Impact of a two step antimicrobial stewardship program in a paediatric haematology and oncology unit.

Objective: To describe the implementation of a multi-step antimicrobial stewardship program in a haemato-oncology and stem cell transplantation program unit. Methods: Pre-post quasi-experimental study with two interrupted time-series analyses, conducted between 01/01/2019 and 31/12/2022 in the Paediatric Haemato-Oncology Unit of the Padua Paediatric Hospital. The interventions were: (1) 02/2020: dissemination of febrile neutropenia clinical pathways, (2) April 2021: provision of the clinical pathways via a customized App (Firstline.

Assessing Response Rates and Sleep Disorder Prevalence: Insights from a Propranolol Treatment Study for Infantile Haemangiomas.

Background: Infantile haemangiomas (IHs) sometimes require treatment with propranolol. Sleep disturbances are the most frequently reported side effects. Monitoring adverse drug events necessitates repeated hospital visits, which can be challenging during a pandemic.

Enforcing surveillance of antimicrobial resistance and antibiotic use to drive stewardship: experience in a paediatric setting.

Background: Antibiotic stewardship (AS) interventions in paediatrics are still not standardized regarding methodology, metrics, and outcomes. We report the results of an AS intervention in the paediatric area based on education and guideline provision via an electronic App.

Materials And Methods: The AS intervention was conducted in 2021 through observation, education, audit and feedback and provision of an electronic App (Firstline.

Antimicrobial Prophylaxis in Neonates and Children Undergoing Dental, Maxillo-Facial or Ear-Nose-Throat (ENT) Surgery: A RAND/UCLA Appropriateness Method Consensus Study.

Surgical site infections (SSIs) represent a potential complication in surgical procedures, mainly because clean/contaminated surgery involves organs that are normally colonized by bacteria. Dental, maxillo-facial and ear-nose-throat (ENT) surgeries are among those that carry a risk of SSIs because the mouth and the first respiratory tracts are normally colonized by a bacterial flora. The aim of this consensus document was to provide clinicians with recommendations on surgical antimicrobial prophylaxis in neonates (<28 days of chronological age) and pediatric patients (within the age range of 29 days−18 years) undergoing dental, maxillo-facial or ENT surgical procedures.

Surgical Antimicrobial Prophylaxis in Patients of Neonatal and Pediatric Age Undergoing Orthopedic and Hand Surgery: A RAND/UCLA Appropriateness Method Consensus Study.

Surgical site infections (SSIs) represent a potential complication in any type of surgery and can occur up to one year after the procedure in the case of implant placement. In the field of orthopedic and hand surgery, the rate of SSIs is a relevant issue, considering the need for the placement of synthesis devices and the type of some interventions (e.g.

High-fat meal, systemic inflammation and glucose homeostasis in obese children and adolescents.

We aimed to assess in obese youths the relationships between interleukin-6 (IL-6), fat meal-induced endotoxemia and glucose homeostasis. Twenty obese children/adolescents (9-17 years old, 11 boys) underwent a standard oral glucose tolerance test and, 7-14 days later, a 5-h fat meal test (fat=69% of energy, saturated/monounsaturated/polyunsaturated fatty acids=31.5%/35%/33.

Phase I/II trial of multicycle high-dose chemotherapy with peripheral blood stem cell support for treatment of advanced ovarian cancer.

Ovarian cancer is chemosensitive, but most patients with advanced disease die from tumor progression. As 25% of the patients can be cured by chemotherapy, it is reasonable to evaluate high-dose chemotherapy (HDCT). Forty-eight patients with untreated ovarian cancer were entered in a multicenter phase I/II trial of multicycle HDCT.

Granulosa cell tumor of the ovary: 10 years follow-up data of 65 patients.

Background: Granulosa cell tumor of the ovary is an uncommon neoplasm. The majority of patients are diagnosed in early stages of disease and overall prognosis is favorable. The stage at time of diagnosis is the only prognostic factor that is unequivocally related to survival.

Therapy of metastatic breast cancer with humanized antibodies against the HER2 receptor protein.

The HER2 protein, a member of the epidermal growth factor family, is encoded by the protooncogene c-erbB-2. Its overexpression, occurring in approximately one-third of all breast carcinomas, is associated with a poor prognosis. A humanized mouse antibody against HER2 has been developed by genetic engineering.

[Rectal resection within the scope of multi-visceral interdisciplinary resection in the pelvis].

Multivisceral resectioning is the only curative treatment for progressive carcinomas extending beyond the organ. The results of 25 consecutively operated patients are presented in this prospective observational study. Twelve patients underwent surgery for a primary tumor and 13 for a recurrence.

Congenital cystic adenomatoid malformation of the lung and fetal hydrops--a case with favourable outcome.

We present a case of congenital cystic adenomatoid malformation of the lung (CCAM) diagnosed at 23 weeks of gestation with concomitant fetal hydrops. The sonographical picture of CCAM disappeared in the third trimester of pregnancy and fetal hydrops resolved under medication with digitalis to the mother. The neonate showed mild dyspnea; the prenatal diagnosis of CCAM was confirmed by chest X-ray and computed tomography.

Differentiation of breast lesions by measurements under craniocaudal and lateromedial compression using a new sonographic method.

Rationale And Objectives: The authors differentiate breast lesions on sonography by measurements in two compression states that are perpendicular to each other.

Methods: Diameters of 100 breast lesions were measured preoperatively under lateromedial and craniocaudal compression with a new sonographic method. This method uses mammography-identical positioning of the breast and a reference structure for detection of changes of sound amplitude and velocity by through transmission of lesions.

[Insulin-like-growth-factor-binding-protein 1 (IGFBP-1) and fetal fibronectin in diagnosis of premature rupture of fetal membranes].

The diagnosis of a premature rupture of membranes presents no problem in the vast majority of cases. However, a reliable diagnosis is clinically not possible in about 10%. Most methods available lack the necessary sensitivity and specificity.

[137 local recurrences after breast carcinoma--a retrospective study].

A retrospective study was performed to follow up the course of the disease in 137 female premenopausal and postmenopausal patients in whom local recurrence of carcinoma of the breast had occurred. Particular attention was given to the dependence of the recurrence-free interval on the tumorobiological parameters of the primary tumour. In 23% of the cases the local recurrence was an expression of generalisation of the tumour with simultaneous occurrence of distant metastases.

Successful emergency splenectomy during pregnancy in a patient with life-threatening idiopathic thrombocytopenia. Case report.

Thrombocytopenia can be a pathophysiological feature of pregnancy. In the case reported, the thrombocyte count was reduced to 1% of normal (1 x 10(9) thrombocytes/l) at 28 weeks of gestation. In chronological order, the patient showed epistaxis, macrohematuria and gingival, conjunctival, intracerebral and pulmonary bleeding.

[Colpohysterectomy. A contribution to gynecologic geriatric surgery].

From 1983 to 1992 we performed 70 interventions because of a total genital prolapse: 51 vaginal hysterectomies and four removals of the cervical stump, both combined with vaginectomy and fifteen vaginectomies of the prolapsed vaginal vault. Two patients underwent another procedure during the same anesthesia: mastectomy and treatment of an inguinal hernia respectively. The youngest patient was 59 years old and the oldest 89.

[Reconstruction of the breast with the m. latissimus dorsi flap after previous mastectomy].

The application of this method over 11 years has shown that careful preoperative planning is crucial for the achievement of good results. There is, however, no restitutio ad integrum. The reconstructed breast will always have a rather firm structure and tend to be scarred.

[Tumor properties of primary tumors and local recurrence of breast cancer].

In 137 patients suffering from a local recurrence after primary treatment of breast cancer, the features examined in a retrospective manner included: staging parameters (TNM-criteria), grading according to Bloom and Richardson, growth fraction by Ki67 positive cells as well as immunohistology and biochemical steroidreceptor-expression. In the primary tumours, a good correlation was detected between size of the tumour and lymph-node involvement, between histopathological grading and Ki67 growth fraction and between low histopathological grading and poor immunohistological and biochemical steroidreceptor content. The results of this particular study show that local recurrence is not accompanied by any significant de-differentiation, neither in its histopathological grading nor in its growth fraction nor in its steroidreceptor-status.

Local therapy of malignant pleural effusion with mitoxantrone.

Twelve patients received intrapleural instilments of the cytostatic agent mitoxantrone in a total dosage of 30 mg for locoregional palliative therapy of malignant pleural effusion. Effusion could be stopped for a mean period of 3.2 months in 11 patients.

[Cytologic cancer prevention with smears of the uterine cervix and endocervical canal in pregnancy].

This study was performed to evaluate the importance of obtaining prepartum Papanicolaou smears routinely. 1,417 patients receiving pregnancy care had normal prenatal Pap smears. 88 (5.

Mammary mycoses.

Since 1969 we have had at our hospital a special consulting room for mammary gland diseases in which we have so far seen more than 17,000 patients. Mycoses are a rare disease of the mammary glands. We are reporting below on the incidence of this disease, the mode of infection and the diagnostic possibilities within the framework of our special clinic.

[Studies into carcino-embryonic antigen (CEA) and enzyme activities of alkaline and acid phosphatase in patients with fibrocystic breast disease (author's transl)].

CEA as well as alkaline and acid phosphatase were measured in patients with fibrocystic breast disease. The values recorded from the punctured fluids were compared to those in peripheral blood. CEA concentrations in cyst fluid were elevated in patients with proliferative breast disease, whereas no correlations could be established between alkaline and acid phosphatase, on the one hand, and various histological forms of breast disease, on the other.

[Position of amniocentesis in prenatal diagnosis (author's transl)].

Transabdominal amniocentesis, applied to 150 patients, is reported in this paper. Reference is made also to briefing of the patient, technique, indications, and complications.

[Intra-amniotic bleeding following rupture of umbilical artery (author's transl)].

Reported is a case of Insertio funiculi furcata with rupture of an umbilical artery. Intra-amniotic bleeding was the result and confirmed by amnioscopy. A living child was delivered by immediate caesarean section.

[Relevance of CEA in benign breast disease (author's transl)].

Serum CEA-concentrations were measured in patients with various benign breast tumors; in addition, CEA levels were determined in the fluid of mammary cysts present. Patients with proliferating mastopathia with and without atypia had CEA values exceeding 25 ng/ml in the cystic fluid (= 46). No significant correlation existed between serum and cystic fluid concentrations.