Italian Journal of Pediatrics最新文献

{"title":"Modeling and scientific analysis of pediatric medication evaluation based on MDM-DEA-Malmquist model: construction of health management in pediatrics in developing countries.","authors":"Kaixian Fang, Shaoqin Xue","doi":"10.1186/s13052-025-01893-0","DOIUrl":"10.1186/s13052-025-01893-0","url":null,"abstract":"<p><strong>Background: </strong>The developing countries represented by China have huge population potential and child population. However, due to economic and social development constraints, pediatrics need help regarding resources and technology. The level of pediatric medical care remains inadequate.</p><p><strong>Methods: </strong>This article constructs an MDM matrix framework for the pediatric medical nursing level. Combining the lean model theory, the key indicators of children's medical care are analyzed. Thus, it helps medical institutions scientifically evaluate and guide pediatric nursing. Based on the linkage extension of the MDM model and the DEA-Malmquist model, an evaluation system was established to reflect the current situation of pediatric drug use in China. The study used provincial indicator data on pediatric medication in China from 2015 to 2021.</p><p><strong>Results: </strong>We found that indicators such as physician literacy, health records, child status, and parental awareness were the most important under different medication cycles and goals. The importance of pre-administration evaluation was as high as 53.5%, and the importance of post-administration evaluation was only 13.7%. The efficacy of pediatric medication in developed provinces was significantly optimized. The input-output structure of pediatric medication in superior provinces was consistent with the feedback sequence of the MDM matrix.</p><p><strong>Conclusions: </strong>This indicates that the evaluation results of the MDM matrix have guiding significance for optimizing pediatric medication efficacy. This paper aims to help developing countries establish an optimized pediatric medication evaluation system and improve the pediatric healthcare environment.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"29"},"PeriodicalIF":3.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370534","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":"Identification of Houge type of X-linked syndromic mental retardation caused by CNKSR2 truncated variants.","authors":"Si-Hua Chang, Jie-Yuan Jin, Yi-Qiao Hu, Run-Yan Wang, Rong Xiang, Xia Wang","doi":"10.1186/s13052-025-01877-0","DOIUrl":"10.1186/s13052-025-01877-0","url":null,"abstract":"<p><strong>Background: </strong>Houge type of X-linked syndromic mental retardation (MRXSHG) is a type of X-linked condition which is mainly manifested as delayed development, mental retardation, epilepsy that begins at an early age, and delayed language acquisition. MRXSHG is a serious disorder with CNKSR2 variant and at least 34 variants have been identified in MRXSHG patients. However, the genotype-phenotype correlation and variants characteristics of CNKSR2 need further investigation and improvement.</p><p><strong>Methods: </strong>Two Chinese MRXSHG families were recruited, and their genetic causes were investigated using whole-exome sequencing (WES), Sanger sequencing, and bioinformatics analysis. To verify the impact of these variants, we used real-time PCR and minigenes consisting of exon 14, intron 14, and exon 15 from both the wild-type and the c.1658-3_1676del DNA sequences.</p><p><strong>Results: </strong>In this study, we reported two Chinese boys with MRXSHG and described some rare MRXSHG phenotypes, such as delayed bone age, slightly widened right fissure, and an underdeveloped right temporal lobe, characterized by reduced growth and volume compared to typical development. Two novel variants in CNKSR2 (c.1658-3_1676del and c.1102G > T, p.Gly368*) were identified in these cases. Minigenes results revealed that variant c.1658-3_1676del produced an aberrant spliceosome assembly.</p><p><strong>Conclusions: </strong>We identified two novel CNKSR2 variants in MRXSHG families, expanding the variant spectrum of CNKSR2, enriching MRXSHG-related phenotypes, and contributing to genetic counseling for MRXSHG patients.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"31"},"PeriodicalIF":3.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11806549/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143370524","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":"The effect of GM-CSF and predictors of treatment outcome in pediatric septic shock patients.","authors":"Zhen-Hao Yu, Gui-Xiang Tian, Yao-Dong Wang, Ting-Yan Liu, Peng Shi, Jia-Yun Ying, Wei-Ming Chen, Yu-Feng Zhou, Guo-Ping Lu, Cai-Yan Zhang","doi":"10.1186/s13052-025-01863-6","DOIUrl":"10.1186/s13052-025-01863-6","url":null,"abstract":"<p><strong>Background: </strong>Pediatric septic shock is a critical condition associated with high mortality rates, largely due to sepsis-induced immunosuppression. Granulocyte-macrophage colony-stimulating factor (GM-CSF) has been explored as a therapeutic intervention to counteract this immunosuppression. Despite its potential, the efficacy of GM-CSF in pediatric septic shock has not been clearly established. This study aims to investigate the impact of GM-CSF administration on survival rates and to identify key predictors of treatment outcomes in pediatric septic shock patients.</p><p><strong>Methods: </strong>We conducted a retrospective cohort study at the Pediatric Intensive Care Unit (PICU) of Children's Hospital of Fudan University, Shanghai, from January 1, 2019, to December 31, 2023. The study included pediatric patients diagnosed with septic shock, analyzing their demographic data, GM-CSF and adjunctive therapies, laboratory results, and clinical outcomes. We employed univariate and multivariate logistic regression models to assess the influence of GM-CSF on 28-day mortality and identify significant predictors of treatment outcomes.</p><p><strong>Results: </strong>The study included 200 pediatric patients, with 66 receiving GM-CSF treatment and 134 not treated with GM-CSF. The initial comparison showed a higher 28-day mortality in the GM-CSF group (59.1%) compared to the non-GM-CSF group (35.1%, P = 0.001). Notably, after adjustment for confounding factors, multivariate analysis revealed that the effect of GM-CSF treatment on 28-day mortality among pediatric septic shock patients did not reach statistical significance, with an odds ratio (OR) of 0.472 and a 95% confidence interval (CI) ranging from 0.153 to 1.457 (P = 0.192). However, the analysis indicated a potential trend suggesting that GM-CSF treatment may contribute to a reduction in 28-day mortality. In addition, significant predictors of treatment outcomes included hematopoietic stem cell transplantation (HSCT), lactic acid (LAC) levels, hospital-acquired septic shock (HASS), red blood cell (RBC) count, and platelet (PLT) count.</p><p><strong>Conclusions: </strong>GM-CSF treatment may benefit pediatric septic shock patients, especially those with higher lactic acid, and lower RBC and platelet counts. These factors, which are significant predictors of outcomes, should be monitored during therapy.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"25"},"PeriodicalIF":3.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122578","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":"Learn from international recommendations and experiences of countries that have successfully implemented monoclonal antibody prophylaxis for prevention of RSV infection.","authors":"Sara Manti, Eugenio Baraldi","doi":"10.1186/s13052-025-01844-9","DOIUrl":"10.1186/s13052-025-01844-9","url":null,"abstract":"<p><p>Respiratory syncytial virus (RSV)-mediated bronchiolitis causes a significant global health burden. Despite this, for several years, the only approved agent for RSV prophylaxis was the anti-RSV monoclonal antibody Palivizumab, reserved for a small population of infants at high risk of developing severe RSV disease. Recently, the availability and approval of nirsevimab to immunize all infants against RSV infection since their first RSV season represented a crucial paradigm shift in RSV prevention. Nirsevimab has been shown to be safe and effective (> 80%) against RSV lower respiratory tract infections (LRTIs) in all infants and children at their first season of RSV. Surveillance studies have demonstrated 90% effectiveness in reducing all-cause hospitalizations, all-cause LRTI hospitalizations, RSV-related LRTI hospitalizations, and severe RSV-related LRTIs. Moreover, the consistency and reproducibility of the beneficial outcomes coming from the prophylaxis with nirsevimab highlights its potential to deliver substantial health benefits, positioning monoclonal antibody administration as a cornerstone in the fight against RSV-related morbidity and mortality. Implementing immunization strategies for infants and children is crucial to align the international experiences and guarantee universal protection. This review provided an updated overview of the monoclonal antibody strategy for preventing RSV infection.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"26"},"PeriodicalIF":3.2,"publicationDate":"2025-02-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11796128/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143189155","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":"Characteristics of plastic bronchitis in children with infectious pneumonia.","authors":"Xulong Cai, Mali Lin, Li Zhou, Wencai Sheng, Wanyan Jiao, Hongliang Bian, Tongjin Yin","doi":"10.1186/s13052-025-01873-4","DOIUrl":"10.1186/s13052-025-01873-4","url":null,"abstract":"<p><strong>Background: </strong>Multiple studies have reported that infectious pneumonia can induce the production of plastic casts, which threatens children's health. We explored the characteristics of plastic bronchitis (PB) in clinical practice by analysing clinical medical records.</p><p><strong>Methods: </strong>A retrospective study was conducted. Children with pneumonia and large chest shadows were included in this study. The differences in characteristics between patients with plastic bronchitis and those without plastic bronchitis were analysed. The distribution of pathogens was statistically analysed. Grouping analysis based on PB and pathogen conditions was also conducted.</p><p><strong>Results: </strong>A total of 185 patients were included in this study. The patients were divided into two groups: the PB group (n = 48) and the non-PB group (n = 137). The duration of illness before hospitalization in the PB group was mostly longer than that in the non-PB group. The frequency distribution of the inspiratory three concave signs in the PB group was significantly greater than that in the non-PB group. Compared with those in the non-PB group, the number of patients with abnormally elevated of D-D dimer, LDH, ALT, and AST in the PB group was significantly greater. Mycoplasma pneumoniae (MP) was the main pathogen observed in both the PB and non-PB groups. In cases of MP infection without plastic bronchitis, treatment with macrolide antibiotics occurred significantly earlier. Most cases of pleural effusion in the PB-MP group were discovered more than 7 days after onset. However, in the PB-nonMP group, most cases of pleural effusion were detected within 7 days of onset. There was a difference observed in the distribution of pulmonary necrosis between the PB group and the non-PB group.</p><p><strong>Conclusions: </strong>MP is a common pathogen observed in PB cases caused by single-pathogen infections and multiple-pathogen infections. PB may be a potential cause of pulmonary necrosis. Furthermore, PB exhibits diverse clinical manifestations due to host and pathogen factors.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"24"},"PeriodicalIF":3.2,"publicationDate":"2025-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122096","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":"Effectiveness of a training program for the acquisition of motor milestones in infants: a randomized clinical trial.","authors":"Luis Fernández-Sola, Beatriz Cano-Díez, Yessica Pons-Solaz, Begoña Vera-Egido, Sergio Moreno-González","doi":"10.1186/s13052-025-01849-4","DOIUrl":"10.1186/s13052-025-01849-4","url":null,"abstract":"<p><strong>Background: </strong>In infants, the acquisition of all motor milestones is considered an expression of correct motor development during the first months of life. An association between typical motor development of the newborn and cognitive areas has been established. Few studies have evaluated the efficiency of parents' knowledge of expected milestones in healthy infants. This study aims to determine whether parents' knowledge of specific tasks can improve the achievement of all gross motor milestones in the newborn.</p><p><strong>Method: </strong>The current study examined gross motor development in term-born infants without pathologies at 9, 12, and 15 months and the effectiveness of a training program developed for parents. The research group comprised 82 full-term infants divided into an experimental group (EG) and a control group (CG) of 41 subjects each. A randomized clinical trial study was performed. The routine follow-up program consisted of four informative sessions on the experimental group at the beginning of each trimester with information about the expected motor milestones and how to stimulate their infants to achieve them. The gross motor development of the participants was measured using the Alberta Infant Motor Scale. An ANCOVA test was performed to assess the possible influence of sex, type of birth, or the presence of siblings controlled and uncontrolled as confounding variables on the results.</p><p><strong>Results: </strong>The initial baseline assessment showed no statistical differences between groups (p > 0,05). After controlling confounding variables, at 9 months the EG scored 5,5 points higher than the CG (p < 0,001). At 12 months, EG scored 3,7 points higher than CG (p < 0,001). At 15 months, EG scored 2,2 points higher than CG (p = 0,001). The experimental group scored significantly higher, with a 25-point higher percentile in each assessment.</p><p><strong>Conclusion: </strong>A learning program aimed at increasing parents' knowledge of their infant´s gross motor development improved it. The information collected will help professionals who support parents in monitoring their babies. Future studies using larger sample sizes, analysing other domains of global infant development, or investigating the possible influence of other parental factors are recommended.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov ID NCT04693494. Registered December 28, 2020, retrospectively registered. https://clinicaltrials.gov/study/NCT04693494 .</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"23"},"PeriodicalIF":3.2,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11786511/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143074763","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":"A child with Chronic Nonbacterial Osteomyelitis and celiac disease: accidental association or two different aspects of the same condition?","authors":"Grazia Bossi, Maria Sole Prevedoni Gorone, Luca Lungarotti, Francesco Pelillo, Amelia Mascolo, Matteo Naso, Daniele Veraldi, Francesca Olivero, Costanza Chirico, Maria Vittoria Marino, Cristina Dutto, Gian Luigi Marseglia","doi":"10.1186/s13052-025-01842-x","DOIUrl":"10.1186/s13052-025-01842-x","url":null,"abstract":"<p><strong>Background: </strong>Chronic Nonbacterial Osteomyelitis (CNO) is a rare auto-inflammatory disease that mainly affects children, and manifests with single or multiple painful bone lesions. Due to the lack of specific laboratory markers, CNO diagnosis is a matter of exclusion from different conditions, first and foremost bacterial osteomyelitis and malignancies. Whole Body Magnetic Resonance (WBMR) and bone biopsy are the gold standard for the diagnosis. Although the association with Inflammatory Bowel Disease (IBD) has been reported in the literature, cases of CNO in celiac patients have never been described before.</p><p><strong>Case presentation: </strong>We report about a girl of 3 years and 8 months of age who presented with severe bone pain, slight increase of inflammatory markers, micro-hematuria and high calprotectin values. Her personal medical history was uneventful, apart from low weight growth. She had never complained of abdominal pain or other gastro-intestinal symptoms. WBMR showed the classical features of multifocal CNO, and biopsy confirmed the diagnosis. Celiac disease (CD) was suspected on the basis of antibody screening, and confirmed by gut biopsy. With gluten-free diet the patient achieved rapid and complete symptom remission together with healing of all the bone lesions proven by WBMR. Three years after the onset of the disease the girl is healthy and totally asymptomatic, still on clinical and radiological follow-up.</p><p><strong>Conclusions: </strong>Based on our experience, the diagnostic work-up of new cases of CNO should include the screening test for CD and, according to the literature, the possibility of IBD should also be properly ruled out. When CNO and CD coexist, gluten-free diet, combined with antinflammatory therapy, could be able to completely reverse bone lesions, shortening the duration of medical treatment. Because the diseases' onset is seldom simultaneous, patients with CNO and IBD deserve a properly extended follow-up. Finally, the analysis of the relationship between CNO and autoimmune intestinal diseases provides a unique opportunity to understand the pathophysiological pro-inflammatory network underlying both types of disorders and it is necessary to make the most suitable therapeutic choice.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"22"},"PeriodicalIF":3.2,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11783928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065557","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":"Avascular necrosis in pediatric rheumatic diseases: an Italian retrospective multicentre study.","authors":"Ivan Taietti, Federico Zini, Emilio Amleto Conti, Enrica Cristini, Irene Borzani, Giulia Ramponi, Claudia Bracaglia, Raffaele Pecoraro, Riccardo Papa, Jessica Tibaldi, Serena Pastore, Gabriele Simonini, Marco Cattalini, Antonella Meini, Achille Marino, Stefano Lanni, Francesca Minoia, Giovanni Filocamo","doi":"10.1186/s13052-025-01845-8","DOIUrl":"10.1186/s13052-025-01845-8","url":null,"abstract":"<p><strong>Background: </strong>Atraumatic avascular necrosis (AVN) is a severe condition that may complicate the course of rheumatic diseases and contribute to long-term damage. However, there is a lack of evidence on this rare event in pediatric rheumatology. The aim of our study was to evaluate the occurrence of avascular necrosis in the context of rheumatologic diseases in Italy and to describe the main demographic and clinical features of AVN patients, with a particular focus on treatment background.</p><p><strong>Methods: </strong>All centres part of the Italian Society of Pediatric Rheumatology were invited to participate in a retrospective case collection of children with rheumatic diseases complicated by a pediatric-onset AVN. Demographic, clinical, laboratory and imaging data were recorded, together with outcome and treatment background, particularly steroid exposure. Population collected was further evaluated according to the different underlying rheumatologic disease and to the time of AVN onset.</p><p><strong>Results: </strong>Fourteen patients (SLE = 7; JIA = 4; others = 3) were collected from 7 centres. Females were predominantly affected (71%) with a median age at AVN diagnosis of 14.3 years. Multifocal involvement was mostly reported (93%), mainly involving femoral heads (44%) and knees (28%). All patients had a severe rheumatologic background and received systemic glucocorticoids with a median cumulative prednisone equivalent dose of 457.5 mg/kg. In all patients but one imaging showed persistence of abnormalities, despite the complete resolution of symptoms in 6 of them. Bisphosphonates were the most used therapeutic approach; orthopedic surgery was required in 2 cases.</p><p><strong>Conclusions: </strong>Despite its rarity, AVN may be a severe complication of pediatric rheumatic diseases. Active monitoring is crucial to promptly identify patients and to prevent long-term damage. Prospective large sample studies are required to better understand the impact of steroid exposure and its complex interplay with other potential contributing factors.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"20"},"PeriodicalIF":3.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776117/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058851","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 between some environmental risk factors and attention-deficit hyperactivity disorder among children in Egypt: a case-control study.","authors":"Riham Abdelhamid Hussein, Rania Hussein Refai, Aleya Hanafy El-Zoka, Hanan Galal Azouz, Mohamed Fakhry Hussein","doi":"10.1186/s13052-025-01843-w","DOIUrl":"10.1186/s13052-025-01843-w","url":null,"abstract":"<p><strong>Background: </strong>Attention-Deficit Hyperactivity Disorder (ADHD) is a complex disease that negatively impacts the social and academic/occupational activities of children and is more common in boys than in girls.</p><p><strong>Methods: </strong>This case-control study aimed to assess the association between some environmental risk factors and ADHD among children in Alexandria, Egypt. It was carried out at the outpatient clinics of El Shatby Pediatric University Hospital in Alexandria, Egypt, with 252 children (126 cases and 126 controls). Hair samples were collected for analysis of lead and manganese levels using Atomic Absorption Spectrophotometer. A pre-designed interview questionnaire was used to determine the important environmental risk factors that may be related to ADHD.</p><p><strong>Results: </strong>Children from parents with low levels of education, living in crowded houses, and occupational exposure to chemical agents were found to be risk factors for ADHD. The mean ± SD hair lead level in ADHD children was 2.58 ± 1.95, while in controls was 1.87 ± 0.92, with a statistically significant difference (p < 0.001). The mean ± SD hair manganese level in ADHD children was 2.10 ± 1.54, while in controls was 1.11 ± 0.69, with a statistically significant difference (p < 0.001). The logistic regression model revealed that six factors had a significant association with ADHD: using of newspapers to wrap food 3 or more times a week (adjusted odds ratio (AOR) = 105.11, 95% CI: 11.18-988.26), daily TV watching by child for more than 5 h (AOR = 63.96, 95% CI: 2.56-1601.32), child's eating commercially packed noodles 3 times or more per week (AOR = 57.73, 95% CI: 3.77-593.93), using unpackaged flour in cooking (AOR = 44.47, 95% CI: 1.83-629.80), eating sweets daily by child (AOR = 6.82, 95% CI: 1.23-37.94), and lastly elevated hair Manganese level (AOR = 3.57, 95% CI: 1.24-10.29).</p><p><strong>Conclusions: </strong>ADHD is a multi-factorial disorder, where many environmental risk factors contribute to its development. Future efforts to determine the best preventive strategy in Egypt must be based on a better knowledge of the role of environmental risk factors in the etiology of the disorder. Eliminating non-essential uses of lead and providing public education regarding the importance of safe disposal of lead-acid batteries and computers are necessary.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"19"},"PeriodicalIF":3.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058807","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":"Abnormal characteristics of inferior vena cava and abdominal aorta among neonates with early onset septic shock.","authors":"Lanlan Mi, Yiman Liu, Fei Bei, Jianhua Sun, Jun Bu, Yuqi Zhang, Weiwei Guo","doi":"10.1186/s13052-024-01829-0","DOIUrl":"10.1186/s13052-024-01829-0","url":null,"abstract":"<p><strong>Background: </strong>The variety of shocks in neonates, if not recognized and treated immediately, is a major cause for fatality. The use of echocardiography may improve assessment and treatment, but its reference values across gestational age (GA) and birth weight (BW) are lacking. To address the information gap, this study aimed at correlating GA and BW of newborns with nonhemodynamic abnormalities, and at evaluating the usefulness of such reference values in neonates with early onset septic (EOS) -shock.</p><p><strong>Methods: </strong>A total of 200 normal newborns were enrolled as controls and subdivided into groups based on GA, BW, days of age, and patent ductus arteriosus (PDA). Echocardiography was used to document inferior vena cava diameter (IVC), inferior vena cava collapsibility index (IVC-CI), and inferior vena cava to abdominal aorta ratio (IVC/AO). In addition, 18 neonates with EOS shock were recruited and evaluated using echocardiography.</p><p><strong>Results: </strong>Among the control newborns, IVC and AO were significantly increased with GA and BW (P < 0.05) but IVC-CI and IVC/AO did not correlate with GA, BW, day of age, and PDA. Compared to the control group, the EOS-shock group had significantly decreased IVC and IVC/AO, and increased IVC-CI (P < 0.05). The cut-off values for indicating EOS-shock were > 34.15% for IVC-CI, < 47.58% for IVCmin/AO, and < 66.11% for IVCmax/AO.</p><p><strong>Conclusions: </strong>The IVC-CI, IVCmin/AO, and IVCmax/AO indices are applicable to all neonates. Although the number of neonates with EOS-shock in our study is small, the cut-off values showed usefulness for diagnosis. Further research is needed to determine the application of the indices in a larger population and among other populations, especially for clinical application in treatment of shock among neonates.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"21"},"PeriodicalIF":3.2,"publicationDate":"2025-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11776259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058143","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}