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Pastori L, Menegazzo F, Salmaso L, De Lorenzi M, Facchin P. Patient organisations for rare diseases in Italy in 2013: the importance of their empowerment. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.087] [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: 11/13/2022] Open
Affiliation(s)
- L Pastori
- Coordinating Centre for Rare Diseases of the Veneto Region, University of the Study of Padova, Padova, Italy
| | - F Menegazzo
- Coordinating Centre for Rare Diseases of the Veneto Region, University of the Study of Padova, Padova, Italy
| | - L Salmaso
- Coordinating Centre for Rare Diseases of the Veneto Region, University of the Study of Padova, Padova, Italy
| | - M De Lorenzi
- Coordinating Centre for Rare Diseases of the Veneto Region, University of the Study of Padova, Padova, Italy
| | - P Facchin
- Coordinating Centre for Rare Diseases of the Veneto Region, University of the Study of Padova, Padova, Italy
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Mazzucato M, Manea S, Minichiello C, Bua M, Facchin P. A web-based system globally monitoring rare diseases: the experience of the Veneto Region, Italy. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv173.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Salmaso L, Ferrante A, Casagranda E, Facchin P. Multi-source study for the identification of congenital malformations at birth. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Boscaro E, Barbieri S, Minichiello C, Mazzucato M, Vianello A, Facchin P. Management of dietary therapy for rare diseases in Veneto Region: appropriateness and sustainability. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Menegazzo F, Salmaso L, Visonà dalla Pozza L, Casagranda E, Facchin P. Adolescent health needs in Veneto Region, Northeast of Italy - year 2011. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv176.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Manea S, Menegazzo F, Fambri M, Bua M, Facchin P. Socio-economic and health impact of chronic diseases on families: patients opinion in Italy - 2013. Eur J Public Health 2015. [DOI: 10.1093/eurpub/ckv171.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Rosa-Rizzotto M, Visonà Dalla Pozza L, Corlatti A, Luparia A, Marchi A, Molteni F, Facchin P, Pagliano E, Fedrizzi E. A new scale for the assessment of performance and capacity of hand function in children with hemiplegic cerebral palsy: reliability and validity studies. Eur J Phys Rehabil Med 2014; 50:543-556. [PMID: 24732444] [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: 06/03/2023]
Abstract
BACKGROUND In hemiplegic children, the recognition of the activity limitation pattern and the possibility of grading its severity are relevant for clinicians while planning interventions, monitoring results, predicting outcomes. OBJECTIVE Aim of the study is to examine the reliability and validity of Besta Scale, an instrument used to measure in hemiplegic children from 18 months to 12 years of age both grasp on request (capacity) and spontaneous use of upper limb (performance) in bimanual play activities and in ADL. DESIGN Psychometric analysis of reliability and of validity of the Besta scale was performed. SETTING Outpatient study sample METHODS Reliability study: A sample of 39 patients was enrolled. The administration of Besta scale was video-recorded in a standardized manner. All videos were scored by 20 independent raters on subsequent viewing. 3 raters randomly selected from the 20-raters group rescored the same video two years later for intra-rater reliability. Intra and inter-rater reliability were calculated using Intraclass Correlation Coefficient (ICC) and Kendall's coefficient (K), respectively. Internal consistency reliability was assessed using Alpha's Chronbach coefficient. Validity study: a sample of 105 children was assessed 5 times (at t0 and 2, 3, 6 and 12 months later) by 20 independent raters. Each patient underwent at the same time to QUEST and Besta scale administration and assessment. Criterion validity was calculated using rho-Pearson coefficient. RESULTS Reliability study: The inter-rater reliability calculated with Kendall's coefficient resulted moderate K=0.47. The intra-rater (or test-retest) reliability for 3 raters was excellent (ICC=0.927). The Cronbach's alpha for internal consistency was 0.972. Validity study: Besta scale showed a good criterion validity compared to QUEST increasing by age and severity of impairment. Rho Pearson's correlation coefficient r was 0.81 (P<0.0001). Limitations. Besta scales in infants finds hard to distinguish between mild to moderately impaired hand function. CONCLUSIONS Besta scale scoring system is a valid and reliable tool, utilizable in a clinical setting to monitor evolution of unimanual and bimanual manipulation and to distinguish hand's capacity from performance.
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Affiliation(s)
- M Rosa-Rizzotto
- Epidemiology and Community Medicine Unit Department of Pediatrics, University of Padua, Padua, Italy -
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Manea S, Dalla Pozza LV, Mola E, Facchin P. [The quality of interdisciplinary communication]. Ann Ig 2011; 23:303-310. [PMID: 22026233] [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: 05/31/2023]
Abstract
Because of a continued increase of complex patients and the development of many areas of sub-specialities in medicine, the use and quality of interdisciplinary communication has been found to be lacking, especially between hospital and primary care physicians, causing a significant gap in the documentation, coverage and care of individual patients. The study focuses on state of the art interdisciplinary communication, with consideration given to current used tools and priorities. An ad hoc questionnaire surveyed 118 physicians about their profession, the types of patients, the frequency of complex cases, the tools used to communicate with each patient and how the physicians rated these tools. The rate of patients needing interdisciplinary communication is 17% of the entire patient sample, all of this percentage having complex health care needs (terminally ill, disabled, often without a personal support network). Physicians frequently used paper documents, despite their lack of quality, as well as the telephone to communicate with other colleagues. Computer devices were scarcely used. Many Doctors (71%) value the actual interdisciplinary communication of low quality, despite the fact that it is considered to have a significant influence on the quality of health care. New tools and methods are needed. For example, dedicated standards of multidisciplinary and multi-professional Continuing Medical Education (CME), as well as the use of computer tools allowing for shared clinical records.
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Affiliation(s)
- S Manea
- Scuola di Specializzazione in Medicina di Comunità, Unità di Epidemiologia e Medicina di Comunità, Dipartimento di Pediatria, Università degli Studi di Padova.
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Rosa-Rizzotto M, Visonà Dalla Pozza L, Turconi AC, Tornetta L, Andreucci E, Zambonin F, Fedrizzi E, Facchin P. The perception of involved professionals towards research feasibility and usefulness: lessons from the Multi-Site Trial on Efficacy of Constraint Induced Movement Therapy in Children with Hemiplegia. Eur J Phys Rehabil Med 2010; 46:369-376. [PMID: 20927003] [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: 05/30/2023]
Abstract
BACKGROUND In the last decades, the world of rehabilitation has been more and more calling for clear evidence to support intervention and numerous research programs have been developed. At stake, relatively little research on opinions and attitude of rehabilitation personnel involved in research conducted in real clinical settings has been carried out. AIM To explore the opinion of professionals involved in a national clinical trial on research. DESIGN Multicentre cross-sectional study. SETTING 19 rehabilitation centres/services (4 research institutes, 15 local rehabilitation services). POPULATION All professional participating to a multi-centre clinical trial on the effects of Constraint Induced Movement Therapy on children with hemiplegic cerebral palsy. METHODS A 15-questions questionnaire inquiring feasibility, usefulness, products, costs, judgement and perceptions about clinical research in rehabilitation was administered. RESULTS Among those working in one of the 19 rehabilitation centres part of the multicentric study, 76 professionals were asked to fill in the questionnaire. 68 professionals answered (89.4% of response rate). More than 75% of the sample thinks that its rehabilitation centre is suited to develop clinical research. Research results useful for the development of their daily activities (new tools for the assessment of children, to demonstrate the efficacy of a new treatment option and to learn a new way of working, and to strengthen the ties within the working team). Research is costly in terms of personal time and effort, but it can modify the rehabilitation praxis (assessment tools, the relationship with colleagues/patients). 98% of the interviewees declared the willingness to participate to other research projects. CONCLUSION AND CLINICAL REHABILITATION IMPACT This survey highlights the importance of conducting research in local rehabilitation services, not only in terms of generation of new evidences, but also in terms of building networks, sharing experiences and knowledge, connecting with centers of excellence and providing a specific training for research conduction.
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Affiliation(s)
- M Rosa-Rizzotto
- Epidemiology and Community Medicine Unit, Pediatrics Department, Padua University, Padua, Italy.
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Guariso G, Meneghel A, Dalla Pozza LV, Romano C, Dall'Oglio L, Lombardi G, Conte S, Calacoci M, Campanozzi A, Nichetti C, Piovan S, Zancan L, Facchin P. Indications to upper gastrointestinal endoscopy in children with dyspepsia. J Pediatr Gastroenterol Nutr 2010; 50:493-9. [PMID: 20639706 DOI: 10.1097/mpg.0b013e3181bb3362] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [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: 12/13/2022]
Abstract
OBJECTIVES The objective of the study was to ascertain the appropriateness of indications for upper gastrointestinal (UGI) endoscopy in children with dyspepsia. METHODS We used the RAND/University of California at Los Angeles method to investigate the appropriateness of the opinions of a panel of experts. The panel judged 2304 theoretical patient scenarios defined by a combination of demographic and clinical variables. Descriptive and multivariate logistic regression analyses were performed. RESULTS The panel rated UGI endoscopy as appropriate in 27.2% of cases, inappropriate in 14.3%, and dubious in 58.5%. Disagreement emerged for 21% of cases. UGI endoscopy was considered increasingly appropriate in cases with a positive family history of peptic ulcer and/or Helicobacter pylori infection (odds ratio [OR] 8.518, P < 0.0001), when dyspepsia interfered with activities of daily living ("sleep" OR 7.540, P < 0.0001; "normal activities" OR 5.725, P < 0.0001), and when patients were older than 10 years ("<or=10 years" OR 0.310, P < 0.0001) the longer the duration ("0-2 months" OR 0.002, P < 0.0001; "3-5 months" OR 0.059, P < 0.0001; "6-11 months" OR 0.516, P = 0.0005) and the greater the severity ("mild" OR 0.002, P < 0.0001; "moderate" OR 0.013, P < 0.0001) of their dyspeptic symptoms. CONCLUSIONS UGI endoscopy is not appropriate for all children with dyspeptic symptoms, but only for cases with a family history of peptic ulcer and/or Helicobacter pylori infection, older than 10 years of age, with symptoms persisting for more than 6 months and severe enough to affect activities of daily living.
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Affiliation(s)
- G Guariso
- Gastroenterology and Endoscopy Unit, Department of Pediatrics, University of Padua, Padua, Italy.
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Ruga E, Fregonese F, Facchin P, D'Elia R. Antibiotic utilization for pediatric patients: retrospective study in Department of Pediatrics, University of Padua. Int J Infect Dis 2002. [DOI: 10.1016/s1201-9712(02)90247-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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Fedrizzi E, Pagliano E, Marzaroli M, Fazzi E, Maraucci I, Furlanetto AR, Facchin P. Developmental sequence of postural control in prone position in children with spastic diplegia. Brain Dev 2000; 22:436-44. [PMID: 11102729 DOI: 10.1016/s0387-7604(00)00182-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [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
The aim of this study was to assess the development of postural control in the prone position in children with spastic diplegia and triplegia, and determine the influence of clinical characteristics, visual acuity and cognitive performance on that development. We also analysed the relation between these early motor achievements in the prone position and the subsequent acquisition of motor competence in the sitting position. We followed 24 diplegic and triplegic children from before age 2 years (mean age 12 months) to mean age 41 months, videorecording motor behaviour every six months and abstracting acquisitions in alignment and balance using a standardised procedure. We confirm a developmental sequence of all the acquired movements in the prone position. 83.3% of the children completed the uprighting sequence in the sagittal plane, acquired good balance, and ability to rotate the head and trunk. 70.8% of the children (all but one of the diplegic children and none among triplegic children) acquired symmetric posture in the frontal plane and 83.3% reduced leg hyperextension. Development was not uniform, and at 12-18 months two groups began to emerge: diplegic children who rapidly achieved all or most of the steps in the sequence and had a favourable prognosis for subsequent motor development; and triplegic children who achieved these steps at a much slower rate or in some cases not at all and had a less favourable prognosis for future development. Diplegic children with normal visual acuity, and general quotient GQ>70 did better than triplegic children with compromised visual acuity and GQ<70. Acquisition of the full uprighting sequence in the prone position before the age of two related to the later acquisition of autonomous sitting.
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Affiliation(s)
- E Fedrizzi
- Department of Developmental Neurology, C. Besta Neurological Institute, Milan, Italy.
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Abstract
Child abuse has recently been recognized by the World Health Organization as a major worldwide health problem impairing the health and welfare of children and adolescents. This paper attempts to look at child abuse from a public health perspective taking into account the vast cultural diversity in which children and adolescents live focusing on the issue of abuse and violence in a broad public health perspective, and trying to highlight the need for greater attention to be given to possible country-specific interventions.
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Affiliation(s)
- C Djeddah
- Violence and Injury Prevention, Social Change and Mental Health, World Health Organization, Geneva, Switzerland
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Abstract
Diurnal changes in the behavioural reactions to subcutaneous formalin injection (20 microl, 1%) into the dorsum of an hindpaw were examined in female CBA/J mice aged 70-75 days, maintained in a 12/12 dark/ light cycle (light on at 07.00 h; light off at 19.00 h). Mice showed higher pain scores, as expressed by the amount of time spent licking the injected paw and by the number of flinching episodes, when tested under red light at the beginning of the dark phase (19.00-22.00: Dark group) than when tested either under white or red light at the beginning of the light phase of the diurnal cycle (7.00-10.00). The increases in pain reactions at night were found both during the first (0-10 min) and the second (11-55 min) phase of the behavioural response to formalin injection. They were not due to aspecific increases in motor behaviour, since self-grooming actually decreased in the Dark group during the second phase of the response, and the amount of locomotor activity after the injection was similar to, or lower than, that found in mice tested in the morning under white or red light, respectively. In another group of female CBA/J mice tested in the hotplate apparatus (at a temperature of 52 degrees), paw-lick latencies were significantly higher in mice tested at dark during the night, whereas jump (escape) latencies were higher in the morning. These results demonstrate different diurnal variations in the reactions to brief or prolonged noxious stimulation in mice, with greater responses to tonic pain at the onset of the dark phase.
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Affiliation(s)
- L Perissin
- Dipartrimo di Scienze e Tecnologie Biomediche, Università di Udine, Italy.
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Perissin L, Facchin P, Bedini A, Diamantini G, Tontini A, Tarzia G. Antimetastatic action of a new analog of dacarbazine in mice bearing Lewis lung carcinoma. Anticancer Res 2000; 20:1513-7. [PMID: 10928064] [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: 02/17/2023]
Abstract
We report the selective antimetastatic properties of 3-(3,3-dimethyl-1-triazenyl)-5-methyl-4,5-dihydroisoxazole in the murine transplantable tumor model Lewis lung carcinoma. The compound verifies a previous study on the correlation of antimetastatic, antitumor and cytotoxic properties of aryl- and heteroaryltriazenes with their Electron Ionization Mass Spectrometry (EI-MS) behavior. The new analog of dacarbazine exhibits a selective antimetastatic activity accompanied by limited thymus toxicity. The mechanism of action is unclear nevertheless any antiproliferative or cytotoxic effect is excluded.
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Affiliation(s)
- L Perissin
- Department of Biomedical Sciences and Technologies, University of Udine, Italy.
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Abstract
A prospective study was carried out to identify predictors of independent walking in 31 children with either spastic diplegia or triplegia, observed from the age of 9 to 18 months (mean, 11 months) and followed for a mean period of 30 months (range, 24 to 36 months). Mean age at most recent examination was 41 months (range, 36 to 54 months). We used an 18-item scheme to chart the acquisition, from the prone position, of prelocomotor, sitting, and locomotor skills. Examinations were conducted every 6 months and videotaped according to a standardized procedure. At latest assessment 18 (58%) of the 31 children had achieved walking, 7 (23%) independently and 11 (35%) with assistance; 13 (42%) did not achieve walking. Ambulatory status was related to developmental quotient and visual acuity: all the children who became independent walkers had normal visual acuity and in 86% of cases a normal general development quotient. Moreover, we found a significant correlation between the number of gross motor skills achieved and the rate of achievement before 2 years of age and ambulatory status at 3 to 5 years of age. Ability to put weight on the hands while prone and to roll from supine to prone position by 18 months of age were significantly related to independent walking, while ability to sit without support was predictive only at around 24 months of age.
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Affiliation(s)
- E Fedrizzi
- Department of Developmental Neurology, C Besta Neurological Institute, Milan, Italy.
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Verlicchi A, Facchin P, Zanotti B. Civilian gunshot wounds to the head with brain stem localization. A case report. J Neurosurg Sci 1998; 42:227-32. [PMID: 10404751] [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: 02/13/2023]
Abstract
The authors present a case of a patient wounded to the head and back by civilian firearm projectiles. The case peculiarity is that only one bullet reached the brain stem level causing significant neurological deficits. The final clinical picture is comparable to the "caudal pontine tegmentum syndrome". The authors describe both the bullet path and the intracranial localization taking into account ballistic details. The problems associated with prognosis, diagnosis, and treatment for gunshot wounds are discussed. In addition, the authors explain the main intracranial lesions and their mechanisms, the role of investigation, and the protocol of medical and surgical treatment. Lastly, a systematic approach for treating these types of gunshot wounds is outlined.
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Affiliation(s)
- A Verlicchi
- Neurological Clinic, University of Bologna, Italy
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Facchin P, Aprile I, Beorchia A, Panizzo R. [Central neurocytoma: diagnosis and treatment. Report of a case]. Radiol Med 1997; 93:775-8. [PMID: 9411527] [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: 02/05/2023]
Affiliation(s)
- P Facchin
- Divisione di Neurochirurgia, Azienda Ospedaliera Santa Maria della Misericordia, Udine
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Abstract
Locomotion patterns were studied in 160 children with cerebral palsy. Ten patterns were distinguished, which were typical of the type of impairment: (1) crawling--mildly impaired children who will achieve independent walking; (2) creeping and crawling--diplegic children with moderate motor impairment; (3) creeping, never leading to independent walking--children with severe diplegia or tetraplegia; (4) bottom shuffling--children with hemiplegia and ataxia and minimal or mild motor impairment; (5) bunny-hopping--dyskinetic children with marked motor impairment but generally not mentally retarded; (6) rolling--severely diplegic and dyskinetic children; (7) other forms of locomotion, such as bridging or grub-type creeping, rare and typical of children with ataxic elements; (8) just walk--children with hemiplegia, diplegia, ataxic diplegia or ataxia, generally in cases of mild motor impairment but mental retardation; (9) just walk with aids--children with severe diplegia; and (10) no mobility. The locomotion pattern, age at onset and even manner of execution all influenced prognosis for walking. Severe deformity affected the choice of locomotion pattern. Though physiotherapy probably would not greatly influence the adoption of a particular locomotion pattern, early intervention might help prevent deformities.
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Affiliation(s)
- M Bottos
- Servizio di Recupero e Rieducazione Funzionale, Bologna, Italy
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20
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Cavazzana M, Calvo F, Facchin P, Barreau P, Geny B, Dal Cortivo L, Dresch C. Use of liquid culture and cell cycle analysis to compare drug damage following in vitro treatment of normal human bone marrow cells with adriamycin, arabinosyl-cytosine, and etoposide. Exp Hematol 1988; 16:876-83. [PMID: 3169155] [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: 01/04/2023]
Abstract
The effects of adriamycin (ADM), arabinosyl-cytosine (ARA-C), and etoposide (VP16) were studied on human bone marrow mononucleated cells using colony formation in agar, a modified liquid culture system, and flow cytometry analysis of the cell cycle. Drug concentrations tested during a 1-h incubation ranged from 0.1 to 4 micrograms/ml for ADM, from 0.3 to 30 micrograms/ml for VP16, and from 10(-7) to 10(-3) M for ARA-C. Regression analysis of the dose-response curves was used to assess the drug concentration that inhibited 90% +/- 5% (LD90) of colony growth. LD90s were 0.4 microgram/ml for ADM, 20 micrograms/ml for VP16, and 10(-4) M for ARA-C. LD90-surviving cells were cultured in liquid medium for 3 weeks. Surviving cells over this time were 13% of the control for ADM, 22% for VP16, and 95.7% for ARA-C. Although cells decreased drastically in ADM- and VP16-treated samples, granulocyte-macrophage colony-forming units (CFU-GM) per 10(5) surviving cells rose to twice the control for ADM, to 60% for VP16, and to 150% for ARA-C. Flow cytometry analysis of the cell cycle was performed at day 0 and at day 4 after treatment with the LD90 dose. It showed a rapid and reversible effect of ARA-C on cells in the S-phase, whereas the action of VP16 concerned all cells, regardless of their cycle phase. We conclude that the direct effects of the three drugs on CFU-GM in agar are poorly predictive of hematopoietic reconstitution capacity, except for VP16. Liquid culture gives a much more accurate appraisal of the long-term damage and recovery due to anticancer drugs.
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Affiliation(s)
- M Cavazzana
- Pediatric Department, University of Padova, Italy
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Rizzoni G, Claris-Appiani A, Edefonti A, Facchin P, Franchini F, Gusmano R, Imbasciati E, Pavanello L, Perfumo F, Remuzzi G. Plasma infusion for hemolytic-uremic syndrome in children: results of a multicenter controlled trial. J Pediatr 1988; 112:284-90. [PMID: 3276865 DOI: 10.1016/s0022-3476(88)80071-4] [Citation(s) in RCA: 98] [Impact Index Per Article: 2.7] [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: 01/05/2023]
Abstract
The results of a controlled trial to ascertain the usefulness of plasma infusion for the treatment of hemolytic-uremic syndrome (HUS) are reported. Criteria for admission were (1) observation within 8 days from first symptoms, (2) dialysis treatment required, and (3) no special treatments and no more than 25 ml blood/kg previously received. Children were subdivided according to age (less than or more than 3 years) and then randomly assigned to treatment with plasma or symptomatic therapy. Thirty-two children ranging in age from 4 months to 6 years entered this study; 17 received plasma (P+ group) and 15 only symptomatic therapy (P- group). The mean follow-up period was 16 months in both groups. Surgical renal biopsy was performed 29 to 49 days after onset in 11 P+ and 11 P- children, and 33 histologic findings were semiquantitatively evaluated. No death occurred in either group. No differences were found in blood pressure, proteinuria, or hematuria at the end of the follow-up period; in no case were severe arteriolar lesions found. There were no significant differences for the scores of the individual histologic measurements; on electron microscopy, no vascular changes were observed in seven children of the P+ group, whereas in five of seven of the P- group, thickening of the lamina rara interna and arteriolar damage were present. The ability of plasma to stimulate prostacyclin (PGI2) production, measured as its stable derivative 6-keto-PGF1 alpha, was within the normal range for all patients. In our patients with predominant glomerular involvement who were treated in a very early phase of HUS, infusions of plasma did not significantly influence the short- and medium-term clinical outcome and were not effective in severe HUS when given later in the course of the disease. A longer follow-up is needed to ascertain whether the presence of endothelial damage, demonstrated by electron microscopy in children who were not given plasma, is of clinical relevance.
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Affiliation(s)
- G Rizzoni
- Paediatric Department, University of Padova, Italy
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Abstract
Primary headaches are frequent in children. They are difficult to diagnose because there is much disagreement about the interpretation of the historical data and the use of signs and/or symptoms in diagnosis. It would be useful, therefore, to standardize this procedure. We used linear discriminant analysis to determine a classification rule capable of diagnosing new cases of chronic and recurrent primary headache in children. We considered 23 symptoms in 118 patients. Through discriminant analysis we chose five variables: frequency of the attacks, type of pain, neurologic deficits, nausea, and vomiting. With this classification rule, we obtained a total correct classification of 84.7% for migraine, psychogenic headache, and non-defined headache in respect to the diagnoses formulated by a pediatrician and a child neuropsychiatrist after 3 months of follow-up. Our method for diagnosing migraine has a sensitivity of 95% and a specificity of 100%. The algorithm, validated on another 105 pediatric patients, produced a total correct result of 82.9%.
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Affiliation(s)
- F Golferini
- Institute for Systems Dynamics and Bioengineering, National Research Council (LADSEB-CNR), Padova, Italy
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Battistella PA, Cavinato M, Cogo P, Facchin P, Lovison L, Pengo V, Schivazappa L. [Study of blood platelet activation in migraine in childhood]. Minerva Med 1987; 78:1051-2. [PMID: 2955251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
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Zacchello G, Pagnan A, Sidran MP, Ziron L, Braggion M, Pavanello L, Facchin P. Further definition of lipid-lipoprotein abnormalities in children with various degrees of chronic renal insufficiency. Pediatr Res 1987; 21:462-5. [PMID: 3588083 DOI: 10.1203/00006450-198705000-00008] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
We characterized the lipid-lipoprotein abnormalities encountered in a series of 45 nonnephrotic uremic children with various degrees of chronic renal insufficiency. A mild hypertriglyceridemia associated with decreased serum high-density lipoprotein cholesterol levels was confirmed. The correlation between high-density lipoprotein cholesterol and creatinine clearance showed a power behavior with a marked decrease in high-density lipoprotein cholesterol below a creatinine clearance value of 40 ml/min/1.73 m2. A number of uremic children accumulate an abnormal population of very low-density lipoprotein particles in their plasma. On agarose gel electrophoresis these particles migrate as a slow moving pre-beta band and are clearly distinguished from the regular fast moving pre-beta very low-density lipoprotein band. This electrophoretic phenomenon has been called double pre-beta lipoproteinemia. The prevalence of double pre-beta lipoproteinemia increased significantly with the degree of impairment of renal function, reaching highest figures in patients on hemodialysis. Accordingly, the very low-density lipoprotein cholesterol/triglyceride ratio also was significantly increased. The double pre-beta lipoproteinemia phenomenon was not detected in any of the control, nonuremic subjects. The clinical importance of double pre-beta lipoproteinemia in uremic plasma is related to its possible atherogenic role.
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Abstract
In the area of primary headaches in children several diagnostic classes (migraine, psychogenic) and other nondefined headaches are recognized. Their clinical diagnosis is complex and still not standardized. We present a Personal Computer program for diagnosing types of primary headaches in children. The program calls for the input of each patient's score on five clinical variables chosen by means of discriminant analysis, and the output gives a clinical diagnosis along with its posterior probability. The program was used on an initial group of 223 pediatric patients and was cross-validated at a first level on a second group of 90 patients and at a second level on a third group of 70 patients. The total correct classification figures were 85.2, 90, and 87.1%, respectively.
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Rigon F, Zanon A, Facchin P, Di Terlizzi A, Funghi C, Rossi P, Baio A, Fenato A, Pastorin L, Benso L. [Anthropometric study of the Veneto rural population from 6- to 12- year-olds. II. Body height standards]. Minerva Pediatr 1986; 38:713-5. [PMID: 3796529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Vindigni G, Del Fabro P, Facchin P, De Nardi F, Cecotto C. On the neurological complications of internal and external shunt in patients with non-neoplastic stenosis of the aqueduct. J Neurosurg Sci 1986; 30:83-6. [PMID: 3772501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In our Department 35 patients have been operated for non-neoplastic stenosis of the aqueduct. In the first years, ventriculocisternal shunt according to Torkildsen was performed, obtaining 6 recoveries and 1 death. Later, ventriculosternostomy acc. to Stookey and Scarf, was carried out in 3 cases, obtaining 2 recoveries and 1 death; by using right ventriculo-atrial shunt we had 4 successes and 1 failure. More recently, since 1973, ventriculoperitoneal shunt has been carried out without deaths out of 21 operated patients. With this technique we have had many complications requiring repeated drainage system revisions in 9 cases, and evacuation of a chronic subdural haematoma in 3 cases. 2 patients, operated by drainage system revision and 1 for evacuation of subdural haematoma, had a dramatic postoperative course, characterised by apallic syndrome. Considering the results of the various techniques, we could conclude that the elective operation must be internal shunt (posterior or anterior ventriculocisternostomy) if, of course, the patency and the functionality of the cisterns have been ascertained.
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Rigon F, Zanon A, Facchin P, di Terlizzi A, Funghi C, Rossi P, Baio A, Fenato A, Pastorin L, Benso L. [Anthropometric study of the rural population of Venice between 6 to 12 years of age. Part I. Weight standards]. Minerva Pediatr 1985; 37:555-60. [PMID: 4058390] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Largajolli G, Bompan MR, Facchin P, Zacchello F. [Assistance to the healthy newborn infant. 1. Experience of a new model of nursery care]. Pediatr Med Chir 1985; 7:287-90. [PMID: 4094917] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
We propose an organizational model which provides proper assistance to the mother and newborn, promoting at the same time, an adequate structure for the child-parent relationship. We refer to the results obtained over a 2-year period, during which we gradually achieved a "rooming-in" situation and organized the assistance in the nursery to the newborns with minor pathology, and without substantial modifications either to structures or personnel. However providing a minimum of equipment and pediatrician and qualified paramedic personnel all the time. We noticed a statistically higher frequency of breastfeeding even after a time lapse (table 3), and a marked decrease of transfers to the neonatal pathology whit, especially among those neonates with minor pathology (tables 5 and 6). The fulfiment a direct connection with the family pediatrician and his services, through a complete and personalized exchange of informations, and a good degree of cooperation with the obstetrician, supported by the results discussed and evaluated together before (or him).
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Largajolli G, Facchin P, Gobber D, Zacchello F. [Assistance to the healthy newborn infant. II. The current situation in Veneto]. Pediatr Med Chir 1985; 7:293-7. [PMID: 4094918] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
We report the results of a research carried out giving all head physicians of the paediatrics departments in Veneto or of the neonatal sections a questionnaire in order to know how the lying-in woman and the healthy newborn are assisted. The principle information requested by the questionnaire are reported in Table n. 1. The structures of the labour and delivery rooms, regarding their present use, allow the continuous presence of the father during the delivery and the accomplishment of the rooming-in. On the contrary the assistance given to the mothers and the newborns is traditional in 80% of the cases, and they hard take measures able to favour suckling and a mother-child contact in the first hours of the delivery (fig. 2). The tendency to admit in the paediatrics department the newborn who presents problems even slight is not influenced by the apparatus equipped in the neonatal section, but it seems to be in proportion to the structure (number of the deliveries a year) and to the staff of the hospital. In conclusion we think that in our district not just logistical and structural limits but cultural and administrative obstacles slacken the accomplishment of a new neonatal assistance. Particularly we consider very important the administrative recognition of the activity carried out by the paediatricians in the neonatal section and in the puerpery, even if it is not linked to hospitalizations in the department.
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Cecotto C, Facchin P, Meo A, De Nardi F. [Arachnoid cysts of the brain]. Riv Neurobiol 1984; 30:613-27. [PMID: 6399951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
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Meo A, Facchin P, Cecotto C, Budai R, Pittaro I, Contento G. [Sensory deficit and changes in SCV as decisive elements in the early diagnosis and prognostic evaluation of the carpal tunnel syndrome]. Riv Neurobiol 1984; 30:409-422. [PMID: 6544490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
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Meo A, Facchin P, Biasizzo E, Cecotto C. [Nonspecific postoperative discitis]. Riv Neurobiol 1984; 30:502-14. [PMID: 6544497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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Meo A, Facchin P, Budai R, Pittaro I, Cecotto C. [Carpal tunnel syndrome. Considerations in a case series of 40 patients treated surgically]. Riv Neurobiol 1984; 30:187-200. [PMID: 6544476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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Cecotto C, Meo A, Fabris G, Facchin P. [Current diagnostic and therapeutic prospects in cervical spinal and spinal cord pathology]. Riv Neurobiol 1984; 30:447-61. [PMID: 6544492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
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