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Toma P.,Bambino Gesu Childrens Hospital | Owens C.M.,Great Ormond Street Hospital for Children
Pediatric Radiology | Year: 2013

We analyze the potential use of ultrasound in the study of the thorax in children. The physical limitations imposed on sonography by the ventilated lung and thoracic cage are well known. We want to discuss new US applications based on the clinical and methodological experience gained in adults as outlined by emergency and critical care specialists. These specialists take information from physical acoustic phenomena that is not directly convertible into images of the human body, starting with the interpretation and handling of artifacts. We give a critical assessment from a radiologic viewpoint that is both necessary and important. © 2013 Springer-Verlag Berlin Heidelberg.

Ricci Z.,Bambino Gesu Childrens Hospital | Ronco C.,Dialysis and Transplantation | Ronco C.,International Renal Research Institute
Current Opinion in Critical Care | Year: 2011

Purpose of review: In the past 3 years substantial progress has been made in the field of renal replacement therapy (RRT) for critically ill patients. Recent findings: Two important multicenter randomized clinical trials have been recently published and extensively discussed: the randomized evaluation of normal versus augmented level (RENAL) replacement therapy study and the VA/NIH Acute Renal Failure Trial Network (ATN) study. The RENAL and ATN studies were designed to compare 'normal' or 'less intensive' renal support to an 'augmented' or 'intensive' therapy: both studies showed no benefit in outcomes by increases in intensity of RRT dose. The definition of 'normal dose' is now recommended in a range of 20-30 ml/kg per h for continuous therapies and/or thrice weekly intermittent hemodialysis. On the contrary, the complex issue of RRT optimal timing still remains uncertain and controversial. Summary: Wide variations in clinical practice still require RRT for critically ill patients to be optimized. The ideal prescription does not exist; however, continuous hemofiltration at a dose of 30 ml/kg/h meets many requirements of optimal care. In order to shed some light in the issue of RRT timing, furthermore, in the near future a standardized and clinically relevant definition of 'early' RRT should be provided. Great expectations currently rely on the utilization of acute kidney injury severity classifications and on new biomarkers of renal function. © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins.

Castelli E.,Bambino Gesu Childrens Hospital
Developmental Medicine and Child Neurology | Year: 2014

This paper is on the article by Phillipou et al. on pages 337-345 of this issue. © 2014 Mac Keith Press.

Ozkara C.,Istanbul University | Vigevano F.,Bambino Gesu Childrens Hospital
Epilepsia | Year: 2011

Several experimental and clinical studies demonstrated an immunologic basis for different forms of epilepsy. A wide range of immune abnormalities have been reported suggesting the existence of various subtypes of epileptic syndromes with different immunopathogenetic mechanisms. This evidence gives rise to the development of immunologic and immunomodulatory treatments such as usage of steroids, plasmapheresis, and intravenous immunoglobulins, which will be discussed briefly in this article. © 2011 International League Against Epilepsy.

Gaudio S.,Bambino Gesu Childrens Hospital | Di Ciommo V.,Unit of Epidemiology
Psychosomatic Medicine | Year: 2011

Objective: To evaluate personality disorder (PD) comorbidity and its clinical correlates in a sample of adolescents with anorexia nervosa (AN) and to compare them with similar studies on adults. Methods: One hundred one female AN outpatients (16-18 years old)-57 with AN restrictive type and 44 with AN binge-purging type-and 71 age-matched, healthy, female participants were assessed using the Structured Clinical Interview for DSM-IV Axis II Disorders. Five selected clinical variables of AN severity were also assessed. Results: Overall, 24.8% of AN outpatients had one or more PD compared with 4.2% of the control participants (p < .001). PDs most frequently found in AN outpatients were avoidant, borderline, and obsessive-compulsive. Associations were found between AN binge-purging type and borderline PD and between AN restrictive type and obsessive-compulsive PD. AN outpatients with a PD had an earlier age of onset of AN (mean [standard deviation {SD}] = 15.4 [1.2] versus 16.1 [0.9], p = .002), lower lifetime lowest BMI (mean [SD] = 14.8 [1.5] versus 15.6 [1.3], p = .01), and more hospital admissions for AN (mean [SD] = 1.4 [0.9] versus 0.3 [0.6], p < .001) compared with those without PDs. Conclusions: Associations were found between AN and PDs in adolescents similar to those found in adults. The presence of a PD is associated with a greater severity of AN. PD assessment of adolescent AN patients may permit a more accurate diagnosis and better treatment planning. © 2011 by the American Psychosomatic Society.

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