25 results on '"Mardegan, V."'
Search Results
2. Trends in neonatal emergency transport in the last two decades
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Trevisanuto, D., Cavallin, F., Loddo, C., Brombin, L., Lolli, E., Doglioni, N., Baraldi, E., Cavicchiolo, M. E., Mardegan, V., Magarotto, M., Nardo, D., Piva, D., Priante, E., and Salvadori, S.
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medicine.medical_specialty ,Joinpoint regression ,medicine.medical_treatment ,Transport ,Intermittent Positive-Pressure Ventilation ,03 medical and health sciences ,0302 clinical medicine ,Neonate ,Pregnancy ,030225 pediatrics ,medicine ,Respiratory management ,Trend ,Humans ,In patient ,030212 general & internal medicine ,Respiratory system ,Mechanical ventilation ,Respiratory Distress Syndrome, Newborn ,Emergency transport ,Continuous Positive Airway Pressure ,business.industry ,Infant, Newborn ,Infant ,Large series ,Respiration, Artificial ,Care facility ,Pediatrics, Perinatology and Child Health ,Emergency medicine ,Female ,business ,Infant, Premature - Abstract
Although maternal antenatal transfer is the preferred option, some infants inevitably need urgent transport to a tertiary neonatal care facility after birth. This study aimed to investigate trends over time in patient characteristics and respiratory management in a large series of neonatal emergency transfers, in order to provide health caregivers an up-to-date profile of such patients and their therapeutic needs. Trends in patient characteristics and respiratory management were evaluated in 3337 transfers by the Eastern Veneto Neonatal Emergency Transport Service in 2000–2019. Joinpoint regression analysis was performed to evaluate trends and to estimate annual percentage changes (APCs). Proportions of preterm neonates increased (APC2000–2012 2.25%), then decreased (APC2012–2019 − 6.04%). Transfers at birth increased (APC2000–2013 2.69%), then decreased (APC2013–2019 − 5.76%). Proportion of neonates with cardiac and surgical diseases declined (APCs2000–2019 − 6.82% and − 3.32%), while proportion of neonates with neurologic diseases increased (APC2000–2019 8.62%). Use of nasal-continuous-positive-airway-pressure (APC2000–2019 9.72%) and high-flow-nasal-cannula (APC2007–2019 58.51%) at call, and nasal-continuous-positive-airway-pressure (APC2000–2019 13.87%) and nasal-intermittent-mandatory-ventilation (APC2000–2019 32.46%) during transfer increased. Mechanical ventilation during transfer decreased (APC2014–2019 − 10.77%). Use of oxygen concentrations at 21% increased at call and during transfer (APCs 2000–2019 2.24% and 2.44%), while oxygen concentrations above 40% decreased at call and during transfer (APCs 2000–2019 − 3.93% and − 5.12%). Conclusion: Our findings revealed a shift toward a more “gentle” approach and the reduced use of oxygen in respiratory management. Equipment and team expertise should meet the requirements of such changing patients and their therapeutic needs.
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- 2021
3. REFLEX ANAL DILATATION: AN OBSERVATIONAL STUDY ON NON-ABUSED CHILDREN PRESENTING TO THE PEDIATRIC EMERGENCY DEPARTMENT: 152
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Sfriso, F., Masiero, S., Mardegan, V., Bressan, S., and Aprile, A.
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- 2012
4. Antibiotics Prescriptions in the Neonatal Intensive Care Unit: How to Overcome Everyday Challenges
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Mozzo, E., primary, Mardegan, V., primary, Trafojer, U., primary, Lago, P., primary, Salvadori, S., primary, Baraldi, E., primary, Giaquinto, C., primary, and Donà, D., additional
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- 2017
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5. REFLEX ANAL DILATATION:AN OBSERVATIONAL STUDY ON NON ABUSED CHILDRENPRESENTING TO THE PEDIATRIC EMERGENCY
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Sfriso, F., Masiero, S., Mardegan, V., Bressan, Silvia, and Aprile, Anna
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child sex abuse - Published
- 2012
6. Il bambino maltrattato: 5 anni di esperienza al Pronto Soccorso pediatrico di Padova
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Mardegan, V., Masiero, S., Moretti, C., Andreola, B., and DA DALT, Liviana
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- 2008
7. Kasabach-Merritt phenomenon in a neonatal kaposiform haemangioendothelioma
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Mardegan, V., primary, Doglioni, N., additional, De Bernardo, G., additional, and Trevisanuto, D., additional
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- 2014
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8. Urinary metabotypes of newborns with perinatal asphyxia undergoing therapeutic hypothermia.
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Valerio E, Mardegan V, Stocchero M, Cavicchiolo ME, Pirillo P, Poloniato G, D'Onofrio G, Bonadies L, Giordano G, and Baraldi E
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- Asphyxia therapy, Humans, Infant, Infant, Newborn, Lysine, Asphyxia Neonatorum therapy, Hypothermia, Induced methods, Hypoxia-Ischemia, Brain complications, Hypoxia-Ischemia, Brain therapy
- Abstract
Perinatal asphyxia (PA) still occurs in about three to five per 1,000 deliveries in developed countries; 20% of these infants show hypoxic-ischemic encephalopathy (HIE) on brain magnetic resonance imaging (MRI). The aim of our study was to apply metabolomic analysis to newborns undergoing therapeutic hypothermia (TH) after PA to identify a distinct metabotype associated with the development of HIE on brain MRI. We enrolled 53 infants born at >35 weeks of gestation with PA: 21 of them showed HIE on brain MRI (the "HIE" group), and 32 did not (the "no HIE" group). Urine samples were collected at 24, 48 and 72 hours of TH. Metabolomic data were acquired using high-resolution mass spectrometry and analyzed with univariate and multivariate methods. Considering the first urines collected during TH, untargeted analysis found 111 relevant predictors capable of discriminating between the two groups. Of 35 metabolites showing independent discriminatory power, four have been well characterized: L-alanine, Creatine, L-3-methylhistidine, and L-lysine. The first three relate to cellular energy metabolism; their involvement suggests a multimodal derangement of cellular energy metabolism during PA/HIE. In addition, seven other metabolites with a lower annotation level (proline betaine, L-prolyl-L-phenylalanine, 2-methyl-dodecanedioic acid, S-(2-methylpropionyl)-dihydrolipoamide-E, 2,6 dimethylheptanoyl carnitine, Octanoylglucuronide, 19-hydroxyandrost-4-ene-3,17-dione) showed biological consistency with the clinical picture of PA. Moreover, 4 annotated metabolites (L-lysine, L-3-methylhistidine, 2-methyl-dodecanedioic acid, S-(2-methylpropionyl)-dihydrolipoamide-E) retained a significant difference between the "HIE" and "no HIE" groups during all the TH treatment. Our analysis identified a distinct urinary metabotype associated with pathological findings on MRI, and discovered 2 putative markers (L-lysine, L-3-methylhistidine) which may be useful for identifying neonates at risk of developing HIE after PA., Competing Interests: The authors have declared that no competing interests exist.
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- 2022
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9. Trends in respiratory management of transferred very preterm infants in the last two decades.
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Cavallin F, Doglioni N, Brombin L, Lolli E, Loddo C, Cavicchiolo ME, Mardegan V, Magarotto M, Mainini N, Nardo D, Peloso RL, Piva D, Priante E, Valerio E, Baraldi E, and Trevisanuto D
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- Continuous Positive Airway Pressure, Female, Humans, Infant, Infant, Extremely Low Birth Weight, Infant, Newborn, Infant, Premature, Pregnancy, Infant, Premature, Diseases, Pulmonary Surfactants therapeutic use, Respiratory Distress Syndrome, Newborn drug therapy
- Abstract
Background: Among infants needing urgent transfer after birth, very preterm infants are a high-risk sub-group requiring special attention. This study aimed to assess trends in early respiratory management in a large series of very preterm infants undergoing postnatal transfer., Methods: Trends in patient characteristics and early respiratory management were assessed in 798 very preterm infants who were transferred by the Eastern Veneto Neonatal Emergency Transport Service in 2000-2019. Trends were analyzed using joinpoint regression analysis and summarized as annual percentage changes (APCs)., Results: Proportion of neonates with birth weight less than 1 kg decreased from 33% to 16% (APC -3.82%). Use of nasal-continuous-positive-airway pressure increased (at call: APC 15.39%; during transfer: APC 15.60%), while use of self-inflating bag (at call: APC -12.09%), oxygen therapy (at call: APC -13.00%; during transfer: APC -23.77%) and mechanical ventilation (at call: APC -2.71%; during transfer: APC -2.99%) decreased. Use of oxygen concentrations at 21% increased (at call: APC 6.26%; during transfer: APC 7.14%), while oxygen concentrations above 40% decreased (at call: APC -5.73%; at transfer APC -8.89%). Surfactant administration at call increased (APC 3%-10%), while surfactant administration when arriving at referring hospital remained around 7-11% (APC 2.55%)., Conclusion: Relevant trends toward "gentle" approaches in early respiratory management of very preterm infants undergoing postnatal transfer occurred during the last twenty years. In addition, the proportion of transferred extremely low birth weight infants halved. Clinicians and stakeholders should consider such information when allocating assets to both hospitals and transfer services and planning regional perinatal programs., (© 2021 Wiley Periodicals LLC.)
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- 2021
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10. Untargeted and Targeted Metabolomic Profiling of Preterm Newborns with EarlyOnset Sepsis: A Case-Control Study.
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Mardegan V, Giordano G, Stocchero M, Pirillo P, Poloniato G, Donadel E, Salvadori S, Giaquinto C, Priante E, and Baraldi E
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Sepsis is a major concern in neonatology, but there are no reliable biomarkers for its early diagnosis. The aim of the study was to compare the metabolic profiles of plasma and urine samples collected at birth from preterm neonates with and without earlyonset sepsis (EOS) to identify metabolic perturbations that might orient the search for new early biomarkers. All preterm newborns admitted to the neonatal intensive care unit were eligible for this proof-of-concept, prospective case-control study. Infants were enrolled as "cases" if they developed EOS, and as "controls"if they did not. Plasma samples collected at birth and urine samples collected within 24 h of birth underwent untargeted and targeted metabolomic analysis using mass spectrometry coupled with ultra-performance liquid chromatography. Univariate and multivariate statistical analyses were applied. Of 123 eligible newborns, 15 developed EOS. These 15 newborns matched controls for gestational age and weight. Metabolomic analysis revealed evident clustering of the cases versus controls, with the glutathione and tryptophan metabolic pathways markedly disrupted in the former. In conclusion, neonates with EOS had a metabolic profile at birth that clearly distinguished them from those without sepsis, and metabolites of glutathione and tryptophan pathways are promising as new biomarkers of neonatal sepsis.
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- 2021
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11. Universal screening of high-risk neonates, parents, and staff at a neonatal intensive care unit during the SARS-CoV-2 pandemic.
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Cavicchiolo ME, Trevisanuto D, Lolli E, Mardegan V, Saieva AM, Franchin E, Plebani M, Donato D, and Baraldi E
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- COVID-19, Coronavirus Infections epidemiology, Female, Health Personnel statistics & numerical data, Humans, Infant, Newborn, Italy, Male, Pandemics prevention & control, Pandemics statistics & numerical data, Parents, Patient Isolation statistics & numerical data, Pneumonia, Viral epidemiology, Prevalence, Risk Assessment, Severe Acute Respiratory Syndrome diagnosis, Severe Acute Respiratory Syndrome epidemiology, Triage, Vulnerable Populations, Coronavirus Infections diagnosis, Disease Transmission, Infectious prevention & control, Infant, Premature, Infection Control methods, Intensive Care Units, Neonatal statistics & numerical data, Neonatal Screening methods, Pneumonia, Viral diagnosis
- Abstract
Since February 21, 2020, SARS-CoV-2 has spread exponentially worldwide. Neonatal patients needing intensive care are considered a vulnerable population. To report the results of a policy based on multi-timepoint surveillance for SARS-CoV-2 of all neonates admitted to the neonatal intensive care unit (NICU), their parents, and all healthcare providers in a part of Italy with a high prevalence of the infection. Observational study conducted from 21 February to 21 April 2020. Intervention consisted of (a) parental triage on arrival at the neonatal ward; (b) universal testing with nasopharyngeal swabs and blood testing for SARS-CoV-2 IgM and IgG antibodies; (c) use of continuous personal protective equipment at the NICU by parents and staff. A total of 6726 triage procedures were performed on 114 parents, and 954 nasopharyngeal swabs were collected from 226 individuals. Five (2.2%) asymptomatic individuals (2 parents and 3 healthcare providers) tested positive on nasopharyngeal swabs and were kept isolated for 14 days. Of 75 admitted newborn, no one tested positive on nasopharyngeal swabs or antibody tests. Three parents presented with fever or flu-like symptoms at triage; they tested negative on swabs.Conclusion: With universal screening of neonates, parents, and staff, there were no cases of SARS-CoV-2 infection among the neonates admitted to a NICU in an area with a high incidence of SARS-CoV-2. Our experience could be usefully compared with other strategies with a view to developing future evidence-based guidelines for managing high-risk neonates in case of new epidemics. What is Known: • The novel coronavirus named SARS-CoV-2 has since spread worldwide at a remarkable rate, with more than 2.5 million confirmed cases. • Pediatric population may be less affected from COVID-19 than adult population but infants and newborn babies seem to be more vulnerable to SARS-CoV-2 infection. What is New: • Using an approach based on triage; testing with nasopharyngeal swabs and serology; and use of personal protective equipment, there were no cases of SARS-CoV-2 infection among neonates in a NICU in a high incidence of SARS-CoV-2 area. • Positive and asymptomatic individuals were identified and isolated early allowing the containment of infection's spread among healthcare providers and parents.
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- 2020
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12. Intrauterine Growth Restriction: New Insight from the Metabolomic Approach.
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Priante E, Verlato G, Giordano G, Stocchero M, Visentin S, Mardegan V, and Baraldi E
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Recognizing intrauterine growth restriction (IUGR) is a matter of great concern because this condition can significantly affect the newborn's short- and long-term health. Ever since the first suggestion of the "thrifty phenotype hypothesis" in the last decade of the 20th century, a number of studies have confirmed the association between low birth weight and cardiometabolic syndrome later in life. During intrauterine life, the growth-restricted fetus makes a number of hemodynamic, metabolic, and hormonal adjustments to cope with the adverse uterine environment, and these changes may become permanent and irreversible. Despite advances in our knowledge of IUGR newborns, biomarkers capable of identifying this condition early on, and stratifying its severity both pre- and postnatally, are still lacking. We are also still unsure about these babies' trajectory of postnatal growth and their specific nutritional requirements with a view to preventing, or at least limiting, long-term complications. In this setting, untargeted metabolomics-a relatively new field of '-omics' research-can be a good way to investigate the metabolic perturbations typically associated with IUGR. The aim of this narrative review is to provide a general overview of the pathophysiological and clinical aspects of IUGR, focusing on evidence emerging from metabolomic studies. Though still only preliminary, the reports emerging so far suggest an "early" pattern of glucose intolerance, insulin resistance, catabolite accumulation, and altered amino acid metabolism in IUGR neonates. Further, larger studies are needed to confirm these results and judge their applicability to clinical practice.
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- 2019
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13. Restricted Palivizumab Recommendations and the Impact on RSV Hospitalizations among Infants Born at > 29 Weeks of Gestational Age: An Italian Multicenter Study.
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Priante E, Tavella E, Girardi E, Militello MA, Mardegan V, Maule MM, Dall'Agnola A, Baraldi E, and Manzoni P
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- Eligibility Determination, Gestational Age, Humans, Incidence, Infant, Newborn, Infant, Premature, Infant, Premature, Diseases epidemiology, Insurance, Pharmaceutical Services, Italy epidemiology, Respiratory Syncytial Virus Infections epidemiology, Retrospective Studies, Seasons, Antiviral Agents therapeutic use, Health Services Accessibility, Hospitalization statistics & numerical data, Infant, Premature, Diseases drug therapy, Palivizumab therapeutic use, Respiratory Syncytial Virus Infections drug therapy
- Abstract
Objective: Premature infants have the highest risk of being hospitalized with respiratory syncytial virus (RSV) infections. Palivizumab is the only licensed agent for RSVhospitalization (RSVH) prophylaxis in infants born at < 35 weeks of gestational age (wGA). In 2016, the Italian Drug Agency (Agenzia Italiana del Farmaco [AIFA]) has restricted the eligibility for reimbursement to infants at high risk of RSVH, ruling out palivizumab administration for infants born at > 29 wGA. The aim of the present study was to compare the incidence of RSVH in two consecutive epidemic seasons (2015-2016 vs. 2016-2017), that is, before and after the new AIFA recommendations on palivizumab eligibility., Study Design: This was a noninterventional retrospective cohort study conducted at three neonatal intensive care units (NICUs) in northern Italy. Infants born at 29 and 35 wGA between March 15, 2015 and March 14, 2017 were enrolled for this study. Electronic medical charts were reviewed and parents were interviewed by telephone. Data were collected on neonatal course during NICU stay, palivizumab administration, and hospitalizations related to respiratory infections during the 1st year of life, comparing the infants born in season 1 with season 2., Results: Of 632 eligible infants, data were available for 536 (262 in season 1 and 274 in season 2). Overall, RSVH occurred 1.9 and 5.1% in infants in seasons 1 and 2, respectively (odds ratio [OR] = 2.77; 95% confidence interval [CI]: 0.98-7.8, p = 0.045). When the analysis was limited to patients not exposed to palivizumab, RSVHs were recorded for 1.8 and 5.9% infants in seasons 1 and 2, respectively (OR = 3.42; 95% CI: 0.96-12.20, p = 0.045). It is noteworthy that the incidence of hospital admissions for respiratory viruses other than RSV did not differ between the two seasons., Conclusion: Restricting eligibility for palivizumab reimbursement led to a significant increase in RSVH but had no impact on hospitalizations for other respiratory viruses. Future decisions on palivizumab prescription and coverage rules should be driven by a careful assessment of the cost-benefit ratio., Competing Interests: P.M. received speaker fees from Abbvie, Janssen; advisory board fees from Abbvie, Sanofi-Pasteur, Janssen, Medimmune; he is founding member of Respiratory Syncytial Virus Network (ReSViNET) Foundation. E.B. received speaker fees from Abbvie, GSK, Janssen; he is founding member of Respiratory Syncytial Virus Network (ReSViNET) Foundation. All the other authors have nothing to disclose related to this article., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)
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- 2019
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14. Performances of low level hospital health caregivers after a neonatal resuscitation course.
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De Bernardo G, Sordino D, Cavallin F, Mardegan V, Doglioni N, Tataranno ML, and Trevisanuto D
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- Female, Humans, Infant, Newborn, Inservice Training, Italy, Male, Manikins, Clinical Competence, Medical Staff, Hospital education, Pediatric Nursing education, Resuscitation education
- Abstract
Background: High fidelity simulation has been executed to allow the evaluation of technical and non-technical skills of health caregivers. Our objective was to assess technical and non-technical performances of low level hospitals health caregivers who attended a Neonatal Resuscitation course using high fidelity simulation in a standard-setting scenario., Methods: Twenty-three volunteers were asked to manage a simple scenario (infant with secondary apnea) after the course. Technical and non-technical skills were assessed by using previously published scores. Performances were assessed during the scenario and after 2 months by filmed video recordings., Results: Sixteen (69.5%) participants failed to pass the minimum required technical score. Staff experience and participation in previous courses were associated to higher score in technical and non-technical skills, while working in level I or II hospitals did not affect the scores. Previous experience in neonatal resuscitation requiring positive pressure ventilation was associated to better non-technical performance. Technical and non-technical scores were significantly correlated (r = 0.67, p = 0.0005). Delayed and direct evaluation of technical skills provided the same scores., Conclusions: A neonatal resuscitation course, performed by using a high fidelity simulation manikin, had a limited impact on technical and non-technical skills of participants working in low level hospitals. Training programs should be tailored to the participants' professional background and to the more relevant sessions.
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- 2016
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15. Respiratory Outcome after Preterm Birth: A Long and Difficult Journey.
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Priante E, Moschino L, Mardegan V, Manzoni P, Salvadori S, and Baraldi E
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- Gestational Age, Humans, Infant, Newborn, Lung diagnostic imaging, Radiography, Thoracic, Respiratory Function Tests, Respiratory Sounds physiopathology, Tomography, X-Ray Computed, Bronchopulmonary Dysplasia epidemiology, Infant, Premature, Lung physiopathology
- Abstract
Despite notable advances in the survival and management of preterm infants in recent decades, chronic lung disease remains a common complication. Approximately one in three infants born preterm (< 32 weeks of gestation) are hospitalized with respiratory problems (mainly due to infections) in their first 2 years of life, and the risk of childhood wheezing is three times higher in this population. By comparison with infants born at term, there seems to be a higher incidence of respiratory morbidity in those born preterm, even in the absence of bronchopulmonary dysplasia (BPD) and in late-preterm babies. Although long-term follow-up data are still not collected systematically, there is evidence of preterm infants' respiratory symptoms, lung function impairments, and radiological abnormalities, tending to persist throughout childhood and into early adulthood. Respiratory conditions associated with preterm birth are often diagnosed and treated as asthma, but the pathophysiological patterns of BPD and asthma are very different. Future research should focus on characterizing preterm infants' pathological pulmonary features by gestational age at birth, and presence or absence of BPD. Improving our current knowledge of the respiratory disorder associated with prematurity might hopefully prompt targeted follow-up protocols, and novel prevention strategies and treatment approaches., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)
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- 2016
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16. Heated, Humidified High-Flow Nasal Cannulae as a Form of Noninvasive Respiratory Support for Preterm Infants and Children with Acute Respiratory Failure.
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Mardegan V, Priante E, Lolli E, Lago P, and Baraldi E
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- Child, Humans, Humidity, Infant, Infant, Newborn, Infant, Premature, Intensive Care Units, Neonatal, Noninvasive Ventilation methods, Pediatrics, Randomized Controlled Trials as Topic, Temperature, Cannula, Noninvasive Ventilation instrumentation, Respiratory Distress Syndrome, Newborn therapy, Respiratory Insufficiency therapy
- Abstract
Heated, humidified high-flow delivered by nasal cannulae (HHHFNC) is increasingly used for noninvasive respiratory support in preterm infants and critically ill children due to its perceived effectiveness and ease of use. Evidence from randomized controlled trials suggests that HHHFNC and continuous positive airway pressure (CPAP) are equally effective as postextubation support in preterm infants. HHHFNC is also used for weaning preterm infants from CPAP. Data on HHHFNC used as the primary support for treating respiratory distress syndrome are conflicting. HHHFNC use in preterm infants is associated with reduced nasal trauma. Inability to measure the pressure generated by HHHFNC systems is a concern because overexpansion can lead to an air leak and lung injury. Great caution is warranted when HHHFNC is used in extremely low-birth-weight infants (who were rarely included in these randomized controlled trials) because a recent retrospective study found its use is associated with a higher likelihood of bronchopulmonary dysplasia or death in this population. HHHFNC has also become popular in pediatric intensive care units and pediatric wards as a method for delivering oxygen and noninvasive respiratory support. Most published studies were conducted on infants and young children with bronchiolitis. The results of a few observational studies and two randomized trials suggest that HHHFNC therapy is effective in the treatment of bronchiolitis. This review discusses the proposed mechanisms of action behind HHHFNC, the results of observational studies, and the evidence emerging from clinical trials on the use of HHHFNC in preterm infants and children critically ill with bronchiolitis., (Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.)
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- 2016
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17. Perinatal zinc deficiency.
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Valerio E, Rotella M, Mardegan V, and Cutrone M
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- Dermatitis etiology, Female, Humans, Infant, Newborn, Infant, Premature, Pregnancy, Zinc deficiency
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- 2016
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18. Delivery room management of extremely low birth weight infants in Italy: comparison between academic and non-academic birth centres.
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Mardegan V, Satariano I, Doglioni N, Criscoli G, Cavallin F, Gizzi C, Martano C, Ciralli F, Torielli F, Villani PE, Di Fabio S, Quartulli L, Giannini L, and Trevisanuto D
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- Body Temperature, Female, Humans, Infant, Newborn, Intensive Care, Neonatal standards, Italy, Practice Guidelines as Topic, Pregnancy, Resuscitation methods, Resuscitation standards, Surveys and Questionnaires, Academic Medical Centers, Birthing Centers standards, Delivery Rooms, Delivery, Obstetric methods, Infant, Extremely Low Birth Weight, Intensive Care, Neonatal methods
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Objective: International Guidelines provide a standardised approach to newborn resuscitation in the DR and, in their most recent versions, recommendations dedicated to management of ELBWI were progressively increased. It is expected that introduction in clinical practice and dissemination of the most recent evidence should be more consistent in academic than in non-academic hospitals. The aim of the study was to compare adherence to the International Guidelines and consistency of practice in delivery room management of extremely low birth weight infants between academic and non-academic institutions., Methods: A questionnaire was sent to the directors of all Italian level III centres between April and August 2012., Results: There was a 92% (n = 98/107) response rate. Apart from polyethylene wrapping to optimise thermal control, perinatal management approach was comparable between academic and non-academic centres., Conclusions: There were minor differences in management of extremely low birth weight infants between Italian academic and non-academic institutions, apart from thermal management. Although there was a good, overall adherence to the International Guidelines for Neonatal Resuscitation, temperature management was not in accordance with official recommendations and every effort has to be done to improve this aspect.
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- 2016
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19. Measurements from preterm infants to guide face mask size.
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Mardegan V, Doglioni N, and Trevisanuto D
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- Humans, Infant, Newborn, Infant, Premature, Masks
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- 2015
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20. Kasabach-Merritt phenomenon in a neonatal kaposiform haemangioendothelioma.
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Mardegan V, Doglioni N, De Bernardo G, and Trevisanuto D
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- Biopsy, Diagnosis, Differential, Female, Hemangioendothelioma diagnosis, Humans, Infant, Newborn, Kasabach-Merritt Syndrome diagnosis, Magnetic Resonance Imaging, Soft Tissue Neoplasms diagnosis, Tomography, X-Ray Computed, Hemangioendothelioma complications, Kasabach-Merritt Syndrome etiology, Soft Tissue Neoplasms complications
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- 2014
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21. Total body polyethylene wraps for preventing hypothermia in preterm infants: a randomized trial.
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Doglioni N, Cavallin F, Mardegan V, Palatron S, Filippone M, Vecchiato L, Bellettato M, Chiandetti L, and Trevisanuto D
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- Body Temperature, Female, Humans, Infant, Newborn, Infant, Premature, Intensive Care Units, Neonatal, Italy, Male, Prospective Studies, Treatment Outcome, Bandages, Body Temperature Regulation, Hypothermia prevention & control, Infant, Premature, Diseases prevention & control, Polyethylene, Rewarming methods
- Abstract
Objective: To evaluate whether a polyethylene total body wrapping (covering both the body and head) is more effective than conventional treatment (covering up to the shoulders) in reducing perinatal thermal losses in very preterm infants., Study Design: This was a multicenter, prospective, randomized, parallel 1:1, unblinded, controlled trial of infants<29 weeks' gestation age, comprising two study groups: experimental group (total body group; both the body and head covered with a polyethylene occlusive bag, with the face uncovered) and control group (only the body, up to the shoulders, covered with a polyethylene occlusive bag). The primary outcome was axillary temperature on neonatal intensive care unit admission immediately after wrap removal., Results: One hundred randomly allocated infants (50 in the total body group and 50 controls) completed the study. Mean axillary temperature on neonatal intensive care unit admission was similar in the two groups (36.5±0.6°C total body vs 36.4±0.8°C controls; P=.53). The rate of moderate hypothermia (temperature<36°C) was 12% in the total body group and 20% in the control group (P=.41). Three subjects in each group (6.0%) had an axillary temperature>37.5°C on admission, and one subject in control group had an axillary temperature>38°C., Conclusion: Total body wrapping is comparable with covering the body up to the shoulders in preventing postnatal thermal losses in very preterm infants., (Copyright © 2014 Elsevier Inc. All rights reserved.)
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- 2014
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22. LMA Supreme for neonatal resuscitation: study protocol for a randomized controlled trial.
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Trevisanuto D, Cavallin F, Mardegan V, Loi NN, Tien NV, Linh TD, Chien TD, Doglioni N, Chiandetti L, and Moccia L
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- Humans, Infant, Newborn, Outcome Assessment, Health Care, Practice Guidelines as Topic, Prospective Studies, Clinical Protocols, Laryngeal Masks, Resuscitation
- Abstract
Background: The most important action in the resuscitation of a newborn in the delivery room is to establish effective assisted ventilation. The face mask and endotracheal tube are the devices used to achieve this goal. Laryngeal mask airways that fit over the laryngeal inlet have been shown to be effective for ventilating newborns at birth and should be considered as an alternative to facemask ventilation or endotracheal intubation among newborns weighing >2,000 g or delivered ≥34 weeks' gestation. A recent systematic review and meta-analysis of supraglottic airways in neonatal resuscitation reported the results of four randomized controlled trials (RCTs) stating that fewer infants in the group using laryngeal mask airways required endotracheal intubation (1.5%) compared to the group using face masks (12.0%). However, there were methodological concerns over all the RCTs including the fact that the majority of the operators in the trials were anesthesiologists.Our hypothesis is based on the assumption that ventilating newborns needing positive pressure ventilation with a laryngeal mask airway will be more effective than ventilating with a face mask in a setting where neonatal resuscitation is performed by midwives, nurses, and pediatricians. The primary aim of this study will be to assess the effectiveness of the laryngeal mask airway over the face mask in preventing the need for endotracheal intubation., Methods/design: This will be an open, prospective, randomized, single center, clinical trial. In this study, 142 newborns weighing >1,500 g or delivered ≥34 weeks gestation needing positive pressure ventilation at birth will be randomized to be ventilated with a laryngeal mask airway (LMA SupremeTM, LMA Company, UK - intervention group) or with a face mask (control group)., Primary Outcome: Proportion of newborns needing endotracheal intubation., Secondary Outcomes: Apgar score at 5 minutes, time to first breath, onset of the first cry, duration of resuscitation, death or moderate to severe hypoxic-ischemic encephalopathy within 7 days of life., Trial Registration: ClinicalTrials.gov identifier: NCT01963936 (October 11, 2013).
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- 2014
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23. Reflex anal dilatation: An observational study on non-abused children.
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Sfriso F, Masiero S, Mardegan V, Bressan S, and Aprile A
- Subjects
- Child, Child, Preschool, Dilatation, Pathologic, Female, Forensic Medicine, Humans, Infant, Male, Physical Examination, Prospective Studies, Sampling Studies, Anal Canal physiology, Muscle Relaxation physiology, Reflex physiology
- Abstract
Objectives: Reflex anal dilatation (RAD) is considered as a possible sign of anal abuse,however studies evaluating its prevalence in non-abused children are limited. The aim of this study was to evaluate the prevalence of RAD in a convenience sample of children with no suspicion of abuse admitted to a Pediatric Emergency Department (PED)., Methods: Prospective observational study including children admitted to the PED of Padova, Italy, between January and June 2011. Patients with no suspicion of abuse and for whom ano-genital examination was part of their medical evaluation were included. Children were excluded if in critical clinical conditions or if any suspicion of abuse arose during medical evaluation. Presence/absence of RAD and of factors favoring its appearance were recorded for each patient., Results: Two-hundred and thirty children (median age of 12 months, interquartile range 5-35 months) were finally included. A positive RAD was reported in 14 (6.1%, CI 95% 3.4-10). Only 3 patients (1.3%, CI 95% 0.3-3.7) showed a positive RAD in the absence of any predisposing factor., Conclusions: RAD is an infrequent sign in non-abused children and it is particularly rare in the absence of any predisposing factor. Case-control studies are necessary to better clarify its diagnostic relevance., (Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.)
- Published
- 2014
- Full Text
- View/download PDF
24. Cerebriform nevus sebaceous in a neonate.
- Author
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Valerio E, Mardegan V, Zanella C, Gaio P, and Cutrone M
- Subjects
- Humans, Infant, Newborn, Nevus, Pigmented pathology, Scalp pathology, Sebaceous Gland Neoplasms pathology
- Published
- 2014
- Full Text
- View/download PDF
25. Lower target oxygen saturation levels in preterm infants are associated with increased mortality and decreased rates of retinopathy of prematurity.
- Author
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Trevisanuto D and Mardegan V
- Subjects
- Female, Humans, Male, Infant, Extremely Premature blood, Infant, Premature, Diseases mortality, Oxygen blood, Oxygen Inhalation Therapy methods, Retinopathy of Prematurity prevention & control
- Published
- 2014
- Full Text
- View/download PDF
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