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V Currò

Publications and source records attributed to V Currò.

30 records · Page 2Linked to original sources

[Computerized prototype of a screening test for the assessment of psychomotor development in childhood].

The aim of Denver's screening test is to study the psychomotor development of normal or supposed normal children aged from 0 to 6 years and to suggest further investigation when an abnormal development is noticed. The test is divided into 4 sections: social behavior, fine motility, language, gross motility. The results are valid only if the test is done in a standardized manner. The aim of this paper is to describe the computerized prototype of the Denver test in use at the Divisional Pediatric Ambulatory of "A. Gemelli" University Policlinic in Rome. This test is used in the context of an automatized ambulatory management system called ARPIA, capable of interacting and guiding "non expert" user. The program performs the following functions: 1) General instructions for the execution and interpretation of the test. The original instructions of the test (1975 version) have been used. 2) Input, modification, exclusion of questions. The archive is organized in the following manner: questions are divided in the above four sections, according to the child, undergoing the test, age limit; the questions regarding information that can be asked directly to the parents or the display of a picture that better explains the test are marked. During the test the questions may be modified using a menu with a certain number of options to facilitate the use of the system. The questions to eliminate from the test may be appropriately marked and removed. The text is not physically deleted from the archive. The inverse operation of inclusion of a formerly removed question may be performed too.(ABSTRACT TRUNCATED AT 250 WORDS)

Child↗

[Implementation of a computerized pharmacological database for pediatric use].

The authors present a pharmacological database to support teaching and care activity carried out in the Divisional Paediatric Ambulatory of the Catholic University of Rome. This database is included in a integrated system, ARPIA (Ambulatory and Research in Pediatric by Information Assistance), devoted to manage ambulatory paediatric data. ARPIA has been implemented by using a relational DBMS, very cheap and highly diffused on personal computers. The database specifies: active ingredient and code number related to it, clinical uses, doses, contra-indications and precautions, adverse effects, besides the possible wrapping available on the market. All this is showed on a single for that appears on the screen and allows a fast reading of the most important elements characterizing every drug. The search of the included drugs can be made on the basis of three different detailed lists: active ingredient, proprietary preparation and clinical use. It is, besides, possible to have a complete report about the drugs requested by the user. This system allows the user, without modifying the program, to interact with the included data modifying each element of the form. In the system there is also a fast consultation handbook containing for every active ingredient, the complete list of italian proprietary medicines. This system aims to give a better knowledge of the most commonly used drugs, not only limited to the paediatrician but also to the ambulatory health staff; an improvement of the therapy furthering, a more effective use of several pharmacological agents and first of all a training device not only to specialists but also to students.

Child↗

[Evaluation of the locomotor system during pediatric health examinations and elements of kinesitherapy].

The pediatrician, being a primary health care physician, has the task of bringing the small patient and his parents to the resolution of all those problems which are erroneously referred to a subspecialist. With this in mind, the authors believe that even common orthopedic problems must be evaluated by the pediatrician. He would decide if and when to refer the child to an orthopedic specialist. Certain problems such as congenital hip dysplasia or scoliosis require specific treatment, whereas others (tibial bowing, genu varum-valgum, flatfoot, metatarsus varus) resolve themselves over time. The authors therefore emphasize the role of the pediatrician in preventing any iatrogenic pathology due to inappropriate treatment.

Child↗

[Correlations between blood pressure values, familial hypertension and anthropometric parameters in a sample of 3-year-old children].

Nowadays evaluation of blood pressure in children is almost routine. In fact hypertension in adults may be preceded by high blood pressure values in childhood. In this study the authors examined systolic blood pressure (SBP) and diastolic blood pressure (DBP), height, weight, ponderosity index and family history of hypertension, in 261 3-year-old children, 139 boys and 122 girls. Average values of SBP were slightly but not significantly higher in males. Coefficients of linear regression and correlation for any pair of the different parameters (SBP-DBP and weight, SBP-DBP and height, SBP-DPB and ponderosity index) were all significantly positive for males, but not for females. The most significant value (r = 0.43) was in the correlation DBP-weight. In studying the family history of hypertension all children were divided into three groups: negative (F.I.-), positive with brothers and/or parents affected (F.I. I+) and positive with other relatives affected (F.I. II+). Average SBP and DPB in the second group were higher than in the third, and much higher than in the first group. These results suggest the importance of prevention in early childhood with alimentary education and serial blood pressure measurements. The individuation of borderline values is also very important.

Age Factors↗

[Neonatal sepsis and perinatal risk factors].

Numerous studies have identified perinatal risk factors of neonatal sepsis. Some authors have attempted to develop a score system and have shown that babies with septicemia usually had a significantly higher score than healthy newborns and infants with other diseases. The aim of our study is to verify the validity of a scoring method based on the following items: maternal disease; e.g. diabetes, severe toxemia, infection; rupture of the membranes more than 24 hours before the delivery; foul-smelling amniotic fluid; complicated delivery; Apgar score less than 7; umbilical catheterization; respiratory distress and other neonatal diagnoses leading to operative procedures. We have evaluated four groups of babies, full-term AGA and SGA and preterm AGA and SGA, 84 with septicemia, 105 with other diseases and 210 healthy newborn infants. None of the perinatal risk factors or neonatal diseases was sufficiently predictive of neonatal septicemia. Only the incidence of umbilical catheterization was significantly higher (p less than 0.01) in preterm AGA (37.1%) and SGA (64.7%) babies with septicemia than in preterm healthy AGA (2.8%) and SGA (7.7%) babies; on the contrary, no statistical differences were found between preterm AGA (37.1%) and SGA (64.7%) infants with septicemia and preterm AGA (42.8%) and SGA (66.6%) infants with other neonatal diseases. A score of 1 was assigned for each of the considered items. In the full-term infants a score of 1 or less was found in 100% of the healthy infants. A score of 2-3 was found in 26% of the septicemic infants and in 42% of the infants with other diseases.(ABSTRACT TRUNCATED AT 250 WORDS)

Birth Weight↗

[Neonatal sepsis caused by coagulase-negative staphylococci].

All cases of neonatal bacteremia occurring at Neonatal Department of Pediatric Clinic, Catholic University of Rome, from January 1976 to December 1983 were examined retrospectively. Twenty-seven (30%) newborn infants with positive blood cultures for coagulase-negative staphylococcus were identified. Seven (25.9%) of the 27 infants were born at term, 4 AGA and 3 SGA; mean birth weight was 2,804 gm (range 2,280-3,670). All of these neonates had clinical evidence and laboratory signs of sepsis, and one had the cerebrospinal-fluid culture positive for coagulase-negative staphylococcus. In the remaining 20 infants (74.1%) the mean birth weight was 1,445 gm (range 810 - 2,400) and mean gestational age was 32 weeks (range 27 - 36). In 15 of the 20 preterm infants clinical signs of septicemia were associated with positive blood culture, and sixty percent of these had received an umbilical artery catheter. An half of coagulase-negative staphylococci isolated from our neonatal sepsis were DNAse-positive and/or phosphatase-positive and/or mannitol-positive. Two full-term infants, one with Down syndrome and one with cardiac malformation, died at 9 days and at 2 weeks of age, respectively. Three of 15 preterm infants with coagulas-negative staphylococcal septicemia died; deaths were among infants of very low birth weights and immature gestations who had severe respiratory syndrome. These data show that coagulase-negative staphylococcus can be important cause of septicemia in patients with compromised host defenses as newborn infants, and especially in the premature babies receiving invasive procedures.

Female↗

[Congenital dysplasia of the hip. Preliminary results of a longitudinal study in the first 6 months of life].

The authors report their experience of a serial follow-up for congenital dysplasia of the hip (CDH). 699 babies born during a three-months period were examined on their first day of life, on the forth and at the age of 1 and 6 months. 2 dislocated hips, 222 clicking hips were discovered in the neonatal period. At the first month 1 dislocated hip and only 6 clicking hips were detected. At the sixth month all babies were normal with the exception of two clicking hips. X-ray examination confirmed clinical dislocation diagnosis and showed pathological signs (subluxation and acetabular dysplasia) also in normal and clicking hips. According to their results the authors suggest that clinical examination during the first 6 months of life and X-ray can decrease the incidence of late diagnosis of CDH.

Female↗

[Physiologic hyperbilirubinemia in low birth weight newborn infants: relation to gestational age, neonatal weight and intra-uterine growth].

Neonatal hyperibilirubinaemia is a real problem for its possible repercussion on the psychomotor development, mainly in low birth weight infants. The Authors studied the physiologic course of bilirubinaemia in 513 low birth weight newborns and then related it to gestational age, birth weight and intrauterine growth. Results obtained show that neonatal hyperbilirubinaemia is strictly depending on gestational age, while both the birth weight and the intrauterine growth have no significant influence on its course. Certainly the very low birth weight infants run the higher risk of Kernicterus and brain injury due to hyperbilirubinaemia; they need therefore a quicker therapeutic approach, though the treatment of physiologic hyperbilirubinaemia must always be planned on the basis of gestational age.

Birth Weight↗

[Hypothyroxinemia in the low birth-weight infant in the screening of congenital hypothyroidism].

Inside a pilot screening program for Congenital Hypothyroidism, T4 and TSH have been tested in sick and healty preteam and fullterm low birth weight (LBW) newborns during the first two months of life, 36 newborns affected by respiratory distress syndrome and 15 by sepsis have been included in the study. Blood samples were collected by heel puncture on 3rd, 10th, 20th, 40th and, in some cases, up to 60th day of life, and adsorbed on filter paper. Our findings show that hypothyroxinaemia in LBW newborns is strictly related to gestational age. In fact, among preterm infants with GA less than or equal to 33 weeks, 25 subjects (69,44%) showed T4 levels less than or equal to 6 micrograms/dl and 5 infants (13,88%) had T4 concentrations less than or equal to 2 micrograms/dl. The incidence of subjects with T4 values less than or equal to 6 micrograms/dl falls to 42,18% in the group of infants with GA = 34-36 weeks and to 17,27% in the group of fullterm LBW infants. None of these newborns showed thyroxine levels less than or equal to 2 micrograms/dl. All the examined infants showed normal TSH levels. The low T4 values may appear soon after birth or later (3rd-20th day of life) and sometimes persist up to 40th or 60th day, despite of always normal TSH levels. The mean of low T4 values at each sampling time is strictly and directly related to gestational age. (ABSTRACT TRUNCATED AT 250 WORDS)

Congenital Hypothyroidism↗

[Possible pathogenetic factors in hypocalcemia of low birth weight newborn infants (author's transl)].

The Authors studied the possible pathogenetic factors in hypocalcemia of 66 low birth weight healthy newborn infants, 28 preterm and 38 small for gestational age babies. To clarify the pathogenesis of neonatal hypocalcemia, the Authors determined daily in the first week of life serum calcium, phosphorus and magnesium concentrations, the serum natrium and kalium level and E.A.B. on capillary blood. Total serum proteins was determined on the 2nd and on the 7th day of age. The incidence of hypocalcemia was 25.7% for all considered babies: 32.1% for preterm infants and 21% for small for gestational age babies. The hypocalcemia of preterm babies appears early during the first three days of life and it results not correlated with the serum phosphorus and the serum magnesium concentrations. On the contrary the small for gestational age babies show a "late" hypocalcemia directly related with an elevated serum concentration of phosphorus and with a reduced serum magnesium level. Both the preterm and the small for gestational age newborn infants had asymptomatic hypocalcemia and the orally administration of high doses of calcium gluconate 10% was able to normalize rapidly the serum calcium level.

Female↗

[Therapy of neonatal infection caused by group B beta-hemolytic Streptococcus].

Expectant therapy for early Group B Streptococcus onset septicemia must provide coverage against other microorganism, such as L. Monocytogenes, H. Influenzae and S. Pneumoniae. It is possible to administer a combination of antimicrobial agents with activity against all or the most likely pathogens. Thus initial expectant therapy includes a broad spectrum semisynthetic penicillin (e.g. ampicillin) and an aminoglycoside (e.g. netilmicin). Vancomicin, teicoplanin and cefotaxime may also be used. Supportive therapy consists on temperature control, i.v. administration of fluids, acid-base balance and electrolytes monitoring, seizures control and ventilation. IV immunoglobulins, granulocyte and serum transfusion are also used. The G-Colony Stimulating Factor (G-CSF, filgastrim) usage is also reported.

Age Factors↗

[The early diagnosis of congenital hip dysplasia: a proposal for a differentiated echographic screening].

Prevention of congenital hip dislocation is one of the main goals of pediatric activity. 839 newborn outpatients, with six months follow-up at least, were recruited at the Pediatric Clinic of the Catholic University of Rome, from January 1991 to December 1992. Every newborn baby was clinically examined for congenital hip dysplasia (CHD) at nursery and afterwards in the ambulatory. Hip sonography was performed, according to Graf's technique, in 504 babies (60%): 17 resulted pathological (3.3%), 30 borderline (6%) and 457 normal (90.7%). Ultrasonographic and clinical findings were compared. Clinical examinations at nursery and ambulatory have shown low sensitivity (21.3% and 34% respectively) in detecting dysplastic hips. Present experience confirms ultrasonography value in the diagnosis of CHD and the utility of its use in a general screening programme.

Follow-Up Studies↗