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Mannarino S, Santacesaria S, Raso I, Garbin M, Pipolo A, Ghiglia S, Tarallo G, De Silvestri A, Vandoni M, Lucini D, Carnevale Pellino V, Bernardelli G, Gatti A, Rossi V, Calcaterra V, Zuccotti G. Benefits in Cardiac Function from a Remote Exercise Program in Children with Obesity. Int J Environ Res Public Health 2023; 20:1544. [PMID: 36674299 PMCID: PMC9861570 DOI: 10.3390/ijerph20021544] [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] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 01/11/2023] [Accepted: 01/12/2023] [Indexed: 06/17/2023]
Abstract
Physical activity (PA) is a crucial factor in preventing and treating obesity and related complications. In this one-arm pre−post longitudinal prospective study, we evaluated the effects of a 12-week online supervised training program on cardiac morphology, function and blood pressure (BP) in children with obesity. The training program consisted of three sessions per week, each lasting 60 min. Advanced echocardiographic imaging (tissue Doppler and longitudinal strain analysis) was used to detect subclinical changes in heart function. Categorical variables were described as counts and percentages; quantitative variables as the mean and standard deviation (SD) as they were normally distributed (Shapiro−Wilks test). Pre−post comparisons were made with a paired t-test. A total of 27/38 (71%) enrolled patients (18M/9F, 11 ± 2 years) completed the training protocol and were considered in the analysis. At baseline, no hypertensive patient was noted; all echocardiographic variables were within the normal range. After training, we observed a significant reduction in BP parameters, including systolic BP values and Z-score, diastolic BP values, centiles and Z-score, and mean arterial pressure (all p < 0.05). Significant variations in echocardiographic interventricular septum (IVSd) thickness (p = 0.011), IVSd Z-score (p = 0.001), left ventricular (LV) end-diastolic diameter (p = 0.045), LV posterior wall thickness Z-score (p = 0.017), and LV global longitudinal strain (p = 0.016) were detected. No differences in LV diastolic function and right ventricular strain were noted. PA plays a decisive role in improving BP control and has benefits on left ventricle systolic function, representing a strategic approach to limit CV risk. Online exercise could be an excellent method of training in children with obesity.
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Affiliation(s)
- Savina Mannarino
- Pediatric Cardiology Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Sara Santacesaria
- Pediatric Cardiology Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Irene Raso
- Pediatric Cardiology Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Massimo Garbin
- Pediatric Cardiology Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Andreana Pipolo
- Pediatric Cardiology Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Silvia Ghiglia
- Pediatric Cardiology Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Gabriele Tarallo
- Pediatric Cardiology Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Annalisa De Silvestri
- Biometry & Clinical Epidemiology, Scientific Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy
| | - Matteo Vandoni
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
| | - Daniela Lucini
- BIOMETRA Department, University of Milan, 20129 Milan, Italy
- Exercise Medicine Unit, Istituto Auxologico Italiano, IRCCS, 20135 Milan, Italy
| | - Vittoria Carnevale Pellino
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
- Department of Industrial Engineering, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giuseppina Bernardelli
- Exercise Medicine Unit, Istituto Auxologico Italiano, IRCCS, 20135 Milan, Italy
- DISCCO Department, University of Milan, 20122 Milan, Italy
| | - Alessandro Gatti
- Laboratory of Adapted Motor Activity (LAMA), Department of Public Health, Experimental Medicine and Forensic Science, University of Pavia, 27100 Pavia, Italy
| | - Virginia Rossi
- Pediatric Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
| | - Valeria Calcaterra
- Pediatric Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
- Department of Internal Medicine, University of Pavia, 27100 Pavia, Italy
| | - Gianvincenzo Zuccotti
- Pediatric Unit, Pediatric Department, Buzzi Children’s Hospital, 20154 Milan, Italy
- Department of Biomedical and Clinical Science, University of Milano, 20157 Milan, Italy
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Ardissino G, Perrone M, Ghiglia S, Salice P, Tel F, Dardi E, Bollani T, Mezzopane A, Capone V, Ardissino M, Vergori A, Piantanida S, Di Michele S, Tchana B, Filippucci L, De Luca F, Consonni D, Buzzetti R. Fluid intake and blood pressure in children: the Salus per Aquam project. J Hypertens 2022; 40:171-179. [PMID: 34857709 DOI: 10.1097/hjh.0000000000002992] [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] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND Sodium intake is known to contribute to the development of hypertension, thus intake reduction is a cornerstone in the prevention and management of hypertension. The increase in renal sodium excretion might represent a further potential preventive and/or therapeutic opportunity. OBJECTIVE To explore the working hypothesis that an increased fluid intake can improve renal sodium handling towards a decrease in blood pressure. METHODS The SPA Project is a multicenter, observational, cross-sectional, cohort study investigating healthy children, aged 5-8 years as to sodium and fluid intake by means of urinary sodium and creatinine from multiple samples taken in different days in order to characterize them in lower/higher sodium and lower/higher fluid intake. Both SBP and DBP (by multiple office blood pressure measurements) were used as outcome measures. RESULTS Three hundred and thirty-nine healthy, nonoverweight children (51.6% boys) with a median age of 5.7 years old (IQR: 5.3-6.2) participated in the study but only 223 could be analyzed. Among children with higher sodium intake, those introducing more fluids, showed a significantly lower blood pressure (both systolic and diastolic) compared with those with lower fluid intake: systolic 86.0 ± 8.5 vs. 90.0 ± 8.1 mmHg; P = 0.014 and diastolic: 53.8 ± 4.9 vs. 58.6 ± 6.6 mmHg; P < 0.0001. CONCLUSION An increased fluid intake is associated with a reduced blood pressure possibly by increasing renal sodium excretion. We speculate that this simple, highly acceptable, inexpensive, and harmless measure might have a role in preventing and/or minimizing the epidemics of hypertension and of its related morbidities both in children and in adults.
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Affiliation(s)
| | - Michela Perrone
- Neonatology and Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
| | - Silvia Ghiglia
- Department of Pediatric Cardiology, Vittore Buzzi Children's Hospital
| | - Patrizia Salice
- Pediatric Cardiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico
| | - Francesca Tel
- Department of Pediatrics, Vittore Buzzi Children's Hospital
| | | | | | | | | | | | | | - Sandra Piantanida
- UO Cardiologia ad Indirizzo Pediatrico, Polo Materno-Infantile, Varese
| | | | - Bertrand Tchana
- Pediatric Cardiology Unit, Parma General and University Hospital, Parma
| | - Lucia Filippucci
- UO Cardiologia Riabilitativa e Prevenzione Patologie Cardiovascolari, USL Umbria1, Perugia
| | | | - Dario Consonni
- Epidemiology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan
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Ardissino G, Vergori A, Vergori C, Martelli L, Daccò V, Villa MC, Masciani M, Monzani A, Salice P, Ghiglia S, Perrone M, Capone V, Mancuso MC, Giussani A, Pieri GR, Bosco A, Brambilla M, Romano R, Rotondo S, Buzzetti R. Multiple, random spot urine sampling for estimating urinary sodium excretion. Eur J Pediatr 2022; 181:83-90. [PMID: 34196792 DOI: 10.1007/s00431-021-04170-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 03/17/2021] [Revised: 06/06/2021] [Accepted: 06/16/2021] [Indexed: 11/26/2022]
Abstract
The measurement of sodium intake may be important for the management of hypertension. Dietary surveys and 24-h urinary collection are often unreliable and/or impractical. We hypothesized that urinary sodium excretion can be accurately estimated through multiple spot urine samples from different days. All enrolled subjects were children of the coauthors of the study. Fifty-two 24-h urinary collections (4 per subject) for measuring sodium excretion and the 297 related urinary samples (1 per voiding) were collected for calculating the urinary sodium/urinary creatinine ratio in 13 children. The mean of 4 measured sodium excretions served as the individual "gold standard". Twenty-four urinary collections were used to generate the equation predicting the mean measured sodium excretion from the mean of 4 urinary sodium/urinary creatinine [= 0.016 × urinary sodium (mmol/L) / urinary creatinine (mmol/L) ratio + 3.3)]; the remaining 28 urinary collections and 153 urinary samples were used for the external validation. All subjects underwent an additional validation procedure involving 12 urinary samples randomly collected on different days 6 months apart. The performance of sodium excretion calculated from a total of over 22,000 possible means of 4 out of all the available urinary samples, randomly taken on different days, was analyzed as to precision (by means of the coefficient of variation) and as to accuracy (by means of the P30). The coefficients of variations of measured vs. calculated sodium excretion were 25.3% vs. 25.8%, and the P30 of calculated sodium excretion was 100%. The excellent performance of calculated sodium excretion was confirmed both by external validation and by samples collected 6 months apart with mean P30s, all between 86 and 100%.Conclusion: In the described experimental conditions, urinary sodium excretion was estimated with equal precision and more accurately (and practically) by the mean of 4 urinary sodium/urinary creatinine ratios from random samples from different days than by a single urinary collection. In real life, with several errors systematically affecting urinary collection, the superiority of calculated sodium excretion is likely to be even greater. What is Known: • The measurement of sodium intake with the current standards of care (dietary survey or 24-h urinary collection) is laborious and can be inaccurate. What is New: • The study provides evidence that sodium intake can be estimated equally precisely, more accurately and more practically with the urinary sodium-to-urinary creatinine ratio from 4 urine samples taken on different days than with a single urinary collection.
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Affiliation(s)
- Gianluigi Ardissino
- Pediatric Nephrology, Dialysis and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | | | | | - Laura Martelli
- Paediatric Department, Hospital Papa Giovanni XXIII, Bergamo, Italy
| | - Valeria Daccò
- Neonatology Unit, Ospedale San Giuseppe, Milan, Italy
| | - Maria Cristina Villa
- Pediatric Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Martino Masciani
- Pediatric and Pediatric Intensive Care Unit, Ospedale Bufalini, Cesena, Italy
| | - Alice Monzani
- Health Science Department, Pediatric Department, Università del Piemonte Orientale, AOU Maggiore della Carità, Novara, Italy
| | - Patrizia Salice
- Pediatric Department, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Ghiglia
- Pediatric Cardiology Unit, Vittore Buzzi Children's Hospital, ASST FBF-Sacco, Milan, Italy
| | - Michela Perrone
- NICU, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Valentina Capone
- Pediatric Nephrology, Dialysis and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maria Cristina Mancuso
- Pediatric Nephrology, Dialysis and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Antenore Giussani
- Kidney Transplant Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giovanni Raimondo Pieri
- Pediatric and Pediatric Emergency Unit, AO SS Antonio e Biagio e C. Arrigo, Alessandria, Italy
| | - Annalisa Bosco
- Pediatric Department, Ospedale F. del Ponte, University of Insubria, Varese, Italy
| | - Marta Brambilla
- Pediatric Nephrology, Dialysis and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Roberto Romano
- Pediatric Department, University of Milano, Milan, Italy
| | - Stefania Rotondo
- Pediatric Nephrology, Dialysis and Transplantation, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
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Ardissino G, Ghiglia S, Salice P, Perrone M, Piantanida S, De Luca FL, Di Michele S, Filippucci L, Dardi ERA, Bollani T, Mezzopane A, Tchana B, Lava SAG. Correction to: Multiple office blood pressure measurement: a novel approach to overcome the weak cornerstone of blood pressure measurement in children. Data from the SPA project. Pediatr Nephrol 2021; 36:477. [PMID: 33226476 DOI: 10.1007/s00467-020-04801-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Gianluigi Ardissino
- Pediatric Nephrology, Dialysis and Transplantation Unit -Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Silvia Ghiglia
- Pediatric Cardiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Patrizia Salice
- Pediatric Cardiology, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Michela Perrone
- Neonatology and Neonatal Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Sandra Piantanida
- Unità operativa Cardiologia ad Indirizzo Pediatrico, Polo Materno-Infantile, Varese, Italy
| | - Francesco L De Luca
- Unità operativa semplice di Cardiologia Pediatrica, Policlinico Universitario, Messina, Italy
| | - Silvia Di Michele
- Unità operativa complessa Pediatria Medica, Ospedale di Pescara, Pescara, Italy
| | - Lucia Filippucci
- Unità operativa Cardiologia Riabilitativa e Prevenzione Patologie Cardiovascolari, USL Umbria1, Perugia, Italy
| | | | | | | | - Bertrand Tchana
- Pediatric Cardiology Unit, General and University Hospital, Parma, Italy
| | - Sebastiano A G Lava
- Pediatric Nephrology, Dialysis and Transplantation Unit -Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. .,Pediatric Cardiology Unit, Department of Pediatrics, Lausanne University Hospital and University of Lausanne, 1011, Lausanne, Switzerland. .,Division of Clinical Pharmacology and Toxicology, Institute of Pharmacological Sciences of Southern Switzerland, Ente Ospedaliero Cantonale, Lugano, Switzerland.
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Esposito S, Salice P, Bosis S, Ghiglia S, Tremolati E, Tagliabue C, Gualtieri L, Barbier P, Galeone C, Marchisio P, Principi N. Altered cardiac rhythm in infants with bronchiolitis and respiratory syncytial virus infection. BMC Infect Dis 2010; 10:305. [PMID: 20969802 PMCID: PMC2987303 DOI: 10.1186/1471-2334-10-305] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Accepted: 10/24/2010] [Indexed: 11/17/2022] Open
Abstract
Background Although the most frequent extra-pulmonary manifestations of respiratory syncytial virus (RSV) infection involve the cardiovascular system, no data regarding heart function in infants with bronchiolitis associated with RSV infection have yet been systematically collected. The aim of this study was to verify the real frequency of heart involvement in patients with bronchiolitis associated with RSV infection, and whether infants with mild or moderate disease also risk heart malfunction. Methods A total of 69 otherwise healthy infants aged 1-12 months with bronchiolitis hospitalised in standard wards were enrolled. Pernasal flocked swabs were performed to collect specimens for the detection of RSV by real-time polymerase chain reaction, and a blood sample was drawn to assess troponin I concentrations. On the day of admission, all of the infants underwent 24-hour Holter ECG monitoring and a complete heart evaluation with echocardiography. Patients were re-evaluated by investigators blinded to the etiological and cardiac findings four weeks after enrolment. Results Regardless of their clinical presentation, sinoatrial blocks were identified in 26/34 RSV-positive patients (76.5%) and 1/35 RSV-negative patients (2.9%) (p < 0.0001). The blocks recurred more than three times over 24 hours in 25/26 RSV-positive patients (96.2%) and none of the RSV-negative infants. Mean and maximum heart rates were significantly higher in the RSV-positive infants (p < 0.05), as was low-frequency power and the low and high-frequency power ratio (p < 0.05). The blocks were significantly more frequent in the children with an RSV load of ≥100,000 copies/mL than in those with a lower viral load (p < 0.0001). Holter ECG after 28 ± 3 days showed the complete regression of the heart abnormalities. Conclusions RSV seems associated with sinoatrial blocks and transient rhythm alterations even when the related respiratory problems are mild or moderate. Further studies are needed to clarify the mechanisms of these rhythm problems and whether they remain asymptomatic and transient even in presence of severe respiratory involvement or chronic underlying disease.
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Affiliation(s)
- Susanna Esposito
- Department of Maternal and Pediatric Sciences, Università degli Studi di Milano, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.
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Selicorni A, Colli AM, Passarini A, Milani D, Cereda A, Cerutti M, Maitz S, Alloni V, Salvini L, Galli MA, Ghiglia S, Salice P, Danzi GB. Analysis of congenital heart defects in 87 consecutive patients with Brachmann-de Lange syndrome. Am J Med Genet A 2009; 149A:1268-72. [PMID: 19449412 DOI: 10.1002/ajmg.a.32838] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Congenital heart defects (CHDs) have been estimated to occur in approximately 20% of patients with Brachmann-de Lange syndrome (BDLS, also known as Cornelia de Lange syndrome, OMIM 122470). We report on the results of a prospective echocardiographic evaluation of a cohort of 87 Italian BDLS patients with longitudinal follow-up from 5 to 12 years. A cardiac anomaly was identified in 29/87 (33.3%) including 28 (32.2%) patients with a structural CHD, and an additional patient (1.2%) with isolated non-obstructive hypertrophic cardiomyopathy (HCM). Of the 28 patients with a CHD, 12 (42.9%) had an isolated obstructive CHD, 10 of which were pulmonary stenosis (36%), 8 (28.6%) had an isolated left to right shunt, and the remainder showed a combination of structural anomalies. Overall incidence of pulmonary stenosis was 39% (11/28). Isolated late-onset mitral or tricuspid valve dysplasia, albeit hemodynamically insignificant, was detected at follow-up examination in 4 (14.3%) patients older than 10 years, previously known to be normal. In contrast to previous studies, only two patients required surgery, one for closure of a large perimembranous ventricular septal defect (VSD) and associated ASD closure (1), and another for VSD closure and relief of pulmonary valve stenosis (1). The remainder are receiving medical follow-up. We believe that the overall frequency (33.3%) and evidence of 4 late onset dysplastic valves anomalies justifies both echocardiographic assessment in all BDLS patients at the first diagnostic assessment, and later on during medical follow-up.
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Affiliation(s)
- Angelo Selicorni
- Division of Pediatrics, IRCCS Fondazione Policlinico Mangiagalli e Regina Elena, Milan, Italy.
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Ghiglia S, Fesslovà V. [Patency of foramen ovale in fullterm and preterm neonates. A follow-up study]. Pediatr Med Chir 2008; 30:192-196. [PMID: 19216202] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
The aim of our study was evaluate the clinical outcome of PFO without associated congenital heart disease, in the 1st year of life, in a consecutive series of preterm vs term infants. Out of 178 infants, 83 F/94 M, 49% born preterm, with echo diagnosis of PFO (< 5 mm) by 1 month of age, 122 were controlled at 3 mo, 67 at 6 mo and 30 at 12 mo distance. 23 (12%) had an associated PDA, 11 preterm (6 G.A. <32 w). Closure at f-u GA > 38 > 32 < 38 < 32 3mo 38/122 31% 24/66 35% 11/42 26% 3/14 22% 6mo 38/67 57% 20/35 57% 13/25 52% 5/7 71% 12 m 11/30 37% 5/13 38% 5/15 33% 1/2 50% PFO diameter slightly increased in 2 out of 122 (ga. > 38 w), remained so in 6, and decreased in 108. Only 3/33 children whose PFO was closed at 3rd month control were. <32 wGA. No one was hemodynamically significant. In all right ventricular prevalence both at ECG and Echo normalized by 3 mo of age: 21/23 PDA spontaneously closed by the following control before PFO closure. Our data show that: (1) PFO has no clinical relevance even in the WLGA newborn; (2) Inverse correlation between GA and early closure; (3) PDA was'nt predictive for early closure; (4) Spontaneous closure of ductus was always earlier the the FOP's one. Our data support that even in preterm infants PFO is benign and there is no need for an emotionally expensive and time losing follow-up.
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Affiliation(s)
- S Ghiglia
- Fondazione IRCCS Ospedale Maggiore Policlinico, Mangiagalli Regina Elena, Milano
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Meier CM, Simonetti GD, Ghiglia S, Fossali E, Salice P, Limoni C, Bianchetti MG. Palatability of angiotensin II antagonists among nephropathic children. Br J Clin Pharmacol 2007; 63:628-31. [PMID: 17302913 PMCID: PMC2000746 DOI: 10.1111/j.1365-2125.2006.02814.x] [Citation(s) in RCA: 17] [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] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
WHAT IS ALREADY KNOWN ABOUT THIS SUBJECT * Among children, medication palatability is crucial for adherence to therapeutic regimen. * Several studies have measured the palatability of antimicrobial suspensions in paediatric patients by means of a visual analogue scale palatability score. WHAT THIS STUDY ADDS * This is the first analysis comparing the taste and smell acceptability of angiotensin II receptor blockers among paediatric patients with kidney disease. * From the perspective of the child with kidney disease, the taste of pulverized candesartan is significantly superior to that of pulverized irbesartan, losartan, telmisartan or valsartan. AIM Angiotensin II receptor blockers are widely prescribed in kidney disease. Among children, medication palatability is crucial for adherence. METHODS Taste and smell acceptability of five angiotensin II receptor blockers were compared among 21 nephropathic children using a visual analogue scale palatability score. RESULTS The score assigned to pulverized tablets of candesartan cilexetil was significantly higher than that assigned to pulverized tablets of irbesartan, losartan, telmisartan and valsartan. CONCLUSIONS From the perspective of the nephropathic child, the taste of pulverized candesartan cilexetil is superior to that of irbesartan, losartan, telmisartan or valsartan.
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Affiliation(s)
- Chiara M Meier
- Ospedale San Giovanni Bellinzona and Ospedale della Beata Vergine, Mendrisio, Switzerland
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Ardissino G, Edefonti A, Bianchetti MG, Corti C, Fossali E, Gioventù M, Ghiglia S, Testa S, Salice P. [Diagnostic and therapeutic criteria of arterial hypertension in childhood]. G Ital Nefrol 2006; 23:149-62. [PMID: 16710820] [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] [Indexed: 05/09/2023]
Abstract
Arterial hypertension (AH), either primary or secondary, is an important issue in childhood for its short- and long-term cardiovascular morbidity. Renal diseases are the most frequent causes of AH in children, but essential hypertension can also be detected early in life. It is important for blood pressure (BP) to be checked regularly (at least once every 5 years) in healthy children and adolescents and every year in those belonging to at-risk categories (family history of AH, low birth weight, obesity, etc). In children, AH is defined as BP recorded in three non-consecutive measurements with an appropriate device and cuff size > or = 95th centile for age, gender and height. Ambulatory BP monitoring is a valuable diagnostic tool and once AH is confirmed, a specific primary cause should always be ruled out (renovascular, cardiac, vascular, endocrine, pharmacologic, other). In case of border-line or significant AH (between 90th and 99th centile) a non-pharmacological treatment should be considered, whereas severe hypertension (>99th centile for height and age) will require pharmacological treatment (Diuretics, Angiotensin Converting Enzyme Inhibitors, Angiotensin Receptor Blockers, beta - and Calcium blockers).
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Affiliation(s)
- G Ardissino
- UO Nefrologia Dialisi e Trapianto Pediatrico, IRCCS Fondazione Ospedale Maggiore Policlinico-Mangiagalli, Milano, Italy
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Foglia CFP, von Vigier RO, Fossali E, Salice P, Ghiglia S, Ardissino G, Pollini I, Bianchetti MG. A simplified antihypertensive drug regimen does not ameliorate control of childhood hypertension. J Hum Hypertens 2005; 19:653-4. [PMID: 15905892 DOI: 10.1038/sj.jhh.1001870] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ghiglia S, Fesslova V, Ferraris G, Buccerio A, Salice P, Colli AM, Gioventù M. [Cardiovascular involvement in new born of HIV positive mothers]. Pediatr Med Chir 2005; 27:94-8. [PMID: 16910458] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
MESH Headings
- Antiretroviral Therapy, Highly Active/methods
- Case-Control Studies
- Female
- HIV Seropositivity/complications
- HIV Seropositivity/diagnosis
- HIV Seropositivity/drug therapy
- HIV Seropositivity/epidemiology
- Heart Defects, Congenital/complications
- Heart Defects, Congenital/diagnosis
- Heart Defects, Congenital/drug therapy
- Heart Defects, Congenital/epidemiology
- Humans
- Infant, Newborn
- Italy/epidemiology
- Pregnancy
- Pregnancy Complications, Infectious/diagnosis
- Pregnancy Complications, Infectious/drug therapy
- Pregnancy Complications, Infectious/epidemiology
- Pregnancy Complications, Infectious/virology
- Prevalence
- Prospective Studies
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Affiliation(s)
- Silvia Ghiglia
- U.O. di Cardiologia, Istituti Clinici di Perfezionamento di Milano.
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Ardissino G, Bianchetti M, Braga M, Calzolari A, Daccò V, Fossali E, Ghiglia S, Orsi A, Pollini I, Sforzini C, Salice P. [Recommendations on hypertension in children: the CHI/d project]. Pediatr Med Chir 2004; 26:408-22. [PMID: 16363766] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/05/2023] Open
Affiliation(s)
- G Ardissino
- Centro di Nefrologia Dialisi e Trapianto Pediatrico, Dipartimento di Pediatria, Clinica de Marchi, Milano
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Ardissino G, Bianchetti M, Braga M, Calzolari A, Daccò V, Fossalis E, Ghiglia S, Orsi A, Pollini I, Sforzini C, Salice P. [Recommendations on hypertension in childhood: the Child Project]. Ital Heart J Suppl 2004; 5:398-412. [PMID: 15182068] [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] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Affiliation(s)
- Gianluigi Ardissino
- Centro di Nefrologia, Dialisi e Trapianto Pediatrico, Dipartimento di Pediatria, Università degli Studi, Milano
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Locati E, Ghiglia S, Dabalà A, Grassadonia P, Pinciroli A, Sachero A. 9.3 Long-term ECG monitoring by telemedicine: What role in the diagnosis of infrequent arrhythmic events? Europace 2003. [DOI: 10.1016/eupace/4.supplement_1.a15-a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Affiliation(s)
- E.H. Locati
- UOC V, Dipartimento CardioToracoVascolare De Gasperis, Az. Osp. Niguarda, Milano
| | - S. Ghiglia
- UOC V, Dipartimento CardioToracoVascolare De Gasperis, Az. Osp. Niguarda, Milano
| | - A. Dabalà
- Centro Cardiologico Bresso, Az. Osp. Milano 3, Monza
| | | | | | - A. Sachero
- UOC V, Dipartimento CardioToracoVascolare De Gasperis, Az. Osp. Niguarda, Milano
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Salice P, Pietrogrande MC, Barbier P, Ghiglia S, Laicini E, Fesslova V. [Cardiovascular abnormalities in Kawasaki disease. An Italian prospective study]. Cardiologia 1998; 43:1367-74. [PMID: 9988946] [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] [Indexed: 02/10/2023]
Abstract
We report a prospective study performed over a 9 year period in 96 children with Kawasaki disease (mean age 35 +/- 29 months), 84 of whom < 5 years of age. The male/female ratio was 1.5 (57/39). A total of 38 patients had cardiac involvement, including flattened T waves in the ECG (10 patients), pericardial effusion (6 patients), myocarditis (1 patient), and coronary artery aneurysms (25 patients; frequency of aneurysms: 26%). All patients were evaluated during the acute phase (first month) of the illness. The first echocardiographic examination was performed 15 days (range 4.30 days) from the appearance of fever, and coronary aneurysms were observed in 23 patients; in 2 patients, however, aneurysms appeared later (2 and 6 months). Aneurysms were small (< or = 4.5 mm) in 12, medium (4.5-7 mm) in 11, and large (> 7 mm) in 12 patients. Male sex (p = 0.02), age < 12 months (p = 0.005), ESR (p = 0.001), platelet count (p = 0.009), and pericardial effusion (p = 0.02) were significantly related to the presence of aneurysm. Among females, incidence of aneurysms was significantly higher in infants < 12 months than in older patients (60 vs 6%, p < 0.001). Intravenous immunoglobulin treatment was started early (within 10 days) in 61 patients and late (> 10 days) in 22. Compared to late treatment, early i.v. immunoglobulin treatment was associated with smaller aneurysms and higher regression rate (67 vs 28%, p < 0.05). No difference was observed concerning frequency and number of dilated vessels as related to therapeutical regimens. Total i.v. immunoglobulin dose (2 g/kg) was administered over 1-2 days in 26 patients (scheme I) or over 4-5 days in 58 (scheme II). Frequency of aneurysms was significantly lower in patients treated early (p = 0.02). No myocardial infarctions or deaths occurred at short- or long-term follow-up.
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Affiliation(s)
- P Salice
- Sezione di Cardiologia Pediatrica, Servizio di Cardiologia, Istituti Clinici di Perfezionamento, Milano
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