TY - JOUR T1 - A congenital purplish tumour. JF - Arch Dis Child Educ Pract Ed Y1 - 2017 A1 - Matarazzo, L A1 - Delise, A A1 - Zennaro, F A1 - Bussani, R A1 - Demarini, S A1 - Berti, I A1 - Ventura, A KW - Congenital Abnormalities KW - Humans KW - India KW - Infant KW - Infant, Newborn KW - Knee KW - Male KW - Neonatology KW - Neoplasms KW - Treatment Outcome VL - 102 IS - 2 U1 - http://www.ncbi.nlm.nih.gov/pubmed/26908941?dopt=Abstract ER - TY - JOUR T1 - HLA-B35, a common genetic trait, in a familial case of Henoch-Schoenlein purpura and Berger's disease. JF - Genet Mol Res Y1 - 2014 A1 - Pellegrin, M C A1 - Matarazzo, L A1 - Neri, E A1 - Pennesi, M A1 - Crovella, S KW - Adolescent KW - Child KW - Female KW - Genotype KW - Glomerulonephritis, IGA KW - HLA-B35 Antigen KW - Humans KW - Male KW - Middle Aged KW - Nephritis KW - Phenotype KW - Purpura, Schoenlein-Henoch AB -

Nephritis characterized by IgA mesangial depositions has been described both in Henoch-Schoenlein purpura (HSP) and in Berger's disease (BD), but common genetic traits are still uncertain. We report here the case of two brothers, the first affected by HSP with persistent nephritis and the second by BD, accidentally discovered as silent microhematuria 1 year after HSP onset in the first brother. HLA genotyping demonstrated the presence of HLA-B35 in both patients. Our findings reinforce the need to screen for urinary abnormalities in family members of patients affected by HSP nephritis to identify a silent IgA nephropathy.

VL - 13 IS - 2 U1 - http://www.ncbi.nlm.nih.gov/pubmed/24782055?dopt=Abstract ER - TY - JOUR T1 - Does EMLA cream application interfere with the success of venipuncture or venous cannulation? A prospective multicenter observational study. JF - Eur J Pediatr Y1 - 2013 A1 - Schreiber, S A1 - Ronfani, L A1 - Chiaffoni, G P A1 - Matarazzo, L A1 - Minute, M A1 - Panontin, E A1 - Poropat, F A1 - Germani, C A1 - Barbi, E KW - Anesthetics, Local KW - Catheterization, Peripheral KW - Child KW - Child, Preschool KW - Female KW - Humans KW - Lidocaine KW - Logistic Models KW - Male KW - Ointments KW - Phlebotomy KW - Prilocaine KW - Prospective Studies KW - Vasoconstriction AB -

UNLABELLED: Venipuncture and intravenous cannulation are the most common painful procedures performed on children. The most widely used topical anesthetic is eutectic mixture of local anesthetics (EMLA). EMLA use is associated with a transient cutaneous vasoconstriction which can make it difficult to identify veins. We assessed with a prospective, multicenter, observational study whether EMLA interferes with venipuncture and intravenous cannulation. The primary study outcome was a success at first attempt in the course of venipuncture or venous cannulation. The study enrolled 388 children; 255 of them received EMLA and 133 did not. Eighty-six percent of procedures were successful at the first attempt in the EMLA group and 76.7 % in the no EMLA group.

CONCLUSION: In this study, EMLA use did not interfere with the success of venipuncture or venous cannulation in children.

VL - 172 IS - 2 U1 - http://www.ncbi.nlm.nih.gov/pubmed/23093138?dopt=Abstract ER - TY - JOUR T1 - Adverse effects during specific oral tolerance induction: in home phase. JF - Allergol Immunopathol (Madr) Y1 - 2012 A1 - Barbi, E A1 - Longo, G A1 - Berti, I A1 - Matarazzo, L A1 - Rubert, L A1 - Saccari, A A1 - Lenisa, I A1 - Ronfani, L A1 - Radillo, O A1 - Ventura, A KW - Adolescent KW - Adult KW - Age Factors KW - Allergens KW - Child KW - Child, Preschool KW - Desensitization, Immunologic KW - Epinephrine KW - Female KW - Food Hypersensitivity KW - Humans KW - Immune Tolerance KW - Immunoglobulin E KW - Male KW - Milk Hypersensitivity KW - Nebulizers and Vaporizers AB -

BACKGROUND: Specific oral tolerance induction (SOTI) is a promising approach for severe food allergies. There are little data in the literature regarding the home-phase of SOTI, not only with regard to type and frequency of adverse reactions but also regarding the most suitable treatment and protocol.

AIMS: To define the incidence and severity of adverse reactions, possible risk factors, and the safety and effectiveness of the home-phase of an original SOTI protocol in a large group of children with severe cow's milk (CM) allergy, after the hospital "rush" phase.

METHODS: The study was conducted by recording in-home phase adverse events, success and failure as reported by parents, and calling families. Adverse reactions were treated following the International Guidelines, arbitrarily modified by introducing nebulised epinephrine for respiratory reactions, oral beclomethasone for acute gastric pain and oral cromolyn for recurrent gastric pain.

RESULTS: Out of 140 patients, 132 were contacted; eight were inaccessible (follow-up 2-84 months). The number of adverse reactions was 1 in every 100 doses. The reactions were treated with nebulised epinephrine (221 reactions), IM epinephrine (6 reactions), and other drugs. Patients with high specific IgE levels (greater than 100 kU(A)/L) and lower CM dose (less than 5 ml) at the end of in-hospital phase showed a higher risk both for number of reactions and use of nebulised epinephrine.

CONCLUSIONS: The home phase of SOTI was characterised by a significant number of adverse reactions, mostly managed with an acceptable rate of side effects. Nebulised epinephrine played a pivotal role in respiratory reactions.

VL - 40 IS - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/21802824?dopt=Abstract ER - TY - JOUR T1 - Adverse effects during specific oral tolerance induction: in-hospital "rush" phase. JF - Eur Ann Allergy Clin Immunol Y1 - 2012 A1 - Barbi, E A1 - Longo, G A1 - Berti, I A1 - Neri, E A1 - Saccari, A A1 - Rubert, L A1 - Matarazzo, L A1 - Montico, M A1 - Ventura, A KW - Administration, Inhalation KW - Anaphylaxis KW - Animals KW - Bronchodilator Agents KW - Child KW - Desensitization, Immunologic KW - Epinephrine KW - Humans KW - Milk KW - Milk Hypersensitivity KW - Retrospective Studies AB -

BACKGROUND: Specific oral tolerance induction (SOTI) is a promising approach in the treatment of severe food allergies. Different protocols have demonstrated its efficacy. Nevertheless, SOTI is still considered an experimental method and should be limited to highly controlled settings.

AIMS: To define the incidence and severity of adverse reactions, possible risk factors, and the safety and effectiveness of nebulized epinephrine as a first-line treatment of respiratory reactions during in-hospital SOTI for cow's milk allergy.

MATERIALS AND METHODS: A retrospective study was conducted by reviewing the medical records of patients admitted for SOTI beginning in 2001. Reactions were classified as mild, moderate and severe on a partially modified Clark scale. Adverse reactions were treated following the International Guidelines with the introduction of nebulized epinephrine for level four reactions.

RESULTS: Of 209 patients, 17 were excluded due to the absence of objective reactions. The remaining 192 were classified as follows: Mild Reactions (Clark Scale 1 to 3): 100 patients received either no treatment, oral antihistamines or nebulized steroids; Moderate Reactions (Clark Scale 4): 87 patients treated with nebulized epinephrine and, depending on their symptoms, oral antihistamines, corticosteroids (nebulized, oral or IV) or nebulized beta 2 agonists; Severe Reactions (Clark Scale 5): 5 children, 4 of whom initially underwent one nebulization of epinephrine and eventually required an IM dose. The fifth patient was immediately treated with IM epinephrine due to hypotension.

DISCUSSION: adverse reactions during this in-hospital SOTI protocol were frequent but easily manageable. Nebulized epinephrine can play a relevant role in the treatment of respiratory reactions.

VL - 44 IS - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/22519128?dopt=Abstract ER - TY - JOUR T1 - Diagnosed child, treated child: food challenge as the first step toward tolerance induction in cow's milk protein allergy. JF - Eur Ann Allergy Clin Immunol Y1 - 2012 A1 - Longo, G A1 - Berti, I A1 - Barbi, E A1 - Calligaris, L A1 - Matarazzo, L A1 - Radillo, O A1 - Ronfani, L A1 - Ventura, A KW - Administration, Oral KW - Adolescent KW - Animals KW - Cattle KW - Child KW - Child, Preschool KW - Humans KW - Immune Tolerance KW - Infant KW - Milk Hypersensitivity KW - Milk Proteins KW - Self Administration AB -

BACKGROUND: Food challenge is required to assess tolerance in cow milk (CM) allergy. A positive challenge contraindicates the reintroduction of CM. Specific oral tolerance induction (SOTI) is a promising treatment.

METHODS: All children admitted for a challenge were prospectively enrolled. To those tolerating between 2 and 150 ml a SOTI protocol was offered. Outcome, adverse reactions, parents' satisfaction were recorded.

RESULTS: Out of 245 challenged patients, 175 reacted 122 out of 125, able to tolerate a minimum dose of 2 ml, underwent SOTI. After one year 75.4% were in an unrestricted diet, 16.1% tolerated between 5 and 150 ml, 8.5% stopped SOTI. Side effects were mild, parents' satisfaction was very high.

CONCLUSIONS: The majority of children tolerating limited amounts of CM at the challenge acquires tolerance with SOTI without relevant side effects. Maintaining on an exclusion diet partially tolerant children should be considered debatable.

VL - 44 IS - 2 U1 - http://www.ncbi.nlm.nih.gov/pubmed/22768724?dopt=Abstract ER -