Italian Journal of Pediatrics最新文献

{"title":"Quality of life of the SQ house dust mite sublingual immunotherapy tablet in Italian adolescents with house dust mite-induced allergic rhinitis.","authors":"Francesco Catamerò, Mattia Giovannini, Simona Barni, Giulia Liccioli, Lucrezia Sarti, Leonardo Tomei, Benedetta Pessina, Claudia Valleriani, Chiara Marzi, Michela Baccini, Diego Peroni, Francesca Mori","doi":"10.1186/s13052-025-01947-3","DOIUrl":"10.1186/s13052-025-01947-3","url":null,"abstract":"<p><p>House dust mite (HDM) is the most common cause of perennial allergy worldwide, causing allergic rhinitis with or without conjunctivitis (AR/C). HDM-related clinical manifestations can be treated with allergy pharmacotherapy or allergen immunotherapy (AIT) in selected cases. AIT is acknowledged as the only therapeutic approach capable of modifying the course of allergic diseases. SQ HDM-SLIT tablets (Accarizax; Merck & Co, Kenilworth, NJ/ALK-Abellò, Hørsholm, Denmark) ensures a constant potency ratio of major HDM allergens of the Dermatophagoides pteronyssinus (DERM_PT) and Dermatophagoides farinae (DERM_FA) HDM species and has demonstrated beneficial effects on allergic rhinoconjunctivitis outcomes. In Italy, rhinoconjunctivitis affects up to as many as 40% of adolescents, but no studies on HDM AIT quality of life (QoL) regarding this exclusive cohort of patients have been specifically conducted. The aim of this study is to evaluate SQ HDM SLIT tablets' performance in improving QoL in Italian adolescents. To assess the treatment at T0, T1, and T2, we employed the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ(s)), a standardized self-administered questionnaire designed for Italian patients aged 12 and above. RQLQ(s) median values at T2 and T1 were significantly lower than those at T0 (p-values equal to 0.0018 and 0.0051 for T0 vs. T2 and T0 vs. T1, respectively). Our findings suggest that the QoL of SQ HDM SLIT tablet is highly promising, demonstrating substantial potential in alleviating signs and symptoms. Our data suggest that QoL significantly improved with SQ-HDM SLIT, highlighting the potential importance of introducing this therapy for selected cases.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"154"},"PeriodicalIF":3.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100886/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144132395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features, risk factors, and outcomes of neonatal invasive candidiasis: a 20-case study series from a tertiary neonatal critical care unit in Oman.","authors":"Basem Abdelhadi, Mujtaba Al Ajmi, Hilal Al Hashami, Manal Al Rawahi","doi":"10.1186/s13052-025-01952-6","DOIUrl":"10.1186/s13052-025-01952-6","url":null,"abstract":"<p><strong>Background: </strong>One of the well-known causes of morbidity and mortality in the neonatal population is invasive candidiasis. In neonatal critical care units, candida sepsis is now the third most frequent cause of late-onset sepsis. The objective of this research was to determine the prevalence of related risk factors, clinical traits, and results related to invasive candidiasis in the neonatal intensive care unit (NICU) at the Royal Hospital in Oman.</p><p><strong>Methods: </strong>A case-control retrospective analysis of 20 newborns admitted between January 2006 and December 2020 to the neonatal intensive care unit at Royal Hospital. In terms of gestational age, birth weight, and date of birth, cases and controls were matched.</p><p><strong>Results: </strong>There were 60 infants in all- 20 cases and 40 controls. The two groups'demographics, including age, sex, and weight, were comparable. The case group compared to the control group had a mean gestational age of 32.2 ± 6.1 weeks against 32.2 ± 5.7 weeks and a mean birth weight of 1978 ± 1202 grammes against 1930 ± 1040 grammes, respectively. A total of 14,820 newborns were admitted to the NICU during the study period, with 20 cases of candidemia, representing an incidence of approximately 1.3 per 1000 admissions. Seventy-five percent of the isolated species were Candida albicans. Sixty-five percent of the instances happened in the second and third week of life. Compared to the control group, the case group's mean NICU stay was longer. Several risk factors, including young maternal age, the presence of a central line, invasive mechanical ventilation, total parenteral nutrition, prolonged hospital stay, necrotizing enterocolitis, abdominal surgeries for congenial intestinal malformations and cardiac surgeries for congenital heart diseases, were found to be related with an elevated risk for invasive candidiasis using univariate analysis. In the case group, the overall mortality rate was 45%, but in the control group, there was no death in the cohort.</p><p><strong>Conclusion: </strong>The following factors were linked to an elevated risk of invasive candidiasis in this case series: total parenteral nutrition, prolonged hospital stay, central line presence, prematurity, abdominal and cardiac surgeries. Those with risk characteristics should be highly suspected for neonatal candidiasis, particularly if their stay in the NICU is longer than seven days. Antifungal prophylaxis should be taken into consideration for these newborns, and presumed antifungal medication should be started as soon as possible.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"153"},"PeriodicalIF":3.2,"publicationDate":"2025-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12100834/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144127574","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":"Newborn blood pressure dynamics during immediate postnatal transition - a retrospective analysis.","authors":"Daniel Pfurtscheller, Christoph Schlatzer, Nina Höller, Bernhard Schwaberger, Lukas P Mileder, Nariae Baik-Schneditz, Gerhard Pichler","doi":"10.1186/s13052-025-02001-y","DOIUrl":"10.1186/s13052-025-02001-y","url":null,"abstract":"<p><strong>Background: </strong>The transition from intrauterine to extrauterine life presents challenges for neonates, who are at increased risk of cardio-respiratory instability. Although electrocardiogram monitoring is recommended for neonatal resuscitation after birth, its ability to assess cardiovascular function is limited. Measuring arterial blood pressure (ABP) is feasible in neonates during the immediate transition period, though its interpretation is complex. This study analyses ABP values during the immediate transition in preterm neonates.</p><p><strong>Methods: </strong>Data from neonates born at the Medical University of Graz between 2009 and 2023 were analysed. All preterm neonates who survived without intraventricular haemorrhage grade II or higher, and who had ABP measured non-invasively at 15 min after birth, were eligible for inclusion. Statistical analyses were employed to evaluate ABP values for each gestational week, ranging from 23 to 36 weeks of gestation.</p><p><strong>Results: </strong>Out of 305 eligible neonates, 267 preterm neonates met the inclusion criteria. The median (IQR) systolic ABP ranged from 46 (43-51) to 64 (56-68) mmHg showing a gradual increase with advancing gestational age. The mean ABP ranged from 30 (27-36) to 45 (37-47) mmHg, also exhibiting a gradual increase with higher gestational age. Similarly, the diastolic ABP ranged from 22 (19-29) to 34 (29-41) mmHg, again showing a gradual increase with advancing gestational age.</p><p><strong>Conclusion: </strong>The findings indicate that ABP values during the immediate transition may be higher than those described after immediate transition in large cohort studies. Moreover, the gradual increase in ABP in preterm neonates with advancing gestational age underscores the necessity for tailored approaches to neonatal cardiovascular management during immediate transition.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"149"},"PeriodicalIF":3.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119724","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":"Estimated impact of nirsevimab prophylaxis on the economic burden of respiratory syncytial virus disease in Northern Italy.","authors":"Chryssoula Tzialla, Andrea Marcellusi, Lidia Decembrino, Stefano Ghirardello, Amelia Licari, GianLuigi Marseglia, Elena Tavella, Paolo Manzoni","doi":"10.1186/s13052-025-01991-z","DOIUrl":"10.1186/s13052-025-01991-z","url":null,"abstract":"<p><strong>Background: </strong>Respiratory syncytial virus (RSV) is a frequent cause of acute lower respiratory tract infection (LRTI) in infants; however, the health and economic burden of infant RSV-associated LRTI in Northern Italy has not been sufficiently assessed. We evaluated the clinical and economic burden of RSV-associated LRTI requiring emergency department (ED) access and/or hospitalization in infants less than 6 months old in two provinces in Northern Italy and estimated the potential impact of universal immunization with a recently approved monoclonal antibody.</p><p><strong>Methods: </strong>Epidemiological data during the 2021-2022 and 2022-2023 RSV seasons were obtained from administrative records and anonymized to comply with confidentiality requirements. Resource utilization was estimated using the costs associated with each event, obtained from the available literature and an analysis of national hospital discharge records. A static decision analytic model was used to estimate RSV-related health and associated cost outcomes.</p><p><strong>Results: </strong>Overall, 882 ED accesses and 430 hospital admissions associated with RSV were recorded during two consecutive epidemic seasons. Intensive care admission was needed in 85 cases. Universal immunization would avoid 406 ED accesses and 199 hospital admissions. The total economic burden was estimated at over €1.5 million, of which 51% was for hospitalization, 20% for intensive care, and 9% for ED access. An additional 10% was estimated for the management of long-term consequences of RSV-associated LRTI. Universal immunization would avoid expenses of €124,092 for ED accesses and €999,629 for hospital admissions.</p><p><strong>Conclusions: </strong>These findings underscore the substantial health and economic burden of RSV disease, highlighting the potential benefits of universal prevention strategies, while informing policymaker decisions regarding implementation of immunoprophylaxis.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"151"},"PeriodicalIF":3.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119721","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":"Correlation between preoperative and postoperative miR-29c-3p level changes and immune response in paediatric acute septic appendicitis and its predictive significance for complications: a retrospective study.","authors":"Li Hong, Baohui Yin, Chunsheng Duan, Lixia Zhou, Yingxuan Huang","doi":"10.1186/s13052-025-01986-w","DOIUrl":"10.1186/s13052-025-01986-w","url":null,"abstract":"<p><strong>Background: </strong>Postoperative complications in children with acute suppurative appendicitis (ASA) can lead to very serious consequences. In this study, we investigated the pre- and postoperative expression of miR-29c-3p in ASA and its value in predicting postoperative complications.</p><p><strong>Methods: </strong>Retrospectively, 128 children with ASA and 93 healthy children were included. The qRT-PCR technique was used to detect miR-29c-3p expression in children with ASA preoperatively and 24 h postoperatively. The levels of immune cells (WBC, NEU, LYM) were detected by routine blood test, and the levels of immune proteins CRP and inflammatory factors (TNF-α and IL-6) were detected by ELISA.</p><p><strong>Results: </strong>Before surgery, children with ASA had higher levels of miR-29c-3p than healthy controls. But after surgery, miR-29ac-3p levels dropped a lot in children with ASA. The serum levels of immune cells (WBC, NEU, LYM), immune protein CRP and inflammatory factors (TNF-α and IL-6) were significantly decreased in children with ASA. Postoperative miR-29c-3p levels were positively correlated with the levels of immune indicators. The patients with higher miR-29c-3p expression levels showed a greater incidence of postoperative complications.</p><p><strong>Conclusions: </strong>The expression of miR-29c-3p was positively correlated to immune cells, immune proteins, and inflammatory factors. The expression levels of miR-29c-3p were related to the occurrence of postoperative complications and could, therefore, be utilized to predict the occurrence of postoperative complications in children with ASA.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"152"},"PeriodicalIF":3.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119716","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":"Development and validation of a nomogram for predicting necrotizing pneumonia in children with refractory Mycoplasma pneumoniae pneumonia.","authors":"Xiaoying Li, Lihua Zhao, Xiaojian Cui, Yongsheng Xu, Tongqiang Zhang, Wei Guo, Jing Ning","doi":"10.1186/s13052-025-02006-7","DOIUrl":"10.1186/s13052-025-02006-7","url":null,"abstract":"<p><strong>Background: </strong>The early prediction of pulmonary necrosis in children with severe pneumonia improves patient prognosis and prevents complications. The aim of this study was to establish a linear model for predicting necrotizing pneumonia (NP) caused by Mycoplasma pneumoniae (MP) infection and to investigate the risk factors for lung necrosis in children with refractory Mycoplasma pneumoniae pneumonia (RMPP).</p><p><strong>Methods: </strong>A total of 536 children with RMPP were enrolled, including 95 with NP and 441 with nonnecrotizing pneumonia (NNP). A prediction model was built on 375 cases and validated on 161 cases, which were divided by random sampling in R software. Multivariate logistic regression was performed to determine optimal predictors and to establish a nomogram for predicting NP. The performance of the nomogram was evaluated by the area under the characteristic curve (AUC), calibration ability and decision curve analysis (DCA).</p><p><strong>Results: </strong>There were 315 (84.0%) NNP patients and 60 (16.0%) NP patients in the training group (n = 375) and 126 (78.3%) NNP patients and 35 NP patients (21.7%) in the validation group (n = 161). Multivariate logistic regression analysis identified 4 independent predictors that were used to construct a nomogram for predicting NP in children with RMPP, namely, fever duration (AOR = 1.475; 95% CI 1.296-1.678; P < 0.001), WBC count (AOR = 1.149; 95% CI 1.073-1.231; P < 0.001), IL-6 concentration (AOR = 1.007; 95% CI 1.002-1.013; P = 0.007) and D-dimer concentration (AOR = 1.361; 95% CI 1.121-1.652; P = 0.002). The area under the curve (AUC) of the nomogram was 0.899 (95% CI, 0.850-0.947) in the training set and 0.920 (95% CI, 0.874-0.966) in the validation set, indicating a good fit. The calibration plot and Hosmer‒Lemeshow test indicated that the predicted probability had good consistency with the actual probability in the training (P = 0.439) and validation (P = 0.526) groups. The DCA curve demonstrated a significantly better net fit in the model.</p><p><strong>Conclusions: </strong>We developed and validated a nomogram model for predicting RMPP-associated NP in its early clinical stages based on fever duration, WBC count, IL-6 and D-dimer concentration. This four-risk factor model may assist physicians in predicting NP induced by RMPP.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"150"},"PeriodicalIF":3.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096616/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119718","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 new association between Kleefstra syndrome and Panayiotopoulos epilepsy.","authors":"Alessandra Giliberti, Stefania Giustiniano, Ylenia Carbonaro, Adele Maria Frisina, Michele Roccella, Gregorio Serra, Rosaria Nardello","doi":"10.1186/s13052-025-01982-0","DOIUrl":"10.1186/s13052-025-01982-0","url":null,"abstract":"<p><strong>Background: </strong>Kleefstra syndrome is a rare genetic disorder attributed to loss of function of EHMT1, either due to a point mutation or a microdeletion in the chromosome region 9q34.3. This gene encodes an enzyme that modifies histone function and is essential for normal development. Individuals with Kleefstra syndrome typically present intellectual disability (from moderate to severe), language delay, autism spectrum disorders, generalized hypotonia, and distinctive facial dysmorphic features. Additional manifestations in children may include cardiac defects, renal and urological malformations, genital anomalies, respiratory infections, epilepsy (including febrile seizures), and psychiatric disorders. Panayiotopoulos syndrome is a specific type of epilepsy, usually presenting in early to mid-childhood with benign focal seizures. These seizures are characterized by primarily autonomic symptoms, abnormal EEG findings showing shifts or multiple seizure foci (often located in occipital lobe), and other autonomic manifestations such as pallor, redness or cyanosis, mydriasis or miosis, heart and breathing problems, thermoregulatory changes, urinary and/or fecal incontinence, hypersalivation, and altered gut motility.</p><p><strong>Case presentation: </strong>We present the case of a child with Kleefstra syndrome and Panayiotopoulos epilepsy. The patient is a 12-year-old male born from a full-term pregnancy to non-consanguineous healthy parents with a family history of neurodevelopmental disorders. At birth, he presented dysmorphic facial features including receding forehead, low-set ears and lingual protrusion. From 6 months of age, he manifested predominantly axial and lower limb hypotonia, associated with a delay in acquiring psychomotor developmental milestones. Genetic counseling was requested, and array-CGH was then performed. Molecular analysis detected a 9q34.3 microdeletion which included the EHMT1 gene, leading to Kleefstra syndrome diagnosis. From the age of 6 years, he began experiencing seizures with features typical of Panayiotopoulos epilepsy and started treatment with valproic acid.</p><p><strong>Conclusions: </strong>We highlight the association between Panayiotopoulos epilepsy and Kleefstra syndrome, which has not been previously reported in the literature. Although this kind of epilepsy is quite frequent in pediatric age and the possibility of a casual co-occurrence should be considered, however in Kleefstra syndrome patients carrying 9q34.3 microdeletion a potential additional role of genetic (besides EHMT1) and epigenetic factors in developing seizures cannot be excluded. The present data expand the genomic and phenotypical features of the syndrome, providing new insights about research, which are useful to achieve genotype/phenotype correlations and better management of affected subjects.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"148"},"PeriodicalIF":3.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093761/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110608","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":"Serum cytokine levels in children with community-acquired pneumonia caused by different respiratory pathogens.","authors":"Yuanhui Duan, Yuexu Ou, Jieling Li, Xiaoming Gan, Jie Cao","doi":"10.1186/s13052-025-02012-9","DOIUrl":"10.1186/s13052-025-02012-9","url":null,"abstract":"<p><strong>Background: </strong>Our study aims to investigate the levels of serum cytokines in children with community-acquired pneumonia (CAP) caused by different respiratory pathogens, and evaluate the predictive value of cytokines levels for severe pneumonia.</p><p><strong>Methods: </strong>A retrospective study was conducted on the clinical data of children hospitalized with CAP. According to the pathogens, patients were divided into the M. pneumoniae group, Adenovirus group, respiratory syncytial virus group, H.influenzae group, and S.pneumoniae group.</p><p><strong>Results: </strong>The M. pneumoniae group was higher than RSV group in the level of serum pro-inflammatory cytokines include IL-2, IL-6, IL-17 A, and IFN-γ. But M. pneumoniae group was higher than Adenovirus group only in IL-6. M. pneumoniae group was higher than H. influenzae group and S. pneumoniae group in IL-17 A, IFN-γ. as primary anti-inflammatory cytokine, IL-10 was lower in the M. pneumoniae group compared with Adenovirus and RSV groups. IL-6 was higher in S. pneumoniae group than RSV group. IFN-γ was lower in H. influenzae group than Adenovirus group and RSV group. IL-10 was higher in RSV group than H. influenzae group. IL-6 was higher in Adenovirus group than RSV group. In M. pneumoniae group and H. influenzae group, the levels of IL-6, IL-10, and IFN-γ were significantly higher in the severe pneumonia subgroup compared with the non-severe pneumonia subgroup (P < 0.05).</p><p><strong>Conclusions: </strong>Compared with other groups, M. pneumoniae group was higher in the level of serum proinflammatory cytokines. Additionally, the levels of IL-6, IL-10, and IFN-γ can be used as predictors of severe pneumonia caused by M. pneumoniae and H. influenzae.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"147"},"PeriodicalIF":3.2,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093880/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110621","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":"Individual and community level determinants of neonatal mortality in sub saharan Africa: findings from recent demographic and health survey data.","authors":"Engidaw Fentahun Enyew, Mihret Getnet, Ashebir Mamay Gebiru, Gashaw Dessie","doi":"10.1186/s13052-025-01997-7","DOIUrl":"10.1186/s13052-025-01997-7","url":null,"abstract":"<p><strong>Background: </strong>A major cause of deaths among children under five is neonatal mortality, a worldwide problem. However, the problem in sub-Saharan Africa is not well documented. Understanding the prevalence of neonatal death and its related causes is crucial for creating efforts and policies that could help address the problem. This study set out to determine the prevalence of neonatal death and its determinants in sub-Saharan Africa.</p><p><strong>Methods: </strong>Using secondary data analysis of demographic and health surveys conducted between 2014 and 2024 in sub-Saharan Africa. Total weighted samples of 133,448 live births in all during the period in 31 Sub- Saharan Africa. The determinants of neonatal mortality were identified using a multilevel mixed-effects logistic regression model. A multilevel binary logistic regression was fitted to identify the significant determinants of neonatal mortality. The Intra-class Correlation Coefficient, Median Odds Ratio, Proportional Change in Variance was used for assessing the clustering effect, and deviance for model comparison. Variables with a p-value < 0.2 in the Bivariable analysis were considered in the multivariable analysis. In the multivariable multilevel binary logistic regression analysis, Adjusted Odds Ratio with 95% CI was reported to declare statistically significant determinants of neonatal mortality.</p><p><strong>Results: </strong>The neonatal mortality in sub-Saharan Africa was 32 per 1000 live births (95% CI: 30, 34). maternal occupation (AOR = 1.26, 95% CI: 1.16, 1.37), home delivery (AOR = 1.29; 95% CI: 1.21, 1.39), caesarean section (AOR = 1.58; 95%CI: 1.36, 1.83), twin births(AOR = 2.48, 95% CI: 2.05, 2.54), birth order of 2-4 (AOR = 1.30, 95% CI: 1.18, 1.44), birth order of ≥ 5 (AOR = 1.43, 95% CI: 1.31, 1.59) and smaller size than average (AOR = 1.49, 95% CI: 1.36, 1.63)were significantly associated with higher odds of neonatal mortality.</p><p><strong>Conclusion: </strong>According to this study, in sub-Saharan Africa neonatal mortality rate was high. The following factors should be taken into account while developing policies and measures to reduce newborn mortality in sub-Saharan Africa: the mother's education, wealth index, occupation, place of delivery, mode of delivery, twin birth, neonatal sex, birth order, and size at birth.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"144"},"PeriodicalIF":3.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090633/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101867","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":"Postoperative amblyopia in children with congenital cataracts: a systematic review and meta-analysis.","authors":"Ailifeire Hailaiti, Xiaoning Yu, Ke Yao, Xingchao Shentu","doi":"10.1186/s13052-025-02010-x","DOIUrl":"10.1186/s13052-025-02010-x","url":null,"abstract":"<p><p>This systematic review and meta-analysis aimed to estimate the prevalence of amblyopia following congenital cataract surgery in children and evaluate key prognostic factors, including age at intervention, cataract phenotype, and follow-up duration. We systematically searched PubMed, EMBASE, and the Cochrane Library for studies published between January 1, 1981, and March 1, 2023. We included clinical trials, case series, and observational studies to analyze surgical timing, visual outcomes, and complications. Among 28 studies (2,167 patients, 3,371 eyes), the pooled amblyopia prevalence was 62% (95% CI: 0.55-0.69, I² = 91.7%). Early surgery (≤ 8 weeks for unilateral, ≤ 12 weeks for bilateral cases) significantly reduced amblyopia risk (P < 0.001) but increased complications, notably glaucoma (26% vs. 6%, P = 0.001). In contrast, intraocular lens (IOL) implantation timing had no significant effect on visual outcomes (P = 0.096). Unilateral partial obstruction conferred a higher amblyopia prevalence than bilateral complete obstruction (68% vs. 36%, P = 0.003), and prolong amblyopia therapy beyond 6 years of age showed limited efficacy. These findings highlight the critical role of timely surgery in optimizing visual recovery, despite its association with complications. Early IOL implantation demonstrated no significant clinical benefits, and the therapeutic window for amblyopia rehabilitation in congenital cataracts is narrower than in other forms.</p>","PeriodicalId":14511,"journal":{"name":"Italian Journal of Pediatrics","volume":"51 1","pages":"141"},"PeriodicalIF":3.2,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12087085/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144101870","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}