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7. Updated Italian recommendations for the diagnosis, treatment and follow-up of the first febrile urinary tract infection in young children

Author

Ammenti, A, Alberici, I, Brugnara, M, Chimenz, R, Guarino, S, La Manna, A, La Scola, C, Maringhini, S, Marra, G, Materassi, M, Morello, W, Nicolini, G, Pennesi, M, Pisanello, L, Pugliese, F, Scozzola, F, Sica, F, Toffolo, A, Montini, G, Ammenti, Anita, Alberici, Irene, Brugnara, Milena, Chimenz, Roberto, Guarino, Stefano, La Manna, Angela, La Scola, Claudio, Maringhini, Silvio, Marra, Giuseppina, Materassi, Marco, Morello, William, Nicolini, Giangiacomo, Pennesi, Marco, Pisanello, Lorena, Pugliese, Fabrizio, Scozzola, Floriana, Sica, Felice, Toffolo, Antonella, Montini, Giovanni, Ammenti, A, Alberici, I, Brugnara, M, Chimenz, R, Guarino, S, La Manna, A, La Scola, C, Maringhini, S, Marra, G, Materassi, M, Morello, W, Nicolini, G, Pennesi, M, Pisanello, L, Pugliese, F, Scozzola, F, Sica, F, Toffolo, A, Montini, G, Ammenti, Anita, Alberici, Irene, Brugnara, Milena, Chimenz, Roberto, Guarino, Stefano, La Manna, Angela, La Scola, Claudio, Maringhini, Silvio, Marra, Giuseppina, Materassi, Marco, Morello, William, Nicolini, Giangiacomo, Pennesi, Marco, Pisanello, Lorena, Pugliese, Fabrizio, Scozzola, Floriana, Sica, Felice, Toffolo, Antonella, and Montini, Giovanni

Abstract

Aim: Our aim was to update the recommendations for the diagnosis, treatment and follow-up of the first febrile urinary tract infection in young children, which were endorsed in 2012 by the Italian Society of Pediatric Nephrology. Methods: The Italian recommendations were revised on the basis of a review of the literature published from 2012 to October 2018. We also carried out an ad hoc evaluation of the risk factors to identify children with high-grade vesicoureteral reflux or renal scarring, which were published in the previous recommendations. When evidence was not available, the working group held extensive discussions, during various meetings and through email exchanges. Results: Four major modifications have been introduced. The method for collecting urine for culture and its interpretation has been re-evaluated. We have reformulated the algorithm that guides clinical decisions to proceed with voiding cystourethrography. The suggested antibiotics have been revised, and we have recommended further restrictions of the use of antibiotic prophylaxis. Conclusion: These updated recommendations have now been endorsed by the Italian Society of Pediatric Nephrology and the Italian Society for Pediatric Infectivology. They can also be used to compare other recommendations that are available, as a worldwide consensus in this area is still lacking

Published
2019

9. P2697Percutaneous coronary intervention with 2nd generation drug eluting stent versus coronary artery bypass grafting in patients with unprotected left main disease: clinical outcome from a referral center

Author

Scudiero, F, primary, Migliorini, A, additional, Stefano, P L, additional, Marcucci, R, additional, Pennesi, M, additional, Carrabba, N, additional, Muraca, I, additional, Vitale, R, additional, Marchionni, N, additional, and Valenti, R, additional

Published
2019
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11. Antibiotic prophylaxis for urinary tract infection-related renal scarring: A systematic review

Author

Hewitt, I, Pennesi, M, Morello, W, Ronfani, L, Montini, G, Hewitt, Ian K., Pennesi, Marco, Morello, William, Ronfani, Luca, Montini, Giovanni, Hewitt, I, Pennesi, M, Morello, W, Ronfani, L, Montini, G, Hewitt, Ian K., Pennesi, Marco, Morello, William, Ronfani, Luca, and Montini, Giovanni

Abstract

CONTEXT: Acute pyelonephritis may result in renal scarring. Recent prospective studies have shown a small benefit of antibiotic prophylaxis in preventing symptomatic and febrile urinary tract infections (UTIs), while being underpowered to detect any influence in prevention of renal damage. OBJECTIVES: Review of the literature and a meta-analysis to evaluate the effect of antibiotic prophylaxis on UTI-related renal scarring. DATA SOURCES: Medline, Embase, and Cochrane Controlled Trials Register electronic databases were searched for studies published in any language and bibliographies of identified prospective randomized controlled trials (RCTs) performed and published between 1946 and August 2016. STUDY SELECTION: Subjects 18 years of age or younger with symptomatic or febrile UTIs, enrolled in prospective RCTs of antibiotic prophylaxis where 99mTc dimercaptosuccinic acid scans were performed at entry into the study and at late follow-up to detect new scar formation. DATA EXTRACTION: The literature search, study characteristics, inclusion and exclusion criteria, and risk of bias assessment were independently evaluated by 2 authors. RESULTS: Seven RCTs (1427 subjects) were included in the meta-analysis. Our results show no influence of antibiotic prophylaxis in preventing renal scarring (pooled risk ratio, 0.83; 95% confidence interval, 0.55-1.26) as did a subanalysis restricted to those subjects with vesicoureteral reflux (pooled risk ratio, 0.79; 95% confidence interval, 0.51-1.24). LIMITATIONS: Limitations include the small number of studies, short duration of follow-up, and insufficient children with high-grade dilating reflux and/or renal dysplasia enrolled in the studies. CONCLUSIONS: Antibiotic prophylaxis is not indicated for the prevention of renal scarring after a first or second symptomatic or febrile UTI in otherwise healthy children.

Published
2017

12. First urinary tract infections in children: the role of the risk factors proposed by the Italian recommendations.

Author

Alberici, I, La Manna, A, Pennesi, M, Starc, M, Scozzola, F, Nicolini, G, Toffolo, A, Marra, G, Chimenz, R, Sica, F, Maringhini, S, Monasta, L, and Montini, G

Subjects
URINARY tract infections, CHILD behavior, DISEASE risk factors, VESICO-ureteral reflux, MULTIVARIATE analysis, MEDICAL protocols, NEPHROLOGY, RETROSPECTIVE studies, DISEASE complications
Abstract

Aim: In 2009, the Italian society for paediatric nephrology suggested the need for cystography, following a first febrile urinary tract infection (UTI), only in children at high risk for dilating vesicoureteral reflux or in the event of a second infection. The aim of this study was to evaluate the adequacy of the risk factors proposed by the Italian guidelines.Methods: Children aged 2-36 months, managed by 10 Italian hospitals between 2009 and 2013, with a first febrile UTI were retrospectively evaluated.Results: Four hundred and fourteen children were included: 51% female, mean age eight months. Escherichia coli was responsible of 84% UTIs. 269 children (65%) presented at least one risk factor, thus were further investigated: 44% had a reflux. The presence of a pathogen other than E. coli significantly predicted high-grade reflux, both in the univariate (Odd Ratio 2.52, 95% Confidence Interval 1.32-4.81, p < 0.005) and multivariate analysis (OR 2.74, 95% CI: 1.39-5.41, p: 0.003). 26/145 children (18%) with no risk factors experienced a second UTI, which prompted the execution of cystography, showing a dilating reflux in 11.Conclusion: Among the risk factors proposed by the Italian guidelines, only the presence of a pathogen other than E. coli significantly predicted reflux. Cystography can be postponed in children with no risk factors. [ABSTRACT FROM AUTHOR]

Published
2019
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13. Shiga Toxin–Producing Escherichia coli Infections Associated with Hemolytic Uremic Syndrome, Italy, 1988–2000

Author

Tozzi, A. E., Caprioli, A., Minelli, F., Gianviti, A., Petris, L., Edefonti, A., Giovanni Montini, Ferretti, A., Palo, T., Gaido, M., Rizzoni, G., Bettinelli, A., Capasso, G., Caringella, A., Coppo, R., Lama, G., Li Volti, S., Maffei, S., Maringhini, S., Miglietti, N., Pecoraro, C., Pela, I., Pennesi, M., Penza, R., Peratoner, L., Perfumo, F., Ratsche, I., Salvaggio, E., Setzu, C., Zacchello, G., Tozzi, Ae, Caprioli, A, Minelli, F, Gianviti, A, De Petris, L, Edefonti, A, Montini, G, Ferretti, A, De Palo, T, Gaido, M, Rizzoni, G, A., Bettinelli, Capasso, Giovambattista, Caringella, A, Coppo, R, Lama, G, Li Volti, S, Maffei, S, Maringhini, S, Miglietti, N, Pecoraro, C, Pela, I, Pennesi, M, Penza, R, Peratoner, L, Perfumo, F, Ratsche, I, Salvaggio, E, Setzu, C, and Zacchello, G.

Subjects
Microbiology (medical), Serotype, Adolescent, Population, lcsh:Medicine, Escherichia coli O157, medicine.disease_cause, Annual incidence, Shiga Toxin, Microbiology, lcsh:Infectious and parasitic diseases, fluids and secretions, Shiga toxin-producing Escherichia coli, Escherichia coli, Humans, Medicine, HUS, lcsh:RC109-216, Serotyping, education, Escherichia coli Infections, laboratory diagnosis, education.field_of_study, biology, business.industry, Research, Incidence, Incidence (epidemiology), lcsh:R, Shiga toxin, Virology, STEC, Infectious Diseases, Italy, Child, Preschool, Population Surveillance, Hemolytic-Uremic Syndrome, biology.protein, hemolytic uremic syndrome, bacteria, epidemiology, business
Abstract

The mean annual incidence of hemolytic uremic syndrome in persons

Published
2003

14. Prospective and sequential study to establish the efficacy of rituximab therapy in maintaining remission of nephritic syndrome in patients with nephropathy at minimal injury or steroid-dependent, recurrent focal segmental glomerulosclerosis (NEMO)

Author

Abbate, M., Giuseppe Remuzzi, Coppo, R., Pennesi, M., Carraro, M., Emma, F., Pecoraro, C., Pisani, A., Capasso, G., Abbate, M., Remuzzi, G., Coppo, R., Pennesi, M., Carraro, M., Emma, F., Pecoraro, C., Pisani, Antonio, Capasso, G., Carraro, Michele, and Pisani, M.

Subjects
drug efficacy, rituximab, steroid
Abstract

No avaible

Published
2010

16. Is antibiotic prophylaxis in children with vesicoureteral reflux effective in preventing pyelonephritis and renal scars? A randomized, controlled trial

Author

PENNESI M, TRAVAN L, PERATONER L, BORDUGO A, CATTANEO A, RONFANI L, MINISINI S, NORTH EAST ITALY PROPHYLAXIS IN VUR STUDY GROUP, VENTURA, ALESSANDRO, Pennesi, M, Travan, L, Peratoner, L, Bordugo, A, Cattaneo, A, Ronfani, L, Minisini, S, Ventura, Alessandro, and NORTH EAST ITALY PROPHYLAXIS IN VUR STUDY, Group

Subjects
Male, Vesico-Ureteral Reflux, Pyelonephritis, Anti-Infective Agents, Urinary, Infant, vesicoureteral reflux, controlled trial, randomized, Anti-Bacterial Agents, Cicatrix, Child, Preschool, Pediatrics, Perinatology and Child Health, Trimethoprim, Sulfamethoxazole Drug Combination, Humans, Female, Kidney Diseases
Abstract

OBJECTIVES. There has been intense discussion on the effectiveness of continuous antibiotic prophylaxis for children with vesicoureteral reflux, and randomized, controlled trials are still needed to determine the effectiveness of long-term antibiotics for the prevention of acute pyelonephritis. In this multicenter, open-label, randomized, controlled trial, we tested the effectiveness of antibiotic prophylaxis in preventing recurrence of pyelonephritis and avoiding new scars in a sample of children who were younger than 30 months and vesicoureteral reflux. METHODS. One hundred patients with vesicoureteral reflux (grade II, III, or IV) diagnosed with cystourethrography after a first episode of acute pyelonephritis were randomly assigned to receive antibiotic prophylaxis with sulfamethoxazole/trimethoprim or not for 2 years. The main outcome of the study was the recurrence of pyelonephritis during a follow-up period of 4 years. During follow-up, the patients were evaluated through repeated cystourethrographies, renal ultrasounds, and dimercaptosuccinic acid scans. RESULTS. The baseline characteristics in the 2 study groups were similar. There were no differences in the risk for having at least 1 pyelonephritis episode between the intervention and control groups. At the end of follow-up, the presence of renal scars was the same in children with and without antibiotic prophylaxis. CONCLUSIONS. Continuous antibiotic prophylaxis was ineffective in reducing the rate of pyelonephritis recurrence and the incidence of renal damage in children who were younger than 30 months and had vesicoureteral reflux grades II through IV.

Published
2008

18. Unità di sedazione pediatrica: Per procedure diagnostiche dolorose

Author

Barbi, E., Pennesi, M., Sarti, A., Bruno, I., Neri, E., Pahor, T., Torre, G., Martelossi, S., Tamaro, P., Rabusin, M., BALSEMIN, FULVIA, FILAFERRO, MANUELA, Ventura, A., Barbi, E., Pennesi, M., Sarti, A., Bruno, I., Neri, E., Pahor, T., Torre, G., Martelossi, S., Tamaro, P., Rabusin, M., Balsemin, Fulvia, Filaferro, Manuela, and Ventura, A.

Subjects
Biopsies, Diagnostic procedures, Biopsie, Sedation, Pediatrics, Perinatology and Child Health, Propofol, Perinatology and Child Health, Diagnostic procedure, Pediatrics
Abstract

Particularly in tertiary care centres, there is an increased need for diagnostic procedures, such as CT scans, magnetic resonance, endoscopies, lumbar punctures, biopsies, etc., which require different degrees of anesthesia and/or sedation of the child to ensure safety and performance and to avoid unnecessary pain and discomfort. The limited availability of anestesiologists often represents a problem, leading to unnecessary waiting time. For this reason paediatricians and nurses with specific training in intensive care are increasingly involved in providing sedation for diagnostic procedures. Safety concerns have been voiced and discussed about the use of a variety of drugs and procedures. The Authors report their one-year experience in a tertiary care paediatric hospital regarding in-ward sedation for non invasive (such as diagnostic imaging) or moderately invasive (such as endoscopies and biopsies) procedures. Propofol was used for moderately invasive procedures. A small task force (2 paediatrician and 2 nurses) was established to ensure continuity and good performance. The experience has been satisfactory in terms of efficacy, safety and cost and has been positively evaluated by both patients and health professionals.

Published
2001

20. CANCERIZATION OF CUTANEOUS FLAP RECONSTRUCTION FOR ORALSQUAMOUS CARCINOMA: THREE CASES STUDIED WITH THE MTDNA-LOOP SEQUENCE ANALYSIS

Author

FARNEDI, ANNA, MARUCCI, GIANLUCA, MARCHETTI, CLAUDIO, MORANDI, LUCA, BADIALI, GIOVANNI, MONTEBUGNOLI, LUCIO, FOSCHINI, MARIA PIA, Cocchi R., Pennesi M. G., EUSEBI, LEONARDO HENRY UMBERTO, POLI TITO, Farnedi A., Marucci G., Marchetti C., Morandi L., Cocchi R., Badiali G., Montebugnoli L., Pennesi M.G., Eusebi L.H., and Foschini M.P.

Subjects
ORAL CANCER, FLAP CANCERIZATION, MTDNA-LOOP
Published
2011

23. Prevalence of coeliac disease in patients with juvenile chronic arthritis

Author

Lepore, L, Martelossi, S, Pennesi, M, Falcini, F, Ermini, El, Ferrari, R, Perticarari, S, Presani, G, Lucchesi, A, Ventura, Alessandro, Lepore, L, Martelossi, S, Pennesi, M, Falcini, F, Ermini, El, Ferrari, R, Perticarari, S, Presani, G, Lucchesi, A, and Ventura, Alessandro

Abstract

J PEDIATR

Published
1996

29. Pediatric nephrology

Author

van Stralen, K., primary, Krischock, L., additional, Schaefer, F., additional, Verrina, E., additional, Groothoff, J., additional, Jager, K., additional, Tizard, J., additional, Harambat, J., additional, van Stralen, K. J., additional, Espinosa, L., additional, Groothoff, J. W., additional, Hulton, S. A., additional, Jankauskiene, A., additional, Jager, K. J., additional, Cochat, P., additional, Ruggiero, B., additional, Gianviti, A., additional, Benetti, E., additional, Peruzzi, L., additional, Barbano, G. C., additional, Corona, F., additional, Ventura, G., additional, Pecoraro, C., additional, Murer, L., additional, Ghiggeri, G. M., additional, Pennesi, M., additional, Edefonti, A., additional, Coppo, R., additional, Emma, F., additional, Bonthuis, M., additional, Musumeci, A., additional, Graziano, U., additional, Nuzzi, F., additional, Ferraiuolo, S., additional, Severino, G., additional, Malgieri, G., additional, and Minale, B., additional

Published
2011
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37. Gene Editing for CEP290-Associated Retinal Degeneration.

Author

Pierce, E. A., Aleman, T. S., Jayasundera, K. T., Ashimatey, B. S., Kim, K., Rashid, A., Jaskolka, M. C., Myers, R. L., Lam, B. L., Bailey, S. T., Comander, J. I., Lauer, A. K., Maguire, A. M., and Pennesi, M. E.

Subjects
*CRISPRS, *RETINAL degeneration, *GENOME editing, *POISONS, *VISION
Abstract

BACKGROUND: CEP290-associated inherited retinal degeneration causes severe early-onset vision loss due to pathogenic variants in CEP290. EDIT-101 is a clustered regularly interspaced short palindromic repeats (CRISPR)-CRISPR-associated protein 9 (Cas9) gene-editing complex designed to treat inherited retinal degeneration caused by a specific damaging variant in intron 26 of CEP290 (IVS26 variant). METHODS: We performed a phase 1-2, open-label, single-ascending-dose study in which persons 3 years of age or older with CEP290-associated inherited retinal degeneration caused by a homozygous or compound heterozygous IVS26 variant received a subretinal injection of EDIT-101 in the worse (study) eye. The primary outcome was safety, which included adverse events and dose-limiting toxic effects. Key secondary efficacy outcomes were the change from baseline in the best corrected visual acuity, the retinal sensitivity detected with the use of full-field stimulus testing (FST), the score on the Ora-Visual Navigation Challenge mobility test, and the vision-related quality-of-life score on the National Eye Institute Visual Function Questionnaire-25 (in adults) or the Children's Visual Function Questionnaire (in children). RESULTS: EDIT-101 was injected in 12 adults 17 to 63 years of age (median, 37 years) at a low dose (in 2 participants), an intermediate dose (in 5), or a high dose (in 5) and in 2 children 9 and 14 years of age at the intermediate dose. At baseline, the median best corrected visual acuity in the study eye was 2.4 log10 of the minimum angle of resolution (range, 3.9 to 0.6). No serious adverse events related to the treatment or procedure and no dose-limiting toxic effects were recorded. Six participants had a meaningful improvement from baseline in cone-mediated vision as assessed with the use of FST, of whom 5 had improvement in at least one other key secondary outcome. Nine participants (64%) had a meaningful improvement from baseline in the best corrected visual acuity, the sensitivity to red light as measured with FST, or the score on the mobility test. Six participants had a meaningful improvement from baseline in the vision-related quality-of-life score. CONCLUSIONS: The safety profile and improvements in photoreceptor function after EDIT-101 treatment in this small phase 1-2 study support further research of in vivo CRISPR-Cas9 gene editing to treat inherited retinal degenerations due to the IVS26 variant of CEP290 and other genetic causes. (Funded by Editas Medicine and others; BRILLIANCE ClinicalTrials.gov number, NCT03872479.). [ABSTRACT FROM AUTHOR]

Published
2024
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50. Prospective and sequential study to establish the efficacy of rituximab therapy in maintaining remission of nephritic syndrome in patients with nephropathy at minimal injury or steroid-dependent, recurrent focal segmental glomerulosclerosis (NEMO),Studio prospettico e sequenziale per stabilire l'efficacia della terapia con rituximab nel mantenere la remissione della sindrome nefrosica in pazienti con nefropatia a lesioni minime o glomerulosclerosi focale steroido-dipendenti o recidivanti (NEMO)

Author

Abbate, M., Remuzzi, G., Coppo, R., Pennesi, M., Carraro, M., Emma, F., Pecoraro, C., Pisani, A., and Giovambattista Capasso

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