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1. Nationwide survey on the management of pediatric pharyngitis in Italian emergency units

Author

Milani, G, Rosa, C, Tuzger, N, Alberti, I, Ghizzi, C, Zampogna, S, Amigoni, A, Agostoni, C, Peroni, D, Marchisio, P, Chiappini, E, Tappi, E, Rabbone, I, Salvini, F, Cozzi, G, Silvagni, D, Pitea, M, Manieri, S, Crisalfi, A, Vaccaro, A, Plebani, A, Falorni, S, Martelli, L, Lanari, M, Di Stefano, G, De Martinis, M, Bulciolu, P, Iughetti, L, Fabiani, E, Greco, R, Cardinale, F, Boera, R, Arrighini, A, Chiaretti, A, Nunziata, F, Salvo, R, Banderali, G, Fasoli, S, Baracchia, G, Antonucci, R, Biondi, A, Tenci, A, Mirri, G, Battisti, L, Bellettato, M, Ruffini, E, Cogo, P, Dragovic, D, Da Dalt, L, Bruni, P, Caloiero, M, Varisco, T, Palmieri, M, Picciotti, E, Cualbu, A, Pradal, U, Grosso, S, Pogliani, L, Selicorni, A, Soffiati, M, Bene, P, Guala, A, Bertolozzi, G, Tommasi, P, Campanozzi, A, Cella, A, Ghitti, C, Groff, P, Bondone, C, Vitale, A, Capalbo, P, Dall'Amico, R, Sisto, A, Livio, E, Tato, E, Flora, M, Raiola, G, Suppiej, A, Clemente, C, Lizzoli, F, Chiarelli, F, Podesta, A, Forte, F, Vasarri, P, Pennoni, G, Parrinello, F, Fornaro, M, Casa, R, Zaglia, F, Tipo, V, Morandi, F, Cecinati, V, Calabro, G, Messini, B, Marseglia, G, Arrigoni, S, Gaggiano, S, Cavalli, C, Gramaglia, G, Serra, L, Valletta, E, Militerno, G, Chiossi, M, Camellino, G, Masi, S, Marchetti, F, Traina, G, Maccarrone, R, Milani G. P., Rosa C., Tuzger N., Alberti I., Ghizzi C., Zampogna S., Amigoni A., Agostoni C., Peroni D., Marchisio P., Chiappini E., Tappi E., Rabbone I., Salvini F. M., Cozzi G., Silvagni D., Pitea M., Manieri S., Crisalfi A., Vaccaro A., Plebani A. M., Falorni S., Martelli L., Lanari M., Di Stefano G., De Martinis M., Bulciolu P., Iughetti L., Fabiani E., Greco R., Cardinale F., Boera R., Arrighini A., Chiaretti A., Nunziata F., Salvo R., Banderali G., Fasoli S., Baracchia G., Antonucci R., Biondi A., Tenci A., Mirri G., Battisti L., Bellettato M., Ruffini E., Cogo P., Dragovic D., Da Dalt L., Bruni P., Caloiero M., Varisco T., Palmieri M., Picciotti E., Cualbu A., Pradal U., Grosso S., Pogliani L. M., Selicorni A., Soffiati M., Bene P., Guala A., Bertolozzi G., Tommasi P., Campanozzi A., Cella A., Ghitti C., Groff P., Bondone C., Vitale A., Capalbo P. T., Dall'Amico R., Sisto A., Livio E. L., Tato E., Flora M., Raiola G., Suppiej A., Clemente C., Lizzoli F., Chiarelli F., Podesta A., Forte F. R., Vasarri P., Pennoni G., Parrinello F., Fornaro M., Casa R., Zaglia F., Tipo V., Morandi F., Cecinati V., Calabro G., Messini B., Marseglia G. L., Arrigoni S., Gaggiano S., Cavalli C., Gramaglia G., Serra L., Valletta E., Militerno G., Chiossi M., Camellino G., Masi S., Marchetti F., Traina G., Maccarrone R. M., Milani, G, Rosa, C, Tuzger, N, Alberti, I, Ghizzi, C, Zampogna, S, Amigoni, A, Agostoni, C, Peroni, D, Marchisio, P, Chiappini, E, Tappi, E, Rabbone, I, Salvini, F, Cozzi, G, Silvagni, D, Pitea, M, Manieri, S, Crisalfi, A, Vaccaro, A, Plebani, A, Falorni, S, Martelli, L, Lanari, M, Di Stefano, G, De Martinis, M, Bulciolu, P, Iughetti, L, Fabiani, E, Greco, R, Cardinale, F, Boera, R, Arrighini, A, Chiaretti, A, Nunziata, F, Salvo, R, Banderali, G, Fasoli, S, Baracchia, G, Antonucci, R, Biondi, A, Tenci, A, Mirri, G, Battisti, L, Bellettato, M, Ruffini, E, Cogo, P, Dragovic, D, Da Dalt, L, Bruni, P, Caloiero, M, Varisco, T, Palmieri, M, Picciotti, E, Cualbu, A, Pradal, U, Grosso, S, Pogliani, L, Selicorni, A, Soffiati, M, Bene, P, Guala, A, Bertolozzi, G, Tommasi, P, Campanozzi, A, Cella, A, Ghitti, C, Groff, P, Bondone, C, Vitale, A, Capalbo, P, Dall'Amico, R, Sisto, A, Livio, E, Tato, E, Flora, M, Raiola, G, Suppiej, A, Clemente, C, Lizzoli, F, Chiarelli, F, Podesta, A, Forte, F, Vasarri, P, Pennoni, G, Parrinello, F, Fornaro, M, Casa, R, Zaglia, F, Tipo, V, Morandi, F, Cecinati, V, Calabro, G, Messini, B, Marseglia, G, Arrigoni, S, Gaggiano, S, Cavalli, C, Gramaglia, G, Serra, L, Valletta, E, Militerno, G, Chiossi, M, Camellino, G, Masi, S, Marchetti, F, Traina, G, Maccarrone, R, Milani G. P., Rosa C., Tuzger N., Alberti I., Ghizzi C., Zampogna S., Amigoni A., Agostoni C., Peroni D., Marchisio P., Chiappini E., Tappi E., Rabbone I., Salvini F. M., Cozzi G., Silvagni D., Pitea M., Manieri S., Crisalfi A., Vaccaro A., Plebani A. M., Falorni S., Martelli L., Lanari M., Di Stefano G., De Martinis M., Bulciolu P., Iughetti L., Fabiani E., Greco R., Cardinale F., Boera R., Arrighini A., Chiaretti A., Nunziata F., Salvo R., Banderali G., Fasoli S., Baracchia G., Antonucci R., Biondi A., Tenci A., Mirri G., Battisti L., Bellettato M., Ruffini E., Cogo P., Dragovic D., Da Dalt L., Bruni P., Caloiero M., Varisco T., Palmieri M., Picciotti E., Cualbu A., Pradal U., Grosso S., Pogliani L. M., Selicorni A., Soffiati M., Bene P., Guala A., Bertolozzi G., Tommasi P., Campanozzi A., Cella A., Ghitti C., Groff P., Bondone C., Vitale A., Capalbo P. T., Dall'Amico R., Sisto A., Livio E. L., Tato E., Flora M., Raiola G., Suppiej A., Clemente C., Lizzoli F., Chiarelli F., Podesta A., Forte F. R., Vasarri P., Pennoni G., Parrinello F., Fornaro M., Casa R., Zaglia F., Tipo V., Morandi F., Cecinati V., Calabro G., Messini B., Marseglia G. L., Arrigoni S., Gaggiano S., Cavalli C., Gramaglia G., Serra L., Valletta E., Militerno G., Chiossi M., Camellino G., Masi S., Marchetti F., Traina G., and Maccarrone R. M.

Published
2023

2. Diagnosis and management of urinary tract infections in children aged 2 months to 3 years in the Italian emergency units: the ItaUTI study

Author

Cenzato, F, Milani, G, Amigoni, A, Sperotto, F, Bianchetti, M, Agostoni, C, Montini, G, Farello, G, Chiarelli, F, Greco, R, Di Lollo, F, Rocco Forte, F, Manieri, S, Carpino, L, Caloiero, M, Cirisano, A, Bragho, S, Della Casa, R, Nunziata, F, Pecoraro, C, Pacifico, R, Lanari, M, Ghizzi, C, Serra, L, Stella, M, Maggiore, G, Fiorini, R, Dodi, I, Morelli, A, Lughetti, L, Cella, A, Vergine, G, De Fanti, A, Dragovic, D, Santori, D, Cozzi, G, Cogo, P, Raponi, M, Lubrano, R, de Martinis, M, Gatto, A, Barbieri, M, Reale, A, Bracaglia, G, Piccotti, E, Borea, R, Gaiero, A, Martelli, L, Arrighini, A, Cianci, P, Cavalli, C, De Santis, L, Pietra, B, Biondi, A, Sala, M, Pogliani, L, Cherubini, S, Bellini, M, Bruni, P, Traina, G, Tommasi, P, Del Barba, P, Arrigoni, S, Salvini, F, Bernardo, L, Bertolozzi, G, Fasoli, S, Marseglia, G, Palumbo, E, Bosco, A, Mirri, G, Fabiani, E, Ruffini, E, Pieragostini, L, Fornaro, M, Ripanti, G, Pannoni, D, Enrico, F, Perona, A, Tappi, E, Nis Haitink, O, Rabbone, I, Capalbo, P, Urbino, A, Guala, A, Cosi, G, Barracchia, M, Martire, B, Cardinale, F, Moramarco, F, Perrone, C, Campanozzi, A, Cecinati, V, Canetto, A, Clemente, C, Cualbu, A, Narducci, F, Mula, G, Bulciolu, P, Antonucci, R, Gramaglia, G, Cavaleri, G, Salpietro, C, Corsello, G, Salvo, R, Palmeri, M, Vitale, M, Morgano, A, Falorni, S, Peroni, D, Masi, S, Bertini, A, Vaccaro, A, Vasarri, P, Reinstadler, P, Soffiati, M, Stefanelli, M, Verrotti di Pianella, A, Bertone, C, Marzini, S, Da Dalt, L, Rugolotto, S, Scozzola, F, Ecclesio Livio, L, Cinquetti, M, Silvagni, D, Bellettato, M, Cenzato F., Milani G. P., Amigoni A., Sperotto F., Bianchetti M. G., Agostoni C., Montini G., Farello G., Chiarelli F., Greco R., Di Lollo F., Rocco Forte F., Manieri S., Carpino L., Caloiero M., Cirisano A., Bragho S., Della Casa R., Nunziata F., Pecoraro C., Pacifico R., Lanari M., Ghizzi C., Serra L., Stella M., Maggiore G., Fiorini R., Dodi I., Morelli A., Lughetti L., Cella A., Vergine G., De Fanti A., Dragovic D., Santori D., Cozzi G., Cogo P., Raponi M., Lubrano R., de Martinis M., Gatto A., Barbieri M. A., Reale A., Bracaglia G., Piccotti E., Borea R., Gaiero A., Martelli L., Arrighini A., Cianci P., Cavalli C., De Santis L., Pietra B. C., Biondi A., Sala M., Pogliani L. M., Cherubini S., Bellini M., Bruni P., Traina G., Tommasi P., Del Barba P., Arrigoni S., Salvini F. M., Bernardo L., Bertolozzi G., Fasoli S., Marseglia G. L., Palumbo E., Bosco A., Mirri G., Fabiani E., Ruffini E., Pieragostini L., Fornaro M., Ripanti G., Pannoni D., Enrico F., Perona A., Tappi E., Nis Haitink O., Rabbone I., Capalbo P. T., Urbino A., Guala A., Cosi G., Barracchia M. G., Martire B., Cardinale F., Moramarco F., Perrone C., Campanozzi A., Cecinati V., Canetto A., Clemente C., Cualbu A., Narducci F., Mula G., Bulciolu P., Antonucci R., Gramaglia G., Cavaleri G., Salpietro C., Corsello G., Salvo R., Palmeri M., Vitale M. A., Morgano A., Falorni S., Peroni D., Masi S., Bertini A., Vaccaro A., Vasarri P., Reinstadler P., Soffiati M., Stefanelli M., Verrotti di Pianella A., Bertone C., Marzini S., Da Dalt L., Rugolotto S., Scozzola F., Ecclesio Livio L., Cinquetti M., Silvagni D., Bellettato M., Cenzato, F, Milani, G, Amigoni, A, Sperotto, F, Bianchetti, M, Agostoni, C, Montini, G, Farello, G, Chiarelli, F, Greco, R, Di Lollo, F, Rocco Forte, F, Manieri, S, Carpino, L, Caloiero, M, Cirisano, A, Bragho, S, Della Casa, R, Nunziata, F, Pecoraro, C, Pacifico, R, Lanari, M, Ghizzi, C, Serra, L, Stella, M, Maggiore, G, Fiorini, R, Dodi, I, Morelli, A, Lughetti, L, Cella, A, Vergine, G, De Fanti, A, Dragovic, D, Santori, D, Cozzi, G, Cogo, P, Raponi, M, Lubrano, R, de Martinis, M, Gatto, A, Barbieri, M, Reale, A, Bracaglia, G, Piccotti, E, Borea, R, Gaiero, A, Martelli, L, Arrighini, A, Cianci, P, Cavalli, C, De Santis, L, Pietra, B, Biondi, A, Sala, M, Pogliani, L, Cherubini, S, Bellini, M, Bruni, P, Traina, G, Tommasi, P, Del Barba, P, Arrigoni, S, Salvini, F, Bernardo, L, Bertolozzi, G, Fasoli, S, Marseglia, G, Palumbo, E, Bosco, A, Mirri, G, Fabiani, E, Ruffini, E, Pieragostini, L, Fornaro, M, Ripanti, G, Pannoni, D, Enrico, F, Perona, A, Tappi, E, Nis Haitink, O, Rabbone, I, Capalbo, P, Urbino, A, Guala, A, Cosi, G, Barracchia, M, Martire, B, Cardinale, F, Moramarco, F, Perrone, C, Campanozzi, A, Cecinati, V, Canetto, A, Clemente, C, Cualbu, A, Narducci, F, Mula, G, Bulciolu, P, Antonucci, R, Gramaglia, G, Cavaleri, G, Salpietro, C, Corsello, G, Salvo, R, Palmeri, M, Vitale, M, Morgano, A, Falorni, S, Peroni, D, Masi, S, Bertini, A, Vaccaro, A, Vasarri, P, Reinstadler, P, Soffiati, M, Stefanelli, M, Verrotti di Pianella, A, Bertone, C, Marzini, S, Da Dalt, L, Rugolotto, S, Scozzola, F, Ecclesio Livio, L, Cinquetti, M, Silvagni, D, Bellettato, M, Cenzato F., Milani G. P., Amigoni A., Sperotto F., Bianchetti M. G., Agostoni C., Montini G., Farello G., Chiarelli F., Greco R., Di Lollo F., Rocco Forte F., Manieri S., Carpino L., Caloiero M., Cirisano A., Bragho S., Della Casa R., Nunziata F., Pecoraro C., Pacifico R., Lanari M., Ghizzi C., Serra L., Stella M., Maggiore G., Fiorini R., Dodi I., Morelli A., Lughetti L., Cella A., Vergine G., De Fanti A., Dragovic D., Santori D., Cozzi G., Cogo P., Raponi M., Lubrano R., de Martinis M., Gatto A., Barbieri M. A., Reale A., Bracaglia G., Piccotti E., Borea R., Gaiero A., Martelli L., Arrighini A., Cianci P., Cavalli C., De Santis L., Pietra B. C., Biondi A., Sala M., Pogliani L. M., Cherubini S., Bellini M., Bruni P., Traina G., Tommasi P., Del Barba P., Arrigoni S., Salvini F. M., Bernardo L., Bertolozzi G., Fasoli S., Marseglia G. L., Palumbo E., Bosco A., Mirri G., Fabiani E., Ruffini E., Pieragostini L., Fornaro M., Ripanti G., Pannoni D., Enrico F., Perona A., Tappi E., Nis Haitink O., Rabbone I., Capalbo P. T., Urbino A., Guala A., Cosi G., Barracchia M. G., Martire B., Cardinale F., Moramarco F., Perrone C., Campanozzi A., Cecinati V., Canetto A., Clemente C., Cualbu A., Narducci F., Mula G., Bulciolu P., Antonucci R., Gramaglia G., Cavaleri G., Salpietro C., Corsello G., Salvo R., Palmeri M., Vitale M. A., Morgano A., Falorni S., Peroni D., Masi S., Bertini A., Vaccaro A., Vasarri P., Reinstadler P., Soffiati M., Stefanelli M., Verrotti di Pianella A., Bertone C., Marzini S., Da Dalt L., Rugolotto S., Scozzola F., Ecclesio Livio L., Cinquetti M., Silvagni D., and Bellettato M.

Abstract

Urinary tract infections (UTIs) are among the most frequent bacterial diseases in infants and children. Physician adherence to recommendations is notoriously often poor, but no data are available on UTIs management in the emergency setting. In this multicenter national study, we investigated the policies regarding UTIs management in children aged 2 months to 3 years in Italian emergency units. Between April and June 2021, directors of the emergency units were invited to answer an online survey on the following items: diagnostic approach to children with fever without an apparent source, therapeutic approach to UTIs, the use of kidney and urinary tract ultrasound, and the criteria for hospitalization. A total of 121 (89%) out of 139 of invited units participated in the study. Overall, units manage children with a suspected or confirmed UTI according to available recommendations for most of the items. However, in almost 80% (n = 94) of units, a sterile perineal bag is used to collect urine for culture. When urine is collected by cathether, heterogeneity exists on the threshold of bacterial load considered for UTI diagnosis. Conclusions: Available recommendations on UTIs in children are followed by Italian emergency units for most of the items. However, the methods to collect urine specimens for culture, one of the crucial steps of the diagnostic work-up, often do not align with current recommendations and CFU thresholds considered for diagnosis largely vary among centers. Efforts should be addressed to validate and implement new child and family friendly urine collection techniques.What is Known:• Several guidelines are published on the management of children with suspected or confirmed urinary tract infection.• No data are available on the management of pediatric urinary tract infections in the emergency setting.What is New:• Almost 80% of the Italian emergency units employ a sterile perineal bag to collect urine for culture.• Diagnostic

Published
2022

3. The development of a Consensus Conference on Pediatric Procedural Sedation in the Emergency Department in Italy: From here where to?

Author

Sforzi I., Bressan S., Saffirio C., De Masi S., Bussolin L., Da Dalt L., De Iaco F., Shavit I., Krauss B., Barbi E., Bergese I., Biermann K. P., Borrometi F., Calligaris L., Cantoni B., Fontanazza S., Fornasari D., Ghizzi C., Gregorini M., Guarino M., L'erario M., La Fauci G., Lai A., Lazzeri S., Leo M. C., Lucenteforte E., Macchiarini A., Maiandi S., Mando M., Mazza A., Montobbio G., Mugelli A., Parrino R., Sammartino M., Schleef J., Spotti A., Tomasello C., Di Francia M. T., Trapani C., Turini M., Vagnoli L., Vergna S., Virgili G., Rosati G. V., Zanon D., Sforzi, I., Bressan, S., Saffirio, C., De Masi, S., Bussolin, L., Da Dalt, L., De Iaco, F., Shavit, I., Krauss, B., Barbi, E., Bergese, I., Biermann, K. P., Borrometi, F., Calligaris, L., Cantoni, B., Fontanazza, S., Fornasari, D., Ghizzi, C., Gregorini, M., Guarino, M., L'Erario, M., La Fauci, G., Lai, A., Lazzeri, S., Leo, M. C., Lucenteforte, E., Macchiarini, A., Maiandi, S., Mando, M., Mazza, A., Montobbio, G., Mugelli, A., Parrino, R., Sammartino, M., Schleef, J., Spotti, A., Tomasello, C., Di Francia, M. T., Trapani, C., Turini, M., Vagnoli, L., Vergna, S., Virgili, G., Rosati, G. V., and Zanon, D.

Subjects
Consensus, medicine.medical_treatment, Training system, MEDLINE, Conscious Sedation, Consensu, Subspecialty, Pediatrics, Emergency department, Pediatric, Procedural sedation and analgesia, 03 medical and health sciences, Hospital, 0302 clinical medicine, Pediatric emergency medicine, 030202 anesthesiology, Multidisciplinary approach, 030225 pediatrics, Health care, Medicine, Humans, Emergency Service, business.industry, Research, lcsh:RJ1-570, lcsh:Pediatrics, medicine.disease, Italy, Emergency Medicine, Analgesia, Emergency Service, Hospital, Medical emergency, business, Human
Abstract

Background In Italy, as in many European countries, Pediatric Emergency Medicine is not formally recognized as a pediatric subspecialty, hindering nation-wide adoption of standards of care, especially in the field of procedural sedation and analgesia (PSA) in the Emergency Department (ED). For this reason PSA in Italy is mostly neglected or performed very heterogeneously and by different providers, with no reference standard. We aimed to describe the procedures and results of the first multidisciplinary and multi-professional Consensus Conference in Italy on safe and effective pediatric PSA in Italian EDs. Methods The preparation, organization and conduct of the Consensus Conference, held in Florence in 2017, followed the recommended National methodological standards. Professionals from different specialties across the country were invited to participate. Results Overall 86 recommendations covering 8 themes (pre-sedation evaluation, pharmacologic agents, monitoring, equipment and discharge checklists, training, non-pharmacologic techniques, the adult ED setting, impact on hospitalizations) were developed, taking into account the Italian training system and healthcare organization characteristics. Conclusion The results of the first multidisciplinary and multi-professional Consensus Conference in Italy are meant to provide up-to-date national guidance to improve the standard of care of children undergoing painful and stressful procedures in the ED. The recommendations will be periodically updated as new relevant evidence is published.

Published
2020

7. Nationwide study of headache pain in Italy shows that pain assessment is still inadequate in paediatric emergency care

Author

Benini, Franca, Piga, Simone, Zangardi, Tiziana, Messi, Gianni, Tomasello, Caterina, Pirozzi, Nicola, Cuttini, Marina, ocerino, A, Crichiutti, G, Barbi, E, Biban, P, Ghizzi, C, Benedetti, M, rrighini, A, Podestà, A F, Scalfaro, C, Stringhi, C, Rotta, S, Salvo, I R Di, Fossali, E, rbino, A, Taglietto, M, Marciano, C, Piccotti, E, Manfredini, L, Mannelli, F, Messeri, A, Cardoni, G, Piattellini, G M, Midulla, F, Chiaretti, A, Campa, A, Borrometi, F, Maremonti, P, Grandolfo, Rita, Fucà, F, and Parrino, R

Subjects
Male, Emergency Medical Services, Pediatrics, hospitals pediatric, 0302 clinical medicine, Pain assessment, Emergency medical services, Medicine, hospital, Child, hospitals general, Pain Measurement, Headache, Regular Article, quality indicators, General Medicine, Hospitals, Pediatric, health care, Italy, Child, Preschool, Practice Guidelines as Topic, Female, Emergency care, Guideline Adherence, Emergency Service, Hospital, medicine.medical_specialty, Adolescent, Pain, Hospitals, General, Disease cluster, preschool, 03 medical and health sciences, 030225 pediatrics, child, emergency care, headache, pain assessment, pain management, adolescent, emergency medical services, emergency service, hospital, female, guideline adherence, humans, male, pain measurement, pediatrics, practice guidelines as topic, retrospective studies, triage, perinatology and child health, Humans, Online Only Articles, Quality Indicators, Health Care, Retrospective Studies, emergency service, business.industry, Retrospective cohort study, Odds ratio, Emergency department, Triage, Pain management, Pediatrics, Perinatology and Child Health, Emergency medicine, Observational study, business, 030217 neurology & neurosurgery, Regular Articles
Abstract

Aim Italian national guidelines on pain management were published in 2010, but there is little information on how effective pain management is in paediatric emergency care, with other countries reporting poor levels. Using headache as an indicator, we described pain assessment in Italian emergency departments and identified predictors of algometric scale use. Methods All Italian paediatric and maternal and child hospitals participated, plus four general hospitals. Data on all children aged 4–14 years admitted during a one-month period with headache as their chief complaint were abstracted from clinical records. Multivariable analyses identified predictors of algometric assessment, taking into account the cluster study design. Results We studied 470 admissions. During triage, pain was assessed using a standardised scale (41.5%), informally (15.5%) or was not recorded (42.9%). Only 32.1% of the children received analgesia in the emergency department. The odds ratios for predictors of algometric assessment were non-Italian nationality (3.6), prehospital medication (1.8), admission to a research hospital (7.3) and a more favourable nurses-to-admissions ratio of 10.8 for the highest versus lowest tertile. Conclusion Despite national guidelines, paediatric pain assessment in Italian emergency care was suboptimal. Hospital variables appeared to be stronger predictors of adequate assessment than patient characteristics.

Published
2016
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8. Duck‐like lips: a new clinical feature for diagnosis of Mycoplasma‐Induced Rash and Mucositis.

Author

Dondi, A., Di Altobrando, A., Parladori, R., Biagi, C., Balsamo, C., Ghizzi, C., Patrizi, A., Lanari, M., and Neri, I.

Subjects
TOXIC epidermal necrolysis, DIAGNOSIS, LIPS, MUCOSITIS
Abstract

2 Poddighe D, Bruni P. Mycoplasma pneumoniae -induced rash and mucositis (MIRM): an unusual mild skin rash associated with severe mucosal involvement. I Mycoplasma pneumoniae i -induced rash and mucositis (MIRM), proposed as a unique entity apart from erythema multiforme (EM), Steven-Johnson Syndrome (SJS) and toxic epidermal necrolysis (TEN) by Canavan I et al i . in 2015, follows a less severe course and is associated with less morbidity and mortality.1,2 In SJS and TEN, widespread, confluent skin lesions, positive Nikolsky sign and significant epidermal detachment are present.3 In MIRM, mucositis, especially oral, is nearly universal (94%) and predominant over a less marked or absent cutaneous involvement.1,4 It is a major cause of morbidity, may lead to multiple confluent erosions, haemorrhagic crusting and sparse vesiculobullous perilabial eruptions and, rarely, to sequelae such as mucosal synechiae and pigmentary changes. Differently from EM-spectrum disease, lip enlargement in MIRM is persistent and can lead to a swelling of the vermilion borders with a "duck-like lips" appearance, which may be a clue to suspect MIRM in children and to timely begin appropriate treatment strategies. [Extracted from the article]

Published
2021
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9. Storia della lingua e linguistica

Author

Ghizzi, Chiara, Ghizzi, C ( Chiara ), Loporcaro, Michele, Ghizzi, Chiara, Ghizzi, C ( Chiara ), and Loporcaro, Michele

Published
2015

12. The pandemic within the pandemic: the surge of neuropsychological disorders in Italian children during the COVID-19 era

Author

Elena, Bozzola, Pietro, Ferrara, Giulia, Spina, Alberto, Villani, Marco, Roversi, Massimiliano, Raponi, Giovanni, Corsello, Annamaria, Staiano, Francesco, Chiarelli, Federica, Cavallo, Farello, Giovanni, Nadia, Rossi, Carmela, Salladini, Sergio, Manieri, Mariapia, Mirauda, Giacomo, Biasucci, Andrea, Cella, Gianluca, Vergine, Angela, Troisi, Federico, Marchetti, Enrico, Valletta, Marcello, Stella, Marcello, Lanari, Duccio Maria Cordelli, Ilaria, Corsini, Jacopo, Pruccoli, Chiara, Ghizzi, Chiara, Franzonello, Egidio, Barbi, Alessandro, Amaddeo, Ilaria, Liguoro, Paola, Cogo, Giuliana, Morabito, Maria Rosaria Marchili, Carla, Brusco, Cristina, Mascolo, Riccardo, Borea, Emanuela, Piccotti, Tommaso, Bellini, Carlo, Agostoni, Raffaele, Badolato, Camilla, Dallavilla, Leonardo, Felici, Simone, Mattozzi, Guido, Pennoni, Elisabetta Mencaroni and, Bozzola E., Ferrara P., Spina G., Villani A., Roversi M., Raponi M., Corsello G., Staiano A., Chiarelli F., Cavallo F., Farello G., Rossi N., Salladini C., Manieri S., Mirauda M.P., Biasucci G., Cella A., Vergine G., Troisi A., Marchetti F., Valletta E., Stella M., Lanari M., Cordelli D.M., Corsini I., Pruccoli J., Ghizzi C., Franzonello C., Barbi E., Amaddeo A., Liguoro I., Cogo P., Morabito G., Marchili M.R., Brusco C., Mascolo C., Borea R., Piccotti E., Bellini T., Agostoni C., Badolato R., Dallavilla C., Felici L., Mattozzi S., Pennoni G., Mencaroni E., Bozzola, Elena, Ferrara, Pietro, Spina, Giulia, Villani, Alberto, Roversi, Marco, Raponi, Massimiliano, Corsello, Giovanni, and Staiano, Annamaria

Subjects
Adolescent, COVID19, Neuropsychological disorder, COVID-19, General Medicine, Settore MED/38, Mental Health, Italy, Quarantine, Children, Neuropsychological disorders, Humans, COVID19, Children, Neuropsychological disorders, Child, Pandemics, Human
Abstract

Background Quarantine and isolation measures during COVID-19 pandemic may have caused additional stress and challenged the mental health of the youth. Aim of the study is to investigate the COVID-19 pandemic impact on neuropsychological disorders (NPD) of Italian children and adolescents to provide general pediatric recommendations. Material and methods A retrospective multicenter observational study was planned by the Italian Pediatric Society (SIP) to explore the impact of COVID-19 on the access of children to pediatric Emergency Departments (pED) for the evaluation of neuropsychological symptoms, collecting the classification codes of diagnoses between March 1, 2019 and March 2, 2021. The period study was split into two sub-periods: a pre COVID-19 period (from March 1 2019 to March 1, 2020) and a COVID-19 period (from March 2, 2020 to March 2, 2021). As additional information, data on NPD hospitalizations in any pediatric department of the involved centers were recorded. Results During the study period, a total of 533,318 children were admitted to the pED involved in the study. Despite a 48.2% decline of pED admissions, there was a significant increase (83.1%) in patient admissions for NPD. The most frequent NPD conditions which increased during the COVID-19 pandemic were suicidal ideation (+ 147%), depression (+ 115%), eating disorder (+ 78.4%), and psychosis (+ 17.2%). During the pandemic period, a 39.5% increase in NPD hospitalizations was observed as well. The NPD disorders that mostly required hospitalizations were suicidal ideation (+ 134%), depression (+ 41.4%), eating disorder (+ 31.4%), and drug abuse (+ 26.7%). COVID-19 pandemic had a major impact on children's health, mainly on their NPD development. Neuropsychological assessment should be required at the primary level, in the pediatrician's office, to facilitate early capture of the sign of impairment and provide an adequate treatment. Conclusion SIP underlines the psychological consequences of COVID 19 pandemic on the youngest and recommends an early identification of NPD in the pediatric population to avoid other serious consequences for children's physical and mental health.

Published
2022
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13. Diagnosis and management of urinary tract infections in children aged 2 months to 3 years in the Italian emergency units: the ItaUTI study

Author

Francesca, Cenzato, Milani, Gregorio P., Angela, Amigoni, Francesca, Sperotto, Bianchetti, Mario G., Carlo, Agostoni, Giovanni, Montini, Farello, Giovanni, Francesco, Chiarelli, Greco, Rita, Franco Di Lollo, Fabio Rocco Forte, Sergio, Manieri, Luigi, Carpino, Mimma, Caloiero, Anastasia, Cirisano, Salvatore, Bragh(`(o)), Roberto Della Casa, Felice, Nunziata, Carmine, Pecoraro, Rosario, Pacifico, Marcello, Lanari, Chiara, Ghizzi, Laura, Serra, Marcello, Stella, Giuseppe, Maggiore, Roberto, Fiorini, Icilio, Dodi, Andrea, Morelli, Lorenzo, Lughetti, Andrea, Cella, Gianluca, Vergine, Alessandro De Fanti, Danica, Dragovic, Daniele, Santori, Giorgio, Cozzi, Paola, Cogo, Marilena, Raponi, Riccardo, Lubrano, Mauro de Martinis, Antonio, Gatto, Maria Antonietta Barbieri, Antonino, Reale, Giorgio, Bracaglia, Emanuela, Piccotti, Riccardo, Borea, Alberto, Gaiero, Laura, Martelli, Alberto, Arrighini, Paola, Cianci, Claudio, Cavalli, Leonardina De Santis, Benedetta Chiara Pietra, Andrea, Biondi, Marco, Sala, Pogliani, Laura M., Simonetta, Cherubini, Marta, Bellini, Paola, Bruni, Giovanni, Traina, Paola, Tommasi, Paolo Del Barba, Sergio, Arrigoni, Salvini, Filippo M., Luca, Bernardo, Giuseppe, Bertolozzi, Silvia, Fasoli, Gian Luigi Marseglia, Emilio, Palumbo, Annalisa, Bosco, Gianpaolo, Mirri, Elisabetta, Fabiani, Ermanno, Ruffini, Luisa, Pieragostini, Martina, Fornaro, Gabriele, Ripanti, Donnina, Pannoni, Felici, Enrico, Anna, Perona, Eleonora, Tappi, Oscar Nis Haitink, Ivana, Rabbone, Pina Teresa Capalbo, Antonio, Urbino, Andrea, Guala, Gianluca, Cosi, Maria Gabriella Barracchia, Baldassarre, Martire, Fabio, Cardinale, Fulvio, Moramarco, Carmelo, Perrone, Angelo, Campanozzi, Valerio, Cecinati, Alessandro, Canetto, Ciro, Clemente, Antonio, Cualbu, Fabio, Narducci, Giuseppina, Mula, Pasquale, Bulciolu, Roberto, Antonucci, Giuseppe, Gramaglia, Giuseppe, Cavaleri, Carmelo, Salpietro, Giovanni, Corsello, Rosario, Salvo, Marcello, Palmeri, Maria Assunta Vitale, Ambra, Morgano, Susanna, Falorni, Diego, Peroni, Stefano, Masi, Alessio, Bertini, Angelina, Vaccaro, Pierluigi, Vasarri, Petra, Reinstadler, Massimo, Soffiati, Maurizio, Stefanelli, VERROTTI di PIANELLA, Alberto, Catherine, Bertone, Stefano, Marzini, Liviana Da Dalt, Simone, Rugolotto, Floriana, Scozzola, Luca Ecclesio Livio, Mauro, Cinquetti, Davide, Silvagni, Massimo Bellettato and, Cenzato F., Milani G.P., Amigoni A., Sperotto F., Bianchetti M.G., Agostoni C., Montini G., Farello G., Chiarelli F., Greco R., Di Lollo F., Rocco Forte F., Manieri S., Carpino L., Caloiero M., Cirisano A., Bragho S., Della Casa R., Nunziata F., Pecoraro C., Pacifico R., Lanari M., Ghizzi C., Serra L., Stella M., Maggiore G., Fiorini R., Dodi I., Morelli A., Lughetti L., Cella A., Vergine G., De Fanti A., Dragovic D., Santori D., Cozzi G., Cogo P., Raponi M., Lubrano R., de Martinis M., Gatto A., Barbieri M.A., Reale A., Bracaglia G., Piccotti E., Borea R., Gaiero A., Martelli L., Arrighini A., Cianci P., Cavalli C., De Santis L., Pietra B.C., Biondi A., Sala M., Pogliani L.M., Cherubini S., Bellini M., Bruni P., Traina G., Tommasi P., Del Barba P., Arrigoni S., Salvini F.M., Bernardo L., Bertolozzi G., Fasoli S., Marseglia G.L., Palumbo E., Bosco A., Mirri G., Fabiani E., Ruffini E., Pieragostini L., Fornaro M., Ripanti G., Pannoni D., Enrico F., Perona A., Tappi E., Nis Haitink O., Rabbone I., Capalbo P.T., Urbino A., Guala A., Cosi G., Barracchia M.G., Martire B., Cardinale F., Moramarco F., Perrone C., Campanozzi A., Cecinati V., Canetto A., Clemente C., Cualbu A., Narducci F., Mula G., Bulciolu P., Antonucci R., Gramaglia G., Cavaleri G., Salpietro C., Corsello G., Salvo R., Palmeri M., Vitale M.A., Morgano A., Falorni S., Peroni D., Masi S., Bertini A., Vaccaro A., Vasarri P., Reinstadler P., Soffiati M., Stefanelli M., Verrotti di Pianella A., Bertone C., Marzini S., Da Dalt L., Rugolotto S., Scozzola F., Ecclesio Livio L., Cinquetti M., Silvagni D., and Bellettato M.

Subjects
Catheter, Urinary tract, Emergency department, Pediatrics, Perinatology and Child Health, Guidelines, Infants, Infection, Survey, Urine, Infant, Guideline
Abstract

Urinary tract infections (UTIs) are among the most frequent bacterial diseases in infants and children. Physician adherence to recommendations is notoriously often poor, but no data are available on UTIs management in the emergency setting. In this multicenter national study, we investigated the policies regarding UTIs management in children aged 2 months to 3 years in Italian emergency units. Between April and June 2021, directors of the emergency units were invited to answer an online survey on the following items: diagnostic approach to children with fever without an apparent source, therapeutic approach to UTIs, the use of kidney and urinary tract ultrasound, and the criteria for hospitalization. A total of 121 (89%) out of 139 of invited units participated in the study. Overall, units manage children with a suspected or confirmed UTI according to available recommendations for most of the items. However, in almost 80% (n = 94) of units, a sterile perineal bag is used to collect urine for culture. When urine is collected by cathether, heterogeneity exists on the threshold of bacterial load considered for UTI diagnosis. Conclusions: Available recommendations on UTIs in children are followed by Italian emergency units for most of the items. However, the methods to collect urine specimens for culture, one of the crucial steps of the diagnostic work-up, often do not align with current recommendations and CFU thresholds considered for diagnosis largely vary among centers. Efforts should be addressed to validate and implement new child and family friendly urine collection techniques. What is Known:• Several guidelines are published on the management of children with suspected or confirmed urinary tract infection.• No data are available on the management of pediatric urinary tract infections in the emergency setting. What is New:• Almost 80% of the Italian emergency units employ a sterile perineal bag to collect urine for culture.• Diagnostic CFU thresholds largely vary among centers.

Published
2022

14. Chilblains in a child with confirmed SARS-CoV-2 infection: a red flag for late-onset skin manifestation in previously infected individuals

Author

Marcello Lanari, Chiara Ghizzi, Lucia Leonardi, Tiziana Lazzarotto, Annalisa Patrizi, Ilaria Corsini, Annalucia Virdi, Cosimo Misciali, Liliana Gabrielli, Francesca Conti, Iria Neri, Alba Guglielmo, Neri I., Conti F., Virdi A., Guglielmo A., Leonardi L., Corsini I., Ghizzi C., Gabrielli L., Lazzarotto T., Lanari M., Patrizi A., and Misciali C.

Subjects
Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Biopsy, Late onset, Dermatology, 030207 dermatology & venereal diseases, 03 medical and health sciences, 0302 clinical medicine, Immune system, Pandemic, Medicine, Humans, Family, Chilblains, Child, Letters to the Editor, Letter to the Editor, business.industry, SARS-CoV-2, Outbreak, COVID-19, medicine.disease, Infectious Diseases, 030220 oncology & carcinogenesis, Immunology, FLAG (chemotherapy), business, Human
Abstract

During the COVID-19 pandemic an outbreak of chilblain lesions has been described worldwide. The relationship with SARS-CoV-2 infection is still debated. Emerging literature regarding this possible correlation focuses on two hypotheses: an endothelial infection or the result of an IFN type I-mediated immune response.

Published
2021

15. Myocarditis and coronary aneurysms in a child with acute respiratory syndrome coronavirus 2

Author

Chiara Zarbo, Alessandro Rocca, Marianna Fabi, Gaetano Gargiulo, Andrea Donti, Fabio Niro, Daniela Di Luca, Cristina Ciuca, Marcello Lanari, Anna Balducci, Chiara Ghizzi, Ciuca C., Fabi M., Di Luca D., Niro F., Ghizzi C., Donti A., Balducci A., Rocca A., Zarbo C., Gargiulo G.D., and Lanari M.

Subjects
lcsh:Diseases of the circulatory (Cardiovascular) system, medicine.medical_specialty, Myocarditis, Coronary aneurysms, Myocarditi, Case Report, Case Reports, 030204 cardiovascular system & hematology, medicine.disease_cause, 03 medical and health sciences, 0302 clinical medicine, Cardiac magnetic resonance imaging, COVID‐19, Internal medicine, medicine, 030212 general & internal medicine, Children, Coronavirus, Aspirin, Respiratory distress, medicine.diagnostic_test, business.industry, Cardiogenic shock, COVID-19, Coronary aneurysm, Shock, medicine.disease, lcsh:RC666-701, Heart failure, Shock (circulatory), Cardiology, medicine.symptom, Cardiology and Cardiovascular Medicine, business, medicine.drug
Abstract

A 6‐year‐old African boy with multi‐viral infection including parvovirus B19 and severe acute respiratory syndrome coronavirus 2 was admitted for persistent fever associated with respiratory distress and myocarditis complicated by cardiogenic shock needing ventilatory and inotropic support. Coronary aneurysms were also documented in the acute phase. Blood tests were suggestive of macrophage activation syndrome. He was treated with intravenous immunoglobulins, aspirin, diuretics, dexamethasone, hydroxychloroquine, and prophylactic low molecular weight heparin. Normalization of cardiac performance and coronary diameters was noticed within the first days. Cardiac magnetic resonance imaging, performed 20 days after the hospitalization, evidenced mild myocardial interstitial oedema with no focal necrosis, suggesting a mechanism of cardiac stunning related to cytokines storm rather than direct viral injury of cardiomyocytes.

Published
2021

16. Multisystem inflammatory syndrome following sars-cov-2 infection in children: One year after the onset of the pandemic in a high-incidence area

Author

Marianna Fabi, Chiara Ghizzi, Alessandro De Fanti, Bianca Elisa Mattesini, Liliana Gabrielli, Laura Andreozzi, Marcello Lanari, Alessia Rizzello, Carlotta Biagi, Daniela Palleri, Daniela Di Luca, Fabio Caramelli, Emanuele Filice, Fabi M., Filice E., Biagi C., Andreozzi L., Palleri D., Mattesini B.E., Rizzello A., Gabrielli L., Ghizzi C., Di Luca D., Caramelli F., De Fanti A., and Lanari M.

Subjects
Inotrope, Male, medicine.medical_specialty, Multisystem inflammatory syndrome in childhood, Adolescent, Disease, Mucocutaneous Lymph Node Syndrome, Microbiology, Article, Ventricular Dysfunction, Left, Virology, Internal medicine, medicine, Humans, Prospective Studies, Kawasaki Disease, Prospective cohort study, Child, Cross-Sectional Studie, biology, Cardiac involvement, business.industry, SARS-CoV-2, Incidence (epidemiology), Myocardium, Interleukin-8, Cytokine profiles, Infant, Newborn, COVID-19, Infant, medicine.disease, Troponin, QR1-502, Infliximab, Systemic Inflammatory Response Syndrome, Cytokine profile, Interleukin-10, Systemic inflammatory response syndrome, Prospective Studie, Infectious Diseases, Cross-Sectional Studies, Italy, Child, Preschool, biology.protein, Kawasaki disease, Female, business, Human, medicine.drug
Abstract

SARS-CoV-2 infection in children can trigger cardiovascular manifestations potentially requiring an intensive treatment and defining a new entity named Multisystem Inflammatory Syndrome in Children (MIS-C), whose features partially overlap with Kawasaki Disease (KD). A cross-sectional study including all diagnoses of MIS-C and KD from April 2020 to May 2021 in our metropolitan area was conducted evaluating clinical, laboratory (including immunological response, cytokines, and markers of myocardial damage), and cardiac (coronary and non-coronary) features at onset of the diseases. Evolution of ventricular dysfunction, valve regurgitations, and coronary lesions was documented. The severity of the disease was also considered based on the need for inotropic support and ICU admission. Twenty-four MIS-C were diagnosed (14 boys, median age 82 months): 13/24 cases (54.17%) presented left ventricular dysfunction, 12/24 (50%) required inotropic support, and 10/24 (41.67%) developed coronary anomalies (CALs). All patients received steroids and IVIG at a median time of 5 days (IQR1:4, IQR3:6.5) from onset of fever and heart function normalized 6 days (IQR1: 5, IQR3: 7) after therapy, while CALs persisted in one. One patient (12.5%) required infliximab because of refractory disease and still presented CALs 18 days after therapy. During the same study period, 15 KD were diagnosed: none had ventricular dysfunction, while 7/15 (46.67%) developed CALs. Three out of 15 patients (20%) still presented CALs 46 days from onset. Compared to KD, MIS-C pts have significantly higher IL8 and similar lymphocytes subpopulations. Despite a more severe presentation and initial cardiac findings compared to KD, the myocardial injury in MIS-C has a rapid response to immunomodulatory treatment (median time 6 days), in terms of ventricular function, valve regurgitations, and troponin. Incidence of CALs is similar at onset, but it tends to regress in most of the cases of MIS-C differently than in KD where CALs persist in up to 40% in the subacute stage after treatment.

Published
2021

17. Coronary Arteries Lesions in Kawasaki Disease: Risk Factors in an Italian Cohort.

Author

Morana E, Guida F, Andreozzi L, Frazzoni L, Baselli LA, Lami F, Corinaldesi E, Cicero C, Mambelli L, Bigucci B, Taddio A, Ghizzi C, Cappella M, Fernicola P, Lanari M, Zagari RM, and Fabi M

Abstract

Background : Kawasaki disease (KD) is a systemic vasculitis of medium arteries, particularly involving coronary arteries. Coronary artery lesions (CALs) is the most serious complication in the acute stage, potentially leading to ischemic cardiomyopathy, myocardial infarction and sudden death. Environmental factors and genetic background contribute to individual susceptibility to develop CALs. The aim of this study was to define the risk factors for CALs in an Italian cohort. Methods : Data of KD patients from 10 Italian sites were registered into a REDCap database where demographic and clinical data, laboratory findings and coronary status were recorded. KD was diagnosed according to AHA definition. We used multiple logistic regression analysis to identify independent risk factors for CALs. Results : A total of 517 patients were enrolled, mainly Caucasians (83.6%). Presentation was complete in 321 patients (62.8%) and IVIG responsiveness in 360 (70%). CALs developed in 136/517 (26.31%). Gender, age, ethnicity, clinical presentation, fever duration, non-coronary cardiac events, Hb, albumin and CRP were significantly different between patients with and without CALs, while seasonality was not. Male gender, age < 18 months, Asian ethnicity, incomplete presentation and fever > 10 days were independent risk factors for CALs. Conclusions : Age younger than 18 months, incomplete KD and longer fever duration are risk factors for CALs. Asian ethnicity also represents a risk factor in our Italian Cohort.

Published
2024
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18. Effects of COVID-19-targeted non-pharmaceutical interventions on pediatric emergency department use: a quasi-experimental study interrupted time-series analysis in North Italian hospitals, 2017 to 2022.

Author

Puntoni M, Maglietta G, Caminiti C, Miniaci A, Lanari M, Caramelli F, Marchetti F, De Fanti A, Iughetti L, Biasucci G, Suppiej A, Miceli A, Ghizzi C, Vergine G, Aricò M, Stella M, and Esposito S

Subjects
Humans, Italy epidemiology, Child, Female, Adolescent, Male, Child, Preschool, Infant, SARS-CoV-2, COVID-19 epidemiology, COVID-19 prevention & control, Interrupted Time Series Analysis, Emergency Service, Hospital statistics & numerical data
Abstract

Background: The use of Non-Pharmaceutical Interventions (NPIs) during the COVID-19 pandemic is debated. Understanding the consequences these measures may have on vulnerable populations including children and adolescents is important., Methods: This is a multicenter, quasi-experimental before-after study involving 12 hospitals of the North Italian Emilia-Romagna Region, with NPI implementation as the intervention event. The 3 years preceding NPI implementation (in March 2020) constituted the pre-pandemic phase. The subsequent 2 years were further subdivided into a school closure phase (SC) and a subsequent mitigation measures phase (MM) with milder restrictions. Interrupted Time Series (ITS) regression analysis was used to calculate PED Standardized Incidence Rate Ratios (SIRR) on the diagnostic categories exhibiting the greatest frequency and/or variation., Results: In the 60 months of the study there were 765,215 PED visits. Compared to the pre-pandemic rate, overall PED presentations dropped by 58 and 39% during SC and MM, respectively. "Symptoms, signs and Ill-defined conditions," "Injury and poisoning" and "Diseases of the Respiratory System" accounted for 74% of the reduction. A different pattern was instead seen for "Mental Disorders," which exhibited the smallest decrease during SC, and is the only category which rose already at the end of SC. ITS analysis confirmed the strong decrease during SC (level change, IRR 0.17, 95%CI 0.12-0.27) and a significant increase in MM (slope change, IRR 1.23, 95%CI 1.13-1.33), with the sharpest decline (-94%) and rise (+36%) observed in the "Diseases of the Respiratory System" category. Mental Disorders showed a significant increasing trend of 1% monthly over the whole study period exceeding pre-pandemic levels at the end of MM. Females and adolescents showed higher increasing rates both in SC and MM., Conclusion: NPIs appear to have influenced PED attendance in different ways according to diagnostic categories, mirroring different mechanisms of action. These effects are beneficial in some cases and harmful in others, and establishing a clear balance between pros and cons is a difficult task for public health decision makers. The role of NPIs on PED use appropriateness deserves investigation. The rise in pediatric mental disorders independent of the pandemic makes interventions addressing these issues urgent., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Puntoni, Maglietta, Caminiti, Miniaci, Lanari, Caramelli, Marchetti, De Fanti, Iughetti, Biasucci, Suppiej, Miceli, Ghizzi, Vergine, Aricò, Stella, Esposito and the Emilia-Romagna Paediatric COVID-19 network.)

Published
2024
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19. Effects of COVID-19-targeted non-pharmaceutical interventions on pediatric hospital admissions in North Italian hospitals, 2017 to 2022: a quasi-experimental study interrupted time-series analysis.

Author

Maglietta G, Puntoni M, Caminiti C, Pession A, Lanari M, Caramelli F, Marchetti F, De Fanti A, Iughetti L, Biasucci G, Suppiej A, Miceli A, Ghizzi C, Vergine G, Aricò M, Stella M, and Esposito S

Subjects
Humans, Italy epidemiology, Child, Adolescent, Child, Preschool, Female, Male, Physical Distancing, Hospitals, Pediatric statistics & numerical data, SARS-CoV-2, Communicable Disease Control, Infant, Quarantine statistics & numerical data, Schools, Controlled Before-After Studies, Pandemics, COVID-19 epidemiology, COVID-19 prevention & control, Interrupted Time Series Analysis, Hospitalization statistics & numerical data
Abstract

Background: The use of Non-Pharmaceutical Interventions (NPIs), such as lockdowns, social distancing and school closures, against the COVID-19 epidemic is debated, particularly for the possible negative effects on vulnerable populations, including children and adolescents. This study therefore aimed to quantify the impact of NPIs on the trend of pediatric hospitalizations during 2 years of pandemic compared to the previous 3 years, also considering two pandemic phases according to the type of adopted NPIs., Methods: This is a multicenter, quasi-experimental before-after study conducted in 12 hospitals of the Emilia-Romagna Region, Northern Italy, with NPI implementation as the intervention event. The 3 years preceding the beginning of NPI implementation (in March 2020) constituted the pre-pandemic phase. The subsequent 2 years were further subdivided into a school closure phase (up to September 2020) and a subsequent mitigation measures phase with less stringent restrictions. School closure was chosen as delimitation as it particularly concerns young people. Interrupted Time Series (ITS) regression analysis was applied to calculate Hospitalization Rate Ratios (HRR) on the diagnostic categories exhibiting the greatest variation. ITS allows the estimation of changes attributable to an intervention, both in terms of immediate (level change) and sustained (slope change) effects, while accounting for pre-intervention secular trends., Results: Overall, in the 60 months of the study there were 84,368 cases. Compared to the pre-pandemic years, statistically significant 35 and 19% decreases in hospitalizations were observed during school closure and in the following mitigation measures phase, respectively. The greatest reduction was recorded for "Respiratory Diseases," whereas the "Mental Disorders" category exhibited a significant increase during mitigation measures. ITS analysis confirms a high reduction of level change during school closure for Respiratory Diseases (HRR 0.19, 95%CI 0.08-0.47) and a similar but smaller significant reduction when mitigation measures were enacted. Level change for Mental Disorders significantly decreased during school closure (HRR 0.50, 95%CI 0.30-0.82) but increased during mitigation measures by 28% (HRR 1.28, 95%CI 0.98-1.69)., Conclusion: Our findings provide information on the impact of COVID-19 NPIs which may inform public health policies in future health crises, plan effective control and preventative interventions and target resources where needed., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Maglietta, Puntoni, Caminiti, Pession, Lanari, Caramelli, Marchetti, De Fanti, Iughetti, Biasucci, Suppiej, Miceli, Ghizzi, Vergine, Aricò, Stella, Esposito and on behalf of Emilia-Romagna Paediatric COVID-19 network.)

Published
2024
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20. Nationwide survey on the management of pediatric pharyngitis in Italian emergency units.

Author

Milani GP, Rosa C, Tuzger N, Alberti I, Ghizzi C, Zampogna S, Amigoni A, Agostoni C, Peroni D, Marchisio P, and Chiappini E

Subjects
Humans, Child, Anti-Bacterial Agents, Emergency Service, Hospital, Hospitals, Amoxicillin-Potassium Clavulanate Combination, Pharyngitis
Abstract

Background: Acute pharyngitis is a frequent reason for primary care or emergency unit visits in children. Most available data on pharyngitis management come from primary care studies that demonstrate an underuse of microbiological tests, a tendency to over-prescribe antibiotics and a risk of antimicrobial resistance increase. However, a comprehensive understanding of acute pharyngitis management in emergency units is lacking. This study aimed to investigate the frequency of rapid antigen test use to diagnose acute pharyngitis, as well as other diagnostic approaches, the therapeutic attitude, and follow-up of children with this condition in the emergency units., Methods: A multicentric national study was conducted in Italian emergency departments between April and June 2022., Results: A total of 107 out of 131 invited units (response rate 82%), participated in the survey. The results showed that half of the units use a scoring system to diagnose pharyngitis, with the McIsaac score being the most commonly used. Most emergency units (56%) were not provided with a rapid antigen diagnostic test by their hospital, but the test was more frequently available in units visiting more than 10,000 children yearly (57% vs 33%, respectively, p = 0.02). Almost half (47%) of the units prescribe antibiotics in children with pharyngitis despite the lack of microbiologically confirmed cases of Group A β-hemolytic streptococcus. Finally, about 25% of units prescribe amoxicillin-clavulanic acid to treat Group A β-hemolytic streptococcus pharyngitis., Conclusions: The study sheds light on the approach to pharyngitis in emergency units, providing valuable information to improve the appropriate management of acute pharyngitis in this setting. The routinary provision of rapid antigen tests in the hospitals could enhance the diagnostic and therapeutic approach to pharyngitis., (© 2023. Società Italiana di Pediatria.)

Published
2023
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21. UPDATE - 2022 Italian guidelines on the management of bronchiolitis in infants.

Author

Manti S, Staiano A, Orfeo L, Midulla F, Marseglia GL, Ghizzi C, Zampogna S, Carnielli VP, Favilli S, Ruggieri M, Perri D, Di Mauro G, Gattinara GC, D'Avino A, Becherucci P, Prete A, Zampino G, Lanari M, Biban P, Manzoni P, Esposito S, Corsello G, and Baraldi E

Subjects
Infant, Newborn, Child, Infant, Humans, Child, Preschool, Hospitalization, Risk Factors, Albuterol therapeutic use, Bronchiolitis therapy, Bronchiolitis drug therapy, Respiratory Syncytial Virus Infections
Abstract

Bronchiolitis is an acute respiratory illness that is the leading cause of hospitalization in young children. This document aims to update the consensus document published in 2014 to provide guidance on the current best practices for managing bronchiolitis in infants. The document addresses care in both hospitals and primary care. The diagnosis of bronchiolitis is based on the clinical history and physical examination. The mainstays of management are largely supportive, consisting of fluid management and respiratory support. Evidence suggests no benefit with the use of salbutamol, glucocorticosteroids and antibiotics with potential risk of harm. Because of the lack of effective treatment, the reduction of morbidity must rely on preventive measures. De-implementation of non-evidence-based interventions is a major goal, and educational interventions for clinicians should be carried out to promote high-value care of infants with bronchiolitis. Well-prepared implementation strategies to standardize care and improve the quality of care are needed to promote adherence to guidelines and discourage non-evidence-based attitudes. In parallel, parents' education will help reduce patient pressure and contribute to inappropriate prescriptions. Infants with pre-existing risk factors (i.e., prematurity, bronchopulmonary dysplasia, congenital heart diseases, immunodeficiency, neuromuscular diseases, cystic fibrosis, Down syndrome) present a significant risk of severe bronchiolitis and should be carefully assessed. This revised document, based on international and national scientific evidence, reinforces the current recommendations and integrates the recent advances for optimal care and prevention of acute bronchiolitis., (© 2023. The Author(s).)

Published
2023
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22. Triage Grading and Correct Diagnosis Are Critical for the Emergency Treatment of Anaphylaxis.

Author

Dondi A, Calamelli E, Scarpini S, Candela E, Biserni GB, Ghizzi C, Lombardi F, Salvago P, Serra L, Corsini I, and Lanari M

Abstract

Introduction: Anaphylaxis is one of the most frequent and misdiagnosed emergencies in the pediatric emergency department (PED). We aimed to assess which factors play a major role for a correct diagnosis and an appropriate therapy. Methods: We reviewed the records of children discharged with a diagnosis of anaphylaxis or an allergic reaction over 11 years from 3 hospitals in the Bologna city area. Results: One hundred and sixteen cases matched the criteria (0.03% of the total admittances) and were divided according to the patients’ symptoms at arrival: active acute patients [AP], n = 50, or non-acute patients ([NAP], n = 66). At the patients’ discharge, anaphylaxis was diagnosed in 39 patients (33.6%). Some features seemed to favor a correct diagnosis: active symptoms at arrival (AP vs. NAP, p < 0.01), high-priority triage code (p < 0.01), and upper airway involvement (p < 0.01). Only 14 patients (12.1%), all in the AP group, received epinephrine, that was more likely administered to patients recognized to have anaphylaxis (p < 0.01) and with cardiovascular, respiratory, or persistent gastrointestinal symptoms (p < 0.02), as confirmed by logistic regression analysis. Conclusions: Anaphylaxis is still under-recognized and under-treated. Correct triage coding and a proper diagnosis seem to foster an appropriate treatment. Physicians often prefer third-line interventions. Specific training for nurses and physicians might improve the management of this disease.

Published
2022
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23. Multicentre study revealed significant gaps between evidence-based recommendations for using corticosteroids for croup and clinical practice.

Author

Pierantoni L, Stera G, Andreozzi L, Pellegrino F, Dondi A, Fabi M, Corsini I, Ghizzi C, and Lanari M

Subjects
Adrenal Cortex Hormones therapeutic use, Child, Child, Preschool, Dexamethasone therapeutic use, Female, Glucocorticoids therapeutic use, Humans, Infant, Male, Retrospective Studies, Croup chemically induced, Croup drug therapy
Abstract

Aim: Adherence to croup management recommendations has been poorly investigated. This study aimed to describe the treatment patterns in two paediatric emergency departments and analyse the adherence to recommendations., Methods: We conducted a retrospective chart review of children diagnosed with croup in two Italian paediatric emergency departments in 2017. Data on clinical presentation, corticosteroid administration and home therapy were collected. Length of stay, hospitalisation and re-access rates were compared among different corticosteroid treatment groups., Results: We enrolled 632 patients (61.1% males) with a mean age of 42.8 ± 55.1 months. Corticosteroids were administered to 403 (63.8%) children in the emergency departments. Dexamethasone was administered to 1 (0.4%) patient. Inhaled and oral corticosteroids were given to 342 (54.1%) and 226 (35.8%) patients, respectively. Home therapy was prescribed for 603 (95.4%) patients, either with inhaled (86.2%) and/or oral (43.8%) corticosteroids. The re-access rate was 2.8%. The actual pharmaceutical costs were an estimated 10 times higher than they would have been if the recommendations had been followed., Conclusion: A significant gap between the evidence and clinical practice for croup treatment was observed. Improving adherence to the recommendations could lead to clinical and economic benefits., (© 2022 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

Published
2022
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24. Pediatric Adverse Drug Reactions: An Observational Cohort Study After Health Care Workers' Training.

Author

Balsamo C, Del Bono C, Pagano G, Valastro V, Ghizzi C, and Lombardi F

Abstract

Objective: Adverse drug reactions (ADRs) in children are an important but underestimated public health issue. This study describes ADRs in a registered pediatric population of Bologna and demonstrates that ADRs might be better detected after health care personnel training., Methods: A prospective cohort was recruited from July 1, 2016, to June 30, 2019, after health care worker sensitization, and compared to a retrospective cohort enrolled from 2013 to 2016. The ADRs are classified by system organ classes and drugs are categorized according to the Anatomical Therapeutic Chemical classification system., Results: We retrospectively recruited 78 pediatric patients with ADRs in the 2013 to 2016 period, and we prospectively enrolled 127 children in the 2016 to 2019 period. In both periods, most of the ADRs reported were classified as non-serious reactions (68.8%). The most frequent ADRs were general and administration site disorders. During 2013 to 2016 vaccines were the most frequent cause of ADRs (83.3%;) and the main reporters were health care workers other than physicians (84.6%), whereas during the second period, medical doctors become the main signalers (65.4%) and ADRs related to vaccines significantly decreased (55.1%). During the 2016 to 2019 period the number of drug categories was higher than in the 2013 to 2016 period (24 vs 8). Patients with ADRs due to vaccinations present more frequently a favourable outcome (63%)., Conclusions: This study demonstrates that active pharmacovigilance and health care personnel sensitization are associated with improved ADR detection, providing valuable information about drugs' safety profile in pediatric patients., Competing Interests: Disclosures. The authors declare no conflicts or financial interest in any product or service mentioned in the manuscript, including grants, equipment, medications, employment, gifts, and honoraria. The authors had full access to all the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis., (Copyright. Pediatric Pharmacy Association. All rights reserved. For permissions, email: mhelms@pediatricpharmacy.org 2022.)

Published
2022
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25. Multisystem Inflammatory Syndrome Following SARS-CoV-2 Infection in Children: One Year after the Onset of the Pandemic in a High-Incidence Area.

Author

Fabi M, Filice E, Biagi C, Andreozzi L, Palleri D, Mattesini BE, Rizzello A, Gabrielli L, Ghizzi C, Di Luca D, Caramelli F, De Fanti A, and Lanari M

Subjects
Adolescent, COVID-19 diagnosis, COVID-19 epidemiology, Child, Child, Preschool, Cross-Sectional Studies, Female, Humans, Infant, Infant, Newborn, Interleukin-10 blood, Interleukin-8 blood, Italy epidemiology, Male, Mucocutaneous Lymph Node Syndrome diagnosis, Prospective Studies, SARS-CoV-2 metabolism, Systemic Inflammatory Response Syndrome diagnosis, Systemic Inflammatory Response Syndrome epidemiology, Ventricular Dysfunction, Left virology, COVID-19 complications, COVID-19 pathology, Mucocutaneous Lymph Node Syndrome pathology, Myocardium pathology, Systemic Inflammatory Response Syndrome pathology, Ventricular Dysfunction, Left pathology
Abstract

SARS-CoV-2 infection in children can trigger cardiovascular manifestations potentially requiring an intensive treatment and defining a new entity named Multisystem Inflammatory Syndrome in Children (MIS-C), whose features partially overlap with Kawasaki Disease (KD). A cross-sectional study including all diagnoses of MIS-C and KD from April 2020 to May 2021 in our metropolitan area was conducted evaluating clinical, laboratory (including immunological response, cytokines, and markers of myocardial damage), and cardiac (coronary and non-coronary) features at onset of the diseases. Evolution of ventricular dysfunction, valve regurgitations, and coronary lesions was documented. The severity of the disease was also considered based on the need for inotropic support and ICU admission. Twenty-four MIS-C were diagnosed (14 boys, median age 82 months): 13/24 cases (54.17%) presented left ventricular dysfunction, 12/24 (50%) required inotropic support, and 10/24 (41.67%) developed coronary anomalies (CALs). All patients received steroids and IVIG at a median time of 5 days (IQR1:4, IQR3:6.5) from onset of fever and heart function normalized 6 days (IQR1: 5, IQR3: 7) after therapy, while CALs persisted in one. One patient (12.5%) required infliximab because of refractory disease and still presented CALs 18 days after therapy. During the same study period, 15 KD were diagnosed: none had ventricular dysfunction, while 7/15 (46.67%) developed CALs. Three out of 15 patients (20%) still presented CALs 46 days from onset. Compared to KD, MIS-C pts have significantly higher IL8 and similar lymphocytes subpopulations. Despite a more severe presentation and initial cardiac findings compared to KD, the myocardial injury in MIS-C has a rapid response to immunomodulatory treatment (median time 6 days), in terms of ventricular function, valve regurgitations, and troponin. Incidence of CALs is similar at onset, but it tends to regress in most of the cases of MIS-C differently than in KD where CALs persist in up to 40% in the subacute stage after treatment.

Published
2021
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26. Vaccines in Children with Inflammatory Bowel Disease: Brief Review.

Author

Esposito S, Antoniol G, Labate M, Passadore L, Alvisi P, Daccò V, Ghizzi C, Colombo C, and Principi N

Abstract

Incidence of inflammatory bowel diseases (IBDs), including Crohn's disease (CD) and ulcerative colitis (UC), is increasing worldwide. Children with IBDs have a dysfunctional immune system and they are frequently treated with immunomodulating drugs and biological therapy, which significantly impair immune system functions and lead to an increased risk of infections. Vaccines are essential to prevent at least part of these infections and this explains why strict compliance to the immunization guidelines specifically prepared for IBD patients is strongly recommended. However, several factors might lead to insufficient immunization. In this paper, present knowledge on the use of vaccines in children with IBDs is discussed. Literature review showed that despite a lack of detailed quantification of the risk of infections in children with IBDs, these children might have infections more frequently than age-matched healthy subjects, and at least in some cases, these infections might be even more severe. Fortunately, most of these infections could be prevented when recommended schedules of immunization are carefully followed. Vaccines given to children with IBDs generally have adequate immunogenicity and safety. Attention must be paid to live attenuated vaccines that can be administered only to children without or with mild immune system function impairment. Vaccination of their caregivers is also recommended. Unfortunately, compliance to these recommendations is generally low and multidisciplinary educational programs to improve vaccination coverage must be planned, in order to protect children with IBD from vaccine-preventable diseases.

Published
2021
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27. Myocarditis and coronary aneurysms in a child with acute respiratory syndrome coronavirus 2.

Author

Ciuca C, Fabi M, Di Luca D, Niro F, Ghizzi C, Donti A, Balducci A, Rocca A, Zarbo C, Gargiulo GD, and Lanari M

Subjects
Acute Disease, COVID-19 pathology, Child, Coronary Aneurysm diagnostic imaging, Coronary Aneurysm pathology, Echocardiography, Humans, Magnetic Resonance Imaging, Male, Myocarditis diagnostic imaging, Myocarditis pathology, Tomography, X-Ray Computed, COVID-19 complications, Coronary Aneurysm etiology, Myocarditis etiology
Abstract

A 6-year-old African boy with multi-viral infection including parvovirus B19 and severe acute respiratory syndrome coronavirus 2 was admitted for persistent fever associated with respiratory distress and myocarditis complicated by cardiogenic shock needing ventilatory and inotropic support. Coronary aneurysms were also documented in the acute phase. Blood tests were suggestive of macrophage activation syndrome. He was treated with intravenous immunoglobulins, aspirin, diuretics, dexamethasone, hydroxychloroquine, and prophylactic low molecular weight heparin. Normalization of cardiac performance and coronary diameters was noticed within the first days. Cardiac magnetic resonance imaging, performed 20 days after the hospitalization, evidenced mild myocardial interstitial oedema with no focal necrosis, suggesting a mechanism of cardiac stunning related to cytokines storm rather than direct viral injury of cardiomyocytes., (© 2020 The Authors. ESC Heart Failure published by John Wiley & Sons Ltd on behalf of the European Society of Cardiology.)

Published
2021
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28. Dural sinus mechanical thrombectomy and continuous local rt-PA infusion in a child with refractory intracranial hypertension and progressive visual loss: A case report.

Author

Cellerini M, Francavilla R, Testoni C, Maffei M, Zucchelli M, and Ghizzi C

Abstract

Background: Children with intracranial hypertension are at risk for visual loss and their visual function must be closely monitored. Surgery with the insertion of a ventriculoperitoneal shunt is imperative when vision is threatened., Case Description: Herein, we report a case of a 5-year-old boy whose refractory intracranial hypertension and severe, progressive visual loss (secondary to a chronic, otogenic, right sigmoid sinus thrombosis, and a contralateral sinus tight stenosis) were resolved by a combination of continuous (6 h), locoregional, infusion of recombinant tissue plasminogen activator (rt-PA), and mechanical thrombectomy., Conclusion: The association of in loco and continuous infusion of recombinant tissue plasminogen activator (rt- PA) with mechanical thrombectomy resulted in effective in partially reopening the occluded sinus and facilitating a good clinical recovery. This combined endovascular approach may represent an alternative, less invasive, therapeutic option to surgery in children with intracranial hypertension caused by chronic cerebral venous sinus thrombosis., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Surgical Neurology International.)

Published
2020
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29. Bilateral Facial Nerve Palsy in a Child: When the Smile Returns.

Author

Messana T, Lombardi F, Canini A, Russo A, Landini C, Curatolo A, Pini A, and Ghizzi C

Abstract

Bilateral facial nerve palsy (FNP) is an extremely rare clinical condition. Different from unilateral FNP, because of idiopathic or Bell's palsy in the majority of cases, bilateral FNP is most often correlated to an underlying medical condition, which can be congenital, neurological, infectious, neoplastic, traumatic, or metabolic. We describe the case of an 8-year-old girl with bilateral facial paralysis because of Epstein-Barr virus infection with late diagnosis and therapy. We discuss the differential diagnosis hypothesis, focusing on the different outcome and recovery times in relation to the timing of treatment., Competing Interests: There are no conflicts of interest.

Published
2018
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31. [A neonatal case of congenital myotonic dystrophy].

Author

Ghizzi C, Cavalli C, Benedetti M, Bolognani M, and Biban P

Subjects
Female, Humans, Infant, Newborn, Myotonic Dystrophy diagnosis, Myotonic Dystrophy congenital
Abstract

Congenital myotonic dystrophy is a rare autosomal disease, caused by an increased number of cytosine-thymine-guanine (CTG) trinucleotide on chromosome 19q. In the neonatal period the most peculiar clinical features are arthrogryposis, hypotonia, facial diplegia, respiratory and feeding difficulties. Clinical and electrical myotonic discharges are difficult to elicit in the newborn. We report a case of congenital myotonic dystrophy in a female newly born presenting with hypotonia, diaphragmatic paralysis, facial diplegia, and contractures of hips, knees and ankles. The diagnosis was confirmed by genetical study on lymphocyte DNA.

Published
2000

32. [Neurologic outcome in infants surgically treated for congenital cardiopathy: preliminary data].

Author

Cavalli C, Cordaro SP, Santini F, Luciani GB, Darra F, Ghizzi C, Lanzoni L, Rossetti L, Fiorini E, Prioli MA, Zoppi G, and Biban P

Subjects
Electroencephalography, Follow-Up Studies, Humans, Infant, Infant, Newborn, Nervous System Diseases physiopathology, Postoperative Complications physiopathology, Treatment Outcome, Heart Defects, Congenital surgery, Nervous System Diseases epidemiology, Postoperative Complications epidemiology
Abstract

Introduction: Both surgical techniques for correction of congenital heart diseases (CHD) and intraoperatory neurologic protection improved during the last 20 years. Nevertheless cardiac surgery is still a risk for neurologic morbidity., Methods and Patients: Analysis of the postoperative neurologic status of infants younger than 6 months who underwent cardiac surgery from January 1998 to December 1999. We reviewed the EEG tracings, cranial ultrasound reports (CUS) and CT scans of 48 patients. Diagnoses were: ventricular septal defect = 15, Fallot (TOF) = 9, patent ductus arteriosus (PDA) = 5, coarctation of aorta = 4, atrio-ventricular septal defect = 4, transposition of great arteries (TGA) = 3, hypoplastic left heart syndrome = 2, pulmonary atresia = 2, total anomalous pulmonary veins drainage = 2, double outlet right ventricle = 1, cor triatriatum = 1. Mean age (range) at intervention was 54 days (2-150), 44 infants (91.7%) survived at follow-up: 23 EEG, 22 CUS and 2 CT were performed in the recent postoperative. Among survivors 5/44 had neurologic complications. EEG was altered in 4: two of them (1 TOF, 1 TGA) had pathologic CUS and CT as well (ischemic pattern in the former, atrophy in the latter). Finally a preterm newborn with PDA had mild abnormalities at CUS. After a mean follow-up of 16 +/- 6 months 3/5 patients had mild-to-moderate psychomotor delay and 2 recovered., Conclusions: According to our preliminary data the prevalence of neurologic complications in infants who undergo cardiac surgery seems to be low. The pathological findings of the recent postoperative seem to recover up to normalization in some cases at mid-term follow-up. As expected, permanent complications effect more often complex CHD. Further follow-up studies to school age will be mandatory to check the very final results of cardiac surgery performed during early infancy.

Published
2000

33. [Criteria for the evaluation of neonatal pain].

Author

Ghizzi C, Benedetti M, and Barlocco EG

Subjects
Humans, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases diagnosis, Infant, Premature, Diseases drug therapy, Pain drug therapy, Pain physiopathology, Pain, Postoperative diagnosis, Pain, Postoperative drug therapy, Reference Values, Pain diagnosis, Pain Measurement methods
Abstract

The common opinion about the painful sensation in newborn and in premature baby, is that the experience of pain begins since birth. One of the difficulties in taking care of pain in neonatology is the valuation of the symptom: actually there aren't enough sensitive and standard methods to define and quantify the pain of newborns and prematures babies. The authors illustrate two scales of pain valuation, that have been tested and then adopted by different french groups. These scales allow to examine respectively, the healthy newborn and the newborn after surgical care and permit also an objective measure of newborn malaise sensation. These scores need the valuation of clinical signs and physiological parameters that are sometimes neglected during the execution of invasive techniques; therefore these tables would awaken the sanitary staff to newborn expressions of pain or discomfort, allowing a best comprehension of baby's feelings and facilitating in this nursing and pharmacological interventions to relieve pain.

Published
1996

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