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Biomedical subjects

F Zacchello

Publications and source records attributed to F Zacchello.

155 records · Page 9Linked to original sources
PubMedDate not supplied

[Gastroesophageal reflux and infantile cerebral palsy: our experience and review of the literature].

22 infant and children, all tetraplegic from cerebral palsy were admitted to our hospital for suspected gastroesophageal reflux. This working diagnosis was confirmed in 17 of them (77%) by an upper GI series and/or 24 hour oesophageal pH monitoring. All 17 were treated with medical therapy. In only 12.5% of them gastroesophageal symptoms improved. Seven children underwent surgery with complete resolution of vomiting in 57% of cases. These data confirm the high frequency of gastroesophageal reflux in children with cerebral palsy and its poor response to medical therapy. Most of these patients require surgical treatment, which unfortunately does not always resolve this vexing problem.

Adolescent↗
PubMedDate not supplied

[Membranous nephropathy associated with chronic hepatitis caused by B virus].

We report 6 cases with membranous glomerulonephritis associated with chronic hepatitis B virus infection, who came under our observation for microscopic haematuria in 2 cases, haematuria and proteinuria in 1 case, and nephrotic syndrome in the others. At the examination all 6 children were found to have hepatomegaly with raised serum transaminase activity. All the patients were positive in the serum for HBsAg and anti-HBc, 3 were HBeAg and anti-HBe negative. Liver biopsy showed features of chronic hepatitis with moderate signs of activity. Renal biopsy was consistent with membranous glomerulonephritis in all patients. With a fluorescent antibody technic HBeAg was found to be deposited in diffuse granular fashion, along glomerular capillary walls, together with IgG, in 2 out of 3 cases stained, but no deposition of HBsAg was detected in all the patients. Steroid therapy was started from 18 to 33 months. Urine analysis became negative in 4 cases and persisted normal in the follow-up. One patient with haematuria developed nephrotic syndrome and one died from miliary tuberculosis. Our findings suggest that the clinical outcome is favourable in children with membranous glomerulonephritis and chronic active hepatitis and that the pathogenesis probably is not unique.

Child↗
PubMedDate not supplied

[Assistance to the healthy newborn infant. 1. Experience of a new model of nursery care].

We propose an organizational model which provides proper assistance to the mother and newborn, promoting at the same time, an adequate structure for the child-parent relationship. We refer to the results obtained over a 2-year period, during which we gradually achieved a "rooming-in" situation and organized the assistance in the nursery to the newborns with minor pathology, and without substantial modifications either to structures or personnel. However providing a minimum of equipment and pediatrician and qualified paramedic personnel all the time. We noticed a statistically higher frequency of breastfeeding even after a time lapse (table 3), and a marked decrease of transfers to the neonatal pathology whit, especially among those neonates with minor pathology (tables 5 and 6). The fulfiment a direct connection with the family pediatrician and his services, through a complete and personalized exchange of informations, and a good degree of cooperation with the obstetrician, supported by the results discussed and evaluated together before (or him).

Breast Feeding↗
PubMedDate not supplied

[Assistance to the healthy newborn infant. II. The current situation in Veneto].

We report the results of a research carried out giving all head physicians of the paediatrics departments in Veneto or of the neonatal sections a questionnaire in order to know how the lying-in woman and the healthy newborn are assisted. The principle information requested by the questionnaire are reported in Table n. 1. The structures of the labour and delivery rooms, regarding their present use, allow the continuous presence of the father during the delivery and the accomplishment of the rooming-in. On the contrary the assistance given to the mothers and the newborns is traditional in 80% of the cases, and they hard take measures able to favour suckling and a mother-child contact in the first hours of the delivery (fig. 2). The tendency to admit in the paediatrics department the newborn who presents problems even slight is not influenced by the apparatus equipped in the neonatal section, but it seems to be in proportion to the structure (number of the deliveries a year) and to the staff of the hospital. In conclusion we think that in our district not just logistical and structural limits but cultural and administrative obstacles slacken the accomplishment of a new neonatal assistance. Particularly we consider very important the administrative recognition of the activity carried out by the paediatricians in the neonatal section and in the puerpery, even if it is not linked to hospitalizations in the department.

Delivery Rooms↗
PubMedDate not supplied

[Migraine and food intolerance: a controlled study in pediatric patients].

The possible correlation between migraine and food intolerance has been found to be of great interest in the recent literature. We have studied 43 patients aged from 7 to 18 years suffering from migraine without aura according to the classification of International Headache Society (IHS): they had at least 2 attacks monthly and they were pharmacological free of any prophylactic treatment for the latest three months. Each patient was given an allergologic anamnesis. Half of them (group A) were first in oligoantigenic regimen (including 8 simple foods) for 4 weeks. Afterward each patient has been challenged weekly in an open trial, introducing in the diet the different foods and additives previously eliminated; then they have been controlled in a simple double blind study. We have taken skin tests (PRICK method) for the most important allergens (foods and main inhalants), plasma levels of total and specific IgE (PRIST and RAST method), and moreover we have taken histamine plasma levels at the beginning and at the end of the oligoantigenic diet, and during challenge test, only in case of headache attacks. The second half of the patients (group B) were not following any diet nor a pharmacological prophylaxis, but they have been followed up with a clinical diary. Among the patients on oligoantigenic diet 12 only concluded the trial: 6/12 presented a completed remission of headache, 5/12 had a significant improvement of the migrainous pattern, 1/12 patients did not get any improvement after the dietetic treatment. The food recognized responsible of the attacks were: cacao, banana, egg, hazelnuts.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[The evolution of care for the critical child: pediatric intensive care].

Pediatric intensive care units (PICUs) have been developed to provide intensive care for children between post-neonatal age and adolescence. These units have largely been developed in North America, mainly in tertiary hospitals. In Italy, critically ill children are still often nursed on adult ICU's, where medical and nursing staff often lack pediatric training. Here we report the first 5-year experience of the multidisciplinary PICU developed at the Department of Pediatrics, University of Padua, focusing on PICU and patients characteristics, as well as on the evaluation of outcome by means of the Pediatric Risk of Mortality (PRISM) score.

Adolescent↗
PubMedDate not supplied

[Silent celiac disease: results of a study in secondary schools of Padua].

Aim of this study was the assessment of the prevalence of coeliac disease (CD) in children attending the secondary school in the city of Padua. 939 students, aged 10-15 years (mean age: 12 years, 7 months), 35% eligible population, were accepted to undergo a study process which included three stages: a) in all students venous sample was taken for measurement of the IgG and IgA anti-gliadin antibodies (AGA); b) measurement of serum immunoglobulins and anti-endomysium antibodies (AEA) if AGA IgA was resulted positive; c) intestinal biopsy was performed in 3 students; two of them had pathologic levels of AGA IgG and IgA and AEA. These patients were females and had decreased rates of statural growth, anemia with iron deficiency, anorexia, abdominal pain, asthenia. The third girl had positive AGA IgG and IgA but absence of AEA and normal biopsy. She also had symptoms of abdominal pain, reduced height. Follow-up studies have been planned to establish a latent phase of CD. In conclusion, the prevalence of CD was 2.13/1000 (0.37-8.55, 95% CI), if we consider the patients with established diagnosis of CD in the same urban area and of the same age, the overall incidence increases to 2.6/1000. This prevalence, therefore, is higher, than that of 0.5/1000 previously reported in the general population, with a ratio of 1/4 between patients already known and the cases detected in this study.

Adolescent↗
PubMedDate not supplied

Renal immunohistochemical distribution, plasma levels and urinary excretion of endothelin after kidney transplantation.

We investigated the immunohistochemical distribution of endothelin (ET) in 22 graft biopsies from kidney-transplanted patients. Like normal kidney tissue, 6/22 biopsies showed either no or only very weak ET positivity in the vascular endothelium. In the other 16 cases ET staining was marked on the vascular endothelium and wall (9/16), inflammatory infiltrates (11/16), glomeruli (7/16) and tubules (5/16). ET positivity in glomeruli and inflammatory infiltrates correlated with the degree of glomerular damage and interstitial inflammation but no correlation was found between the immunohistochemical results and the clinical variables considered. ET plasma levels (ET-PL) in patients (5.13 + 1.77 pmol/L) did not differ significantly from age-matched healthy controls (3.76 + 0.93 pmol/L), nor did ET urinary excretion (ET-U/CR-U) (33.94 + 21.89 and 24.94 + 8.5 pmol/mmol/L respectively). Neither ET-PL nor ET-U/CR-U was correlated with histological and immunohistochemical data or with the clinical variables. Our study suggests a potential role of ET as a local pro-inflammatory and growth factor in renal allografts and confirms its importance in the sequence of events involved in the progression of kidney damage.

Adolescent↗
PubMedDate not supplied

[Anxiety and memory in hospitalized adolescents; effect of the projection of a film].

The purpose of our study was the evaluation of the effects of a film on the anxiety and memory of cronically ill adolescents (n. 25) versus healthy adolescents (n. 25). The chronic illness was: renal failure, renal transplantation (6 months before), scoliosis and Crohn's disease. The S.T.A.I.-Y test was administered before and after the film to evaluate the state-anxiety before and after the vision, only the trait-anxiety was evaluated before. The state and trait-anxiety was not abnormal, although the state anxiety was increased in the hospitalized adolescents before the vision (mean S.T.A.I.-Y = 43.2) and was decreasing (mean S.T.A.I.-Y = 37.32) after it. This result confirms the needs of a global paediatric health-care in order to minimise psychosocial traumas, associated with hospitalisation. The second goal of our research was the mood and memory correlation and the mood-congruency. We administered two memory tests (free and guided) using a recorder and a questionnaire. Our study presents a better free-memory in healthy subjects (16.6% vs. 5.16% in the hospitalized adolescents) and a better guided-memory in the healthy subjects (13.7% vs. 7.08% in the hospitalized adolescents). Our results can't confirm the mood-congruency theory, although the study conclusion is concerning a general decreasing of memory competence, following the repeated hospital admissions and the chronic illness.

Adolescent↗