Epistaxis in children under the age of two: possible marker of abuse/neglect? A retrospective study in North-Eastern Piedmont hospitals.

AIM: Epistaxis is an extremely common event at all ages; however, under two years of age epistaxis is a very rare event and recent studies carried out in Great Britain concern this event as related to possible non-accidental trauma. To date, no other studies carried out in Italy are available on this topic. METHODS: A file review of all cases of epistaxis occurred in children under the age of 2 who were admitted into the ED in our area over a period of two years was carried out. RESULTS: We have collected data concerning 10 cases of epistaxis occurred in children under 2 years of age with an incidence of 10.4 cases per 10000 accessions to the ED of children under the age of 2. Four of the cases had attendances for head injury or facial trauma. CONCLUSION: The results obtained are higher than the results of the British studies adopting the same methodology, but comparable to their surveillance data on the general population. Through the analysis of the collected data, two correlated assumptions have been made: a possible relationship between epistaxis and neglect, and a relation between epistaxis and domestic accidents.

[To reduce the pain of heel prick in the newborn: comparison of six types of lancets]. / Ridurre il dolore da prelievo capillare nel neonato: confronto tra 6 dispositivi pungidito.

Heel prick is an usual method performed to get a blood sample for newborn screening. Its wide use justifies the effort in reducing the pain as much as possible and some simple steps, including the use of spring heelsticks, are recommended by national and international guide-lines. But not all the heelsticks cause the same pain and allow to get enough blood for the screening. The aim of this work was to test six automatic heelstick devices with regard to the pain in heel prick measured with NIPS scale and, at the same time, to value their effectiveness in getting a blood sample suitable for filter paper for newborn screening. The following devices were assessed: Amnes Minilet Lancets, Wuxi Xinda Ltd, Exxe Safe Blade, Lifescan Stik Johnson & Johnson, One Touch Ultra Soft, Accu-Chek Safe T Pro Plus. The device Exxe Safe Blade statistically differs from all others: it is the least painful and it doesn't need any prick repetition.

[Congenital Milroy Oedema: a case report of a family]. / Edema congenito di Milroy. descrizione di una famiglia.

The authors describe the case of a newborn and their family with Nonne-Milroy disease (hereditary lymphedema type I), a genetic disease that is usually characterized by lymphedema, that most often affects the lower extremities or less frequently the back of the hands. We discuss etiology, inheritance pattern, differential diagnosis and follow-up.

Vitamin D at term of pregnancy and during lactation in white and black women living in Northern Italy.

AIM: Evaluate the vitamin D serum status in a population of white and black mothers who live in the same geographic area of northern Italy (45 degrees 8' N of latitude) and its correlation with vitamin D serum concentrations of the respective newborns at birth, at 2 and 12 months. METHODS: Twelve white woman-infant pairs and 12 black woman-infant pairs were recruited from January through March 2006. The study population had no pre-existing disease and delivered at term of pregnancy (37-41 weeks of gestational age). Only black infants were given vitamin D supplementation from birth to 1 year of age. RESULTS: Eleven black and 12 white women had low vitamin D serum levels at term of pregnancy. Similarly, black and white newborns were both vitamin D deficient at birth. After 12 months white women re-gained physiological vitamin D serum levels, whereas black women maintained a status of vitamin D deficiency. Black newborns who were given supplementation showed lower vitamin D serum concentrations as compared with white newborns at 1 year of age. CONCLUSION: These data showed that all the women living in the same region of northern Italy without any supplementation are equally vitamin D deficient at term of pregnancy regardless of their skin pigmentation. Consequently, every woman should be supplied with additional vitamin D during pregnancy and lactation, though such supplementation seems to exert the most beneficial effects in black women.

Lack of improvement in the modality of beta2 administration in pediatric departments: survey in Piedmont and Aosta Valley.

AIM: In recent years many consensus conferences of scientific societies have reaffirmed the advantages of metered dose inhalator (MDI) and spacer administration compared to classic aerosol in acute asthma and maintenance therapy. Faced with a more than convincing documentation, the practitioners have shown a controversial attitude concerning this type of administration. At the same time, as a general acceptance of its superiority there is an inexplicable lack of use. METHODS: This survey was carried out in 2006 and it involved pediatric hospital wards in Piedmont and Aosta Valley to evaluate the use of spacers in acute asthma in hospitalised children undergoing treatment. These results were compared to those obtained from another survey carried out in 2008 using identical questionnaires in the same departments in order to evaluate the implementation of such a practice. RESULTS: In the two years between one survey and the other no increase in the use of MDI and spacer has been detected, but, on the contrary, a consistent decrease. CONCLUSION: Notwithstanding the amount of evidence concerning its superiority compared to nebulisers MDI and spacer is not commonly used for asthma therapy yet. A "promotional" multidisciplinary intervention could play a determining role in the implementation of such a practice.