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1. Corrigendum: The new Italian registry of infantile thrombosis (RITI): a reflection on its journey, challenges and pitfalls

Author

Maria Federica Pelizza, Matteo Martinato, Anna Rosati, Margherita Nosadini, Paola Saracco, Paola Giordano, Matteo Luciani, Laura Ilardi, Donatella Lasagni, Angelo Claudio Molinari, Rossana Bagna, Antonella Palmieri, Luca Antonio Ramenghi, Massimo Grassi, Mariella Magarotto, Federica Magnetti, Andrea Francavilla, Giuseppe Indolfi, Agnese Suppiej, Chiara Gentilomo, Roberta Restelli, Antonella Tufano, Daniela Tormene, Jacopo Norberto Pin, Clarissa Tona, Davide Meneghesso, Lidia Rota, Marta Conti, Giovanna Russo, Giulia Lorenzoni, Dario Gregori, Stefano Sartori, Paolo Simioni, Collaborators of the R.I.T.I. (Italian and Registry of Infantile Thrombosis), Accorsi Patrizia, Aceto Gabriella, Agnoletti Gabriella, Agostini Manuela, Alfarano Angela, Altieri Elena, Amador Carolina, Antonelli Camilla, Arena Vittoria, Asta Francesca, Baggio Laura, Ballardini Elisa, Baracetti Margherita, Baraldi Eugenio, Barberis Laura, Barisone Elena, Basso Anne Letizia, Battajon Nadia, Bersani Iliana, Biddeci Giada, Biffanti Roberta, Bonardi Claudia Maria, Bonaudo Roberto, Boniver Clementina, Boscarol Gianluca, Bottino Roberto, Bravar Giulia, Brizzi Ilaria, Brolatti Noemi, Braguglia Annabella, Guaragni Brunetta, Bugin Samuela, Calvo Pier Luigi, Capasso Antonella, Capodiferro Donatella, Cappelleri Alessia, Cascarano Maria Teresa, Casellato Susanna, Casini Tommaso, Catarzi Serena, Cavaliere Elena, Cavicchiolo Maria Elena, Celestino Silvia, Celle Maria Elena, Centonze Nicola, Cerutti Alessia, Chakrokh Roksana, Offer Chiara, Chiodin Elisabetta, Chirico Gaetano, Chukhlantseva Natalia, Cifarelli Paola, Cinelli Giulia, Coinu Marisa, Colonna Clara, Comito Donatella, Corato Alessandra, Cordelli Duccio Maria, Crichiutti Giovanni, Cursio Ida, Dagri Arianna, De Maria Beatrice, Del Borrello Giovanni, Di Rienzo Francesca, Doglioni Nicoletta, Dolcemascolo Valentina, Dotta Andrea, Drigo Paola, Drimaco Pietro, Ellero Serena, Falcone Alessandra, Fantauzzi Ambra, Farinasso Daniela, Ferilli Michela, Festa Silvia, Fischer Maximilian, Foiadelli Thomas, Fotzi Ilaria, Francavilla Rosa, Freschi Paola, Gaffuri Marcella, Gallo Elena, Gamalero Lisa, Gandioli Claudia, Garuccio Sergio, Gentile Diletta, Ghionzoli Marco, Giliberti Paola, Greco Filippo, Guariento Chiara, Guidotti Isotta, Iodice Alessandro, Janes Augusta, Laghi Elena, Lampugnani Elisabetta, Lassandro Giuseppe, Laverda Anna Maria, Lazzerotti Alessandra, Lo Tartaro Meragliotta Patrizia, Lombardini Martina, Lorenzon Eleonora, Mainini Nicoletta, Massoud Michela, Materia Valeria, Mattera Raffaele, Mauro Isabella, Melani Federico, Meli Mariaclaudia, Messina Giovanni, Monticone Sonia, Moras Marzia, Negro Ilaria, Olzai Giorgio, Pancani Simone, Pandolfi Maria, Passariello Annalisa, Passarini Alice, Passone Eva, Pastorino Myriam, Pegoraro Veronica, Pennoni Serena, Perilongo Giorgio, Pozzessere Anna, Pruna Dario, Pusiol Anna, Putti Maria Caterina, Rabbone Ivana, Radicioni Maurizio, Renna Salvatore, Ricci Maria Luisa, Rimini Alessandro, Rivellini Sara, Rustioni Gianluca, Salvadori Sabrina, Santoiemma Valentina, Santoro Nicola, Schiavulli Michele, Sebellin Sofia, Sesta Michela, Soffiati Massimo, Sorbo Monica, Spanedda Giuseppina, Stangalini Valeria, Stasolla Salvatore, Tanzi Giorgia, Testa Tiziana, Teutonico Federica, Timpani Giuseppina, Toldo Irene, Trapani Sandra, Vaccari Roberto, Vecchi Marilena, Vento Giovanni, Veraldi Daniele, Villa Giovanna, Visintin Gianluca, Zambelloni Cesare, and Zellini Francesco

Subjects
thrombosis, stroke, children, pediatric, registry, thromboembolism, Pediatrics, RJ1-570
Published
2024
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2. The new Italian registry of infantile thrombosis (RITI): A reflection on its journey, challenges and pitfalls

Author

Maria Federica Pelizza, Matteo Martinato, Anna Rosati, Margherita Nosadini, Paola Saracco, Paola Giordano, Matteo Luciani, Laura Ilardi, Donatella Lasagni, Angelo Claudio Molinari, Rossana Bagna, Antonella Palmieri, Luca Antonio Ramenghi, Massimo Grassi, Mariella Magarotto, Federica Magnetti, Andrea Francavilla, Giuseppe Indolfi, Agnese Suppiej, Chiara Gentilomo, Roberta Restelli, Antonella Tufano, Daniela Tormene, Jacopo Norberto Pin, Clarissa Tona, Davide Meneghesso, Lidia Rota, Marta Conti, Giovanna Russo, Giulia Lorenzoni, Dario Gregori, Stefano Sartori, Paolo Simioni, Collaborators of the R.I.T.I. (Italian Registry of Infantile Thrombosis), Accorsi Patrizia, Aceto Gabriella, Agnoletti Gabriella, Agostini Manuela, Alfarano Angela, Altieri Elena, Amador Carolina, Antonelli Camilla, Arena Vittoria, Asta Francesca, Baggio Laura, Ballardini Elisa, Baracetti Margherita, Baraldi Eugenio, Barberis Laura, Barisone Elena, Basso Anne Letizia, Battajon Nadia, Bersani Iliana, Biddeci Giada, Biffanti Roberta, Bonardi Claudia Maria, Bonaudo Roberto, Boniver Clementina, Boscarol Gianluca, Bottino Roberto, Bravar Giulia, Brizzi Ilaria, Brolatti Noemi, Braguglia Annabella, Guaragni Brunetta, Bugin Samuela, Calvo Pier Luigi, Capasso Antonella, Capodiferro Donatella, Cappelleri Alessia, Cascarano Maria Teresa, Casellato Susanna, Casini Tommaso, Catarzi Serena, Cavaliere Elena, Cavicchiolo Maria Elena, Celestino Silvia, Celle Maria Elena, Centonze Nicola, Cerutti Alessia, Chakrokh Roksana, Offer Chiara, Chiodin Elisabetta, Chirico Gaetano, Chukhlantseva Natalia, Cifarelli Paola, Cinelli Giulia, Coinu Marisa, Colonna Clara, Comito Donatella, Corato Alessandra, Cordelli Duccio Maria, Crichiutti Giovanni, Cursio Ida, Dagri Arianna, De Maria Beatrice, Del Borrello Giovanni, Di Rienzo Francesca, Doglioni Nicoletta, Dolcemascolo Valentina, Dotta Andrea, Drigo Paola, Drimaco Pietro, Ellero Serena, Falcone Alessandra, Fantauzzi Ambra, Farinasso Daniela, Ferilli Michela, Festa Silvia, Fischer Maximilian, Foiadelli Thomas, Fotzi Ilaria, Francavilla Rosa, Freschi Paola, Gaffuri Marcella, Gallo Elena, Gamalero Lisa, Gandioli Claudia, Garuccio Sergio, Gentile Diletta, Ghionzoli Marco, Giliberti Paola, Greco Filippo, Guariento Chiara, Guidotti Isotta, Iodice Alessandro, Janes Augusta, Laghi Elena, Lampugnani Elisabetta, Lassandro Giuseppe, Laverda Anna Maria, Lazzerotti Alessandra, Lo Tartaro Meragliotta Patrizia, Lombardini Martina, Lorenzon Eleonora, Mainini Nicoletta, Massoud Michela, Materia Valeria, Mattera Raffaele, Mauro Isabella, Melani Federico, Meli Mariaclaudia, Messina Giovanni, Monticone Sonia, Moras Marzia, Negro Ilaria, Olzai Giorgio, Pancani Simone, Pandolfi Maria, Passariello Annalisa, Passarini Alice, Passone Eva, Pastorino Myriam, Pegoraro Veronica, Pennoni Serena, Perilongo Giorgio, Pozzessere Anna, Pruna Dario, Pusiol Anna, Putti Maria Caterina, Rabbone Ivana, Radicioni Maurizio, Renna Salvatore, Ricci Maria Luisa, Rimini Alessandro, Rivellini Sara, Rustioni Gianluca, Salvadori Sabrina, Santoiemma Valentina, Santoro Nicola, Schiavulli Michele, Sebellin Sofia, Sesta Michela, Soffiati Massimo, Sorbo Monica, Spanedda Giuseppina, Stangalini Valeria, Stasolla Salvatore, Tanzi Giorgia, Testa Tiziana, Teutonico Federica, Timpani Giuseppina, Toldo Irene, Trapani Sandra, Vaccari Roberto, Vecchi Marilena, Vento Giovanni, Veraldi Daniele, Villa Giovanna, Visintin Gianluca, Zambelloni Cesare, and Zellini Francesco

Subjects
thrombosis, stroke, children, pediatric, registry, thromboembolism, Pediatrics, RJ1-570
Abstract

IntroductionThrombotic events in neonates and children represent a rare although severe occurrence in view of the associated risk of mortality and sequelae. Quality evidence is limited in this field, and registry studies provide an essential base for research. The aim of this paper is to present the new Italian Registry of Infantile Thrombosis (RITI), set it into the scene of international thrombosis and stroke registries, and provide some insight on the challenges associated with registry management.MethodsWe present the detailed structure and content of the new RITI registry, a brief overview of its main data, and a reflection on its features, pitfalls and the main challenges related to its management.ResultsThe RITI, initially started in 2007 and officially re-launched in 2017 after structural modifications, is a non-interventional retrospective and prospective registry study collecting data on neonatal and pediatric patients (0–18 years) who experienced a systemic or cerebral thrombotic event in Italy. The RITI is managed by a multidisciplinary team with expertise in pediatric thrombosis, and participation is open to all Italian physicians, on a voluntary basis. The overall aim of the registry is to acquire new evidence to better characterize the population of children with thrombotic events and improve their management and outcome. 48 Italian pediatric and intensive care units are actively involved in the RITI, including 85 medical doctors from 16 Italian regions. A total of 1,001 neonates and children affected by cerebral or systemic thrombosis have been enrolled.DiscussionThe RITI is one of the largest available European registries of neonatal and pediatric thrombosis. National registries like the RITI represent a model for the study of rare conditions based on multidisciplinary and multicenter collaboration, aimed at overcoming the limitations due to small populations of patients, and creating a network of experts for patient referral and continuous education. Moreover, registry studies have a pivotal role in the research on pediatric thrombosis, due to the limited feasibility of high-quality studies. In our experience, the main critical stages, pitfalls and challenges in registry management include adequate registry designing, diffusion, data completeness and quality control.

Published
2023
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3. Systemic Catheter-Related Venous Thromboembolism in Children: Data From the Italian Registry of Pediatric Thrombosis

Author

Donatella Lasagni, Margherita Nosadini, Angelo Claudio Molinari, Paola Saracco, Maria Federica Pelizza, Fiammetta Piersigilli, Maria Caterina Putti, Marcella Gaffuri, Paola Giordano, Giulia Lorenzoni, Andrea Francavilla, Sandra Trapani, Matteo Luciani, Agnese Suppiej, Antonella Tufano, Daniela Tormene, Matteo Martinato, Dario Gregori, Stefano Sartori, Paolo Simioni, The Systemic Thromboses Working Group of the Italian Registry of Pediatric Thrombosis (RITI Registro Italiano Trombosi Infantili), Manuela Agostini, Bianca Bassi, Elisa Bertoni, Anna Casani, Daniela Farinasso, Elena Gallo, Chiara Gentilomo, Massimo Grassi, Fabio Lunetta, Mariella Magarotto, Francesca Maschio, Antonella Palmieri, Andrea Pettenazzo, Roberto Sangermani, and Annamaria Laverda

Subjects
thrombosis, catheter-complications, central venous catheter (CVC), pediatric, children, registry, Pediatrics, RJ1-570
Abstract

BackgroundCentral venous catheters (CVCs) represent one of the main risk factors for venous thrombotic events (VTEs) in children.MethodsWe studied the Italian Registry of Pediatric Thrombosis (RITI) with regard to systemic radiologically confirmed CVC-related VTEs (CVC-VTEs) occurred during 6.5 years in children aged 29 days to 18 years.ResultsA total of 78 CVC-VTEs were included, which occurred in 76 patients (40/76, 53% males). CVC-VTEs comprised 67 non-cardiac VTEs (86%) and 11 intracardiac thrombotic events (ICTEs) (14%); the median age at onset was 19 and 17 months, respectively. The most frequent reason for CVC insertion was supportive therapy. The catheters were placed percutaneously in 85% of cases (56/66) and surgically in the remaining 15% (10/66). Peripherally inserted central catheters (PICCs) were used in 47% (31/66) cases, partially implanted catheters in 42% (28/66), non-implantable catheters in 7% (5/66), and totally implanted catheters (Port) in 2% (1/66). CVC-VTEs were symptomatic in 77% of cases (60/78), while in the remaining 23%, they were incidentally detected on the imaging performed for the underlying condition. The median time between CVC insertion and the onset of symptoms was 10 days in non-cardiac VTEs and 39 days in ICTEs. Doppler ultrasound was the diagnostic technique most frequently used. The venous compartment most frequently affected was the veins of the lower extremities (52%, 43/73). Anti-thrombotic treatment was administered in 96% of CVC-VTEs (75/78). About 2.6% (2/76) of patients experienced a second thrombotic event. At discharge, post-thrombotic syndrome was reported in 13.5% (5/37) events with available data, CVC replacement in 10.8% (4/47), and ischemic necrosis with toe finger amputation in 2.7% (1/37). Three patients died due to an underlying condition; no CVC-VTE-related deaths were reported.ConclusionsWe have carried out a registry-based study on CVC-VTEs in the children in Italy, providing the data that may help improve the detection and management of this CVC-related complication.

Published
2022
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4. Foetal Thrombosis of Torcular Herophili: Report of Two Cases and Review of the Literature

Author

Chiara, Gentilomo, Elena, Cavaliere, Renzo, Manara, Margherita, Nosadini, Stefano, Sartori, and Suppiej, Agnese

Subjects
Dural sinus thrombosis, Ultrasound, Neonates, Foetal, Dural sinus thrombosis, Dural sinus malformations, Magnetic Resonance Imaging, Foetal, Neonates, Ultrasound, Dural sinus malformations, Magnetic Resonance Imaging, NO
Published
2017

5. Significant Increase in Clopidogrel Use Across U.S. Children’s Hospitals

Author

Yuan-Shung Huang, Chiara Gentilomo, and Leslie Raffini

Subjects
Heart Defects, Congenital, Male, medicine.medical_specialty, Ticlopidine, Adolescent, Databases, Factual, Population, Pharmacy, Pediatrics, Risk Assessment, Epidemiology, Humans, Medicine, Poisson Distribution, cardiovascular diseases, Mortality, Child, Intensive care medicine, education, Stroke, Retrospective Studies, Inpatients, education.field_of_study, Aspirin, business.industry, Coronary Thrombosis, Infant, Newborn, Warfarin, Infant, Retrospective cohort study, Venous Thromboembolism, Length of Stay, Hospitals, Pediatric, medicine.disease, Clopidogrel, United States, Child, Preschool, Pediatrics, Perinatology and Child Health, Emergency medicine, Drug Therapy, Combination, Female, Pulmonary Embolism, Cardiology and Cardiovascular Medicine, business, Platelet Aggregation Inhibitors, medicine.drug
Abstract

The primary aim of this study was to describe the use of the antiplatelet agent clopidogrel in pediatric tertiary care hospitals and to evaluate how it has changed over time. This retrospective cohort study of pediatric inpatients from 2000 to 2009 used the Pediatric Health Information System database (PHIS) which contains data from 42 U.S. tertiary care children's hospitals. Pharmacy billing codes were used to identify hospital admissions during which clopidogrel was administered. Patient demographics and concurrent use of other anticoagulant and antiplatelet drugs were collected. The International Classification of Diseases, ninth edition (ICD-9) codes were used to categorize admissions by potential indications for antiplatelet drugs and to identify bleeding and thrombotic events. From 2001 to 2009, clopidogrel use increased 15-fold, from 6 to 89.5 per 100,000 admissions. Patients with cardiac disease accounted for the largest proportion (75%), followed by stroke (9.4%) and Kawasaki disease (6.1%). Among those with cardiac disease, hypoplastic left heart syndrome (38%) and pulmonary artery anomalies (37%) were the most common. Aspirin was used concurrently during 52% of the admissions, enoxaparin during 9%, and warfarin during 5%. The use of clopidogrel is increasing rapidly among children with cardiovascular diseases. This population has a high risk of bleeding, thrombosis, and mortality. It therefore is imperative that future studies continue to evaluate the safety and efficacy of clopidogrel for these children.

Published
2010

6. Ramsay Hunt Syndrome

Author

Enrico Ravagnan, Eugenio Baraldi, Enrico Valerio, Mario Cutrone, and Chiara Gentilomo

Subjects
Male, medicine.medical_specialty, Adolescent, Ramsay Hunt syndrome, business.industry, Herpes Zoster Oticus, Developmental Neuroscience, Neurology, Pediatrics, Perinatology and Child Health, medicine, Humans, Neurology (clinical), Psychiatry, business
Published
2015

7. Secondary parenchymal and vascular changes after middle cerebral artery stroke in children

Author

Laura Milanese, Irene Toldo, Valentina Citton, Chiara Gentilomo, Agnese Suppiej, Margherita Nosadini, Renzo Manara, Paolo Simioni, Stefano Sartori, and Claudio Baracchini

Subjects
medicine.medical_specialty, pediatrics, Population, Ischemia, Information Storage and Retrieval, Models, Biological, Multimodal Imaging, Sensitivity and Specificity, NO, Pattern Recognition, Automated, User-Computer Interface, Imaging, Three-Dimensional, children, Artificial Intelligence, medicine.artery, Internal medicine, Image Interpretation, Computer-Assisted, medicine, Computer Graphics, Pediatric stroke, Radiology, Nuclear Medicine and imaging, Computer Simulation, cardiovascular diseases, education, Stroke, Neuroradiology, education.field_of_study, Models, Statistical, business.industry, Reproducibility of Results, Numerical Analysis, Computer-Assisted, Signal Processing, Computer-Assisted, medicine.disease, Image Enhancement, Hyperintensity, Stroke, children, pediatrics, MRI, Subtraction Technique, Middle cerebral artery, Corticospinal tract, Cardiology, Neurology (clinical), Radiology, Cardiology and Cardiovascular Medicine, business, Algorithms, MRI
Abstract

Ischemic brain lesions might present with unexpected increased signal intensity at MR angiography within the ischemic lesion and secondary parenchymal changes in regions distal to the ischemia itself. We retrospectively investigated the rate and time course of vascular and parenchymal changes in children with isolated middle cerebral artery (MCA) stroke. Twelve children (mean age at stroke onset 4.8 years, range 0.8–15 years, six females, seven right MCA strokes) suffering from a first ever acute isolated MCA stroke had repeated MR scans (mean scan number, 3.5; range 2–6; mean follow-up, 11 months; range 0.5–24 months). Ipsilaterally to MCA stroke, we recorded increased vessel signal at MR angiography during first to fourth day in 4/7 children (all had MCA recanalization), corticospinal tract cytotoxic-like edema during second day to second month in 7/11 (three children with globus pallidum ischemia had concomitant substantia nigra changes during second to third week), corticospinal tract T2 abnormalities from fifth day onwards in 9/12, focal thalamic cytotoxic-like edema during fifth day to first month in 5/8, focal thalamic T2 hyperintensity during sixth day to third week in 2/4, and faint T2 hypointensity from second month in 7/10 children. Vascular and secondary parenchymal changes, likely due to luxury perfusion, Wallerian, retrograde, or trans-synaptic degeneration, are common in pediatric MCA stroke population. They might mimic new ischemic lesions or suggest conditions different from stroke leading to diagnostic pitfalls and inappropriate treatment.

Published
2013

8. Clinical Data of Neonatal Systemic Thrombosis

Author

Paola Saracco, Rossana Bagna, Chiara Gentilomo, Mariella Magarotto, Alice Viano, Federica Magnetti, Paola Giordano, Matteo Luciani, Angelo Claudio Molinari, Agnese Suppiej, Luca Antonio Ramenghi, Paolo Simioni, Manuela Agostini, Annalisa Bastelli, Petrina Bastrenta, Antonio Belcastro, Anna Casani, Nadia Castellino, Daniela Farinasso, Marcella Gaffuri, Maria Rita Gallina, Elena Gallo, Lorenzo Giacchetti, Laura Ilardi, Nicola Laforgia, Donatella Lasagni, Ignazio Lofù, Fabio Lunetta, Francesco Messina, Barbara Perrone, Altea Petrucci, Andrea Pettenazzo, Fiammetta Piersigilli, Maurizio Radicioni, Antonella Tufano, and Luca Vecchiato

Subjects
Male, Pediatrics, Neonatal intensive care unit, population, 030204 cardiovascular system & hematology, 0302 clinical medicine, Models, Risk Factors, Thrombophilia, Registries, risk-factors, Anticoagulants, Arteries, Coronary Circulation, Data Collection, Female, Gestational Age, Humans, Infant, Newborn, Italy, Models, Statistical, Neonatology, Patient Discharge, Sepsis, Venous Thromboembolism, Human coagulation system, education.field_of_study, renal venous thrombosis, pediatric-patients, united-states, thromboembolism, thrombophilia, vasculopathy, management, Gestational age, Perinatology and Child Health, Statistical, Thrombosis, medicine.medical_specialty, Population, NO, 03 medical and health sciences, 030225 pediatrics, medicine, education, business.industry, Infant, Newborn, Placental disease, medicine.disease, Clinical trial, Pediatrics, Perinatology and Child Health, business
Abstract

Objective To evaluate clinical data and associated risk conditions of noncerebral systemic venous thromboembolism (VT), arterial thromboembolism (AT), and intracardiac thromboembolism (ICT) in neonates. Study design Data analysis of first systemic thromboembolism occurring in 75 live neonates (0-28 days), enrolled in the Italian Registry of Pediatric Thrombosis from neonatology centers between January 2007 and July 2013. Results Among 75 events, 41 (55%) were VT, 22 (29%) AT, and 12 (16%) ICT; males represented 65%, and 71% were preterm. In 19 (25%), thromboembolism was diagnosed on the first day of life. In this "early onset" group, prenatal-associated risk conditions (maternal/placental disease) were reported in 70% and inherited thrombophilia in 33%. Postnatal risk factors were present in 73%; infections and central vascular catheters in 56% and 54% VT, respectively, and in 67% ICT vs 27% AT ( Conclusions This report from the Registro Italiano Trombosi Infantili, although limited by representing an uncontrolled case series, can be used to develop future clinical trials on appropriate management and prevention of neonatal thrombosis, focusing on obstetrical surveillance and monitoring of critically ill neonates with vascular access. A thrombosis risk prediction rule specific for the neonatal population should be developed through prospective controlled studies.

Published
2016

9. Varicella and stroke in children: good outcome without steroids

Author

Anna Maria Laverda, Luca Bartolini, Chiara Gentilomo, Stefano Sartori, Milena Calderone, and Paolo Simioni

Subjects
Male, Pediatrics, medicine.medical_specialty, Herpesvirus 3, Human, viruses, Protein Z, medicine.disease_cause, Antiviral Agents, Virus, Protein S, Chickenpox, Recurrence, medicine, Humans, Stroke, Autoantibodies, biology, Vascular disease, business.industry, Autoantibody, Varicella zoster virus, virus diseases, Hematology, General Medicine, medicine.disease, Surgery, Treatment Outcome, Child, Preschool, biology.protein, Female, Steroids, business, Vascular Stenosis
Abstract

Varicella zoster virus (VZV) is the only human virus known to replicate in arteries. After the acute infection, the virus persists in a noninfectious latent form in ganglia along the neuraxis, with intermittent periods of reactivation. Both primary and secondary reactivation are associated with stroke in children. These patients, regardless of the chosen treatment, have a high risk of recurrence, particularly those with worsening arterial stenosis. There are no specific therapy protocols for varicella-associated stroke in children, and the use of steroids or antiviral drugs is still controversial. We present a series of 4 children with stroke following varicella infection, with no recurrence and stable vascular stenosis at a mean follow-up of 18 months without steroid treatment. We also analyze possible correlations between anti-protein C, protein S and protein Z autoantibodies, and post-varicella arteriopathy.

Published
2010

10. High prevalence of inherited thrombophilia in 'presumed peri-neonatal' ischemic stroke

Author

Sabrina Gavasso, Paola Drigo, Agnese Suppiej, Anna Maria Laverda, Pier Antonio Battistella, Malida Franzoi, Paolo Simioni, and Chiara Gentilomo

Subjects
Male, Pediatrics, medicine.medical_specialty, Population, Thrombophilia, Protein S, Brain Ischemia, NO, Cohort Studies, Risk Factors, Thromboembolism, medicine, Factor V Leiden, Prevalence, Humans, education, Stroke, education.field_of_study, biology, business.industry, Infant, Newborn, Hematology, General Medicine, Cerebral Infarction, medicine.disease, Exact test, Cohort, biology.protein, Prothrombin G20210A, Female, Blood Coagulation Tests, Nervous System Diseases, business, Follow-Up Studies
Abstract

The aim of this study was to assess the prevalence of inherited thrombophilia in ‘peri-neonatal arterial ischemic stroke’ (AIS), and its possible correlation with type of stroke and long-term neurological outcome. A cohort of twenty-four infants affected by AIS were analysed for risk factors, clinical and neuroradiological features, coagulation and thrombophilia profile and outcome. Two subgroups were considered, based on clinical presentation: infants symptomatic in the neonatal period, acute AIS (aAIS) and those with a delayed presentation (presumed peri-neonatal onset, pAIS). The mean follow-up on patients was 3 yr and 1 month (range 1–15 yr). Inherited thrombophilia, consisting of factor V Leiden and prothrombin G20210A mutations, protein C and/or protein S deficiencies, was detected in 28.6%. A significantly higher prevalence of inherited thrombophilia was observed in infants with pAIS compared with aAIS (Fisher’s exact test, P = 0.011). Infants with pAIS had a significantly worse neurological outcome with respect to aAIS (Fisher’s exact test, P = 0.014). Inherited thrombophilia was significantly higher in patients with a poor neurological outcome (Fisher’s exact test P = 0.002). Although the clinical presentation (aAIS vs. pAIS) was associated with future neurological disabilities, it is the thrombophilia but not the clinical presentation, which remains the only significant prognostic factor in the logistic regression analysis. Although preliminary, these data suggest an association of unfavourable neurological outcome and inherited prothrombotic defects in neonatal AIS. The higher prevalence of inherited thrombophilia identified in pAIS and the worse neurological outcome encourage further investigations in population-based studies.

Published
2008

11. Cerebral sinus venous thrombosis with parenchymal infarcts in a newborn with severe haemophilia A and subdural haematomas

Author

Paolo Simioni, Chiara Gentilomo, Graziella Saggiorato, Renzo Manara, Ezio Zanon, A. M. Laverda, and Agnese Suppiej

Subjects
medicine.medical_specialty, medicine.diagnostic_test, business.industry, MEDLINE, Magnetic resonance imaging, Hematology, General Medicine, medicine.disease, Cerebral sinus venous thrombosis, NO, Surgery, Hematoma, X ray computed, medicine, Sinus thrombosis, Severe haemophilia A, business, Genetics (clinical)
Published
2008

12. Cerebral sinovenous thrombosis in children: Thrombophilia and clinical outcome

Author

Malida Franzoi, Pier Antonio Battistella, Chiara Gentilomo, Agnese Suppiej, Paolo Simioni, and Anna Maria Laverda

Subjects
Male, Pediatrics, medicine.medical_specialty, Adolescent, business.industry, Infant, Newborn, Infant, Hematology, Thrombophilia, medicine.disease, NO, Sinus Thrombosis, Intracranial, Sinovenous thrombosis, Child, Preschool, Medicine, Humans, Female, business, Child
Published
2008

13. Thromboembolic complications in children with cancer: data from the Italian registry of childhood thrombosis (RITI)

Author

Paola Giordano, Angelo Claudio Molinari, E. Cavaliere, Chiara Gentilomo, Paolo Simioni, Maria Caterina Putti, V. Buccella, Anna Falanga, Paola Saracco, M. Grassi, and D. Sperlì

Subjects
education.field_of_study, Pediatrics, medicine.medical_specialty, business.industry, Population, Cancer type, Cancer, Hematology, Vte prophylaxis, medicine.disease, Thrombosis, Cancer data, Medicine, business, education, Venous thromboembolism, Cohort study
Abstract

and relative rates to those previously reported [1], however we have also shown that that this rate varies by over 10 fold by cancer type. This will have important implications for the appropriate selection of patients for VTE prophylaxis. Reference: [1] Cronin-Fenton DP, et al. Hospitalisation for venous thromboembolism in cancer patients and the general population: a population-based cohort study in Denmark, 1997-2006. Br J Cancer, 2010;103(7):947-953.

Published
2012

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