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Cucinotta U, Acunzo M, Payen E, Talbotec C, Chasport C, Alibrandi A, Lacaille F, Lambe C. The Impact of Teduglutide on Real-Life Health Care Costs in Children with Short Bowel Syndrome. J Pediatr 2023:113882. [PMID: 38135030 DOI: 10.1016/j.jpeds.2023.113882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 11/27/2023] [Accepted: 12/17/2023] [Indexed: 12/24/2023]
Abstract
OBJECTIVES To analyze the real-life health care costs of home parenteral nutrition (HPN) in children with short bowel syndrome with intestinal failure (SBS-IF) before and after treatment with teduglutide, and to compare those with costs of children with SBS-IF not treated with teduglutide. STUDY DESIGN All consecutive children with SBS-IF on HPN treated with subcutaneous teduglutide starting from 2018 through 2020 in a tertiary French referral center were retrospectively included. These patients were matched to children with SBS-IF on HPN followed during the same 3-year period who were eligible for the teduglutide but were not treated. HPN direct medical costs included: home-care visits, HPN bags, hospital admissions, and teduglutide. A comparison of costs before/after treatment, and between patients treated/not treated was performed. RESULTS Sixty children were included: 30 (50%) treated with teduglutide and 30 (50%) untreated. In the treated group, the median total costs of HPN significantly decreased after 1 (p<0.001) and 2 years of treatment (p<0.001) from 59.454 euros/year/patient to 43.885 euros/year/patient and 34.973 euros/year/patient, respectively. Comparing patients treated and not treated, the total HPN costs/year/patient were similar at baseline (p=0.6) but were significantly lower in the teduglutide-treated group after 1 (p=0.006) and 2 years of treatment (p<0.001). When adding the cost of teduglutide into the analysis, the total cost increased significantly in the treated group, and remained much higher even after modeling a reduction in the cost of the drug to 1/3 the present cost and PN weaning (p<0.001). CONCLUSIONS Treatment with teduglutide is associated with a significant reduction in the annual costs of HPN but still remains expensive because of the drug itself. Finding cost saving strategies is essential.
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Affiliation(s)
- Ugo Cucinotta
- Pediatric Gastroenterology and Nutrition, Necker Enfants Malades University Hospital, Paris, France; Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy.
| | - Miriam Acunzo
- Pediatric Gastroenterology and Nutrition, Necker Enfants Malades University Hospital, Paris, France; Department of Pediatrics Vittore Buzzi Children's Hospital, Milan, Italy
| | - Elise Payen
- Pediatric Gastroenterology and Nutrition, Necker Enfants Malades University Hospital, Paris, France
| | - Cécile Talbotec
- Pediatric Gastroenterology and Nutrition, Necker Enfants Malades University Hospital, Paris, France
| | - Céline Chasport
- Pharmacy, Hopital Universitaire Necker - Enfants Malades, Paris, France
| | - Angela Alibrandi
- Statistical and Mathematical Science Unit, Department of Economics, University of Messina, Messina, Italy
| | - Florence Lacaille
- Pediatric Gastroenterology and Nutrition, Necker Enfants Malades University Hospital, Paris, France
| | - Cécile Lambe
- Pediatric Gastroenterology and Nutrition, Necker Enfants Malades University Hospital, Paris, France
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Cucinotta U, Romano C, Dipasquale V. A Systematic Review to Manage Avoidant/Restrictive Food Intake Disorders in Pediatric Gastroenterological Practice. Healthcare (Basel) 2023; 11:2245. [PMID: 37628443 PMCID: PMC10454601 DOI: 10.3390/healthcare11162245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 07/22/2023] [Accepted: 08/08/2023] [Indexed: 08/27/2023] Open
Abstract
Avoidant/Restrictive food intake disorder (ARFID) is a feeding disorder characterized by persistent difficulty eating, such as limited choices of preferred foods, avoidance or restriction of certain foods or food groups, and negative emotions related to eating or meals. Although ARFID mainly affects children, it can also occur in adolescents and adults. ARFID can have serious physical and mental health consequences, including stunted growth, nutritional deficiencies, anxiety, and other psychiatric comorbidities. Despite its increasing importance, ARFID is relatively underrecognized and undertreated in clinical practice. Treatment consists of a multidisciplinary approach involving pediatric gastroenterologists, nutritionists, neuropsychiatrists, and psychologists. However, there are several gaps in the therapeutic approach for this condition, mainly due to the lack of interventional trials and the methodological variability of existing studies. Few studies have explored the nutritional management of ARFID, and no standardized guidelines exist to date. We performed a systematic literature review to describe the different nutritional interventions for children and adolescents diagnosed with ARFID and to assess their efficacy and tolerability. We identified seven retrospective cohort studies where patients with various eating and feeding disorders, including ARFID, underwent nutritional rehabilitation in hospital settings. In all studies, similar outcomes emerged in terms of efficacy and tolerability. According to our findings, the oral route should be the preferred way to start the refeeding protocol, and the enteral route should be generally considered a last resort for non-compliant patients or in cases of clinical instability. The initial caloric intake may be adapted to the initial nutritional status, but more aggressive refeeding regimens appear to be well tolerated and not associated with an increased risk of clinical refeeding syndrome (RS). In severely malnourished patients, however, phosphorus or magnesium supplementation may be considered to prevent the risk of electrolyte imbalance, or RS.
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Affiliation(s)
| | | | - Valeria Dipasquale
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, 98124 Messina, Italy; (U.C.); (C.R.)
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Dipasquale V, Cucinotta U, Alibrandi A, Laganà F, Ramistella V, Romano C. Early Tube Feeding Improves Nutritional Outcomes in Children with Neurological Disabilities: A Retrospective Cohort Study. Nutrients 2023; 15:2875. [PMID: 37447202 DOI: 10.3390/nu15132875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 06/13/2023] [Accepted: 06/20/2023] [Indexed: 07/15/2023] Open
Abstract
Tube feeding is a life-saving treatment for children with neurological disabilities (ND), who often suffer from malnutrition and feeding disorders. Nonetheless, it is still not widely used. Our aim was to evaluate the outcomes of exclusive tube feeding in a cohort of ND children. All consecutive ND children who started tube feeding at our center within the last 5 years were included in this retrospective study. Weight-for-age, body mass index (BMI), mid-upper arm circumference (MUAC) Z-scores, and symptoms were collected at baseline (V0), 6 (V1), and 12 months (V2) after gastrostomy placement. Fifty children (62% males) were included. The ND-underlying disease was genetic (n = 29, 58%), hypoxic-ischemic encephalopathy (n = 17, 34%), or metabolic (n = 4, 8%). Indications for tube feeding were malnutrition (n = 35, 70%), recurrent respiratory infections (n = 11, 22%), or both (n = 4, 8%). Enteral formulae were polymeric (n = 29, 58%), semi-elemental (n = 17, 34%), hypercaloric (n = 3, 6%), or elemental (n = 1, 2%). Homemade blended feed was offered to three children (6%) in addition to the formula. Weight and BMI increased over the study period. Except for constipation, all symptoms (cough, vomiting, and diarrhea) improved at 6 and 12 months (p < 0.05). Non-serious complications (n = 8; track disruption, granuloma, and skin infection) were observed. Longer disease duration (p < 0.001) at the start of tube feeding was associated with the absence of normalization of nutritional status (BMI Z-score > 2 SD) at 12 months. Tube feeding with commercially available enteral formulae should be started as early as possible for better outcomes.
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Affiliation(s)
- Valeria Dipasquale
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", "G. Martino" University Hospital, 98124 Messina, Italy
| | - Ugo Cucinotta
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", "G. Martino" University Hospital, 98124 Messina, Italy
| | - Angela Alibrandi
- Statistical and Mathematical Sciences Unit, Department of Economics, University of Messina, 98122 Messina, Italy
| | - Francesca Laganà
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", "G. Martino" University Hospital, 98124 Messina, Italy
| | - Vincenzo Ramistella
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", "G. Martino" University Hospital, 98124 Messina, Italy
| | - Claudio Romano
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", "G. Martino" University Hospital, 98124 Messina, Italy
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Galletta F, Cucinotta U, Marseglia L, Cacciola A, Gallizzi R, Cuzzocrea S, Messina S, Toscano A, Gitto E. Hemophagocytic lymphohistiocytosis following gene replacement therapy in a child with type 1 spinal muscular atrophy. J Clin Pharm Ther 2022; 47:1478-1481. [PMID: 35924856 DOI: 10.1111/jcpt.13733] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 06/02/2022] [Accepted: 06/06/2022] [Indexed: 12/31/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Onasemnogene abeparvovec (OA) is the first gene replacement therapy for the treatment of paediatric patients with bi-allelic mutations in the SMN1 gene. Efficacy and safety of OA have been assessed in several studies with promising results, despite rare side effects have been described. CASE SUMMARY A 3-year-old child with spinal muscular atrophy was treated with OA and subsequently developed fever, widespread erythematous skin lesions and hepatosplenomegaly. Laboratory tests were suggestive for Hemophagocytic lymphohistiocytosis (HLH). WHAT IS NEW AND CONCLUSION To our knowledge, this is the first case of HLH following gene replacement therapy with OA, described in literature.
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Affiliation(s)
- Francesca Galletta
- Neonatal and Pediatric Intensive Care Unit, University of Messina, Messina, Italy, Department of Human Pathology in Adult and Developmental Age, University of Messina, Messina, Italy
| | - Ugo Cucinotta
- Neonatal and Pediatric Intensive Care Unit, University of Messina, Messina, Italy, Department of Human Pathology in Adult and Developmental Age, University of Messina, Messina, Italy
| | - Lucia Marseglia
- Neonatal and Pediatric Intensive Care Unit, University of Messina, Messina, Italy, Department of Human Pathology in Adult and Developmental Age, University of Messina, Messina, Italy
| | - Annalisa Cacciola
- Neonatal and Pediatric Intensive Care Unit, University of Messina, Messina, Italy, Department of Human Pathology in Adult and Developmental Age, University of Messina, Messina, Italy
| | - Romina Gallizzi
- Pediatric Unit, Department of Medical of Health Sciences, Magna Graecia University, Catanzaro, Italy
| | - Salvatore Cuzzocrea
- Department of Chemical, Biological, Pharmaceutical and Environmental Sciences, University of Messina, Messina, Italy
| | - Sonia Messina
- Unit of Neurology and Neuromuscular Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Antonio Toscano
- Unit of Neurology and Neuromuscular Diseases, Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - Eloisa Gitto
- Neonatal and Pediatric Intensive Care Unit, University of Messina, Messina, Italy, Department of Human Pathology in Adult and Developmental Age, University of Messina, Messina, Italy
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Dipasquale V, Cucinotta U, Romano C. Biosimilars in Pediatric IBD: Updated Considerations for Disease Management. Biologics 2022; 16:57-66. [PMID: 35721798 PMCID: PMC9205321 DOI: 10.2147/btt.s367032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Accepted: 06/03/2022] [Indexed: 11/23/2022]
Abstract
Biologic drugs have significantly modified the pharmacological management of several chronic conditions, including inflammatory bowel diseases (IBD). By contrast, in the last two decades, biologics have been associated with increased direct medical costs. As patents for the reference drugs have expired, the development and commercialization of biosimilars through abbreviated licensing pathways represented an affordable alternative in patients fulfilling the indication for biologics. A growing body of evidence, first in adults and then in the pediatric age group too, has provided reassuring data in terms of efficacy and safety of biosimilars both in naïve patients and in those previously on reference drugs who had to switch to the biosimilar. This review summarizes the currently available evidence for biosimilar use in IBD, with a focus on pediatric IBD. The most common practical approaches to biosimilar use in the pediatric clinical settings are also discussed.
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Affiliation(s)
- Valeria Dipasquale
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
- Correspondence: Valeria Dipasquale, Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, Via Consolare Valeria 1, Messina, 98124, Italy, Tel +390902212918, Email
| | - Ugo Cucinotta
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
| | - Claudio Romano
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood “G. Barresi”, University of Messina, Messina, Italy
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Macaluso FS, Giuliano A, Fries, W, Viola A, Abbruzzese A, Cappello M, Giuffrida E, Carrozza L, Privitera AC, Magnano A, Ferracane C, Scalisi G, Minissale MG, Giangreco E, Garufi S, Bertolami C, Cucinotta U, Graziano F, Casà A, Renna S, Teresi G, Rizzuto G, Mannino M, Maida M, Orlando A. Severe Activity of Inflammatory Bowel Disease is a Risk Factor for Severe COVID-19. Inflamm Bowel Dis 2022; 29:217-221. [PMID: 35385102 PMCID: PMC9383704 DOI: 10.1093/ibd/izac064] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND Data from the first wave of the coronavirus disease 2019 (COVID-19) pandemic suggested that patients with inflammatory bowel disease (IBD) are not at higher risk of being infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) than the general population and that a worse prognosis is not associated with immunomodulatory drugs, with the possible exception of systemic steroids. METHODS This retrospective, observational study included consecutive IBD patients from the Sicilian Network for Inflammatory Bowel Disease (SN-IBD) cohort who had a SARS-CoV-2 infection diagnosis (polymerase chain reaction-confirmed presence of the viral genome in a nasopharyngeal swab) during the second COVID-19 pandemic wave (September 2020 to December 2020). Data regarding demographics, IBD features and treatments, and comorbidities were analyzed in correlation with COVID-19 clinical outcomes. RESULTS Data on 122 patients (mean age, 43.9 ± 16.7 years; males, 50.0%; Crohn's disease, 62.3%; ulcerative colitis, 37.7%) were reported. Twelve patients developed COVID-19-related pneumonia (9.8%), 4 (3.3%) required respiratory assistance (nonmechanical ventilation or orotracheal intubation), and 4 died (case fatality rate, 3.3%). In a multivariable analysis, age (odds ratio [OR], 1.034; 95% CI, 1.006-1.147; P = .032) and severe IBD activity (OR, 13.465; 95% CI, 1.104-164.182; P = .042) were independent predictors of COVID-19-related pneumonia, while severe IBD activity (OR, 15.359; 95% CI, 1.320-178.677; P = .030) was the only independent predictor of severe COVID-19, a composite endpoint defined as the need for respiratory assistance or death. A trend towards a protective role of tumor necrosis factor α inhibitors on pneumonia development was reported (P = .076). CONCLUSIONS In this cohort of patients with IBD and SARS-CoV-2 infection, severe IBD activity was the only independent risk factor for severe COVID-19.
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Affiliation(s)
- Fabio Salvatore Macaluso
- Inflammatory Bowel Disease Unit, “Villa Sofia-Cervello” Hospital, Palermo, Italy,Address correspondence to: Fabio Salvatore Macaluso, MD, IBD Unit, “Villa Sofia-Cervello” Hospital, Viale Strasburgo 233, 90146 Palermo, Italy ()
| | - Alessandra Giuliano
- Inflammatory Bowel Disease Unit, “Villa Sofia-Cervello” Hospital, Palermo, Italy
| | - Walter Fries,
- Inflammatory Bowel Disease Unit, Policlinico “G. Martino,”Messina, Italy
| | - Anna Viola
- Inflammatory Bowel Disease Unit, Policlinico “G. Martino,”Messina, Italy
| | - Alfredo Abbruzzese
- Inflammatory Bowel Disease Unit, Policlinico “G. Martino,”Messina, Italy
| | - Maria Cappello
- Gastroenterology and Hepatology Section, Promise, University of Palermo, Palermo, Italy
| | - Enrica Giuffrida
- Gastroenterology and Hepatology Section, Promise, University of Palermo, Palermo, Italy
| | - Lucio Carrozza
- Gastroenterology and Hepatology Section, Promise, University of Palermo, Palermo, Italy
| | | | - Antonio Magnano
- Gastroenterology Unit, Policlinico “Vittorio Emanuele,”Catania, Italy
| | | | | | - Maria Giovanna Minissale
- **Gastroenterology and Endoscopy Unit, “Buccheri La Ferla Fatebenefratelli” Hospital, Palermo, Italy
| | | | - Serena Garufi
- Gastroenterology Unit, “S. Elia- M. Raimondi” Hospital, Caltanissetta, Italy
| | | | - Ugo Cucinotta
- Pediatric Gastroenterology and Cystic Fibrosis Unit, University of Messina, Messina, Italy
| | - Francesco Graziano
- Pediatric Gastroenterology and Cystic Fibrosis Unit, University of Messina, Messina, Italy,Pediatric Unit, “Villa Sofia-Cervello” Hospital, Palermo, Italy
| | - Angelo Casà
- Inflammatory Bowel Disease Unit, “Villa Sofia-Cervello” Hospital, Palermo, Italy
| | - Sara Renna
- Inflammatory Bowel Disease Unit, “Villa Sofia-Cervello” Hospital, Palermo, Italy
| | - Giulia Teresi
- Inflammatory Bowel Disease Unit, “Villa Sofia-Cervello” Hospital, Palermo, Italy
| | - Giulia Rizzuto
- Inflammatory Bowel Disease Unit, “Villa Sofia-Cervello” Hospital, Palermo, Italy
| | - Mariella Mannino
- Inflammatory Bowel Disease Unit, “Villa Sofia-Cervello” Hospital, Palermo, Italy
| | - Marcello Maida
- Gastroenterology Unit, “Papardo Piemonte” Hospital, Messina, Italy
| | - Ambrogio Orlando
- Inflammatory Bowel Disease Unit, “Villa Sofia-Cervello” Hospital, Palermo, Italy
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Valenzise M, D'Amico F, Cucinotta U, Lugarà C, Zirilli G, Zema A, Wasniewska M, Pajno GB. The lockdown effects on a pediatric obese population in the COVID-19 era. Ital J Pediatr 2021; 47:209. [PMID: 34663397 PMCID: PMC8521262 DOI: 10.1186/s13052-021-01142-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/28/2021] [Indexed: 12/23/2022] Open
Abstract
Background The social consequences of COVID-19 pandemic are universally known. In particular, the pediatric population is dealing with a radical lifestyle change. For some risk categories, such as overweight or obese children, the impact of home confinement has been greater than for others. The increased sedentary life, the wrong diet and social distancing have stopped the chance of losing weight. The aims of this study were to analyse the impact of COVID-19 lockdown on the behavior changes in a obese pediatric population and to explore the correlation between the new lifestyle and the level of parental instruction. Methods Data show features of 40 obese and overweight pediatric patients of our Clinic in Messina (Italy). We evaluated weight, height, BMI and other biochemical parameters: total cholesterol, HDL, LDL, triglyceride, transaminases, glycemia and insulinemia. After the lockdown, we contacted all patients in order to get some information about diet, physical activity and sedentary lifestyle changes in correlation to the level of their parents’ instruction. Additionally, we also evaluated 20 children twice from a clinical and laboratory perspective. Results The study showed an increase of daily meals during COVID-19 lockdown (3.2 ± 0.4 vs 5 ± 1, P < 0.001). In particular, children whose parents have primary school diploma ate a greater significant number of meals during the lockdown, compared to those who have parents with secondary school diploma (P = 0.0019). In addition, the 95% of patients did low physical activity during the lockdown and the 97.5% spent more time in sedentary activity. Even if BMI’s values don’t show significant differences, they have increased after the lockdown. We didn’t find any correlation between biochemical parameters before and after the lockdown. Conclusion The lockdown has had bad consequences on good style of life’s maintenance in overweight and obese children. The absence of a significant correlation between the worsening of biochemical parameters and the lockdown doesn’t allow to exclude any long-term consequences. It’s safe to assume that, if the hours spent in sedentary activity and the number of meals don’t diminish, there will probably repercussion on the biochemical parameters.
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Affiliation(s)
- M Valenzise
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy.
| | - F D'Amico
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | - U Cucinotta
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | - C Lugarà
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | - G Zirilli
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | - A Zema
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | - M Wasniewska
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | - G B Pajno
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
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Cucinotta U, Dipasquale V, Costa S, Pellegrino S, Ramistella V, Romano C. Vedolizumab-associated pulmonary manifestations in children with ulcerative colitis. J Clin Pharm Ther 2021; 47:254-256. [PMID: 34278581 DOI: 10.1111/jcpt.13494] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 07/09/2021] [Accepted: 07/12/2021] [Indexed: 12/15/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE The off-label use of vedolizumab (VDZ) for inflammatory bowel disease in children is increasing. We report on possibly the first case of VDZ-associated pulmonary manifestations in paediatrics. CASE SUMMARY This report details the case of a 13-year-old child with ulcerative colitis who was initiated on VDZ due to persistent active disease. After the first three doses, he developed a persistent and productive cough. Microbiological work-up was normal. VDZ discontinuation led to the resolution of symptoms. WHAT IS NEW AND CONCLUSION To our knowledge, this is the first case report of VDZ-associated pulmonary manifestations in paediatrics. A direct, pro-inflammatory effect of VDZ has been hypothesized, but further studies are warranted.
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Affiliation(s)
- Ugo Cucinotta
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
| | - Valeria Dipasquale
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
| | - Stefano Costa
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
| | - Salvatore Pellegrino
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
| | - Vincenzo Ramistella
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
| | - Claudio Romano
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy
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Romano C, Pallio S, Cucinotta U, Accorsi P, Dipasquale V. Fibers in pediatric functional gastrointestinal disorders. Practical considerations from clinical cases. Expert Rev Gastroenterol Hepatol 2021; 15:583-587. [PMID: 33522316 DOI: 10.1080/17474124.2021.1884543] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Introduction: Functional gastrointestinal disorders (FGIDs) are common in children and incur high direct and indirect social costs. Partially hydrolyzed guar gum (PHGG) is a natural and water-soluble dietary fiber that is derived from guar gum. It has been proposed as complementary therapy in pediatric FGIDs, especially in chronic functional constipation and irritable bowel syndrome.Areas covered: By focusing on four clinical cases, this article illustrates the use of PHGG fiber as sole supplement ingredient or as a formula component in orally- and tube-fed children suffering from malnutrition due to FGIDs, with or without special medical conditions such as neurological disability. The formula used was a whey peptide-based nutritionally complete formula containing PHGG as a source of soluble dietary fiber. It was offered under medical supervision and after full consideration of all feeding options.Expert opinion: Implementing appropriate feeding behaviors, adapted to age and potential comorbidities, is an essential requisite for therapeutic management of FGIDs. The use of a PHGG supplement or a nutritionally complete formula containing PHGG as a source of soluble dietary fiber can be helpful to manage pediatric FGIDs.
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Affiliation(s)
- Claudio Romano
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G.Barresi", University of Messina, Messina, Italy
| | - Socrate Pallio
- Division of Digestive Endoscopy, University of Messina, Messina, Italy
| | - Ugo Cucinotta
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G.Barresi", University of Messina, Messina, Italy
| | - Paola Accorsi
- Pediatric Nutrition Team, Pediatric Unit of Santa Maria Nuova Hospital, Azienda Unit Sanitaria Locale di Reggio Emilia-IRCCS (AUSL-IRCCS), Reggio Emilia, Italy
| | - Valeria Dipasquale
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G.Barresi", University of Messina, Messina, Italy
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Valenzise M, Cucinotta U, Aversa T, Messina MF, Wasniewska M, Pajno GB. Transient hyperthyroidism in a 6-year-old girl with Epstein-Barr virus infection: a link between infectious mononucleosis and autoimmune thyroid disease. J BIOL REG HOMEOS AG 2021; 35:349-351. [PMID: 33634672 DOI: 10.23812/20-374-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- M Valenzise
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | - U Cucinotta
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | - T Aversa
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | - M F Messina
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | - M Wasniewska
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
| | - G B Pajno
- Department of Human Pathology of Adulthood and Childhood, University of Messina, Messina, Italy
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11
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Dipasquale V, Passanisi S, Cucinotta U, Cascio A, Romano C. Implications of SARS-COV-2 infection in the diagnosis and management of the pediatric gastrointestinal disease. Ital J Pediatr 2021; 47:71. [PMID: 33761992 PMCID: PMC7988257 DOI: 10.1186/s13052-021-01020-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 03/03/2021] [Indexed: 02/07/2023] Open
Abstract
Gastrointestinal diseases such as celiac disease, functional gastrointestinal disorders (FGIDs), inflammatory bowel disease (IBDs) and acute or chronic diarrhea are quite frequent in the pediatric population. The approach, the diagnosis and management can be changed in the 2019 coronavirus disease (COVID-19) pandemic era. This review has focused on: i) the current understanding of digestive involvement in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infected children and adolescents and the clinical implications of COVID-19 for pediatric gastroenterologists, ii) the impact of COVID-19 on the clinical approach to patients with pre-existing or onset diseases, including diagnosis and treatment, and iii) the role and limited access to the instrumental diagnosis such as digestive endoscopy. To date, it is unclear if immunosuppression in patients with IBD and chronic liver disease represents a risk factor for adverse outcomes. Scheduled outpatient follow-up visits may be postponed, especially in patients in remission. Conversely, telemedicine services are strongly recommended. The introduction of new therapeutic regimens should be made on an individual basis, discussing the benefits and risks with each patient. Furthermore, psychological care in all children with chronic disease and their parents should be ensured. All non-urgent and elective endoscopic procedures may be postponed as they must be considered at high risk of viral transmission. Finally, until SARS-CoV-2 vaccination is not available, strict adherence to standard social distancing protocols and the use of personal protective equipment should continue to be recommended.
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Affiliation(s)
- Valeria Dipasquale
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Via Consolare Valeria, 98124, Messina, Italy
| | - Stefano Passanisi
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Via Consolare Valeria, 98124, Messina, Italy
| | - Ugo Cucinotta
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Via Consolare Valeria, 98124, Messina, Italy
| | - Antonio Cascio
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Palermo, Italy
| | - Claudio Romano
- Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Via Consolare Valeria, 98124, Messina, Italy.
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12
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Cannavò L, Cucinotta U, Zirilli G, Lima M, Pajno GB, Wasniewska M, Valenzise M. Malignant insulinoma, a very rare cause of pediatric hypoglycemia. J BIOL REG HOMEOS AG 2020; 34:1167-1170. [PMID: 32638580 DOI: 10.23812/19-478-l-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- L Cannavò
- G. Martino Hospital, Pediatric Unit, Department of Adulthood and Chilhood Human Pathology, University of Messina, Messina, Italy
| | - U Cucinotta
- G. Martino Hospital, Pediatric Unit, Department of Adulthood and Chilhood Human Pathology, University of Messina, Messina, Italy
| | - G Zirilli
- G. Martino Hospital, Pediatric Unit, Department of Adulthood and Chilhood Human Pathology, University of Messina, Messina, Italy
| | - M Lima
- Sant'Orsola Hospital, Department of Pediatric Surgery, University of Bologna, Bologna, Italy
| | - G B Pajno
- G. Martino Hospital, Pediatric Unit, Department of Adulthood and Chilhood Human Pathology, University of Messina, Messina, Italy
| | - M Wasniewska
- G. Martino Hospital, Pediatric Unit, Department of Adulthood and Chilhood Human Pathology, University of Messina, Messina, Italy
| | - M Valenzise
- G. Martino Hospital, Pediatric Unit, Department of Adulthood and Chilhood Human Pathology, University of Messina, Messina, Italy
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13
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Cucinotta U, Mazza F, Pajno GB, Gallizzi R. Acute haemorrhagic oedema of infancy: a condition that is not always benign. BMJ Case Rep 2020; 13:13/11/e236059. [PMID: 33139355 DOI: 10.1136/bcr-2020-236059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Acute haemorrhagic oedema of infancy (AHOI) is a rare condition and an unusual diagnosis for the paediatrician, as approximately 300 cases have been reported in literature so far. Although it was considered for years a less serious variant of Henoch-Schönlein purpura, nowadays it is thought to be a different entity, with his own characteristics and clinical outcome. In literature it is described as a benign condition, self-limiting and without any systemic involvement in most of the cases. We present an atypical case of AHOI with a severe presentation and which needed an aggressive and prolonged steroid therapy.
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Affiliation(s)
- Ugo Cucinotta
- Department of Human Pathology in Adult and Developmental Age 'Gaetano Barresi', University of Messina, Messina, Sicilia, Italy
| | - Francesca Mazza
- Department of Human Pathology in Adult and Developmental Age 'Gaetano Barresi', University of Messina, Messina, Sicilia, Italy
| | - Giovanni Battista Pajno
- Department of Human Pathology in Adult and Developmental Age 'Gaetano Barresi', University of Messina, Messina, Sicilia, Italy
| | - Romina Gallizzi
- Department of Human Pathology in Adult and Developmental Age 'Gaetano Barresi', University of Messina, Messina, Sicilia, Italy
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14
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Dipasquale V, Cucinotta U, Romano C. Acute Malnutrition in Children: Pathophysiology, Clinical Effects and Treatment. Nutrients 2020; 12:nu12082413. [PMID: 32806622 PMCID: PMC7469063 DOI: 10.3390/nu12082413] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2020] [Revised: 07/31/2020] [Accepted: 08/10/2020] [Indexed: 11/16/2022] Open
Abstract
Acute malnutrition is a nutritional deficiency resulting from either inadequate energy or protein intake. Children with primary acute malnutrition are common in developing countries as a result of inadequate food supply caused by social, economic, and environmental factors. Secondary acute malnutrition is usually due to an underlying disease causing abnormal nutrient loss, increased energy expenditure, or decreased food intake. Acute malnutrition leads to biochemical changes based on metabolic, hormonal, and glucoregulatory mechanisms. Most children with primary acute malnutrition can be managed at home with nutrition-specific interventions (i.e., counseling of parents, ensuring household food security, etc.). In case of severe acute malnutrition and complications, inpatient treatment is recommended. Secondary acute malnutrition should be managed by treating the underlying cause.
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15
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Colavita L, Cucinotta U, Galletta F, Chimenz R, Nicocia G, Giannitto N, Ceravolo G, Sturiale M, Ceravolo A, Salpietro C, Cuppari C. Group A beta-hemolytic Streptococcus and heart in children. J BIOL REG HOMEOS AG 2020; 34:59-62. SPECIAL ISSUE: FOCUS ON PEDIATRIC CARDIOLOGY. [PMID: 33000602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- L Colavita
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - U Cucinotta
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - F Galletta
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - R Chimenz
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology, University of Messina, "G. Martino" Policlinic, Italy
| | - G Nicocia
- Department of clinical and Experimental medicine, University of Messina, "G. Martino" Policlinic, Italy
| | - N Giannitto
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - G Ceravolo
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - M Sturiale
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | | | - C Salpietro
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - C Cuppari
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
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16
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Meo F, Salpietro A, Ceravolo G, Concolino D, De Sarro R, Gitto E, Viola I, Sestito S, Cucinotta U, Giannitto N, Cuppari C, Corso M, Ceravolo MD, Calabrò MP, Chimenz R. Cardiovascular complications in children with chronic kidney injury. J BIOL REG HOMEOS AG 2020; 34:43-46. SPECIAL ISSUE: FOCUS ON PEDIATRIC CARDIOLOGY. [PMID: 33000599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- F Meo
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - A Salpietro
- Pediatric Clinic, ASST-Spedali Civili of Brescia, University of Brescia, Brescia, Italy
| | - G Ceravolo
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - D Concolino
- Department of Science of Health, University Magna Graecia of Catanzaro, Pediatric Unit, University of Catanzaro, Italy
| | - R De Sarro
- Department of Science of Health, University Magna Graecia of Catanzaro, Pediatric Unit, University of Catanzaro, Italy
| | - E Gitto
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Neonatal and Pediatric Intensive Care Unit, University of Messina, Messina, Italy
| | - I Viola
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - S Sestito
- Department of Science of Health, University Magna Graecia of Catanzaro, Pediatric Unit, University of Catanzaro, Italy
| | - U Cucinotta
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - N Giannitto
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - C Cuppari
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - M Corso
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - M D Ceravolo
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - M P Calabrò
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Cardiology, University of Messina, "G. Martino" Policlinic, Italy
| | - R Chimenz
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology, and Rheumatology with Dialysis, University of Messina, "G. Martino" Policlinic, Italy
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17
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Warm A, Gasbarro A, Concolino D, Sio A, Ceravolo G, Nicocia G, Ferrarolo C, Cucinotta U, Sestito S, Calabrò MP, Gitto E, Cordaro S. Preterm Patent Ductus Arteriosus: controversies overview. J BIOL REG HOMEOS AG 2020; 34:127-129. SPECIAL ISSUE: FOCUS ON PEDIATRIC CARDIOLOGY. [PMID: 33000612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- A Warm
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Neonatal and Pediatric Intensive Care Unit, University of Messina, Messina, Italy
| | - A Gasbarro
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Neonatal and Pediatric Intensive Care Unit, University of Messina, Messina, Italy
| | - D Concolino
- Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - A Sio
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - G Ceravolo
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - G Nicocia
- Department of clinical and Experimental medicine, University of Messina, "G. Martino" Policlinic, Italy
| | - C Ferrarolo
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - U Cucinotta
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatric, University of Messina, "G. Martino" Policlinic, Italy
| | - S Sestito
- Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - M P Calabrò
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Cardiology, University of Messina, "G. Martino" Policlinic, Italy
| | - E Gitto
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Neonatal and Pediatric Intensive Care Unit, University of Messina, Messina, Italy
| | - S Cordaro
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Neonatal and Pediatric Intensive Care Unit, University of Messina, Messina, Italy
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18
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Sestito S, Roppa K, Parisi F, Moricca MT, Pensabene L, Chimenz R, Ceravolo MD, Cucinotta U, Ceravolo G, Calabrò MP, Cuppari C, Mondello P, Musolino D, Tallarico V, Concolino D. The heart in Anderson-Fabry disease. J BIOL REG HOMEOS AG 2020; 34:63-69. SPECIAL ISSUE: FOCUS ON PEDIATRIC CARDIOLOGY. [PMID: 33000603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- S Sestito
- Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - K Roppa
- Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - F Parisi
- Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - M T Moricca
- Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - L Pensabene
- Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - R Chimenz
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology, University of Messina, "G. Martino" Policlinic, Italy
| | - M D Ceravolo
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - U Cucinotta
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - G Ceravolo
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - M P Calabrò
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Cardiology, University of Messina, "G. Martino" Policlinic, Italy
| | - C Cuppari
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - P Mondello
- Division of Hematology, Department of Human Pathology in Adulthood and Childhood "Gaetano Barresi", University of Messina, 98125 Messina, Italy
| | - D Musolino
- Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - V Tallarico
- Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy
| | - D Concolino
- Pediatric Unit, Department of Science of Health, University Magna Graecia of Catanzaro, Catanzaro, Italy
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19
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Chimenz R, Fede C, Di Benedetto V, Concolino D, Scuderi MG, Salvo V, Gitto E, Cucinotta U, Viola V, Betta P, Cannavò L, Cuppari C. Hemodialysis in children: how, when and why. J BIOL REG HOMEOS AG 2019; 33:87-89. Special Issue: Focus on Pediatric Nephrology. [PMID: 31630720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
End-stage renal diseases requiring chronic dialysis are rare in childhood and adolescence, but they are associated with high mortality and impaired quality of life (1, 2). The most common disease that causes chronic kidney disease (CKD) is primary glomerular disease (GD), followed by congenital abnormalities of the kidney and urinary tract, cystic, hereditary or congenital disorders and, more rarely, secondary GD. However, patients with secondary GD, urologic disorders, and metabolic diseases have greater mortality risk than patients with primary GD (3). Here, we focused on the different options of treatment available, and specifically we compared peritoneal dialysis and hemodialysis, showing pros and cons between them.
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Affiliation(s)
- R Chimenz
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - C Fede
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - V Di Benedetto
- Department of Pediatric Surgery "Policlinico-Vittorio Emanuele" of Catania, Italy
| | - D Concolino
- Department of Medical and Surgical Sciences, Pediatric Unit, "Magna Graecia" University, Catanzaro, Italy
| | - M G Scuderi
- Department of Pediatric Surgery "Policlinico-Vittorio Emanuele" of Catania, Italy
| | - V Salvo
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - E Gitto
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - U Cucinotta
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - V Viola
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - P Betta
- Neonatal Intensive Care Unit, Policlinico-Vittorio Emanuele" of Catania, Italy
| | - L Cannavò
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - C Cuppari
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
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20
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Chimenz R, Cannavò L, Spinuzza A, Fede C, Cucinotta U, Pensabene L, Betta P, Gitto E, Concolino D, Cuppari C. Unusual presentation of Henoch-Schönlein purpura. J BIOL REG HOMEOS AG 2019; 33:69-74. Special Issue: Focus on Pediatric Nephrology. [PMID: 31630717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Henoch Schonlein Purpura (HSP) is a systematic IgA-mediated vasculitic disease that affects the small vessels of the skin, the joints, the gastrointestinal tract and the kidneys (1). It is the most common childhood vaculitis, with an incidence estimated at 3-26 per 100,000 children, and with a male-to-female ratio of 2:1 (2-6). The 90% of patients are under 10 years of age, with a mean age of 4 years (4). It seems to be most common in fall and winter in children, and summer and winter in adults (7). Recent studies suggested a strong genetic predisposition in individuals with immunoglobulin Avasculitis (IgAV) associated to HLA class II region. Clinically, the non-thrombocytopenic purpura often located on lower extremities and buttocks is the essential element for the diagnosis of HSP. Treatment is supportive, because the disease is usually benign and self-limited. Indeed, in children, the prognosis is good, with a self-limited course and without any complications and after a median follow-up of 12 months, complete recovery was obtained in 83% of the IgAV patients (4, 8). The aim of our study is to describe some atypical presentations of the HSP in children.
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Affiliation(s)
- R Chimenz
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - L Cannavò
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - A Spinuzza
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - C Fede
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - U Cucinotta
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - L Pensabene
- Department of Medical and Surgical Sciences, Pediatric Unit, "Magna Graecia" University, Catanzaro, Italy
| | - P Betta
- Neonatal Intensive Care Unit, Policlinico-Vittorio Emanuele" of Catania, Italy
| | - E Gitto
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - D Concolino
- Department of Medical and Surgical Sciences, Pediatric Unit, "Magna Graecia" University, Catanzaro, Italy
| | - C Cuppari
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
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21
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D'Angelo G, Manti S, Marseglia L, De Cola C, Betta P, Cucinotta U, Concolino D, Falsaperla M, Fede C, Gitto E, Chimenz R. Clinical course of a pediatric series of multicystic dysplastic kidney. J BIOL REG HOMEOS AG 2019; 33:25-31. Special Issue: Focus on Pediatric Nephrology. [PMID: 31630710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- G D'Angelo
- Department of Clinical and Experimental Medicine, University of Messina, Italy
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - S Manti
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics.University of Messina, Policlinico "G. Martino" Messina, Italy
| | - L Marseglia
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - C De Cola
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - P Betta
- Neonatal Intensive Care Unit, Policlinico-Vittorio Emanuele" of Catania, Italy
| | - U Cucinotta
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G.Martino" Messina, Italy
| | - D Concolino
- Department of Medical and Surgical Sciences, Pediatric Unit, "Magna Graecia" University, Catanzaro, Italy
| | - M Falsaperla
- Department of Urology, Vittorio Emanuele Hospital, Catania, Italy
| | - C Fede
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - E Gitto
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - R Chimenz
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G.Martino"Messina, Italy
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22
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Chimenz R, Spinuzza A, Cannavò L, Di Benedetto V, Scuderi MG, Concolino D, D'Angelo G, Sallemi A, Fusco M, Cucinotta U, Fede C, Arrigo T, Cuppari C. Monosymptomatic enuresis: the therapeutic weapons. J BIOL REG HOMEOS AG 2019; 33:45-51. Special Issue: Focus on Pediatric Nephrology. [PMID: 31630713] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Nocturnal enuresis (NE) was defined by the World Health Organization (ICD-10) and the American Psychiatric Association (DSM-5) as bed-wetting in children aged >5 years. In cases of mental retardation, the developmental age may be equivalent to 5 years. In this review, we focus on the current knowledge about the etiology of enuresis and the most recent therapeutical options. Both non-pharmacological and pharmacological therapies are included, although the relative effectiveness of each remains uncertain. To date, motivational, alarm and drug therapies are the mainstay of treatment. Alarm therapy remains the first-line treatment modality for NE, while desmopressin is the most commonly used medical treatment.
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Affiliation(s)
- R Chimenz
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - A Spinuzza
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - L Cannavò
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - V Di Benedetto
- Department of Pediatric Surgery "Policlinico-Vittorio Emanuele" of Catania, Italy
| | - M G Scuderi
- Department of Pediatric Surgery "Policlinico-Vittorio Emanuele" of Catania, Italy
| | - D Concolino
- Department of Medical and Surgical Sciences, Pediatric Unit, "Magna Graecia" University, Catanzaro, Italy
| | - G D'Angelo
- Department of Clinical and Experimental Medicine, University of Messina, Italy
| | - A Sallemi
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - M Fusco
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - U Cucinotta
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - C Fede
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G.Martino" Messina, Italy
| | - T Arrigo
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - C Cuppari
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics.University of Messina, Policlinico "G.Martino" Messina, Italy
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23
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Bruni V, Petrisano M, Tarsitano F, Falvo F, Parisi F, Cucinotta U, Betta P, Di Benedetto V, Scuderi MG, Pensabene L, Sestito S, Cuppari C, Fede C, Chimenz R, Concolino D. Alport's syndrome. J BIOL REG HOMEOS AG 2019; 33:19-24. Special Issue: Focus on Pediatric Nephrology. [PMID: 31630709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Alport's syndrome (AS, OMIM 301050) is a hereditary disorder characterized by progressive renal failure, hearing impairment and ocular changes. It is clinically and genetically heterogeneous and in its natural history, renal disease progresses from microscopic haematuria to proteinuria, and finally to progressive renal insufficiency. AS is caused by an inherited defect in a type IV collagen, a structural material, expressed in many tissues that is essential for the normal function of different parts of the body. In most of cases, about the 85%, Alport's syndrome is X-linked and is originated by mutations in the COL4A5 gene. In the remaining cases, it may be inherited in either an autosomal recessive, or rarely in an autosomal dominant manner. Mostly, the condition is caused by mutations in the COL4A3 or COL4A4 genes. Coexisting mutations in COL4A3, COL4A4, COL4A5 or COL4A6 were found to cause an Alport's syndrome phenotype with digenic inheritance. Diagnosis of the condition is based on family history, clinical signs, and specific procedures such as a kidney biopsy. The diagnosis can be confirmed by genetic testing. Treatment may include use of a hearing aid, hemodialysis, and peritoneal dialysis to treat those with end-stage renal failure, and, as the last step, kidney transplantation. Firstly described by Arthur C. Alport's, in 1927, over the years it has become a pathology of high scientific interest. At the moment, thanks to advances in diagnostic techniques, it is possible to make an early diagnosis avoiding irreversible damages and life -threatening complications.
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Affiliation(s)
- V Bruni
- Department of Medical and Surgical Sciences, Pediatric Unit, "Magna Graecia" University, Catanzaro, Italy
| | - M Petrisano
- Department of Medical and Surgical Sciences, Pediatric Unit, "Magna Graecia" University, Catanzaro, Italy
| | - F Tarsitano
- Department of Medical and Surgical Sciences, Pediatric Unit, "Magna Graecia" University, Catanzaro, Italy
| | - F Falvo
- Department of Medical and Surgical Sciences, Pediatric Unit, "Magna Graecia" University, Catanzaro, Italy
| | - F Parisi
- Department of Medical and Surgical Sciences, Pediatric Unit, "Magna Graecia" University, Catanzaro, Italy
| | - U Cucinotta
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G.Martino" Messina, Italy
| | - P Betta
- Neonatal Intensive Care Unit, Policlinico-Vittorio Emanuele" of Catania, Italy
| | - V Di Benedetto
- Department of Pediatric Surgery "Policlinico-Vittorio Emanuele" of Catania, Italy
| | - M G Scuderi
- Department of Pediatric Surgery "Policlinico-Vittorio Emanuele" of Catania, Italy
| | - L Pensabene
- Department of Medical and Surgical Sciences, Pediatric Unit, "Magna Graecia" University, Catanzaro, Italy
| | - S Sestito
- Department of Medical and Surgical Sciences, Pediatric Unit, "Magna Graecia" University, Catanzaro, Italy
| | - C Cuppari
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G.Martino" Messina, Italy
| | - C Fede
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G.Martino"Messina, Italy
| | - R Chimenz
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G.Martino"Messina, Italy
| | - D Concolino
- Department of Medical and Surgical Sciences, Pediatric Unit, "Magna Graecia" University, Catanzaro, Italy
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24
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Chimenz R, Sallemi A, Fusco M, Cannavò L, Salvo V, Marseglia L, Cucinotta U, Gitto E, Concolino D, Arrigo T, Salpietro C. Local therapy with ozone in the management of the exit site in a patient undergoing peritoneal dialysis. J BIOL REG HOMEOS AG 2019; 33:91-94. Special Issue: Focus on Pediatric Nephrology. [PMID: 31630721] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The natural history of children with end stage renal disease is dialysis until a transplant can be done. There are two types of dialysis: hemodialysis and peritoneal dialysis (1). Peritoneal dialysis is preferred in young children because getting the vascular access for hemodialysis is challenging (2). Catheters should be surgically placed in a paramedian or lateral abdominal region with an extremity located in Douglas' pouch.
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Affiliation(s)
- R Chimenz
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Pediatric Nephrology and Rheumatology with Dialysis, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - A Sallemi
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - M Fusco
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - L Cannavò
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - V Salvo
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - L Marseglia
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - U Cucinotta
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - E Gitto
- Neonatal Intensive Care Unit, Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", University of Messina, Italy
| | - D Concolino
- Department of Medical and Surgical Sciences, Pediatric Unit, "Magna Graecia" University, Catanzaro, Italy
| | - T Arrigo
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
| | - C Salpietro
- Department of Human Pathology in Adult and Developmental Age "Gaetano Barresi", Unit of Emergency Pediatrics, University of Messina, Policlinico "G. Martino" Messina, Italy
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25
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Cucinotta U. Contributo clinico all’impiego dell’azoto-iprite nel trattamento dei tumori polmonari irricuperabili. Oncology 2009. [DOI: 10.1159/000223601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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26
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Cucinotta U. [Adhesives in surgical research]. MINERVA CHIR 1986; 41:465-8. [PMID: 3725077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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27
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Cucinotta U. [On the experimental use of some derivatives of cyanoacrylate in emergency surgery of the liver]. MINERVA CHIR 1974; 29:751-2. [PMID: 4842114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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28
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Cucinotta U. [The action of gastric mucoprotein in experimental ulcers]. Arch Sci Med (Torino) 1969; 126:637-43. [PMID: 17340817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Experimentally-induced ulcers in the dog (phenylquino!incarbonic acid) and in the rat (ligature of the pylorus, constriction) were treated with 20 mg/kg per day (dog) and 20 mg per animal per day (rat) of mucoprotein. The protective action excercised by this substance was demonstrated by increases in mean survival times and by the failure to apear, or by the more rapid regression, of lesions in the treated animals.
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29
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Navarra S, Cucinotta U, Romeo G, Basile M, Melita P, Di Mauro S, Cappello R, Gentile C. [Experimental autotransplantation of the lung. Histological study]. Chir Ital 1968; 20:1148-70. [PMID: 4914920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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30
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Navarra S, Cucinotta U, Romeo G, Montanini S, Basile M, Melita P, Cappello R, Pracanica G. [Autotransplantation of the lung. Experimental contribution to surgical technic]. Chir Ital 1968; 20:1086-117. [PMID: 4924304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
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