84% ritiene fondamentali gli anni della specializzazione per la formazione sub-specialistica.
Conclusioni: La nostra indagine suggerisce che nelle scuole di specializzazione in pediatria la formazione pneumologica deve essere incrementata
Ultrastructural Characterization of Genetic Diffuse Lung Diseases in Infants and Children: A Cohort Study and Review
Full text linkPediatric diffuse lung diseases are rare disorders with an onset in the neonatal period or in infancy, characterized by chronic respiratory symptoms and diffuse interstitial changes on imaging studies. Genetic disorders of surfactant homeostasis represent the main etiology. Surfactant protein B and ABCA3 deficiencies typically cause neonatal respiratory failure, which is often lethal within a few weeks or months. Although heterozygous ABCA3 mutation carriers are mostly asymptomatic, there is growing evidence that monoallelic mutations may affect surfactant homeostasis. Surfactant protein C mutations are dominant or sporadic disorders leading to a broad spectrum of manifestations from neonatal respiratory distress syndrome to adult pulmonary fibrosis. The authors performed pathology and ultrastructural studies in 12 infants who underwent clinical lung biopsy. One carried a heterozygous SP-B mutation, 3 carried SP-C mutations, and 7 carried ABCA3 mutations (5 biallelic and 2 monoallelic). Optical microscopy made it possible to distinguish between surfactant-related disorders and other forms. One of the ABCA3 monoallelic carriers had morphological features of alveolar capillary dysplasia, a genetic disorder of lung alveolar, and vascular development. One patient showed no surfactant-related anomalies but had pulmonary interstitial glycogenosis, a developmental disorder of unknown origin. Electron microscopy revealed specific lamellar bodies anomalies in all SP-B, SP-C, and ABCA3 deficiency cases. In addition, the authors showed that heterozygous ABCA3 mutation carriers have an intermediate ultrastructural phenotype between homozygous carriers and normal subjects. Lung biopsy is an essential diagnostic procedure in unexplained diffuse lung disorders, and electron microscopy should be performed systematically, since it may reveal specific alterations in genetic disorders of surfactant homeostasis
Pediatric Pulmonology Education In Italian Residency Programs
No full textPediatric respiratory diseases are common and one of the main reasons for pediatric consultation. However, education on this subject is not equally provided in Italian Pediatric residency programs, although a national training syllabus to become a subspecialist pediatrician has been recently released. To investigate the current pediatric pulmonology education, the Italian Pediatric Respiratory Society (SIMRI) Junior Members Forum and the Italian National Observatory for Trainees and Young Paediatricians (ONSP), as young members of the Italian Society of Pediatrics, decided to administer a survey to the Italian pediatric resident network
Hyaluronic acid for the treatment of airway diseases in children: Little evidence for few indications
No full textBackground: Hyaluronic acid (HA) is major physiological component of the extracellular matrix, which, in its high molecular weight form (HMW-HA) has anti-inflammatory properties. The diffusion of many different medical devices for inhalation therapy containing HA has led to an increase in their prescription, also in children. Here, we systematically review the published evidence on the efficacy and safety of HA for the treatment of upper and lower airway diseases in childhood. Methods: Relevant published studies (randomized controlled trials) for the efficacy of HA inhalation in children with upper airways diseases, asthma, cystic fibrosis (CF), and non-CF bronchiectasis were searched in Pubmed, Scopus, and Web of Knowledge databases by combining the adequate Medical Subject Headings terms and keywords, with no limit for the year of publication. Results: We identified seven relevant publications for upper airways diseases, one for asthma, and five for CF, while we found no clinical trial including children with non-CF bronchiectasis. Meta-analysis was not conducted due to the heterogeneity of the included studies. Conclusions: The evidence of HA efficacy in the treatment of the upper and lower airways is still limited in children. Available data suggest that inhaled HMW-HA could be useful in the treatment of recurrent upper respiratory infections and chronic or recurrent inflammation of the middle ear and adenoids as well as of the lower airways in cystic fibrosis in association with hypertonic saline solution. Studies on larger populations and on the different formulations and nebulization methods, especially in pediatric age, are urgently needed
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Sleep architecture in children with spinal muscular atrophy type 2
No full textThere have been few published reports on the sleep patterns of patients with spinal muscular atrophy (SMA) type 2, and none on sleep microstructure. The aim of this study was to analyze sleep architecture and microstructure in a group of children with SMA type 2, compared with age-matched and sex-matched controls
A young girl with apparent treatment-resistant asthma treated at Bambino Gesù children's hospital
No full textA 9.8 year–old-girl was first admitted in our unit for a persistent bronchospasm, poorly responsive to salbutamol, and progressive onset of respiratory distress after spontaneous expectoration of a bronchial cast (figure 1A). Her clinical history was uneventful until she was 7 years old, when she suffered from two subsequent bouts of pneumonia, but no admission was required. In the following years, she presented few episodes of bronchospasm, clinically diagnosed, with good response to bronchodilator and no limitation on her daily activities. Her family history was positive for allergic disease. On physical examination at her arrival, she appeared quite unwell with persistent wet cough, bilateral respiratory wheeze but normal levels of saturation. The remaining examination was normal.We have a previously healthy young girl with positive family history for allergies and personal history of few lower respiratory infections and intermittent episodes of wheezing. Patient's history and the spontaneous expectoration of a bronchial cast during an acute episode of bronchospasm, together with her physical examination characterised by intense cough and diffuse wheeze are suggestive of a case of plastic bronchitis (PB), already described as possible complication of allergic asthma. The differential diagnosis, though, should always include more inflammatory diseases of the lung, such as cystic fibrosis, pulmonary infections and acute chest syndrome in sickle-cell anaemia.1.Patient was afebrile; blood exams were normal, including: haemoglobin, c-reactive protein, immunoglobulins and lipid values. Allergy tests were positive to house dust mites and few pollen, but sweat tests and nasal brushing for ciliary dyskinesia were negative. Spirometry showed mainl
Misleading presentation of staphylococcal pneumonia in an adolescent girl: a case report
No full textS. aureus is a relatively uncommon causative agent of community-acquired pneumonia. The clinical presentation of staphylococcal community-acquired pneumonia is typically acute and severe. Rarely, its clinical and imaging features may mimic other lung diseases, thereby delaying and misleading the diagnosis. We report a case of a 13-year-old girl without predisposing factors who was admitted with a recent history of mild chest pain, weakness and slight fever. Although clinical presentation and imaging findings suggested tuberculosis infection, broncho-alveolar lavage results showed a positivity for methicillin-susceptible S. aureus. A complete recovery was observed after a 21-day course of antibiotics. Our case highlights that staphylococcal pneumonia may develop in adolescents without underlying risk factors, mimicking, in rare cases, clinical presentation and radiological features of pulmonary tuberculosis
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