@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 {8490, title = {Torticollis as the Presenting Sign of Cervical Spondylodiscitis.}, journal = {Pediatr Emerg Care}, year = {2016}, month = {2016 Feb 10}, abstract = {

Acquired torticollis is a common clinical finding in children evaluated in the pediatric emergency department. It may be the presentation symptom of different illnesses, such as trauma, muscle contraction, infections, or malignancies, and an accurate differential diagnosis is required to correctly identify the cause and choose the right treatment. Spondylodiscitis is a low-grade bacterial infection that involves intervertebral disks and the adjacent vertebral bodies. Spondylodiscitis of the cervical spine is unusual and may be a rare cause of torticollis. We report the case of a 4-year-old male patient admitted to the emergency department for a 5-day history of painful torticollis. Blood tests showed an elevated erythrocyte sedimentation rate. The radiograph of the cervical spine showed a thin fifth cervical soma. The magnetic resonance imaging of cervical spine showed the alteration of cervical vertebral bodies and intervertebral disks, suggesting the diagnosis of cervical spondylodiscitis. The patient recovered after endovenous antibiotic treatment. We suggest that cervical spondylodiscitis should be suspected and investigated by means of an magnetic resonance imaging in every case of unexplained torticollis with persisting symptoms.

}, issn = {1535-1815}, doi = {10.1097/PEC.0000000000000643}, author = {Pizzol, Antonio and Bramuzzo, Matteo and Pillon, Roberto and Taddio, Andrea and Barbi, Egidio} } @article {3573, title = {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 = {1110-6}, abstract = {

UNLABELLED: The European Medicine Agency recommendations limiting codeine use in children have created a void in managing moderate pain. We review the evidence on the pharmacokinetic, pharmacodynamic and safety profile of tramadol, a possible substitute for codeine.

CONCLUSION: Tramadol appears to be safe in both paediatric inpatients and outpatients. It may be appropriate to limit the current use of tramadol to monitored settings in children with risk factors for respiratory depression, subject to further safety evidence.

}, issn = {1651-2227}, doi = {10.1111/apa.12738}, author = {Marzuillo, Pierluigi and Calligaris, Lorenzo and Barbi, Egidio} } @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} }