Paola Tonetto - Academia.edu (original) (raw)
Papers by Paola Tonetto
The Journal of Steroid Biochemistry and Molecular Biology
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Journal of biological regulators and homeostatic agents
In a Neonatal Intensive Care Unit (NICU) counseling should be a shared culture for all the care g... more In a Neonatal Intensive Care Unit (NICU) counseling should be a shared culture for all the care givers: it should be developed by all the professionals, to face up to parents' needs of information, explanations, facility of decisions, finding of resources, agreement, help, reassurance, attention. The first essential aspect is the training in counseling skills, by periodic courses for all professionals of the department (physicians, nurses, and physiotherapists). In our department, a professional counselor is present, assisting the medical staff in direct counseling. The counselor's intervention allows a better parent orientation in the situation. A more effective sharing of these rules also facilitates the communication among parents and medical staff. Periodic meetings are established among the medical staff, in which the professional counselor discusses difficult situations to share possible communicative strategies. We wanted to have not only a common communicative style,...
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Minerva pediatrica, 2010
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Minerva pediatrica, 1994
A cross section study was performed on 1342 children living in the Turin district to examine the ... more A cross section study was performed on 1342 children living in the Turin district to examine the modalities followed for milk-feeding during the first year of life. Children examined had been admitted to the infants' ward of the Pediatric University Clinic of Turin suffering from common illness of early infancy. Mothers were asked to fill in a questionnaire concerning breast-feeding, formula feeding and cow's milk feeding. Data collected show that 75% of infants were exclusively breast-fed at birth, that a large number of infants are already fed cow's milk after the 3rd month of life, that hypoallergenic formulas are overused (18.5% among adapted formulas), and that follow-up formulas are underused. Most of the mothers (74%) say that their dietary choices were made by their physician. These data indicate that infant dietary trends in our district are often not in accordance with scientific recommendations.
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Frontiers in Bioscience, 2011
The Holder method is the recommended pasteurization method for human milk banks, as it ensures th... more The Holder method is the recommended pasteurization method for human milk banks, as it ensures the microbiological safety of human milk (HM). The loss of some biologically active milk components, due to the heat treatment, is a main limit to the diffusion of donor HM. High-temperature short-time (HTST) pasteurization may be an alternative to maintain the nutritional and immunological quality of HM. The aim of the present study was to compare the impact of Holder and HTST pasteurization on the HM protein profile. The protein patterns of HTST-treated milk and raw milk were similar. The Holder method modified bile salt-stimulated lipase, lactoferrin and components of the immune system. The HTST method preserved the integrity of bile salt-stimulated lipase, lactoferrin and, to some extent, of IgAs. Holder pasteurization decreased the amount of bile salt-stimulated lipase and inactivated the remaining molecules, while the HTST method did not alter its activity. Pasteurization increased the bioavailable lysine quantity. HTST pasteurization seems to better retain the protein profile and some of the key active components of donor HM.
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Journal of human lactation : official journal of International Lactation Consultant Association, 2016
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La Pediatria Medica e Chirurgica, 2015
Hypogalactia has a relative high frequency in women having delivered preterm infants, who often h... more Hypogalactia has a relative high frequency in women having delivered preterm infants, who often have difficulties in maintaining a sufficient production of milk for their infants' needs over prolonged periods of time. Recent studies have shown a potential galactogogue effect of silymarin on milk production in animal models (cows and rats) and in humans (mothers of term newborns); nonetheless, none of the studies conducted on humans consisted of double-blind randomized clinical trials and no data are available concerning mothers who delivered preterm infants. The aim of our study was to assess the efficacy of silymarin (BIO-C®) as galactogogue and its tolerability in mothers who delivered preterm infants. We enrolled 50 mothers at 10±1 days post-partum who had delivered infants at ® and placebo arms. No adverse events were observed in the 2 arms among mothers and infants, and silymarin and its metabolites were not detectable in the analyzed human milk samples. Further investigation on specific patient groups affected by hypogalactia, defined according to stricter criteria, should be planned to assess the efficacy of the product in increasing milk production.
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Pediatrics, 2006
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Journal of biological regulators and homeostatic agents
Hyperbilirubinemia and jaundice are natural, physiological phenomena which are only to be expecte... more Hyperbilirubinemia and jaundice are natural, physiological phenomena which are only to be expected in the neonatal period, within certain limits. The highest percentage of jaundice in breastfed newborns should be evaluated in connection with inadequate management of breastfeeding rather than a direct effect of breast milk. Breastfeeding is also linked to visible jaundice persisting beyond the first two weeks of life (breast milk jaundice), but the appearance of skin jaundice is not a reason for interrupting breastfeeding which can and should continue without any interruption in most cases. There have been numerous contributions to the literature which have rescaled the direct role of breast milk both in early jaundice and in the more severe cases of late jaundice. The reviewed guidelines for detection and management of hyperbilirubinemia underline how prevention of badly managed breastfeeding and early support for the couple mother-child are effective prevention measures against severe early-onset jaundice; furthermore, the breastfeeding interruption is no longer recommended as a diagnostic procedure to identify breast milk jaundice because of its low specificity and the risk to disregarding the detection of a potentially dangerous disease.
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La Pediatria medica e chirurgica : Medical and surgical pediatrics
This study presents the outcome of a multidisciplinary approach to the infants with atopic dermat... more This study presents the outcome of a multidisciplinary approach to the infants with atopic dermatitis. Forty six patients, 40 males and 6 females, afflicted with atopic dermatitis, aged 3 months-2 years, were examined. A careful history was taken for each case to identify possible allergic disease and particular attention was placed on the relation between food assumption and appearance of lesions. The association of diet, dermatological therapy, elimination of environmental stimulus where possible, treatment of lesions and pruritus and good psychological support enable the Authors to obtain 57% of complete remission of atopic dermatitis. In 43% improvement was observed.
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Journal of biological regulators and homeostatic agents
Preterm infants fed fortified human milk in standard fashion receive less protein than they need ... more Preterm infants fed fortified human milk in standard fashion receive less protein than they need due to customary assumptions. Protein is limiting for growth and neurocognitive development,and shortfalls of protein are not acceptable. Adjustable fortification regimen has been proven as an effective way to provide adequate protein intakes and appropriate growth in this group of infants. Italian Association of Human Milk Banks (AIBLUD) has promoted and implemented this Adjustable fortification regimen in neonatal intensive care units (NICUs) with success. This paper presents an update of Adjustable fortification regimen; a new protocol already utilized in several italian NICUs.
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Minerva pediatrica, 2010
Counselling is a professional intervention based on skills to communicate and to build relationsh... more Counselling is a professional intervention based on skills to communicate and to build relationships. The project "Not alone", related to counselling at our Neonatal Intensive Care Unit, is aimed to let counselling become a "shared culture" for all the care givers. The first essential aspect is to form the ability of counselling through periodic courses for all professionals of the department (physicians, nurses, physiotherapists). In our department a professional counsellor is present assisting the medical staff in direct counselling. The counsellor's intervention allows a better parent orientation in the situation. A more effective sharing of these rules also facilitates the communication among parents and medical staff. Periodic meetings are established among the medical staff, in which the professional counsellor discusses difficult situations in order to share possible communicative strategies. We wanted to have not only a common communicative style, but...
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Acta bio-medica de L'Ateneo parmense : organo della Società di medicina e scienze naturali di Parma, 2000
A child with neonatal pseudohypoaldosteronism is referred. The diagnosis was delayed and complica... more A child with neonatal pseudohypoaldosteronism is referred. The diagnosis was delayed and complicated as her parents didn't tell us that her sister had been affected by the same illness. The child was born after premature rupture of membranes at 34 weeks. At birth, her conditions were satisfactory. The general conditions of the child gradually worsened and, though she regularly ate human pastorized bank milk, she didn't gain any weight. After 13 days she appeared dehydrated with marbled dry skin and haloed eyes, hypotonic and hyporeflexic. Her suction became more and more weaker, with frequent regurgitations and vomiting. Laboratory tests pointed out hyponatremia (110 mEq/l) and hyperkalemia (6.8 mEq/l). We were able to establish diagnosis of primary pseudohypoaldosteronism measuring plasma concentrations of aldosterone (> 5000 pg/ml), 17 hydroxyprogesterone (normal) and corticosteroids (normal). The child was then supplemented with sodium chlorure. A gradual improvement o...
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Acta bio-medica de L'Ateneo parmense : organo della Società di medicina e scienze naturali di Parma, 2000
A child with severe generalized hypotonia and respiratory insufficiency, with an unknown positive... more A child with severe generalized hypotonia and respiratory insufficiency, with an unknown positive family history for Steinert's disease, is referred. We want to point out the importance of correct anamnesis and of physical examination during pregnancy to suspect and diagnose rare and incurable fetal pathologies. The child was born after caesarean section. Polyhydramnios and decreased fetal movements were noticed during pregnancy. At birth, the baby presented asphyxia (Apgar 4/6) and respiratory insufficiency: he was then intubed. He received assisted ventilation for 37 days. At the physical examination, the child appeared hypotonic, hyporeflexic, without sucking reflex, with arthrogryposis and ligament laxity. On first day, chest X-ray showed paralysis of the right hemidiaphragm. His mother presented with hypotonia of the facial muscles, lid drop, light muscular weakness, positivity to neostigmine test: we then assumed that the baby was affected by transient neonatal myasthenia ...
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Frontiers in bioscience (Elite edition), 2011
The Holder method is the recommended pasteurization method for human milk banks, as it ensures th... more The Holder method is the recommended pasteurization method for human milk banks, as it ensures the microbiological safety of human milk (HM). The loss of some biologically active milk components, due to the heat treatment, is a main limit to the diffusion of donor HM. High-temperature short-time (HTST) pasteurization may be an alternative to maintain the nutritional and immunological quality of HM. The aim of the present study was to compare the impact of Holder and HTST pasteurization on the HM protein profile. The protein patterns of HTST-treated milk and raw milk were similar. The Holder method modified bile salt-stimulated lipase, lactoferrin and components of the immune system. The HTST method preserved the integrity of bile salt-stimulated lipase, lactoferrin and, to some extent, of IgAs. Holder pasteurization decreased the amount of bile salt-stimulated lipase and inactivated the remaining molecules, while the HTST method did not alter its activity. Pasteurization increased t...
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Journal of human lactation : official journal of International Lactation Consultant Association, Jan 26, 2015
At present, the Italian Association of Donor Human Milk Banks (Associazione Italiana Banche del L... more At present, the Italian Association of Donor Human Milk Banks (Associazione Italiana Banche del Latte Umano Donato, AIBLUD) consists of 31 milk banks, whose management is based on Italian Guidelines. In 2013, AIBLUD performed a systematic survey to collect data on the activities of banks operating in Italy in the years previous to this date. The purpose of this survey was to evaluate the operational procedures of Italian Human Milk Banks in order to identify both areas of strength and room for improvement. A questionnaire was utilized to obtain national data from the 28 banks active in the year 2012 in order to evaluate the number of donors, volume of human milk collected, and other information relating to the period 2007 to 2012. In all, 89% of the banks (25/28) responded to the survey. Data received primarily concerned the number of donors, volume of milk collected, and average amount of milk from each donor in the period 2007 to 2012. It was evident that in 2012 human milk banks ...
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Early Human Development, 2014
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Journal of Maternal-Fetal and Neonatal Medicine, 2011
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Journal of Maternal-Fetal and Neonatal Medicine, 2010
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PEDIATRICS, 2006
. Provided by Google Indexer on January 26, 2011 www.pediatrics.org Downloaded from ... Stephen C... more . Provided by Google Indexer on January 26, 2011 www.pediatrics.org Downloaded from ... Stephen Cook, MD Peggy Auinger, MS Strong Children's Research Center Department of Pediatrics University of Rochester School of Medicine and Dentistry Rochester, NY 14642 Michael ...
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The Journal of Steroid Biochemistry and Molecular Biology
Bookmarks Related papers MentionsView impact
Journal of biological regulators and homeostatic agents
In a Neonatal Intensive Care Unit (NICU) counseling should be a shared culture for all the care g... more In a Neonatal Intensive Care Unit (NICU) counseling should be a shared culture for all the care givers: it should be developed by all the professionals, to face up to parents' needs of information, explanations, facility of decisions, finding of resources, agreement, help, reassurance, attention. The first essential aspect is the training in counseling skills, by periodic courses for all professionals of the department (physicians, nurses, and physiotherapists). In our department, a professional counselor is present, assisting the medical staff in direct counseling. The counselor's intervention allows a better parent orientation in the situation. A more effective sharing of these rules also facilitates the communication among parents and medical staff. Periodic meetings are established among the medical staff, in which the professional counselor discusses difficult situations to share possible communicative strategies. We wanted to have not only a common communicative style,...
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Minerva pediatrica, 2010
Bookmarks Related papers MentionsView impact
Minerva pediatrica, 1994
A cross section study was performed on 1342 children living in the Turin district to examine the ... more A cross section study was performed on 1342 children living in the Turin district to examine the modalities followed for milk-feeding during the first year of life. Children examined had been admitted to the infants' ward of the Pediatric University Clinic of Turin suffering from common illness of early infancy. Mothers were asked to fill in a questionnaire concerning breast-feeding, formula feeding and cow's milk feeding. Data collected show that 75% of infants were exclusively breast-fed at birth, that a large number of infants are already fed cow's milk after the 3rd month of life, that hypoallergenic formulas are overused (18.5% among adapted formulas), and that follow-up formulas are underused. Most of the mothers (74%) say that their dietary choices were made by their physician. These data indicate that infant dietary trends in our district are often not in accordance with scientific recommendations.
Bookmarks Related papers MentionsView impact
Frontiers in Bioscience, 2011
The Holder method is the recommended pasteurization method for human milk banks, as it ensures th... more The Holder method is the recommended pasteurization method for human milk banks, as it ensures the microbiological safety of human milk (HM). The loss of some biologically active milk components, due to the heat treatment, is a main limit to the diffusion of donor HM. High-temperature short-time (HTST) pasteurization may be an alternative to maintain the nutritional and immunological quality of HM. The aim of the present study was to compare the impact of Holder and HTST pasteurization on the HM protein profile. The protein patterns of HTST-treated milk and raw milk were similar. The Holder method modified bile salt-stimulated lipase, lactoferrin and components of the immune system. The HTST method preserved the integrity of bile salt-stimulated lipase, lactoferrin and, to some extent, of IgAs. Holder pasteurization decreased the amount of bile salt-stimulated lipase and inactivated the remaining molecules, while the HTST method did not alter its activity. Pasteurization increased the bioavailable lysine quantity. HTST pasteurization seems to better retain the protein profile and some of the key active components of donor HM.
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Journal of human lactation : official journal of International Lactation Consultant Association, 2016
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La Pediatria Medica e Chirurgica, 2015
Hypogalactia has a relative high frequency in women having delivered preterm infants, who often h... more Hypogalactia has a relative high frequency in women having delivered preterm infants, who often have difficulties in maintaining a sufficient production of milk for their infants' needs over prolonged periods of time. Recent studies have shown a potential galactogogue effect of silymarin on milk production in animal models (cows and rats) and in humans (mothers of term newborns); nonetheless, none of the studies conducted on humans consisted of double-blind randomized clinical trials and no data are available concerning mothers who delivered preterm infants. The aim of our study was to assess the efficacy of silymarin (BIO-C®) as galactogogue and its tolerability in mothers who delivered preterm infants. We enrolled 50 mothers at 10±1 days post-partum who had delivered infants at ® and placebo arms. No adverse events were observed in the 2 arms among mothers and infants, and silymarin and its metabolites were not detectable in the analyzed human milk samples. Further investigation on specific patient groups affected by hypogalactia, defined according to stricter criteria, should be planned to assess the efficacy of the product in increasing milk production.
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Pediatrics, 2006
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Journal of biological regulators and homeostatic agents
Hyperbilirubinemia and jaundice are natural, physiological phenomena which are only to be expecte... more Hyperbilirubinemia and jaundice are natural, physiological phenomena which are only to be expected in the neonatal period, within certain limits. The highest percentage of jaundice in breastfed newborns should be evaluated in connection with inadequate management of breastfeeding rather than a direct effect of breast milk. Breastfeeding is also linked to visible jaundice persisting beyond the first two weeks of life (breast milk jaundice), but the appearance of skin jaundice is not a reason for interrupting breastfeeding which can and should continue without any interruption in most cases. There have been numerous contributions to the literature which have rescaled the direct role of breast milk both in early jaundice and in the more severe cases of late jaundice. The reviewed guidelines for detection and management of hyperbilirubinemia underline how prevention of badly managed breastfeeding and early support for the couple mother-child are effective prevention measures against severe early-onset jaundice; furthermore, the breastfeeding interruption is no longer recommended as a diagnostic procedure to identify breast milk jaundice because of its low specificity and the risk to disregarding the detection of a potentially dangerous disease.
Bookmarks Related papers MentionsView impact
La Pediatria medica e chirurgica : Medical and surgical pediatrics
This study presents the outcome of a multidisciplinary approach to the infants with atopic dermat... more This study presents the outcome of a multidisciplinary approach to the infants with atopic dermatitis. Forty six patients, 40 males and 6 females, afflicted with atopic dermatitis, aged 3 months-2 years, were examined. A careful history was taken for each case to identify possible allergic disease and particular attention was placed on the relation between food assumption and appearance of lesions. The association of diet, dermatological therapy, elimination of environmental stimulus where possible, treatment of lesions and pruritus and good psychological support enable the Authors to obtain 57% of complete remission of atopic dermatitis. In 43% improvement was observed.
Bookmarks Related papers MentionsView impact
Journal of biological regulators and homeostatic agents
Preterm infants fed fortified human milk in standard fashion receive less protein than they need ... more Preterm infants fed fortified human milk in standard fashion receive less protein than they need due to customary assumptions. Protein is limiting for growth and neurocognitive development,and shortfalls of protein are not acceptable. Adjustable fortification regimen has been proven as an effective way to provide adequate protein intakes and appropriate growth in this group of infants. Italian Association of Human Milk Banks (AIBLUD) has promoted and implemented this Adjustable fortification regimen in neonatal intensive care units (NICUs) with success. This paper presents an update of Adjustable fortification regimen; a new protocol already utilized in several italian NICUs.
Bookmarks Related papers MentionsView impact
Minerva pediatrica, 2010
Counselling is a professional intervention based on skills to communicate and to build relationsh... more Counselling is a professional intervention based on skills to communicate and to build relationships. The project "Not alone", related to counselling at our Neonatal Intensive Care Unit, is aimed to let counselling become a "shared culture" for all the care givers. The first essential aspect is to form the ability of counselling through periodic courses for all professionals of the department (physicians, nurses, physiotherapists). In our department a professional counsellor is present assisting the medical staff in direct counselling. The counsellor's intervention allows a better parent orientation in the situation. A more effective sharing of these rules also facilitates the communication among parents and medical staff. Periodic meetings are established among the medical staff, in which the professional counsellor discusses difficult situations in order to share possible communicative strategies. We wanted to have not only a common communicative style, but...
Bookmarks Related papers MentionsView impact
Acta bio-medica de L'Ateneo parmense : organo della Società di medicina e scienze naturali di Parma, 2000
A child with neonatal pseudohypoaldosteronism is referred. The diagnosis was delayed and complica... more A child with neonatal pseudohypoaldosteronism is referred. The diagnosis was delayed and complicated as her parents didn't tell us that her sister had been affected by the same illness. The child was born after premature rupture of membranes at 34 weeks. At birth, her conditions were satisfactory. The general conditions of the child gradually worsened and, though she regularly ate human pastorized bank milk, she didn't gain any weight. After 13 days she appeared dehydrated with marbled dry skin and haloed eyes, hypotonic and hyporeflexic. Her suction became more and more weaker, with frequent regurgitations and vomiting. Laboratory tests pointed out hyponatremia (110 mEq/l) and hyperkalemia (6.8 mEq/l). We were able to establish diagnosis of primary pseudohypoaldosteronism measuring plasma concentrations of aldosterone (> 5000 pg/ml), 17 hydroxyprogesterone (normal) and corticosteroids (normal). The child was then supplemented with sodium chlorure. A gradual improvement o...
Bookmarks Related papers MentionsView impact
Acta bio-medica de L'Ateneo parmense : organo della Società di medicina e scienze naturali di Parma, 2000
A child with severe generalized hypotonia and respiratory insufficiency, with an unknown positive... more A child with severe generalized hypotonia and respiratory insufficiency, with an unknown positive family history for Steinert's disease, is referred. We want to point out the importance of correct anamnesis and of physical examination during pregnancy to suspect and diagnose rare and incurable fetal pathologies. The child was born after caesarean section. Polyhydramnios and decreased fetal movements were noticed during pregnancy. At birth, the baby presented asphyxia (Apgar 4/6) and respiratory insufficiency: he was then intubed. He received assisted ventilation for 37 days. At the physical examination, the child appeared hypotonic, hyporeflexic, without sucking reflex, with arthrogryposis and ligament laxity. On first day, chest X-ray showed paralysis of the right hemidiaphragm. His mother presented with hypotonia of the facial muscles, lid drop, light muscular weakness, positivity to neostigmine test: we then assumed that the baby was affected by transient neonatal myasthenia ...
Bookmarks Related papers MentionsView impact
Frontiers in bioscience (Elite edition), 2011
The Holder method is the recommended pasteurization method for human milk banks, as it ensures th... more The Holder method is the recommended pasteurization method for human milk banks, as it ensures the microbiological safety of human milk (HM). The loss of some biologically active milk components, due to the heat treatment, is a main limit to the diffusion of donor HM. High-temperature short-time (HTST) pasteurization may be an alternative to maintain the nutritional and immunological quality of HM. The aim of the present study was to compare the impact of Holder and HTST pasteurization on the HM protein profile. The protein patterns of HTST-treated milk and raw milk were similar. The Holder method modified bile salt-stimulated lipase, lactoferrin and components of the immune system. The HTST method preserved the integrity of bile salt-stimulated lipase, lactoferrin and, to some extent, of IgAs. Holder pasteurization decreased the amount of bile salt-stimulated lipase and inactivated the remaining molecules, while the HTST method did not alter its activity. Pasteurization increased t...
Bookmarks Related papers MentionsView impact
Journal of human lactation : official journal of International Lactation Consultant Association, Jan 26, 2015
At present, the Italian Association of Donor Human Milk Banks (Associazione Italiana Banche del L... more At present, the Italian Association of Donor Human Milk Banks (Associazione Italiana Banche del Latte Umano Donato, AIBLUD) consists of 31 milk banks, whose management is based on Italian Guidelines. In 2013, AIBLUD performed a systematic survey to collect data on the activities of banks operating in Italy in the years previous to this date. The purpose of this survey was to evaluate the operational procedures of Italian Human Milk Banks in order to identify both areas of strength and room for improvement. A questionnaire was utilized to obtain national data from the 28 banks active in the year 2012 in order to evaluate the number of donors, volume of human milk collected, and other information relating to the period 2007 to 2012. In all, 89% of the banks (25/28) responded to the survey. Data received primarily concerned the number of donors, volume of milk collected, and average amount of milk from each donor in the period 2007 to 2012. It was evident that in 2012 human milk banks ...
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Early Human Development, 2014
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Journal of Maternal-Fetal and Neonatal Medicine, 2011
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Journal of Maternal-Fetal and Neonatal Medicine, 2010
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PEDIATRICS, 2006
. Provided by Google Indexer on January 26, 2011 www.pediatrics.org Downloaded from ... Stephen C... more . Provided by Google Indexer on January 26, 2011 www.pediatrics.org Downloaded from ... Stephen Cook, MD Peggy Auinger, MS Strong Children's Research Center Department of Pediatrics University of Rochester School of Medicine and Dentistry Rochester, NY 14642 Michael ...
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