32 research outputs found
Cefalee e sindromi correlate
No full textLa cefalea è il disturbo somatico riferito più frequentemente da bambini ed adolescenti. La prevalenza di cefalea in età evolutiva è molto variabile compresa tra il 5.9% e l’ 82%. Le cefalee vengono distinte in primarie e secondarie. Nella stragrande maggioranza dei casi si tratta di cefalee primarie classificabili come emicranie o cefalee tensive.Il sistema di classificazione corrente è quello pubblicato dall’International Headache Society (IHS) nel 2004, conosciuto come ICHD-II (International Classification of Headache Disorder). Il trattamento farmacologico delle cefalee in età evolutiva consta di una terapia al bisogno ed una terapia profilattica da introdurre qualora la frequenza degli attacchi superi i 4 episodi al mese.L’utilizzo di trattamenti non farmacologici in età pediatrica nasce dall’esigenza di avere una terapia scevra da effetti collaterali Tra le tecniche utilizzate va sicuramente annoverato il biofeedback una metodica attraverso cui il soggetto riceve informazioni sul suo stato biologico, che può modificare con il training.Un’altra tecnica utilizzata è quella del relaxation training che comprende metodiche che si propongono il controllo della tensione muscolare o l’induzione del rilassamento mentale. L’ipnosi, analogamente alle tecniche di biofeedback, permette ai bambini una migliore gestione del dolore in situazione di emergenza
Levetiracetam in età evolutiva
No full textViene presentata una casistica di 48 pazienti in età pediatrica e adolescenziale che hanno utilizzati una recente molecola, il levetiracetam, nella terapia antiepilettica. Vengono riportati i risultati sulle crisi e la tollerabilità del farmaco
Anorexia nervosa among first- and second-generation immigrant children and adolescents in Italy: treatment and clinical outcomes
No full textPURPOSE: Cultural and environmental factors have frequently been implicated in the pathogenesis of Eating Disorders (ED). Although ED have been considered as "Western culture-bound syndromes", increasing rates of ED among non-Western groups are being documented. The present study aims to investigate treatment and clinical outcomes among first-generation immigrant children and adolescents (FGI) (patients born abroad) and second-generation immigrant youth (SGI, patients born in Italy) with Anorexia Nervosa (AN). METHODS: The study retrospectively compares treatment, hospitalizations, traumatic past events, clinical features, and treatment outcome (improvement in percentual body-mass index - %BMI) between FGI and SGI young patients with AN (10-18 years). Correlations were adjusted for age and severity (%BMI) at presentation. Treatments and outcomes were investigated at the baseline (T0), 2 weeks (T1), one month (T2), 3 months (T3), 6 months (T4), and 12 months (T5). RESULTS: Thirty-six patients (50% FGI) were enrolled. At T1 (F(1.26)=6.335, p=0.018), and at T2 (F(1.30)=18.752, p<0.001) FGI presented a significantly higher %BMI improvement than SGI. FGI required significantly less (OR=0.379, p=0.017), and shorter (F(1.32)=5.827, p=0.022) hospitalizations, when compared with SGI. CONCLUSIONS: When compared to SGI, FGI with AN required fewer and shorter hospitalizations and had a better early-treatment weight outcome. Larger nationwide studies should investigate the need for and access to treatment of immigrant populations with AN
Timing of Psychopharmacological and Nutritional Interventions in the Inpatient Treatment of Anorexia Nervosa: An Observational Study
No full textThis study aims to investigate possible different outcomes in the inpatient treatment of
anorexia nervosa (AN) related to different timings of psychopharmacological and nutritional interventions.
A retrospective observational study was conducted, involving young patients hospitalized
for AN, treated with naso-gastric tube feeding (NGT). Participants were divided into five groups
according to early (0–7 days) or late (8+ days) introduction of atypical antipsychotics (AAP) and NGT:
early AAP-early NGT (EE), early AAP-late NGT (EL), late AAP-early NGT (LE), late AAP-late NGT
(LL) and a control group treated with NGT only (NGT). Concurrent clinical and treatment variables
were analyzed. AN psychopathology was measured with the Eating Disorder Inventory-3 (EDI-3)
EDRC score. Outcomes were assessed as admission-discharge body-mass index (BMI) improvement
and length of hospital stay (LOS). Contributions of variables related to outcomes were assessed with
multifactorial-analyses of variance (MANOVA). Seventy-nine patients were enrolled in the study.
LOS was different among treatment groups (F (4, 75) = 5.993, p < 0.001), and EE patients showed
lower LOS than LE (p < 0.001) and LL (p = 0.025) patients. BMI improvement was not significantly
different among treatment groups but correlated negatively with age (F (1, 72) = 10.130, p = 0.002),
and admission BMI (F (1, 72) = 14.681, p < 0.001). In conclusion, patients treated with early AAP
and early NGT showed lower LOS than those treated with late AAP. Prognostic treatment variables
should be investigated in wider samples
DXA as a key instrument for the evaluation and the follow-up of adolescents affected by anorexia nervosa.
No full textFollow-up of bone mineral density and body composition in adolescents with restrictive anorexia nervosa: role of dual-energy X-ray absorptiometry
No full textBACKGROUND/OBJECTIVES: Restrictive Anorexia nervosa (ANR) is an eating disorder (ED) characterized by a low bone mineral
content (BMC) and by an alteration in body composition (reduction and abnormal distribution of fat mass—FM and lean
mass—LM). The aim of our study was to address whether bone and body composition changes could be influenced by hormonal
status and sport in female adolescents with restrictive anorexia nervosa-ANR.
SUBJECTS/METHODS: Prospective study on 79 adolescents with ANR submitted to Dual Energy X-Ray Absorptiometry—DXA at
baseline-T0 and after 12 months-T12. Among the 46/79—58.2% patients that completed the study, we evaluated total and regional
FM and LM%, as well as lumbar bone mineral density (BMD) and Z-score, linking them to clinical variables: menarche/amenorrhea/
hormonal therapy and physical activity.
RESULTS: At T0: body mass index (BMI)1⁄416.4±1.4 kg/m2 with low levels of FM% (21.7±5.7) low BMC in 12/46—26.0% (mean
Z-score: 1.21±1.27, with higher values related to physical activity—P1⁄40.001). At T12: a significant increase in BMI—P1⁄40.001,
with LM reduction and FM increase (more evident in the trunk—Po0.001); regarding bone, no significant changes were observed,
though a tendency in terms of improvement associated with resumption of menses.
CONCLUSIONS: After 1 year, weight recovery was not associated with a reestablishment of bone values; by contrast, it was
associated with an increase and a distortion in FM distribution, more evident in trunk region (potential and adjunctive risk factor for
the relapse of the psychiatric condition). The complexity of these clinical findings suggested DXA, a low-dose and low-cost
technique, in long-term monitoring of ANR patients
Oxcarbazepina: valutazione di una casistica in mono e politerapia in età pediatrica
No full textVengono presentati i risultati della utilizzazione di un farmaco antiepilettico (oxcarbazepina) su una popolazione in età pediatrica e adolescenziale. Viene rilevata la buona efficacia e tollerabiltà del farmaco
Post-Traumatic Headache in Children after Minor Head Trauma: Incidence, Phenotypes, and Risk Factors
No full textMinor head trauma (MHT) is very frequent in children and post-traumatic headache (PTH) is one of its most common complications; however, its management is still a challenge. We aimed to assess the incidence and clinical characteristics of, and risk factors for, PTH among children referred to our pediatric emergency department (PED) for MHT. A total of 193 patients aged 3–14 years evaluated for MTH were enrolled and followed up for 6 months through phone calls and/or visits. PTH occurred in 25/193 patients (13%). PTH prevalence was significantly higher in school-aged (≥6 years) than in pre-school-aged children (21.6% vs. 4.9%, respectively, p < 0.009). Females were found to be more affected. The median time of onset was 4.6 days after MHT; resolution occurred in a median of 7 weeks. In 83.3% of patients, PTH subsided in <3 months, while in 16.7% it persisted longer. A total of 25% of children exhibited the migraine and 75% the tension-type variant. Our analysis indicates the presence of headache upon arrival in PED, isolated or associated with nausea and dizziness, as a factor predisposing the patient to the development of PTH. Our findings could be useful to identify children at risk for PTH for specific follow-up, family counseling, and treatment
P133 – 2909: Hemiplegic migraine with onset in childhood: The first multicenter Italian study
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