Dionigi Ribaldone

Late intravenous gamma globulin treatment in infants and children with Kawasaki disease and coronary artery abnormalities

Abstract Kawasaki disease or mucocutaneous lymph node syndrome is a febrile illness affecting infants and children. The major complication leading to mortality and morbidity is the development of coronary artery aneurysms or ectasia, occurring in approximately 10 to 25% of the patients affected by this disease. 1–3 High-dose intravenous gamma globulin is effective in reducing the incidence of coronary artery abnormalities. 1,4 If this treatment is not administered within 10 days from the onset of the disease, its efficacy is questionable. 1,5 This study assesses the effect of a later gamma globulin treatment on the course of established coronary artery abnormalities.

Balloon dilatation of critically obstructed modified (polytetrafluoroethylene) Blalock-Taussig shunts

Abstract Balloon dilatation is increasingly used to treat a wide range of congenital and acquired vascular stenoses in infancy and childhood. 1–4 However, to our knowledge, there has been only 1 published report of a successful dilatation of a stenosed modified (polytetrafluoroethylene) Blalock-Taussig shunt. 5 In our report, we have reviewed the technique used and the results obtained in 8 patients with critically stenosed or completely occluded graft.

Early treatment of patent ductus arteriosus in premature infants with severe respiratory distress syndrome

SummaryIn 1983, a US National Collaborative Study (NCS) proposed criteria for the diagnosis of hemodynamically significant patent ductus arteriosus (PDA) in premature infants with respiratory distress syndrome (RDS), but the widespread use of pulsed Doppler cross-sectional echocardiography (PD-CSE) in neonatal intensive care units has made direct assessment of the ductus possible thus providing more timely therapy. We have compared the results in 30 premature infants with severe RDS, assessed according to the guidelines of the US NCS, with those in 51 infants whose PDA was diagnosed by PD-CSE. Together with a significant reduction in the age at treatment (7.8±3.9 vs 2.4±1.1 days), there was a reduced dependence on artificial ventilation (14.8±11.0 vs 7.8±2.7 days), a reduction in the number requiring surgical ligation of PDA (9 vs 2), a decreased incidence of bronchopulmonary-dysplasia (BPD) (40% vs 16%), and a reduction of unfavorable outcome of treatment (death or BPD) (76% vs 49%).

Unusual ultrasound finding of patent ductus arteriosus in a preterm infant

SummaryPatency of the ductus arteriosus (PDA) is a common finding in small premature infants. Recently pulsed-Doppler-cross sectional echocardiography (PD-CSE) has been successfully used in these patients. We report a case of a premature infant with an unusual PD-CSE pattern.