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V Fanos

Publications and source records attributed to V Fanos.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

[Nosocomial infections in pediatric and neonatal intensive care: an epidemiological update].

Hospital-acquired infection (nosocomial infection) is a world-wide problem. The peculiar susceptibility of newborns and children, the widespread use of antibiotics, advances in hospital practice, have resulted in an increased incidence and recognition of neonatal and pediatric bacterial nosocomial infections. The aim of this review is to present an update on epidemiology of hospital-acquired infections, quoting recent and relevant papers on this topic. Main risk factors for the neonatal and the pediatric intensive care infections are presented, respectively. Emerging antibiotic-resistant gram-positive and gram-negative bacteria in intensive care units are also considered. Infection control programmes are necessary to monitor and to prevent nosocomial infections.

Child↗
PubMedDate not supplied

Drug misadventuring in neonatal nephrology.

Drug-related problems are associated with significant morbidity and mortality. Numerous factors contribute to the development of drug-related problems. These factors may be patient-dependent, such as the patient's degree of organ function and/or dysfunction, and underlying disease states. On the contrary the factors may depend on the specific drug and its pharmacokinetic parameters. Recently it has been also demonstrated the importance of genetic factors. Drug-related problems include a wide range of situations including the so-called drug misadventuring: adverse drug reaction (ADR), adverse drug event (ADE), drug-induced disorder (DID), adverse drug experience (ADEexp). Certain drug classes are commonly associated with drug-induced disorders. Antibiotics and chemotherapeutic agents are responsible for approximately 30 percent of all adverse reactions. By an epidemiologic point of view between 3% and 11% of hospital admissions could be attributed to drug-related problems. Drug-induced disorders have historically been classified as predictable (Type A) or unpredictable (Type B) toxicity. Thus, a substantial portion of drug-induced disorders are predictable and potentially avoidable The kidney is vulnerable to drugs because of its high blood flow and large capillary surface area, its role as the excretory route for many drugs and its detoxifying action. Drug-induced acute renal failure accounts for 20% of total cases of acute renal failure in adult patients. Little is known about epidemiology of drug-induced disorders, especially in the pediatric kidney. Systematic epidemiological data on the incidence of drug-induced acute renal failure in newborn are not available. However, an increase in the last 10 years, in the involvement of drugs in acute renal failure has been observed in newborns. In the past it was suggested that drug-induced kidney damage (especially tht caused by aminoglycosides or glycopeptides) is less frequent and severe in newborns than in adults. However, this subject is controversial. Furthermore, it has recently been confirmed that low birth weights contribute to early onset of end stage renal disease. In view of the extremely widespread use of drugs in neonatology and the multiplicity of potential nephrotoxic factors, it is important to prevent iatrogenic effects. Ten rules for prevention of drug-induced nephrotoxicity are presented.

Drug-Related Side Effects and Adverse Reactions↗
PubMedDate not supplied

[Solitary kidney].

A functionally solitary kidney may be the consequence of renal agenesis, dysplasia, or surgical procedures. Compensatory hypertrophy and physiologic mechanisms intervene to preserve renal function. The authors discuss the physiopathology of solitary kidney in several clinical conditions.

Humans↗
PubMedDate not supplied

[IgA nephropathy in pediatrics].

IgA nephropathy is a primitive cronic idiopatic glomerulonephritis, characterized by diffuse depositis of IgA in the glomeruler mesangium. Familial cases are also descripted. IgA nephropaty is more frequent in males and in white rase. In Italy it's the most frequently recognized glomerulonephritis in renal biopsia (20%), especially in patients with dismorfic micro or macroematuria and nephrotic proteinuria. Clinical presentation is often in association with respiratory tract or gastrointestinal disorders. The most relevant pathogenetic hypothesis suggest an IgA abnormal glycosilation, with mesangial IgA aggregation, increased mesangial reactivity and release of inflammatory mediators and fibrotic agents. Treatment is considered in rapidly progressing forms. At the present, there is no treatment of proven value in all patients, althoug interesting results have been published with prednison, ACE-inhibitors or fish-oil in decresing renal deterioration rate. Natural history varies in different series. Renal survival at 10 years is 85% in Italy, 94% in France, 97% in the USA. Poor prognostic factor are heavy proteinuria and hypertension. However a wide inter-individual variability is observed.

Child↗
PubMedDate not supplied

[Bacterial ecology in a neonatal intensive care unit].

A study about bacterial colonization/infection has been performed in 523 newborn, consecutively hospitalized in the Neonatal Intensive Care Unit (NICU) of Verona. Bacteriological samples were taken routinely at the admission in all patients and selectively only in neonates at risk of infection. The obtained data revealed a significative prevalence of gram-positive organisms (particularly Staphylococcus epidermidis highly resistant to antibiotics commonly used); among gram-negative bacteria Pseudomonas spp. resulted the more frequently isolated micro-organisms. According to data obtained, antimicrobial approach to bacterial infection in our NICU is finally discussed.

Anti-Bacterial Agents↗
PubMedDate not supplied

News on vaccinations.

Explore the source record for details and available documents.

Bacterial Infections↗
PubMedDate not supplied

[Volvulus and intestinal malrotation in the newborn].

Midgut malrotation with volvulus is a life-threatening surgical emergency. Because the consequences of malrotation associated with midgut volvulus may be catastrophic, prompt diagnosis and treatment are required to prevent mortality and short-gut syndrome. Intestinal malrotation is usually observed in the neonatal period. Bilious vomiting and bloody stools are the two most common clinical presentations, but the patients exhibit often no abnormal physical findings on abdominal examination. Imaging techniques (Rx, US) of the upper gastrointestinal tract must be very accurate in order to diagnose volvulus but frequently they fail to identify this illness. If any doubt exists, refer with pediatric surgical support for consultation.

Humans↗
PubMedDate not supplied

[Staphylococcal infection in the newborn: teicoplanin therapy].

Infections caused by Gram-positive bacteria, particularly in neonatal patients, have increased dramatically over the past 10 years. In the present study 19 newborns (7 at term, 12 preterm) with proven staphylococcal infection were treated with teicoplanin, after a previous ineffective antibiotic treatment (amikacin+oxacillin or third-generation cephalosporin). Bacterial eradication and clinical cure were achieved in all neonates. No adverse events related to the drug occurred. No significant change was observed in serial biochemical and hematological tests. Our results suggest that teicoplanin is highly effective and safe in neonatal staphylococcal infections.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Aminoglycosides, risk factors and neonatal kidney].

Antibiotics are the leading cause of drug-induced kidney disease, and among them the aminoglycosides (AMG) are the main nephrotoxic agents, bringing about kidney damage via a direct dose-dependent mechanism. The combination of an aminoglycoside and a penicillin derivative is still the most commonly recommended and used first-line treatment modality in the empirical therapy of neonatal sepsis, despite the low therapeutic index of AMG. The immaturity of neonatal kidney function, particularly in preterm neonates, makes newborn infants particularly susceptible to AMG-induced kidney damage. Numerous factors intervene in bringing about AMG-induced kidney damage, such as factors related to the antibiotic itself (intrinsic toxicity, administration route, type of monitoring of blood concentrations), those related to the subject treated (neonatal age, constitutional sensitivity), and others related to associated pathology (neonatal anoxia, renal hypoperfusion, respiratory distress/mechanical ventilation, hyperbilirubinaemia/phototherapy, electrolyte disorders, and even the acute sepsis calling for antibiotic therapy), as well as pharmacological factors (concomitant therapies such as diuretics, indomethacin and other antibiotics, particularly glycopeptides and cephalosporins).

Aminoglycosides↗
PubMedDate not supplied

[Determination of blood cystatin C in pregnant women during labor and in their newborns].

INTRODUCTION: Human cystatin C is a basic low molecular mass protein (M(r) = 13,359) freely filtered by the glomerulus and almost completely reabsorbed and catabolized by the proximal tubular cells. In this study, we determined maternal and neonatal serum cystatin C levels both in a group of healthy pregnant women and in their newborns over the first five days of life. PATIENTS AND METHODS: Fifty healthy pregnant women, aged from 19 to 40 years, were selected. Newborns (31 males, 19 females) demonstrated the 1-min Apgar score ranging between 8 and 10, and the 5-min between 9 and 10. Their gestational age (GA) ranged between 37 and 43 weeks. Cystatin C was determined by using the cystatin C PET kit (Dako, Milano, Italy). We also determined serum creatinine and urea in all patients by using the Ektachem enzymatic assay (Ortho Diagnostic Division, Milano, Italy). RESULTS: In pregnant women, serum cystatin C was 1.52 +/- 0.39 mg/L, ranging from 0.69 to 2.30 mg/L. Serum creatinine was 58.9 +/- 11.5 mumol/L, and serum urea was 3.117 +/- 0.729 mmol/L. In newborns, serum cystatin C was at birth 2.29 +/- 0.52 mg/L, ranging from 1.17 to 4.84 mg/L. Subsequently, cystatin C significantly decreased over the first five days of life. Serum creatinine was at birth 80.08 +/- 14.26 mumol/L. By using analysis of variance (ANOVA) we found a statistically significant difference between maternal and neonatal cystatin C (p < 0.001) as well as between maternal and neonatal creatinine (p +/- 0.001). However, no correlation has been demonstrated by simple linear regression between maternal and neonatal cystatin C (r = 0.05), while maternal and neonatal creatinine significantly correlated (r = 0.45). CONCLUSIONS: Our preliminary findings suggest that cystatin C does not cross the placental barrier. Thus, in the neonate cystatin C serum levels may solely derived from himself.

Adult↗