Institute of Paediatrics

Perugia, Italy

Institute of Paediatrics

Perugia, Italy

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Incorvaia C.,ICP Hospital | Dell'Albani I.,Stallergenes | Di Cara G.,Institute of Paediatrics | Piras P.,Santissima Trinita Hospital | Frati F.,Stallergenes
European Annals of Allergy and Clinical Immunology | Year: 2013

In its century-long history, allergen immunotherapy (AIT), has shown continuous evolution in terms of the materials and the treatment schedules used, the adequate duration, and the mechanisms of action underlying its clinical efficacy. The passage from the empirical phase of AIT to the era of evidence-based medicine (EBM) was associated with achievement of the highest levels of evidence. This regarded both forms of AIT currently used, represented by subcutaneous immunotherapy (SCIT) and sublingual immunotherapy (SLIT). In particular, SLIT tablet preparations of pharmaceutical quality provided physicians and patients a treatment whose efficacy had been confirmed with the highest level of scientific evidence and improved the credibility of AIT for the entire medical field. However, further advances are needed for AIT in terms of optimal patient selection and the required dosage, as well as the quality and composition of the allergen extracts, factors favouring compliance, and the most appropriate duration capable of maintaining the clinical benefit over time.


Khoo T.-B.,Institute of Paediatrics | Tukimin S.M.B.,Hospital Kuala Lumpur | Syed Zainal Abidin S.M.B.,Hospital Kuala Lumpur | Lai J.-J.,Hospital Kuala Lumpur | Yusoof N.A.B.,Hospital Kuala Lumpur
Neurology Asia | Year: 2016

Objective: To evaluate the long-term efficacy, retention rate and tolerability of ketogenic diet treatment (KD) for children with medically refractory epilepsies from a single tertiary centre in Malaysia. Methods: Children who were treated with ketogenic diet since 2006 and had at least 2 years follow up after initiation of the KD were evaluated retrospectively using intention-to-treat principle. Response is defined at seizure reduction of > 50%. Efficacy was assessed as percentage of patients who had seizure reduction by >50%, >90% and seizure freedom and retention rate was the proportion of patients who remained on ketogenic diet. Result: A total of thirty children were included. The median duration of treatment was 8 months (range: 7 days to 6 years). Retention rates at 3, 6, 12 and 24 months were 80%, 70%, 50% and 40% and responder rates were 70%, 63%, 47% and 37% respectively. The common adverse effects were constipation (43%), hunger (23%), excessive weight gain or loss (20%), vomiting (10%), hyperuricaemia(30%), hypocalcaemia (20%) and renal calculi (13%). The common reasons for stopping were because the diet was too restrictive (33%), infrequent seizure or seizure freedom (23%), not effective (17%) but none was due to the adverse effects. Conclusion: Ketogenic diet treatment is effective and well-tolerated by Malaysian children in general. © 2016, ASEAN Neurological Association. All rights reserved.


Yeap B.H.,Institute of Paediatrics | Zahari Z.,Institute of Paediatrics
Pediatric Surgery International | Year: 2010

Purpose: Neonatal neoplasms are rare tumours notorious for their atypical presentation and unpredictable behaviour. Their optimal treatment remains uncertain, a dilemma compounded by the deleterious effects of adjuvant chemo- or radiotherapy during this vulnerable period of growth. This paper examined the relatively high incidence of these tumours and its impact on paediatric surgery in Malaysia. Methods: Neonatal tumours treated at the Department of Paediatric Surgery, Kuala Lumpur Hospital over an 8-year period were retrospectively analysed. Besides data pertaining to patient demographics, distribution of tumour types and survival rates, morbidity from disease as well as treatment was emphasised in particular. Results: The 28 neonatal tumours, majority of which were sacrococcygeal teratoma, constituted 7% of all tumours treated by the unit. Surgical excision remained the mainstay of treatment. Mortality and morbidity from disease and treatment were not insignificant, at 7 and 29%, respectively. Conclusion: The outcome of neonatal tumours treated in Malaysia appeared to be influenced by indigenous factors unique to the local healthcare setting. Several solutions were expounded, chief among these are strategies of improved and earlier detection, in addition to the centralisation of expertise for this group of tumours. © 2009 Springer-Verlag.


PubMed | Institute of Paediatrics
Type: Comparative Study | Journal: Pediatric surgery international | Year: 2010

Neonatal neoplasms are rare tumours notorious for their atypical presentation and unpredictable behaviour. Their optimal treatment remains uncertain, a dilemma compounded by the deleterious effects of adjuvant chemo- or radiotherapy during this vulnerable period of growth. This paper examined the relatively high incidence of these tumours and its impact on paediatric surgery in Malaysia.Neonatal tumours treated at the Department of Paediatric Surgery, Kuala Lumpur Hospital over an 8-year period were retrospectively analysed. Besides data pertaining to patient demographics, distribution of tumour types and survival rates, morbidity from disease as well as treatment was emphasised in particular.The 28 neonatal tumours, majority of which were sacrococcygeal teratoma, constituted 7% of all tumours treated by the unit. Surgical excision remained the mainstay of treatment. Mortality and morbidity from disease and treatment were not insignificant, at 7 and 29%, respectively.The outcome of neonatal tumours treated in Malaysia appeared to be influenced by indigenous factors unique to the local healthcare setting. Several solutions were expounded, chief among these are strategies of improved and earlier detection, in addition to the centralisation of expertise for this group of tumours.

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