69 research outputs found
Adherence among Italian paediatricians to the Italian guidelines for the management of fever in children: a cross sectional survey.
L’Accademia delle idee : iniziativa dei giovani per i giovani. Contenitore di progetti innovativi?
L\u2019Accademia delle Idee \ue8 un\u2019iniziativa della Societ\ue0 Italiana di Nefrologia, dedicata ai giovani che lavorano in
ambito nefrologico. La proposta \ue8 nata con l\u2019obiettivo di mettere in comunicazione i giovani nefrologi ed il
mondo imprenditoriale e dare loro una possibilit\ue0 per valorizzare le Idee con immediata applicabilit\ue0 che
nascono dall\u2019attivit\ue0 di ricerca clinica. Ha l\u2019obiettivo inoltre di creare una rete di conoscenza e collaborazione
tra i giovani ricercatori della nefrologia italiana per facilitare l\u2019instaurarsi di rapporti di collaborazione
e favorire la creazione di nuovi progetti e la pubblicazione di lavori di elevato impatto scientifico.
Il presente articolo descriver\ue0 l\u2019evento svolto, mostrando punti forti e criticit\ue0 anche attraverso le impressioni
dei partecipanti ed esporr\ue0 ambizioni e aspirazioni per il prossimo futuro
Use of Telemedicine Healthcare Systems in Children and Adolescents with Chronic Disease or in Transition Stages of Life: Consensus Document of the Italian Society of Telemedicine (SIT), of the Italian Society of Preventive and Social Pediatrics (SIPPS), of the Italian Society of Pediatric Primary Care (SICuPP), of the Italian Federation of Pediatric Doctors (FIMP) and of the Syndicate of Family Pediatrician Doctors (SIMPeF)
Telemedicine is considered an excellent tool to support the daily and traditional practice of the health profession, especially when referring to the care and management of chronic patients. In a panorama in which chronic pathologies with childhood onset are constantly increasing and the improvement of treatments has allowed survival for them into adulthood, telemedicine and remote assistance are today considered effective and convenient solutions both for the chronic patient, who thus receives personalized and timely assistance, and for the doctors, who reduce the need for direct intervention, hospitalizations and consequent management costs. This Consensus document, written by the main Italian Scientific Societies involved in the use of telemedicine in pediatrics, has the objectives to propose an organizational model based on the relationships between the actors who participate in the provision of a telemedicine service aimed at minors with chronic pathologies, identifying specific project links between the areas of telemedicine in the developmental age from the first 1000 days of life to the age adult. The future scenario will have to be able to integrate digital innovation in order to offer the best care to patients and citizens. It will have to be able to provide the involvement of patients from the very beginning of the design of any care pathway, increasing where possible the proximity of the health service to citizens
Inter-society consensus for the use of inhaled corticosteroids in infants, children and adolescents with airway diseases
Background: In 2019, a multidisciplinary panel of experts from eight Italian scientific paediatric societies developed a consensus document for the use of inhaled corticosteroids in the management and prevention of the most common paediatric airways disorders. The aim is to provide healthcare providers with a multidisciplinary document including indications useful in the clinical practice. The consensus document was intended to be addressed to paediatricians who work in the Paediatric Divisions, the Primary Care Services and the Emergency Departments, as well as to Residents or PhD students, paediatric nurses and specialists or consultants in paediatric pulmonology, allergy, infectious diseases, and ear, nose, and throat medicine. Methods: Clinical questions identifying Population, Intervention(s), Comparison and Outcome(s) were addressed by methodologists and a general agreement on the topics and the strength of the recommendations (according to the GRADE system) was obtained following the Delphi method. The literature selection included secondary sources such as evidence-based guidelines and systematic reviews and was integrated with primary studies subsequently published. Results: The expert panel provided a number of recommendations on the use of inhaled corticosteroids in preschool wheezing, bronchial asthma, allergic and non-allergic rhinitis, acute and chronic rhinosinusitis, adenoid hypertrophy, laryngitis and laryngospasm. Conclusions: We provided a multidisciplinary update on the current recommendations for the management and prevention of the most common paediatric airways disorders requiring inhaled corticosteroids, in order to share useful indications, identify gaps in knowledge and drive future research
Prostaglandin E2 and bacterial lipopolysaccharide stimulate bioactive interleukin-1 release from rat hypothalamic explants.
While interleukin-1 (IL-1) is intimately involved in locally modulating the acute inflammatory response, it is also able to influence processes at remote sites, i.e., in an endocrine manner. While there is as yet little evidence that IL-1 can cross the blood-brain barrier, many effects such as fever, increased slow-wave sleep, anorexia and the modulation of neuroendocrine function suggest an action of circulating IL-1 at regulatory sites within the hypothalamus. However, there is accumulating evidence for IL-1 originating within the central nervous system (CNS), and it is currently unclear as to whether the neurally mediated manifestations of the acute inflammatory response are due to activation of central or peripheral (circulating) IL-1. In this study we have characterized the release of IL-1 from rat hypothalamic explants, and we have investigated the effects of putative modulators of IL-1 release, lipopolysaccharide (LPS) and the prostaglandins E2 (PGE2) and F2 alpha (PGF2 alpha). After 1 h of incubation, IL-1-like activity in hypothalamic supernatants ranged between 175 and 2,304 munits/mg of protein; this was substantially inhibited by the addition to the bioassay system of antibodies (1:200) against IL-1 alpha, but not against IL-1 beta. LPS and PGE2 significantly stimulated IL-1 release at 100 and 1 ng/ml respectively, whereas PGF2 alpha had no effect in the range of doses tested. It is therefore concluded that the control of hypothalamic IL-1 release may be investigated by means of acute rat hypothalamic explants.(ABSTRACT TRUNCATED AT 250 WORDS
Italian primary care paediatricians’ adherence to the 2019 National Guideline for the management of acute otitis media in children: A cross-sectional study
Introduction: The Italian Guideline for the management of acute otitis media (AOM) in children has been recently updated. We conducted a cross-sectional survey to investigate the adherence of Italian primary care paediatricians to the guideline recommendations. Methods: A questionnaire including 13 closed-ended questions was administered to the paediatricians participating in the 24th National Congress of Practical Pediatrics, held in Florence in November 2019. The answers were collected and analyzed. Results: Eight hundred fifty-four out of 1000 questionnaires were collected (85.4%). Most of the participants declared that they did not remove the cerumen (63.9%). Pneumatic otoscope and tympanometry were routinely used by a minority of paediatricians (9.6% and 3.9%, respectively); all the participants declared to routinely prescribe oral analgesic drugs and 97.6% of them considered amoxicillin or amoxicillin/clavulanic acid as the first-choice antibiotic. In an uncomplicated unilateral AOM case, the preferred strategy was immediate antibiotic therapy in children under two years of age (83.1%) and watchful waiting in those >2 years (77.3%). Oral amoxicillin was most commonly prescribed at the 80\u2013100 mg/kg/day (56.6%), in 3 daily doses (87.7%), while amoxicillin/clavulanic acid was equally prescribed at 80\u2013100 or 50 mg/kg/day (47.1%\u201348.5%), mainly in 2 doses (58.6%). However, both drugs are recommended at a dosage of 80\u201390 mg/kg/day (calculated on amoxicillin), in 3 daily doses. Although the Guideline recommends ten days of therapy, both drugs were most commonly prescribed for 7\u20138 days (55.5%\u201357.7%). Pneumococcal and flu vaccines were recommended only by 41.6% and 31.6% of participants, respectively. Conclusions: Our data suggest adequate adherence of the guideline recommendations considering the preferred antibiotic drug, pain management and the choice between immediate antibiotic therapy and watchful waiting. Conversely, targeted training programs are needed to improve adherence to recommendations on cerumen removal, use of pneumatic otoscopy, correct use of antibiotics in terms of optimal dosage, duration and number of daily administrations, and to implement proper AOM prevention strategies
Increase of extracellular brain calcium involved in interleukin-1 beta-induced pyresis in the rabbit: antagonism by dexamethasone.
1. This study investigates the role of extracellular brain calcium in the hyperthermia induced by interleukin-1 beta (IL-1 beta). 2. Intracerebroventricular (i.c.v.) injection of IL-1 beta (12.5 ng kg-1) in rabbits caused a prompt and sustained rise in cerebrospinal fluid (CSF) Ca2+ concentration ([Ca2+]) followed by enhanced prostaglandin E2 (PGE2) release and hyperthermia. 3. A linear and significant correlation was observed between the increase in [Ca2+] induced by IL-1 beta and the rise in body temperature. 4. Ventriculo-cisternal perfusion with artificial CSF containing the calcium chelator EGTA (1.3 mM) blocked the IL-1-induced PGE2 release and countered the febrile response. 5. I.c.v. administration of dexamethasone (Dex) (2.4 and 24 micrograms kg-1) 100 min prior to IL-1 beta, dose-dependently antagonized the cytokine-induced Ca2+ increase, the PGE2 release and the febrile response. 6. These results suggest that changes in extracellular brain calcium are involved in the regulation of body temperature. In this light, the antipyretic action of Dex may be related to its effect on Ca2+ uptake
4-Substituted-5-acetyl-2-methyl-6-phenyl-3(2H)pyridazinones as PGE2 and IL-1 release inhibitors from mouse adherent macrophages
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