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Mennini M, Lionetti E, Malamisura M, Di Nardo G, Auricchio R, Lionetti P, Romano C. Management of food protein-induced allergic proctocolitis in Italy: A nationwide survey by SIGENP. Pediatr Allergy Immunol 2024; 35:e14109. [PMID: 38488437 DOI: 10.1111/pai.14109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/24/2024] [Accepted: 02/16/2024] [Indexed: 03/19/2024]
Affiliation(s)
- Maurizio Mennini
- Pediatrics Unit, NESMOS Department, Faculty of Medicine and Psychology, Sapienza University, S. Andrea Hospital, Rome, Italy
| | - Elena Lionetti
- Department of Specialized Clinical Sciences and Odontostomatology, Polytechnic University of Marche, Ancona, Italy
| | - Monica Malamisura
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Giovanni Di Nardo
- Pediatrics Unit, NESMOS Department, Faculty of Medicine and Psychology, Sapienza University, S. Andrea Hospital, Rome, Italy
| | - Renata Auricchio
- Department of Translational Medical Science, University of Naples Federico II, Napoli, Italy
| | - Paolo Lionetti
- Gastroenterology and Nutrition Unit, University of Florence-Meyer Hospital, Florence, Italy
| | - Claudio Romano
- Pediatric Gastroenterology and Cystic Fibrosis Unit, University of Messina, Messina, Italy
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Mantegazza C, Ferraro S, Biganzoli D, Destro F, Quitadamo P, Isoldi S, Torroni F, Malamisura M, Renzo S, Fioretti L, Gandullia P, Tantari G, Maino M, Fava G, Bramuzzo M, Zingarella S, Illiceto MT, Norsa L, Pellegrino M, Antoniello LM, Orizio P, Nanni A, Cisarò F, Felici E, Romano C, Oliva S. Foreign body ingestion in children: Definition of a nomogram to predict surgical or endoscopic intervention. Dig Liver Dis 2024; 56:312-321. [PMID: 37586909 DOI: 10.1016/j.dld.2023.07.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 06/28/2023] [Accepted: 07/11/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND AND AIMS Foreign body ingestion (FBI) in children requires early identification to prevent adverse outcomes and may necessitate endoscopic or surgical intervention. This study aims to develop a nomogram that identifies children who require urgent surgical or endoscopic intervention by using the patient's medical history and clinical parameters collected at admission. METHODS This study is a retrospective review (01/2015-12/2020) of a multicenter case series of children admitted for FBI. Data from 5864 records from 24 hospitals in Italy were analyzed. Logistic regression models were used to establish the probability of requiring surgical or endoscopic intervention based on patient history and clinical characteristics. The nomogram representing the results from the multivariable model was reported to examine the propensity for surgery/endoscopy. RESULTS The study identified a significant association between intervention and various factors, including type of foreign body (blunt: reference category, disk battery (odds ratio OR:4.89), food bolus (OR:1.88), magnets (OR:2.61), sharp-pointed (OR:1.65), unknown (OR:1.02)), pre-existing diseases or conditions (OR 3.42), drooling (OR 10.91), dysphagia (OR 5.58), vomiting (OR 3.30), retrosternal pain (OR 5.59), abdominal pain (OR 1.58), hematemesis (OR 2.82), food refusal/poor feeding (OR 2.99), and unexplained crying (OR 2.01). The multivariable regression model showed good calibration and discrimination ability, with an area under the ROC curve of 0.77. CONCLUSIONS This study developed the first nomogram to predict the probability of the need for surgical or endoscopic intervention in children with FBI, based on the information collected at admission. The nomogram will aid clinicians in identifying children who require early intervention to prevent adverse outcomes.
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Affiliation(s)
| | - Simona Ferraro
- Center of Functional Genomics and Rare diseases Department of Pediatrics Buzzi Children's Hospital, Milan, Italy
| | - Davide Biganzoli
- Center of Functional Genomics and Rare Diseases, Buzzi Children's Hospital, Via Castelvetro 24, Milan, Italy
| | - Francesca Destro
- Department of Paediatric Surgery, Buzzi Children's Hospital, Milan, Italy
| | - Paolo Quitadamo
- Pediatric Gastroenterology and Epatology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy
| | - Sara Isoldi
- Pediatric Gastroenterology and Epatology Unit, Santobono-Pausilipon Children's Hospital, Naples, Italy; Maternal and Child Health Department, Sapienza - University of Rome, Santa Maria Goretti Hospital, Polo Pontino, Latina, Italy
| | - Filippo Torroni
- Digestive Surgery and Endoscopy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Monica Malamisura
- Digestive Surgery and Endoscopy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Sara Renzo
- Gastroenterology and Nutrition Unit, Meyer Children's Hospital, IRCCS, Florence, Italy
| | - Lorenzo Fioretti
- Gastroenterology and Nutrition Unit, Meyer Children's Hospital, IRCCS, Florence, Italy
| | - Paolo Gandullia
- Gastroenterology and Endoscopy Unit, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Giacomo Tantari
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, Genoa, Italy
| | - Marta Maino
- Digestive Endoscopy, Fondazione IRCCS San Gerardo dei Tintori, Monza, Italy
| | - Giorgio Fava
- Department of Pediatric Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Matteo Bramuzzo
- Pediatric Gastroenterology, Digestive Endoscopy and Clinical Nutrition Unit, Department of Pediatric, Institute for Maternal and Child Health IRCCS "Burlo Garofolo", Trieste, Italy
| | - Silvia Zingarella
- Department of Pediatrics, Woman's and Child's University Hospital of Verona, Italy
| | - Maria Teresa Illiceto
- Pediatric Gastroenterology and Digestive Endoscopic Unit, Department of Pediatrics, "Santo Spirito" Hospital of Pescara, Italy
| | - Lorenzo Norsa
- Pediatric Hepatology Gastroenterology and Transplantation, ASST Papa Giovanni XXIII, Bergamo, Italy
| | - Maristella Pellegrino
- Pediatric Surgery Unit, Maternal and Child Department, ASST GOM of Niguarda, Milan, Italy
| | - Luca Maria Antoniello
- Pediatric Surgery Unit, Division of Women's and Children's Health, Padova University Hospital
| | - Paolo Orizio
- Department of Pediatric Surgery, Spedali Civili Children's Hospital, Brescia, Italy
| | - Alessio Nanni
- Department of Paediatrics, Marche Polytechnic University, G.Salesi Hospital, Ancona, Via Corridoni 11, 60123 Ancona, Italy
| | - Fabio Cisarò
- Digestive Endoscopy Unit, San Giovanni Battista Molinette Hospital, Azienda Ospedaliera-Universitaria, Città della Salute e della Scienza di Torino, Turin, Italy
| | - Enrico Felici
- Pediatric and Pediatric Emergency Unit, Children Hospital, AO SS Antonio e Biagio e C. Arrigo, Alessandria, Italy
| | - Claudio Romano
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology and Pediatrics, University of Messina, Italy
| | - Salvatore Oliva
- Maternal and Child Health Department, Pediatric Gastroenterology and Liver Unit, Sapienza - University of Rome, Rome, Italy.
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Artesani MC, Urbani S, Riccardi C, Esposito M, De Angelis P, Rea F, Tambucci R, Malamisura M, Buzzonetti L, Fiocchi AG. Vernal keratoconjunctivitis and eosinophilic esophagitis: A rare combination? World Allergy Organ J 2024; 17:100855. [PMID: 38283996 PMCID: PMC10821585 DOI: 10.1016/j.waojou.2023.100855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 11/24/2023] [Accepted: 12/08/2023] [Indexed: 01/30/2024] Open
Abstract
Vernal keratoconjunctivitis (VKC) is a bilateral ocular inflammatory disease with a conjunctival and corneal involvement and typical onset during childhood. Eosinophilic esophagitis (EoE) is a chronic disease characterized by eosinophilic inflammation of the mucosa (≥15 eosinophils/HPF) and symptoms of esophageal dysfunction. EoE and VKC are both immune-mediated diseases sharing a similar pathogenetic mechanism and a high association with other allergic diseases. Nevertheless, no data are currently available about their clinical association. We present 4 cases of concomitant diagnosis of vernal keratoconjunctivitis and eosinophil esophagitis suggesting that these conditions may coexist in the same patient more frequently than expected. Health care providers should be aware of the possibility of co-occurrence in their daily practice.
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Affiliation(s)
| | - Sara Urbani
- Allergy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Carla Riccardi
- Allergy Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | | | - Paola De Angelis
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Francesca Rea
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Renato Tambucci
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Monica Malamisura
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Luca Buzzonetti
- Ophthalmology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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Tambucci R, Roversi M, Rea F, Malamisura M, Angelino G, Biondi I, Simeoli R, Goffredo BM, Francalanci P, Simonetti A, Livadiotti S, Corsetti T, Dall'Oglio L, Rossi P, Pontrelli G, De Angelis P. Oral Viscous Budesonide in Children With Eosinophilic Esophagitis After Repaired Esophageal Atresia: A Clinical Trial. J Pediatr Gastroenterol Nutr 2023; 77:249-255. [PMID: 37195886 DOI: 10.1097/mpg.0000000000003830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/19/2023]
Abstract
OBJECTIVES A high prevalence of eosinophilic esophagitis (EoE) has been reported in children with repaired esophageal atresia (EA). Topical steroids proved to be an effective and safe therapy in EoE, although not approved in pediatrics. We report the results of the first clinical trial of oral viscous budesonide (OVB) performed in children with EoE after repaired esophageal atresia (EoE-EA). METHODS This open-label, single-arm, phase 2 clinical trial with randomized pharmacokinetic sampling, was conducted at the Bambino Gesù Children's Hospital between September 2019 and June 2021. EoE-EA patients received an age-banded dose of OVB twice daily for 12 weeks and were endoscopically evaluated. The primary endpoint was the rate of patients achieving histological remission. Secondary endpoints included clinical and endoscopic benefit after treatment, and safety assessments. RESULTS Eight consecutive EA-EoE patients were enrolled (median age 9.1 years, interquartile range 5.5). Of these, 5 received 0.8 mg and 3 received 1.0 mg twice daily of OVB. Histological remission was obtained in all but 1 patient (87.5%). The clinical score showed significant improvement at the end of treatment in all patients. No endoscopic features of EoE were found after treatment. No treatment-emergent adverse event occurred. CONCLUSION OVB is an effective, safe, and well-tolerated formulation of budesonide for use in pediatric patients with EoE-EA.
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Affiliation(s)
- Renato Tambucci
- From the Digestive Endoscopy Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Marco Roversi
- Residency School of Pediatrics, University of Rome Tor Vergata, Rome, Italy
| | - Francesca Rea
- From the Digestive Endoscopy Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Monica Malamisura
- From the Digestive Endoscopy Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Giulia Angelino
- From the Digestive Endoscopy Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Isabella Biondi
- the Centre of Excellence for the Development and Implementation of Medicines, Vaccines, and Medical Devices for Pediatric Use, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Raffaele Simeoli
- the Division of Metabolic Diseases and Drug Biology, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Bianca Maria Goffredo
- the Division of Metabolic Diseases and Drug Biology, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Paola Francalanci
- From the Digestive Endoscopy Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Alessandra Simonetti
- the Centre of Excellence for the Development and Implementation of Medicines, Vaccines, and Medical Devices for Pediatric Use, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Susanna Livadiotti
- the Centre of Excellence for the Development and Implementation of Medicines, Vaccines, and Medical Devices for Pediatric Use, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Tiziana Corsetti
- the Unit of Clinical Pharmacy, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Luigi Dall'Oglio
- the Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Paolo Rossi
- the Centre of Excellence for the Development and Implementation of Medicines, Vaccines, and Medical Devices for Pediatric Use, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Giuseppe Pontrelli
- the Centre of Excellence for the Development and Implementation of Medicines, Vaccines, and Medical Devices for Pediatric Use, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Paola De Angelis
- From the Digestive Endoscopy Unit, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
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Quitadamo P, Anselmi F, Mantegazza C, Tambucci R, Campanozzi A, Malamisura M, Raucci U, Tipo V, Dolce P, Saccomani MD, Chiaro A, Mancini V, Felici E, Orizio P, Parma B, Salvatore S, Borrelli O. Hematemesis in Infants: The First Evidence-Based Score to Predict the Need for Timely Endoscopy. Pediatr Emerg Care 2022; 38:e1245-e1250. [PMID: 35482500 DOI: 10.1097/pec.0000000000002579] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Infantile acute upper gastrointestinal bleeding involves a decision for therapeutic intervention that most pediatricians first coming into contact with the patient are, not unreasonably, unable to objectively provide. Therefore, some objective tools of individual risk assessment would seem to be crucial. The principal aim of the present study was to investigate the anamnestic and clinical parameters of infants with hematemesis, together with laboratory and instrumental findings, to create a scoring system that may help identify those infants requiring an appropriate and timely application of upper gastrointestinal (GI) endoscopy. METHODS Clinical data of infants admitted for hematemesis to the participating centers over the study period were systematically collected. According to the outcome dealing with rebleeding, need for blood transfusion, mortality, finding of GI bleeding lesions, or need for surgical intervention, patients were blindly divided into a group with major clinical severity and a group with minor clinical severity. Univariate and multivariate logistic regressions were conducted to investigate significant prognostic factors for clinical severity. RESULTS According to our findings, we drafted a practical diagnostic algorithm and a clinical score able to predict the need for timely upper GI endoscopy (BLOVO infant score). Our clinical scoring system was created by incorporating anamnestic factors, clinical parameters, and laboratory findings that emerged as predictors of a worst outcome. CONCLUSIONS We provided the first objective tool of individual risk assessment for infants with hematemesis, which could be very useful for pediatricians first coming into contact with the patient in the emergency department.
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Affiliation(s)
- Paolo Quitadamo
- From the Department of Pediatrics, Santobono-Pausilipon Children's Hospital
| | - Federica Anselmi
- Department of Translational Medical Science, Section of Pediatrics, "Federico II" University of Naples, Naples
| | - Cecilia Mantegazza
- Department of Pediatrics, University of Milan, Buzzi Children's Hospital, Milan
| | - Renato Tambucci
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital, IRCCS, Rome
| | - Angelo Campanozzi
- Department of Medical and Surgical Sciences, University Hospital of Foggia, Foggia
| | - Monica Malamisura
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital, IRCCS, Rome
| | - Umberto Raucci
- Pediatric Emergency Department, Bambino Gesù Children's Hospital, IRCCS, Rome
| | - Vincenzo Tipo
- Emergency Pediatric Department, Santobono-Pausilipon Children's Hospital, Naples
| | - Pasquale Dolce
- Department of Public Health, University of Naples Federico II, Naples
| | | | - Andrea Chiaro
- Paediatric Gastroenterology and Digestive Endoscopy Unit, Giannina Gaslini Institute, Genoa
| | - Valentina Mancini
- Department of Pediatrics and Neonatology, San Carlo Borromeo Hospital, Milan
| | - Enrico Felici
- Pediatric and Pediatric Emergency Unit, "Umberto Bosio" Center for Digestive Diseases, The Children Hospital, AO SS Antonio e Biagio e Cesare Arrigo, Alessandria
| | - Paolo Orizio
- Department of Pediatric Surgery, Spedali Civili Children's Hospital, Brescia
| | - Barbara Parma
- Paediatric Department, ASST-Lariana, Sant'Anna General Hospital, Como
| | - Silvia Salvatore
- Pediatric Department, Ospedale "F. Del Ponte," University of Insubria, Varese, Italy
| | - Osvaldo Borrelli
- Division of Neurogastroenterology and Motility, Department of Paediatric Gastroenterology, UCL Institute of Child Health and Great Ormond Street Hospital, London, United Kingdom
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Abstract
INTRODUCTION The role of point-of-care ultrasound (POCUS) in routine clinical practice is rapidly growing, whereas adult specialties have already included training programs regarding this topic; pediatric residency schools are still late on this topic, particularly in Italy. METHODS We performed an online anonymous survey to Italian residents. The online survey has been submitted to the resident representatives of each pediatric residency school in Italy by the Italian Observatory of Pediatric Residents; each representative in turn distributed it to the pediatric residents of his own school. RESULTS Three sixty-one residents responded to the survey. Only 7.8% of residents declared that in their residency school, an official training program on POCUS exists, although more than 95% of respondents declared that such a training would be of primary importance for their future practice. Most residents do not know how to use an ultrasound machine nor the differences between different probes. CONCLUSIONS Our results demonstrate that POCUS training is still missing in Italy. Given the growing number of evidences of the benefits from including POCUS in clinical practice and patient evaluation, efforts are needed to fill this gap, in Italy and, probably, in most European countries. Such a training will definitely help the new generation of pediatricians improve their curriculum and, therefore, child health.
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Affiliation(s)
| | | | - Anna Maria Musolino
- Pediatric Emergency Department, Bambino Gesù Children Hospital, IRCCS, Rome, Italy
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Baaleman DF, Malamisura M, Benninga MA, Bali N, Vaz KH, Yacob D, Di Lorenzo C, Lu PL. The not-so-rare absent RAIR: Internal anal sphincter achalasia in a review of 1072 children with constipation undergoing high-resolution anorectal manometry. Neurogastroenterol Motil 2021; 33:e14028. [PMID: 33301220 PMCID: PMC8047870 DOI: 10.1111/nmo.14028] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/21/2020] [Accepted: 10/16/2020] [Indexed: 01/01/2023]
Abstract
BACKGROUND Our objective is to describe the prevalence of patients with internal anal sphincter achalasia (IASA) without Hirschsprung disease (HD) among children undergoing anorectal manometry (ARM) and their clinical characteristics. METHODS We performed a retrospective review of high-resolution ARM studies performed at our institution and identified patients with an absent rectoanal inhibitory reflex (RAIR). Clinical presentation, medical history, treatment outcomes, and results of ARM and other diagnostic tests were collected. We compared data between IASA patients, HD patients, and a matched control group of patients with functional constipation (FC). KEY RESULTS We reviewed 1,072 ARMs and identified 109 patients with an absent RAIR, of whom 28 were diagnosed with IASA. Compared to patients with FC, patients with IASA had an earlier onset of symptoms and were more likely to have abnormal contrast enema studies. Compared to patients with HD, patients with IASA were more likely to have had a normal timing of meconium passage, a later onset of symptoms, and were diagnosed at an older age. At the latest follow-up, the majority of patients diagnosed with IASA (54%) were only using oral laxatives. Over half of patients with IASA had been treated with anal sphincter botulinum toxin injection, and 55% reported a positive response. CONCLUSIONS AND INFERENCES Patients diagnosed with IASA may represent a more severe patient population compared to patients with FC, but have a later onset of symptoms compared to patients with HD. They may require different treatments for their constipation and deserve further study.
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Affiliation(s)
- Desiree F. Baaleman
- Division of Pediatric Gastroenterology, Hepatology, and NutritionDepartment of PediatricsNationwide Children’s HospitalColumbusOHUSA
- Department of Pediatric Gastroenterology and NutritionEmma Children’s Hospital, Amsterdam UMCUniversity of Amsterdam & VU UniversityAmsterdamthe Netherlands
- Amsterdam UMCUniversity of Amsterdam, Gastroenterology and HepatologyAmsterdam Gastroenterology Endocrinology MetabolismAmsterdamthe Netherlands
| | - Monica Malamisura
- Division of Pediatric Gastroenterology, Hepatology, and NutritionDepartment of PediatricsNationwide Children’s HospitalColumbusOHUSA
- Digestive endoscopy and surgery UnitBambino Gesù Children’s Hospital IRCCSRomeItaly
| | - Marc A. Benninga
- Department of Pediatric Gastroenterology and NutritionEmma Children’s Hospital, Amsterdam UMCUniversity of Amsterdam & VU UniversityAmsterdamthe Netherlands
| | - Neetu Bali
- Division of Pediatric Gastroenterology, Hepatology, and NutritionDepartment of PediatricsNationwide Children’s HospitalColumbusOHUSA
| | - Karla H. Vaz
- Division of Pediatric Gastroenterology, Hepatology, and NutritionDepartment of PediatricsNationwide Children’s HospitalColumbusOHUSA
| | - Desale Yacob
- Division of Pediatric Gastroenterology, Hepatology, and NutritionDepartment of PediatricsNationwide Children’s HospitalColumbusOHUSA
| | - Carlo Di Lorenzo
- Division of Pediatric Gastroenterology, Hepatology, and NutritionDepartment of PediatricsNationwide Children’s HospitalColumbusOHUSA
| | - Peter L. Lu
- Division of Pediatric Gastroenterology, Hepatology, and NutritionDepartment of PediatricsNationwide Children’s HospitalColumbusOHUSA
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Tambucci R, Malamisura M, Napoli M, Rea F, Faraci S, Romeo EF, Angelino G, Caldaro T, Guerra L, Contini ACI, Federici di Abriola G, Dall'Oglio L, De Angelis P, Torroni F. Break the Rule of Three: Critical Thoughts From a Tertiary Care Experience With Bougie Dilators. J Pediatr Gastroenterol Nutr 2021; 72:e28. [PMID: 33075012 DOI: 10.1097/mpg.0000000000002969] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Renato Tambucci
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
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9
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Tambucci R, Isoldi S, Angelino G, Torroni F, Faraci S, Rea F, Romeo EF, Caldaro T, Guerra L, Contini ACI, Malamisura M, Federici di Abriola G, Francalanci P, Conforti A, Dall'Oglio L, De Angelis P. Evaluation of Gastroesophageal Reflux Disease 1 Year after Esophageal Atresia Repair: Paradigms Lost from a Single Snapshot? J Pediatr 2021; 228:155-163.e1. [PMID: 32918920 DOI: 10.1016/j.jpeds.2020.09.015] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 08/26/2020] [Accepted: 09/04/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To analyze the findings of both multichannel intraluminal impedance with pH (MII-pH) and endoscopy/histopathology in children with esophageal atresia at age 1 year, according to current recommendations for the evaluation of gastroesophageal reflux disease (GERD) in esophageal atresia. STUDY DESIGN We retrospectively reviewed both MII-pH and endoscopy/histopathology performed in 1-year-old children with esophageal atresia who were followed up in accordance with international recommendations. Demographic data and clinical characteristics were also reviewed to investigate factors associated with abnormal GERD investigations. RESULTS In our study cohort of 48 children with esophageal atresia, microscopic esophagitis was found in 33 (69%) and pathological esophageal acid exposure on MII-pH was detected in 12 (25%). Among baseline variables, only the presence of long-gap esophageal atresia was associated with abnormal MII-pH. Distal baseline impedance was significantly lower in patients with microscopic esophagitis, and it showed a very good diagnostic performance in predicting histological changes. CONCLUSIONS Histological esophagitis is highly prevalent at 1 year after esophageal atresia repair, but our results do not support a definitive causative role of acid-induced GERD. Instead, they support the hypothesis that chronic stasis in the dysmotile esophagus might lead to histological changes. MII-pH may be a helpful tool in selecting patients who need closer endoscopic surveillance and/or benefit from acid suppression.
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Affiliation(s)
- Renato Tambucci
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy; Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy.
| | - Sara Isoldi
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy; Women's and Children's Health Department, Pediatric Gastroenterology and Hepatology Unit, Sapienza University of Rome, Rome, Italy
| | - Giulia Angelino
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Filippo Torroni
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Simona Faraci
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Francesca Rea
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | | | - Tamara Caldaro
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Luciano Guerra
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | | | - Monica Malamisura
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | | | - Paola Francalanci
- Department of Pathology, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Andrea Conforti
- Neonatal Surgery Unit, Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Luigi Dall'Oglio
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Paola De Angelis
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
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Lubrano R, Villani A, Berrettini S, Caione P, Chiara A, Costantino A, Formigari R, Franzoni E, Gattinara GC, Giustardi A, La Marca G, Lionetti P, Lima M, Maffei C, Malamisura M, Manzoni G, Marseglia GL, Memeo A, Mosca F, Perricone G, Peruzzi L, Piacentini G, Pozzobon G, Riva E, Tesoro S, Zampino G, Zanetto F, Zecca M, Bloise S. Point of view of the Italians pediatric scientific societies about the pediatric care during the COVID-19 lockdown: what has changed and future prospects for restarting. Ital J Pediatr 2020; 46:142. [PMID: 33008445 PMCID: PMC7531060 DOI: 10.1186/s13052-020-00907-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 09/23/2020] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND The coronavirus disease 2019 (COVID-19) is currently rare in children and they seem to have a milder disease course and better prognosis than adults. However, SARS-Cov-2 pandemic has indirectly caused problems in pediatric medical assistance. In view of this we wanted to draw a picture of what happened during health emergency and analyze future prospects for restarting. METHODS We involved the Italian pediatric scientific societies institutionally collected in the Italian Federation of Associations and Scientific Societies of the Pediatric Area (FIARPED); We sent a questionnaire to all scientific societies about the pediatric care activity during the COVID-19 emergency and future perspectives for the phase of post-containment. RESULTS The analysis of the questionnaires showed significant decrease of:admission, outpatient visits and specialist consultancy activities during the COVID-19 emergency, primarily linked to the fear of infection. Instead it was increased the serious degree of diseases admitted. Most of scientific societies maintained the relationship with chronic patients through some form of telemedicine, reporting a strong positive opinion about this modality. Finally showed the need to give life a new approach for hospitalizations and outpatient visits through a greater use of telemedicine, educational programs on families and a more decisive role of family pediatricians. CONCLUSIONS Our study highlighted many aspects that can be improved in pediatric care. We think that It will be necessary a new shared strategy to improve the management and continuity of care for pediatric patients, primarily developing a network of collaboration between families, family pediatrician and hospitals and by enhancing the use of new methods of telecommunications.
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Affiliation(s)
- Riccardo Lubrano
- Federazione Italiana delle Associazioni e Società Scientifiche dell'Area Pediatrica e Società Italiana di Emergenza Urgenza Pediatrica, Rome, Italy. .,Dipartimento Materno Infantile e di Scienze Urologiche, Sapienza Università di Roma, UOC di Pediatria e Neonatologia, Ospedale Santa Maria Goretti, Polo di Latina, Latina, Italy.
| | | | | | - Paolo Caione
- Società Italiana di Videochirurgia Infantile, Rome, Italy
| | | | - Antonella Costantino
- Società Italiana di Neuropsichiatria dell'Infanzia e dell'Adolescenza, Milan, Italy
| | - Roberto Formigari
- Società Italiana di Cardiologia Pediatrica e delle Cardiopatie Congenite, Firenze, Italy
| | | | | | | | - Giancarlo La Marca
- Società Italiana per lo Studio delle Malattie Metaboliche Ereditarie e lo Screening neonatale, Milan, Italy
| | - Paolo Lionetti
- Società Italiana di Gastroenterologia Epatologia e Nutrizione Pediatrica, Milan, Italy
| | - Mario Lima
- Società Italiana di Chirurgia Pediatriaca, Milan, Italy
| | - Claudio Maffei
- Società Italiana di Endocrinologia e Diabetologia Pediatrica, Ferrara, Italy
| | | | | | | | - Antonio Memeo
- Società Italiana di Ortopedia e Traumatologia Pediatrica, Rome, Italy
| | - Fabio Mosca
- Società Italiana di Neonatologia, Rome, Italy
| | | | - Licia Peruzzi
- Società Italiana di Nefrologia Pediatrica, Milan, Italy
| | | | | | - Enrica Riva
- Società Italiana di Nutrizione Pediatrica, Milan, Italy
| | - Simonetta Tesoro
- Società di Anestesia e Rianimazione Neonatale e Pediatrica Italiana, Rome, Italy
| | - Giuseppe Zampino
- Società Italiana di Malattie Genetiche Pediatriche e Disabilità, Rome, Italy
| | | | - Marco Zecca
- Associazione Italiana di Ematologia e Oncologia Pediatrica, Rome, Italy
| | - Silvia Bloise
- Federazione Italiana delle Associazioni e Società Scientifiche dell'Area Pediatrica e Società Italiana di Emergenza Urgenza Pediatrica, Rome, Italy.,Dipartimento Materno Infantile e di Scienze Urologiche, Sapienza Università di Roma, UOC di Pediatria e Neonatologia, Ospedale Santa Maria Goretti, Polo di Latina, Latina, Italy
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11
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Picascia S, Camarca A, Malamisura M, Mandile R, Galatola M, Cielo D, Gazza L, Mamone G, Auricchio S, Troncone R, Greco L, Auricchio R, Gianfrani C. In Celiac Disease Patients the In Vivo Challenge with the Diploid Triticum monococcum Elicits a Reduced Immune Response Compared to Hexaploid Wheat. Mol Nutr Food Res 2020; 64:e1901032. [PMID: 32374905 DOI: 10.1002/mnfr.201901032] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 02/11/2020] [Indexed: 12/27/2022]
Abstract
SCOPE Gluten from the diploid wheat Triticum monococcum (TM) has low content of immunostimulatory sequences and a high gastro-intestinal digestibility. Gluten-reactive T cells elicited by diploid and hexaploid (Triticum aestivum-TA) wheat in celiac disease (CD) patients upon a brief oral challenge are analyzed. METHODS AND RESULTS Seventeen patients with CD (median age 13 years) consumed for 3 days sandwiches made with TM (cultivar Norberto-ID331, N=11), or TA (cultivar Sagittario, N=11) flours, corresponding to 12 gr of gluten/die. Immunostimulatory properties are assessed in blood by measuring the IFN-γ-secreting T cells by EliSpot and the expression of inflammatory cytokines/receptors (IL-12A, IL-15, IL-18RAP, IFN-γ) by qPCR. TA mobilizes a remarkable number of gliadin-specific, IFN-γ-secreting T cells (p<0.05), while no significant cell mobilization is induced by TM (p=ns). Similar results are obtained in response to five immunogenic peptides from α-, ω-, and γ-gliadins, although with a large individual variability. An increased mRNA expression for IL-12A and IFN-γ is detected in the group eating TA compared to those consuming TM (p<0.05). CONCLUSIONS Although T. monococcum is a cereal not suitable for the diet of celiacs, this diploid wheat elicits a reduced in vivo T-cell response compared to T. aestivum in celiac patients.
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Affiliation(s)
- Stefania Picascia
- Institute of Biochemistry and Cell Biology, National Research Council, Via Pietro Castellino, 111, Napoli, Naples, 80131, Italy
| | - Alessandra Camarca
- Institute of Food Sciences, National Research Council, Via Roma, 64, Avellino, 83100, Italy
| | - Monica Malamisura
- Department of Medical Translational Sciences, Section of Pediatrics, Federico II University of Naples, Via Sergio Pansini, 5, Napoli, 80131, Italy
| | - Roberta Mandile
- Department of Medical Translational Sciences, Section of Pediatrics, Federico II University of Naples, Via Sergio Pansini, 5, Napoli, 80131, Italy
| | - Martina Galatola
- Department of Medical Translational Sciences, Section of Pediatrics, Federico II University of Naples, Via Sergio Pansini, 5, Napoli, 80131, Italy
| | - Donatella Cielo
- Department of Medical Translational Sciences, Section of Pediatrics, Federico II University of Naples, Via Sergio Pansini, 5, Napoli, 80131, Italy
| | - Laura Gazza
- CREA Research Centre for Engineering and Agro-Food Processing, Via Po, 14, Roma, 00198, Italy
| | - Gianfranco Mamone
- Institute of Food Sciences, National Research Council, Via Roma, 64, Avellino, 83100, Italy
| | - Salvatore Auricchio
- Department of Medical Translational Sciences, Section of Pediatrics, Federico II University of Naples, Via Sergio Pansini, 5, Napoli, 80131, Italy.,European Laboratory for the Food Induced Diseases (E.L.F.I.D), Federico II University of Naples, Via Sergio Pansini, 5, Napoli, 80131, Italy
| | - Riccardo Troncone
- Department of Medical Translational Sciences, Section of Pediatrics, Federico II University of Naples, Via Sergio Pansini, 5, Napoli, 80131, Italy.,European Laboratory for the Food Induced Diseases (E.L.F.I.D), Federico II University of Naples, Via Sergio Pansini, 5, Napoli, 80131, Italy
| | - Luigi Greco
- Department of Medical Translational Sciences, Section of Pediatrics, Federico II University of Naples, Via Sergio Pansini, 5, Napoli, 80131, Italy.,European Laboratory for the Food Induced Diseases (E.L.F.I.D), Federico II University of Naples, Via Sergio Pansini, 5, Napoli, 80131, Italy
| | - Renata Auricchio
- Department of Medical Translational Sciences, Section of Pediatrics, Federico II University of Naples, Via Sergio Pansini, 5, Napoli, 80131, Italy.,European Laboratory for the Food Induced Diseases (E.L.F.I.D), Federico II University of Naples, Via Sergio Pansini, 5, Napoli, 80131, Italy
| | - Carmen Gianfrani
- Institute of Biochemistry and Cell Biology, National Research Council, Via Pietro Castellino, 111, Napoli, Naples, 80131, Italy.,European Laboratory for the Food Induced Diseases (E.L.F.I.D), Federico II University of Naples, Via Sergio Pansini, 5, Napoli, 80131, Italy
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12
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Quitadamo P, Tambucci R, Alessandrella A, Andreozzi M, Malamisura M, Isoldi S, Caldaro T, Zenzeri L, Verrotti A, De Angelis P, Siani P, Staiano A. Association between body positioning and gastroesophageal reflux in paediatric age. Acta Paediatr 2020; 109:1033-1039. [PMID: 31602697 DOI: 10.1111/apa.15049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 09/05/2019] [Accepted: 10/07/2019] [Indexed: 12/12/2022]
Abstract
AIM Postural measures are frequently recommended for gastroesophageal reflux (GER) symptoms, despite limited evidence. This was the first study to assess the impact of upright and recumbent body positions on GER episodes in children and adolescents, not just infants. METHODS We retrospectively assessed the pH-impedance parameters of paediatric patients referred for possible GER-related symptoms to two hospitals in Naples and Rome, Italy, from September 2016 to September 2018. Data were separately obtained for the time that the patients spent in upright and recumbent positions. RESULTS Data from 187 patients under the age of 18 were collected, at a mean age of just over seven years. We found that the acid exposure time was stable irrespective of changes in body position (P > .05). The mean number of reflux episodes per hour was 2.99 during the upright position and 1.21 during the recumbent position (P < .05), and the mean oesophageal acid clearance time was 44.4 and 93.4 seconds, respectively (P < .05). CONCLUSION Most paediatric patients experienced reflux in the upright rather than recumbent position, probably as a result of frequent transient lower oesophageal sphincter relaxations while they were awake. In particular, our findings provide new insights into postural measures for reflux in children and adolescents.
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Affiliation(s)
- Paolo Quitadamo
- Department of Translational Medical Science Section of Pediatrics “Federico II” University of Naples Naples Italy
- Department of Pediatrics A.O.R.N. Santobono‐Pausilipon Naples Italy
| | - Renato Tambucci
- Digestive Endoscopy and Surgery Unit Bambino Gesù Children's Hospital‐IRCCS Rome Italy
- Department of Biotechnological and Applied Clinical Sciences Pediatric Unit University of L'Aquila L'Aquila Italy
| | - Annalisa Alessandrella
- Department of Translational Medical Science Section of Pediatrics “Federico II” University of Naples Naples Italy
| | - Marialuisa Andreozzi
- Department of Translational Medical Science Section of Pediatrics “Federico II” University of Naples Naples Italy
| | - Monica Malamisura
- Digestive Endoscopy and Surgery Unit Bambino Gesù Children's Hospital‐IRCCS Rome Italy
| | - Sara Isoldi
- Digestive Endoscopy and Surgery Unit Bambino Gesù Children's Hospital‐IRCCS Rome Italy
| | - Tamara Caldaro
- Digestive Endoscopy and Surgery Unit Bambino Gesù Children's Hospital‐IRCCS Rome Italy
| | - Letizia Zenzeri
- Department of Pediatrics University of Perugia Perugia Italy
| | - Alberto Verrotti
- Department of Biotechnological and Applied Clinical Sciences Pediatric Unit University of L'Aquila L'Aquila Italy
| | - Paola De Angelis
- Digestive Endoscopy and Surgery Unit Bambino Gesù Children's Hospital‐IRCCS Rome Italy
| | - Paolo Siani
- Department of Pediatrics A.O.R.N. Santobono‐Pausilipon Naples Italy
| | - Annamaria Staiano
- Department of Translational Medical Science Section of Pediatrics “Federico II” University of Naples Naples Italy
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13
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Lega S, Pin A, Arrigo S, Cifaldi C, Girardelli M, Bianco AM, Malamisura M, Angelino G, Faraci S, Rea F, Romeo EF, Aloi M, Romano C, Barabino A, Martelossi S, Tommasini A, Di Matteo G, Cancrini C, De Angelis P, Finocchi A, Bramuzzo M. Diagnostic Approach to Monogenic Inflammatory Bowel Disease in Clinical Practice: A Ten-Year Multicentric Experience. Inflamm Bowel Dis 2020; 26:720-727. [PMID: 31375816 DOI: 10.1093/ibd/izz178] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND AIMS Multiple monogenic disorders present as very early onset inflammatory bowel disease (VEO-IBD) or as IBD with severe and atypical features. Establishing a genetic diagnosis may change patients' management and prognosis. In this study, we describe the diagnostic approach to suspected monogenic IBD in a real clinical setting, discussing genetic and phenotypic findings and therapeutic implications of molecular diagnosis. METHODS Information of patients with VEO-IBD and early onset IBD with severe/atypical phenotypes (EO-IBD s/a) managed between 2008-2017 who underwent a genetic workup were collected. RESULTS Ninety-three patients were included, and 12 (13%) reached a genetic diagnosis. Candidate sequencing (CS) was performed in 47 patients (50%), and next generation sequencing (NGS) was performed in 84 patients (90%). Candidate sequencing had a good diagnostic performance only when guided by clinical features specific for known monogenic diseases, whereas NGS helped finding new causative genetic variants and would have anticipated one monogenic diagnosis (XIAP) and consequent bone marrow transplant (BMT). Patients with monogenic IBD more frequently were male (92% vs 54%; P = 0.02), had extraintestinal findings (100% vs 34%; P < 0.001), and had disease onset ≤1 month of life (25% vs 1%; P = 0.006). Genetic diagnosis impacted patient management in 11 patients (92%), 7 of whom underwent BMT. CONCLUSION A genetic diagnosis can be established in a significant proportion of suspected monogenic IBD and has an impact on patients' management. Candidate sequencing may be deployed when clinical findings orientate toward a specific diagnosis. Next generation sequencing should be preferred in patients with nonspecific phenotypes.
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Affiliation(s)
- Sara Lega
- University of Trieste, Department of Medicine, Surgery and Health Sciences, Trieste, Italy
| | - Alessia Pin
- University of Trieste, Department of Medicine, Surgery and Health Sciences, Trieste, Italy
| | - Serena Arrigo
- Pediatric Gastroenterology and Endoscopy Unit, Institute Giannina Gaslini, Genoa, Italy
| | - Cristina Cifaldi
- Department of Pediatrics, Children's Hospital Bambino Gesù, Rome, Italy
| | - Martina Girardelli
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Anna Monica Bianco
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Monica Malamisura
- Digestive Diseases Unit, Children's Hospital Bambino Gesù, Rome, Italy
| | - Giulia Angelino
- Digestive Diseases Unit, Children's Hospital Bambino Gesù, Rome, Italy
| | - Simona Faraci
- Digestive Diseases Unit, Children's Hospital Bambino Gesù, Rome, Italy
| | - Francesca Rea
- Digestive Diseases Unit, Children's Hospital Bambino Gesù, Rome, Italy
| | | | - Marina Aloi
- Pediatric Gastroenterology And Liver Unit, Sapienza University of Rome, Rome, Italy
| | - Claudio Romano
- Pediatric Gastroenterology and Cystic Fibrosis Unit, University of Messina, Messina, Italy
| | - Arrigo Barabino
- Pediatric Gastroenterology and Endoscopy Unit, Institute Giannina Gaslini, Genoa, Italy
| | - Stefano Martelossi
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | - Alberto Tommasini
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
| | | | - Caterina Cancrini
- Department of Pediatrics, Children's Hospital Bambino Gesù, Rome, Italy
| | - Paola De Angelis
- Digestive Diseases Unit, Children's Hospital Bambino Gesù, Rome, Italy
| | - Andrea Finocchi
- Department of Pediatrics, Children's Hospital Bambino Gesù, Rome, Italy
| | - Matteo Bramuzzo
- Institute for Maternal and Child Health, IRCCS Burlo Garofolo, Trieste, Italy
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14
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Tambucci R, Rea F, Angelino G, Malamisura M, Mennini M, Riccardi C, Farello G, Valfré L, Dall’Oglio L, Markowitz JE, Fiocchi AG, De Angelis P. Eosinophilic esophagitis in esophageal atresia: Tertiary care experience of a "selective" approach for biopsy sampling. World Allergy Organ J 2020; 13:100116. [PMID: 32256942 PMCID: PMC7132091 DOI: 10.1016/j.waojou.2020.100116] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 03/03/2020] [Accepted: 03/05/2020] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND A high prevalence (9.5-30%) of eosinophilic esophagitis (EoE) in patients with esophageal atresia (EA) has been reported. The application of the EoE criteria to EA patients might be problematic. To date, only studies using a "routine" biopsy approach, even in asymptomatic patients, have been performed. The aim of the study was to establish the prevalence of EoE among symptomatic EA patients (EA/EoE group) without anastomotic stricture (AS) and to compare their characteristics with those of EoE patients from general population (EoE group). METHODS From 2005 to 2018, we reviewed charts of children with EA and EoE. "Selective" biopsy approach only in EA children without AS and/or endoscopic feature of EoE was performed. Characteristics of EA/EoE and EoE groups were compared. RESULTS Among 370 EA and 118 EoE, 15 EA/EoE patients were detected (4.0% of EA patients). Male predominance and a high prevalence of allergy without differences between EA/EoE and EoE groups was observed. EA/EoE children were significantly younger (p < 0.0001). PPI-responder patients were significantly more prevalent in EA/EoE group (p = 0.045). CONCLUSION Our data confirm that EA patients are at high risk for developing EoE. High incidence, early onset, and high prevalence of PPI-responders might suggest that esophageal motility disorders interact to increase propensity to EoE in EA patients. However, our study also suggests that overdiagnosis of EoE may occur in EA and that adapted criteria for EoE diagnosis should be developed for EA patients. TRIAL REGISTRATION Not applicable for this retrospective study.
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Affiliation(s)
- Renato Tambucci
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
- Department of Biotechnological and Applied Clinical Sciences, University of L'Aquila, L'Aquila, Italy
- Corresponding author. Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital, IRCCS, Piazza Sant’Onofrio 4, 00165, Rome, Italy.
| | - Francesca Rea
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Giulia Angelino
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Monica Malamisura
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Maurizio Mennini
- Pediatric Allergology Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Carla Riccardi
- Pediatric Allergology Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Giovanni Farello
- Pediatric Unit, Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy
| | - Laura Valfré
- Neonatal Surgery Unit, Department of Medical and Surgical Neonatology, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Luigi Dall’Oglio
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
| | - Jonathan E. Markowitz
- Pediatric Gastroenterology, Greenville Health System, University of South Carolina School of Medicine-Greenville, Clemson University School of Health Research, Greenville, SC, USA
| | | | - Paola De Angelis
- Digestive Endoscopy and Surgery Unit, Bambino Gesù Children's Hospital-IRCCS, Rome, Italy
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15
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Malamisura M, Colantuono R, Salvati VM, Croce R, D'Adamo G, Passaro T, D'Angelo E, Boffardi M, Garzi A, Malamisura B. Current Espghan Guidelines for Celiac Disease in Pediatric Age, Tertiary Care Center Experience: A Proposal for Further Simplification. Transl Med UniSa 2019; 20:13-18. [PMID: 31850247 PMCID: PMC6910143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
According to the 2012 ESPGHAN criteria for diagnosis of celiac disease (CD), duodenal biopsy (DB) can be avoided in children with a clear malabsorption syndrome, anti-tissue transglutaminase IgA (tTG2) ≥ 10x the cut-off, anti-endomysium IgA (EMA) and HLA DQ2/DQ8 genes. The aim of this study is to report our experience and evaluate the accuracy of the actual guidelines. PATIENTS AND METHODS This is a retrospective study conducted on all patients diagnosed CD from 2012 to 2018 in our Center. For all patients enrolled were analyzed: data of family history, symptoms, serology, genetics, Marsh grade and follow-up. RESULTS A total of 481 children [mean age 6,4 yrs; F:M= 1.8:1] were included in the study. The mean age of patients who were not subject to DB was lower (4.51 yrs) comparing with patients that received DB (6.48 yrs). Out of the 256 patients with anti-tTG2 ≥ 10 fold, 121 underwent DB because of mild symptoms (84/121) or no symptoms (37/121). In all cases Marsh type 3 was found and HLA haplotypes was compatible with CD diagnosis. CONCLUSIONS Our study confirms that the serology has a primary importance to diagnose CD, regardless of the symptoms. These data suggest that biopsy and HLA haplotypes search, in presence of anti-tTG2 IgA ≥ 10x the cut-off, are wasteful and unhelpful for the patients.
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Affiliation(s)
- M Malamisura
- Academic Department of Pediatrics, Ospedale Pediatrico Bambino Gesù, IRCCS, University of Rome, Italy
| | - R Colantuono
- Post-graduate School of Pediatrics - University of Salerno, Italy
| | - V M Salvati
- Pediatric Unit and Center for Celiac Disease - University Hospital of Salerno, Campus of Cava de' Tirreni, Italy
| | - R Croce
- Pediatric Unit and Center for Celiac Disease - University Hospital of Salerno, Campus of Cava de' Tirreni, Italy
| | - G D'Adamo
- Pediatric Unit and Center for Celiac Disease - University Hospital of Salerno, Campus of Cava de' Tirreni, Italy
| | - T Passaro
- Pediatric Unit and Center for Celiac Disease - University Hospital of Salerno, Campus of Cava de' Tirreni, Italy
| | - E D'Angelo
- Pediatric Unit and Center for Celiac Disease - University Hospital of Salerno, Campus of Cava de' Tirreni, Italy
| | - M Boffardi
- Pediatric Unit and Center for Celiac Disease - University Hospital of Salerno, Campus of Cava de' Tirreni, Italy
| | - A Garzi
- Mini-invasive and Robotic Pediatric Surgery - Maternal and Child Department, University of Salerno, Italy
| | - B Malamisura
- Pediatric Unit and Center for Celiac Disease - University Hospital of Salerno, Campus of Cava de' Tirreni, Italy
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16
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Pagani S, Bozzola E, Strisciuglio C, Meazza C, Miele E, Malamisura M, De Angelis P, Bozzola M. Growth Hormone Receptor Gene Expression Increase Reflects Nutritional Status Improvement in Patients Affected by Crohn's Disease. Front Pediatr 2018; 6:338. [PMID: 30483486 PMCID: PMC6240681 DOI: 10.3389/fped.2018.00338] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Accepted: 10/19/2018] [Indexed: 01/07/2023] Open
Abstract
Background: We proposed to verify the role of growth hormone receptor gene expression in growth failure of children with Crohn's disease (CD). Methods: We measured serum levels of growth hormone binding protein (GHBP) and insulin-like growth factor-I (IGF-I), and growth hormone receptor (GHR) gene expression in peripheral blood mononuclear cells of 21 patients with CD (before and after therapy) and in 27 age-sex-matched controls. Results: At diagnosis, significantly lower insulin-like growth factor-I and growth hormone binding protein levels were found in the CD group compared to the controls. Growth hormone receptor mRNA expression was lower in patients at diagnosis compared to the controls, even though the difference did not reach statistical significance, and significantly increased in patients in the following year. Insulin-like growth factor-I levels showed significant improvements 1 year after diagnosis compared to basal levels. On the contrary, growth hormone binding protein values had not significantly changed after 1 year of therapy. Conclusion: Our study raises the hypothesis of another mechanism through which cytokines interact with the growth hormone/insulin-like growth factor-I (GH/IGF-I) axis.
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Affiliation(s)
- Sara Pagani
- Unit of Pediatrics and Adolescentology, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Elena Bozzola
- Pediatrics Department Bambino Gesù Children's Hospital, Rome, Italy
| | - Caterina Strisciuglio
- Department of Women, Children and General and Specialized Surgery, Second University of Naples, Naples, Italy
| | - Cristina Meazza
- Unit of Pediatrics and Adolescentology, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
| | - Erasmo Miele
- Pediatric Gastroenterology Division, University of Naples Federico II, Naples, Italy
| | - M Malamisura
- Digestive Surgery and Endoscopy Unit,Bambino Gesù Children's Hospital, Rome, Italy
| | - Paola De Angelis
- Digestive Surgery and Endoscopy Unit,Bambino Gesù Children's Hospital, Rome, Italy
| | - Mauro Bozzola
- Unit of Pediatrics and Adolescentology, Department of Internal Medicine and Therapeutics, University of Pavia, Pavia, Italy
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Traina G, Valluzzi RL, Fierro V, Riccardi C, Artesani MC, De Vuono A, Fiocchi A, Martelli AG, Ríos LA, Alcocer CR, Navarrete E, Del Rio Navarro BE, Gonzalez V, Velasco B, Perez Aviles HJ, Fernandez RJ, Pozo FC, Farhan AJ, Arshad H, Hussain A, Sharikadze O, Okhotnikova O, Alcover J, Rodriguez D, Pineda F, Dalal I, Weinbrand-Goichberg J, Benor S, Rottem M, Kivity S, Sato S, Yanagida N, Ebisawa M, Umanets T, Pineda F, Antipkin Y, Barzylovich V, Lapshyn V, Umanets T, Umanets M, Yuriev S, Pineda F, Rodriguez D, Alcover J, Bekir S, Pincock T, Vieira Hernandez A, Capriles Hulett A, Sánchez Borges M, Fabiano F, Albarran C, Goyal R, Gupta S, Gaurav G, Luskin AT, Griffin NM, Wagelie-Steffen A, Trzaskoma BL, Limb SL, Busse WW, Zeiger RS, Gonzalez-Reyes E, Casale TB, Chipps BE, Sugizaki C, Goto F, Sato S, Yanagida N, Ebisawa M, Yamaide A, Mitsunaga K, Tomiita M, Hoshioka A, Shimojo N, Pop LL, Ciucǎ IM, Tǎmaş L, Lazarescu M, Pienar C, Yamaide F, Fikri B, Sato H, Shimojo N, Okishima N, Kobayashi M, Takai M, Nishigata K, Yoda R, Oana YT, Kajiwara C, Shimodaira M, Suzuki T, Iizawa H, Kamijo K, Karmakar B, Bhattacharya SG, Blohlávková S, Kopelentová E, Víšek P, Štádler J, Šetinová I, Novobílská J, Lundelin K, Salminen S, Isolauri E, Pitt T, Flanders T, Peñalver M, Martínez P, Lluch M, Malet A, Nam YH, Jin HJ, Lee SK, Kulalert P, Sritipsukho P, Pathumanond J, Baynova K, Labella M, De Aramburu T, Prados M, Haanpää L, Aarnio J, Nermes M, Af Ursin P, Kaljonen A, Isolauri E, Bala N, Bhagwat K, Hindley J, Chapman M, Baalasubramanian S, Besednjak-Kocijančič L, SenGupta K, Bhattacharya SG, Chipps BE, Antonova E, Kong AM, Iqbal A, Teague WG, Chipps BE, Antonova E, Trzaskoma B, Ortiz B, Paknis B, Iqbal A, Rosen K, Szefler S, Alblooshi A, Al-Hammadi S, Vega A, Gutiérrez-Rivas R, Alonso AM, Beitia JM, Belén Mateo M, Cárdenas R, García-Domínguez JJ, Pitchon Dos Reis R, Gonçalves Alvim C, Andrade C, Reis A, Ribeiro H, Panaitescu Bunu C, Marusciac L, Paralescu S, Tamas P, Panitescu Bunu C, Marusciac L, Paralescu S, Tamas P, Martí Guadaño E, Escobar Bolaños C, Martí José N, Pau Casanovas P, Biarnés Rib G, Castells M, de Vicente Jiménez T, Mennini M, Riccardi C, De Angelis P, Rea F, Malamisura M, Tambucci R, Fiocchi A, Dall'Oglio L, Mennini M, Del Chierico F, Napolitano T, Reddel S, Vernocchi P, D'Ambrosio A, Putignani L, Artesani MC, Dahdah L, Fierro V, Banzato C, Echeverría Zudaire LA, Plaza AM, Bosque García M, Íbero M, Mazzina O, Fierro V, Marzano V, Riccardi C, Mazzina O, Dahdah L, Mennini M, Artesani MC, Mazzina O, Pecora V, Koch P, Valluzzi RL, Fierro V, Fiocchi A, Pecora V, Valentini D, Mennini M, Dahdah L, Mazzina O, Santamaria F, Valluzzi R, Mukherjee A, Kandhare A, Bodhankar S. Proceedings of the 2017 WAO Symposium on Hot Topics in Allergy: Pediatric & Regulatory Aspects: Rome, Italy/Vatican City. 27-29 April 2017. World Allergy Organ J 2017; 10:39. [PMID: 29444193 PMCID: PMC5773904 DOI: 10.1186/s40413-017-0170-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Giovanni Traina
- U.O.C Pediatria, Ospedale G. Salvini, Garbagnate Milanese, Milan, Italy
| | - Rocco Luigi Valluzzi
- 2Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Italy
| | - Vincenzo Fierro
- 2Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Italy
| | - Carla Riccardi
- 2Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Italy
| | - Maria Cristina Artesani
- 2Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Italy
| | - Andrea De Vuono
- Ufficio Statistica, Ospedale G. Salvini, Garbagnate Milanese, Milan, Italy
| | - Alessandro Fiocchi
- 2Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Italy
| | | | - Luis Alberto Ríos
- 4Pediatric Allergy and Clinical Immunology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Christian R Alcocer
- 4Pediatric Allergy and Clinical Immunology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Elsy Navarrete
- 4Pediatric Allergy and Clinical Immunology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | | | - Victor Gonzalez
- 4Pediatric Allergy and Clinical Immunology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Berenice Velasco
- 4Pediatric Allergy and Clinical Immunology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Herberth J Perez Aviles
- 4Pediatric Allergy and Clinical Immunology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - Roberto Jose Fernandez
- 4Pediatric Allergy and Clinical Immunology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | - F Cesar Pozo
- 4Pediatric Allergy and Clinical Immunology, Hospital Infantil de México Federico Gómez, Mexico City, Mexico
| | | | - Hasan Arshad
- 6Faculty of Medicine, Southampton University, Southampton, UK
| | | | - Olena Sharikadze
- 8Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
| | - Olena Okhotnikova
- 8Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
| | | | | | | | - Ilan Dalal
- 10Pediatric Allergy Unit, E. Wolfson Medical Center, Pediatric Department, E. Wolfson Medical Center, Sackler faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | | | - Shira Benor
- 12Allergy and Clinical Immunology Unit, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Menachem Rottem
- 13Allergy Asthma and Immunology Unit, Emek Medical Center, Afula, Israel
| | - Shmuel Kivity
- 12Allergy and Clinical Immunology Unit, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sakura Sato
- 14Department of Allergy, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
| | - Noriyuki Yanagida
- 15Department of Pediatrics, Sagamihara National Hospital, Kanagawa, Japan
| | - Motohiro Ebisawa
- 14Department of Allergy, Clinical Research Center for Allergy and Rheumatology, Sagamihara National Hospital, Kanagawa, Japan
| | - Tetiana Umanets
- Institute of Pediatrics, Obstetrics and Gynecology, Kyiv, Ukraine
| | | | - Youriy Antipkin
- Institute of Pediatrics, Obstetrics and Gynecology, Kyiv, Ukraine
| | | | | | - Tetiana Umanets
- Institute of Pediatrics, Obstetrics and Gynecology, Kyiv, Ukraine
| | | | - Sergey Yuriev
- Ukrainian School of Molecular Allergy and Immunology, Kyiv, Ukraine
| | | | | | | | - Suzan Bekir
- Collective.care Allergy Clinic, Sydney, Australia.,Australian Allergy Centre, Sydney, Australia
| | - Tobias Pincock
- Collective.care Allergy Clinic, Sydney, Australia.,Australian Allergy Centre, Sydney, Australia
| | | | | | - Mario Sánchez Borges
- 26Departamento de Pediatria, Centro Medico Docente La Trinidad, Caracas, Venezuela
| | | | - Carlos Albarran
- 25Departamento de Alergologia, Hospital de San Juan De Dios, Caracas, Venezuela
| | - Rohit Goyal
- 28Max Super Speciality Hospital, Bathinda, India
| | | | - Garg Gaurav
- 30Deen Dayal Upadhyay Hospital, New Delhi, India
| | | | | | | | | | | | - William W Busse
- 34University of Wisconsin School of Medicine and Public Health, Madison, WI USA
| | - Robert S Zeiger
- 35Deptartment of Allergy and Research and Evaluation, Kaiser Permanente Southern California, San Diego, CA USA
| | - Erika Gonzalez-Reyes
- 36The Children's Hospital of San Antonio, Baylor College of Medicine, San Antonio, TX USA
| | - Thomas B Casale
- 37Division of Allergy and Immunology, University of South Florida, Tampa, FL USA
| | - Bradley E Chipps
- 38Capital Allergy and Respiratory Disease Center, Sacramento, CA USA
| | - Chizuko Sugizaki
- 39Clinical Research Center, Sagamihara National Hospital, Sagamihara, Japan
| | - Fumiko Goto
- 39Clinical Research Center, Sagamihara National Hospital, Sagamihara, Japan
| | - Sakura Sato
- 39Clinical Research Center, Sagamihara National Hospital, Sagamihara, Japan
| | - Noriyuki Yanagida
- 39Clinical Research Center, Sagamihara National Hospital, Sagamihara, Japan
| | - Motohiro Ebisawa
- 39Clinical Research Center, Sagamihara National Hospital, Sagamihara, Japan
| | - Akiko Yamaide
- 40Department of Allergy and Rheumatology, Chiba Children's Hospital, Chiba, Japan
| | - Kanako Mitsunaga
- 40Department of Allergy and Rheumatology, Chiba Children's Hospital, Chiba, Japan
| | - Minako Tomiita
- 40Department of Allergy and Rheumatology, Chiba Children's Hospital, Chiba, Japan
| | - Akira Hoshioka
- 40Department of Allergy and Rheumatology, Chiba Children's Hospital, Chiba, Japan
| | - Naoki Shimojo
- 41Department of Pediatrics, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Liviu L Pop
- 42Department of Pediatrics II, Victor Babeş University of Medicine and Pharmacy Timisora, Timisoara, Romania.,National Cystic Fibrosis Center, Timisoara, Romania
| | - Ioana-Mihaela Ciucǎ
- 42Department of Pediatrics II, Victor Babeş University of Medicine and Pharmacy Timisora, Timisoara, Romania.,National Cystic Fibrosis Center, Timisoara, Romania
| | - Liviu Tǎmaş
- 43Department of Biochemistry, Victor Babeş University of Medicine and Pharmacy Timisora, Timisoara, Romania
| | | | - Corina Pienar
- 42Department of Pediatrics II, Victor Babeş University of Medicine and Pharmacy Timisora, Timisoara, Romania
| | - Fumiya Yamaide
- 45Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Bahrul Fikri
- 45Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hironori Sato
- 45Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Naoki Shimojo
- 45Department of Pediatrics, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Naoko Okishima
- 46Department of Health and Nutritional Science, Matsumoto University, Matsumoto, Japan
| | - Miyabi Kobayashi
- 46Department of Health and Nutritional Science, Matsumoto University, Matsumoto, Japan
| | - Mizuki Takai
- 46Department of Health and Nutritional Science, Matsumoto University, Matsumoto, Japan
| | - Kotarou Nishigata
- 46Department of Health and Nutritional Science, Matsumoto University, Matsumoto, Japan
| | - Ryou Yoda
- 46Department of Health and Nutritional Science, Matsumoto University, Matsumoto, Japan
| | - Yu-Ta Oana
- 46Department of Health and Nutritional Science, Matsumoto University, Matsumoto, Japan
| | - Chifu Kajiwara
- 46Department of Health and Nutritional Science, Matsumoto University, Matsumoto, Japan
| | - Moe Shimodaira
- 46Department of Health and Nutritional Science, Matsumoto University, Matsumoto, Japan
| | - Tomoka Suzuki
- 46Department of Health and Nutritional Science, Matsumoto University, Matsumoto, Japan
| | - Hiromi Iizawa
- 47Health Support Station, Matsumoto University, Matsumoto, Japan
| | | | | | | | - Simona Blohlávková
- Immuno-flow, s.r.o., Prague, Czech Republic.,52Medical Faculty, Charles University, Pilsen, Czech Republic
| | - Eliška Kopelentová
- Allergology Department, Kolín Hospital, Kolín, Czech Republic.,54Allergology and Immunology Department, Faculty Hospital Motol, Prague, Czech Republic
| | - Petr Víšek
- Allergology and Immunology Department, Litomyšl, Czech Republic
| | | | | | | | - Krisa Lundelin
- 58Department of Paediatrics, Turku University Hospital, Turku, Finland
| | - Seppo Salminen
- 58Department of Paediatrics, Turku University Hospital, Turku, Finland.,59Functional Foods Forum, University of Turku, Turku, Finland
| | - Erika Isolauri
- 58Department of Paediatrics, Turku University Hospital, Turku, Finland
| | - Tracy Pitt
- Department of Paediatrics, Humber River Hospital, Toronto, ON Canada.,61Deptartment of Paediatrics, Queen's University, Kingston, ON Canada
| | | | | | - Patricia Martínez
- Allergy and Clinical Immunology Service, Hospital de Nens de Barcelona, Barcelona, Spain
| | - Magdalena Lluch
- Allergy and Clinical Immunology Service, Hospital de Nens de Barcelona, Barcelona, Spain
| | - Alfonso Malet
- Allergy and Clinical Immunology Service, Hospital de Nens de Barcelona, Barcelona, Spain
| | - Young-Hee Nam
- 65Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea
| | - Hyun Jung Jin
- 66Department of Internal Medicine, Yeungnam University Medical School, Daegu, Korea
| | - Soo-Keol Lee
- 65Department of Internal Medicine, College of Medicine, Dong-A University, Busan, Korea
| | - Prapasri Kulalert
- 67Division of Clinical Epidemiology, and Division of Allergy and Immunology, Deptartment of Pediatrics, Faculty of Medicine, Thammasat University (Rungsit Campus), Pathum Thani, Thailand.,68Thammasat University Center of Excellence of Asthma, Allergy and Immunology, Thammasat University Hospital, Pathum Thani, Thailand
| | - Paskorn Sritipsukho
- 69Division of Allergy and Immunology, Department of Pediatrics, Faculty of Medicine, Thammasat University (Rungsit Campus), Pathum Thani, Thailand.,70Center of Excellence in Applied Epidemiology, Thammasat University (Rungsit campus), Pathum Thani, Thailand
| | - Jayanton Pathumanond
- 71Division of Clinical Epidemiology, Faculty of Medicine, Thammasat University (Rungsit Campus), Pathum Thani, Thailand
| | - Krasimira Baynova
- 72Allergy Unit, University Hospital Virgen del Rocío, Seville, Spain
| | - Marina Labella
- 72Allergy Unit, University Hospital Virgen del Rocío, Seville, Spain
| | | | - Manuel Prados
- 72Allergy Unit, University Hospital Virgen del Rocío, Seville, Spain
| | - Leena Haanpää
- 73Child and Youth Research Institute, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Jasmin Aarnio
- 75Faculty of Medicine, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Merja Nermes
- 74Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
| | - Piia Af Ursin
- 73Child and Youth Research Institute, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Anne Kaljonen
- 75Faculty of Medicine, Department of Clinical Medicine, University of Turku, Turku, Finland
| | - Erika Isolauri
- 74Department of Pediatrics and Adolescent Medicine, Turku University Hospital, Turku, Finland
| | - Nandana Bala
- 77Rainbow Children's Hospital, Bangalore, India.,79Indoor Biotechnologies Inc, Charlottesville, VA USA
| | | | | | | | | | | | - Koyel SenGupta
- 81Division of Plant Biology, Bose Institute, Kolkata, India
| | | | - Bradley E Chipps
- 82Capital Allergy and Respiratory Disease Center, Sacramento, CA USA
| | | | - Amanda M Kong
- Truven Health Analytics, an IBM Company, Cambridge, MA USA
| | - Ahmar Iqbal
- 83Genentech, Inc., South San Francisco, CA USA
| | - W Gerald Teague
- 85Child Health Research Center, University of Virginia School of Medicine, Charlottesville, VA USA
| | - Bradley E Chipps
- 86Capital Allergy and Respiratory Disease Center, Sacramento, CA USA
| | | | | | - Benjamin Ortiz
- 88Novartis Pharmaceuticals Corporation, East Hanover, NJ USA
| | - Brandee Paknis
- 88Novartis Pharmaceuticals Corporation, East Hanover, NJ USA
| | - Amar Iqbal
- 87Genentech, Inc., South San Francisco, CA USA
| | - Karin Rosen
- 87Genentech, Inc., South San Francisco, CA USA
| | - Stanley Szefler
- 89Pediatric Asthma Research Program, Children's Hospital and University of Colorado School of Medicine, Colorado, Aurora, CO USA
| | - Afaf Alblooshi
- 90Deptartment of Pediatrics, UAE University, Al-Ain, United Arab Emirates
| | | | - Arantza Vega
- 91Allergy Service, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | | | - Ana Maria Alonso
- 91Allergy Service, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - Juan Maria Beitia
- 91Allergy Service, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - Maria Belén Mateo
- 91Allergy Service, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - Remedios Cárdenas
- 91Allergy Service, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | | | - Raquel Pitchon Dos Reis
- 93Department of Pediatrics, Federal University of Minas Gerais, Belo Horizonte, Brazil.,94Allergy Department, Mater Dei Hospital, Belo Horizonte, Brazil
| | | | - Claudia Andrade
- 93Department of Pediatrics, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Adriana Reis
- 93Department of Pediatrics, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | - Henrique Ribeiro
- 93Department of Pediatrics, Federal University of Minas Gerais, Belo Horizonte, Brazil
| | | | - Laura Marusciac
- OncoGen Research Center, Emergency Clinical County Hospital, Timisoara, Romania
| | - Sorin Paralescu
- 95Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Paul Tamas
- OncoGen Research Center, Emergency Clinical County Hospital, Timisoara, Romania
| | | | - Laura Marusciac
- OncoGen Research Center, Emergency Clinical County Hospital, Timisoara, Romania
| | - Sorin Paralescu
- 97Victor Babes University of Medicine and Pharmacy, Timisoara, Romania
| | - Paul Tamas
- OncoGen Research Center, Emergency Clinical County Hospital, Timisoara, Romania
| | | | | | | | | | | | - Mariana Castells
- 101Desensitization Unit, Brigham and Women's Hospital, Boston, MA USA
| | | | - Maurizio Mennini
- 103Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Carla Riccardi
- 103Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Papola De Angelis
- 104Digestive Surgery and Endoscopy Unit, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Francesca Rea
- 104Digestive Surgery and Endoscopy Unit, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Monica Malamisura
- 104Digestive Surgery and Endoscopy Unit, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Renato Tambucci
- 104Digestive Surgery and Endoscopy Unit, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Alessandro Fiocchi
- 103Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Luigi Dall'Oglio
- 104Digestive Surgery and Endoscopy Unit, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Maurizio Mennini
- 105Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | | | - Tania Napolitano
- 105Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Silvia Reddel
- 106Human Microbiome Unit, Bambino Gesù Children Hospital, Rome, Italy
| | - Pamela Vernocchi
- 106Human Microbiome Unit, Bambino Gesù Children Hospital, Rome, Italy
| | - Angelo D'Ambrosio
- 106Human Microbiome Unit, Bambino Gesù Children Hospital, Rome, Italy
| | - Lorenza Putignani
- 106Human Microbiome Unit, Bambino Gesù Children Hospital, Rome, Italy
| | | | - Lamia Dahdah
- 107Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Vincenzo Fierro
- 107Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Claudia Banzato
- 108Department of Life and Reproduction Sciences, Section of Pediatrics, University of Verona, Verona, Italy
| | | | - Ana María Plaza
- 110Pediatric Allergy and Clinical Immunology Department, Hospital Sant Joan de Déu, University of Barcelona, Barcelona, Spain
| | - Montserrat Bosque García
- 111Division of Pneumology, Hospital Parc Taulí, Autonomous University of Barcelona, Barcelona, Spain
| | - Marcel Íbero
- 112Allergy Unit, Hospital de Terrassa, Barcelona, Spain
| | - Oscar Mazzina
- 107Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Vincenzo Fierro
- 113Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Valeria Marzano
- 114Human Microbiome Unit, Bambino Gesù Children Hospital, Rome, Italy
| | - Carla Riccardi
- 113Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Oscar Mazzina
- 113Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Lamia Dahdah
- 113Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Maurizio Mennini
- 115Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Maria Cristina Artesani
- 115Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Oscar Mazzina
- 115Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Valeria Pecora
- 115Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Pierluigi Koch
- 115Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Rocco Luigi Valluzzi
- 115Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Vincenzo Fierro
- 115Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Alessandro Fiocchi
- 115Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Valentina Pecora
- 116Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Diletta Valentini
- 117Division of Infectious disease, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Maurizio Mennini
- 116Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Lamia Dahdah
- 116Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Oscar Mazzina
- 116Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Francesca Santamaria
- 116Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Rocco Valluzzi
- 116Division of Allergy, University Department of Pediatrics, Pediatric Hospital Bambino Gesù, Rome, Vatican City Italy
| | - Anwesha Mukherjee
- Department of Pharmacology, Poona College of Pharmacy, Bharati Videyapeeth Deemed University, Pune, India
| | - Amit Kandhare
- Department of Pharmacology, Poona College of Pharmacy, Bharati Videyapeeth Deemed University, Pune, India
| | - Subhash Bodhankar
- Department of Pharmacology, Poona College of Pharmacy, Bharati Videyapeeth Deemed University, Pune, India
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Maiorana A, Malamisura M, Emma F, Boenzi S, Di Ciommo VM, Dionisi-Vici C. Early effect of NTBC on renal tubular dysfunction in hereditary tyrosinemia type 1. Mol Genet Metab 2014; 113:188-93. [PMID: 25172236 DOI: 10.1016/j.ymgme.2014.07.021] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2014] [Revised: 07/24/2014] [Accepted: 07/24/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND Hereditary tyrosinemia type 1 (HT1) is characterized by severe progressive liver disease and renal tubular dysfunction. NTBC therapy has revolutionized the management of HT1 but its effect on renal tubular function has so far been poorly investigated. The aim of this study was to describe the early effect of NTBC on renal tubular disease in patients with HT1. METHODS Five HT1 patients (age between 5 and 53 months) with different types of presentation were evaluated before and during the first 2 weeks of therapy with NTBC in a retrospective case analysis for phosphate metabolism and renal tubular function. RESULTS Before starting NTBC therapy, all children manifested signs of renal dysfunction which included hypophosphatemia, acidosis, reduced phosphate reabsorption, aminoaciduria, glycosuria (Fanconi syndrome), and variable degree of proteinuria. Some patients also presented increased urinary calcium/creatinine ratio and raised fractional excretion of sodium. Starting of NTBC therapy resulted in the rapid normalization of plasma phosphate within one week from its initiation in majority of patients and in all patients during the second week of therapy. TmP/GFR normalized in 48h, while the other markers of renal dysfunction showed an improving trend over 2 weeks. CONCLUSIONS NTBC is an efficient treatment for renal tubular dysfunction in HT1, allowing the return to normal function within a few weeks. Its early effect on renal tubular cells appeared to be very rapid, particularly in normalizing plasma phosphate and TmP/GFR. In our series of patients, the TmP/GFR resulted as the most reliable index of tubular function.
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Affiliation(s)
- A Maiorana
- Department of Pediatric Medicine, Division of Metabolism and Research Unit of Metabolic Biochemistry.
| | - M Malamisura
- Department of Pediatric Medicine, Division of Metabolism and Research Unit of Metabolic Biochemistry.
| | - F Emma
- Department of Nephrology & Urology, Division of Nephrology and Dialysis.
| | - S Boenzi
- Department of Pediatric Medicine, Division of Metabolism and Research Unit of Metabolic Biochemistry.
| | - V M Di Ciommo
- Department of Health, Unit of Epidemiology, Bambino Gesù Children's Hospital and Research Institute, Piazza S. Onofrio 4, 00165 Rome, Italy.
| | - C Dionisi-Vici
- Department of Pediatric Medicine, Division of Metabolism and Research Unit of Metabolic Biochemistry.
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Passariello A, Maddalena Y, Malamisura M, Rojo S, Aragione N, Iaccarino E, Franco G, Giliberti P. Metabolic Alkalosis resulting from a Congenital Duodenal Diaphragm. J Neonatal Surg 2014. [DOI: 10.47338/jns.v3.138] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Duodenal diaphragm is an unusual cause of upper intestinal obstruction. We present here a neonate with duodenal diaphragm who presented with features of metabolic alkalosis. Further, an algorithm of management of metabolic alkalosis in a newborn is suggested.
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Ferrara P, De Angelis MC, Caporale O, Malamisura M, Del Volgo V, Vena F, Gatto A, Chiaretti A. Possible impact of comorbid conditions on the persistence of nocturnal enuresis: results of a long-term follow-up study. Urol J 2014; 11:1777-1782. [PMID: 25194075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Accepted: 06/18/2014] [Indexed: 06/03/2023]
Abstract
PURPOSE To describe the natural history of patients with nocturnal enuresis (NE) during a 10-year period and to evaluate possible impact of comorbid conditions on the persistence of NE. MATERIALS AND METHODS Ninety-five children (male to female ratio [M:F] 65:30), aged at first visit between 6 and 21 years were included in this study. Of study subjects 75 had primary monosymptomatic nocturnal enuresis (PMNE), 3 had secondary monosymptomatic nocturnal enuresis (SMNE) and 17 had non-monosymptomatic nocturnal enuresis (NMNE). Demographic and NE-related details were assessed from electronic medical records and by telephone interview at the times 3, 6, 12 months and 3, 5, 10 years after the first examination. Sixty-seven of 95 patients were enrolled, of whom 57 had PMNE (M:F ratio 39:18, mean age 9.35 ± 2.81 years, mean age at improvement 11.5 ± 4.08 years), 8 had NMNE (M:F ratio 4:4, mean age 10.1 ± 2.64 years, mean age at improvement 12.6 ± 1.68 years) and 2 had SMNE (M:F ratio 1:1, mean age 12 years, mean age at improvement 13.5 ± 2.12 years). RESULTS The mean duration of follow up was 7.2 ± 2.5 years. All of the 67 children had 5 years follow up. Only 29 of 67 patients (19 with PMNE, 8 with NMNE and 2 with SMNE) had 10 years follow up and 4 of 19 with PMNE were still affected by NE. Out of 57 patients with PMNE 12 (2/12 with language disorders, 1/12 varicocele and 1/12 cryptorchidism) and out of 8 patients with NMNE 1 were still enuretic while all patients with SMNE were in remission. CONCLUSION We observed that language disorders and testicular pathology in NE children could be comorbidities associated with persistence of NE and treatment resistance.
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Affiliation(s)
- Pietro Ferrara
- Institute of Pediatric, Catholic University of Sacred Heart, Rome, Italy.
| | | | | | | | | | | | - Antonio Gatto
- Institute of Pediatric, Catholic University of Sacred Heart, Rome, Italy
| | - Antonio Chiaretti
- Institute of Pediatric, Catholic University of Sacred Heart, Rome, Italy
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Ferrara P, Ianniello F, Cutrona C, Quintarelli F, Vena F, Del Volgo V, Caporale O, Malamisura M, De Angelis MC, Gatto A, Chiaretti A, Riccardi R. A focus on recent cases of suicides among Italian children and adolescents and a review of literature. Ital J Pediatr 2014; 40:69. [PMID: 25022200 PMCID: PMC4445587 DOI: 10.1186/s13052-014-0069-3] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/11/2014] [Accepted: 07/08/2014] [Indexed: 12/24/2022] Open
Abstract
Suicidal behaviors are among the leading causes of death worldwide. The large spread of suicide suggests that educational programs and literature to parents or guardians should include information about the potential risks and potential consequences of the onset of the idea of suicide in children. We identified 55 cases of suicide among children and young adults <18-year-old occurring in Italy between 1st January, 2011 and 31st December, 2013. The results point to the need to increase our understanding of the dramatic rise in suicidal behaviors during childhood/adolescence and of the causal pathways linking these behaviors to child-adolescent mental disorders. During routine care visits, pediatricians should be skilled to recognize risk factors for adolescent suicide in order to intervene appropriately.
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Affiliation(s)
- Pietro Ferrara
- Institute of Pediatrics, Catholic University of Sacred Heart, Rome, Italy.
| | | | | | | | | | | | | | | | | | - Antonio Gatto
- Institute of Pediatrics, Catholic University of Sacred Heart, Rome, Italy.
| | - Antonio Chiaretti
- Institute of Pediatrics, Catholic University of Sacred Heart, Rome, Italy.
| | - Riccardo Riccardi
- Institute of Pediatrics, Catholic University of Sacred Heart, Rome, Italy.
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Ferrara P, Romano V, del Bufalo E, Bottaro G, Caporale O, Del Volgo V, Vena F, Pecoraro R, Malamisura M, De Angelis MC, Fasano A. Humanitarian mission improves health conditions of schoolchildren in Ethiopia. the case of Adwa. Pediatr Med Chir 2014; 35:259-62. [PMID: 24620552 DOI: 10.4081/pmc.2013.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE The objective of this study is to compare health conditions of schoolchildren receiving aids from the mission Kidane Mehret Integrated Project (KMIP) in the city of Adwa, Ethiopia, with the ones of the general population. METHODS From September, 2008, to November, 2008, 400 children were randomly selected in the school inside KMIP and in the one of Adi Abetu. In phase 1, a questionnaire was distributed to children's families. In phase 2, children underwent physical examination. RESULTS Girls from KMIP started weaning on average at 7.3+/-3.9 vs 8.3+/-4.7 months of the control group (p>0.05); boys from KMIP started weaning on average at 6.7+/-4.1 vs 8.7+/-5.1 months of the control group (p<0.01). Centiles for height for age, weight for age and BMI for age were significantly higher in girls attending KMIP compared to the control group. CONCLUSIONS Merged data suggests the significant impact of KMIP on the schoolchildren of Adwa. Moreover, women and youngest children, usually the most discriminates, were the band of the society that benefited most from the aids coming from the mission.
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