L’Ambulatorio protetto: visitare ai tempi del Covid-19

A 3-months baby comes to our emergency department for an abdominal mass of elastic consistency that suddenly appeared for a week and grown exponentially in the last few days. Blood examinations identify a septic state of the child, and the emergency CT recognizes the abdominal mass’s cystic structure. The surgical removal and the histological analysis will confirm the diagnosis of Infected Common Macrocystic Lymphatic Malformation. This case allows us to remember to pediatricians the main features of Cystic Lymphatic Malformations that should always be considered during the differential diagnosis of abdominal masses of sudden onset in an infant.

Rilevare e curare la violenza all’infanzia: l’esperienza pugliese di GIADA

This article illustrates the path built over a decade by the Interdisciplinary Assistance Group for Abused Women and Children (GIADA) which has gradually taken on a stable dimension at the “Giovanni XXIII” Pediatric Hospital in Bari. The article describes the functions performed and the architecture of the Apulian model in which GIADA acts as a Level III Center for the prevention, diagnosis and treatment of the different forms of violence against children.

L’emocromo: così convenzionale, così richiesto, ma così sconosciuto

Complete blood count (CBC) is one of the mostly performed diagnostic exam. It can give a variety of informations about a child’s health status. The article has the aim of guiding the pediatrician into reading the the different values of the CBC, in order to properly recognize and interpret the alterations and underlying the red flags which must be identified in order to proceed into further investigations or to request a specialist consultation (pediatric hematologist).

Studi epidemiologici osservazionali europei: le coorti dalla nascita

Objective: in recent years there has been a growing interest in birth cohorts. The aim of this review is to know and understand the state of the art of European cohorts to date, with a focus on those that started data collection at birth. In particular, the aim is to provide an overview of current research topics and designs, and provide input for those creating collaborations and laying out guidelines aimed at unifying cohort methodologies to enable data merging and maximize knowledge acquisition. Methods: we searched PubMed and Embase for articles referring to longitudinal, prospective European birth cohorts, and searched online cohort inventories. Results: we found references to 111 birth cohorts, 45 of which began enrolment at birth. These cohorts began between 1921 and 2015 and represented 19 countries, with varying sample sizes (236 to 21,000 children). As of 5 January 2020, 5 were still recruiting. The main areas addressed were allergic diseases (14 cohorts) and environmental exposure (12 cohorts) and most cohorts were publicly funded. Conclusion: given the large costs of running cohorts and the importance of long follow-up periods in identifying the risk factors for disorders thought to have a perinatal/early life etiology, current cohorts must be designed to answer research questions considering several aspects, from genetic ones to psychological, social, and environmental ones. Furthermore, universally recognized methodological aspects are needed to permit the comparison and merging of cohort data.

Le sfide alla salute psicofisica delle famiglie italiane nel periodo dell’emergenza Covid-19: uno studio pilota sull’impatto del burnout genitoriale in diverse categorie professionali

Objectives: to assess the impact of the Covid-19 pandemicon parenting in families with pediatric age childrenand examine how parental burnout can be influenced by the presence of one or more children with certified diagnosis of full-blown physical or psychological-psychiatric pathology. Methods: the sample consisted of 970 parents with pediatric age children who were administered a questionnaire on parental burnout. Results: mothers have a higher level of burnout. A significant main effect emerged with respect to the parents’ work: manual workers have higher burnout levels during quarantine. The presence of children with a certified diagnosis is a predictor of parental burnout. Conclusions: the primary pediatrician should care of potentially risky situations that undermine children mental and physical health, especially by supervising the decline of parental care both in families with cases of manifest pathology and in those in good health conditions.

Il modello del counseling nutrizionale nella gestione del paziente pediatrico in sovrappeso

As assessed by the recent data published by the Observatory “Okkio alla Salute” [1-2], the overweight and the obesity are increasingly common in childhood; in Italy, the 23% of kids of 8/9 years are overweighed and the 9% of them are obese. The diet therapy for the pediatric patient is increasingly necessary at local, outpatient and hospital level. The diet therapy and nutritional programmes, however, present some specific issues and complexities, from different points of view (biological and technical, behavioural and communication one). In this Paper, the Authors propose and analyse the approach to the child and its family context based on the Nutritional Counselling model. The Paper illustrates the theoretic principles and applicative practices of an approach based on a systemic view of the nutrition behaviour.

Il rifiuto del trattamento sanitario da parte dei genitori della persona minore di età e la prevenzione del ricorso al giudice tutelare: il caso della trasfusione ematica

In clinical practice, there may be situations of conflict between parents and doctors regarding care choices for minors. A relatively frequent case is represented by the parents’ refusal to consent to blood transfusion. The article outlines an updated legislative framework on the issue and a possible operational approach, which has proved to be effective in meeting the health needs of patients and the wishes expressed by parents.