@article {10848, title = {Teaching pain recognition through art: the Ramsay-Caravaggio sedation scale.}, journal = {Ital J Pediatr}, volume = {44}, year = {2018}, month = {2018 Jan 31}, pages = {20}, abstract = {

BACKGROUND: Clinical observation is a key component of medical ability, enabling immediate evaluation of the patient{\textquoteright}s emotional state and contributing to a clinical clue that leads to final decision making. In medical schools, the art of learning to look can be taught using medical humanities and especially visual arts. By presenting a Ramsay sedation score (RSS) integrated with Caravaggio{\textquoteright}s paintings during a procedural sedation conference for pediatric residents, we want to test the effectiveness of this approach to improve the quality of learning.

METHODS: In this preliminary study, we presented videos showing sedated pediatric patients in the setting of a procedural sedation lesson to two randomized groups of residents, one attending a lesson on RSS explained through the masterpieces of Caravaggio, the other without artistic support. A week later we tested their learning with ten multi-choice questions focused on theoretical questions about sedation monitoring and ten more questions focused on recognizing the appropriate RSS viewing the videos. The primary outcome was the comparison of the total number of RSS layers properly recognized in both groups. We also evaluated the appreciation of the residents of the use of works of art integrated with the lesson.

RESULTS: Eleven students were randomized to each group. Two residents in the standard lesson did not attend the test. The percentage of correct answers on the theoretical part was similar, 82\% in the art group and 89\% in the other (p > 0.05). No difference was found in the video recognition part of the RSS recognition test. Residents exposed to paintings shown great appreciation for the integration of the lesson with the Caravaggio{\textquoteright}s masterpieces.

CONCLUSIONS: Adding artwork to a standard medical conference does not improve the performance of student tests, although this approach has been greatly appreciated by residents.

}, keywords = {Clinical Competence, Conscious Sedation, Deep Sedation, Education, Medical, Graduate, Female, Hospitals, University, Humans, Internship and Residency, Italy, Male, Medicine in the Arts, Monitoring, Physiologic, Pain Measurement, Paintings, Pediatrics, Video Recording}, issn = {1824-7288}, doi = {10.1186/s13052-018-0453-5}, author = {Poropat, Federico and Cozzi, Giorgio and Magnolato, Andrea and Monasta, Lorenzo and Borrometi, Fabio and Krauss, Baruch and Ventura, Alessandro and Barbi, Egidio} } @article {10478, title = {A Teenager with Sudden Unilateral Breast Enlargement.}, journal = {J Pediatr}, volume = {182}, year = {2017}, month = {2017 03}, pages = {394}, keywords = {Bullying, Child, Gynecomastia, Hematoma, Humans, Male, Wounds, Nonpenetrating}, issn = {1097-6833}, doi = {10.1016/j.jpeds.2016.11.044}, author = {Pellegrin, Maria Chiara and Naviglio, Samuele and Cattaruzzi, Elisabetta and Barbi, Egidio and Ventura, Alessandro} } @article {8494, title = {Thalidomide for inflammatory bowel disease: Systematic review.}, journal = {Medicine (Baltimore)}, volume = {95}, year = {2016}, month = {2016 Jul}, pages = {e4239}, abstract = {

BACKGROUND: Thalidomide is an immunomodulatory drug used in the experimental treatment of refractory Crohn disease and ulcerative colitis. We aimed to review the existing evidence on the efficacy and safety of thalidomide in the treatment of inflammatory bowel diseases.

METHODS: CENTRAL, MEDLINE, LILACS, POPLINE, CINHAL, and Web of Science were searched in March 2016. Manual search included conference and reference lists. All types of studies, except single case reports, were included. Outcomes evaluated were: induction of remission; maintenance of remission; steroid reduction; effect on penetrating Crohn disease; endoscopic remission; adverse events.

RESULTS: The research strategies retrieved 722 papers. Two randomized controlled trials and 29 uncontrolled studies for a total of 489 patients matched the inclusion criteria. Thalidomide induced a clinical response in 296/427 (69.3\%) patients. Clinical remission was achieved in 220/427 (51.5\%) cases. Maintenance of remission was reported in 128/160 (80.0\%) patients at 6 months and in 96/133 (72.2\%) at 12 months. Reduction in steroid dosage was reported in 109/152 (71.7\%) patients. Fistulas improved in 49/81 (60.5\%) cases and closed in 28/81 (34.6\%). Endoscopic improvement was observed in 46/66 (69.7\%) and complete mucosal healing in 35/66 (53.0\%) patients. Cumulative incidence of total adverse events and of those leading to drug suspension was 75.6 and 19.7/1000 patient-months, respectively. Neurological disturbances accounted for 341/530 (64.3\%) adverse events and were the most frequent cause of drug withdrawal.

CONCLUSION: Existing evidence suggests that thalidomide may be a valid treatment option for patients with inflammatory bowel diseases refractory to other first- and second-line treatments.

}, issn = {1536-5964}, doi = {10.1097/MD.0000000000004239}, author = {Bramuzzo, Matteo and Ventura, Alessandro and Martelossi, Stefano and Lazzerini, Marzia} } @article {8319, title = {Thiopurine Biotransformation and Pharmacological Effects: Contribution of Oxidative Stress.}, journal = {Curr Drug Metab}, volume = {17}, year = {2016}, month = {2016}, pages = {542-9}, abstract = {

BACKGROUND: Thiopurine antimetabolites are important agents for the treatment of severe diseases, such as acute lymphoblastic leukemia and inflammatory bowel disease. Their pharmacological actions depend on biotransformation into active thioguanine-nucleotides; intracellular metabolism is mediated by enzymes of the salvage pathway of nucleotide synthesis and relies on polymorphic enzymes involved in thiopurines{\textquoteright} catabolism such as thiopurine-S-methyl transferase. Given the enzymes involved in thiopurines{\textquoteright} metabolism, it is reasonable to hypothesize that these drugs are able to induce significant oxidative stress conditions, possibly altering their pharmacological activity.

METHODS: A systemic search of peer-reviewed scientific literature in bibliographic databases has been carried out. Both clinical and preclinical studies as well as mechanistic studies have been included to shed light on the role of oxidative stress in thiopurines{\textquoteright} pharmacological effects.

RESULTS: Sixty-nine papers were included in our review, allowing us to review the contribution of oxidative stress in the pharmacological action of thiopurines. Thiopurines are catabolized in the liver by xanthine oxidase, with potential production of reactive oxidative species and azathioprine is converted into mercaptopurine by a reaction with reduced glutathione, that, in some tissues, may be facilitated by glutathione- S-transferase (GST). A clear role of GSTM1 in modulating azathioprine cytotoxicity, with a close dependency on superoxide anion production, has been recently demonstrated. Interestingly, recent genome-wide association studies have shown that, for both azathioprine in inflammatory bowel disease and mercaptopurine in acute lymphoblastic leukemia, treatment effects on patients{\textquoteright} white blood cells are related to variants of a gene, NUDT15, involved in biotransformation of oxidated nucleotides.

CONCLUSIONS: Basing on previous evidences published in literature, oxidative stress may contribute to thiopurine effects in significant ways that, however, are still not completely elucidated.

}, issn = {1875-5453}, author = {Pelin, Marco and De Iudicibus, Sara and Londero, Margherita and Spizzo, Riccardo and Dei Rossi, Sveva and Martelossi, Stefano and Ventura, Alessandro and Decorti, Giuliana and Stocco, Gabriele} } @article {7747, title = {Three cases of Bartonella quintana infection in children.}, journal = {Pediatr Infect Dis J}, volume = {34}, year = {2015}, month = {2015 May}, pages = {540-2}, abstract = {

We present 3 children affected by B. quintana infection treated at the IRCCS Burlo Garofolo of Trieste between March and April 2013. B. quintana infection is rare but it should be suspected in patients with fever and lymphadenopathy who do not respond to conventional antibiotic treatment. All patients had a complete recovery without sequelae or relapses.

}, issn = {1532-0987}, doi = {10.1097/INF.0000000000000666}, author = {Magnolato, Andrea and Pederiva, Federica and Spagnut, Giulia and Maschio, Massimo and Ventura, Alessandro and Taddio, Andrea} } @article {7749, title = {Treatment of asthma based on symptoms.}, journal = {J Pediatr}, volume = {166}, year = {2015}, month = {2015 May}, pages = {1324-5}, keywords = {Asthma, Female, Humans, Male, Spirometry}, issn = {1097-6833}, doi = {10.1016/j.jpeds.2015.01.029}, author = {Bibalo, Cristina and Longo, Giorgio and Ventura, Alessandro} } @article {1994, title = {Is treatment with hydroxychloroquine effective in surfactant protein C deficiency?}, journal = {Arch Bronconeumol}, volume = {49}, year = {2013}, month = {2013 May}, pages = {213-5}, abstract = {

We present the case of two twin brothers with surfactant protein C deficiency who were treated with hydroxychloroquine for three years, with apparent success. The exact physiopathology of this disease is not known and there is no specific treatment for it. There is merely news from a few previous descriptions in the literature about the use of hydroxychloroquine for surfactant protein C deficiency with satisfactory results. Two years after the treatment was withdrawn, the twins were evaluated once again: they presented no new infections, growth and general state were normal and chest CT showed a notable additional reduction in the interstitial pneumopathy. These data seem to cast some doubt on the efficacy of hydroxychloroquine, and they suggest that the clinical improvement was simply the natural evolution of the disease.

}, keywords = {Disease Progression, Diseases in Twins, Dyspnea, Failure to Thrive, Humans, Hydroxychloroquine, Infant, Newborn, Male, Pulmonary Alveolar Proteinosis, Pulmonary Surfactant-Associated Protein C, Respiratory Insufficiency, Tomography, X-Ray Computed, Twins, Monozygotic}, issn = {1579-2129}, doi = {10.1016/j.arbres.2012.08.005}, author = {Rabach, Ingrid and Poli, Furio and Zennaro, Floriana and Germani, Claudio and Ventura, Alessandro and Barbi, Egidio} } @article {1836, title = {Type 1 diabetes mellitus and celiac disease: usefulness of gluten-free diet.}, journal = {Acta Diabetol}, volume = {50}, year = {2013}, month = {2013 Oct}, pages = {821-2}, issn = {1432-5233}, doi = {10.1007/s00592-011-0316-7}, author = {Pascolo, Paola and Faleschini, Elena and Tonini, Giorgio and Ventura, Alessandro} } @article {1816, title = {Thromboembolism in pediatric inflammatory bowel disease: systematic review.}, journal = {Inflamm Bowel Dis}, volume = {17}, year = {2011}, month = {2011 Oct}, pages = {2174-83}, abstract = {

BACKGROUND: Several studies suggest an increased risk of venous and arterial thromboembolism (TE) in adults with inflammatory bowel disease (IBD) compared to the general population. We performed a systematic review of studies on incidence and characteristic of TE in children with IBD.

METHODS: We searched Medline, LILACS, EMBASE, POPLINE, CINHAL, and reference lists of identified articles, without language restrictions, in August 2010.

RESULTS: Population studies suggest that there is an increased risk of TE in children with IBD compared to controls. TE occurred in children with IBD in all age ranges, mostly (82.8\%) during active disease, and more frequently in children with ulcerative colitis (odds ratio [OR] 3.7, 95\% confidence interval [CI] 1.8-7.6). At least one specific risk factor for TE was recognized in 50\% of cases; two risk factors were present in 24\%. Out of 92 published cases of TE in children with IBD, 54.3\% occurred in cerebral site, 26\% in the limbs, 13\% in the abdominal vessels, and the remaining in the retina and lungs. After a first episode of TE, an early recurrence was observed in 11.4\% of children, a late recurrence in 10\%. A number of different therapeutic schemes were used. Overall mortality was 5.7\% and was mostly associated with cerebral TE.

CONCLUSIONS: Population studies are needed to clarify the risk of TE in children with IBD, the relative weight of other risk factors, the characteristics of the events, and to define guidelines of therapy and prophylaxis.

}, keywords = {Adult, Child, Humans, Inflammatory Bowel Diseases, Risk Factors, Thromboembolism}, issn = {1536-4844}, doi = {10.1002/ibd.21563}, author = {Lazzerini, Marzia and Bramuzzo, Matteo and Maschio, Massimo and Martelossi, Stefano and Ventura, Alessandro} } @article {1763, title = {Two lumens, one diagnosis.}, journal = {J Pediatr}, volume = {159}, year = {2011}, month = {2011 Sep}, pages = {511}, keywords = {Capsule Endoscopy, Child, Preschool, Gastrointestinal Hemorrhage, Humans, Male, Meckel Diverticulum, Recurrence}, issn = {1097-6833}, doi = {10.1016/j.jpeds.2011.04.041}, author = {Pastore, Serena and Gortani, Giulia and Maschio, Massimo and Di Leo, Grazia and Ventura, Alessandro} } @article {1665, title = {Therapeutic strategy in p47-phox deficient chronic granulomatous disease presenting as inflammatory bowel disease.}, journal = {J Allergy Clin Immunol}, volume = {125}, year = {2010}, month = {2010 Apr}, pages = {943-946.e1}, keywords = {Age of Onset, Anti-Bacterial Agents, Antibodies, Monoclonal, Child, Drug Therapy, Combination, Gene Deletion, Granulomatous Disease, Chronic, Humans, Inflammatory Bowel Diseases, Male, NADPH Oxidase, Steroids, Treatment Outcome, Vidarabine}, issn = {1097-6825}, doi = {10.1016/j.jaci.2010.01.035}, author = {Freudenberg, Folke and Wintergerst, Uwe and Roesen-Wolff, Angela and Albert, Michael H and Prell, Christine and Strahm, Brigitte and Koletzko, Sibylle and Ehl, Stephan and Roos, Dirk and Tommasini, Alberto and Ventura, Alessandro and Belohradsky, Bernd H and Seger, Reinhard and Roesler, Joachim and G{\"u}ng{\"o}r, Tayfun} }