Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 79
Filtrar
Más filtros

Banco de datos
País/Región como asunto
Tipo del documento
País de afiliación
Intervalo de año de publicación
1.
Cell ; 184(25): 6010-6014, 2021 12 09.
Artículo en Inglés | MEDLINE | ID: mdl-34890548

RESUMEN

The COVID-19 information epidemic, or "infodemic," demonstrates how unlimited access to information may confuse and influence behaviors during a health emergency. However, the study of infodemics is relatively new, and little is known about their relationship with epidemics management. Here, we discuss unresolved issues and propose research directions to enhance preparedness for future health crises.


Asunto(s)
COVID-19/psicología , Infodemia , Difusión de la Información/ética , COVID-19/epidemiología , Epidemias/psicología , Humanos , Difusión de la Información/métodos , Salud Pública , Investigación/tendencias , SARS-CoV-2
2.
BMC Infect Dis ; 24(1): 388, 2024 Apr 11.
Artículo en Inglés | MEDLINE | ID: mdl-38605310

RESUMEN

BACKGROUND: Respiratory syncytial virus (RSV) infection in children under 5 years have a significant clinical burden, also in primary care settings. This study investigates the epidemiology and burden of RSV in Italian children during the 2019/20 pre-pandemic winter season. METHODS: A prospective cohort study was conducted in two Italian regions. Children with Acute Respiratory Infection (ARI) visiting pediatricians were eligible. Nasopharyngeal swabs were collected and analyzed via multiplex PCR for RSV detection. A follow-up questionnaire after 14 days assessed disease burden, encompassing healthcare utilization and illness duration. Statistical analyses, including regression models, explored associations between variables such as RSV subtype and regional variations. RESULTS: Of 293 children with ARI, 41% (119) tested positive for RSV. Median illness duration for RSV-positive cases was 7 days; 6% required hospitalization (median stay: 7 days). Medication was prescribed to 95% (110/116) of RSV cases, with 31% (34/116) receiving antibiotics. RSV subtype B and regional factors predicted increased healthcare utilization. Children with shortness of breath experienced a 36% longer illness duration. CONCLUSIONS: This study highlights a significant clinical burden and healthcare utilization associated with RSV in pre-pandemic Italian primary care settings. Identified predictors, including RSV subtype and symptomatology, indicate the need for targeted interventions and resource allocation strategies. RSV epidemiology can guide public health strategies for the implementation of preventive measures.


Asunto(s)
COVID-19 , Infecciones por Virus Sincitial Respiratorio , Virus Sincitial Respiratorio Humano , Infecciones del Sistema Respiratorio , Niño , Humanos , Lactante , Preescolar , Virus Sincitial Respiratorio Humano/genética , Hospitalización , Estaciones del Año , Estudios Prospectivos , Pandemias , COVID-19/epidemiología , Infecciones por Virus Sincitial Respiratorio/epidemiología , Infecciones del Sistema Respiratorio/epidemiología , Italia/epidemiología , Atención Primaria de Salud
3.
Pediatr Cardiol ; 44(8): 1736-1740, 2023 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-37597120

RESUMEN

The autosomal recessive (AR) form of Long QT Syndrome (LQTS) is described both associated with deafness known as Jervell and Lange-Nielsen (JLN) syndrome, and without deafness (WD). The aim of the study is to report the characteristics of AR LQTS patients and the efficacy of the therapy. Data of all children with AR LQTS referred to the Bambino Gesù Children's Hospital IRCCS from September 2012 to September 2021were included. Three (30%) patients had compound heterozygosity and 7 (70%) had homozygous variants of the KCNQ1 gene, the latter showing deafness. Four patients (40%) presented aborted sudden cardiac death (aSCD): three with previous episodes of syncope (75%), the other without previous symptoms (16.6% of asymptomatic patients). An episode of aSCD occurred in 2/3 (66.7%) of WD and heterozygous patients, while in 2/7 (28%) JLN and homozygous patients and in 2/2 patients with QTC > 600 ms. All patients were treated with Nadolol. In 5 Mexiletine was added, shortening QTc and obtaining the disappearance of the T-wave alternance (TWA) in 3/3. Episodes of aSCD seem to be more frequent in LQTS patients with compound heterozygous variants and WD than in those with JLN and homozygous variants. Episodes of aSCD also appear more frequent in children with syncope or with QTc value > 600 ms, even on beta-blocker therapy, than in patients without syncope or with Qtc < 600 ms. However, our descriptive results should be confirmed by larger studies. Moreover, Mexiletine addition reduced QTc value and eliminated TWA.


Asunto(s)
Sordera , Paro Cardíaco , Síndrome de Jervell-Lange Nielsen , Síndrome de QT Prolongado , Niño , Humanos , Canal de Potasio KCNQ1/genética , Mexiletine/uso terapéutico , Síndrome de QT Prolongado/tratamiento farmacológico , Síndrome de QT Prolongado/genética , Síndrome de QT Prolongado/diagnóstico , Síndrome de Jervell-Lange Nielsen/tratamiento farmacológico , Síndrome de Jervell-Lange Nielsen/genética , Síndrome de Jervell-Lange Nielsen/diagnóstico , Síncope/genética
4.
J Med Internet Res ; 24(1): e29656, 2022 01 13.
Artículo en Inglés | MEDLINE | ID: mdl-34854814

RESUMEN

BACKGROUND: Social robots (SRs) have been used for improving anxiety in children in stressful clinical situations, such as during painful procedures. However, no studies have yet been performed to assess their effect in children while waiting for emergency room consultations. OBJECTIVE: This study aims to assess the impact of SRs on managing stress in children waiting for an emergency room procedure through the assessment of salivary cortisol levels. METHODS: This was an open randomized clinical trial in children attending a pediatric emergency department. Children accessing the emergency room were randomized to 1 of 3 groups: (1) playing with a NAO SR, (2) playing with a study nurse, or (3) waiting with parents. The salivary cortisol levels of all children were measured through a swab. Salivary cortisol levels before and after the intervention were compared in the 3 groups. We calculated the effect size of our interventions through the Cohen d-based effect size correlation (r). RESULTS: A total of 109 children aged 3-10 years were enrolled in the study, and 94 (86.2%) had complete data for the analyses. Salivary cortisol levels significantly decreased more in the group exposed to robot interaction than in the other two groups (r=0.75). Cortisol levels decreased more in girls (r=0.92) than in boys (r=0.57). CONCLUSIONS: SRs are efficacious in decreasing stress in children accessing the emergency room and may be considered a tool for improving emotional perceptions of children and their families in such a critical setting. TRIAL REGISTRATION: ClinicalTrials.gov NCT04627909; https://clinicaltrials.gov/ct2/show/study/NCT04627909.


Asunto(s)
Robótica , Aminoacridinas , Niño , Servicio de Urgencia en Hospital , Femenino , Humanos , Masculino , Padres , Interacción Social
5.
Muscle Nerve ; 64(5): 599-603, 2021 11.
Artículo en Inglés | MEDLINE | ID: mdl-34368972

RESUMEN

INTRODUCTION/AIMS: Spinal muscular atrophy type 1 (SMA 1) is a devastating motor neuron disorder that leads to progressive muscle weakness, respiratory failure and premature death. Although sensory electrophysiological changes have been anecdotally found in pediatric SMA 1 patients, the age of onset of sensory neuropathy remains unknown. METHODS: Sensory nerve conduction studies of the median and sural nerves were performed in 28 consecutive SMA 1 patients of different ages. Sensory nerve conduction velocities and sensory nerve action potential (SNAP) amplitudes recorded in these patients were compared with those obtained from 93 healthy subjects stratified by age. RESULTS: SNAP amplitudes decreased with increasing age in the sural and median nerves, without any significant difference between upper and lower limbs. DISCUSSION: Our data suggest that sural and median nerve SNAP amplitudes are normal in younger patients, while an axonal neuropathy appears in older ones.


Asunto(s)
Enfermedades del Sistema Nervioso Periférico , Atrofias Musculares Espinales de la Infancia , Potenciales de Acción/fisiología , Anciano , Niño , Humanos , Nervio Mediano , Conducción Nerviosa/fisiología , Atrofias Musculares Espinales de la Infancia/complicaciones , Nervio Sural
6.
Eur J Pediatr ; 180(8): 2389-2400, 2021 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-34196791

RESUMEN

Children with medical complexity (CMC) are a high priority population with chronic illnesses dependent on the use of health services, on technological systems to support their vital functions and characterized by multiple health needs. One of the main challenges linked to chronic conditions is finding solutions to monitor CMC at home, avoiding re-hospitalization and the onset of complications. Telemedicine enables to remotely follow up patients and families. An integrative review was performed to assess whether telemedicine improves health outcomes for CMC. Medline/PubMed, CINAHL, Cochrane Library, Web of Science, and Scopus were searched to identify studies describing the effect of using telemedicine systems on health outcomes for CMC. The PRISMA guidelines were used to select the papers. The methodological quality of the studies was evaluated through the Johanna Briggs Institute critical appraisal tools and the Cochrane Collaboration ROB 2.0. A total of 17 papers met the quality criteria and were included. Specialized telemedicine systems (tele-visits), telehealth, and tele-monitoring have been reported to reduce unplanned hospitalizations and visits, decrease total costs for healthcare services and families, and increase satisfaction for family members. No effect was found on the quality of life in children and their families.Conclusion: Available evidence supporting the use of telemedicine in CMC is favorable but limited. High-quality methodological studies including other unexplored health outcomes such as mental health, hospital readmissions, mortality, caregiver competences, and self-efficacy are needed to confirm the effectiveness of telemedicine systems in improving health outcomes for CMC. What is Known: • CMC are an extremely fragile patient population with frequent access to healthcare services compared with other chronic conditions. • There is conflicting evidence of the effectiveness of telemedicine clinical outcomes, healthcare utilization, and costs in pediatrics. What is New: • There is some evidence that for CMC, telemedicine reduces unplanned hospitalizations, healthcare service costs, and financial burden for families, while increasing caregivers' satisfaction with care. • Further research is needed to confirm the effectiveness of telemedicine systems in improving health for CMC.


Asunto(s)
Calidad de Vida , Telemedicina , Cuidadores , Niño , Enfermedad Crónica , Humanos , Evaluación de Resultado en la Atención de Salud
7.
BMC Med Ethics ; 22(1): 18, 2021 02 27.
Artículo en Inglés | MEDLINE | ID: mdl-33639926

RESUMEN

BACKGROUND: Providing understandable information to patients is necessary to achieve the aims of the Informed Consent process: respecting and promoting patients' autonomy and protecting patients from harm. In recent decades, new, primarily digital technologies have been used to apply and test innovative formats of Informed Consent. We conducted a systematic review to explore the impact of using digital tools for Informed Consent in both clinical research and in clinical practice. Understanding, satisfaction and participation were compared for digital tools versus the non-digital Informed Consent process. METHODS: We searched for studies on available electronic databases, including Pubmed, EMBASE, and Cochrane. Studies were identified using specific Mesh-terms/keywords. We included studies, published from January 2012 to October 2020, that focused on the use of digital Informed Consent tools for clinical research, or clinical procedures. Digital interventions were defined as interventions that used multimedia or audio-video to provide information to patients. We classified the interventions into 3 different categories: video only, non-interactive multimedia, and interactive multimedia. RESULTS: Our search yielded 19,579 publications. After title and abstract screening 100 studies were retained for full-text analysis, of which 73 publications were included. Studies examined interactive multimedia (29/73), non-interactive multimedia (13/73), and videos (31/73), and most (34/38) studies were conducted on adults. Innovations in consent were tested for clinical/surgical procedures (26/38) and clinical research (12/38). For research IC, 21 outcomes were explored, with a positive effect on at least one of the studied outcomes being observed in 8/12 studies. For clinical/surgical procedures 49 outcomes were explored, and 21/26 studies reported a positive effect on at least one of the studied outcomes. CONCLUSIONS: Digital technologies for informed consent were not found to negatively affect any of the outcomes, and overall, multimedia tools seem desirable. Multimedia tools indicated a higher impact than videos only. Presence of a researcher may potentially enhance efficacy of different outcomes in research IC processes. Studies were heterogeneous in design, making evaluation of impact challenging. Robust study design including standardization is needed to conclusively assess impact.


Asunto(s)
Consentimiento Informado , Multimedia , Adulto , Humanos , Proyectos de Investigación
8.
J Med Internet Res ; 23(8): e29556, 2021 08 13.
Artículo en Inglés | MEDLINE | ID: mdl-34292866

RESUMEN

BACKGROUND: Italy has experienced severe consequences (ie, hospitalizations and deaths) during the COVID-19 pandemic. Online decision support systems (DSS) and self-triage applications have been used in several settings to supplement health authority recommendations to prevent and manage COVID-19. A digital Italian health tech startup, Paginemediche, developed a noncommercial, online DSS with a chat user interface to assist individuals in Italy manage their potential exposure to COVID-19 and interpret their symptoms since early in the pandemic. OBJECTIVE: This study aimed to compare the trend in online DSS sessions with that of COVID-19 cases reported by the national health surveillance system in Italy, from February 2020 to March 2021. METHODS: We compared the number of sessions by users with a COVID-19-positive contact and users with COVID-19-compatible symptoms with the number of cases reported by the national surveillance system. To calculate the distance between the time series, we used the dynamic time warping algorithm. We applied Symbolic Aggregate approXimation (SAX) encoding to the time series in 1-week periods. We calculated the Hamming distance between the SAX strings. We shifted time series of online DSS sessions 1 week ahead. We measured the improvement in Hamming distance to verify the hypothesis that online DSS sessions anticipate the trends in cases reported to the official surveillance system. RESULTS: We analyzed 75,557 sessions in the online DSS; 65,207 were sessions by symptomatic users, while 19,062 were by contacts of individuals with COVID-19. The highest number of online DSS sessions was recorded early in the pandemic. Second and third peaks were observed in October 2020 and March 2021, respectively, preceding the surge in notified COVID-19 cases by approximately 1 week. The distance between sessions by users with COVID-19 contacts and reported cases calculated by dynamic time warping was 61.23; the distance between sessions by symptomatic users was 93.72. The time series of users with a COVID-19 contact was more consistent with the trend in confirmed cases. With the 1-week shift, the Hamming distance between the time series of sessions by users with a COVID-19 contact and reported cases improved from 0.49 to 0.46. We repeated the analysis, restricting the time window to between July 2020 and December 2020. The corresponding Hamming distance was 0.16 before and improved to 0.08 after the time shift. CONCLUSIONS: Temporal trends in the number of online COVID-19 DSS sessions may precede the trend in reported COVID-19 cases through traditional surveillance. The trends in sessions by users with a contact with COVID-19 may better predict reported cases of COVID-19 than sessions by symptomatic users. Data from online DSS may represent a useful supplement to traditional surveillance and support the identification of early warning signals in the COVID-19 pandemic.


Asunto(s)
COVID-19 , Pandemias , Humanos , Italia/epidemiología , Pandemias/prevención & control , SARS-CoV-2 , Triaje
9.
Eat Weight Disord ; 26(5): 1491-1501, 2021 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-32720247

RESUMEN

PURPOSE: DSM-5 describe three forms of restrictive and selective eating: Anorexia Nervosa-Restrictive (AN-R), Anorexia Nervosa-Atypical (AN-A), and Avoidant/Restrictive Food Intake Disorder (ARFID). While AN is widely studied, the psychopathological differences among these three diseases are not clear. The aim of this study was to (i) compare the clinical features of AN-R, AN-A, and ARFID, in a clinical sample recruited from a specialized EDs program within a tertiary care children's Hospital; (ii) identifying three specific symptom profiles, to better understand if restrictive ED share a common psychopathological basis. METHODS: Data were collected retrospectively. Psychometric assessment included: the Children's Depression Inventory (CDI), the Multidimensional Anxiety Scale for Children (MASC), the Child Behavior Checklist (CBCL), and the Eating Disorder Inventory-3 (EDI-3). RESULTS: A final sample of 346 children and adolescent patients were analyzed: AN-R was the most frequent subtype (55.8%), followed by ARFID (27.2%) and AN-A (17%). Patients with ARFID presented different features from AN-R and AN-A, characterized by lower weight and medical impairment, younger age at onset, and a frequent association with separation anxiety and ADHD symptoms. EDI-3 profiles showed specific different impairment for both AN groups compared to ARFID. However, no differences was detected for items: 'Interpersonal Insecurity', "Interoceptive Deficits", "Emotional Dysregulation", and "Maturity Fears". CONCLUSIONS: Different ED profiles was found for the three groups, but they share the same general psychopathological vulnerability, which could be at the core of EDs in adolescence. LEVEL OF EVIDENCE: III. Evidence obtained from case-control analytic studies.


Asunto(s)
Anorexia Nerviosa , Trastorno de la Ingesta Alimentaria Evitativa/Restrictiva , Trastornos de Alimentación y de la Ingestión de Alimentos , Adolescente , Niño , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Trastornos de Alimentación y de la Ingestión de Alimentos/diagnóstico , Humanos , Estudios Retrospectivos
10.
Arch Gynecol Obstet ; 302(4): 801-819, 2020 10.
Artículo en Inglés | MEDLINE | ID: mdl-32671543

RESUMEN

PURPOSE: Current data show that maternal mental conditions affect about 10% of pregnant women worldwide. Assessing timing and patterns of mental health illness, therefore, is critical to ensure the wellbeing of the mother, the new-born and the whole family. The aim of this review is to summarize the latest evidence linking maternal mental disorders and adverse reproductive outcomes. METHODS: Following the PRISMA guidelines for systematic reviews, a literature search was conducted to ascertain the possible impact of mental health conditions on reproductive outcomes before and during pregnancy. The comprehensive strategy included cohort studies, randomised controlled trials and literature reviews on women with Primary Maternal Mental Illness (PMMI) and Secondary Maternal Mental Illness (SMMI) considering periconceptional, obstetric and foetal-neonatal outcomes. PubMed, WoS, CINAHL and Google scholar were used for the search. Cross-referencing in bibliographies of the selected papers ensured wider study capture. RESULTS: Evidence linking depressive disorders and infertility among PMMI is weak. Given this, women with prior mental conditions experience additional distress when undergoing fertility treatments. Primary mental disorders may also increase the risk of miscarriage and other pregnancy complications (e.g., gestational diabetes). For SMMI, there is more robust evidence correlating Preterm Birth (PTB) and Low Birth Weight (LBW) with common mental disorders which develop during pregnancy. CONCLUSION: Prevention and management of maternal mental health diseases and minor mental conditions within the first 1000 days' timeframe, should have a place in the holistic approach to women going through reproductive decisions, infertility treatment and pregnancy.


Asunto(s)
Antidepresivos/efectos adversos , Trastornos Mentales/tratamiento farmacológico , Salud Mental/estadística & datos numéricos , Complicaciones del Embarazo/psicología , Resultado del Embarazo , Mujeres Embarazadas/psicología , Antidepresivos/uso terapéutico , Femenino , Humanos , Recién Nacido de Bajo Peso , Recién Nacido , Salud Materna , Trastornos Mentales/psicología , Embarazo , Nacimiento Prematuro/prevención & control , Atención Prenatal
11.
Infection ; 45(2): 171-178, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27614887

RESUMEN

PURPOSE: This study was planned to collect evidences of familial pertussis transmission to infants younger than 6 months of age. Understanding the dynamics of transmission of pertussis in families is essential to plan effective prevention strategies that could be integrated in pertussis control. METHODS: The seroprevalence of IgG antibodies to pertussis toxin (PT-IgG) and prolonged cough symptoms were evaluated in parents of 55 infants aged <6 months hospitalized for confirmed pertussis. Parents of 33 infants with lower respiratory tract infection (LRTI) and parents of 57 healthy infants admitted as outpatients for hip ultrasound examination (HE) were enrolled as controls. RESULTS: Parents of pertussis cases had PT-IgG levels significantly higher as compared to LRTI and HE parents. More than 40 % were compatible as transmitters of pertussis to their babies, since they had a level of PT-IgG ≥ 100 IU/ml, which is considered diagnostic for a recent pertussis episode. Based on serology, the percentage of pertussis cases that had at least one parent as source of infection was 49.1 %. When cough symptoms were taken into account, the percentage of parents putative transmitters of the infection to their infants increased to 56.4 %. CONCLUSIONS: Parents are scarcely aware of the household transmission of pertussis to their newborns. Our study highlights the need to advise parents about the likelihood of transmission to the newborn and to be particularly aware of coughing symptoms in the household. Since infection can be asymptomatic, a serological survey of family members should also be considered.


Asunto(s)
Salud de la Familia , Transmisión Vertical de Enfermedad Infecciosa , Padres , Tos Ferina/transmisión , Anticuerpos Antibacterianos/sangre , Antitoxinas/sangre , Estudios de Casos y Controles , Femenino , Humanos , Inmunoglobulina G/sangre , Lactante , Recién Nacido , Masculino , Estudios Seroepidemiológicos
12.
Pacing Clin Electrophysiol ; 39(7): 669-74, 2016 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-27062386

RESUMEN

BACKGROUND: The etiological diagnosis of syncope and/or palpitations in children is often challenging. However, when noninvasive conventional examinations are inconclusive, the subcutaneous miniaturized implantable loop recorder (ILR) is recommended. The aim of our study was to evaluate the efficacy of miniaturized cardiac implantable devices in the early diagnosis of arrhythmias in children ≤6 years. METHODS: From March 2014 to May 2015, 21 patients (median age 5 years) underwent implantation of miniaturized ILR at our Institution after a complete cardiac work up. Median follow-up was 10 months. RESULTS: One patient underwent device removal for pocket infection and one needed a pocket revision. Eleven (52%) patients did not show any symptom and/or arrhythmia. Eight patients experienced symptoms during ILR monitoring: six had no electrocardiographic abnormalities, two had significant sinus pauses. Two patients had significant arrhythmias without symptoms and in one of these a pacemaker was implanted. The overall diagnostic yield was 47%. CONCLUSIONS: Miniaturized ILR could be very useful to make a diagnosis and to decide future management strategies in small patients with undefined symptoms or severe cardiac diseases. Considering its characteristics, miniaturized ILR could start a new era in the diagnosis and follow-up of young patients with symptomatic and/or malignant arrhythmias.


Asunto(s)
Arritmias Cardíacas/diagnóstico , Muerte Súbita Cardíaca/prevención & control , Electrocardiografía Ambulatoria/instrumentación , Técnicas Electrofisiológicas Cardíacas/instrumentación , Prótesis e Implantes , Arritmias Cardíacas/complicaciones , Arritmias Cardíacas/prevención & control , Niño , Preescolar , Muerte Súbita Cardíaca/etiología , Diagnóstico Precoz , Diseño de Equipo , Análisis de Falla de Equipo , Femenino , Humanos , Almacenamiento y Recuperación de la Información , Masculino , Reproducibilidad de los Resultados , Medición de Riesgo/métodos , Sensibilidad y Especificidad
13.
Int J Mol Sci ; 17(5)2016 May 06.
Artículo en Inglés | MEDLINE | ID: mdl-27164095

RESUMEN

Even if varicella is generally considered a harmless disease in childhood, severe complications may occur. We examined varicella skin complications (VSCs) in hospitalized immunologically healthy children, over a nine-year period. We also systematically analyzed previous reports to calculate the rate of VSCs in the literature. VSCs occurred in 16.4% of children hospitalized for varicella. This figure is in accordance with the literature, as the range of VSCs was 2.6%-41.2%. Skin complications may represent determinants of hospitalization and of other indirect costs in young children.


Asunto(s)
Varicela/complicaciones , Enfermedades de la Piel/epidemiología , Adolescente , Varicela/epidemiología , Niño , Preescolar , Femenino , Hospitalización/estadística & datos numéricos , Humanos , Masculino , Enfermedades de la Piel/etiología
14.
Ig Sanita Pubbl ; 71(1): 115-27, 2015.
Artículo en Italiano | MEDLINE | ID: mdl-25927654

RESUMEN

Varicella is an infectious disease still frequent in Italy, where 8 out 20 Regions have adopted universal vaccination programs starting from 2003. Accordingly to National Vaccination Plan, all Regions should introduce universal varicella vaccination in 2015. An independent multidisciplinary group of experts met to discuss some debated questions. The available evidence of varicella vaccine efficacy in the 8 Regions was evaluated and the evidence of safety of monovalent and combined varicella vaccines are presented. The strategy for introducing universal varicella vaccine in the pediatric immunization schedule is discussed. The expert group concludes that available evidence supports the active offer of varicella vaccine in all Italian Regions and that catch up programs for susceptible cohorts should be encouraged.


Asunto(s)
Vacuna contra la Varicela , Varicela/prevención & control , Vacunación Masiva , Niño , Humanos , Italia
15.
J Pediatr ; 164(5): 1228-30, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-24423433

RESUMEN

We investigated in children with spinal muscular atrophy type 2 the consistency of 4 different equations for predicting resting energy expenditure (REE) compared with measured REE by using indirect calorimetry. In patients with spinal muscular atrophy type 2, measured REE was lower than predicted. We also found a correlation between energy consumption and motor skills.


Asunto(s)
Metabolismo Basal , Atrofias Musculares Espinales de la Infancia/metabolismo , Adolescente , Calorimetría Indirecta/métodos , Estudios de Casos y Controles , Niño , Preescolar , Femenino , Humanos , Lactante , Masculino
16.
J Pediatr ; 165(5): 967-72.e1, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25108542

RESUMEN

OBJECTIVE: To evaluate the impact of the 2009 Italian pediatric clinical guidelines on the management of syncope. STUDY DESIGN: A retrospective study of patients who presented to the Emergency Department (ED) of Bambino Gesù Children's Hospital with syncope during the 2 years before and then for 2 years after the establishment of the Italian pediatric clinical guidelines. Implementation of the clinical guidelines included educational seminars, additional training of health care workers, and the availability of clinical guidelines and its algorithms on ED examination rooms. RESULTS: We studied a population of 1073 patients (n = 470 vs n = 603). Most patients had neurocardiogenic syncope with a greater increase in postimplementation period (n = 241, 51.3% vs n = 454, 49.8%); we also noticed a parallel reduction of the number of patients with undefined syncope (30% vs 8.3%). We observed an increase in electrocardiogram (n = 328, 69.8% vs n = 512, 85.1%; P < .001), a reduction in electroencephalogram (n = 54, 11.5% vs n = 25, 4.1%; P < .001), and computed tomography scan/magnetic resonance imaging utilization (n = 26, 5.5% vs n = 8, 1.3%; P < .001). In addition, there was a significant reduction of hospital admission rates (n = 195; 41.5% vs n = 116, 19.2%; P < .001). The time period was significantly associated with improvements in all procedures at the multivariate analysis. CONCLUSIONS: Providing practitioners in the ED with age-oriented clinical guidelines increased the efficiency of clinical management of pediatric syncope. Our study demonstrated that the implementation of pediatric clinical guidelines on syncope improve diagnosis, reduce hospital admissions, and decrease the use of unnecessary diagnostic tests.


Asunto(s)
Técnicas y Procedimientos Diagnósticos/estadística & datos numéricos , Servicio de Urgencia en Hospital/estadística & datos numéricos , Adhesión a Directriz/estadística & datos numéricos , Hospitalización/estadística & datos numéricos , Guías de Práctica Clínica como Asunto , Síncope/diagnóstico , Adolescente , Niño , Preescolar , Femenino , Humanos , Lactante , Italia , Masculino , Estudios Retrospectivos
17.
BMC Psychiatry ; 14: 270, 2014 Sep 24.
Artículo en Inglés | MEDLINE | ID: mdl-25248437

RESUMEN

BACKGROUND: In 2009, an earthquake devastated the Abruzzo region in Italy. Despite the occurrence of several disasters in this country, no study on mental health of Italian children has ever been conducted in complex emergencies. Objective of the study was to assess the prevalence of psychiatric symptoms among children in the affected area 12 to 17 months after the event. METHODS: A community sample of 1839 3-14 years children was identified from the general population assigned to 37 paediatricians of the National Health System, including children living in the earthquake epicentre, the surrounding earthquake zone, and the adjacent non-affected areas. Psychiatric symptoms were assessed with the Child Behavior Checklist (CBCL) and the Youth Self Report (YSR), completed by 452 children aged 11-14 years. The association between symptoms and sociodemographic, health, family, and earthquake-related factors was examined. RESULTS: The prevalence of CBCL-defined cases was 14.9% in the epicentre, 13.0% in the remainder earthquake zone, 13.9% in the unaffected area (p = .876). No differences among areas were found when comparing the YSR results. Prevalence of CBCL-defined post-traumatic stress (PTS) cases was 8.4% in the epicentre, 4.0% in the remainder earthquake zone, 2.2% in the unaffected area (p = .002). PTS and anxiety were significantly more frequent in the epicentre than in other areas only in the 6-10 year-old children group (respectively p = .009 and p = .014). In multivariate logistic analyses, factors associated with PTS were living in the epicentre (OR = 3.6) and child or maternal history of mental health care prior to the earthquake (respectively OR = 7.1 and OR = 4.5). CONCLUSIONS: Children living in the epicentre, particularly those 6-10 years old, had the highest prevalence of CBCL-defined cases, and of PTS and anxiety symptoms one year after the earthquake. No signs of increased psychopathology were detected in younger (3-5 years) or older children (11-14 years). Family and health related factors showed stronger association with psychiatric outcomes than earthquake-related factors. The identification of populations at higher risk of developing psychiatric symptoms has implications for public health interventions in complex emergencies.


Asunto(s)
Desastres , Terremotos , Trastornos Mentales/epidemiología , Adolescente , Ansiedad/epidemiología , Lista de Verificación , Niño , Preescolar , Femenino , Humanos , Italia/epidemiología , Masculino , Salud Mental , Prevalencia , Autoinforme , Trastornos por Estrés Postraumático/epidemiología , Factores de Tiempo
18.
Recenti Prog Med ; 105(12): 454-6, 2014 Dec.
Artículo en Italiano | MEDLINE | ID: mdl-25533232

RESUMEN

Prevalence of overweight and obesity in childhood has substantially increased worldwide in recent decades with children becoming obese at progressively younger ages. Obesity in children carries a wide range of serious complications, and contributes to an increased prevalence of cardiovascular risk factors such as hypertension, hypertrygliceridema, low high-density lipoprotein cholesterol (HDL), impaired glucose metabolism and early atherosclerotic changes not only in adulthood but since in very early pediatric age. In the ORIGIN study (Outcome Reduction with an Initial Glargine Intervention), cardiometabolic risk factors including fatty liver were already detectable in preschoolers at the onset of overweight/obesity despite short-term exposure to excess weight and fairly reduced insulin sensitivity. These facts together with the evidence that early cardiometabolic impairment reverts with lifestyle intervention in pediatric age, emphasize the need to start prevention of childhood obesity and screening of cardiometabolic co-morbities at the earliest stage with multidisciplinary strategies.


Asunto(s)
Enfermedades Cardiovasculares/etiología , Obesidad/complicaciones , Sobrepeso/complicaciones , Factores de Edad , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/prevención & control , Niño , Hígado Graso/complicaciones , Hígado Graso/epidemiología , Hígado Graso/etiología , Humanos , Resistencia a la Insulina , Estilo de Vida , Obesidad/epidemiología , Obesidad/prevención & control , Sobrepeso/epidemiología , Sobrepeso/prevención & control , Prevalencia , Factores de Riesgo
19.
J Clin Med ; 13(10)2024 May 16.
Artículo en Inglés | MEDLINE | ID: mdl-38792490

RESUMEN

Artificial intelligence (AI) is experiencing advances and integration in all medical specializations, and this creates excitement but also concerns. This narrative review aims to critically assess the state of the art of AI in the field of endometriosis and adenomyosis. By enabling automation, AI may speed up some routine tasks, decreasing gynecologists' risk of burnout, as well as enabling them to spend more time interacting with their patients, increasing their efficiency and patients' perception of being taken care of. Surgery may also benefit from AI, especially through its integration with robotic surgery systems. This may improve the detection of anatomical structures and enhance surgical outcomes by combining intra-operative findings with pre-operative imaging. Not only that, but AI promises to improve the quality of care by facilitating clinical research. Through the introduction of decision-support tools, it can enhance diagnostic assessment; it can also predict treatment effectiveness and side effects, as well as reproductive prognosis and cancer risk. However, concerns exist regarding the fact that good quality data used in tool development and compliance with data sharing guidelines are crucial. Also, professionals are worried AI may render certain specialists obsolete. This said, AI is more likely to become a well-liked team member rather than a usurper.

20.
Artículo en Inglés | MEDLINE | ID: mdl-36833707

RESUMEN

Eating disorders are considered one of the psychiatric disorders with a higher risk of death. Food addiction, related to some food addictive-like behaviours, is often in comorbidity with eating disorders and is associated with worse psychopathology. The present study aims to outline the food addiction profile, investigated using the Yale Food Addiction Scale 2.0 (YFAS 2.0), in 122 adolescents (median age: 15.6 years) suffering from eating disorders and to investigate its association with psychopathology. Patients filled out the Youth Self Report, the Multidimensional Anxiety Scale for Children 2, The Children Depression Inventory 2, and the Eating Disorder Inventory 3 (EDI-3). Pearson's chi-square test and multiple correspondence analysis were used to identify profiles. The mean symptom count was 2.8 ± 2.7. The "withdrawal" symptom was the most frequent (51%) and the most associated with clinical scores. The diagnosis of bulimia nervosa and the EDI-3 bulimia scale resulted to be the only variables to be associated with positive YFAS 2.0 symptoms. Conversely, anorexia nervosa, restrictive and atypical, was not associated with YFAS 2.0 symptoms. In conclusion, outlining the food addiction profile of eating disorders may give information about a patient's phenotype and could help to identify specific treatment models.


Asunto(s)
Conducta Adictiva , Bulimia Nerviosa , Trastornos de Alimentación y de la Ingestión de Alimentos , Adicción a la Comida , Humanos , Adicción a la Comida/diagnóstico , Adicción a la Comida/psicología , Conducta Adictiva/psicología , Bulimia Nerviosa/psicología , Psicopatología
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA