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Witnessed violence is a form of child abuse with detrimental effects on child wellbeing and development, whose recognition relies on the assessment of their mother exposure to intimate partner violence (IPV). The aim of this study was to assess the frequency of witnessed violence in a population of children attending a pediatric emergency department (ED) in Italy, by searching for IPV in their mother, and to define the characteristics of the mother-child dyads. An observational cross-sectional study was conducted from February 2020 to January 2021. Participating mothers were provided a questionnaire, which included the Woman Abuse Screening Tool (WAST) and additional questions about their baseline data and health. Descriptive analysis was reported as frequency and percentage for the categorical variables and median and interquartile range (IQR) for quantitative variables. Mothers and children screened positive and negative for IPV and witnessed violence, respectively, were compared by the chi-square test or the exact Fisher test for categorical variables, and by the Wilcoxon-Mann-Whitney test for continuous variables. Out of 212 participating mothers, ninety-three (43.9%) displayed a positive WAST. Mothers tested positive were mainly Italian (71%, p 0.003), had a lower level of education (median age at school dropout 19, p 0.0002), and a higher frequency of unemployment (p 0.001) and poor personal health status (8.6%, p 0.001). The children of mothers tested positive showed a higher occurrence of abnormal psychological-emotional state (38.7%, p 0.002) and sleep disturbances (26.9%, p 0.04).IPV was common in a population of mothers seeking care for their children in a pediatric ED.• Witnessed violence is a form of child abuse, usually inferred by their mothers' exposure to IPV. The latter is suffered by one in three women worldwide.• This study shows a 43.9% prevalence of IPV among mothers attending an Italian pediatric ED. • Positive mother-child dyads displayed a higher frequency of poor mothers' health status and children's abnormal emotional state and sleep disturbances.

OBJECTIVE: To evaluate glucose metabolism and insulin sensitivity in children with idiopathic growth hormone (GH) deficiency treated with recombinant human GH (rhGH) and to identify possible risk factors for the development of glucose abnormalities in this population. METHODS: We retrospectively collected data from 101 patients (60 males, median age 10.4 years, 77 prepubertal), with confirmed GH deficiency, enrolled before starting rhGH and followed up for the first three years of treatment. Glucose metabolism was evaluated every year by oral glucose tolerance test (OGTT) and glycated hemoglobin (HbA1c). OGTT was used to calculate insulin sensitivity (HOMA-S) and insulin resistance (HOMA-IR), defined as HOMA-IR>3. RESULTS: RhGH was effective in improving growth and its dosage was significantly reduced after the first year of therapy. No patient developed diabetes mellitus. After one year of therapy, a significant increase in HbA1c (p=0.0042) and insulin levels (fasting p

AimDescribe the use of the pediatric emergency department of a tertiary-level children’s hospital in Italy by adolescents. MethodsThis retrospective study was based on the medical records of patients aged 13 to 17 years, who accessed the pediatric emergency department of the Institute for Maternal and Child Health IRCCS Burlo Garofolo, from 1 January to 31 December 2018. For each patient, we reported: age, gender, triage category, chief complaint, diagnosis, admission status, and hospital ward of destination. The primary outcome was to describe the use of the department in terms of leading causes of access, diagnoses, and outcomes. ResultsDuring the study period, 3062 adolescents accessed to the department, for a total of 3895 unscheduled visits. The principal causes of access were trauma (45.3%) and organic diseases (38.8%). 249 adolescents (6.4%) had mental health problems. One-hundred-forty-two adolescents (3.6%) were admitted to the hospital, 54 of whom to the neuropsychiatric ward, for mental health problems. Compared to younger patients entering the department, adolescents were admitted to the neuropsychiatric ward more frequently (p

Child abuse and maltreatment are frequent and often underestimated phenomena. The present retrospective study shows the important role of the paediatriacians operating in the Emergency Units in intercepting and correctly addressing abused and maltreated children.

A 15-year-old girl was admitted with acute crampy abdominal pain and repeated vomiting over the preceding 2 hours; no fever, diarrhoea or abdominal trauma was reported. She had started oestrogen-progestin contraception 3 months ago. She had sought medical advice twice in the previous weeks for self-limiting episodes of right hand swelling, without urticaria. On examination, she was unwell and in pain, with severe tenderness in the right lower quadrant, without guarding or rebound tenderness. Bowel sounds were diminished. Blood tests were unremarkable. Two hours after admission, an abdominal ultrasound scanning showed an impressive wall thickening (1 cm) of the terminal ileum, caecum and ascending colon (figure 1). Abundant free intraperitoneal fluids in the pelvis and in the hepatorenal recess were present.edpract;103/1/22/EDPRACT2016311823F1F1EDPRACT2016311823F1Figure 1Marked caecal wall thickening evidenced at the ultrasound scanning.Which of the following is the most likely diagnosis in this patient? Ileocolic intussusceptionGastrointestinal manifestation of Henoch-Schönlein purpuraAbdominal attack of hereditary angioedema (HAE)Acute pancreatitisWhich of the following blood tests may help to confirm the diagnosis? Erythrocyte sedimentation rateC4Serum amylase: 36 IU/LC1-inhibitorHow should this patient be evaluated and treated?

We present the case of two twin brothers with surfactant protein C deficiency who were treated with hydroxychloroquine for three years, with apparent success. The exact physiopathology of this disease is not known and there is no specific treatment for it. There is merely news from a few previous descriptions in the literature about the use of hydroxychloroquine for surfactant protein C deficiency with satisfactory results. Two years after the treatment was withdrawn, the twins were evaluated once again: they presented no new infections, growth and general state were normal and chest CT showed a notable additional reduction in the interstitial pneumopathy. These data seem to cast some doubt on the efficacy of hydroxychloroquine, and they suggest that the clinical improvement was simply the natural evolution of the disease.

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The synthesis of 1-halobenzyl-1H-indazole-3-carboxylic acids is described and the effects of these compounds on testicular weight and inhibition of spermatogenesis are reported. Histologically the antispermatogenic activity of all the active derivatives was similar. Rat testis showed disorganization of the seminiferous tubules consisting mainly of lesion and loss of spermatocytes and spermatids while the spermatogonia and interstitial tissue appeared normal. 1-(24-dichlorobenzyl)-1H-indazole-3-carboxylic acid 1-(24-dichlorobenzyl)-1H-indazole-3-carboxylic acid 1-(4-chloro-2-methylbenzyl)-1H-indazole-3-carboxylic acid and their glycerol esters showed the most potent antispermatogenic activity.

The synthesis of a series of halogenated 1-benzylindazole-3-carboxylic acids and related derivatives is described. These compounds were studied for their effect on testicular weight and on the inhibition of spermatogenesis. Many of the derivatives, but in particular 1-(2,4-dichlorobenzyl)-1H-indazole-3-carboxylic acid (11), 1-(2,4-dibromobenzyl)-1H-indazole-3-carboxylic acid (13), 1-(4-chloro-2-methylbenzyl)-1H-indazole-3-carboxylic acid (27), and their glycerol esters, showed potent antispermatogenic activity.The synthesis of 1-halobenzyl-1H-indazole-3-carboxylic acids is described and the effects of these compounds on testicular weight and inhibition of spermatogenesis are reported. Histologically, the antispermatogenic activity of all the active derivatives was similar. Rat testis showed disorganization of the seminiferous tubules consisting mainly of lesion and loss of spermatocytes and spermatids while the spermatogonia and interstitial tissue appeared normal. 1-(2,4-dichlorobenzyl)-1H-indazole-3-carboxylic acid, 1-(2,4-dichlorobenzyl)-1H-indazole-3-carboxylic acid, 1-(4-chloro-2-methylbenzyl)-1H-indazole-3-carboxylic acid and their glycerol esters showed the most potent antispermatogenic activity.