Italian Journal of Pediatrics最新文献

{"title":"Value of peripheral blood cell parameters and their derived ratios in predicting intravenous immunoglobulin resistance in Kawasaki disease.","authors":"Qiqin Tang, Xiujuan Xu, Chuan Gan","doi":"10.1186/s13052-026-02267-w","DOIUrl":"10.1186/s13052-026-02267-w","url":null,"abstract":"<p><p>OBJECTIVE: Intravenous immunoglobulin (IVIG) serves as the first-line therapy for Kawasaki disease (KD); however, a significant minority of patients exhibit resistance to this treatment. Currently, there is a lack of easily accessible and reliable predictors for IVIG resistance. This study systematically evaluates the utility of baseline peripheral blood cell counts and their ratios in predicting IVIG non-response. METHODS: We assembled a retrospective cohort from the Children’s Hospital of Chongqing Medical University, including all KD patients admitted between January 1, 2023, and June 30, 2025. Patients were classified as either IVIG-responsive or IVIG-resistant based on the resolution of fever following the initial IVIG treatment. We compared baseline demographics, laboratory data, and coronary artery lesion (CAL) status. Univariable analysis was conducted to identify factors associated with IVIG resistance, and receiver-operating characteristic (ROC) curves were utilized to quantify predictive performance. RESULTS: Among the 210 children diagnosed with KD, 15 (7.1%) were classified as IVIG-resistant, while 195 (92.9%) were responsive to treatment. No significant differences were observed in sex, age at onset, or the frequency of CAL between the two groups; however, the hospital length of stay was significantly longer in the resistant cases (P < 0.001). Prior to IVIG treatment, the resistant group exhibited elevated neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), monocyte-to-lymphocyte ratio (MLR), and systemic immune-inflammation index (SII) (P = 0.003, 0.001, 0.013, 0.029, respectively), alongside a lower absolute lymphocyte count (P < 0.001). ROC analysis revealed that NLR (AUC 0.733; cut-off 1.07; sensitivity 100%, specificity 84.6%) and PLR (AUC 0.766; cut-off 64.43; sensitivity 100%, specificity 84.1%) were the most robust pre-treatment predictors of IVIG resistance. Following IVIG administration, responsive patients demonstrated significant alterations in multiple cellular parameters, whereas resistant patients exhibited only minimal changes. The extent of change was markedly different between the groups, particularly for PLR: PLR decreased in resistant patients but increased in responders. The difference in PLR before and after infusion (ΔPLR) provided excellent discrimination (AUC 0.840; cut-off 81.77; sensitivity 93.3%, specificity 90.3%). CONCLUSIONS: Elevated baseline NLR, PLR, MLR, and SII are identified as risk factors for IVIG resistance in KD. NLR values exceeding 1.07 and PLR values greater than 64.43 demonstrate high predictive value. A decline in post-treatment PLR of ≥ 81.77 serves as an additional strong indicator of non-response to IVIG. </p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13244895/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771630","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":"Mapping of pediatric allergy structures in Italy: a nationwide survey.","authors":"Giulio Dinardo, Mattia Giovannini, Francesca Galletta, Angela Klain, Maria de Filippo, Cristiana Indolfi, Gian Luigi Marseglia, Michele Miraglia Del Giudice, Sara Manti","doi":"10.1186/s13052-026-02261-2","DOIUrl":"10.1186/s13052-026-02261-2","url":null,"abstract":"<p><strong>Background: </strong>Pediatric allergology and immunology has expanded markedly over recent decades, paralleling the rising prevalence of allergic diseases. National data on the availability and organization of dedicated services in Italy are lacking. This project aimed to provide the first nationwide mapping of Italian Society of Pediatric Allergy and Immunology (SIAIP)-affiliated pediatric allergology and immunology structures, describing their geographical distribution and main organizational features of service delivery.</p><p><strong>Methods: </strong>Between 2023 and 2025, a structured nationwide mapping was conducted by regional SIAIP representatives. Data referred to the years 2024-2025 and included geographic location, weekly clinical activity, patient contact modalities (telephone and e-mail), and availability of digital services such as telemedicine. Data were summarized using descriptive statistics and reported as frequencies and percentages.</p><p><strong>Results: </strong>A total of 188 pediatric allergology and immunology territorial structures were identified across Italy. Their distribution was uneven: 86 were located in Northern Italy (45.7%), 42 in Central Italy (22.3%), and 60 in Southern Italy and the Islands (31.9%), highlighting marked regional heterogeneity. Clinical activity was frequently limited, with many structures operating only one to two days per week. Communication pathways were variable and often restricted to scheduled hours or mediated by booking services. Direct clinician contact was inconsistently available. Telemedicine and digital follow-up services were rarely implemented, indicating limited integration of remote care in routine practice.</p><p><strong>Conclusions: </strong>The Italian pediatric allergology network shows important structural limitations, including regional disparities, reduced service availability, and minimal integration of telemedicine. These findings provide a framework for healthcare planning and underline the urgency of strengthening workforce organization, service capacity, and digital health implementation.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13352835/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147771577","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":"Münchausen syndrome by proxy: a literary review and a reminder for every health care professional.","authors":"Alessandra Giliberti, Stefania Giustiniano, Ylenia Carbonaro, Adele Maria Frisina, Michele Roccella, Rosaria Nardello","doi":"10.1186/s13052-026-02232-7","DOIUrl":"10.1186/s13052-026-02232-7","url":null,"abstract":"<p><p>Münchhausen syndrome by proxy (MBPS), also commonly referred to as Medical Child Abuse (MCA), and now officially classified in the DSM-5-TR as Factitious Disorder Imposed on Another (FDIOA), is a severe condition that involves a caregiver who fabricates or induces signs and symptoms of physical, psychiatric, or developmental disorders in a child or other dependent victim. The primary motivation is the achievement of psychological gain—such as attention and sympathy—rather than obvious external benefits. Unfortunately this is frequently observed by health teams in clinics, hospital wards and emergency rooms and undoubtedly, these conditions generate high costs and unnecessary procedures in health care facilities and sometimes can evolve into the death of the child, depending on the gravity of the illness or the abuse. It is important for both physical and mental health of the children to diagnose as soon as possible this disorder and that’s why our team decided to write this review, in order to provide a complete and updated manuscript about such often misdiagnosed pathology so dangerous for children.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13218000/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147716745","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":"Causal effects of single-carbon metabolism and vitamin levels on autism spectrum disorder risk: a bidirectional Mendelian randomized study.","authors":"Jun Zhu, Yun Yi, Ling Ma, Sheng Tao, Jingjing Sun, Danwei Zhang, Xue Sun, Kaimo Ding","doi":"10.1186/s13052-026-02254-1","DOIUrl":"10.1186/s13052-026-02254-1","url":null,"abstract":"<p><p>BACKGROUND: Observational epidemiology studies suggested a relationship between single-carbon metabolism and vitamin levels with autism spectrum disorder (ASD) risk. We aimed to explore the causal relationship between them at the genetic level. METHODS: We performed a two-sample bidirectional Mendelian randomization (MR) analysis using genome-wide association studies summary statistics. The inverse-variance weighted (IVW) method was used as the primary analysis. We applied other complementary methods, including weighted median, weighted mode, and MR Egger regression. MR Egger and MR pleiotropy residual sum and outlier (MR-PRESSO) are used to detect and correct the effects of horizontal pleiotropy. RESULTS: There were no causal associations between genetically predicted single-carbon metabolism and vitamin levels with ASD risk in IVW analysis (Homocysteine: 95% CI: 0.952–1.082, P = 0.652; Folate in Serum or Plasma: 95% CI: 0.968–1.249, P = 0.143; VB12: 95% CI: 0.989–2.133, P = 0.057; VB6: 95% CI: 0.647–1.247, P = 0.522; VC: 95% CI: 0.794–1.881, P = 0.362; VD: 95% CI: 0.825–1.551, P = 0.443; and VE: 95% CI: 0.87–1.711, P = 0.249). Reversely, we did not find significant causal effects of ASD on single-carbon metabolism and vitamin levels in MR analysis (all P > 0.05). Based on sensitivity analyses, heterogeneity and horizontal pleiotropy are unlikely to distort causal estimates. CONCLUSIONS: The MR study suggests that no evidence of a causal association was found between single-carbon metabolism and vitamin levels with ASD risk. Further studies are needed to validate these conclusions. CLINICAL TRIAL NUMBER: Not applicable. </p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"52 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13088691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147698610","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":"Associations of systemic inflammatory indices and metabolically healthy vs. unhealthy obesity in children.","authors":"Meliha Esra Bіlіcі","doi":"10.1186/s13052-026-02262-1","DOIUrl":"10.1186/s13052-026-02262-1","url":null,"abstract":"<p><p>OBJECTIVE: Childhood obesity, which continues to rise globally, is associated with inflammation-driven metabolic disturbances and increased cardiometabolic risk. Individual variability in metabolic health—independent of obesity severity—has led to the concept of metabolically healthy obesity (MHO). This study aimed to evaluate the relationship between metabolic health status and systemic inflammatory indices in childhood obesity, including analyses adjusted for sex and pubertal stage to account for physiologic developmental changes. METHODS: This retrospective study included children with BMI SDS ≥ 2, categorised as Metabolically Unhealthy Obese (MUO) if they had ≥ 1 of the following: fasting glucose ≥ 100 mg/dL, HOMA-IR ≥ 2.5 (prepubertal) or ≥ 4 (pubertal), triglycerides ≥ 150 mg/dL, HDL ≤ 40 mg/dL, or systolic/diastolic blood pressure ≥ 95th percentile. Children with none of these findings were classified as MHO. Inflammatory indices—neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), systemic inflammation index (SII), and systemic immune-response index (SIRI)—were analysed using ROC curves and multivariable regression. Additional analyses adjusted for age, sex, pubertal stage, and BMI SDS were performed to account for developmental influences on inflammatory markers. RESULTS: A total of 388 obese children (58.1% female, mean age 11.5 ± 2.9 years) were included; 35.4% were morbidly obese, and 45.6% were classified as MUO. MUO children had significantly higher white blood cell, neutrophil, and monocyte counts, as well as higher fasting glucose, HOMA-IR, triglycerides, and total cholesterol, with lower HDL levels. Dyslipidemia was the most common metabolic abnormality. SII demonstrated strong discriminatory ability for metabolic health (AUC = 0.854; 82% sensitivity; 72% specificity). SII was positively associated with HOMA-IR, TG/HDL-C, and non-HDL cholesterol (p = 0.006; p = 0.004; p = 0.01, respectively). After adjustment for age, sex, pubertal stage, and BMI SDS, the associations of SII and SIRI with metabolic health status were attenuated but remained directionally consistent, indicating that developmental factors partially influence systemic inflammatory responses. CONCLUSION: The high prevalence of MUO among obese children highlights their substantial cardiometabolic risk burden. SII and SIRI appear to be promising, readily accessible biomarkers for identifying metabolic deterioration, showing meaningful correlations with key cardiometabolic risk indicators. These indices may support clinicians in early detection and monitoring of metabolic dysfunction in pediatric obesity, even when accounting for developmental stage. </p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13192174/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690146","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 nomogram for early prediction of pertussis-associated pneumonia in children: a retrospective clinical study.","authors":"Jiaying Ren, Dan Chen, Tipei Zhang, Yanhong Ren, Xiaomin Sun","doi":"10.1186/s13052-026-02263-0","DOIUrl":"10.1186/s13052-026-02263-0","url":null,"abstract":"<p><strong>Background: </strong>Pertussis, an acute respiratory infection caused by Bordetella pertussis, has recently shown a global resurgence. Pneumonia represents one of its most frequent and severe complications. The present study aimed to identify risk factors for pertussis-associated pneumonia and to develop a predictive model for early identification of high-risk pediatric patients.</p><p><strong>Methods: </strong>A retrospective analysis was performed on 123 children hospitalized with pertussis at the Children's Hospital Affiliated to Zhengzhou University between 1 June 2024 and 31 December 2024(training cohort). Using univariate analysis, least absolute shrinkage and selection operator (LASSO) and multivariate logistic regression analysis, identified the predictors for pertussis-associated pneumonia. An independent cohort enrolled between 1 January 2025 and 31 July 2025, was used for external validation cohort. Receiving operating characteristic curve (ROC), calibration plots, decision curve analysis (DCA), and clinical impact curves (CIC) were used to evaluate the performance of the model.</p><p><strong>Results: </strong>We identified five independent predictors of pertussis-associated pneumonia: white blood cell count (WBC; OR = 1.112, 95% CI: 1.012-1.221), interleukin-6 (IL-6; OR = 1.153, 95% CI: 1.049-1.267), lymphocyte percentage (Lym%; OR = 1.045, 95% CI: 1.013-1.078), interleukin-17a (IL-17a; OR = 1.209, 95% CI: 1.024-1.427), and Co-infection (OR = 3.096, 95% CI: 1.260-7.610). The area under the receiver operating characteristic curve (AUC) was 0.824 (95% CI: 0.747-0.900) in the training cohort and 0.792 (95% CI: 0.718-0.865) in the external validation cohort. The Hosmer-Lemeshow test indicated good calibration (P = 0.590 in the training cohort; P = 0.735 in the external validation cohort). Decision curve analysis and clinical impact curves confirmed clinical utility.</p><p><strong>Conclusion: </strong>A clinically useful nomogram model was developed for early prediction of pertussis-associated pneumonia in children. Application of this model may assist clinicians in promptly identifying high-risk patients and implementing timely interventions to improve outcomes.Notably, this study had a small sample size (n = 123) relative to the five predictors, and the external validation cohort was from the same center, which may limit the model's generalizability to heterogeneous clinical settings.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13191853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690181","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":"Persistent use of broad-spectrum antibiotics for suspected community acquired urinary tract infections in children in Italian primary care settings.","authors":"Emelyne Gres, Piero Veronese, Giulia Brigadoi, Maria Vego Scocco, Giangiacomo Nicolini, Daniele Dona', Elisa Barbieri","doi":"10.1186/s13052-026-02260-3","DOIUrl":"10.1186/s13052-026-02260-3","url":null,"abstract":"<p><p>BACKGROUND: Urinary tract infections (UTIs) are common in children, and diagnosis is often difficult due to nonspecific symptoms, urine collection challenges, and increasing antimicrobial resistance. The emergence of ESBL-producing organisms highlights the need for locally informed guidelines supported by antibiotic stewardship activities. This study aimed to describe antibiotic prescribing patterns for suspected community-acquired UTIs (CA-UTIs) in the Italian primary care setting among children aged 0–14 years and to assess the impact of the 2019 Italian Society of Paediatric Nephrology (SINePe) guidelines update on prescribing behaviour in children aged 2 months to 3 years. METHODS: We conducted a database analysis including Italian children aged 0–14 years between 2015 and 2024 using data from the Pedianet database, which contains anonymized electronic health records of over 275,000 children. CA-UTI episodes were identified through ICD-9-CM codes and free-text searches, then manually validated. All antibiotic prescriptions (classified by ATC codes and AWaRe classification) issued during each episode and associated to the CA-UTI were included. An interrupted time-series (ITS) analysis using a Poisson model was conducted to evaluate the impact of the 2019 national consensus guidelines on yearly antibiotic prescribing patterns in children aged 2 months to 3 years with a first episode of CA-UTI. RESULTS: From 2015 to 2024, 32,519 suspected CA-UTI episodes in 26,650 children were included. The majority of children experienced a single episode (79.9%). Co-amoxiclav was the most frequently prescribed antibiotic, followed by third-generation cephalosporins, which remained common across the study period. Fosfomycin use increased with age and was more frequent among older children. Over 2550 first CA-UTI episodes were included in the ITS analysis showing no significant changes in prescribing patterns following the 2019 guideline update. Similar trends were confirmed when restricting the analysis to empiric antibiotic treatments. CONCLUSION: Co-amoxiclav remains the first-line empiric therapy for paediatric CA-UTIs in Italian primary care, although third-generation cephalosporins are still frequently prescribed despite revised recommendations. These findings highlight the need for continued antimicrobial stewardship efforts and monitoring to optimize paediatric UTI management in the community setting. </p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13185351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662634","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":"Guidelines on diagnosis and management of gastroesophageal reflux disease in infants, children and adolescents: a joint consensus from Italian pediatric societies (SIP and SIGENP) -part I. diagnosis.","authors":"Silvia Salvatore, Caterina Strisciuglio, Elena Bozzola, Stefania Cappa, Antonio Corsello, Giovanni Di Nardo, Maurizio Fuoti, Antonino Gulino, Chiara Mameli, Massimiliano Orso, Licia Pensabene, Barbara Polistena, Renato Tambucci, Francesca Vassallo, Claudio Romano, Annamaria Staiano","doi":"10.1186/s13052-026-02218-5","DOIUrl":"10.1186/s13052-026-02218-5","url":null,"abstract":"<p><p>BACKGROUND: Gastroesophageal reflux disease (GERD) is a common reason for referral to pediatric and gastroenterology clinics. Still, uncertainty and variability exist in the evaluation, diagnostic approaches and management among different age groups and clinicians. This study aimed to report the results of a Guidelines process and an Italian expert Consensus focusing on the diagnosis of GERD in children to improve the clinical approach to these patients. METHODS: A multidisciplinary board of 16 participants identified eight PICO (Population/Patient/Problem, Intervention, Comparator and Outcome) questions, including definition, signs and symptoms, risk factors, diagnostic tests, treatment and prognosis of gastroesophageal reflux (GER) and GERD in children: four PICO questions were related to the diagnosis of GERD. Four databases (PubMed/Medline, Embase, Web of Science and Google Scholar) were searched from their inception to May 11, 2024, limited to children (0–18 years) and English language. For each PICO question a specific search string was developed. Guidelines, systematic reviews and clinical studies on diagnosis and management in children were considered to formulate evidence-based recommendations. Agreement was defined based on a 9-point Likert scale. A two-round Delphi method was conducted and consensus was defined as ≥ 80% agreement or disagreement. This paper focused on clinical symptoms and diagnosis of GER and GERD in pediatric ages. RESULTS: 123 studies were included that satisfied systematic research criteria. The panel provided 14 recommendations on diagnosis of GER and GERD and practice points for specific questions to clarify some clinical issues. CONCLUSION: Symptoms of GER(D) are common in the pediatric population while regurgitation is frequently reported in the first months of life. In infancy symptoms mostly disappear spontaneously or after dietary modification. In infants and children with esophageal or extresophageal persistent symptoms, esophageal pH-MII monitoring and endoscopy are indicated to detect and characterize reflux episodes, phenotypes of GERD and esophagitis. In older children and adolescents reporting typical heartburn or in those with severe neurological impairment, a time-limited empirical trial of PPI can be considered as an initial diagnostic approach, with further testing reserved for non-responders. </p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13185181/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662629","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":"Role of IL-6 gene polymorphisms in children with autism spectrum disorders.","authors":"Noha M Abdullah, Hend M Moness, Marwa Waly Eldin Ali, Ebtihal Mokhtar Abdelsamei, Ebtesam Esmail Hassan, Dalia Abdelrahman Meshref","doi":"10.1186/s13052-026-02245-2","DOIUrl":"10.1186/s13052-026-02245-2","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Autism spectrum disorder (ASD) is a common neurodevelopmental disorder characterized by impairment in social interaction, and communication skills, along with restricted or repetitive behaviors. The diagnosis of ASD depends on behavioral parameters. Numerous studies have reported immune system abnormalities and proposed a potential role of autoimmunity in the pathogenesis of ASD. This study aims to assess the correlation between specific cytokines, such as interleukin-6 (IL-6), and particular IL-6 polymorphisms, including IL-6-174G/C (rs1800795) gene polymorphism, IL-6-572 C/G (rs1800796) gene polymorphism and IL-6-597G/A (rs1800797) gene polymorphism among children with ASD.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;The current study included 100 children with ASD were recruited during their regular follow up to Pediatric Neuro-Psychiatry Clinic of Minia University Hospital of Children. They diagnosed according to DSM-5 ASD criteria. A another 100 children were recruited as control group by simple randomly selected school (pre & elementary school) in Mina Governate, Upper Egypt, their ages and sex matched with the ASD children, they were apparently neuropsychiatric and developmentally normal and free from any chronic systemic illness. The participants were assessed for serum IL-6 levels and single-nucleotide changes in IL-6-174G/C, IL-6-572 C/G and IL-6-597G/A gene polymorphisms.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The prevalence of the GG genotype and G allele of the IL-6-174G/C gene polymorphism was significantly higher in ASD patients compared to healthy control (P value = 0.0002, 0.03 respectively). In contrast, the GC genotype and C allele of IL-6 -174G/C gene polymorphism were significantly elevated in the control group compared to children with ASD, indicating a protective role against ASD in the Egyptian population. The prevalence of the CG genotype, GG genotype, and G allele of the IL-6-572 C/G gene polymorphism was significantly higher in ASD patients compared to control individuals, indicating an increased risk of ASD within the Egyptian population. The IL-6-597G/A gene polymorphism analysis revealed no significant differences between the two groups in GG and GA genotypes or allelic frequencies. Nevertheless, the AA genotype was only found in the autistic group. Furthermore, ASD patients exhibited significantly higher serum levels of IL-6 than the healthy controls. The GG genotype distribution of IL-6-174G/C gene polymorphism was significantly associated with increased serum levels of IL-6.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The IL-6 (-174G/C) gene polymorphism (GG genotype) was associated with ASD. Moreover, the (CG + GG) genotypes of IL-6-572 C/G gene polymorphism were associated with ASD, and the (AA genotype) of IL-6-597G/A gene polymorphism was detected only in ASD. This indicates their role in the increased incidence of ASD among the Egyptian population. In addition, IL-6 serum level was significantly elevated ","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13077965/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147662672","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":"Making regional comparisons policy-ready: clarified, standardised methods and region-wide RSV hospital discharge estimates from Emilia-Romagna, Italy.","authors":"Marco Montalti, Gabriella Frasca, Simona Di Mario, Enrica Perrone, Roberta Giroldini, Christian Cintori, Giuseppe Diegoli","doi":"10.1186/s13052-026-02233-6","DOIUrl":"10.1186/s13052-026-02233-6","url":null,"abstract":"<p><p>Respiratory syncytial virus (RSV) prophylaxis with nirsevimab was introduced in Italy from the 2024–2025 epidemic season. The preprint “Impact of Regional heterogeneity of RSV infection prophylaxis on bronchiolitis in Italy” provides timely information for clinicians and health-system planners; however, several methodological specifications require clarification to ensure reproducibility and valid cross-regional comparability, particularly for the Emilia-Romagna Region. In Emilia-Romagna, programme choices were supported by a retrospective analysis of routinely collected hospital discharge and birth registry data (2015–2023), documenting that most of the RSV-associated hospital-admission burden is concentrated in infancy and follows a marked seasonal pattern, with severe outcomes largely confined to the first year of life. This evidence informed a risk-stratified approach during the initial roll-out. Using region-wide hospital discharge records from all Emilia-Romagna hospitals, we observed larger reductions between October 2023–March 2024 and October 2024–March 2025 than those presented as “regional” estimates in the preprint: total hospitalisations decreased from 1384 to 607 (−56.1%) among children aged < 14 years and from 1131 to 364 (−67.8%) among infants aged < 1 year; paediatric intensive care unit admissions decreased from 136 to 32 (−76.5%) and from 126 to 23 (−81.7%), respectively. To maximise the policy value of cross-regional comparisons and to support a more uniform, evidence-based national strategy in future seasons, key methods should be reported in a clear and standardised way.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"52 1","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13067385/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654318","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}