1,720,972 research outputs found
Spondilodiscite 2016: lezioni dai casi
No full textSpondylodiscitis is an infectious disease that involves two contiguous vertebrae and the interposed disc; it affects children in the first years of life when the local vascularization is characterized by the persistence of connecting vessels. It is a rarity and the fact that it can present in different ways often leads to a severe diagnostic delay. Starting from four clinical cases of spondylodiscitis, the paper aims at underlining several peculiarities of the disease
in order to convey some take-home messages to diagnose it and treat it correctly
Cosa deve sapere il pediatra della linfoistiocitosi emofagocitica attraverso i casi degli specializzandi
No full textHemophagocytic lymphohistiocytosis (HLH) is a potentially life-threatening syndrome caused by severe hypercytokinemia due to a highly stimulated but ineffective immune response. HLH is not a disease by its own but is rather a common final consequence of an inherited or acquired inability of the immune system to cope with a trigger, which in most cases is an infection. HLH in autoinflammatory and autoimmune conditions is usually termed macrophage activation syndrome (MAS) and can be as severe as other forms of HLH. In absence of treatment HLH has a high mortality rate due to the overwhelming immune activation, and early recognition with prompt immunosuppressive treatment may be life saving. The paper presents four cases of HLH/MAS: each one has a different underlying cause and shows a possible presenting picture of the disease, helping paediatrician to recognize it
Successful treatment of acne with isotretinoin in chronic granulomatous disease
No full textNo abstract available
Dolore da venipuntura: come trattarlo?
No full textVenipuncture, although it is relatively simple and fast, is one of the painful procedures which is most frequently performed on paediatric patients. The pain in this context is present in 50% of children, and has been rated as moderate to severe in 36% of children aged 3 to 6 years and 13% of those aged 7 to 17 years. The response to pain is influenced and shaped by past painful experiences. Infants who have not been adequately treated in regard to procedural analgesia undergo a real conditioning. Considering that pain has two basic components, nociception and suffering, the best approach will be multidisciplinary, based on pharmacological and non-pharmacological strategies
Mental health problems in children and adolescents in the emergency department
No full textNot applicabl
Sirolimus Therapy in Congenital Hyperinsulinism: A Successful Experience Beyond Infancy
No full textCongenital hyperinsulinism (CHI) due to diffuse involvement of the pancreas is a challenging and severe illness in children. Its treatment is based on chronic therapy with diazoxide and/or octreotide, followed by partial pancreatectomy, which is often not resolutive. Sirolimus, a mammalian target of rapamycin inhibitor, was reported to be effective in treating CHI in infants. We report here the case of an 8-year-old boy affected by a severe form of CHI due to a biallelic heterozygous ABCC8 mutation who responded to sirolimus with a dramatic improvement in his glucose blood level regulation and quality of life, with no serious adverse events after 6 months of follow-up. To the best of our knowledge, this is the first report of a successful intervention in an older child. It provides a promising basis for further studies comparing sirolimus with other treatments, particularly in older children
A quasi randomized-controlled trial to evaluate the effectiveness of clowntherapy on children’s anxiety and pain levels in emergency department
Full text linkThe aim of the study is to investigate if the presence of medical clowns during painful procedures in the emergency department (ED) affects children's anxiety and pain. Forty children (4-11 years) admitted to the ED with the need of painful procedures were prospectively enrolled. They were randomly assigned to the clown group, where children interacted with clowns or to the control group in which they were entertained by parents and ED nurses. The children's anxiety was assessed by the Children's Anxiety and Pain Scales; pain was evaluated with the Numerical Rating Scale and Wong-Backer Scale, according to the children's age. Staff and clown's opinions were evaluated by means of dedicated questionnaires. Children's anxiety levels in the clown group were significantly lower than those compared with the control group, while children's pain levels did not change between the two groups.
CONCLUSION:
The presence of clowns in the ED before and during painful procedures was effective in reducing children's anxiety.
WHAT IS KNOWN:
• Anxiety and fear caused by medical procedures exacerbate children's pain and may interfere with the procedure. • To reduce anxiety, fear, and pain and to facilitate patient's evaluation, different non-pharmacological approaches have been proposed and positive effects of laughter and humor have been reported. What is New: • The presence of clowns in the waiting room and in the ED during medical evaluation and painful procedures helps to reduce children's anxiet
Il dolore acuto del bambino: Dalla misurazione al trattamento, farmacologico e non.
No full textBackground - Pain is a relevant symptom reported by children who require Emergency Unit evaluation, but it is still underestimated and undertreated. Purpose - This review offers simple information about pharmacological and non-pharmacological approaches in the management of pain in emergency settings and in subcentres. Data sources - Found on PubMed articles, using different key-words: pain, procedural pain, children, emergency unit, epidemiology, measurement, management, and treatment. Results - Pain has to be measured before treatment. It can be controlled with non-pharmacological and pharmacological approaches, which have specific guidelines.
Conclusions - Instruments for any kind of pain are available; an insufficient management is attributable to poor knowledge rather than to lack of means
Somatic symptom disorder was common in children and adolescents attending an emergency department complaining of pain
Full text linkAIM:
The aim of this study was to quantify the prevalence of somatic pain in a paediatric emergency department (ED).
METHODS:
We conducted a prospective observational study using patients admitted to the ED of an Italian children's hospital between December 2014 and February 2015. We enrolled children aged 7-17 who turned up at the ED complaining of pain. Patients and parents were asked to fill in a questionnaire to allow the analysis of the patients' medical history and provide contact details for follow-up. We divided the enrolled patients into four groups: post-traumatic pain, organic pain, functional pain and somatic pain. The questionnaire was used to define pain characteristics and to generate an impairment score.
RESULTS:
Of the 713 patients who met inclusion criteria, 306 (42.9%) were enrolled in the study. Of these, 135 (44.0%) suffered from post-traumatic pain, 104 (34.0%) from organic pain, 41 (13.4%) from functional pain and 26 (8.6%) from somatic pain. Somatic pain patients had endured pain longer, had missed more school days and had suffered severe functional impairment.
CONCLUSION:
This study highlighted that somatic pain was a significant contributor to paediatric emergency room visits and should be suspected and diagnosed in children reporting pain
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