Nunzia Decembrino

Posaconazole oral dose and plasma levels in pediatric hematology-oncology patients

Posaconazole is a triazole with limited pharmacokinetic information in children. This study assessed the correlation between posaconazole oral solution daily dosage/kg/body weight and trough plasma level.

Retrospective study on the incidence and outcome of proven and probable invasive fungal infections in high-risk pediatric onco-hematological patients

Invasive fungal infection (IFI) is a cause of morbidity, mortality and increased health costs in children undergoing chemotherapy or hematopoietic stem cell transplant (HSCT).

Changes in the incidence of candidemia and related mortality in patients with hematologic malignancies in the last ten years. A SEIFEM 2015-B report

The epidemiology of invasive fungal infections (IFI) among patients with hematologic malignancies who are undergoing either conventional chemotherapy or hematopoietic stem cell transplantation (HSCT) is changing due to the introduction of new, effective antifungal agents for both prophylaxis and

Management of outbreaks in neonatal intensive care units

Outbreaks in neonatal intensive care units (NICUs) have disastrous consequences for neonates and raise enormous concerns in staff, altering usual practice patterns of the NICU. Our objective was to perform a systematic analysis for gaining insights into the control and prevention of NICUs outbreaks. Epidemiology, risk factors and outcomes are reviewed.

Multicenter randomized, double-blind controlled trial to evaluate the efficacy of laser therapy for the treatment of severe oral mucositis induced by chemotherapy in children: LaMPO RCT

To demonstrate the efficacy of laser photobiomodulation (PBM) compared to that of placebo on severe oral mucositis (OM) in pediatric oncology patients. The primary objective was the reduction of OM grade (World Health Organization [WHO] scale) 7 days after starting PBM. Secondary objectives were reduction of pain, analgesic consumption, and incidence of side effects.

Diagnosi prenatale tardiva di infezione da Toxoplasma Gondii: un grave caso di idrocefalo

We describe a case of severe fetal hydrocephalus due to Toxoplasmosis which could not be diagnosed until late gestational age due to the lack of a serologic surveillance during pregnancy. Abnormal ultrasound in the third trimester revealed a massive bilateral ventriculomegaly and Toxoplasma Gondii was demonstrated in maternal blood. This case is an example of severe fetal toxoplasmosis diagnosed in utero.

Patologia autoimmune: outcome gravidico e neonatale

The pregnancy of a woman with autoimmune disease should be considered at risk because of the inflammation process, the possible transplacental passage of maternal autoantibodies to the fetus and the possible conse-quences of the therapy performed during pregnancy. The purpose of this study was to evaluate the influence of autoimmune disease or autoantibody positivity on pregnancy and neonatal outcome. Data from 60 infants born to 55 women with autoimmune disease or with autoantibody positivity during pregnancy were collected. The results revealed a higher incidence of miscarriage (24.3% vs 10-15%), preterm (21% vs 5-9%) and low birth weight (<2500 g) (23.3% vs 10.5% ) in women with autoimmune disease than the general population. There was however no significant difference on the number of IUGR (6.7% vs 3-7%). The 45% of pregnant women presented obstetric complications. The assessment of antibody titers in infants showed positivity in 67.3% of those born from ANA positive mothers, 16/16 (100%) infants born to anti-SSA/Ro positive mothers were positive, as the only case of ENA Scl-70 positivity was trans-mitted, 4/5 (80%) of those born from mothers anti-SSB/La positive were positive. In our series, anti-SSA/Ro antibodies were present at birth in 16 infants, but no baby developed atrioventricular heart block, in agreement with the low rates found even in recent studies. There were no significative electrocardiographic abnormalities: nonspecific abnormalities of repolarization (22.91%), prevalence of right heart (33.3%), slightly lengthened cQT interval (4.17%). Ecographic investigations documented 2 cases of cardiac interventricular defect, and at cere-bral ultrasound 3 cases of intra-ventricular hemorrhage wich resulted in multicystic leukomalacia, 2 cases of white matter leukodystrophy with agenesis of the corpus callosum. Mild anemia (12.3% of the cases) and thrombocytopenia (5.4%) were detected. No cases of cholestasis were reported. In conclusion, for the increased risk of obstetric complications and the possible negative effects on the newborn, a careful monitoring of preg-nancies of women with autoimmune disease and a complete follow up of infants is necessary.

Considerazioni su un caso di pubertà precoce transitoria in neonata VLBW

Le cisti ovariche sono un reperto occasionale nei feti e nei neonati. Noi riportiamo il caso di una neonata di peso molto basso alla nascita con comparsa di cisti ovariche estradiolo secernenti in associazione ad edema dei geni-tali, imbibizione delle piccole e grandi labbra e presenza di bottone mammario bilaterale. La concentrazione dell’estradiolo era elevata. A quattro mesi di eta corretta si e osservata la regressione delle cisti e la riduzione dell’estradiolo nei range prepuberi. Gli elevati valori di gonadotropine placentari stimolano l’ovaio dei neonati pretermine a produrre cisti ovariche secernenti elevati livelli di estradiolo. Cio induce una transitoria stimolazio-ne dei genitali interni ed esterni come in una puberta precoce idiopatica o transitoria.