TY - JOUR T1 - Inclusion cyst of anterior fontanelle. JF - Arch Dis Child Y1 - 2018 A1 - Udina, Chiara A1 - Calligaris, Lorenzo A1 - Berti, Irene A1 - Cattaruzzi, Elisabetta A1 - Barbi, Egidio U1 - http://www.ncbi.nlm.nih.gov/pubmed/30131348?dopt=Abstract ER - TY - JOUR T1 - Pain Intensity and Risk of Bone Fracture in Children With Minor Extremity Injuries. JF - Pediatr Emerg Care Y1 - 2018 A1 - Zanchi, Chiara A1 - Giangreco, Manuela A1 - Ronfani, Luca A1 - Germani, Claudio A1 - Giorgi, Rita A1 - Calligaris, Lorenzo A1 - Norbedo, Stefania A1 - Liccari, Giulio A1 - Cozzi, Giorgio A1 - Barbi, Egidio AB -

OBJECTIVES: Injuries are one of the most common causes of pediatric emergency department (ED) visit. The aim of this study was to investigate the relationship between the intensity of pain at the ED visit of children presenting with an extremity injury and the risk of fracture.

METHODS: We conducted a retrospective study, considering all patients presenting to the ED of a children's hospital in Italy, with an accidental extremity injury, between May and December 2015. We selected all children aged 8 to 17 years who underwent an x-ray. Children with major, multiple, or nonextremity injuries were excluded. Age, sex, spontaneous and palpation pain, local swelling, time between injury, and medical evaluation were recorded. Sensibility and specificity of spontaneous and palpation pain in detecting a fracture were calculated.

RESULTS: We reviewed 994 medical records; of these, 344 (34.6%) reported a fracture. Children's median age was 12 years (interquartile range [IQR], 10-14). Median spontaneous pain at the ED visit was not significantly different between children with and without a fracture: 4.0 (1.0-6.0) and 5 (1.0-6.0), respectively (P = 0.129). Children with mild palpation pain and children without an increase of pain of at least 2 points between spontaneous and palpation pain were fractured in 3.2% and 0.97% of cases, respectively.

CONCLUSIONS: In this series, pain intensity in children with a minor extremity injury was not a good marker of fracture. Nevertheless, children with mild palpation pain or with a mild increase of pain between spontaneous and palpation pain had a low risk of fracture.

U1 - http://www.ncbi.nlm.nih.gov/pubmed/29369266?dopt=Abstract ER - TY - JOUR T1 - Risk of hospitalisation after early-revisit in the emergency department. JF - J Paediatr Child Health Y1 - 2017 A1 - Cozzi, Giorgio A1 - Ghirardo, Sergio A1 - Fiorese, Ilaria A1 - Proietti, Ilaria A1 - Monasta, Lorenzo A1 - Minute, Marta A1 - Barbi, Egidio A1 - Calligaris, Lorenzo KW - Adolescent KW - Child KW - Child, Preschool KW - Emergency Service, Hospital KW - Female KW - Hospitalization KW - Humans KW - Infant KW - Italy KW - Male KW - Retrospective Studies KW - Risk Assessment KW - Tertiary Care Centers KW - Time Factors AB -

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'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.

VL - 53 IS - 9 U1 - http://www.ncbi.nlm.nih.gov/pubmed/28513890?dopt=Abstract ER - TY - JOUR T1 - Current concepts in management of pain in children in the emergency department. JF - Lancet Y1 - 2016 A1 - Krauss, Baruch S A1 - Calligaris, Lorenzo A1 - Green, Steven M A1 - Barbi, Egidio KW - Acute Pain KW - Analgesics, Opioid KW - Anesthetics, Local KW - Anti-Inflammatory Agents, Non-Steroidal KW - Anxiety KW - Child KW - Emergency Medicine KW - Emergency Service, Hospital KW - Humans KW - Pain Management KW - Pediatrics KW - Stress, Psychological AB -

Pain is common in children presenting to emergency departments with episodic illnesses, acute injuries, and exacerbation of chronic disorders. We review recognition and assessment of pain in infants and children and discuss the manifestations of pain in children with chronic illness, recurrent pain syndromes, and cognitive impairment, including the difficulties of pain management in these patients. Non-pharmacological interventions, as adjuncts to pharmacological management for acute anxiety and pain, are described by age and development. We discuss the pharmacological management of acute pain and anxiety, reviewing invasive and non-invasive routes of administration, pharmacology, and adverse effects.

VL - 387 IS - 10013 U1 - http://www.ncbi.nlm.nih.gov/pubmed/26095580?dopt=Abstract ER - TY - JOUR T1 - A minor trauma revealing linear morphoea in a 4-year-old female. JF - Arch Dis Child Y1 - 2016 A1 - Pastore, Serena A1 - Contorno, Sarah A1 - Caddeo, Giulia A1 - Calligaris, Lorenzo A1 - Taddio, Andrea U1 - http://www.ncbi.nlm.nih.gov/pubmed/27173895?dopt=Abstract ER - TY - JOUR T1 - Acute pseudotumoral hemicerebellitis in a child: a rare and distinct entity? JF - J Child Neurol Y1 - 2015 A1 - Alberini, Elena A1 - Vellante, Valerio A1 - Zennaro, Floriana A1 - Calligaris, Lorenzo A1 - Barbi, Egidio A1 - Carrozzi, Marco A1 - Devescovi, Raffaella KW - Brain KW - Cerebellar Diseases KW - Child KW - Diagnosis, Differential KW - Encephalitis KW - Humans KW - Magnetic Resonance Imaging KW - Male AB -

A pseudotumoral presentation of acute hemicerebellitis is rare in pediatric age. The authors report a new single case study of a 7-year-old child with pseudotumoral unilateral cerebellitis mimicking an intracranial tumor, which clinically presented itself with signs of intracranial hypertension and mild contralateral hemiparesis, completely recovered after anti-inflammatory therapy. Brain magnetic resonance imaging (MRI) was essential for the differential diagnosis between inflammatory and neoplastic processes. The literature highlighting specific clues about pseudotumoral hemicerebellitis as a distinct clinical and radiological entity is reviewed.

VL - 30 IS - 4 U1 - http://www.ncbi.nlm.nih.gov/pubmed/25143480?dopt=Abstract ER - TY - JOUR T1 - Phleboliths as a marker of slow-flow venous malformation. JF - Arch Dis Child Y1 - 2015 A1 - Calligaris, Lorenzo A1 - Berti, Irene A1 - Barbi, Egidio VL - 100 IS - 11 U1 - http://www.ncbi.nlm.nih.gov/pubmed/26242634?dopt=Abstract ER - TY - JOUR T1 - Cow's milk allergy in children, from avoidance to tolerance. JF - Endocr Metab Immune Disord Drug Targets Y1 - 2014 A1 - Calligaris, Lorenzo A1 - Longo, Giorgio A1 - Badina, Laura A1 - Berti, Irene A1 - Barbi, Egidio KW - Animals KW - Cattle KW - Child KW - Child, Preschool KW - Desensitization, Immunologic KW - Humans KW - Immune Tolerance KW - Milk Hypersensitivity KW - Milk Substitutes KW - Retrospective Studies AB -

Food allergy is the primary cause of anaphylaxis in paediatric age affecting roughly 4% of children and their families worldwide, and requiring changes in dietary habits. The prognosis for food allergy in children has traditionally been regarded as good for the most frequent allergens, however the prognosis for cow's milk allergy in the pediatric age is currently considered to be worse than previously believed. There is now enough evidence that measures of avoidance for children at risk did not have any preventive effect whatsoever, but they still came to be counterproductive by avoiding the physiological interaction between food allergens and gastrointestinal mucosal immune system. Programs of specific oral tolerance induction (SOTI) have obtained interesting results in the treatment of food allergy supporting the idea that antigen exposure through gastrointestinal section is important to allow the development of tolerance. Nevertheless this approach is not yet considered "ready" for community recommendations. In this paper we describe our experience in the field of SOTI in children with cow's milk allergy.

VL - 14 IS - 1 U1 - http://www.ncbi.nlm.nih.gov/pubmed/24450451?dopt=Abstract ER - TY - JOUR T1 - Re: Tramadol can selectively manage moderate pain in children following European advice limiting codeine use. JF - Acta Paediatr Y1 - 2014 A1 - Calligaris, Lorenzo A1 - Marzuillo, Pierluigi A1 - Barbi, Egidio VL - 103 IS - 11 U1 - http://www.ncbi.nlm.nih.gov/pubmed/25069539?dopt=Abstract ER - TY - JOUR T1 - Tramadol can selectively manage moderate pain in children following European advice limiting codeine use. JF - Acta Paediatr Y1 - 2014 A1 - Marzuillo, Pierluigi A1 - Calligaris, Lorenzo A1 - Barbi, Egidio AB -

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.

VL - 103 IS - 11 U1 - http://www.ncbi.nlm.nih.gov/pubmed/25041277?dopt=Abstract ER - TY - JOUR T1 - Concentrated midazolam for intranasal administration: a pilot study. JF - Pediatr Emerg Care Y1 - 2011 A1 - Calligaris, Lorenzo A1 - Davide, Zanon A1 - Alessandra, Maestro A1 - De Bortoli, Romina A1 - Chiaretti, Antonio A1 - Barbi, Egidio KW - Administration, Intranasal KW - Child KW - Child, Preschool KW - Conscious Sedation KW - Dose-Response Relationship, Drug KW - Female KW - Humans KW - Hypnotics and Sedatives KW - Infant KW - Male KW - Midazolam KW - Pain KW - Pilot Projects KW - Preoperative Care VL - 27 IS - 3 U1 - http://www.ncbi.nlm.nih.gov/pubmed/21378534?dopt=Abstract ER -