Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 6 de 6
Filtrar
1.
Pediatr Endocrinol Rev ; 8 Suppl 2: 314-21, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21705985

RESUMEN

Thyroid cancer is the most frequent endocrine neoplasm in the general population. Its incidence is 5-10/100,000 per year, with an annual death rate of 0.2-1.2/100,000 in men and 0.4-2.8/100,000 in women. In thalassaemia patients the frequency of this disease is unknown. In this paper we describe five cases of papillary thyroid cancer in thalassaemia patients followed at the Day Hospital for Thalassaemia and Haemoglobinopathies, in Ferrara, Italy. We consider the possible key role of iron as a carcinogenic agent and we also discuss the practical implications of our clinical observations.


Asunto(s)
Carcinoma Papilar/epidemiología , Carcinoma Papilar/metabolismo , Hierro/metabolismo , Talasemia beta/epidemiología , Talasemia beta/metabolismo , Adulto , Carcinoma , Resultado Fatal , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Cáncer Papilar Tiroideo , Neoplasias de la Tiroides/epidemiología , Neoplasias de la Tiroides/metabolismo
2.
Arch Dis Child ; 105(9): 896-899, 2020 09.
Artículo en Inglés | MEDLINE | ID: mdl-30636224

RESUMEN

OBJECTIVE AND DESIGN: Risk factors for severe measles are poorly investigated in high-income countries. The Italian Society for Paediatric Infectious Diseases conducted a retrospective study in children hospitalised for measles from January 2016 to August 2017 to investigate the risk factors for severe outcome defined by the presence of long-lasting sequelae, need of intensive care or death. RESULTS: Nineteen hospitals enrolled 249 children (median age 14.5 months): 207 (83%) children developed a complication and 3 (1%) died. Neutropaenia was more commonly reported in children with B3-genotype compared with other genotypes (29.5% vs 7.7%, p=0.01). Pancreatitis (adjusted OR [aOR] 9.19, p=0.01) and encephalitis (aOR 7.02, p=0.04) were related to severe outcome in multivariable analysis, as well as C reactive protein (CRP) (aOR 1.1, p=0.028), the increase of which predicted severe outcome (area under the receiver operating characteristic curve 0.67, 95% CI 0.52 to 0.82). CRP values >2 mg/dL were related to higher risk of complications (OR 2.0, 95% CI 1.15 to 3.7, p=0.01) or severe outcome (OR 4.13, 95% CI 1.43 to 11.8, p<0.01). CONCLUSION: The risk of severe outcome in measles is independent of age and underlying conditions, but is related to the development of organ complications and may be predicted by CRP value.


Asunto(s)
Sarampión/complicaciones , Niño , Preescolar , Encefalitis Viral/etiología , Femenino , Humanos , Lactante , Unidades de Cuidado Intensivo Pediátrico/estadística & datos numéricos , Italia/epidemiología , Masculino , Sarampión/mortalidad , Sarampión/patología , Virus del Sarampión/genética , Neutropenia/etiología , Pancreatitis/etiología , Curva ROC , Factores de Riesgo , Índice de Severidad de la Enfermedad
3.
Pediatr Endocrinol Rev ; 6 Suppl 1: 181-4, 2008 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-19337175

RESUMEN

The primary cause of cardiac dysfunction in thalassemia is believed to be myocardial iron overload. Besides iron, other factors may play a role in the impairment of myocardial contractility, including prolonged heart tissue hypoxia, pericardial involvement, arrhythmias, endocrine complications and vitamin D deficiency. We present the case of a 7 year-old boy with ?-thalassaemia major and cardiac dysfunction, pericardial effusion and associated endocrinopathies. His serum thyrotropin (TSH) level was increased, and total and free thyroxine (FT4) were low. In addition, biochemical results and serum PTH level were compatible with a diagnosis of hypoparathyroidism. Other laboratory findings were not consistent with rheumatic heart disease, viral myocarditis or autoimmune disease. The child was treated with digoxin, diuretics, oral calcium, vitamin D, L-thyroxine (25 microg daily, which was later gradually increased) and subcutaneous iron chelation therapy (45 mg/kg, six days/week). The patient was discharged from our Unit after 7 days and within 3 months he had appreciable myocardial improvement and disappearance of the pericardial effusion.


Asunto(s)
Cardiomiopatías/metabolismo , Hipoparatiroidismo/metabolismo , Hipotiroidismo/metabolismo , Sobrecarga de Hierro/metabolismo , Derrame Pericárdico/metabolismo , Talasemia beta/metabolismo , Calcio/uso terapéutico , Cardiomiopatías/tratamiento farmacológico , Cardiotónicos/uso terapéutico , Niño , Digoxina/uso terapéutico , Diuréticos/uso terapéutico , Humanos , Quelantes del Hierro/uso terapéutico , Sobrecarga de Hierro/tratamiento farmacológico , Masculino , Derrame Pericárdico/tratamiento farmacológico , Tiroxina/uso terapéutico , Talasemia beta/terapia
4.
Pediatr Endocrinol Rev ; 6 Suppl 1: 170-3, 2008 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-19337173

RESUMEN

The severity of thyroid dysfunction in patients with beta-thalassaemia major is variable in different series. An exaggerated thyrotropin response to thyrotropin-releasing-hormone (TRH) has been found in 1 out of 5 beta-thalassaemia major patients. Because it is not well known how many of these patients will develop overt or subclinical hypothyroidism, we reviewed retrospectively the thyroid status (thyroid hormones, TBG, TG basal and TSH peak after TRH test) of 24 children and adolescents with beta-thalassemia major (mean age 12.1+/-3.9 years) on periodic transfusion therapy, regularly followed in our Centre during the last 20 years. As controls we studied 30 normal subjects aged 13.4+/-2.5 years. In our group of 24 thalassaemics an exaggerated TSH response to TRH test was found in 8 (33.3%), 3 of whom developed subclinical or overt hypothyroidism from 3 to 11 years later. TSH peak values correlated directly with ferritin levels, ALT, and compliance index to chelation therapy. Our data suggest that an exaggerated TSH response to TRH test is frequent in beta-thalassemia major, and may evolve into subclinical or overt hypothyroidism as we found in 37.5% of our patients with sub-biochemical hypothyroidism.


Asunto(s)
Sobrecarga de Hierro/sangre , Hormona Liberadora de Tirotropina/farmacología , Tirotropina/sangre , Talasemia beta/sangre , Adolescente , Niño , Humanos , Hipotiroidismo/sangre , Estudios Retrospectivos , Estadísticas no Paramétricas , Tiroglobulina/sangre , Tiroxina/sangre , Triyodotironina/sangre
5.
Pediatr Infect Dis J ; 37(12): e347-e349, 2018 12.
Artículo en Inglés | MEDLINE | ID: mdl-29570177

RESUMEN

Tuberculosis (TB) is a severe problem in underdeveloped countries. Cutaneous TB is rare and often goes unrecognized. We report a Pakistani child with multifocal cutaneous and pulmonary TB. Microbiologic diagnosis was obtained when the abscesses were biopsied. Four-drug therapy produced rapid improvement of the lesions. A high level of suspicion must be maintained when evaluating children from countries at risk.


Asunto(s)
Antituberculosos/uso terapéutico , Mycobacterium tuberculosis/aislamiento & purificación , Tuberculosis Cutánea/diagnóstico , Adolescente , Femenino , Humanos , Piel/microbiología , Tuberculosis Cutánea/tratamiento farmacológico , Tuberculosis Pulmonar/diagnóstico , Tuberculosis Pulmonar/tratamiento farmacológico
6.
Expert Rev Anti Infect Ther ; 16(4): 351-358, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29569505

RESUMEN

BACKGROUND: Acute/subacute haematogenous osteomyelitis (AHOM/SAHOM) are potentially devastating diseases. Updated information about the epidemiology, management and outcome of AHOM/SAHOM is needed to minimize the risk of complications and sequelae. METHODS: A multicenter study was performed to evaluate retrospectively the management and outcome of AHOM/SAHOM in Italy. Data from children aged >1 month, and hospitalized between 2010 and 2016, in 19 pediatric centers, were analyzed. RESULTS: 300 children with AHOM and 98 with SAHOM were included. Median age was 6.0 years (IQR: 2.0-11.0). No clinical difference was observed with the exception of fever at onset (63.0% vs. 42.9%; P < 0.0001), and a more common spinal involvement in SAHOM (6.7% vs 20.4%; P < 0.001). Fifty-Eight Staphylococcus aureus strains were isolated; 5 (8.6%) were MRSA. No Kingella kingae infection was documented. No different risk for complication/sequela was observed between AHOM and SAHOM (38.3% vs. 34.7%; OR:0.85; 95%CI: 0.53-1.38; P = 0.518). Duration and type of antibiotic therapy were not associated with risk of complication/sequelae. CONCLUSION: AHOM and SAHOM displayed some differences, however occurrence and risk factors for complications and sequelae are similar, and the same empiric treatment might be recommended.


Asunto(s)
Antibacterianos/uso terapéutico , Osteomielitis/complicaciones , Infecciones Estafilocócicas/epidemiología , Enfermedad Aguda , Adolescente , Antibacterianos/administración & dosificación , Niño , Preescolar , Femenino , Hospitalización , Humanos , Lactante , Italia/epidemiología , Masculino , Staphylococcus aureus Resistente a Meticilina/aislamiento & purificación , Osteomielitis/tratamiento farmacológico , Osteomielitis/microbiología , Estudios Retrospectivos , Factores de Riesgo , Infecciones Estafilocócicas/microbiología
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA