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Enrico Lombardi

Publications and source records attributed to Enrico Lombardi.

10 recordsLinked to original sources
PubMed2005

Piloting a web-based continuing professional development program for asthma education.

PURPOSE: Continuing professional development is an integral component of modern medical practice, yet traditional educational methods are impractical for many Primary Care Physicians. Web-based programs may fulfill the requirements of busy practitioners who have difficulty attending formal education sessions. METHODS: We piloted the use of a learning management system to deliver asthma education materials to Primary Care Physicians in both Australia and Italy in their native languages. Each group of Physicians accessed an education module which contained content pages, self-tests, a quiz and a survey. Details of how the Physicians used the system, their preferences and performance on the assessment were monitored. RESULTS: The learning management system was well received by both Italian and Australian Physicians. Thirty-eight (18 Australian, 20 Italian) Physicians used the system. Participants visited an average of 8.8 pages, with a mean time per hit of 2.9 min. Formative assessment was undertaken by 63.2% and summative assessment by 68.4% of participants. There were no substantial differences in performance between Physicians from both countries. Italian physicians tended to use the system after hours whereas Australian Physicians appear to do so between patient visits. CONCLUSIONS: Simple web-based systems are suitable for delivering educational materials to Primary Care Physicians in a manner likely to be used.

Asthma↗
PubMed2005

Long eyelashes in a case series of 93 children with vernal keratoconjunctivitis.

OBJECTIVE: Vernal keratoconjunctivitis (VKC) is a chronic conjunctivitis that affects children mainly in temperate areas, with exacerbations in spring and summer. Eyelashes provide natural protection for the eyes from sunshine, wind, and foreign bodies. These factors induce a worsening of signs and symptoms in VKC, whereas mechanical protection of the eyes produces relief. The aim of this study was to evaluate eyelash length in a large series of VKC patients and in age- and gender-matched healthy subjects. METHODS: Upper eyelash length was measured in 93 VKC patients (mean age: 8.7 years; range: 4-18 years) with a digital caliper. History, clinical form, type of presentation, degree of severity, and drug therapy were evaluated. Skin tests and serum-specific immunoglobulin E for common allergens, serum-total immunoglobulin E, peripheral blood eosinophil counts, and serum eosinophil cationic protein were determined. Two age- and gender-matched control subjects for each VKC patient underwent the same eyelash measurement. RESULTS: The upper eyelashes were significantly longer in VKC patients than in control subjects (mean +/- SD: 8.9 +/- 1.17 mm vs 7.9 +/- 1.07 mm). In healthy subjects, a negative correlation was found between eyelash length and age. With multivariate analysis, unlike control subjects, the eyelash length in VKC patients did not correlate with age, was positively correlated with the degree of severity of VKC, and was negatively correlated with the use of topical cyclosporine. CONCLUSIONS: Patients with VKC had longer eyelashes than healthy matched subjects. The ocular inflammation, by unknown chemical mediators, was likely responsible for the excessive eyelash growth. The finding may represent a defensive mechanism against physical agents that might have a crucial role in the etiopathogenesis of this disease.

Adolescent↗
PubMed2004

Anaphylaxis: a 7-year follow-up survey of 46 children.

BACKGROUND: Little is known about the frequency of and the features associated with recurrent anaphylaxis in pediatric populations. During 1994 to 1996, we enrolled 76 children affected by anaphylaxis in a prospective study to analyze their clinical and allergic features. OBJECTIVE: To undertake a follow-up study of these children to ascertain how many experienced a recurrence of anaphylaxis. METHODS: After a mean interval of 7 years, a pediatric allergist conducted a telephone interview of patients who had been enrolled in our 1994-1996 study. RESULTS: A telephone interview was successfully completed in 46 (61%) of the 76 patients who had been enrolled in our 1994-1996 study. Of these 46 patients, 14 (30%) had experienced a recurrence of anaphylaxis. Children with atopic dermatitis either during 1994 to 1996 (64% vs 34%; P = .04) or at the time of the current study (43% vs 16%; P = .03) and those with urticaria-angioedema at the time of the current study (93% vs 31%; P = .0002) were found to be at a significantly higher risk for recurrent anaphylaxis. Furthermore, those children who were sensitive to at least 1 food allergen during 1994 to 1996 were more likely to have experienced a recurrence of anaphylaxis (93% vs 56%; P < .04). CONCLUSIONS: This study suggests that patients may have a greater risk of recurrence of anaphylaxis if they have atopic dermatitis, urticaria-angioedema, or at least 1 positive result of skin prick tests to food allergens.

Adolescent↗
PubMed2002

Efficacy and safety of cyclosporine eyedrops in vernal keratoconjunctivitis.

BACKGROUND: Corticosteroids have been the only effective topically administered treatment for severe vernal keratoconjunctivitis (VKC), but their prolonged use is often associated with complications. Topical cyclosporine therapy has been used in the past decade, but few controlled trials have been conducted, and conflicting results have been reported. OBJECTIVE: This study sought to evaluate the efficacy and safety of ocular administration of cyclosporine in VKC. METHODS: Twenty-four children with severe VKC were treated with cyclosporine 2% eyedrops. The treatment began in spring and lasted 4 months. One eye was treated with cyclosporine (Cs-eye); the fellow eye received the vehicle as placebo (Pl-Cs-eye) during the first 2 weeks in a double-blind, placebo-controlled trial and thereafter was treated with cyclosporine (open trial). Patients were instructed to protect their eyes against sunlight. Ocular symptoms and signs were scored at entry and at 2 weeks, 4 weeks, and 4 months after the beginning of treatment. All children underwent biochemical and immunologic evaluations. RESULTS: Compared with baseline, scores for ocular signs and symptoms at 2 weeks decreased significantly in the Cs-eyes (P < 0.001), and signs improved in the Pl-Cs-eyes (P = 0.001). A significant difference was noted between Cs-eyes and Pl-Cs-eyes at 2 weeks for both subjective (P < 0.005) and objective (P < 0.001) scores. At 4 weeks, scores for signs (P < 0.001) and symptoms (P = 0.01) were reduced in the Pl-Cs-eyes, with no further improvement in the Cs-eyes. At 4 months, clinical scores had declined further, and serum eosinophil cationic protein levels were significantly lower than at entry (P = 0.009). Most patients reported mild burning sensation and tearing after administration of cyclosporine. Four patients (17%) required an additional brief period of topical corticosteroid therapy. CONCLUSIONS: Cyclosporine eyedrops were effective and safe for treating severe VKC, without causing major side effects. Most of the therapeutic effect was achieved after 2 weeks. The initial therapeutic effect was maintained during the next 3 months, with a further slow decrease in the symptoms.

Anti-Allergic Agents↗
PubMedDate not supplied

[Frequency of asthma and allergies in Italian children and adolescents: results from SIDRIA-2].

The present study investigated the prevalences of asthma, allergic rhinitis (both to pollen and to other causes) and eczema in Italian children (6-7 yr old) and adolescents (13-14 yr old) in the second phase of SIDRIA (2002), aiming also to highlight geographical differences in the prevalence of the studied diseases. Prevalence of lifetime asthma is 9.3% in children and 10.3% in adolescents; lifetime prevalences of allergic rhinitis and eczema are 12.3% and 15.9% in children, 20.9% and 11.9% in adolescents. In both age groups, prevalence of lifetime asthma and lifetime and past 12 months wheezing was greater in central than in northern and southern areas. A similar situation was also seen for allergic rhinitis but not for eczema whose prevalence decreased between North to South of Italy. An excess in prevalence of lifetime asthma and rhinitis was found in metropolitan areas compared to other areas; prevalence of eczema did not show any difference by urbanization level. Prevalence of asthma and, only in children, prevalence of rhinitis symptoms was greater in males than in females. On the contrary, prevalence of eczema and, only in adolescents, prevalence of rhinitis symptoms was greater in females. Prevalence of childhood asthma, allergic rhinitis and eczema in Italy ranks intermediate with respect to other countries participating in ISAAC phase three.

Adolescent↗
PubMedDate not supplied

[Risk factors in the pre-, perinatal and early life (first year) for wheezing in young children].

In recent years some studies have focused attention on the contribution of early life risk factors in the pathogenesis of asthma and wheezing. In our study we tested the hypothesis that wheezing in childhood is not a single disorder and that different wheezing phenotypes (called transient early wheezing, persistent wheezing and late-onset wheezing) are associated with different risk factors. We evaluated the association between pre, perinatal and early life (1st year) risk factors and different wheezing phenotypes in children 6-7 years old enrolled in the SIDRIA-2 project. Maternal smoking in pregnancy is associated with early and persistent wheezing; prematurity, child's admission to hospital shortly after birth for respiratory problems, indicators of respiratory infections during the child's first year of life are associated with early wheezing. An increase in childhood infections from contact with siblings or day care attendance is a risk factor for early wheezing but protective against late-onset wheezing, while an opposite pattern was observed for breastfeeding. Finally, mould or dampness in the child's bedroom during his first year of life is associated with all wheezing phenotypes. The risk factors studied are differently associated with different wheezing phenotypes.

Asthma↗
PubMedDate not supplied

[Effects of indoor exposures on respiratory and allergic disorders].

Several studies have shown that indoor pollution increases the risk for chronic pulmonary diseases and acute respiratory symptoms in children/adolescents. Some associations have been confirmed by studies. Other relations are still unclear, such as those regarding dog and cat ownership. In this study we assessed the relationships of the exposure to mould and dog/cat ownership with respiratory/allergic symptoms/diagnoses, such as wheezing, asthma, rhinoconjunctivitis, eczema, and cough/phlegm in 20,016 children (6-7 yrs old) and 13,266 adolescents (13-14 yrs old) from 12 Italian areas. Early mould exposure (in the first year of life) was positively related to all considered symptoms/diagnoses (significantly for wheezing, asthma, rhinoconjunctivitis in both children and adolescents, and for cough/phlegm among children); current exposure (in the last year) was a significant risk factor for wheeze, among children. In the latter, dog exposure only in the first year of life increased the risk for wheezing and cough/phlegm, whereas the presence of a dog lifetime seemed a protective factor (though not significant) for all symptoms/diagnoses; negative relations (but not significant) suggested a protective effect by the cat for asthma, independently of exposure period. Among adolescents, the presence of a dog both lifetime and only in the first year of life was significantly related to cough/phlegm; except for rhino-conjunctivitis, all symptoms/diagnoses were negatively related to the presence of a cat lifetime (though not significantly). In conclusion, our results confirmed the effects of mould exposure, especially when it occurs early, on the prevalence of respiratory disorders such as asthma, rhinitis and cough in the pediatric age. The complex relations between keeping a dog or cat at home and respiratory/allergic symptoms/diseases in childhood warrants further studies.

Adolescent↗