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Biomedical subjects

V Currò

Publications and source records attributed to V Currò.

At least 19 recordsLinked to original sources

Intracranial hemorrhage at the onset of thrombotic thrombocytopenic purpura in an infant: therapeutic approach and intensive care management.

Thrombotic thrombocytopenic purpura (TTP) is quite rare in infancy and must be treated intensively as a life-threatening disease. Diffuse vascular thromboses may occur, and neurologic involvement is a cornerstone of the diagnosis of TTP. We describe a case of an infant who presented with a sudden cerebral hemorrhage and subsequently developed the typical clinical features of TTP. Emergency treatment in the Pediatric Intensive Care Unit (PICU) consisted of plasma therapy and exchange-transfusion (EXT) to arrest the intravascular process and the exsanguinating blood loss. Exchange-transfusion is a life-saving procedure that is rarely performed after the neonatal age.

Critical Care↗

Randomised controlled trial assessing the effectiveness of a booklet on the duration of breast feeding.

OBJECTIVE: To test the efficacy of an information booklet to increase the duration of breast feeding. RESEARCH DESIGN: Randomised design, stratifying by maternal residence and working activity. Two hundred women were recruited, 103 received the booklet and verbal counselling and 97 verbal counselling only. POPULATION: Infants observed from 15 September 1993 to 15 June 1994 in the well baby outpatient clinic of the Paediatric Institute of the Catholic University of Rome, Italy. MAIN RESULTS: No statistically significant difference was found between the two groups in the prevalence of exclusive or complementary breast feeding at 6 months of age: 48.5% and 59.2% in the intervention group, 43.7% and 51.5% in the control group. The median duration of exclusive or complementary breast feeding was 24 and 27 weeks in the treated group, 22 and 25 in the control group. CONCLUSIONS: The information booklet alone does not seem to increase the duration and the prevalence of breast feeding at 6 months of age. The use of written material with a more individualised support and more extensive use of randomised clinical trials in the evaluation of health promoting programmes is recommended.

Adult↗

What proportion of multiple births are due to ovulation induction? A register-based study in Italy.

OBJECTIVES: This study evaluated the increase in risk of multiple births associated with ovulation induction and calculated the proportion of multiple births attributable to this treatment. METHODS: Cases were 350 multiple births and controls were 737 single births enrolled from April 1993 to March 1994 in the Mercurio Project, an investigation of reproductive outcomes in Italy. RESULTS: Ovulation induction was used in 45 case births (12.9%) and 24 control births (3.3%); the adjusted odds ratio was 4.1 (95% confidence interval [CI] = 2.4, 6.9). The odds ratio for triplet or higher order births was 72.2 (95% CI = 25.7, 202.8). When unlike-sexed multiple births were considered, the odds ratio increased for twin births, but not for triplet or higher births. The highest odds ratios were found when ovulation induction was used with assisted reproduction. The proportion of multiple births attributable to ovulation induction was 9.7% overall, 5.4% for twin births, and 69.8% for triplet or higher births. CONCLUSIONS: Ovulation induction increases the risk of multiple births and has been responsible for the rise in the rate of triplet or higher order births in Italy in the last decade. Its indiscriminate and improper use should be avoided.

Adult↗

Functionality of the ARPIA ambulatory information system.

Although database-based medical information systems are becoming popular, experiments done by researchers tell us that physicians still do not fully accept them. Key factors for changing physicians' practice habits are the availability of more powerful methods and tools for interactive data acquisition and retrieval. Problems involving human engineering usually require the identification of and experimentation with many novel approaches before the most suitable answer is discovered. ARPIA is an ambulatory information system experimenting on the effectiveness and acceptability (by medical users) of new intelligent and friendly interaction techniques and tools. In particular, it tests a novel flexible dialogue-based man-machine interface offering physical and logical data 'independence' during retrieval operations. Other features of the system are: a fast and robust data acquisition environment; a text- and picture-based data presentation and report generation facility; finally, a set of modules offering the ambulatory staff effective assistance in some extra complex interactive tasks. A user-oriented description of the main functionality of ARPIA is given; users' feedback summarizing almost 2 years of usage of the system is also reported.

Ambulatory Care Information Systems↗

Serial blood T4 and TSH determinations in low birth weight infants. Influence of gestational age, birth weight and neonatal pathology on thyroid function.

Serial blood T4 and TSH determinations were performed on a total number of 352 low birth weight (LBW) infants: 210 healthy newborns and 142 infants affected by respiratory distress syndrome (RDS), sepsis, hyperbilirubinaemia, hypocalcemia, or hypoglycemia. The healthy infants have been divided into three groups in relation to gestational age (less than or equal to 33 wk, 34-36 wk, greater than or equal to 37 wk). Statistical evaluation among groups shows that reduced T4 concentration in LBW infants is strictly related to gestational age, while TSH failed to demonstrate any significant correlation. No significant influence of birth weight on T4 and TSH has been observed. The preterm newborns affected by RDS or sepsis showed a significant reduction of mean T4 concentrations up to 20th day of life when compared with healthy controls similar for gestational age and birth weight. TSH levels are not significantly different. No significant modifications of T4 and TSH have been found related to the other pathological conditions. The significant reduction of T4 and the high incidence of subjects with low T4 values observed in healthy and sick preterm population lend further support to the use of TSH determination for optimum screening of congenital hypothyroidism.

Birth Weight↗

Hand dermatoglyphics in trisomy 4p.

A dermatoglyphic analysis of the hands of 16 patients with trisomy for the short arm of chromosome 4 has revealed an increased frequency of whorl patterns on fingertips, presence of axial triradii in position t' on palms and an increase of the main line index. Although of little diagnostic value these changes must be included in the constellation of major signs which characterize the 4p trisomy syndrome.

Chromosomes, Human, 4-5↗

Pilot study for congenital hypothyroidism, preliminary report.

Preliminary results of a pilot study on congenital hypothyroidism performed on 8,025 newborns in Italy over a 10-month period are reported. The determination of both T4 and TSH on dried blood, spotted on filter paper, as screening procedure at day 3-5 of life revealed three cases of primary hypothyroidism and one case of hypo-thyroxin-binding-globulinemia (hypo-TBG-emia). The diagnosis of primary hypothyroidism was established on the basis of low T4 and high TSH levels in two of the three cases; in the third, with elevated TSH and normal T4 levels at screening, thyroid scintiscan showed an ectopic gland located at the base of the tongue. In the case of hypo-TBG-emia, low T4 and TBG levels were associated with normal TSH values. Some cases of transient hypothyroidism were observed in premature infants.

Congenital Hypothyroidism↗

Familial thyroxine-binding globulin deficiency detected in a pilot screening program for congenital hypothyroidism.

During a pilot screening program for congenital hypothyroidism, performed in Italy over a three years period on 38,000 newborns, seven cases (1/5,400) of thyroxine-binding globulin (TBG) deficiency, have been detected. None of these infants was affected by any pathology or had been treated with drugs which could explain TBG deficiency as an acquired condition. Familial studies pointed out that the transmission of the defect is consistent or compatible with X-chromosome linkage.

Congenital Hypothyroidism↗

[Reproducibility of pediatric information collected with various methods: postal/telephone questionnaire and direct interview].

The paper reports on a research aimed to evaluate the repeatability of some paediatric data obtained from the parents by using different collection instruments: telephone interview, mail questionnaire, in-person interview. The study included 699 children consecutively born in the Policlinico Universitario "A. Gemelli" from September to November 1983. After 3 years a questionnaire containing questions about measles, anti measles immunization, age at which the baby started to walk, disease delaying the walking, and orthopaedic examinations was sent by mail to 149 families; the other 550 families were searched for by telephone and, if found, asked the same questions. All the contacted families were invited for a paediatric check-up, during which the same data were collected through direct interview. For each question crude agreement and K statistic (which controls for the agreement attributable to chance) were computed with respect to both the phone/direct and mail direct comparisons. 391 families (56%) were traced for the first interview, due to the high number of them which had moved home. Among these 289 (74%) attended the paediatric check-up. On the whole, rather high values of K statistic were observed, ranging from 0.59 (question on diseases delaying the walking, comparison phone/direct) to 0.93 (question on anti-measles immunization, comparison mail/direct). Due to the small sample size, the estimates concerning the comparison mail/direct are rather imprecise. Although its potential is limited by the low response rate, the study brings good evidence that the information considered is not sufficiently reliable when reported retrospectively by parents. However, the keeping of a prospective individual record containing data of medical interest should be encouraged.

Data Collection↗

[Otitis media in childhood: a critical review of the literature].

Infection of the middle ear is one of the most common childhood illnesses accounting for one-third of the pediatrics practice during the first five years of life. Therefore treatment and prevention of the otitis media are of considerable importance. A review of the literature of the otitis media during the pediatric age is reported. In fact in the last years a large amount of knowledge, sometimes referring discordant opinions, has been acquired. The Authors report epidemiology, anatomy, pathology, physiology, microbiology, classification, clinical data diagnosis and therapy of the otitis media. Common conditions of the middle ear (normal, acute otitis media, chronic otitis media, recurrent otitis media) are described. In particular acute otitis media, otitis media with effusion, perforation of the tympanic membrane, fluid level in the middle ear, severe retraction or bulging of the tympanic membrane are pointed out in color-photographs.

Acute Disease↗

[The catarrhal child].

The first seven years of a child's development are often described as the catarrhal stage. This is because of the increased incidence of upper respiratory tract infections. Nasal obstruction in the children is common and symptoms are often distressing. The authors report a rational approach to this problem to produce effective treatment of recurrent nasal obstruction. In particular clinical features, diagnosis, and therapy of recurrent rhinitis, adenoid hypertrophy, and tonsillar obstruction are described. The indications for adenoidectomy, tonsillectomy or adenotonsillectomy has been questioned.

Child↗