Biomedical subjects

Giorgio Meneghelli

Publications and source records attributed to Giorgio Meneghelli.

3 recordsLinked to original sources

PubMed2005

Office spirometry in primary care pediatrics: a pilot study.

OBJECTIVE: The aim of this study was to investigate the validity of office spirometry in primary care pediatric practices. METHODS: Ten primary care pediatricians undertook a spirometry training program that was led by 2 pediatric pulmonologists from the Pediatric Department of the University of Padova. After the pediatricians' training, children with asthma or persistent cough underwent a spirometric test in the pediatrician's office and at a pulmonary function (PF) laboratory, in the same day in random order. Both spirometric tests were performed with a portable turbine flow sensor spirometer. We assessed the quality of the spirometric tests and compared a range of PF parameters obtained in the pediatricians' offices and in the PF laboratory according to the Bland and Altman method. RESULTS: A total of 109 children (mean age: 10.4 years; range: 6-15) were included in the study. Eighty-five (78%) of the spirometric tests that were performed in the pediatricians' offices met all of the acceptability and reproducibility criteria. The 24 unacceptable test results were attributable largely to a slow start and failure to satisfy end-of-test criteria. Only the 85 acceptable spirometric tests were considered for analysis. The agreement between the spirometric tests that were performed in the pediatrician's office and in the PF laboratory was good for the key parameters (forced vital capacity, forced expiratory volume in 1 second, and forced expiratory flow between 25% and 75%). The repeatability coefficient was 0.26 L for forced expiratory volume in 1 second (83 of 85 values fall within this range), 0.30 L for forced vital capacity (81 values fall within this range), and 0.58 L/s for forced expiratory flow between 25% and 75% (82 values fall within this range). In 79% of cases, the primary care pediatricians interpreted the spirometric tests correctly. CONCLUSIONS: It seems justifiable to perform spirometry in pediatric primary care, but an integrated approach involving both the primary care pediatrician and certified pediatric respiratory medicine centers is recommended because effective training and quality assurance are vital prerequisites for successful spirometry.

Adolescent↗

PubMed2003

Patterns and perceptions of complementary/alternative medicine among paediatricians and patients' mothers: a review of the literature.

UNLABELLED: For many families and their children, the use of complementary/alternative medicine (CAM) is an accepted adjunct or alternative to conventional therapy, even if data available in the literature regarding risks and adverse drug reactions (ADRs) pertaining to childhood populations are scarce. Moreover, despite widespread and increasing use of CAM, there are limited data on how paediatricians communicate with mothers and/or patients about CAM. Therefore, we report the studies available in the literature in the paediatric field and summarise what is known about ADRs and risks of CAM, taking into account in particular problems related to interactions between phytotherapy and conventional medicines and to counselling. CONCLUSION: from the analysis of the literature, some interesting aspects emerge: (1) the extent of CAM use in the paediatric field is increasingly sought by parents of children with chronic illnesses; (2) most parents who choose CAM medicine for their children believe that these therapies are "natural" and thus "safe" and (3) physicians often feel to know too little about CAM and wish to learn more for different reasons including "to dissuade whether the alternative method is unsafe and/or ineffective". Therefore, paediatricians should be prepared to discuss alternative therapies with parents, since talking about CAM may help to minimise the risks and to restrain parental misconceptions and doubts. Educational interventions for parents should also be performed to bring about a more aware use of traditional and alternative medicines.

Attitude to Health↗

PubMedDate not supplied

[Patologie delle alte vie respiratorie del bambino in ambulatorio: un'esperienza italiana. Diseases of the upper respiratory tract in children in ambulatory care: an Italian experience].

BACKGROUND: Overuse of antibiotics for children is widespread and contributes to the emergence of antibiotic-resistant bacteria. Moreover, non steroidal antiinflammatory drugs (NSAIDs) are often overprescribed despite of their renal and gastrointestinal side-effects. OBJECTIVES: To assess the behaviour and the factors influencing the prescribing practice of family pediatricians for the common upper respiratory diseases of pre-school children in an outpatient setting. METHODS: 125 family pediatricians, who provide primary care in an outpatient setting to young children in North-East of Italy (Veneto region), adhered to a survey consisting in a 40-item questionnaire about the factors that could influence their prescribing practice as regards otitis media (OM), pharyngitis (FGT) and broncopneumoniae (BPN) treatment of patients aged 0 to 5 years. Data were collected in November 2002. Descriptive analysis of data was performed using DELPHI TM7 professional Study Program. RESULTS: The child's age resulted an important factor, influencing the antibiotic prescription either in OM or in BPN. 86% of pediatricians emphasized the use of antipneumococcal vaccine, overall in children younger than 2 years with recurrent OM, while 71% adviced this vaccination in children younger than 5 years with relapsing BPN. The awareness of complications in OM and BPN often induced pediatricians to prescribe drugs. The most frequently prescribed antibiotic in OM, FGT and also BPN was amoxicillin for 7-10 days. According to the international guidelines, a small percentage (14%) of clinicians prescribe antibiotics for 5 days in OM, but most of them generally wait some hours to prescribe antibiotics. PenV was considered the most active drug in FGT and its disappearance from the market was considered negatively by italian pediatricians. Moreover, even if the rapid immunoenzymatic test for Group A beta-hemolyticus Streptococcus (GABHS) is considered sensitive, many pediatricians defined the throat culture the most accurate test to diagnose a GABHS pharyngitis. Paracetamol was frequently prescribed in these diseases, between 74% for OM and 53% for BPN. Among NSAIDs, niflumic acid and ibuprofen were the drugs most frequently prescribed in FGT and in OM respectively. About 30% of pediatricians refers that parents require drugs in the treatment of upper respiratory tract diseases. CONCLUSIONS: Our results show that antibotics are generally not over-prescribed by italian pediatricians, but often prescribed for a long time, likely because of fear of complications and uncertainty of the diagnosis, particularly in OM, being not always available the pneumotoscope. About NSAIDs, niflumic acid is frequently not evidence-based used in Italy. Frequently, side-effects associated with NSAIDs administration were reported.

Adult↗