@article {10844, title = {Retrospective study showed that palpitations with tachycardia on admission to a paediatric emergency department were related to cardiac arrhythmias.}, journal = {Acta Paediatr}, volume = {108}, year = {2019}, month = {2019 Feb}, pages = {328-332}, abstract = {

AIM: This retrospective study reviewed the prevalence and long-term prognosis of children aged 0-18 with palpitations who were admitted to the emergency department (ED) of an Italian paediatric hospital.

METHODS: We examined all admissions to the ED of the IRCCS Burlo Garofolo between January 2009 and December 2015 by selecting triage diagnoses of palpitations. The hospital discharge cards were reviewed to assess vital parameters, physical examinations, diagnostic tests, cardiology consultations and final diagnoses.

RESULTS: Of the 142 803 patients who attended our ED for any reason, 96 (0.07\%) complained of palpitations. Despite this low prevalence, it was noteworthy that 13.5\% had a real underlying arrhythmic cause and needed medical assistance. Over half (52.1\%) were women and the mean age was 12.7 years. At the long-term follow-up, at a mean of 47 {\textpm} 23 months, 53.8\% of patients with a cardiac arrhythmia had received medical therapy and 46.1\% had undergone trans-catheter ablation for supraventricular tachycardia. A heart rate above 146 beats per minute or palpitations for more than an hour was statistically related to a cardiac arrhythmia.

CONCLUSION: Palpitations were an infrequent cause of admission to our ED, but 13.5\% who displayed them had an underlying cardiac arrhythmia.

}, issn = {1651-2227}, doi = {10.1111/apa.14486}, author = {Bobbo, Marco and Amoroso, Stefano and Tamaro, Gianluca and Gesuete, Valentina and D{\textquoteright}agata Mottolese, Biancamaria and Barbi, Egidio and Ventura, Alessandro} } @article {10864, title = {Red Flags in Torticollis: A Historical Cohort Study.}, journal = {Pediatr Emerg Care}, volume = {34}, year = {2018}, month = {2018 Jul}, pages = {463-466}, abstract = {

OBJECTIVE: This study aimed to assess the spectrum of pathologies responsible for torticollis in children presenting to the emergency department and to evaluate the associated symptoms to determine clinical red flags for hospitalization.

METHODS: This was a historical retrospective cohort study. Medical records of children evaluated in our emergency department for torticollis from 2008 to 2013 were reviewed.

RESULTS: Among 392 identified patients, 61\% had postural torticollis,19.4\% infection related, 16.3\% traumatic, and 3.5\% other. Twenty-five patients (6.4\%) were hospitalized. Four variables were strongly and independently related to the severe outcome: fever, sore throat, headache, and age.

CONCLUSIONS: The association of 2 or 3 of these 4 features carried a risk of 32\% and 58\%, respectively, of having a severe illness.

}, keywords = {Adolescent, Child, Child, Preschool, Cohort Studies, Emergency Service, Hospital, Female, Hospitalization, Humans, Male, Retrospective Studies, Torticollis}, issn = {1535-1815}, doi = {10.1097/PEC.0000000000001377}, author = {Starc, Meta and Norbedo, Stefania and Tubaro, Martina and Ronfani, Luca and Bassanese, Giulia and Barbi, Egidio} } @article {10551, title = {Risk of hospitalisation after early-revisit in the emergency department.}, journal = {J Paediatr Child Health}, volume = {53}, year = {2017}, month = {2017 Sep}, pages = {850-854}, abstract = {

AIM: Early-revisits are frequent in the paediatric emergency department (ED) setting, but few data are available about early-revisited patients. The aim of this study was to investigate the hospitalisation rate of a population of early-revisited patients and to detect if an early-revisited patient was at risk of a more severe disease.

METHODS: Between June 2014 and January 2015, we conducted a retrospective cohort study, considering all patients presented to the ED of a tertiary level children{\textquoteright}s hospital in Italy. We selected all patients who were revisited within 72 h from the initial visit (study cohort), while all other patients accessed in the same period were considered the control cohort. The two cohorts were compared for age, gender, triage category, hospitalisation rate, diagnosis at admission and hospital length of stay.

RESULTS: In the study period, we reviewed 10 750 visits, of which 430 (4\%) were unplanned revisits for the same chief complaint within 72 h from the initial visit. Hospitalisation rate of early-revisited patients was significantly higher compared to control patients (8.4 vs. 2.9\%). Hospitalisation rate increases in parallel with the number of revisits, but in many cases, it was not directly related to a worst triage category, neither to a longer hospital length of stay.

CONCLUSION: Early revisited patients in the ED had a significantly higher risk of hospitalisation, but this risk was only partially related to their clinical conditions.

}, keywords = {Adolescent, Child, Child, Preschool, Emergency Service, Hospital, Female, Hospitalization, Humans, Infant, Italy, Male, Retrospective Studies, Risk Assessment, Tertiary Care Centers, Time Factors}, issn = {1440-1754}, doi = {10.1111/jpc.13561}, author = {Cozzi, Giorgio and Ghirardo, Sergio and Fiorese, Ilaria and Proietti, Ilaria and Monasta, Lorenzo and Minute, Marta and Barbi, Egidio and Calligaris, Lorenzo} } @article {3578, title = {Re: Tramadol can selectively manage moderate pain in children following European advice limiting codeine use.}, journal = {Acta Paediatr}, volume = {103}, year = {2014}, month = {2014 Nov}, pages = {e466}, issn = {1651-2227}, doi = {10.1111/apa.12763}, author = {Calligaris, Lorenzo and Marzuillo, Pierluigi and Barbi, Egidio} }