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1.
Euro Surveill ; 26(14)2021 04.
Artículo en Inglés | MEDLINE | ID: mdl-33834960

RESUMEN

BackgroundVery few studies describe factors associated with COVID-19 diagnosis in children.AimWe here describe characteristics and risk factors for COVID-19 diagnosis in children tested in 20 paediatric centres across Italy.MethodsWe included cases aged 0-18 years tested between 23 February and 24 May 2020. Our primary analysis focused on children tested because of symptoms/signs suggestive of COVID-19.ResultsAmong 2,494 children tested, 2,148 (86.1%) had symptoms suggestive of COVID-19. Clinical presentation of confirmed COVID-19 cases included besides fever (82.4%) and respiratory signs or symptoms (60.4%) also gastrointestinal (18.2%), neurological (18.9%), cutaneous (3.8%) and other unspecific influenza-like presentations (17.8%). In multivariate analysis, factors significantly associated with SARS-CoV-2 positivity were: exposure history (adjusted odds ratio (AOR): 39.83; 95% confidence interval (CI): 17.52-90.55; p < 0.0001), cardiac disease (AOR: 3.10; 95% CI: 1.19-5.02; p < 0.0001), fever (AOR: 3.05%; 95% CI: 1.67-5.58; p = 0.0003) and anosmia/ageusia (AOR: 4.08; 95% CI: 1.69-9.84; p = 0.002). Among 190 (7.6%) children positive for SARS-CoV-2, only four (2.1%) required respiratory support and two (1.1%) were admitted to intensive care; all recovered.ConclusionRecommendations for SARS-CoV-2 testing in children should consider the evidence of broader clinical features. Exposure history, fever and anosmia/ageusia are strong risk factors in children for positive SARS-CoV-2 testing, while other symptoms did not help discriminate positive from negative individuals. This study confirms that COVID-19 was a mild disease in the general paediatric population in Italy. Further studies are needed to understand risk, clinical spectrum and outcomes of COVID-19 in children with pre-existing conditions.


Asunto(s)
Prueba de COVID-19 , COVID-19 , Pandemias , Adolescente , COVID-19/diagnóstico , COVID-19/epidemiología , Niño , Preescolar , Estudios Transversales , Femenino , Humanos , Lactante , Recién Nacido , Italia/epidemiología , Masculino , Factores de Riesgo
2.
Pediatr Emerg Care ; 33(8): 579-581, 2017 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-27055168

RESUMEN

Listeria monocytogenes is a facultative anerobic, gram-positive bacillus that is isolated from the soil, vegetables, and wild or domestic animals. Listeria infection is usually found in the older adults, immunocompromised patients, pregnant women, and newborns, whereas it is rare in healthy infants and children. Listeria monocytogenes may cause meningitis, meningoencephalitis, brain abscess, pyogenic arthritis, osteomyelitis, and liver abscess in children. The course of meningoencephalitis by Listeria is often severe and even fatal. Complications such as acute hydrocephalus, brain abscess, and spine abscess can develop, and the mortality associated with listeriosis is significantly high. We present a case of a previously healthy 7-year-old boy who developed Listeria monocytogenes meningitis.


Asunto(s)
Antibacterianos/administración & dosificación , Listeria monocytogenes/aislamiento & purificación , Meningitis por Listeria/diagnóstico , Meningitis por Listeria/tratamiento farmacológico , Enfermedad Aguda , Encéfalo/diagnóstico por imagen , Niño , Humanos , Inmunocompetencia , Masculino , Meningitis por Listeria/líquido cefalorraquídeo , Reacción en Cadena en Tiempo Real de la Polimerasa , Punción Espinal , Tomografía Computarizada por Rayos X
3.
BMJ Paediatr Open ; 8(1)2024 Sep 04.
Artículo en Inglés | MEDLINE | ID: mdl-39237270

RESUMEN

BACKGROUND: Despite evidence showing that the intranasal and sublingual routes are safe and effective in providing analgesia, no data are available about their day-to-day use in the emergency department (ED). The aim of this study was to assess the frequency of the use of the intranasal and sublingual routes, and the clinical characteristics of the patients receiving analgesia through these routes. METHODS: A multicentre study was performed in the EDs participating in the Pain in Paediatric Emergency Room research group. It included a survey and a retrospective data collection in which the medical records of all patients who received analgesia from 1 April 2022 to 31 May 2022 were collected. RESULTS: 48 centres (91%) answered the survey. The intranasal and sublingual routes were used in 25 centres (52%). 13 centres (27%) used both routes, 9 centres (19%) used only the sublingual and 3 centres (6%) used only the intranasal route.12 centres (48%) participated in the retrospective study. Data about 3409 patients, median age 9 years (IQR 5-12), were collected. Among them, 337 patients (9.6%) received sublingual analgesia, and 87 patients (2.5%) received intranasal analgesia. The intranasal route was employed for injuries in 79 (90.8%) cases, and fentanyl was the drug delivered in 85 (97.7%) cases. The sublingual route was used mainly for injuries (57.3%), but also for abdominal pain (15.4%), musculoskeletal pain (14.5%) and headache (10.7%). Paracetamol, ketorolac and tramadol were administered through this route. CONCLUSIONS: The use of the intranasal and sublingual routes for analgesia in the paediatric ED is still limited.


Asunto(s)
Administración Intranasal , Servicio de Urgencia en Hospital , Manejo del Dolor , Humanos , Administración Sublingual , Estudios Retrospectivos , Niño , Masculino , Femenino , Adolescente , Preescolar , Manejo del Dolor/métodos , Analgesia/métodos , Analgésicos/administración & dosificación
4.
Pediatr Emerg Care ; 22(1): 35-7, 2006 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-16418610

RESUMEN

We present a case of a 4-month-old girl referred to the emergency department with a provisional diagnosis of acute life-threatening event with a recent episode of heart block and a history of long-lasting fever. Soon after admission, the child suddenly deteriorated rapidly; she became pulseless with complete heart block and died despite intensive resuscitation efforts. Postmortem examination showed coronary arteritis with aneurysmal dilatation and coronary thrombosis, revealing atypical Kawasaki disease. With this case presentation, we discuss the importance of early recognition and treatment of atypical and/or incomplete forms of Kawasaki disease, which are most common in young infants and may lead, if untreated, to coronary artery abnormalities with a potential for myocardial infarctions, aneurysm formation, and sudden death. In addition, the relevance of postmortem examination in a case of sudden and undiagnosed infant death is underlined.


Asunto(s)
Enfermedad Coronaria/patología , Síndrome Mucocutáneo Linfonodular/fisiopatología , Enfermedad Coronaria/etiología , Resultado Fatal , Femenino , Humanos , Lactante , Síndrome Mucocutáneo Linfonodular/complicaciones , Síndrome Mucocutáneo Linfonodular/diagnóstico
5.
Brain Dev ; 27(2): 155-9, 2005 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-15668058

RESUMEN

Gradenigo syndrome in children during otitis media is a very rare complication since the use of antibiotics: nevertheless, it must be taken into account in case of otitis media, abducens nerve paralysis and facial pain in regions innervated by the first and second division of trigeminal nerve. We report the case of a 4-year-old boy whose neurological signs and clinical history prompted us to entertain a diagnosis of Gradenigo syndrome, which was not confirmed by CT and MRI findings, revealing otomastoiditis and sinus thrombosis.


Asunto(s)
Enfermedades del Nervio Abducens/etiología , Otitis Media/complicaciones , Antibacterianos/uso terapéutico , Preescolar , Diagnóstico Diferencial , Electroencefalografía , Humanos , Imagen por Resonancia Magnética , Masculino , Otitis Media/tratamiento farmacológico , Trombosis de los Senos Intracraneales/tratamiento farmacológico , Trombosis de los Senos Intracraneales/etiología , Tomografía Computarizada por Rayos X
6.
Paediatr Anaesth ; 17(1): 75-9, 2007 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-17184438

RESUMEN

Achondroplasia can result in respiratory difficulty in early infancy, from anatomical abnormalities such as mid-facial hypoplasia and/or adenotonsillar hypertrophy, leading to obstructive apnea, or to pathophysiological changes occurring in nasopharyngeal or glossal muscle tone, related to neurological abnormalities (foramen magnum and/or hypoglossal canal problems, hydrocephalus), leading to central apnea. More often, the two respiratory components (central and obstructive) are both evident in mixed apnea. Polysomnographic recording should be used during preoperative and postoperative assessment of achondroplastic children and in the subsequent follow-up to assess the adequacy of continuing home respiratory support, including supplemental oxygen, bilevel positive airway pressure, or assisted ventilation.


Asunto(s)
Acondroplasia/complicaciones , Trastornos Respiratorios/etiología , Respiración Artificial/métodos , Acondroplasia/cirugía , Tonsila Faríngea/cirugía , Obstrucción de las Vías Aéreas/etiología , Obstrucción de las Vías Aéreas/cirugía , Descompresión Quirúrgica/métodos , Femenino , Foramen Magno/cirugía , Humanos , Lactante , Ventilación con Presión Positiva Intermitente/métodos , Monitoreo Fisiológico/métodos , Oxígeno/metabolismo , Polisomnografía/métodos , Trastornos Respiratorios/cirugía , Respiración Artificial/efectos adversos , Apnea Obstructiva del Sueño/etiología , Apnea Obstructiva del Sueño/cirugía , Síndrome , Factores de Tiempo , Tonsilectomía/métodos
7.
Pediatr Int ; 49(6): 801-5, 2007 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-18045275

RESUMEN

BACKGROUND: Home care support is beneficial for children needing mechanical ventilation, when clinically stable. METHODS: A retrospective analysis was carried out of the long-term home ventilation management of a pediatric population with chronic respiratory failure composed of 20 ventilator-dependent children categorized according to age, diagnosis and ventilation support. Age groups consisted of 10% under 1 year, 30% between 2 and 5 years, 30% between 6 and 12 years, and 30% older than 12 years. Diagnostic categories included myopathic disorder, n = 5; congenital central hypoventilation syndrome, n = 6; chest wall disorder, n = 5; cystic fibrosis, n = 1; pulmonary hypertension, n = 1; and diaphragmatic paralysis, n = 2. RESULTS: Sixty-five percent were ventilated using non-invasive mode (NIMV): eight with nasal mask, five with full-face mask, and two children in NIMV also used negative pressure mode; 35% were ventilated using tracheostomy, one of them also used a diaphragmatic pacer. Seventy percent needed nocturnal ventilatory support, (20% 12-18 h, 10% full-day). A total of 18 children were included in the home care and follow-up program. Two children died: one because of worsening of his chronic disease and one because of septic shock. CONCLUSION: Although home care ventilation is not yet widely diffused, it represents a valid alternative to long hospitalization for children with stable chronic respiratory failure.


Asunto(s)
Servicios de Atención a Domicilio Provisto por Hospital , Respiración Artificial , Insuficiencia Respiratoria/terapia , Adolescente , Niño , Preescolar , Enfermedad Crónica , Costos Directos de Servicios , Servicios de Atención a Domicilio Provisto por Hospital/economía , Humanos , Lactante , Estudios Retrospectivos
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