Italian Journal of Pediatrics最新文献

{"title":"Asthma-related mortality in Italian children and adolescents.","authors":"Francesca Saretta, Mattia Giovannini, Angela Klain, Luca Pecoraro, Stefania Arasi, Simona Barni, Lucia Caminiti, Riccardo Castagnoli, Mariannita Gelsomino, Lucia Liotti, Carla Mastrorilli, Francesca Mori, Gianluigi Marseglia, Elio Novembre","doi":"10.1186/s13052-026-02303-9","DOIUrl":"10.1186/s13052-026-02303-9","url":null,"abstract":"<p><p>Despite the progress made in the last few decades in diagnosis and therapy, children and adolescents still die of asthma worldwide. In this study, we collected all asthma-related death events in Italian children and adolescents (0-19 years old) from 2013 to 2023 through the Italian National Statistical Database. 46 deaths were recorded, with a mortality rate of 0.39 per million individuals aged 0-19 years old (population denominator: 10.7 million), with the highest number of deaths observed in North-East Regions (36.9%) and 39/46 (84.7%) deaths between 10 and 19 years old. Factors associated with fatal asthma are also discussed. Targeted preventive strategies and further research are called for, particularly in high-incidence regions and adolescents.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"52 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13445919/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148678520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of doxycycline treatment with time to first documented MP-RNA negative conversion in pediatric Mycoplasma pneumoniae pneumonia: a retrospective cohort study.","authors":"Di Lian, Jianxing Wei, Meiling Xie, Chenye Lin, Qiuyu Tang","doi":"10.1186/s13052-026-02322-6","DOIUrl":"10.1186/s13052-026-02322-6","url":null,"abstract":"<p><strong>Background: </strong>Macrolide-resistant Mycoplasma pneumoniae (MRMP) complicates the treatment of pediatric M. pneumoniae pneumonia (MPP). We evaluated whether treatment with doxycycline, compared with azithromycin, was associated with faster first documented negative conversion of M. pneumoniae RNA (MP-RNA) and clinical recovery during a period of high macrolide resistance prevalence.</p><p><strong>Methods: </strong>This retrospective cohort study included 137 children hospitalized with MPP between October 2023 and January 2025 who received azithromycin (n = 90) or doxycycline (n = 47) monotherapy initiated on admission. MP-RNA was monitored using simultaneous amplification and testing. The primary endpoint was the time from the first antibiotic dose to first documented MP-RNA negative conversion. Multivariable Cox regression, propensity score overlap weighting, and an approximate interval-censored Weibull accelerated failure time model were used.</p><p><strong>Results: </strong>The doxycycline group was older and had greater baseline disease severity. The median time to first documented MP-RNA negative conversion was shorter with doxycycline than with azithromycin (6.0 vs. 10.0 days; P < 0.001). Doxycycline use was associated with faster negative conversion in the multivariable Cox model (summary HR 9.28, 95% CI 5.02-17.17; P < 0.001). After overlap weighting, 19 of 20 covariates met the balance threshold, although residual age imbalance remained (absolute SMD = 0.164); the association persisted (summary HR 8.08, 95% CI 4.27-15.31; P < 0.001). The interval-censored model yielded a time ratio of 0.60 (95% CI 0.53-0.67; P < 0.001). The 24-hour rapid defervescence rate was 89.4% with doxycycline and 37.8% with azithromycin (risk difference 51.6%, 95% CI 36.3%-63.4%). No severe treatment-limiting adverse events were documented. Among 24 doxycycline-treated children aged < 8 years, no tooth discoloration or enamel hypoplasia was reported during follow-up, although dental assessment was not standardized.</p><p><strong>Conclusions: </strong>Doxycycline use was associated with faster first documented MP-RNA negative conversion and clinical recovery than azithromycin. These retrospective, nonrandomized findings do not establish causal superiority. Doxycycline may be considered when macrolide resistance is confirmed or strongly suspected, but prospective multicenter studies are required.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"52 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13545780/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148891289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical and laboratory features of pediatric Mycoplasma pneumoniae Pneumonia with viral versus bacterial co-infection.","authors":"Yixin Zhu, Xin Zhang, Ying Jin","doi":"10.1186/s13052-026-02308-4","DOIUrl":"https://doi.org/10.1186/s13052-026-02308-4","url":null,"abstract":"<p><strong>Objective: </strong>To analyse the epidemiological, clinical, and laboratory differences among children, in Suzhou, with Mycoplasma pneumoniae (MP) mixed with viral or bacterial pneumonia and to provide evidence for early clinical differentiation and localised prevention.</p><p><strong>Methods: </strong>This retrospective study included 392 children with Mycoplasma pneumoniae pneumonia (MPP) who were divided into an MPP mixed with viral pneumonia group (n = 254) and a bacterial pneumonia group (n = 138). Epidemiological characteristics, clinical manifestations, immune, coagulation, and inflammatory indicators, pathogen distribution, and bacterial drug susceptibility were compared.</p><p><strong>Results: </strong>The MPP mixed with viral pneumonia group had older children [6 (3, 8) vs. 4 (2, 6.25) years, P = 0.001], a higher incidence of pneumonia in spring (51.97% vs. 18.12%, P < 0.001), and more crackles and fewer breath sounds (P < 0.05). The MPP mixed with bacterial group was more common in the summer and autumn, with a higher vomiting incidence (P = 0.021), higher C3 abnormal rate (P = 0.049) and greater procalcitonin elevation (P < 0.001). The MPP mixed with viral pneumonia group had higher level of serum amyloid A and D-dimer (P < 0.05). Human rhinovirus was the predominant virus (53.67%), and Streptococcus pneumoniae was the main bacterium (58.99%) with 100% Erythromycin resistance but high sensitivity to Penicillin G and Cefotaxime.</p><p><strong>Conclusions: </strong>The two groups differed in age, season, clinical features, and several biomarkers. Viral coinfection was associated with higher SAA and D-dimer, while bacterial coinfection with higher PCT. However, the discriminatory value of these markers is limited, and they should be used in conjunction with other clinical data. Local pathogens were dominated by rhinovirus and S. pneumoniae, with the latter exhibiting complete erythromycin resistance, highlighting the need for surveillance and rational antibiotic use.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"52 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13495482/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lung ultrasound versus chest X-ray in pediatric lower respiratory tract infections at a tertiary center: a prospective observational study.","authors":"Rehab Elmeazawy, Asmaa Azmy Aborady, Ahmed Mohamed Abd-Razik, Adel Ali Erfan, Mohamed Adel Eltomey, Mohamed Bassiony Hamza","doi":"10.1186/s13052-026-02314-6","DOIUrl":"10.1186/s13052-026-02314-6","url":null,"abstract":"<p><strong>Background: </strong>Lower respiratory tract infections (LRTIs) are a major cause of morbidity in children. While chest X-ray (CXR) is widely used for diagnosis, it has limitations including radiation exposure and suboptimal sensitivity. Lung ultrasound (LUS) is an emerging rapid, non-invasive alternative. This study aimed to evaluate the diagnostic performance of LUS versus CXR in pediatric LRTIs, with a focus on subgroup variability.</p><p><strong>Methods: </strong>This prospective observational study included 338 children (aged 1 month-18 years) with suspected LRTIs admitted to a tertiary care hospital. All patients underwent clinical assessment, CXR, and LUS at admission and follow-up. LUS findings were compared with CXR using sensitivity, specificity, predictive values, accuracy, and Cohen's kappa (κ) for agreement.</p><p><strong>Results: </strong>LUS demonstrated high sensitivity for pulmonary pathology at admission (95.6%) and follow-up (96.7%), with specificity improving from 29.4% at admission to 62.9% at follow-up. Overall agreement between LUS and CXR progressed from fair at admission (Cohen's κ = 0.311, 95% CI: 0.198-0.424) to substantial at follow-up (Cohen's κ = 0.607, 95% CI: 0.501-0.713). Subgroup analysis demonstrated meaningful variation in LUS-CXR agreement across diagnostic categories. The highest concordance was observed in pneumonia (κ = 0.438-0.470, moderate agreement), consistent with LUS's established strength in detecting parenchymal consolidation. Agreement was notably lower in recurrent wheezing (κ = 0.208-0.283, fair agreement) and was poor to negligible in acute bronchiolitis (κ = -0.029-0.000) and the heterogeneous \"others\" group (κ = -0.053-0.182). LUS demonstrated high accuracy in detecting consolidations, subpleural lesions, and pleural abnormalities, and facilitated serial monitoring of disease progression during hospitalization.</p><p><strong>Conclusion: </strong>LUS is a promising, radiation-free imaging modality for the diagnosis and follow-up of pediatric LRTIs, particularly pneumonia, demonstrating moderate to substantial agreement with CXR. Its lower specificity and reduced performance in airway-predominant conditions highlight the importance of cautious interpretation alongside clinical findings.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"52 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13401307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148584395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early lung ultrasound at one hour of life and subsequent oxygen requirement during the first 48 h after birth: a prospective observational study.","authors":"Bogdan Rotea, Andra Rotea, Mirabela Dima, Ileana Enătescu, Bogdan Cerbu, Mădălina Șuba, Ovidiu Roșca, Daniela Iacob","doi":"10.1186/s13052-026-02313-7","DOIUrl":"10.1186/s13052-026-02313-7","url":null,"abstract":"<p><strong>Background: </strong>Early identification of newborns at risk for respiratory support remains challenging. Lung ultrasound (LUS) provides real-time information on pulmonary aeration, while right diaphragmatic ultrasound evaluates respiratory muscle function.</p><p><strong>Objectives: </strong>To assess whether lung and right diaphragmatic ultrasound findings obtained at one hour of life differed between term and near-term newborns who subsequently required free-flow oxygen supplementation within the first 48 h after birth and those who did not.</p><p><strong>Methods: </strong>This prospective observational study included term and near-term newborns undergoing standardized lung ultrasound and right diaphragmatic ultrasound at one hour of life. Lung ultrasound was performed using a six-region protocol with a 0-3 scoring system. Right diaphragmatic function was assessed by diaphragmatic thickening fraction and excursion. The primary outcome was the requirement for free-flow oxygen supplementation at any time during the first 48 h of life. Continuous variables are reported as median and interquartile range (IQR), and categorical variables as counts and percentages. Group comparisons, logistic regression, and receiver operating characteristic (ROC) curve analysis were performed.</p><p><strong>Results: </strong>A total of 121 newborns underwent ultrasound assessment at one hour of life. Free-flow oxygen supplementation within the first 48 h was required in 28 newborns (23.1%). Lung ultrasound score at one hour was significantly higher in newborns requiring oxygen than in those who did not (10.5 [IQR 9-11] vs. 7 [IQR 5-8], p < 0.001). Right diaphragmatic thickening fraction was 21.5% (IQR 17.2-24.1) in the oxygen group and 20.0% (IQR 18.2-22.7) in the no oxygen group, while right diaphragmatic excursion was 5.55 mm (IQR 5.25-5.8) and 5.6 mm (IQR 5.3-6.1), respectively; neither differed significantly between groups. In multivariable analysis adjusting for gestational age and cesarean delivery, lung ultrasound score remained significantly associated with subsequent oxygen requirement (adjusted OR 3.41 per one-point increase, 95% CI 2.08-5.60, p < 0.001). ROC analysis showed promising discriminatory performance in this exploratory cohort, with an AUC of 0.94 (95% CI 0.85-0.99); a lung ultrasound score threshold of 9 provided 89.3% sensitivity and 88.2% specificity.</p><p><strong>Conclusions: </strong>In this cohort of term and near-term newborns, a higher lung ultrasound score at one hour of life was significantly associated with subsequent free-flow oxygen requirement within the first 48 h and showed promising discriminatory performance in this exploratory cohort. In contrast, right diaphragmatic ultrasound parameters did not clearly differentiate between groups. These findings support the potential role of early lung ultrasound in neonatal respiratory risk stratification, but external validation in larger prospective cohorts is required.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453081/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148548900","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical spectrum and ascertainment pathways in pediatric female dystrophinopathy.","authors":"Hui Jiao, Jinli Bai, Ping Li, Jing Sun, Dongqing Li, Jianzhao Zhang, Yujin Qu, Xiaoyin Peng","doi":"10.1186/s13052-026-02312-8","DOIUrl":"https://doi.org/10.1186/s13052-026-02312-8","url":null,"abstract":"<p><strong>Background: </strong>Pediatric female dystrophinopathy may be asymptomatic at evaluation or may show skeletal muscle and cardiac manifestations, but childhood presentations are often subtle. We aimed to characterize the clinical spectrum, ascertainment pathways, subclinical muscle involvement, and inheritance patterns in this population.</p><p><strong>Methods: </strong>This single-center retrospective case series was conducted between January 2024 and December 2025 and included 35 girls with genetically confirmed DMD gene variants identified from existing clinical records. Primary ascertainment route was recorded separately from cross-sectional clinical status at evaluation and classified as symptom-driven presentation, incidental or unexplained hyperCKemia, family-based cascade screening, or incidental genomic discovery. Clinical status at evaluation was assigned after systematic clinical review with reference to published female dystrophinopathy classifications. Statistical analyses were exploratory.</p><p><strong>Results: </strong>The median age was 5 years (range, 1-10). Primary ascertainment routes were symptom-driven presentation in 8/35 (22.9%), incidental or unexplained hyperCKemia in 18/35 (51.4%), family-based cascade screening in 8/35 (22.9%), and incidental genomic discovery in 1/35 (2.9%). After systematic clinical review, clinical status at evaluation was classified as asymptomatic in 29 participants, BMD-like in 1, DMD-like in 3, and cardiac-symptom/CMR observations in 2. All 18 girls initially identified through incidental or unexplained hyperCKemia were classified as asymptomatic because no muscle weakness was documented on neurological examination, although some had exercise intolerance, easy fatigue, myalgia, or cramps. EMG abnormalities were identified in 14/34 participants, including definite myopathic findings in 5 and subtle short-duration motor-unit-potential changes in 9. Variants were apparently de novo in 15 cases, maternally inherited in 18, and paternally inherited in 2, including one case inherited from a father with low-level mosaicism in peripheral blood.</p><p><strong>Conclusions: </strong>Pediatric female dystrophinopathy shows a broad childhood spectrum and may be recognized before objective muscle weakness is documented. Separating ascertainment route from clinical status highlights recurrent or persistent hyperCKemia and mild exercise-related complaints as practical entry points for targeted neuromuscular assessment and longitudinal follow-up. Earlier recognition in childhood may support timely neuromuscular and cardiac surveillance, parental evaluation when appropriate, family-based genetic counseling, and future reproductive planning.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148497534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features and outcomes associated with macrolide resistance - associated mutations in pediatric Mycoplasma pneumoniae pneumonia.","authors":"Yilan Huang, Zili Zhang, Ming Liang, Jiaxing Xu, Chengyu Lu, Jili Yuan","doi":"10.1186/s13052-026-02310-w","DOIUrl":"10.1186/s13052-026-02310-w","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the clinical characteristics of macrolide resistance - associated mutations in hospitalized children with Mycoplasma pneumoniae pneumonia (MPP) and to evaluate their associations with severe Mycoplasma pneumoniae pneumonia (SMPP) and prolonged cough.</p><p><strong>Methods: </strong>A total of 1,094 hospitalized children with MPP were retrospectively enrolled. Among them, 1,069 underwent A2063G/A2064G mutation testing, whereas 25 were not tested. Patients were classified into mutation-positive, mutation-negative, and untested groups according to mutation testing results. Clinical features, laboratory parameters, treatment profiles, and outcomes were compared among groups. Logistic regression and receiver operating characteristic (ROC) curve analyses were performed to identify risk factors for SMPP and prolonged cough.</p><p><strong>Results: </strong>The proportion of SMPP was higher in the mutation-positive group than in the mutation-negative group. In addition, patients in the mutation-positive group exhibited a more pronounced inflammatory response and greater immune imbalance, as reflected by increased neutrophil percentage and D - dimer levels, along with decreased CD4 and CD8 counts. Univariate analysis showed that A2063G/A2064G mutation status was associated with both SMPP and prolonged cough. However, multivariable analysis identified fibrinogen and AST as independent factors associated with SMPP, while prolonged cough was additionally associated with the duration of azithromycin and clarithromycin therapy, as well as CD8 levels.</p><p><strong>Conclusion: </strong>Children with macrolide resistance-associated mutations exhibited a higher inflammatory burden and a higher unadjusted proportion of SMPP. However, after adjustment, A2063G/A2064G mutation status was not independently associated with SMPP or prolonged cough. Clinical management should integrate inflammatory markers, oxygenation status, and clinical presentation for individualized monitoring and treatment.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13670534/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148470575","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Respiratory function in children and young adults affected by neurofibromatosis type 1 treated with selumetinib.","authors":"Elettra Zuliani, Francesco Baldo, Sergio Ghirardo, Andrea Magnolato, Irene Bruno, Massimo Maschio, Egidio Barbi","doi":"10.1186/s13052-026-02297-4","DOIUrl":"10.1186/s13052-026-02297-4","url":null,"abstract":"<p><strong>Background: </strong>Plexiform neurofibromas (PNs) are benign tumors that can cause pain, disfigurement, and disability in patients with neurofibromatosis type 1. Selumetinib, a MEK1/2 inhibitor, is the first drug who showed efficacy in inducing PNs shrinkage, reducing the associated morbidities in pediatric patients. Overall, selumetinib showed a good safety profile. However, multiple adverse effects have been reported both in pediatric and adult patients, including respiratory ones. Serial spirometry is suggested in patients with thoracic neurofibromas to detect changes that may underly PN's modifications. The aims of this study are to investigate the trend of pulmonary function in pediatric patients with NF1 treated with selumetinib and to determine the onset of respiratory adverse events.</p><p><strong>Methods: </strong>This is a retrospective study conducted at the Pediatric Department of the Institute for Maternal and Child Health IRCCS \"Burlo Garofolo\" in Trieste, Italy. We identified all the patients diagnosed with NF1 at our institution who received selumetinib. We excluded patients unable to perform spirometry at treatment start, and patients above 18 years of age. We registered patients' forced vital capacity (FVC) and forced expiratory volume in the first second (FEV1) for the first two years of follow-up and record any possible respiratory adverse effect since the beginning of the treatment.</p><p><strong>Results: </strong>A total of 21 patients were included (7 females, 14 males) out of the 24 treated with selumetinib. Patients' median age when selumetinib was started was 12 years. Neurofibromas were located mostly in the upper body, but 13 of them were in the thoracic area. The duration of the clinical follow-up ranged from 9 months to 72 months (6 years), with a mean follow-up length of 37 months. During the follow-up period, none of the patients reported pulmonary symptoms and no significant changes of the spirometry values were detected. Among those with thoracic plexiform neurofibromas, no correlation was found between spirometry values and PN's volumetric changes at the MRI.</p><p><strong>Conclusions: </strong>Our experience suggests that selumetinib does not impact on pulmonary function in children and young adults. Serial spirometry should not be mandatory or could be at least distanced since it is not an appropriate method to precisely monitor plexiform neurofibromas changes over time.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148436764","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occurrence of diarrhea in pediatric bronchopneumonia patients: relevance to nursing management.","authors":"Yinyan Tang, Qian Zhang, Tingting Yu","doi":"10.1186/s13052-026-02301-x","DOIUrl":"10.1186/s13052-026-02301-x","url":null,"abstract":"<p><strong>Background: </strong>Diarrhea represents a frequent complication in pediatric patients with bronchopneumonia. This study was designed to identify independent risk factors for diarrheal complications and to propose evidence-informed nursing interventions.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted among 280 hospitalized children with bronchopneumonia. Demographic, anthropometric, laboratory, and treatment-related data were extracted from electronic medical records. Multicollinearity was assessed by variance inflation factor (VIF), and independent risk factors were identified through binary logistic regression with model fit evaluated by the Hosmer-Lemeshow test.</p><p><strong>Results: </strong>The incidence of diarrhea was 23.57%. Eight independent risk factors were identified: antibiotic duration ≥ 7 days (OR = 3.006), β-lactamase inhibitor combination use (OR = 2.916), combined antibiotic use (OR = 2.401), mixed pulmonary infection (OR = 2.105), age < 5 years (OR = 2.048), weight-for-height/length z-score < - 2 (OR = 1.982), serum albumin < 35 g/L (OR = 1.896), and C-reactive protein ≥ 20 mg/L (OR = 1.845). Probiotic administration was an independent protective factor (OR = 0.849). All VIF values were < 5, and the Hosmer-Lemeshow test indicated adequate model fit (P > 0.05).</p><p><strong>Conclusion: </strong>Diarrhea in children with bronchopneumonia is associated with multiple clinical and therapeutic variables, with β-lactamase inhibitor combinations and prolonged antibiotic therapy conferring the highest risk. These findings provide a hypothesis-generating foundation for risk-stratified nursing strategies to reduce diarrheal complications. However, given the retrospective design and the inability to distinguish antibiotic-associated diarrhea from infectious diarrhea, the identified associations should be interpreted cautiously, and any derived clinical recommendations require prospective validation.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644138/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"New insight into anomalies of coronary arteries in children: diagnosis, treatment with perioperative and postoperative course and prognosis.","authors":"Kamila Kurkiewicz-Sawczak, Filip Baszkowski, Filip Sawczak, Malwina Baturo, Kinga Walska-Świerc, Rafał Surmacz, Dominika Wysocka, Marta Kałużna-Oleksy, Waldemar Bobkowski","doi":"10.1186/s13052-026-02302-w","DOIUrl":"10.1186/s13052-026-02302-w","url":null,"abstract":"<p><strong>Background: </strong>Coronary artery anomalies (CAAs) are rare and heterogeneous congenital abnormalities. However, some of them are associated with serious consequences, including myocardial ischemia, heart failure, and even death. This study aimed to characterize symptoms, course, treatment, and prognosis of different types of CAAs.</p><p><strong>Methods: </strong>This single-centre retrospective cohort study included 38 consecutive paediatric patients hospitalised in the Department of Paediatric Cardiology due to a diagnosis of CAAs between 01.2012-03.2025. Patients were divided into two groups: anomalous origin of the coronary arteries (Origin anomalies) and coronary artery fistulae (CAF), respectively, 20 and 18 patients. The collected data included clinical symptoms, laboratory tests, electrocardiography, echocardiographic parameters, course of treatment and long-term follow-up.</p><p><strong>Results: </strong>The mean age of the analysed group was 3.32 ± 5.35 years (range: 1 day - 16 years; IQR0-4.25). The study group included 42% males. During the follow-up, no patient died. There were significant differences between groups in the occurrence of dyspnoea (p < 0.001), cyanosis (p = 0.048), echocardiographic parameters: mitral insufficiency (p = 0.001), left ventricle dilatation (p < 0.001), left ventricular end diastolic diameter z-score (p = 0.023) and end systolic diameter z-score (p = 0.004) and lower ejection fraction (p = 0.001), which was more prevalent in the origin anomalies group than in the CAF group. Moreover, lower haemoglobin (p = 0.006) and haematocrit (p = 0.005) were observed in the origin anomalies group compared to the CAF group.</p><p><strong>Conclusions: </strong>Our study showed that prompt diagnosis and treatment, including transcatheter or surgical intervention, were associated with clinical improvement and no mortality observed during the follow-up period in the study group. Symptoms like dyspnoea, cyanosis, syncope, no weight gain, feeding disorder and fatigue, especially in younger children, should prompt us to expand the diagnosis and look for diseases such as CAAs. Additionally, patients with origin anomalies had more frequent cyanosis, dyspnoea, mitral insufficiency, left ventricle dilatation and lower ejection fraction, haematocrit, and haemoglobin levels than patients with CAF.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13644035/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148420772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}