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Biomedical subjects

A Cracco

Publications and source records attributed to A Cracco.

12 recordsLinked to original sources
PubMed2000

Interstitial lung disease in children: a multicentre survey on diagnostic approach.

Chronic interstitial lung disease (ILD) is a rare disorder in the paediatric age group, with a poor prognosis. The diagnostic approach to ILD is based on more or less invasive methods. This study was implemented to verify which methods are the most often used in children. Questionnaires (333) were sent to members of the European Respiratory Society Paediatric Assembly belonging to 187 European and non-European centres. Questions concerned the use of noninvasive diagnostic methods, e.g. history taking, physical examination, routine laboratory tests, respiratory function tests and radiology (chest radiography, high-resolution computed tomography (HRCT)), and the use of invasive techniques such as bronchoalveolar lavage (BAL), transbronchial biopsy (TBB), open lung biopsy (OLB), video-assisted thoracoscopic biopsy (VAT) and HRCT with fine-needle aspiration biopsy (FNAB). Thirty eight centres returned the questionnaires and 131 children with ILD were studied. A diagnosis of ILD was achieved in five (3.8%) patients using noninvasive techniques alone. Using the various biopsy methods, histological assessment was performed on a total of 98 (74.8%) children. The most frequently used invasive technique both alone and in combination was BAL (83, 63.3%), followed by OLB (64, 48.8%), TBB (26, 19.8%) and VAT (11, 8.4%); FNAB was used in one patient. In conclusion a diagnosis of interstitial lung disease was reached on the basis of aetiological and/or histological findings in 117 (89%) of the 131 patients studied.

Adolescent↗
PubMed1999

Reference values of exhaled nitric oxide for healthy children 6-15 years old.

Nitric oxide (NO) can be detected in human exhaled air, and its endogenous production is increased in patients with asthma. It may provide a noninvasive means for measuring airway inflammation. The aim of this study was to establish reference values for exhaled NO concentrations in a large number of healthy school-age children. We measured exhaled NO levels in 159 white healthy children (88 girls, 71 boys, age range 6-15 years) recruited from two public schools of Padua, Italy. Exhaled NO levels in exhaled gas were measured by a tidal breathing method with a chemiluminescence analyzer, and NO steady-state levels were recorded. Nasal NO levels were measured by direct sampling from the nose during mouth breathing. The mean concentration of endogenous NO in orally exhaled gas was 8.7 parts per billion (ppb) (95% confidence interval (C.I.), 8.1-9.2 ppb) and sampled data followed a log-normal distribution (Kolmogorov-Smirnov d = 0.77, P > 0.2). No difference was found between boys (mean value, 8.4 ppb; 95% C.I., 7.3-9.4 ppb) and girls (mean value, 8.9 ppb; 95% C.I., 7.9-9.9 ppb). No significant correlation was found between age, height, or spirometric data and exhaled NO levels (r < 0.2). The mean value of nasal NO concentrations was 216 ppb (95% C.I., 204-228 ppb). There was no correlation between exhaled and nasal NO values (r = 0.16, P = ns). In conclusion, this study establishes a reference range for exhaled NO values measured by a tidal breathing method in children between age 6-15 years. The observed levels are independent of age, gender, and lung function, and can be used to monitor airway inflammation in asthmatic children.

Adolescent↗
PubMed1997

Use of the paediatric bronchoscope, flexible and rigid, in 51 European centres.

We have undertaken a survey to establish current practices and differences in the use of bronchoscopes in children in European centres. A questionnaire was sent to all 220 members of the Paediatric Assembly of the European Respiratory Society (ERS). The questions concerned the following points: indications for bronchoscopy; site of bronchoscopy; type of sedation; any oxygen supplementation during the procedure; number of procedures performed in the previous 12 months; number of procedures performed in the neonatal intensive care unit; number of bronchoalveolar lavages (BALs); side-effects during and after the procedures; and diagnostic yield. Fifty one European centres (40.8% of the European centres contacted) took part in the study. A total of 7,446 bronchoscopies had been performed in the last 12 months: 4,587 using the flexible bronchoscope and 2,859 using the rigid bronchoscope. At centres using only the fibreoptic bronchoscope, the most frequent indication was "recurrent/persistent pneumonia" (17%); at centres using only the rigid bronchoscope, it was "foreign body inhalation" (36.7%); at centres using both methods, the most frequent indication was "other indications" (23.9%). In 12 months, 2,231 BALs were performed: 1,419 in immunocompetent children and 812 in immunocompromised patients. In centres using only the fibreoptic bronchoscope, the highest yield was for "stridor" (81%); in centres using only the rigid bronchoscope, the highest yield was for "persistent atelectasis" (68%); and in centres using both instruments, it was for "foreign body inhalation" (93%). The results of the study suggest that bronchoscopy in children is now a well-established procedure at several European centres, while others are just beginning to use this technique.

Bronchoalveolar Lavage Fluid↗
PubMed1995

The first 20 minutes after a single dose of inhaled salmeterol in asthmatic children.

Very little is known as yet about the effect of salmeterol in pediatric asthma, so a trial was performed on children with mild asthma to compare salmeterol with salbutamol in terms of how quickly they took effect. The double-blind study involved 11 children (mean age 13.4 years) randomly assigned to inhale salmeterol 50 micrograms, salbutamol 200 micrograms, or a placebo three times on alternate days. Peak expiratory flow (PEF), heart rate, and blood pressure were measured before and 5, 10, 15, and 20 min after administering the medication. With salbutamol, PEF was higher at 5 and 10 min, subsequently dropping off at 15 and 20 min; with salmeterol, PEF was better at 10 and 20 min. Forced expiratory volume at 1 s (FEV1) measurements taken at the baseline and after 10 and 20 min revealed an important and consistent rise in values after salmeterol, whereas salbutamol was more effective after 10 min than after 20 min. No significant changes were recorded in heart rate or blood pressure after salbutamol; after salmeterol, there was a significant increase in heart rate after 5 min, but not at subsequent measurements. In conclusion, salmeterol begins to take effect already within 10 min of a single administration in asthmatic children, although the onset of its effect is slower than with salbutamol.

Administration, Inhalation↗
PubMedDate not supplied

The Pediatric Bowel Management Clinic in children with severe chronic constipation. Personal experience.

The multifactorial nature of functional constipation in children suggests that a multidisciplinary management approach may be effective and leads to both patients and parents' satisfaction and significant short term improvement. The authors describe their experience with the study and treatment of children with severe chronic constipation in a newly-created Pediatric Bowel Management Clinic (BMC). Further studies will examine the long-term impact of the clinic.

Adolescent↗
PubMedDate not supplied

[Psychological study of adults surgically treated in childhood for hypospadias].

The authors present the study and results in 100 subjects operated of hypospadia. They interviewed patients within 15 and 22 years old, in randomized selection and in permanent percent relations as far as: different types of pathology, the age of surgery effected in Vicenza Hospital - Pediatric Surgery Department (1971-1981). Through a structured questionnaire they tried to analyse psychological lived in operated subjects as far as: surgery, convalescence, psychologic problems before and after surgery, way of life when they became adults. Results explain that exist some psychologic problems in operated patients (8.5 years old) before surgery and during convalescence, while there is no problem after surgery. Moreover when these subjects became adults their kind of life (school, profession, sexuality) is without psychopathological problems. This is because of positive attitudes pre-acquired, brief convalescence and above all the high and positive quality of surgery effected.

Adolescent↗
PubMedDate not supplied

[Cardiosurgical intervention in extracorporeal circulation and intellectual performance in childhood. Study and follow-up of 20 cases].

6 and 12 months before and after surgery in E.C.C., twenty subjects, at the age of development between 6 and 14 years, suffering from congenital heart disease, were subjected to psychometric observations with tests of level and others (wisc, raven, pm 38, rey, bender), in order to analyse the intellective level, specific mental capacities and eventual modifications in the mental and cognitive performances of the patients. No psychometric, statistically meaningful variations were generally noticed during the 3 observations. No meaningful correlations resulted between the duration of E.C.C. and psychometric observations. The patients subjected to the E.C.C. longer than the average of the total group generally didn't show any statistically meaningful variations in the scores of the 3 observations. To sum up the authors think that the experimental group showed and maintained before and after the cardiac surgery, a normal developing and maturative level and anyway that after the follow-up, no changes in the several intellective capacities of the patient were noticed.

Adolescent↗
PubMedDate not supplied

[The subject with spina bifida and his family: psychological and social aspects. I].

This paper is to examine the psychological and social effects in spina bifida. In 130 subjects, aged from 4 to 24 years old, the levels of the I.Q. have been studied and they have been distributed into revelant percentual groupings, and the psychologic perception problems of the malformation of the subject have been studied. Finally, dominant psychologic and social problems have also been considered.

Adolescent↗
PubMedDate not supplied

[The spina bifida patient and his family: psychologic and social aspects. 2].

In the second part of the present work the data which was obtained through questionnaires and interviews with 130 families with children affected by spina bifida is presented. Presented first are the immediate sociopsychological aspects of the family when they are informed about the malformation, the derived psychological effects and the preoccupations relating to the life of their child. Then the aspects of the successive social and psychological problems of these parents are presented, and finally the expectations and demands of the same parents following the psychological operations carried out at the centre to the benefit of the children and their families.

Family↗
PubMedDate not supplied

[Biofeedback in asthmatic children].

This paper reports the results of the treatment of continuous bronchial asthma in children, 7-14 years old, by means of biofeedback and the counter-conditioning. We observed the remission of the symptomatology in all the cases, with a statistical significance.

Adolescent↗
PubMedDate not supplied

[Sound alarms and conditioning therapy in the treatment of childhood enuresis: a study of 180 cases].

The Authors present the study and results in 180 cases of infantile enuresis, treated with a new bell alarm associated to conditioning psychological treatment (toilet training, token economy, motivational counseling, urine stop exercises, etc.). The cases have been subdivided into the type of enuresis, age and sex. 140 (77.8%) subjects aged from 6 years to 16 years with primary enuresis, and 40 (22.2%) aged from 6 years to 15 years with secondary enuresis have been treated. The following results were obtained in the primary enuresis with this type of treatment after a follow-up of 6-12 months: permanent recovery in 85.71% of the cases, relapse after 6 months in 11.42%, improvement in 5% and failures in 9,29% of the cases. In secondary enuresis the following results were obtained: permanent recovery after 12 months in 75% of the cases, relapse after 6 months in 10%, improvement in 7.5% and failures in 17.5% of the cases. The differences in the results between the two types of enuresis with respect to the age of the cases up to 12 years are proved and relatively less with respect to the average time of treatment for the total remission. Regarding the sex of the cases no significant therapeutic answer was noted neither in the final results nor in the time of treatment in both types of enuresis. Finally, it is not the substitution of symptoms which are proved but the benefits of a general and psychological level.

Acoustic Stimulation↗