[Aortic coarctation in the 1st year of life. II. Surgical technics and results in 77 operated cases].
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Age Factors↗
Biomedical subjects
P Ferrazzi
Publications and source records attributed to P Ferrazzi.
[Heart transplant: an emotional storm for the child and his family].
The purpose of the present study was a psychological analysis of the emotional state of a family awaiting heart transplantation. Current practice suggests that such emotional reaction is characterized by mixed and contradictory feelings which require further investigation. Subjects were 5 children waiting for transplant and 5 with previous transplant. Methods were: 1) open interview with children and parents; 2) projective drawing test for children (Corman family test, H.T.P., L.A.D.S., M.U.C.T., K.F.D.); 3) "palinomas" questionnaire which investigates: awareness of the illness, child relation with the food, feelings of competence and control, self-esteem and perception of the self. "Palinomas" was created in Italy by a hospital psychological team in order to give a chance to the child to talk about himself and to maintain control over the situation. The information we obtained by "palinomas" revealed to be very useful to understand the personality of the child through the main areas reported above. Within the limits of an introductory study, results indicate that family needs an active psychological support in order to develop a more positive attitude.
Adolescent↗
Pediatric heart transplantation without chronic maintenance steroids.
From 1986 to February 1993, 40 children aged 2 months to 18 years (average age 10.4 +/- 5.8 years) underwent heart transplantation. Indications for transplantation were idiopathic cardiomyopathy (52%), congenital heart disease (35%) with and without prior repair (71% and 29%, respectively), hypertrophic cardiomyopathy (5%), valvular heart disease (3%), and doxorubicin cardiomyopathy (5%). Patients were managed with cyclosporine and azathioprine. No prophylaxis with antilymphocyte globulin was used. Steroids were given to 39% of patients for refractory rejection, but weaning was always attempted and generally successful (64%). Five patients (14%) received maintenance steroids. Four patients died in the perioperative period and one died 4 months later. There have been no deaths related to rejection or infection. Average follow-up was 36 +/- 19 months (range 1 to 65 months). Cumulative survival is 88% at 5 years. In patients less than 7 years of age, rejection was monitored noninvasively. In the first postoperative month, 89% of patients were treated for rejection. Freedom from serious infections was 83% at 1 month and 65% at 1 year. Cytomegalovirus infections were treated successfully with ganciclovir in 11 patients. No impairment of growth was observed in children who underwent transplantation compared with a control population. Twenty-one patients (60%) have undergone annual catheterizations and no sign of graft atherosclerosis has been observed. Seizures occurred in five patients (14%) and hypertension was treated in 10 patients (28%). No patient was disabled and no lymphoproliferative disorder was observed.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗