Inter-society consensus document on treatment and prevention of bronchiolitis in newborns and infants

Acute bronchiolitis is the leading cause of lower respiratory tract infection and hospitalization in children less than 1 year of age worldwide. It is usually a mild disease, but some children may develop severe symptoms, requiring hospital admission and ventilatory support in the ICU. Infants with pre-existing risk factors (prematurity, bronchopulmonary dysplasia, congenital heart diseases and immunodeficiency) may be predisposed to a severe form of the disease. Clinical diagnosis of bronchiolitis is manly based on medical history and physical examination (rhinorrhea, cough, crackles, wheezing and signs of respiratory distress). Etiological diagnosis, with antigen or genome detection to identify viruses involved, may have a role in reducing hospital transmission of the infection. Criteria for hospitalization include low oxygen saturation (<90-92%), moderate-to-severe respiratory distress, dehydration and presence of apnea. Children with pre-existing risk factors should be carefully assessed. To date, there is no specific treatment for viral bronchiolitis, and the mainstay of therapy is supportive care. This consists of nasal suctioning and nebulized 3% hypertonic saline, assisted feeding and hydration, humidified O2 delivery. The possible role of any pharmacological approach is still debated, and till now there is no evidence to support the use of bronchodilators, corticosteroids, chest physiotherapy, antibiotics or antivirals. Nebulized adrenaline may be sometimes useful in the emergency room. Nebulized adrenaline can be useful in the hospital setting for treatment as needed. Lacking a specific etiological treatment, prophylaxis and prevention, especially in children at high risk of severe infection, have a fundamental role. Environmental preventive measures minimize viral transmission in hospital, in the outpatient setting and at home. Pharmacological prophylaxis with palivizumab for RSV bronchiolitis is indicated in specific categories of children at risk during the epidemic period. Viral bronchiolitis, especially in the case of severe form, may correlate with an increased incidence of recurrent wheezing in pre-schooled children and with asthma at school age. The aim of this document is to provide a multidisciplinary update on the current recommendations for the management and prevention of bronchiolitis, in order to share useful indications, identify gaps in knowledge and drive future research

Tutti Diversi Tutti Uguali. Progetto per la prevenzione delle disabilit\ue0 nei servizi educativi per l'infanzia

Un progetto di GlaxoSmithKline per lo sviluppo di un piano di collaborazione permanente fra educatrici di asili nido, insegnanti di scuole dell\u2019infanzia, pediatri, esperti di educazione speciale, psicologi, istituzioni, famiglie, per il riconoscimento e la cura dei bambini con bisogni speciali.A GlaxoSmithKline project for the development of a permanent collaboration plan between nursery educators, nursery school teachers, pediatricians, special education specialists, psychologists, institutions, families, for the recognition and care of children with special needs

Hexavalent vaccines: characteristics of available products and practical considerations from a panel of Italian experts in Public Health

Combination vaccines represent a valuable technological innovation in the field of infectious disease prevention and public health, because of their great health and economic value from the individual, societal, and healthcare system perspectives.In order to increase parents’ and healthcare professionals’ confidence in the vaccination programs and maintain their benefits to society, more information about the benefits of innovative vaccination tools such as combination vaccines is needed.Purpose of this work is an examination of available hexavalent vaccines, that protect against Diphtheria, Tetanus, Pertussis, Poliomyelitis, Hepatitis B and Haemophilus influenzae type b infections. From the epidemiological updates of vaccine preventable diseases to the vaccine development cycle, from the immunogenicity of antigenic components to the safety and co-administration with other vaccines, several aspects of available hexavalent vaccines are discussed and deepened.Also a number of practical considerations on schedules, age of employment, strategies for vaccination recovery, vaccination in at-risk births are issued, based on the recommendations of Italian Ministry of Health, Italian Society of Pharmacology (SIF), Italian Society for Pediatrics (SIP), Italian Federation of Family Paediatricians (FIMP) and Italian Society of Hygiene, Preventive Medicine and Public Health (SItI)

The 2016 Lifetime Immunization Schedule approved by the Italian scientific societies: a new paradigm to promote vaccination at all ages

Medical scientific societies have the core mission of producing, pooling and disseminating solid and updated scientific information. We report the successful experience of the partnership of four national Medical Scientific Societies active in Italy in producing scientific advice on vaccines and vaccination. In particular, i) the Italian Society of Hygiene, Preventive Medicine and Public Health; SitI, ii) the Italian Society of Paediatrics; SIP, ii) the Italian Federation of Family Paediatricians; FIMP, and iv) the Italian Federation of General Medicine FIMMG) have worked together since 2012 to produce shared evidence-based recommendations on vaccination schedules, namely the "Lifetime Immunization Schedule" which introduced for the first time in Italy a life-course approach to vaccination. The 2014 edition of the "Lifetime Immunization Schedule" was used as a basis to develop the 2017-2019 Italian National Prevention Plan, approved by The Italian Ministry of Health in February 2017. In this report, we present the structure, content and supporting evidence of the new 2016 "Lifetime Immunization Schedule" and we expand on the influential role of medical scientific societies in researching and advocating for effective and safe vaccination programmes' implementation at the national level

[Prevention of HPV cancer related through HPV-9: state of the art, potential benefits and open issues]

HPV vaccines currently marketed in Italy (bivalent and quadrivalent against HPV 16-18 and HPV and 6,11,16,18 respectively) are an extraordinary tool for the primary prevention of HPV related diseases, particularly of the cervical cancer. Although the implementation of the organized vaccination programs has already translated (for some endpoint) in confirmation of clinical efficacy, remains excluded a significant proportion of the diseases linked to non-vaccine HPV types. The new nonavalent vaccine (HPV9), of impending commercialization, represents an evolution of the quadrivalent, the composition of which are added five high-risk HPV types (HPV 31,33,45,52,58). The high clinical-immunological efficacy in experimental trials against the new genotypes (&gt; 96% for CIN2 +), and the equivalence immunogenic to the four already present in the previous vaccine, will render the use of HPV9 a tool able to control in an even more effective HPV disease. The potential of the new vaccine is linked to the reduction of the HPV cancer burden by 2-20% according to anatomical site, with major benefits for cervical cancer, vulvo-vaginal, penile and more limited benefits for anal tumours. Moreover, the potential benefits could be also linked to the reduction of incidence of pre-neoplastic lesions arising in the lower-genital tract, especially in the cervix (CIN2-3), so often cause lengthy and expensive diagnostic and therapeutic procedures. In the face of this broad provision of benefit from HPV9 vaccine, we have also to consider all the variables related to its introduction in the vaccination calendars: the market price, the schedule of administration (currently in three doses) and data regarding the cost-effectiveness. The authors recognize the new vaccine (currently registered only in the US) a lot of potential in the prevention of HPV-related diseases

I vaccini e le vaccinazioni

Le quattro Società firmatarie del Calendario per la Vita (SITI, SIP, FIMMG e FIMP) vista la richiesta di attenzione su questo elaborato sul tema dei vaccini, prodotto dalla Società Italiana di Farmacologia (SIF) presieduta dal Prof. Giorgio Cantelli Forti, ne esprimono grande apprezzamento. Gli argomenti trattati sono divenuti particolarmente importanti e attuali con la recente approvazione dei LEA in concomitanza al Piano Nazionale Vaccini 2017 – 2019. Il testo ispirato anche ai contenuti e principi del nostro Calendario per la Vita, arricchisce la cultura vaccinale con la giusta positività che si contrappone alle strumentali campagne denigratorie che periodicamente compaiono sul web creando incertezze e smarrimento a una popolazione che, per merito delle vaccinazioni, si è dimenticata le tragiche conseguenze di molte malattie infettive degli scorsi decenni

I vaccini e le vaccinazioni

Le quattro Società firmatarie del Calendario per la Vita (SITI, SIP, FIMMG e FIMP) vista la richiesta di attenzione su questo elaborato sul tema dei vaccini, prodotto dalla Società Italiana di Farmacologia (SIF) presieduta dal Prof. Giorgio Cantelli Forti, ne esprimono grande apprezzamento. Gli argomenti trattati sono divenuti particolarmente importanti e attuali con la recente approvazione dei LEA in concomitanza al Piano Nazionale Vaccini 2017 – 2019. Il testo ispirato anche ai contenuti e principi del nostro Calendario per la Vita, arricchisce la cultura vaccinale con la giusta positività che si contrappone alle strumentali campagne denigratorie che periodicamente compaiono sul web creando incertezze e smarrimento a una popolazione che, per merito delle vaccinazioni, si è dimenticata le tragiche conseguenze di molte malattie infettive degli scorsi decenni