Biomedical subjects

A G Marchi

Publications and source records attributed to A G Marchi.

81 records · Page 5Linked to original sources

PubMedDate not supplied

Evaluation of skin laceration repair by tissue adhesive in the pediatric emergency room.

The effectiveness of skin laceration repair by tissue adhesive has been evaluated, by comparison also with thread suture and steristrip application, in 926 0-15-year-old patients referred to the Emergency Room of our Institute during 1988. Tissue adhesive has been carried out more frequently in younger children and in some wound localizations especially at the face. At follow-up good aesthetic and functional results were observed. The rare complications, being related to incorrect choice of site application, can be avoided by following appropriate directions for use. Considering the compliance of the patients and their family, this non invasive technique of repair seems to be particularly suitable in childhood.

Adolescent↗

PubMedDate not supplied

[A multicenter study of child poisonings. Preliminary epidemiological results].

The project of a multicentre study of poisoning in children planned by 4 Italian pediatric departments to get epidemiologic and clinic information is presented. The study is carried out retrospectively on admissions during 1975-90 and prospectively during 1991-92. Poisonings are classified as not-confirmed, asymptomatic because of early treatment or symptomatic. In the latter group three degrees of severity are assessed. Diagnostic-therapeutic protocols will be elaborated and quality of the hospital care evaluated according to peer review methodology. Preliminary data on changing pattern of poisoning over the time and on main toxic agents involved in younger children are also reported. The first topic has been studied taking into account 1831 patients aged 0-13 years, admitted during 1977-79 and 1987-89. A decrease of exposures to drugs and an increase of poisonings under the age of 3 years have been observed in more recent period. On the other hand household products resulted to be the main poisoning agents in 1044 children under the age of 5 years during 1984-86. Lack of infant supervision by parents and possible influence of compulsory child resistant containers only for drugs are stressed. The findings suggest the need of health education campaigns in general population as well of safety devices for some domestic harmful products.

Age Factors↗

PubMedDate not supplied

[Costs and benefits of the use of tissue adhesives in wounds in children].

Costs and benefits of the repair in Emergency Room of skin lacerations by tissue adhesive in children are reported. In 1987-88 2150 children under 16 were referred to our Institute because of lacerations. About one of three of them needed repair by subcutaneous suture; in the others, sutures or sterile stripes or adhesive tissue could be employed. Adhesive tissue use increased significantly during 1988 because of its advantages: no need of local anesthesia, syringes, sterile suture instruments and dressing materials; no further dressing; no suffering of children during the treatment; good aesthetic results. Now it is the first choice treatment of the lacerations in which subcutaneous suture is not necessary. Moreover this technique is cheap, and reduced significantly 1988 costs for laceration repair in our department.

Adolescent↗

PubMedDate not supplied

[The problem of caustic poisoning in children].

The exposure to caustic substances in childhood, being accidental in most cases, can cause doubts in the initial diagnostic therapeutic approach; the risk of missing lesions following caustic ingestion when symptoms are scarce or lacking is high. The paper provides an overview of the physiopathology and clinical presentation of caustic injuries and stress the possibility of burns of esophagus and/or stomach even without oropharyngeal symptoms and/or signs. The esophagogastroduodenoscopy has now an essential role in the evaluation of gastrointestinal tract injury, as a guide to the therapy and as a prognostic criterion. So it is possible to reduce the risk of poor outcomes by the appropriate treatment. Anyway the primary prevention against the exposition to caustic substances at home is fundamental and must be effected both through active and passive measures.

Adolescent↗

PubMedDate not supplied

[Study of the risk of analgesic-antipyretic drugs in children].

Poisonings by analgesic-antipyretic drugs in childhood in our country need specific prevention measures because of their incidence and clinical severity. We analysed the clinical-epidemiologic data of 114 cases of poisonings in children under 16 years of age and the results of a questionnaire answered by 507 adults to identify risks factors. The most of these poisonings happened at home; the esposition was accidental in younger children, even if it often depended from therapeutic mishaps; it was more frequently voluntary at the age of 10. Disinformation on risks and lack of appropriate store in the house are the main factors. The prevention therefore must be based either on the education and the use of safe child resistant containers, besides other passive preventive measures.

Accident Prevention↗

PubMedDate not supplied

[Evaluation of the outpatient treatment of burns in children].

Outpatient treatment of burns and scalds has been evaluated at the Paediatric Emergency Unit of the Children's Hospital in Trieste. 183 children aged 0-15 years were treated by occlusive topical medication; in all cases control after three and twelve months was performed. No toxic symptomatology due to topical medication was observed. In four children local infection was resolved by topical aminoglycosides; in other four cases general antibiotics had to be administered because of isolate fever. Keloids resulted in 6 cases, 5 of them in the group of 32 children in which base treatment had to be integrated with other topical therapy because of early complications.

Adolescent↗

PubMedDate not supplied

[Longitudinal evaluation, from 1974 to 1983, of the use of antibiotics in a pediatric emergency unit].

A quantitative and qualitative evaluation of the use of antibiotics in the Paediatrics Emergency Unit of the Children's Hospital in Trieste covering the last ten years has been carried out. The results show an evident and progressive trend towards optimal standards in the therapeutic approach, revealing a marked reduction in the prescription of antibiotics for diseases of definite or presumptive viral origin and the use of first choice antibiotics in almost all of the cases. The promotion of the appropriate use of antibiotic treatment introduced at the Children's Hospital between 1978 and 1979 is apparent. The need for these permanently self-evaluating surveys aimed to assure continuous updating and to maintain optimal therapeutic standards is considered.

Anti-Bacterial Agents↗

PubMedDate not supplied

[Bronchial asthma in a pediatric emergency service].

The aim of this study was to assess the prevalence, clinical patterns and treatment of asthma in a well-defined area near the North East Italian border (Province of Trieste, 212 kmq, 30,000 inhabitants aged 0-15 years), served by only one children's hospital. The study was carried out from January to December 1991, in the Emergency Department (ED). 118 patients aged from 3 months to 16 years (mean age 5 years) presented bronchial asthma (0.7% of total ED consultation, 6.2% of acute respiratory tract disease). 29 (24.6%) were first diagnosis, 89 (75.4%) were formerly diagnosed. 57% of patients came to the ED in autumn and winter, 36% in spring and 7% in summer; 19.5% of patients came to the ED during the night. Main presentation symptoms were cough (66%), dyspnea (46%), fever (24%). Treatment consisted of aerosolized salbutamol (50%), associated with oral corticosteroids (31%), iv corticosteroids (3%), aerosolized beclomethasone (10%); 6% of patients received only oral salbutamol. 21 patients were hospitalized, all but one in the ED. In all cases hospitalization lasted less than 2 days and therapy was similar to that of non hospitalized patients, except for administration of aminophylline and iv corticosteroid in 5% of patients. ED consultation and hospitalization for bronchial asthma are low in our area, probably due to good working of the Allergologic Centre and to good connection of this structure with paediatricians.

Administration, Oral↗

PubMedDate not supplied

[The antibiotic treatment of respiratory infections in a pediatric emergency room].

Eight years after the first study published in this Journal (1985, 7: 533), we compared antibiotic treatment of respiratory infections at the Pediatric Emergency Department of the Children's Hospital in Trieste. All patients with pneumonia and pertussis received antibiotics, compared to 87% of otitis, 55% of pharyngo-tonsillitis, 4% of upper respiratory infections (U.R.I.); neither asthma nor laryngitis were treated with antibiotics. In particular, only 13% of otitis were treated by symptomatics, the others with amoxicillin (51%), amoxicillin + clavulanic acid (18%), cefaclor (12%), trimethoprim-sulphamethoxazole (5%), josamycin (1%). 45% of pharyngo-tonsillitis was treated with symptomatics, 32% with macrolides and 10% with penicillin; rarer treatment comprehended amoxicillin, amoxicillin + clavulanic acid (10%) and cefaclor (3%). Pneumonia was treated with amoxicillin or cefaclor (30% both), with amoxicillin + clavulanic acid (10%) or with macrolides (30%), the last in provision of mycoplasmal etiology. Antibiotic treatment of U.R.I. is progressively decreased from 79% in 1974 to 13% in 1983 and to 4% in 1991. Antibiotic treatment in our Department was appropriate in the majority of patients, with almost all bacterial form treated with first choice, cheaper antibiotic. A negative, limited trend was detected for pharyngo-tonsillitis: first choice antibiotics passed from 82% in 1983 to 76% in 1991. Another positive factor is due to the homogeneous manners of the doctors working at the Emergency Department, belonging to two different teams (Emergency and Clinical Departments), probably with the use of common clinical protocols.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗