La Pediatria medica e chirurgica : Medical and surgical pediatrics
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The diagnosis of acute appendicitis remains a critical challenge for paediatric surgeons. White Blood Cell (WBC) count, once considered a basic exam, is still routinely performed in most institutions, despite its lack of accuracy. Aim of this study is to assess the additional value of WBC count in the diagnosis of acute appendicitis. ⋯ WBC count at admission has no proven additional value in the diagnosis of acute appendicitis and can be omitted without modifying diagnostic pathway and without affecting diagnostic accuracy.
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Case Reports
Case report: Salmonella panama osteomyelitis in a Ghanaian child with sickle cell disease.
Sickle cell disease is a rare condition in italian patients and even rarer are its complications, in particular Salmonella osteomyelitis. We describe a case of a Ghanaian child with sickle cell disease who developed osteomyelitis due to Salmonella panama, treated successfully with surgical debridement, followed by a prolonged period of specific antibiotic therapy.
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Neonatal intensive care has greatly improved the survival chances but, at the same time, it has also given rise to serious ethical problems. Different contexts influence both physicians attitude and end-of-life practices in neonatology. The clinicians can not ever follow the principles of bioethics, as they are sometimes in conflict. ⋯ However, a clinician has also an obligation to follow the Code of Professional Medical Ethics which cautions against therapeutic aggressiveness; but this document has not legal status. In addition, Italian law is strongly protective of infant life and any discrimination on the basis of malformation or poor prognosis violates constitutional law; moreover, the resuscitation of a preterm infant is mandatory even when the birth is the result of induced late abortion. The author concludes emphasizing the importance, in decision making, of accepting difference as opposed to the logic of the absoluteness of normality, because many handicaps may be accepted and a society expresses its moral richness also by the solidarity reserved to its weakest sons.