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Biomedical subjects

M Chiossi

Publications and source records attributed to M Chiossi.

16 recordsLinked to original sources

The risk associated with poisonings in children.

The risk associated with poisonings in children was assessed on 6175 subjects admitted to the pediatric hospitals of 3 regions of Northern Italy between 1975 and 1990. The frequency of exposures and the severity of sequelae allowed high- and low-risk substances to be identified. Risks were studied separately in the 0-4, 5-9 and 10-13 y age group to determine age-related differences. A decrease in drug-related poisonings and an increase of those caused by household products, particularly in the first 2 y of life, were observed in 1983-90 as against 1975-82 in association with the introduction of safety caps and containers for drugs. Our study points out the need to strengthen active primary prevention through health education and parental and adolescent information, and to improve passive prevention through the extension of safety closures to household products.

Adolescent↗

[The pediatric emergency department: assessment of clinical activity and interaction with local health authorities].

A perspective study was carried out at the Emergency Department of the Gaslini Institute on a sample of the children admitted from May to September 1990. The study aimed to describe types and modalities of admission. "G. Gaslini" Institute is a multidisciplinary children's hospital: 45% of patients admitted in the hospital come from the southern regions of Italy, while the admission at the Emergency Department were local in 82%. Among all children considered, 2080 (71.9% were admitted on request of their parents, who did not ask previously any physician; of those cases, 356 (17%) were hospitalized, 474 (25%) were either examined by specialist or treated and then discharged. In the remaining cases, no intervention was necessary. As a consequence, 58% of children were admitted without any clinically plausible reason. Parents' anxiety clearly played an important role in most cases. 840 children were addressed to the Emergency Department by a physician, 652 (22.3%) by the doctor in charge, 213 (32.7%) of which were sent back home by the doctor on duty, who did not think it necessary any treatment. Of the 120 (4.1%) children sent by different Emergency Departments, 95 (79.1%) were hospitalized. The reason why physicians addressed quite a large number of children to the Emergency Department, when they didn't need any intervention remain nucleo. Their diagnosis, in fact, agreed with those of the doctor on duty in 83% of cases. In conclusion, it is difficult to imagine a diagnostic or therapeutic problem which needs specific structures. Cooperative programs with physicians working in our region will be carried out in order to control, where possible, admission to Emergency Departments.

Adolescent↗

[The Gaslini Medical-Surgical Emergency Service. Organizational and functional aspects].

The Authors take into account the organization of the medical emergency service at Gaslini children's hospital. Emergency medicine has been developing as a pediatric subspecialty, involving medical surgical and intensive care units to meet the peculiar needs of the acutely ill child. Moreover epidemiological data regarding all kinds of activity have been collected; they show a decrease in admitted patients and an increase in outpatients. These data undertime how effectively the service can act as a filter as well.

Age Factors↗

[The activities of a pediatric emergency department. The emergency problems].

The authors reviewed records of admission at the Fist Ais-Emergency Service of "G. Gaslini" Children's Hospital, data referring both to in and outpatients. First of all we took into account epidemiological data analysing occurrence and types of diseases; at the same time a demographic study, which aimed to show a decrease in the child population in Genova, was performed. Secondly we compared these data with the real number of admitted patients: collected data showed that this service has been used excessively.

Age Factors↗

Discharge report accuracy.

The clinical report is one of the most useful ways of cooperation between the hospital doctors and general practitioners. This paper is aimed at checking the accuracy of clinical reports in an Italian children's hospital. The authors examined 200 clinical reports after establishing some criteria to be fulfilled in order to write a good clinical report. Only 18 reports were considered good; the results were discussed with the physicians who had written the reports. At a second evaluation, the authors checked the efficacy of the proposed changes: 97 clinical reports were considered good.

Child↗

[Theophylline poisoning in childhood: depurative therapy using a combination of activated charcoal and a saline cathartic].

The Authors describe two cases of theophylline poisoning and discuss advantages of activated charcoal and magnesium hydroxide therapy. This treatment seems to be better in patients for whom hemoperfusion could be delayed. In fact, activated charcoal can determine a real decrease in serum theophylline as experimental data show. Patients who overdose with slow release theophylline preparation should receive multiple oral doses of activated charcoal; they should also receive multiple oral doses of cathartic, both saline or sorbitol like. There is a lack of references about the activated charcoal plus magnesium hydroxide regimen particularly in childhood. The Authors discuss their own experience.

Adolescent↗

[Cerebral gigantism or Sotos' syndrome].

The paper describes a case of Sotos syndrome and reviews the world literature on the subject. Inheritance may be dominant autosomal as well as recessive, although the latter is quite rare. The pathophysiology is not well known but a common underlying basis between various syndromes (Sotos; Beckwith-Wiedemann; Klippel-Trenaunay) is hypothesised.

Brain Diseases↗

[Significance of the evaluation of C-peptide in children with type 1 diabetes mellitus].

In type I diabetes mellitus (DM) the presence of C peptide (Cp), whose determination is unaffected by exogenous insulin, is considered expression of a residual beta-cell activity, which allows a better metabolic control. In 35 children affected by type I DM the fasting Cp was measured: in 18 cases (1st group) a value greater than or equal to 1 ng/ml was observed, while in the remaining 17 (2nd group) the Cp value was less than 1 ng/ml. A statistical comparison between the two groups demonstrated that in the first one a better metabolic control was achieved with a daily lower insulin dosage. Moreover in the 1st group the onset of the disease was more recent, while there was no difference between the two groups with regard to the age at diagnosis. The Cp evaluation and follow-up is useful in the assessment of the individual case; furthermore, on the basis of these studies, an immunosuppressive treatment may be considered during the early phase of the disease, when a residual beta-cell activity is demonstrated.

Adolescent↗