Italian Journal of Pediatrics最新文献

{"title":"Comparing Italian versus European strategies and technologies for respiratory care in NICU: results of a survey of the Union of European Neonatal and Perinatal Societies (UENPS) and the Italian Society of Neonatology (SIN).","authors":"Camilla Gizzi, Flavia Petrillo, Maria Luisa Ventura, Luigi Gagliardi, Daniele Trevisanuto, Gianluca Lista, Raffaele Dellacà, Artur Beke, Giuseppe Buonocore, Antonia Charitou, Manuela Cucerea, Boris Filipović-Grčić, Nelly Georgieva Jeckova, Esin Koç, Joana Saldanha, Manuel Sanchez-Luna, Dalia Stoniene, Heili Varendi, Giulia Vertecchi, Luigi Orfeo, Fabio Mosca, Corrado Moretti","doi":"10.1186/s13052-025-01936-6","DOIUrl":"10.1186/s13052-025-01936-6","url":null,"abstract":"<p><strong>Background: </strong>Our survey aimed to compare information on respiratory care in Neonatal Intensive Care Units (NICUs) in Italy and in the European and Mediterranean region.</p><p><strong>Methods: </strong>Cross-sectional electronic survey. An 89-item questionnaire focusing on the current modes, devices, and strategies employed in neonatal units in the domain of respiratory care was sent to directors/heads of 528 NICUs.</p><p><strong>Results: </strong>The response rate was 75% (397/528 units). The median number of NICU beds and the admission rate per unit/year of preterm infants < 1500 g was significantly lower in Italy compared with Europe (p < 0.001). In most Italian Delivery Rooms (DR) full resuscitation is given from 22 to 23 weeks gestational age, while 21.0% of the European units initiate from 24 weeks. Initial FiO₂ is set as per American Academy of Pediatrics guidelines in 81.1% of Italian units compared to 30.9% of the European ones (p < 0.001). DR surfactant is less often given through Less-Invasive-Surfactant-Administration (LISA) in Italy (53.4% vs. 76.2% of units, p < 0.03). Volume-targeted, synchronized intermittent positive-pressure ventilation (IPPV) is the preferred invasive mechanical ventilation (MV) mode to treat acute RDS across the surveyed units, however 22.9% % of Italian centers vs. 6.8% of the European ones use HFOV as first choice (p < 0.001). During HFOV, 78% of Italian NICUs set mean airway pressure (MAP) following a lung recruitment procedure compared to 41% of the centers in Europe (p < 0.001). In the NICUs, most of the non-invasive (NIV) modes used are nasal CPAP and nasal IPPV. For infants on NIV, LISA strategy is used in 25.6% of Italian vs. 60.0% of European units (p < 0.001). 70% of surveyed units use a brand caffeine. Inhaled steroids are used in 42.3% of Italian vs. 65.4% of European NICUs (p < 0.001).</p><p><strong>Conclusions: </strong>respiratory support strategies among the surveyed Italian and European NICUs are quite dissimilar in some areas, particularly where high-quality evidence is lacking. We believe that hese data will allow stakeholders to make comparisons and to identify opportunities for improvement.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"100"},"PeriodicalIF":3.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948922/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719300","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":"Treatment of sinusitis in children: an Italian intersociety consensus (SIPPS-SIP-SITIP-FIMP-SIAIP-SIMRI-SIM-FIMMG).","authors":"Elisabetta Venturini, Margherita Del Bene, Lara Fusani, Eleonora Fusco, Alessia Morlando, Elena Chiappini, Maria Carmen Verga, Giuseppe Di Mauro, Silvia Garazzino, Guido Castelli Gattinara, Susanna Esposito, Eugenia Bruzzese, Nicola Principi, Gian Luigi Marseglia, Fabio Midulla, Mattia Doria, Daniele Donà, Stefania Stefani, Annalisa Capuano, Paolo Biasci, Antonio D'Avino, Annamaria Staiano, Alfredo Guarino, Andrea Lo Vecchio, Luisa Galli","doi":"10.1186/s13052-025-01868-1","DOIUrl":"10.1186/s13052-025-01868-1","url":null,"abstract":"<p><p>Sinusitis is an inflammation of the mucous membrane of the paranasal sinuses. Bacterial sinusitis usually occurs as a complication of viral infections of the upper respiratory tract and is a frequent cause of medical consultation. The clinical presentation of acute bacterial sinusitis can vary. It most commonly manifests as an upper respiratory tract infection (nasal congestion, postnasal drip, cough) that persists for more than 10 days without clinical improvement. Unfortunately, updated guidelines in paediatric age are not currently available. The purpose of this consensus is to provide guidelines for the therapeutic management of previous healthy paediatric patients with sinusitis. A systematic review was conducted to identify the most recent and relevant evidence. Embase, Scopus, PubMed, and Cochrane databases were systematically screened, combining the terms \"children\" and \"sinusitis\" and \"antibiotics\" and \"rhinosinusitis\" with a date restriction from 2012 to April 2024, but without language limitations. The certainty of evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methods. The final recommendations were obtained through a Delphi consensus of an expert panel. In children with a diagnosis of uncomplicated acute bacterial sinusitis, made according to strict clinical criteria, systemic empiric antibiotic therapy with amoxicillin or amoxicillin-clavulanic acid is indicated at a high dose (90 mg/kg/day, calculated based on amoxicillin, preferably in 3 daily doses) and for at least 10 days. In children with chronic sinusitis, systemic antibiotic treatment is not recommended, and it is not possible to make any specific recommendation regarding antibiotic agents due to the scarcity of scientific evidence supporting treatment. In conclusion, the diagnosis of sinusitis is primarily clinical, and despite acute sinusitis generally having a favourable course, some cases can present orbital and intracranial complications. The misuse of antibiotics in managing upper respiratory tract infections, including acute sinusitis, and the challenges posed by antibiotic resistance are a current issue in paediatric care. Due to the scarcity, heterogeneity, and poor quality of available evidence either supporting or opposing the use of systemic antibiotic therapy in children with sinusitis prospective studies on larger and more homogeneous cohort are needed.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"102"},"PeriodicalIF":3.2,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11948864/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143719304","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":"Prevalence and risk factors of anemia in internationally adopted children: a cohort study.","authors":"Danilo Buonsenso, Ugo Maria Pierucci, Anna Camporesi, Francesca Raffaelli, Maria Chiara Barbieri, Lucia Scarlato, Arianna Turriziani Colonna, Mariella Iademarco, Ilaria Lazzareschi, Piero Valentini","doi":"10.1186/s13052-025-01944-6","DOIUrl":"10.1186/s13052-025-01944-6","url":null,"abstract":"<p><strong>Background: </strong>Adoptive children, who have often experienced inadequate healthcare, malnutrition, and exposure to infectious diseases in their countries of origin, are vulnerable to a range of health problems among which anemia is a major one, potentially leading to long term sequelae. We aimed to investigate the prevalence and risk factors associated with anemia in a cohort of internationally adopted children evaluated at the Pediatric Clinic of the Policlinico Universitario \"A. Gemelli\" in Rome. between 2007 and 2023.</p><p><strong>Methods: </strong>Retrospective cohort analysis. Demographic and hematological data were collected for each child. Associations between categorical variables was studied with Pearson's or Fisher's test and between quantitative and qualitative variables with Analysis of Variance (ANOVA) with Bonferroni correction. The occurrence of a Hb level inferior to -2SD and that of presenting together Hb Z score < -2SD for and low ferritin have been considered as a binary outcome and studied with multivariable logistic regression models.</p><p><strong>Results: </strong>Nine hundred and sixty-nine children have been enrolled. Weight and height were significantly lower in children from Asia and India compared to Africa and Latin America. Hb z-scores were significantly lower in the 11-18 age group compared to all other age groups. In univariate analysis, Hb z-scores were associated with black skin color and the presence of parasites in stool. Hemoglobin levels were not associated with patient BMI, creatinine levels, bilirubin, TSH, FT3, FT4, AST, or ALT. The mean corpuscular volume (MCV) was associated in univariate analysis with age at arrival, skin color, Macro-area of origin, duration of institutional stay, iron levels. At same MCV, Hb was higher in Asia compared to Africa (p < 0.001). 55 patients had both Hb and MCV values below two SD. These patients are predominantly characterized by black skin color and originating from Africa and India.</p><p><strong>Conclusions: </strong>There is possibly a complex interplay between environmental exposures and genetic predispositions in shaping the health outcomes of adopted children. Healthcare providers who care for internationally adopted children should prioritize comprehensive health assessments that include screening for anemia, nutritional deficiencies, and parasitic infections.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"99"},"PeriodicalIF":3.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709791","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":"Neurofibromatosis type I (NF1) and bone involvement in a pediatric setting: insights from FGF23 levels.","authors":"Giulia Rodari, Valeria Citterio, Masami Ikehata, Deborah Mattinzoli, Giulietta Scuvera, Federico Grilli, Eriselda Profka, Federico Giacchetti, Valentina Collini, Alessandro Risio, Claudia Cesaretti, Federica Natacci, Carlo Alfieri, Giovanna Mantovani, Claudia Giavoli","doi":"10.1186/s13052-025-01941-9","DOIUrl":"10.1186/s13052-025-01941-9","url":null,"abstract":"<p><strong>Background: </strong>Neurofibromatosis type I (NF1) is an autosomal dominant disorder characterized by extremely different phenotypes, sometimes including reduced bone mass. The underlying cause of bone impairment in these patients remains poorly understood, especially in children. Previous studies in mice and single reports in NF1 patients with osteomalacia have shown elevated serum FGF23 levels. The aim of this study was to explore for the first time these results in NF1 pediatric patients to eventually provide biological insight into bone involvement in NF1.</p><p><strong>Methods: </strong>This is an observational, cross-sectional, single-centre study evaluating FGF23/αKlotho levels, as well as other markers of bone metabolism and densitometric parameters in 31 children affected by NF1 and comparing them to 21 age- and sex-matched controls.</p><p><strong>Results: </strong>We enrolled 31 patients with NF1(M/F 13/18; 11.7 ± 2.9 years). After correction for bone age, BMAD Z-score was < -2SDS in 5/31 patients (16.1%). No difference was found between FGF23 and αKlotho between NF1 patients and controls. No association was found between auxological, biochemical, genetic and radiological parameters and FGF23 values.</p><p><strong>Conclusion: </strong>In conclusion, this represents the first study assessing FGF23 levels in NF1 children and its possible relationship with decreased bone mineral density. Contrarily to previous observations, no significant differences were found between NF1 patients and controls regarding FGF23 and αKlotho levels. Additionally, there was no clear association between FGF23 and bone involvement, thus suggesting that this phenomenon is not FGF23-driven or FGF23 derangements might occur later in life. Further research is needed to understand the multifactorial mechanisms and determine optimal intervention strategies.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"98"},"PeriodicalIF":3.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934798/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143709635","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":"Landscape of paediatric endocrine clinical practice in Italy: results from a survey of the Italian Society for Paediatric Endocrinology and Diabetology (ISPED).","authors":"Maria Elisabeth Street, Anna Di Sessa, Andrea Esposito, Anastasia Ibba, Giorgia Pepe, Riccardo Bonfanti, Felice Citriniti, Giuseppe D'Annunzio, Maria Rosaria Licenziati, Malgorzata Wasniewska, Valentino Cherubini, Mariacarolina Salerno","doi":"10.1186/s13052-025-01940-w","DOIUrl":"10.1186/s13052-025-01940-w","url":null,"abstract":"<p><strong>Background: </strong>Pediatric endocrinology has developed enormously over the last 30 years. Many conditions followed-up are rare and/or chronic complex diseases requiring a high level of expertise. Therefore, defining pediatric endocrinology workforce has become crucial. We aimed to provide an overview of the landscape of the Italian Pediatric Endocrinology centers.</p><p><strong>Methods: </strong>A national electronic survey on clinical endocrine practice among the Italian Society for Pediatric Endocrinology and Diabetes (ISPED) centers was carried out. The full time equivalent (FTE) was used to assess the time dedicated by healthcare providers (HCPs) to pediatric endocrinology and calculate the needs.</p><p><strong>Results: </strong>Ninety-one centers completed the electronic survey. Forty-four/91 centers had incorporated a pediatric diabetology service, while the remaining had an independent center. Among HCPs, 271 were pediatric endocrinologists (94 with a temporary, and 265 with a permanent contract). In 14/91 centers, adult endocrinologists were part of the medical staff. In 45/91 centers clinical activity was carried out five days a week. A mean FTE of 0.56 for medical doctors, 0.49 for nurses, 0.31 for dietitians, and 0.13 for psychologists was reported. An average of 110 patients with rare diseases was followed per centre per year. Based on the ISPAD international criteria for the FTE required for the care of diabetic youths we considered rare diseases as a reference instead of diabetes, without considering any other consultations, and this showed a shortage of 80% of required pediatric endocrinologists, 89% of needed nurses, 93% of required dietitians, and 94% of required psychologists. Moreover, approximately 20 pediatric endocrinologists were expected to retire within the following two years. Overall, a mean of 1148 consultations/year per centre was reported for each medical FTE (a mean of 367 first consultations, and 786 follow-ups). Education and training for growth hormone and other specific treatments were provided by a variety of HCPs, mainly by medical doctors (22/91 centers).</p><p><strong>Conclusions: </strong>At present pediatric endocrinology shows a significant burden of activity with a severe shortage of personnel. This should be addressed by policy makers in order to develop strategic programs to ensure optimal care. Recognizing pediatric endocrinology as a subspecialty and offering appropriate training programs would represent a significant step further.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"90"},"PeriodicalIF":3.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934765/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700212","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":"Fat, flames and ultrasounds: the effects of obesity on pediatric joint inflammation.","authors":"Armando Di Ludovico, Ilaria Mascioli, Saverio La Bella, Giovanni Grassi, Concetta Mastromauro, Luciana Breda, Francesco Chiarelli, Anna Maria Musolino, Cosimo Giannini, Antonio Corsello","doi":"10.1186/s13052-025-01937-5","DOIUrl":"10.1186/s13052-025-01937-5","url":null,"abstract":"<p><p>The association between childhood obesity and the early appearance of joint degeneration, particularly in the infrapatellar \"Hoffa's\" fat pad, highlights the importance of early diagnosis and treatment. The purpose of this review is to describe the role of ultrasound imaging as a first-line imaging tool for the early detection, prevention, and follow-up of degenerative structural changes in children's joints. By combining ultrasound findings with clinical assessments and indices, healthcare providers can gain a more comprehensive understanding of obesity-related joint alterations. This integrative approach enables early therapeutic interventions, improving outcomes for affected children. Proactive management of pediatric obesity will not only improve the long-term outcomes of obesity-related joint disorders but also reduce the burden of related complications, such as osteoarthritis, in adulthood.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"96"},"PeriodicalIF":3.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700220","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":"Improving machine learning models through explainable AI for predicting the level of dietary diversity among Ethiopian preschool children.","authors":"Gizachew Mulu Setegn, Belayneh Endalamaw Dejene","doi":"10.1186/s13052-025-01892-1","DOIUrl":"10.1186/s13052-025-01892-1","url":null,"abstract":"<p><strong>Background: </strong>Child nutrition in Ethiopia is a significant concern, particularly for preschool-aged children. Children must have a varied diet to ensure they receive all the essential nutrients for good health. Unfortunately, many children in Ethiopia lack access to a range of foods, which can lead to malnutrition and other health issues. While machine learning (ML) has the potential to analyse extensive datasets, the lack of transparency in these models can impede their effectiveness in real-world applications, especially in public health. This research aims to enhance machine learning models by integrating Explainable AI (XAI) methods to more accurately predict the level of dietary diversity in Ethiopian preschool children.</p><p><strong>Methods: </strong>To Improve the ML Model for Predicting the Level of Dietary Diversity among Ethiopian Preschool Children. We employed an ensemble ML approach with XAI. The Ethiopian demographic health survey collected a dataset consisting of dietary information and relevant socioeconomic variables. The data were preprocessed to obtain quality data that are suitable for the ensemble ML algorithms to develop a model. We applied filter (chi-square and mutual information) and wrapper (sequential backwards) feature selection methods to identify the most influential factors for dietary diversity (DD). Ethiopia demographic health survey (from 2011 to 2019). Datasets were used. We developed a predictive model using a decision tree, random forest, gradient boosting, light gradient boosting, CatBoost, and XGBClassifier. We evaluated it using accuracy, precision, recall, F1_score, and receiver operating characteristic (ROC)-based evaluation techniques.</p><p><strong>Results: </strong>The ensemble ML models exhibited robust predictive performance, and light gradient boosting outperformed the other ensemble ML algorithms by 95.3%. The explainability of the Light Gradient Boosting Ensemble Model was determined using Eli5 and LIME. The child's age, household wealth index, household region, source of drinking water, frequency of listening to the radio, and mother's education level were the most crucial variables for the prediction of Minimum Dietary Diversity (MDD) in Ethiopia.</p><p><strong>Conclusions: </strong>The research effectively demonstrated that integrating Explainable AI with machine learning can accurately predict dietary diversity in preschoolers in Ethiopia. The results of this study have significant implications for stakeholders in child development and nutrition, as well as for policymakers and medical experts. Targeted interventions and policies to enhance the nutritional health of Ethiopian preschool children are made possible by the explainable AI model that has been constructed.</p><p><strong>Trial registration: </strong>Retrospectively registered.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"91"},"PeriodicalIF":3.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700223","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":"An analysis of real-life data of infants born to mothers with autoimmune thyroiditis: do they need to be followed-up?","authors":"Beatrice Righi, Nives Melli, Alessandra Cassio, Alessio Canovi, Francesco Leo, Chiara Sartori, Alessandra Polese, Rossana Colla, Alessandro De Fanti, Giancarlo Gargano, Maria Elisabeth Street","doi":"10.1186/s13052-025-01915-x","DOIUrl":"10.1186/s13052-025-01915-x","url":null,"abstract":"<p><strong>Background: </strong>Infants born to mothers with autoimmune thyroiditis (AT) could be at risk of developing thyroid dysfunction, and maternal anti-thyroid antibodies have been shown to have a clinical impact on offspring. We aimed at evaluating the usefulness of our follow-up intervention protocol in newborns from mothers with AT and to define the most appropriate management for these neonates.</p><p><strong>Methods: </strong>89 mothers with AT and their newborns were included. Data on maternal thyroid function and autoimmunity were collected; serum thyroid function and autoimmunity of infants were assessed regularly until normalisation of thyroid stimulating hormone (TSH) and anti-thyroid antibodies, according to the local protocol.</p><p><strong>Results: </strong>Thyroid auto-antibodies were measured in 38% and in 62% of mothers before and during pregnancy, respectively. Anti-thyroid peroxidase (anti-TPO) and anti-thyroglobulin (anti-TG) were positive in 97% and 61%, respectively, of the mothers assessed. Anti-TSH receptor antibodies (TRAb) were checked in 18% of the mothers and all were negative. 94% of newborns at first evaluation had positive anti-thyroid antibodies, starting to normalise or decrease from the second month of life. Analysing TSH levels according to the days of postnatal life of collection samples (T1: 30 ± 7 days, T2: 61 ± 9 days, T3: 105 ± 49 days, T4: 135 ± 31 days, T5: 247 ± 64 days), peak TSH levels were found at T4 (4.4 ± 2.2 mU/L), within the cut-off of 6 mU/L. 84% of children maintained a normal thyroid function during follow-up; 12% of infants presented a TSH above 6 mU/L at least in one blood test, showing normalisation during follow-up. Only one infant received replacement therapy for hypothyroidism at 2 months. 91% of the 22 thyroid ultrasounds (US) performed were normal. In those with changes thyroid function normalised anyway.</p><p><strong>Conclusions: </strong>Mothers with AT do not seem to deliver newborns at risk of overt hypothyroidism. However, because of the possible negative effects of maternal anti-thyroid antibodies, we underline the importance of monitoring thyroid autoimmunity during pregnancy, including both anti-TG besides anti-TPO antibodies.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"97"},"PeriodicalIF":3.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934720/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700490","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 nutritional management and risk of neonatal bronchopulmonary dysplasia: a systematic review and mata analysis.","authors":"Jiayi Yang, Hua Mei, Mengyue Huo, Yuheng Zhang, Chun Xin","doi":"10.1186/s13052-025-01929-5","DOIUrl":"10.1186/s13052-025-01929-5","url":null,"abstract":"<p><p>This study examines the relationship between early postnatal nutrition, fluid management in preterm infants, and the risk of bronchopulmonary dysplasia (BPD). A comprehensive review was conducted across multiple databases, including PubMed, Embase, Cochrane Library, Web of Science, and major Chinese databases, covering studies up to 31 August 2024. Case-control and cohort studies on nutritional management and BPD were analyzed using meta-analysis in Stata 15.0. The study is registered on Prospero (CRD42023484951). A total of 11 studies involving 1,826 infants (894 with BPD, 931 controls) were included. Findings showed significantly lower calorie intake in the BPD group during the first postnatal week (Mean Difference = -6.20, 95% CI: -8.91 to -3.48, P < 0.05). While fluid intake differences were not statistically significant (Mean Difference = 5.31, 95% CI: -0.57 to 11.19, P = 0.077), the BPD group had lower protein (Mean Difference = -0.13, 95% CI: -0.22 to -0.04, P < 0.05), lipid (Mean Difference = -0.39, 95% CI: -0.49 to -0.299, P < 0.05), and carbohydrate intake (Mean Difference = -0.74, 95% CI: -0.95 to -0.54, P < 0.05). Time to full enteral nutrition was also prolonged in the BPD group (Mean Difference = 11.23, 95% CI: 9.68-12.78, P < 0.05). These results suggest that inadequate early nutrition may increase BPD risk. Optimizing nutritional and fluid management, alongside respiratory support, is essential for prevention.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"94"},"PeriodicalIF":3.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700042","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":"Multidisciplinary treatment of severe spinal deformity complicated with severe cardiopulmonary dysfunction: a case report.","authors":"Beiyu Xu, Chao Li, Longtao Qi, Yao Zhao, Wence Wu, Chengxian Yang, Ranlv Zhu, Zhengrong Yu, Chunde Li","doi":"10.1186/s13052-025-01925-9","DOIUrl":"10.1186/s13052-025-01925-9","url":null,"abstract":"<p><strong>Background: </strong>Severe spinal deformity (Cobb angle > 90°) often leads to cardiopulmonary dysfunction, posing significant surgical risks. We report a rare case of severe kyphoscoliosis with cardiopulmonary failure treated with non-invasive ventilation, anti-shock treatment, Halo-pelvic traction (HPT), and orthopedic surgery, emphasizing the importance of multidisciplinary cooperation.</p><p><strong>Case presentation: </strong>A 13-year-old Boy with genetic suspicion of distal arthrogryposis (Type 5D) presented with Cobb angles of 94° (scoliosis) and 69° (kyphosis), respiratory failure (PO₂ 36.3 mmHg), and pre-shock status. A multidisciplinary team stabilized the patient using non-invasive ventilation, nutritional optimization and HPT. Post-traction correction rates reached 46.8% (coronal) and 53.6% (sagittal). Subsequent posterior spinal fusion (T1-L5) achieved 69% correction, resolving cardiopulmonary dysfunction and resulting in a highly satisfactory therapeutic outcome.</p><p><strong>Conclusions: </strong>This case illustrates a case with severe spinal deformity combined with extremely severe cardiopulmonary dysfunction and highlights the importance of multidisciplinary cooperation in high-risk pediatric patients.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"92"},"PeriodicalIF":3.2,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11934723/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143700230","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}