Adolescent gymnast with persistent back pain

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A young soccer player with sudden pain after kicking the ball

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A quasi randomized-controlled trial to evaluate the effectiveness of clowntherapy on children\u2019s anxiety and pain levels in emergency department

The aim of the study is to investigate if the presence of medical clowns during painful procedures in the emergency department (ED) affects children's anxiety and pain. Forty children (4-11 years) admitted to the ED with the need of painful procedures were prospectively enrolled. They were randomly assigned to the clown group, where children interacted with clowns or to the control group in which they were entertained by parents and ED nurses. The children's anxiety was assessed by the Children's Anxiety and Pain Scales; pain was evaluated with the Numerical Rating Scale and Wong-Backer Scale, according to the children's age. Staff and clown's opinions were evaluated by means of dedicated questionnaires. Children's anxiety levels in the clown group were significantly lower than those compared with the control group, while children's pain levels did not change between the two groups. CONCLUSION: The presence of clowns in the ED before and during painful procedures was effective in reducing children's anxiety. WHAT IS KNOWN: \u2022 Anxiety and fear caused by medical procedures exacerbate children's pain and may interfere with the procedure. \u2022 To reduce anxiety, fear, and pain and to facilitate patient's evaluation, different non-pharmacological approaches have been proposed and positive effects of laughter and humor have been reported. What is New: \u2022 The presence of clowns in the waiting room and in the ED during medical evaluation and painful procedures helps to reduce children's anxiet

Neonatal acute scrotum: do not forget Amyand hernia

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Paediatric Behçet's disease presenting with recurrent papillitis and episcleritis: a case report

<p>Abstract</p> <p>Introduction</p> <p>Behçet's disease is a chronic multisystem vasculitis characterized by mucocutaneous, articular, neurological, gastrointestinal and ophthalmological lesions. Ocular involvement is mainly represented by recurrent uveitis, especially posterior uveitis; however, iridocyclitis, retinal and choroidal vasculitis, optic neuritis and retinal vascular occlusion can also occur.</p> <p>Case presentation</p> <p>A 12-year-old Caucasian boy with a history of recurrent buccal aphthosis and nonspecific gastrointestinal symptoms was admitted to our hospital with blurred vision associated with acute episcleritis and papillitis. The patient's pathergy test was positive, suggesting a diagnosis of Behçet's disease. Corticosteroid and cyclosporine therapy was started, but further episodes were noted in both eyes. The patient was then switched to intravenous infliximab, with complete resolution of the inflammation after the second infusion.</p> <p>Conclusion</p> <p>Episcleritis and papillitis should be added to the list of uncommon manifestations of pediatric Behçet's disease. Infliximab is an effective, new therapeutic approach for Behçet's disease that is refractory to the conventional corticosteroid and immunosuppressive therapy.</p

Adolescent with intermittent haematuria

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Macrocephaly and palmoplantar pitting

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Sulle spine

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L'ossigenoterapia: Indicazioni, vie di somministrazione e parametri da valutare

The main issues concerning oxygen treatment in children are discussed in this paper ranging from physiopathological premises to practical daily issues. Indications to oxygen treatment, monitoring issues, clinical tips, advantages and disadvantages of different ways of administering oxygen are focused, mainly with a practice based approach. Signs and symptoms of hypoxemia, hypercapnia and increased breathing work are highlighted. The two different mechanisms leading to respiratory failure (type I and type II) are discussed along with the proper indications for treatment

A Spotted Bone

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