Hospitalization, Asthma Phenotypes, and Readmission Rates in Pre-school Asthma.

Children with pre-school asthma suffer disproportionally more often from severe asthma exacerbations with emergency visits and hospital admissions compared to school children. Despite this high disease burden, there are only a few reports looking at this particular severe asthma cohort. Similarly, there is little real-life research on the distribution of asthma phenotypes and personalized treatment at discharge in this age group.

Invasive candidiasis in pediatric intensive care in Greece: a nationwide study.

Purpose: To record the practices for prevention and management of invasive candidiasis in the PICU and investigate the epidemiology of candidiasis and its outcome nationwide.

Methods: A multicenter national study among PICUs throughout Greece. A questionnaire referring to local practices of prevention and management of candidemia was filled in, and a retrospective study of episodes that occurred during 5 years was conducted in all seven Greek PICUs.

Subclinical VZV reactivation in immunocompetent children hospitalized in the ICU associated with prolonged fever duration.

A prospective observational study was conducted to examine whether asymptomatic VZV reactivation occurs in immunocompetent children hospitalized in an ICU and its impact on clinical outcome. A secondary aim was to test the hypothesis that vaccinated children have a lower risk of reactivation than naturally infected children. Forty immunocompetent paediatric ICU patients and healthy controls were enrolled.

Ciprofloxacin in critically ill children.

Data regarding the use of fluoroquinolones in critically ill children are scarce. We present our experience regarding the use of ciprofloxacin in this specific patient population. We prospectively identified all paediatric patients who received ciprofloxacin treatment in the intensive care unit of the tertiary care P.

Liposomal amphotericin B in critically ill paediatric patients.

What Is Known And Objective: Literature provides much evidence regarding liposomal amphotericin B treatment for fungal infections in neonates and infants. Relevant data regarding critically ill paediatric patients of older age are scarce. We aimed to present our experience regarding liposomal amphotericin B use in critically ill paediatric patients from a tertiary-care paediatric hospital in Athens, Greece.

Inhaled colistin for the treatment of tracheobronchitis and pneumonia in critically ill children without cystic fibrosis.

Data regarding the role of inhaled colistin in critically ill pediatric patients without cystic fibrosis are scarce. Three children (one female), admitted to the intensive care unit (ICU) of a tertiary-care pediatric hospital in Athens, Greece, during 2004-2009 received inhaled colistin as monotherapy for tracheobronchitis (two children), and as adjunctive therapy for necrotizing pneumonia (one child). Colistin susceptible Acinetobacter baumannii and Pseudomonas aeruginosa were isolated from the cases' bronchial secretions specimens.

Clinical, neuropsychological, neurophysiologic, and genetic features of a new Italian pedigree with familial cortical myoclonic tremor with epilepsy.

We studied the clinical, neuropsychological, neurophysiologic, and genetic features of an Italian family with familial cortical myoclonic tremor with epilepsy (FCMTE). Clinically affected members of the family had limb and voice tremor, seizures, and myoclonus involving the eyelids during blinking. Neuropsychological testing disclosed visuospatial impairment, possibly due to temporal lobe dysfunction.

Intravenous colistimethate (colistin) use in critically ill children without cystic fibrosis.

Introduction: The increasing frequency of infections caused by multidrug-resistant (MDR) Gram-negative bacteria has led to the reappraisal of colistimethate use.

Methods: We present a case series of critically ill pediatric patients without cystic fibrosis who received intravenous colistimethate treatment. All available relevant medical records were reviewed.

Thrombotic thrombocytopenic purpura: prospective neurologic, neuroimaging and neurophysiologic evaluation.

Background And Objectives: Neurologic symptoms are present in 60% of patients with thrombotic thrombocytopenic purpura (TTP) on initial examination and ultimately develop in about 90% of cases during the course of the disease. Despite central nervous system involvement being frequent, abnormalities in the brain of patients with TTP are infrequent on neuroimaging (CT/MRI) and neurophysiologic (EEG) evaluation, often reversible and mainly limited to symptomatic stages of the disease. The aim of our study was to establish the value of a complete neurologic screening as part of the work up of TTP.

Epileptic patients refractory to drug therapy.

We compared two groups of patients with idiopathic epilepsy, 41 patients whose seizure frequency was not controlled by adequate therapy and 39 patients in good seizure control, in respect of hematology, kidney and liver function tests, serum IgG, IgA and IgM concentrations and drug concentrations. The only difference that emerged were in the serum immunoglobulins, which were raised in the drug refractory group, significantly (p less than 0.01) so in the case of IgG.

Periodic activity in electroencephalography.

We report ana analysis of 12 cases in which periodic activity was observed in more than one EEG recording in patients with subacute sclerosing panencephalitis (4 cases), encephalitis of unknown etiology (1 case) and vascular disease (7 cases). In the patients with infective disease periodic high voltage potentials were elicited from all over the brain and the background rhythm was markedly impaired. In the patients with vascular disease the bursts were localized, reversible and sometimes recurrent.

Effects of carotid compression, as assessed by near infrared spectroscopy, upon cerebral blood volume and hemoglobin oxygen saturation.

Near infrared spectroscopy, a recently developed optoelectronic technique, has been studied as a possible method of monitoring the adequacy of cerebral perfusion in 22 patients who were candidates for carotid endarterectomy. Using this technique, changes in haemoglobin volume, haemoglobin oxygen saturation and redox level of cytochrome-c-oxidase were recorded from the frontoparietal region during routine carotid compression tests performed under continuous electroencephalographic (EEG) monitoring. A highly significant association was found between EEG slowing, indicating impaired cerebral function, and a fall in haemoglobin volume and oxygen saturation, indicating a reduced blood and oxygen supply to the brain (Fisher exact test, P less than 10(-5].

Anticonvulsant therapy and its possible consequences on peripheral nervous system: a neurographic study.

We studied 80 epileptic patients receiving antiepileptic drugs in mono- or polytherapy. For every patient, peroneal and median nerve motor conduction velocities and median nerve sensory conduction velocity were calculated. The average conduction velocity values were remarkably slower than those of a group of 55 normal subjects.

Influence of glucoregulation with continuous subcutaneous insulin infusion on nerve conduction velocity and beat to beat variation in diabetics.

Limited and contrasting data are available on the relationship between metabolic control and diabetic neuropathy. In eight type I diabetics peripheral and autonomic neuropathy were studied, first in conditions of poor metabolic control and then after one and three months during which an improved control of glycemic levels had been obtained by continuous subcutaneous insulin infusion. Autonomic neuropathy was investigated by evaluating beat to beat variation during deep breathing; peripheral neuropathy by measuring maximum motor conduction velocity of peroneal and median nerves and sensory conduction velocity of median nerve.

[Calcium-phosphorus changes in chronic anticonvulsant therapy: effects of the administration of 25-hydroxyvitamin D3 on secondary hyperparathyroidism].

The present study represents a contribution to the knowledge of secondary hyperparathyroidism (SHP) in patients treated with anticonvulsant drugs (AC). In these subjects alterations of the calcium: phosphorus metabolism as rickets and osteomalacia are frequent; however literature data on SHP are scarce. Our research carried out on 29 adult patients under treatment with one or more AC for periods ranging from 9 months to 12 years confirmed that 25-OHD levels in the serum are low, especially in patients treated for longer times.

Congenital fiber type disproportion with fatal outcome: a case report.

A child with congenital fiber type disproportion without structural changes in muscle fibres is reported. Although this pattern suggests a favorable prognosis, the clinical worsening followed by death at the age of 17 months shows that there is as yet no predictor for a benign course for this myopathy.

Kearns-Sayre syndrome. A case of the complete syndrome with encephalic leukodystrophy and calcification of basal ganglia.

A case of a complete Kearns-Sayre syndrome, of early onset, associated with cerebral and cerebellar leukodystrophy and basal ganglia calcification is reported. The clinical, neurophysiological and morphological findings suggest multisystem involvement.

A longitudinal electroencephalographic study in acute leukaemia.

A longitudinal electroencephalographic study of 100 patients suffering from acute leukaemia is reported. An high incidence of EEG abnormalities indicates the central nervous system involvement with no clinical manifestations. The patients have been divided in two groups: A) with normal EEG and B) with pathological (cerebro-meningeal localisation) but many causes (metabolic, toxic or microcirculatory disturbances) can produce the abnormalities.

[Epileptic psychoses].

A psychotic episode is described in a 21 year old male suffering since the age of 14 of generalized convulsions and tipical absences, scarecely controlled by antiepileptic drugs. The psychotic episode took place after a "Petit Mal Status", and was characterized by behaviour disorders, psycomotor excitement and delusions. During the episode the EEG became normal and epileptic seizures were not observed.

[Kleine-Levin syndrome].

A case of a 15 years old boy with a Kleine-Levin syndrome is presented. Neurological examination and X-ray studies, including pneumoencephalography, were normal. Laboratory findings were also normal except for a flattened response to glucose load.