Minerva pediatrica
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Comparative Study
Comparison of two different neonatal skin care practices and their influence on transepidermal water loss in healthy newborns within first 10 days of life.
Physiologic post-partum skin adaptation to the relative dry extra-uterine environment is a dynamic process which begins immediately after birth. Considering the differences from adult skin, the neonatal skin is more prone to damage by environmental factors; therefore, skin care regimens should be age adapted to ensure a good epidermal maturation. The effects of two different skin care practices were evaluated by transepidermal water loss (TEWL) measurement in 94 newborns aged ≤ 10 days: group 1 (G1), newborns washed only with a cotton washcloth moistened with water; group 2 (G2), newborns washed with liquid baby cleansers and hydrated with moisturizers. These recordings were compared to TEWL baseline values of the same neonates and to adults' values. ⋯ Tested skin care regimens could influence the process of functional adaptation of skin, in the early postnatal period. We could hypothesize that daily washing with liquid baby cleansers and moisturizing may delay the natural maturation of skin barrier function.
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The aim of this study was to compare caregivers' knowledge and management of fever in an Italian Pediatric Emergency Department and to determine whether caregivers of a single child or those whose child had a history of chronic illness report greater symptoms of "fever phobia". ⋯ Caregivers aggressively administer antipyretics or take the child to the Pediatric Emergency Department in case of fever. Having an only child is not clearly associated with fever phobia. History of chronic illness calls for consideration in further studies to explore it as a trigger factor to fever phobia.
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Comparative Study
Esophageal multichannel intraluminal impedance and pH monitoring in children: indications and limits.
Aim of the study was to compare multichannel intraluminal impedance (MII)-pH monitoring versus pH only, as first-line assessment of gastroesophageal reflux (GER) in children and to define the relation between GER and symptoms as well relation between types of GER and age of children. ⋯ MII-pH study must be reserved to patients younger than 2-year old (high probability of weakly acid reflux) and children with atypical symptoms.
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The continuous development of medicine increases the possibility of sustaining life functions, which frequently leads to prolonging the patient's agony or exposing him/her to unnecessary suffering. The application of some medical procedures, technical equipment and pharmacological measures that prolong the process of dying in terminally ill children may be a sign of therapeutic obstinacy. Such actions are not an outcome of concern for the welfare of young patients and violate their dignity. ⋯ Following fragments of the article characterize Polish ideas on terminally ill children's rights, the current situation of these children in medical care, and the origins and character of the document approved by the PPS. The complementation of the commentary are remarks made by a team of experts that develop guidelines which apply to specific clinical problems associated with the care of terminally ill children. This article is yet another voice in the wide debate on the moral imperative of refraining from therapeutic obstinacy in medical practice.