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1. Cyclic vomiting syndrome in children: a nationwide survey of current practice on behalf of the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP) and Italian Society of Pediatric Neurology (SINP).

Author

Isoldi S, Di Nardo G, Mallardo S, Parisi P, Raucci U, Tambucci R, Quitadamo P, Salvatore S, Felici E, Cisarò F, Pensabene L, Banzato C, Strisciuglio C, Romano C, Fusco P, Rigotti F, Sansotta N, Caimmi S, Savasta S, Zuin G, Di Stefano M, Provera S, Campanozzi A, Rossi P, Gatti S, Corpino M, Alvisi P, Martelossi S, Suppiej A, Gandullia P, Verrotti A, Terrin G, Pacenza C, Fornaroli F, Comito D, D'Arrigo S, Striano P, Raviglione F, Carotenuto M, Orsini A, Belcastro V, Di Corcia G, Raieli V, Ferilli MAN, Ruscitto C, Spadoni E, Grosso S, D'Alonzo R, Papa A, Pavone P, Meli M, Velardita M, Mainetti M, Vanacore N, and Borrelli O

Subjects
Child, Cross-Sectional Studies, Humans, Italy, Practice Guidelines as Topic standards, Treatment Outcome, Child Nutrition Sciences, Gastroenterology, Health Care Surveys, Neurology, Pediatrics, Societies, Medical, Vomiting
Abstract

Background: Cyclic Vomiting Syndrome (CVS) is a rare functional gastrointestinal disorder, which has a considerable burden on quality of life of both children and their family. Aim of the study was to evaluate the diagnostic modalities and therapeutic approach to CVS among Italian tertiary care centers and the differences according to subspecialties, as well as to explore whether potential predictive factors associated with either a poor outcome or a response to a specific treatment., Methods: Cross-sectional multicenter web-based survey involving members of the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP) and Italian Society of Pediatric Neurology (SINP)., Results: A total of 67 responses were received and analyzed. Most of the respondent units cared for less than 20 patients. More than half of the patients were referred after 3 to 5 episodes, and a quarter after 5 attacks. We report different diagnostic approaches among Italian clinicians, which was particularly evident when comparing gastroenterologists and neurologists. Moreover, our survey demonstrated a predilection of certain drugs during emetic phase according to specific clinic, which reflects the cultural background of physicians., Conclusion: In conclusion, our survey highlights poor consensus amongst clinicians in our country in the diagnosis and the management of children with CVS, raising the need for a national consensus guideline in order to standardize the practice., (© 2022. The Author(s).)

Published
2022
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2. Cyclic vomiting syndrome in children: a nationwide survey of current practice on behalf of the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP) and Italian Society of Pediatric Neurology (SINP)

Author

Sara Isoldi, Giovanni Di Nardo, Saverio Mallardo, Pasquale Parisi, Umberto Raucci, Renato Tambucci, Paolo Quitadamo, Silvia Salvatore, Enrico Felici, Fabio Cisarò, Licia Pensabene, Claudia Banzato, Caterina Strisciuglio, Claudio Romano, Patrizia Fusco, Francesca Rigotti, Naire Sansotta, Silvia Caimmi, Salvatore Savasta, Giovanna Zuin, Marina Di Stefano, Silvia Provera, Angelo Campanozzi, Paolo Rossi, Simona Gatti, Mara Corpino, Patrizia Alvisi, Stefano Martelossi, Agnese Suppiej, Paolo Gandullia, Alberto Verrotti, Gianluca Terrin, Caterina Pacenza, Fabiola Fornaroli, Donatella Comito, Stefano D’Arrigo, Pasquale Striano, Federico Raviglione, Marco Carotenuto, Alessandro Orsini, Vincenzo Belcastro, Giovanna Di Corcia, Vincenzo Raieli, Michela Ada Noris Ferilli, Claudia Ruscitto, Elisabetta Spadoni, Salvatore Grosso, Renato D’Alonzo, Amanda Papa, Piero Pavone, Mariaclaudia Meli, Mario Velardita, Martina Mainetti, Nicola Vanacore, Osvaldo Borrelli, Isoldi, S., Di Nardo, G., Mallardo, S., Parisi, P., Raucci, U., Tambucci, R., Quitadamo, P., Salvatore, S., Felici, E., Cisaro, F., Pensabene, L., Banzato, C., Strisciuglio, C., Romano, C., Fusco, P., Rigotti, F., Sansotta, N., Caimmi, S., Savasta, S., Zuin, G., Di Stefano, M., Provera, S., Campanozzi, A., Rossi, P., Gatti, S., Corpino, M., Alvisi, P., Martelossi, S., Suppiej, A., Gandullia, P., Verrotti, A., Terrin, G., Pacenza, C., Fornaroli, F., Comito, D., D'Arrigo, S., Striano, P., Raviglione, F., Carotenuto, M., Orsini, A., Belcastro, V., Di Corcia, G., Raieli, V., Ferilli, M. A. N., Ruscitto, C., Spadoni, E., Grosso, S., D'Alonzo, R., Papa, A., Pavone, P., Meli, M., Velardita, M., Mainetti, M., Vanacore, N., and Borrelli, O.

Subjects
Pediatric, Vomiting, Gastroenterology, General Medicine, Child Nutrition Sciences, outcomes, Cyclic vomiting, Pediatrics, cyclic vomiting, management, pediatric, child, cross-sectional studies, humans, quality of life, surveys and questionnaires, vomiting, gastroenterology, neurology, Management, Cross-Sectional Studies, Treatment Outcome, Italy, Neurology, Health Care Surveys, Practice Guidelines as Topic, Humans, Child, Societies, Medical, Outcome
Abstract

Background Cyclic Vomiting Syndrome (CVS) is a rare functional gastrointestinal disorder, which has a considerable burden on quality of life of both children and their family. Aim of the study was to evaluate the diagnostic modalities and therapeutic approach to CVS among Italian tertiary care centers and the differences according to subspecialties, as well as to explore whether potential predictive factors associated with either a poor outcome or a response to a specific treatment. Methods Cross-sectional multicenter web-based survey involving members of the Italian Society of Pediatric Gastroenterology, Hepatology and Nutrition (SIGENP) and Italian Society of Pediatric Neurology (SINP). Results A total of 67 responses were received and analyzed. Most of the respondent units cared for less than 20 patients. More than half of the patients were referred after 3 to 5 episodes, and a quarter after 5 attacks. We report different diagnostic approaches among Italian clinicians, which was particularly evident when comparing gastroenterologists and neurologists. Moreover, our survey demonstrated a predilection of certain drugs during emetic phase according to specific clinic, which reflects the cultural background of physicians. Conclusion In conclusion, our survey highlights poor consensus amongst clinicians in our country in the diagnosis and the management of children with CVS, raising the need for a national consensus guideline in order to standardize the practice.

Published
2022

3. Characteristics of Acute Nystagmus in the Pediatric Emergency Department

Author

Rocco Bonfatti, Liviana Da Dalt, Umberto Raucci, Daniela Gioè, Lucia Calistri, Elisabetta Mencaroni, Pasquale Parisi, Elena Bellelli, Luca Zagaroli, Agnese Suppiej, Nicola Vanacore, Alberto Verrotti, Duccio Maria Cordelli, Antonella Palmieri, Salvatore Grosso, Elisa Poletto, Giacomo Garone, Annalisa Rossetti, Stefano Masi, Francesco La Penna, Marta Marin, Renato D'Alonzo, Paola De Liso, Mario Velardita, Garone G., Suppiej A., Vanacore N., La Penna F., Parisi P., Calistri L., Palmieri A., Verrotti A., Poletto E., Rossetti A., Cordelli D.M., Velardita M., D'alonzo R., De Liso P., Gioe D., Marin M., Zagaroli L., Grosso S., Bonfatti R., Mencaroni E., Masi S., Bellelli E., Da Dalt L., and Raucci U.

Subjects
Male, Ataxia, Brain Neoplasms, Central Nervous System Infections, Child, Child, Preschool, Cohort Studies, Cranial Nerve Diseases, Demyelinating Diseases, Dizziness, Emergency Service, Hospital, Female, Headache, Humans, Intracranial Hypertension, Italy, Migraine Disorders, Nausea, Nystagmus, Pathologic, Poisoning, Retrospective Studies, Strabismus, Vertigo, Vestibular Diseases, Vomiting, Pediatrics, Nystagmus, 0302 clinical medicine, Migraine Disorder, Retrospective Studie, Epidemiology, Medicine, Vestibular Disease, Aataxia, brain neoplasms, central nervous system infections, child, child, preschool, cohort studies, cranial nerve diseases, demyelinating diseases, dizziness, emergency service, hospital, female, headache, humans, intracranial hypertension, male, migraine disorders, nausea, nystagmus, pathologic, poisoning, retrospective studies, strabismus, vertigo, vestibular diseases, vomiting, Emergency Service, biology, Dizzine, Demyelinating Disease, medicine.symptom, Human, Cohort study, medicine.medical_specialty, Socio-culturale, Central Nervous System Infection, Brain Neoplasm, Hospital, 03 medical and health sciences, Ataxia, Brain Neoplasms, Central Nervous System Infections, Child, Cranial Nerve Diseases, Demyelinating Diseases, Dizziness, Headache, Intracranial Hypertension, Nausea, nystagmus, Strabismu, 030225 pediatrics, Preschool, Cranial Nerve Disease, Pathologic, business.industry, Retrospective cohort study, biology.organism_classification, medicine.disease, Migraine, Pediatrics, Perinatology and Child Health, Cohort Studie, business
Abstract

OBJECTIVES: Acute nystagmus (AN) is an uncommon neurologic sign in children presenting to pediatric emergency departments. We described the epidemiology, clinical features, and underlying causes of AN in a large cohort of children, aiming at identifying features associated with higher risk of severe underlying urgent conditions (UCs). METHODS: Clinical records of all patients aged 0 to 18 years presenting for AN to the pediatric emergency departments of 9 Italian hospitals in an 8-year period were retrospectively reviewed. Clinical and demographic features and the underlying causes were analyzed. A logistic regression model was applied to detect predictive variables associated with a higher risk of UCs. RESULTS: A total of 206 patients with AN were included (male-to-female ratio: 1.01; mean age: 8 years 11 months). The most frequently associated symptoms were headache (43.2%) and vertigo (42.2%). Ataxia (17.5%) and strabismus (13.1%) were the most common neurologic signs. Migraine (25.7%) and vestibular disorders (14.1%) were the most common causes of AN. Idiopathic infantile nystagmus was the most common cause in infants CONCLUSIONS: AN should be considered an alarming finding in children given the risk of severe UCs. Cranial nerve palsy, ataxia, and strabismus should be considered red flags during the assessment of a child with AN.

Published
2020

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