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Biomedical subjects

G Borgnolo

Publications and source records attributed to G Borgnolo.

16 recordsLinked to original sources
PubMed2001

Antibiotic prescription in italian children: a population-based study in Friuli Venezia Giulia, north-east Italy.

UNLABELLED: Comprehensive information on prescription patterns of antibiotics in Italy is scarce. This study describes the use of systemic antibiotics in children according to age and sex in Friuli Venezia Giulia, north-east Italy. A pharmacological prescription database was used to identify individual prescriptions provided to all 0-15-y-old resident children (n = 140,630) during 1998. Overall, 124,383 prescriptions were identified. The prescription rate was highest in the 3-6 y olds, with 1491 antibiotic prescriptions per 1,000 children per year. Antibiotics were prescribed for 52% of infants, 57.2% of toddlers and 62% of preschool children. Twenty-nine percent of the prescriptions were for cephalosporins, 27% for macrolides and 24% for broad-spectrum penicillins. Prescription rates were much higher than in other countries such as Denmark, with more antibiotic courses prescribed for more children at all ages. Prescriptions from general practitioners and family paediatricians often included second-line antibiotics (e.g. cephalosporins and macrolides) or antibiotics that have not been approved for community-acquired paediatric infections (e.g. quinolones). CONCLUSION: The development of regional guidelines for antibiotic use in children should be urgently recommended.

Adolescent↗
PubMed2001

Breastfeeding by objectives.

BACKGROUND: In many countries, the rates of breastfeeding fall far short of those recommended. National plans to promote breastfeeding are badly needed. We describe the results of a breastfeeding promotion programme planned by objectives and financial penalties in a small region of Italy. METHODS: This observational study was conducted in all the maternity hospitals and immunisation clinics of the six local health authorities of Friuli Venezia Giulia, in the northeast of Italy. The regional health authority included breastfeeding in its annual plans for 1998 and 1999, and asked local health authorities to develop local workplans and targets. A financial penalty was contemplated for local health authorities not achieving objectives and targets. The rates of exclusive, predominant and complementary breastfeeding were measured at birth and at 16-19 weeks of age. Data were collected, using standard definitions and methods, at discharge from hospitals and at the time of the second mandatory immunisation. RESULTS: All local health authorities and hospitals set up a breastfeeding reporting system in 1998 and defined breastfeeding promotion activities for 1999. The rate of exclusive breastfeeding at discharge and at 16-19 weeks increased significantly between 1998 and 1999, with a corresponding reduction of complementary breastfeeding. CONCLUSION: Financial penalties may contribute to the promotion of exclusive breastfeeding.

Birth Rate↗
PubMed1996

C-reactive protein in viral and bacterial gastroenteritis in childhood.

To differentiate bacterial from viral infections the level of C-reactive protein in serum samples was studied in three groups of children under 5 years of age with gastroenteritis. Of the 53 children with bacterial infection, 41 (77%) had C-reactive protein levels > or = 12 mg1 -1, 32 (66%) > or = 20 mgl-1 and 24 (45%) > or = 35 mgl-1. Of the 35 patients with viral infection, 4 (11%) had C-reactive protein levels > or = 12 mgl-1, 3 (9%) > or = 20 mgl-1 and 1 (3%) > or = 35 mgl-1. The best balance between sensitivity and specificity of C-reactive protein was obtained for a cut-off level > or = 12 mgl-1 (sensitivity 77%, specificity 89%) as compared to > or = 20 mgl-1 (sensitivity 58%, specificity 97%) and > or = 35 mgl-1 (sensitivity 44%, specificity 97%). Our results suggest that the determination of C-reactive protein values may be a useful tool for predicting bacterial gastroenteritis in children.

Acute Disease↗
PubMed1996

A case-control study of Salmonella gastrointestinal infection in Italian children.

A case-control study of 85 cases with non-typhoid Salmonella gastroenteritis, 85 outpatient controls and 79 inpatient controls was conducted among children in Monfalcone, north-east Italy, between June 1989 and June 1994. Logistic regression was used to evaluate the effect of demographic and socio-economic characteristics, duration of breastfeeding, history of intestinal illnesses and household diarrhoea, and the recent use of antimicrobials. Breastfeeding was the single most important factor associated with a 5-fold decreased risk of Salmonella infection. In addition, children who were treated with antimicrobials before onset of gastroenteritis had a 3-fold increased risk. Low social class and history of other chronic non-infectious intestinal diseases were also directly associated with illness.

Adolescent↗
PubMed1995

Tumour necrosis factor, interleukin-6 and C-reactive protein in patients with louse-borne relapsing fever in Ethiopia.

The serum concentrations of tumour necrosis factor (TNF), interleukin-6 (IL-6) and C-reactive protein (CRP) were studied in 25 patients with louse-borne relapsing fever, to evaluate their association with the level of bacteraemia, anti-borrelia chemotherapy and the presence of a Jarish-Herxheimer reaction (JHR). Although there was an association between the level of bacteraemia and the development of JHR and complications during treatment, TNF, IL-6 and CRP concentrations were not associated with the JHR. TNF concentrations increased after the administration of antibiotics and remained high for 24 h. IL-6 was elevated on admission but soon decreased. CRP was high on admission and remained so throughout the illness. The observed elevations in TNF, IL-6 and CRP may be associated more with the administration of antibiotics than with the presence of a JHR.

Adolescent↗
PubMed1993

Louse-borne relapsing fever in Ethiopian children: a clinical study.

An outbreak of louse-borne relapsing fever, caused by the return to their original recruitment areas of soldiers at the end of 30 years of fighting in northern Ethiopia, was reported in the Arsi region. We studied 103 infants and children with louse-borne relapsing fever who were admitted to Asella Hospital between 1 May 1991 and 30 April 1992. Twenty-one per cent of the patients had a clear history of contact with sick ex-soldiers; 42% were students admitted to the hospital following the re-opening of schools after the summer vacation. The common clinical features of the disease were fever in 100%, headache in 84.5%, chills in 74%, abdominal pain in 51%, epistaxis in 20%, hepatomegaly in 26%, splenomegaly in 14%, petechial rash in 34% and jaundice in 10%. Differences in symptoms and signs according to age are described. Observed complications were pneumonia in 14% and central nervous system involvement in 10%. Four children went into deep coma, and two of them died. Severe disease was associated with a high density of spirochaetes in blood smears. Patients were treated with two low doses of penicillin or one dose of penicillin followed by, according to age, chloramphenicol or tetracycline, and with intravenous fluids. The case fatality rate was 1.9%. Jarisch-Herxheimer reactions occurred in 61% of patients. There were relapses in 2.9% of treated patients.

Adolescent↗
PubMed1993

Louse-borne relapsing fever. A clinical and an epidemiological study of 389 patients in Asella Hospital, Ethiopia.

An outbreak of louse-borne relapsing fever, due to the return of soldiers to their original recruitment areas, after the end of thirty years of fighting in northern Ethiopia, was reported in Arsi region, southern Ethiopia. The epidemic spread to different members of the community and eventually the schools. We studied 389 patients affected by the epidemic and who were admitted to Asella Hospital between June 1991 and May 1992. Twenty-seven per cent of the patients were ex-soldiers; 28% were students, who were admitted to the hospital since the schools were opened after the summer vacations. The common clinical features of the disease were fever (99%), headache (92%), hepatosplenomegaly (66%), myalgia (55%), arthralgia (51%), petechial rash (43%), epistaxis (24%) and jaundice (23%). Observed complications were pneumonia (10%), pulmonary edema (6%), myocarditis (3%) and 6 abortions in 15 pregnancies. Patients were treated with low dose penicillin and i.v. fluids. The in-hospital case fatality rate was 3.6%. Jarisch-Herxheimer reaction occurred in 43% of the patients. 1.8% of the patients had relapses after treatment.

Adolescent↗
PubMedDate not supplied

[Multicenter study on bronchopneumonia treated in a hospital environment in Friuli-Venezia Giulia: 1) Epidemiology].

Results are presented of a vast analysis into Bronchopneumonia (B.P.) conducted in North East Italy as activity of the Regional Section of the Italian Paediatric Society. The survey of the 14 Paediatric Centres in the Friuli Venezia Giulia Region, produced a total of 536 cases of B.P. in the period January-December 1982. Some significant connections between the several epidemiologic parameters investigated, with special interest in length of hospitalization, are commented. Bed occupancy, short vs. long stays, efficient management are discussed having also in consideration specific possible necessities of some local communities.

Bronchopneumonia↗
PubMedDate not supplied

[Multicenter study on bronchopneumonia treated in a hospital environment in Friuli-Venezia Giulia: 2) Antibiotic therapy].

An analysis of a year's admissions for Pneumonia in all the Paediatric Department of the Region Friuli Venezia Giulia is presented. The study was conducted as activity of the Regional Section of the Italian Paediatric Society. The survey of the 14 Paediatric Centres produced a total of 536 cases of Pneumonia in the period January-December 1982 and was focused on antimicrobial therapy adopted pre and after hospitalization. General and specific therapeutic choices are discussed. Drawing the attention on the differences among centres.

Anti-Bacterial Agents↗
PubMedDate not supplied

[Cholelithiasis in children: observations on a further case and the technique of laparoscopic cholecystectomy in a child].

A new case of gallstone in a child, with non apparent predisposing condition, who underwent laparoscopic cholecystectomy is reported. The importance of considering cholelithiasis in children with abdominal pain as well as the value of ultrasonography in diagnosis is stressed. The technique of laparoscopic cholecystectomy modified for pediatric patients and its benefits (decreased pain and ileus after surgery, shortened hospitalization and improved cosmesis) are discussed.

Child↗
PubMedDate not supplied

[Aplasia cutis congenita: report of 4 additional cases and review of the literature].

Aplasia cutis congenita is a heterogeneous group of disorders characterized by focal absence of skin at birth. In the majority of cases, the involved area is limited to the scalp. These disorders are relatively rare. As a result of misinterpretation, medicolegal advice can be sought by parents who believed that their child's scalp had been injured during surgical induction of labour or fetal monitoring. We report four additional patients (two familiar and two sporadic cases) and discuss, in the light of a comprehensive review of the literature, the probable pathogenesis, the clinical variability and the treatment.

Age Factors↗
PubMedDate not supplied

[Clinico-epidemiological observations of 77 pediatric cases of infection with non-typhi salmonellae].

Non-typhoid salmonellosis remains a common infective illness. We studied 77 consecutively admitted children aged 1 month to 15 years in order to determine frequency of antecedents, the strain of the isolated organisms, clinical findings, frequency of complications and the adequacy of management. The presentation and severity of the illness were compared between younger than two and older children. Salmonella typhimurium was isolated in 65% of the cases. Two thirds of the tested strains were multiresistant to antibiotics. Non-typhoid salmonellosis usually occurred in the form of acute gastroenteritis: in only 4% of the cases it presented as pyrexia of unknown origin without gastrointestinal symptoms. 30% of the cases had been exposed to one or more antimicrobial agents within four weeks before the date of their stool culture. Only 30% had been breast fed. Previously diagnosed cow's milk protein intolerance resulted to be present in 14% of the less than two years old children (p < 0.02). Abdominal pain and headache were found more frequently in older children (p < 0.02). Protein C reactive values were significantly higher in this age group (p < 0.05). 25% of the children were mildly or moderately dehydrated. Hypernatremia was uncommon. 31% of the cases were treated with antibiotics: the antimicrobial treated children presented diarrhoea for longer period (p < 0.05) and they remained admitted for longer time (p < 0.00).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

[Spontaneous pneumomediastinum in an adolescent].

Spontaneous pneumomediastinum is defined as nontraumatic mediastinal air leak in patients without underlying lung disease. In children and adolescents it is rarely described and is likely to be underdiagnosed. We describe a case. The aetiopathogenesis, clinical findings, diagnosis and treatment are discussed.

Adolescent↗
PubMedDate not supplied

[Atypical Plasmodium vivax malaria in an adopted child].

An atypical, because of relatively high parasitemia, multiply-infected erythrocytes and long incubation, Plasmodium vivax malaria case in an foreign born adopted child is presented. Features typical of Plasmodium vivax were enlarged infected erythrocytes, characteristic schizont and Schuffner's dots. Our observation emphasizes the importance of blood smear evaluation in traveller and foreign born adopted children.

Adoption↗