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3. Pediatric Headache in Primary Care and Emergency Departments: Consensus with RAND/UCLA Method

Author

Prezioso, Giovanni, Suppiej, Agnese, Alberghini, Valentina, Bergonzini, Patrizia, Capra, Maria Elena, Corsini, Ilaria, De Fanti, Alessandro, Fiumana, Elisa, Fornaro, Martina, Marangio, Lucia, Ricciardelli, Paolo, Serra, Laura, Cordelli, Duccio Maria, Esposito, Susanna, The Emilia-Romagna Headache Study Group, null, Prezioso, Giovanni, Suppiej, Agnese, Alberghini, Valentina, Bergonzini, Patrizia, Capra, Maria Elena, Corsini, Ilaria, De Fanti, Alessandro, Fiumana, Elisa, Fornaro, Martina, Marangio, Lucia, Ricciardelli, Paolo, Serra, Laura, Cordelli, Duccio Maria, Esposito, Susanna, and The Emilia-Romagna Headache Study Group, null

Subjects
prophylaxi, Paleontology, Socio-culturale, General Biochemistry, Genetics and Molecular Biology, RAND/UCLA appropriateness method, red flags, Space and Planetary Science, migraine, prophylaxis, headache, pediatric headache, acute therapy, Ecology, Evolution, Behavior and Systematics
Abstract

Headache is the most frequent neurological symptom in childhood and the main reason for admission to pediatric emergency departments. The aim of this consensus document is to define a shared clinical pathway between primary care pediatricians (PCP) and hospitals for the management of children presenting with headache. For the purposes of the study, a group of hospital pediatricians and a group of PCP from the Emilia Romagna’s health districts were selected to achieve consensus using the RAND/UCLA appropriateness method. Thirty-nine clinical scenarios were developed: for each scenario, participants were asked to rank the appropriateness of each option from 1 to 9. Agreement was reached if ≥75% of participants ranked within the same range of appropriateness. The answers, results, and discussion helped to define the appropriateness of procedures with a low level of evidence regarding different steps of the diagnostic-therapeutic process: primary care evaluation, emergency department evaluation, hospital admission, acute therapy, prophylaxis, and follow-up. The RAND proved to be a valid method to value appropriateness of procedures and define a diagnostic-therapeutic pathway suitable to the local reality in the management of pediatric headache. From our results, some useful recommendations were developed for optimizing the healthcare professionals’ network among primary care services and hospitals.

Published
2022

4. Carbon monoxide mediates vasodilator effects of glutamate in isolated pressurized cerebral arterioles of newborn pigs

Author

Fiumana, Elisa, Parfenova, Helena, Jaggar, Jonathan H., and Leffler, Charles W.

Subjects
Arteries -- Research, Heme -- Research, Carbon monoxide -- Usage, Carbon monoxide -- Research, Biological sciences
Abstract

The excitatory neurotransmitter glutamate causes dilation of newborn pig cerebral arterioles in vivo that is blocked by inhibition of carbon monoxide (CO) production. CO, a potent dilator in cerebral circulation in vivo, is produced endogenously in cerebral microvessels via heine oxygenase (HO). In isolated pressurized cerebral arterioles (-200 [micro]m) from newborn pigs, we investigated the involvement of CO and the endothelium in response to glutamate. A CO-releasing molecule, dimanganese decacarbonyl ([10.sup.-8]-[10.sup.-6] M), dilated cerebral arterioles. Glutamate ([10.sup.-6]-[10.sup.-4] M) and 1-aminocyclopentane-cis-1,3-dicarboxylic acid (cis-ACPD; [10.sup.-6]-[10.sup.-5] M), a N-methyl-D-aspartate (NMDA) receptor agonist, caused cerebral vascular dilation. Dilation of cerebral arterioles to glutamate and cis-ACPD was abolished by chromium mesoporphyrin (CrMP; [10.sup.-6] M), a HO inhibitor. In contrast, CrMP did not alter dilation to isoproterenol, a [beta]-adrenergic receptor agonist. Endothelium-denuded cerebral arterioles did not dilate to glutamate or bradykinin (endothelium-dependent dilator), whereas responses to isoproterenol were preserved. These data indicate that cerebral arterioles from newborn pigs may directly respond to glutamate and the NMDA receptor agonists by endothelium-dependent dilation that involves stimulation of CO production via the HO pathway in the endothelium. heme oxygenase; endothelial

Published
2003

8. Multifocal Skin Tuberculosis

Author

Malaventura, Cristina, primary, Bulian, Anna, additional, Cacciatore, Euro, additional, Fiumana, Elisa, additional, Govoni, Maria Rita, additional, Maggiore, Giuseppe, additional, and Borgna-Pignatti, Caterina, additional

Published
2018
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9. Perampanel and forced EEG normalization: a possible association

Author

Angelo, Russo, Elisabetta, Spezia, Fiumana, Elisa, Tullio, Messana, Antonella, Boni, Melissa, Filippini, Patrizia, Bergonzini, Margherita, Santussi, Faggioli, Raffaella, Azzurra, Guerra, and Giuseppe, Gobbi

Subjects
Socio-culturale
Published
2017

10. Pediatric Tuberculosis in Italian Children: Epidemiological and Clinical Data from the Italian Register of Pediatric Tuberculosis

Author

Galli, Luisa, primary, Lancella, Laura, additional, Tersigni, Chiara, additional, Venturini, Elisabetta, additional, Chiappini, Elena, additional, Bergamini, Barbara, additional, Codifava, Margherita, additional, Venturelli, Cristina, additional, Tosetti, Giulia, additional, Marabotto, Caterina, additional, Cursi, Laura, additional, Boccuzzi, Elena, additional, Garazzino, Silvia, additional, Tovo, Pier, additional, Pinon, Michele, additional, Le Serre, Daniele, additional, Castiglioni, Laura, additional, Lo Vecchio, Andrea, additional, Guarino, Alfredo, additional, Bruzzese, Eugenia, additional, Losurdo, Giuseppe, additional, Castagnola, Elio, additional, Bossi, Grazia, additional, Marseglia, Gian, additional, Esposito, Susanna, additional, Bosis, Samantha, additional, Grandolfo, Rita, additional, Fiorito, Valentina, additional, Valentini, Piero, additional, Buonsenso, Danilo, additional, Domenici, Raffaele, additional, Montesanti, Marco, additional, Salvini, Filippo, additional, Riva, Enrica, additional, Dodi, Icilio, additional, Maschio, Francesca, additional, Abbagnato, Luisa, additional, Fiumana, Elisa, additional, Fornabaio, Chiara, additional, Ballista, Patrizia, additional, Portelli, Vincenzo, additional, Bottone, Gabriella, additional, Palladino, Nicola, additional, Valenzise, Mariella, additional, Vecchi, Barbara, additional, Di Gangi, Maria, additional, Lupi, Carla, additional, Villani, Alberto, additional, and de Martino, Maurizio, additional

Published
2016
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11. Adherence to guidelines for management of children hospitalized for acute diarrhea

Author

Lo Vecchio, A, Liguoro, I, Bruzzese, D, Scotto, R, Parola, L, Gargantini, G, Guarino, A, Kosova, P, Di Benedetto, L, Gattinara, Gc, Cursi, L, Parmigiani, S, Maddaluno, S, Campa, A, Caroccia, C, Adamoli, P, Forchì, G, Di Bari, C, Daniele, Rm, Saitta, F, Di Fraia, T, Bellettato, M, Meneghini, A, Principi, N, Esposito, S, Borgna, Caterina, Fiumana, Elisa, Zanconato, S, Masiero, S, Paravati, F, Pacenza, C, Colella, Mg, Cherubini, S, Frasca, D, Siani, P, De Brasi, D, Montrasio, G, Parolo, E, Podestà, Af, Tonella, M, Longhi, R, Ortisi, Mt, Rondanini, G, Calzi, P, Zucchinetti, P, Insolvibile, A, Navone, C, Ventura, F, Parisi, G, Isolato, V, Pace, M, Martemucci, L, D'Avino, P, Vetrano, G, Limongelli, Mg, Perrone, L, Capristo, C, Icilio, D, and Muccioli, R.

Subjects
child, Economica, acute diarrhea, acute diarrhea, child, guidelines, guidelines
Published
2014

14. Is the interruption of antiretroviral treatment during pregnancy an additional major risk factor for mother-to-child transmission of HIV type 1?

Author

Galli, L, Puliti, D, Chiappini, E, Gabiano, C, Ferraris, G, Mignone, F, Viganò, A, Giaquinto, C, Genovese, O, Anzidei, G, Badolato, R, Buffolano, W, Maccabruni, A, Salvini, F, Cellini, M, Ruggeri, M, Manzionna, M, Bernardi, S, Tovo, P, de Martino, M, De Benedictis, F, Osimani, P, La Rovere, D, Quercia, M, Baldi, F, Ciccia, M, Faldella, A, Masi, M, Plebani, A, Spinelli, E, Dedoni, M, Gariel, D, Chiarello, P, Magnolia, Mg, Sticca, M, Vivalda, L, Bezzi, Teresa Maria, Fiumana, Elisa, Bianchi, L, Battiglia, N, Gervaso, P, Bondi, E, Cosso, D, Gotta, C, Ginocchio, L, Rosso, R, Viscoli, C, Amoretti, C, Esposito, S, Farina, F, Giacomet, V, Lipreri, R, Salvatici, E, Stucchi, S, Palazzi, G, Paolucci, P, De Luca, G, Giannattasio, A, Tancredi, F, Tarallo, L, Rampon, O, Dalle Nogare, E, Romano, A, Saitta, M, Mariani, B, Biver, P, Consolini, R, Palla, G, De Fanti, A, Dodi, I, Verna, M, Bove, G, Casadei, Am, Castelli Gattinara, G, Catania, S, Martino, Am, Sirufo, Mm, Ganau, A, Cristiano, L, Scolfaro, C, Versace, A, Portelli, V, Gentilini, L, Mazza, A, Bernardon, M, Bua, J, Rabusin, M, Pellegatta, A, Fortunati, P., Galli, L, Puliti, D, Chiappini, E, Gabiano, C, Ferraris, G, Mignone, F, Viganò, A, Giaquinto, C, Genovese, O, Anzidei, G, Badolato, R, Buffolano, Wilma, Maccabruni, A, Salvini, F, Cellini, M, Ruggeri, M, Manzionna, M, Bernardi, S, Tovo, P, de Martino, M, and Italian Register for HIV Infection in, C. h. i. l. d. r. e. n.

Subjects
Microbiology (medical), antiretroviral treatment, medicine.medical_specialty, Anti-HIV Agents, Pregnancy Trimester, Third, HIV Infections, transmission mother-to-child, HIV infection, Cohort Studies, HIV, Italian Register for HIV Infection in Children, therapeutic use, Cohort Studies, Delivery, Obstetric, Female, HIV Infections, drug therapy/transmission, HIV-1, isolation /&/ purification, Humans, Infant, Newborn, Infectious Disease Transmission, Vertical, Pregnancy, Pregnancy Complications, Infectious, drug therapy, Pregnancy Trimester, First, Pregnancy Trimester, Third, Prospective Studies, Risk Factors, Viral Load, Withholding Treatment, Pregnancy, Risk Factors, medicine, Elective Cesarean Delivery, Humans, Prospective Studies, Risk factor, Pregnancy Complications, Infectious, Maternal Transmission, Obstetrics, business.industry, Infant, Newborn, Viral Load, medicine.disease, Delivery, Obstetric, Confidence interval, Infectious Disease Transmission, Vertical, Surgery, Pregnancy Trimester, First, Infectious Diseases, Withholding Treatment, Cohort, HIV-1, Gestation, Female, business, Viral load
Abstract

There is currently an experts' agreement discouraging interruption of antiretroviral treatment (ART) during the first trimester of pregnancy in women infected with human immunodeficiency virus type 1 (HIV-1). However, this recommendation is poorly supported by data. We evaluated the effects of discontinuing ART during pregnancy on the rate of mother-to-child transmission.Logistic regression models were performed in a prospective cohort of 937 children who were perinatally exposed to HIV-1 to estimate adjusted odds ratios for confounding factors on mother-to-child transmission, including maternal interruption of ART.Among 937 pregnant women infected with HIV-1, ART was interrupted in 81 (8.6%) in the first trimester and in 11 (1.2%) in the third trimester. In the first trimester, the median time at suspension of ART was 6 weeks (interquartile range [IQR], 5-6 weeks) and the time without treatment was 8 weeks (IQR, 7-11 weeks). In the third trimester, the median time at suspension of ART was 32 weeks (IQR, 23-36 weeks) and the time without treatment was 6 weeks (IQR, 2-9 weeks). The plasma viral load was similar in women who had treatment interrupted in the first trimester and in those who did not have treatment interrupted. Overall, the rate of mother-to-child transmission in the whole cohort was 1.3% (95% confidence interval [CI], 0.7%-2.3%), whereas it was 4.9% (95% CI, 1.9%-13.2%) when ART was interrupted in the first trimester and 18.2% (95% CI, 4.5%-72.7%) when ART was interrupted in the third trimester. In the multiple logistic regression models, only interruption of ART during either the first or the third trimester, maternal mono- or double therapy, delivery by a mode other than elective cesarean delivery, and a viral load at delivery4.78 log(10) copies/mL were independently associated with an increased rate of mother-to-child transmission.Discontinuing ART during pregnancy increases the rate of mother-to-child transmission of HIV-1, either when ART is stopped in the first trimester and subsequently restarted or when it is interrupted in the third trimester. This finding supports recommendations to continue ART in pregnant women who are already receiving treatment for their health.

Published
2009

16. Cancer rates after year 2000 significantly decrease in children with perinatal HIV infection: A study by the Italian Register for HIV Infection in Children

Author

Chiappini, E, Galli, L, Tovo, Pa, Gabiano, C, Lisi, C, Giaquinto, C, Rampon, O, Gattinara, Gc, De Marco, G, Osimani, P, Manzionna, M, Miniaci, A, Pintor, C, Rosso, R, Esposito, S, Viganò, A, Dodi, I, Maccabruni, A, Fundarò, C, de Martino, M, Osimani, P., Cordiali, R., De Mattia, D., Manzionna, M., Di Bari, C., Ruggeri, M., Masi, M., Miniaci, A., Specchia, F., Ciccia, M., Lanari, M., Baldi, F., Battisti, L., Fiorino, C., Dessı`, C., Pintor, C., Dedoni, M., Fenu, M. L., Cavallini, R., Anastasio, E., Merolla, F., Sticca, M., Pomero, G., Bezzi, Teresa Maria, Fiumana, Elisa, Bonsignori, F., Gervaso, P., Seini, E., Cecchi, M. T., Cosso, D., Timitilli, A., Stronati, M., Plebani, A., Pinzani, R., Bongianin, I., Vigano`, A., Giacomet, V., Erba, P., Salvini, F., Zuccotti, G. V., Giovannini, M., Ferraris, G., Lipreri, R., Moretti, C., Cellini, M., Cano, M. C., Paolucci, P., Bruzzese, E., De Marco, G., Tarallo, L., Tancredi, F., Pennazzato, M., Rampon, O., Dalle Nogare, E. R., Sanfilippo, A., Romano, A., Saitta, M., Dodi, I., Barone, A., Maccabruni, A., Consolini, R., Legitimo, A., Magnani, C., Falconieri, P., Fundaro`, C., Genovese, O., Panzanella, A., Casadei, A. M., Martino, A., Concato, C., Anzidei, G., Bove, G., Cerilli, S., Catania, S., Ajassa, C., Ganau, A., Cristiano, L., Mazza, A., Di Palma, A., Mignone, F., Riva, C., Scorfaro, C., Portelli, V., Rabusin, M., Pellegatta, A., Molesini, M., Chiappini, Elena, Galli, Luisa, Tovo, Pier-Angelo, Gabiano, Clara, Lisi, Catiuscia, Giaquinto, Carlo, Rampon, Osvalda, Gattinara, Guido Castelli, De Marco, Giulio, Osimani, Patrizia, Manzionna, Mariano, Miniaci, Angela, Pintor, Carlo, Rosso, Raffaella, Esposito, Susanna, Viganò, Alessandra, Dodi, Icilio, Maccabruni, Anna, Fundarò, Carlo, De Martino, Maurizio, Italian Register for HIV Infection in, Children, and Lanari, M.

Subjects
Registrie, Pediatrics, Cancer Research, Time Factors, HIV Infections, Antiretroviral Therapy, Highly Active, Neoplasms, HIV Infection, Registries, Sida, Child, biology, Incidence (epidemiology), Medicine (all), Incidence, Child, Preschool, Disease Progression, Humans, Infant, Infant, Newborn, Italy, Treatment Outcome, Oncology, symbols, Population study, Viral disease, Human, medicine.medical_specialty, cancer rates, HIV infection, children, Time Factor, Antiretroviral Therapy, symbols.namesake, Acquired immunodeficiency syndrome (AIDS), medicine, cancer, Highly Active, Poisson regression, Preschool, Settore MED/38 - Pediatria Generale e Specialistica, Perinatal HIV infection, business.industry, Cancer, Newborn, medicine.disease, biology.organism_classification, Italian Register for HIV infection in children, El Niño, Neoplasm, business
Abstract

Purpose To evaluate the impact of highly active antiretroviral therapy (HAART) on cancer incidence in HIV-infected children throughout a 20-year period. Patients and Methods An observational population study was conducted on 1,190 perinatally HIV-infected children enrolled onto the Italian Register for HIV Infection in Children from 1985 to 2004 and never lost to follow-up (total observation time, 10,037.66 years). Cancer rates were calculated in the pre-HAART (1985 to 1995), early HAART (1996 to 1999), and late HAART (2000 to 2004) periods and compared using Poisson regression adjusted for age. The proportion of HAART-treated children increased from 4.1% in 1996 to 60.4% in 1999 and to 81.5% in 2004. In the same time frame, the proportion of children receiving HAART for at least 2 years increased from 3.1% to 77.0%. Results Overall, 35 cancers occurred. Cancer rates were 4.49 (95% CI, 2.37 to 6.64), 4.09 (95% CI, 1.68 to 6.50), and 0.76 (95% CI, 0.00 to 1.80) per 1,000 children per year in 1985 to 1995, 1996 to 1999, and 2000 to 2004, respectively. Notably, there was no significant difference comparing the periods from 1985 to 1995 and 1996 to 1999 (P = .081). By contrast, cancer rates were significantly lower in the period from 2000 to 2004 than in 1996 to 1999 (P < .0001). Results were confirmed by separately analyzing data from children observed from birth (P = .418 for 1985 to 1995 v 1996 to 1999; P = .001 for 1996 to 1999 v 2000 to 2004). Conclusion Dramatically reduced cancer rates were observed only in the late HAART period in parallel to the increasing proportion of children receiving HAART therapy.

Published
2007

17. Virologic, immunologic, and clinical benefits from early combined antiretroviral therapy in infants with perinatal HIV-1 infection

Author

Chiappini, E., Galli, L., Atovo, P. i. e. r., Gabiano, C., Castelli Gattinara, G., Guarino, A., Baddato, R., Giaquinto, C., Lisi, C., de Martino, M., Osimani, P., Cordiali, R., De Mattia, D., Manzionna, M., Di Bari, C., Ruggeri, M., Masi, M., Miniaci, A., Specchia, F., Ciccia, M., Lanari, M., Baldi, F., Battisti, L., Fiorino, C., Dessı`, C., Pintor, C., Dedoni, M., Fenu, M. L., Cavallini, R., Anastasio, E., Merolla, F., Sticca, M., Pomero, G., Bezzi, Teresa Maria, Fiumana, Elisa, Bonsignori, F., Gervaso, P., Seini, E., Cecchi, M. T., Cosso, D., Timitilli, A., Stronati, M., Plebani, A., Pinzani, R., Bongianin, I., Vigano`, A., Giacomet, V., Erba, P., Salvini, F., Zuccotti, G. V., Giovannini, M., Ferraris, G., Lipreri, R., Moretti, C., Cellini, M., Cano, M. C., Paolucci, P., Bruzzese, E., De Marco, G., Tarallo, L., Tancredi, F., Pennazzato, M., Rampon, O., Dalle Nogare, E. R., Sanfilippo, A., Romano, A., Saitta, M., Dodi, I., Barone, A., Maccabruni, A., Consolini, R., Legitimo, A., Magnani, C., Falconieri, P., Fundaro`, C., Genovese, O., Panzanella, A., Casadei, A. M., Martino, A., Concato, C., Anzidei, G., Bove, G., Cerilli, S., Catania, S., Ajassa, C., Ganau, A., Cristiano, L., Mazza, A., Di Palma, A., Mignone, F., Riva, C., Scorfaro, C., Portelli, V., Rabusin, M., Pellegatta, A., Molesini, M., Chiappini, E, Galli, L, Tovo, Pa, Gabiano, C, Gattinara, Gc, Guarino, Alfredo, Baddato, R, Giaquinto, C, Lisi, C, and DE MARTINO, M.

Subjects
medicine.medical_specialty, Pediatrics, Anti-HIV Agents, medicine.medical_treatment, Immunology, combined antiretroviral therapy, CD4-CD8 Ratio, HIV Infections, HIV-1 infection, Asymptomatic, Drug Administration Schedule, Acquired immunodeficiency syndrome (AIDS), Immunopathology, Antiretroviral Therapy, Highly Active, Medicine, Immunology and Allergy, Humans, Sida, ART, infants, Chemotherapy, biology, business.industry, Age Factors, Infant, Viral Load, biology.organism_classification, medicine.disease, Infectious Disease Transmission, Vertical, Surgery, CD4 Lymphocyte Count, Infectious Diseases, Treatment Outcome, Child, Preschool, Lentivirus, Disease Progression, HIV-1, Viral disease, medicine.symptom, business, Epidemiologic Methods, Viral load
Abstract

Objective: To investigate the impact of early versus deferred combined antiretroviral treatment (ART) in asymptomatic or moderately symptomatic [Centers for Disease Control and Prevention (CDC) category N, A or B] infants with perinatal HIV-1 infection. Methods: A multi-centre nationwide case-control study was conducted. Data from 30 infants treated with combined ART with three or more drugs before 6 months of age were compared with data from 103 infants starting ART with three or more drugs after 6 months of age. The median follow-up time was 4.1 years (range, 1.0-6.5 years). Results: No difference was evident in the first available viral load and CD4 T-lymphocyte percentage between the two groups of children. Early-treated infants showed significantly lower viral loads than infants receiving deferred treatment at all the follow-up periods. A higher proportion of early-treated infants than infants receiving deferred treatment (73.3% versus 30.1%; P < 0.0001) reached an undetectable viral load. Higher CD4 T-lymphocyte percentages were found in early-treated infants at 13-24 (P < 0.0001), 25-36 (P < 0.0001), and 37-48 (P = 0.003) months of age. No early-treated infant versus 20 of 103 (19.4%) infants receiving deferred ART (P=0.02) showed a CD4 T-lymphocyte percentage of less than 15% at one time point during follow-up. No CDC category A, B or C clinical event occurred in early-treated infants over the follow-up period while 44 of 103 (42.7%) infants receiving deferred treatment presented a decline in the CDC category. Kaplan-Meier analyses revealed significant differences in CDC category A (P = 0.0002), B (P = 0.0003), and C (P = 0.0018) event-free survivals. Conclusion: The data suggest virologic, immunologic, and clinical benefits from early administration of ART.

Published
2006

18. Early triple therapy vs mono or dual therapy for children with perinatal HIV infection

Author

Chiappini, E, Galli, L, Gabiano, C, Tovo, Pa, de Martino, M, Osimani, P., Cordiali, R., De Mattia, D., Manzionna, M., Di Bari, C., Ruggeri, M., Masi, M., Miniaci, A., Specchia, F., Ciccia, M., Lanari, M., Baldi, F., Battisti, L., Fiorino, C., Dessı`, C., Pintor, C., Dedoni, M., Fenu, M. L., Cavallini, R., Anastasio, E., Merolla, F., Sticca, M., Pomero, G., Bezzi, Teresa Maria, Fiumana, Elisa, Bonsignori, F., Gervaso, P., Seini, E., Cecchi, M. T., Cosso, D., Timitilli, A., Stronati, M., Plebani, A., Pinzani, R., Bongianin, I., Vigano`, A., Giacomet, V., Erba, P., Salvini, F., Zuccotti, G. V., Giovannini, M., Ferraris, G., Lipreri, R., Moretti, C., Cellini, M., Cano, M. C., Paolucci, P., Bruzzese, E., De Marco, G., Tarallo, L., Tancredi, F., Pennazzato, M., Rampon, O., Dalle Nogare, E. R., Sanfilippo, A., Romano, A., Saitta, M., Dodi, I., Barone, A., Maccabruni, A., Consolini, R., Legitimo, A., Magnani, C., Falconieri, P., Fundaro`, C., Genovese, O., Panzanella, A., Casadei, A. M., Martino, A., Concato, C., Anzidei, G., Bove, G., Cerilli, S., Catania, S., Ajassa, C., Ganau, A., Cristiano, L., Mazza, A., Di Palma, A., Mignone, F., Riva, C., Scorfaro, C., Portelli, V., Rabusin, M., Pellegatta, A., Molesini, M., Chiappini E., Galli L., Gabiano C., Tovo P A., De Martino M., for the Italian Register for HIV Infection in Children: [.., Osimani P., Specchia F., Molesini M., and ]

Subjects
Perinatal HIV infection, Pediatrics, medicine.medical_specialty, HIV INFECTIONS, business.industry, Therapy, General Medicine, Virology, Perinatal hiv, medicine, INFANT, Dual therapy, business, MATERNAL-FETAL RELATIONS, DISEASE TRANSMISSION, ANTIHIV AGENTS
Abstract

The time at which antiretroviral therapy (ART) should be initiated in children with perinatal human immunodeficiencyvirus (HIV) infection remains controversial. In a cohort study, Berk et al1 reported clinical benefit from mono/dual ART started before 60 days of life in 10 children compared with treatment administered at 61 to 120 days of life in 16 children. The 23 children who received early triple ART were not investigated because none of them progressed to category C diagnosis by 3 years of age. We performed a similar analysis in a cohort study of a larger data set of children with a longer follow-up to evaluate the outcomes of early and very early triple ART.

Published
2006

19. Lower mother-to-child HIV-1 transmission in boys is independent of type of delivery and antiretroviral prophylaxis. The Italian register for HIV intection in children

Author

Galli, L., Puliti, D., Chiappini, E., Gabiano, C., Tovo, P. A., Pezzotti, P., de Martino, M., Osimani, P., Cordiali, R., De Mattia, D., Manzionna, M., Di Bari, C., Ruggeri, M., Masi, M., Miniaci, A., Specchia, F., Ciccia, M., Lanari, M., Baldi, F., Battisti, L., Fiorino, C., Dessı`, C., Pintor, C., Dedoni, M., Fenu, M. L., Cavallini, R., Anastasio, E., Merolla, F., Sticca, M., Pomero, G., Bezzi, Teresa Maria, Fiumana, Elisa, Bonsignori, F., Gervaso, P., Seini, E., Cecchi, M. T., Cosso, D., Timitilli, A., Stronati, M., Plebani, A., Pinzani, R., Bongianin, I., Vigano`, A., Giacomet, V., Erba, P., Salvini, F., Zuccotti, G. V., Giovannini, M., Ferraris, G., Lipreri, R., Moretti, C., Cellini, M., Cano, M. C., Paolucci, P., Bruzzese, E., De Marco, G., Tarallo, L., Tancredi, F., Pennazzato, M., Rampon, O., Dalle Nogare, E. R., Sanfilippo, A., Romano, A., Saitta, M., Dodi, I., Barone, A., Maccabruni, A., Consolini, R., Legitimo, A., Magnani, C., Falconieri, P., Fundaro`, C., Genovese, O., Panzanella, A., Casadei, A. M., Martino, A., Concato, C., Anzidei, G., Bove, G., Cerilli, S., Catania, S., Ajassa, C., Ganau, A., Cristiano, L., Mazza, A., Di Palma, A., Mignone, F., Riva, C., Scorfaro, C., Portelli, V., Rabusin, M., Pellegatta, A., and Molesini, M.

Subjects
infant's gender, vertical transmission, antiretroviral prophylaxis
Published
2005

20. Persistently high IgA serum levels are a marker of immunological or virological failure of combined antiretroviral therapy in children with perinatal HIV-1 infection

Author

Chiappini, E., Galli, L., Tovo, P. A., Gabiano, C., de Martino, M., Osimani, P., Cordiali, R., De Mattia, D., Manzionna, M., Di Bari, C., Ruggeri, M., Masi, M., Miniaci, A., Specchia, F., Ciccia, M., Lanari, M., Baldi, F., Battisti, L., Fiorino, C., Dessı`, C., Pintor, C., Dedoni, M., Fenu, M. L., Cavallini, R., Anastasio, E., Merolla, F., Sticca, M., Pomero, G., Bezzi, Teresa Maria, Fiumana, Elisa, Bonsignori, F., Gervaso, P., Seini, E., Cecchi, M. T., Cosso, D., Timitilli, A., Stronati, M., Plebani, A., Pinzani, R., Bongianin, I., Vigano`, A., Giacomet, V., Erba, P., Salvini, F., Zuccotti, G. V., Giovannini, M., Ferraris, G., Lipreri, R., Moretti, C., Cellini, M., Cano, M. C., Paolucci, P., Bruzzese, E., De Marco, G., Tarallo, L., Tancredi, F., Pennazzato, M., Rampon, O., Dalle Nogare, E. R., Sanfilippo, A., Romano, A., Saitta, M., Dodi, I., Barone, A., Maccabruni, A., Consolini, R., Legitimo, A., Magnani, C., Falconieri, P., Fundaro`, C., Genovese, O., Panzanella, A., Casadei, A. M., Martino, A., Concato, C., Anzidei, G., Bove, G., Cerilli, S., Catania, S., Ajassa, C., Ganau, A., Cristiano, L., Mazza, A., Di Palma, A., Mignone, F., Riva, C., Scorfaro, C., Portelli, V., Rabusin, M., Pellegatta, A., Molesini, M., Chiappini E., Galli L., Tovo PA., Gabiano C., de Martino M., Osimani P, Masi M., Specchia F., Molesini M., and The Italian Register for HIV Infection in Children

Subjects
Adolescent, Anti-HIV Agents, Immunology, HIV Infections, HIV-1 infection, Perinatal hiv, Antiretroviral Therapy, Highly Active, Clinical Studies, Immunology and Allergy, Medicine, Humans, Treatment Failure, Child, viremia, business.industry, combinedantiretroviral therapy, hyper-IgA, Infant, Newborn, Normal population, Infant, Viral Load, Antiretroviral therapy, Virological failure, Infectious Disease Transmission, Vertical, CD4 Lymphocyte Count, Immunoglobulin A, Child, Preschool, HIV-1, Drug Monitoring, business, Viral load, Biomarkers, Follow-Up Studies
Abstract

Summary Non-expensive and low-complexity surrogate markers for monitoring the response to combined antiretroviral therapy (combined-ART) are needed in poor-resource settings where routine assessment of CD4+ T-lymphocyte count and viral load can not be afforded. We longitudinally evaluated Ig serum levels in 234 HIV-1 infected children receiving combined-ART with ≥ 3 drugs. Since Ig levels physiologically vary with age, differences at different age periods were evaluated as differences in z-scores calculated using the mean and standard deviation of the normal population for each age period. Data from 17 (7·3%) children with immunological failure and from 54 (23·1%) children with virological failure of combined-ART were compared with data from not-failed children. At baseline children with immunological failure showed higher IgM z-scores (P = 0·042) than children without. After 3–12 months of therapy immunologically failed children displayed higher viral loads (P < 0·0001) and IgA (P = 0·043) z-scores than not-failed children. Similarly, at the same follow-up time, children with virological failure showed lower CD4+ T-lymphocyte percentages (P = 0·005) and higher IgA z-scores (P < 0·0001) than not-failed children. No difference in IgG or IgM z-scores was evidenced between failed and not-failed children after 3–12 months of therapy. In conclusion, IgA serum level is a cheap and low-complexity marker of immunological or virological failure of combined-ART which might be adopted in poor-resource settings.

Published
2005

23. Celiac disease in children with migraine

Author

Borgna-Pignatti, Caterina, Fiumana, Elisa, Milani, Monia, Calacoci, Marisa, and Soriani, Stefano

Abstract

To the Editor.-- In an interesting article, Zeinik et al (1) recently investigated the presence of neurologic disorders in patients with celiac disease (CD). They found those disorders to be [...]

Published
2004

24. [Management of children with headache in a Pediatric Emergency Department before and after the introduction of the Second International Classification of Headache Disorders (ICHD-II)].

Author

Gioachin A, Fiumana E, Tarocco A, Verzola A, Forini E, Guerra V, Salani M, and Faggioli R

Subjects
Child, Costs and Cost Analysis, Diagnostic Tests, Routine economics, Diagnostic Tests, Routine statistics & numerical data, Headache Disorders economics, Hospital Costs, Hospitals, University economics, Hospitals, University statistics & numerical data, Humans, Italy, Medicine, Patient Admission statistics & numerical data, Radiography economics, Radiography statistics & numerical data, Referral and Consultation economics, Referral and Consultation statistics & numerical data, Resource Allocation, Retrospective Studies, Unnecessary Procedures, Diagnosis-Related Groups, Disease Management, Emergency Service, Hospital economics, Emergency Service, Hospital statistics & numerical data, Headache Disorders classification, Headache Disorders therapy, Pediatrics economics, Pediatrics organization & administration
Abstract

The aim of this study was to evaluate how the management of children admitted with headache to a Pediatric Emergency Department, was modified by the introduction of the Second International Classification of Headache Disorders ( ICHD-II) published in 2004. The complexity and average costs of the services provided to patients in 2002 and 2011 were compared. The results revealed a decrease in the number of tests performed and in-hospital admissions. However, tests were more complex, and an increase in requests of specialist advice was observed. We hypothesized that this change may be related to the introduction of ICHD-II, which suggests a more rational approach to the child with headache and a better use of hospital resources.

Published
2013
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