Italian Journal of Pediatrics最新文献

Background: Maternal diabetes mellitus (DM) significantly affects fetal cardiac and placental structure and function. This study aimed to assess structural and functional cardiac changes in infants of diabetic mothers (IDMs) using echocardiographic data and cord blood cardiac biomarkers.

Methods: M-mode and pulsed-wave tissue Doppler imaging (PW-TDI) echocardiography along with cord blood cardiac markers were evaluated in 40 IDMs and 40 healthy term newborns. Cardiac biomarkers included troponin T (Trop-T), N-terminal pro-brain natriuretic peptide (NT-proBNP), and ischemia-modified albumin (IMA).

Results: Among the diabetic mothers, 87.5% had gestational diabetes mellitus (GDM) and 12.5% had type 1 diabetes mellitus (T1DM). Interventricular septum (IVS) thickness was significantly greater in the IDM group. Of the IDMs, 32.5% had asymmetric septal hypertrophy. Mid-septal tissue Doppler Imaging (TDI) parameters showed significantly altered velocities and time intervals. NT-proBNP and IMA levels were significantly elevated in the IDMs group, while Trop-T was not statistically different. No correlation was found between TDI parameters and biomarker levels.

Conclusion: Cardiac dysfunction and elevated cord blood biomarkers in IDMs reflect subclinical stress. These findings support the utility of TDI and biochemical markers for early cardiac assessment in IDMs. Larger studies are needed to validate the use of these markers for routine screening and to better understand their pathophysiological significance.

Background: Respiratory infections are one of the most common causes of morbidity and mortality among children. After the COVID-19 pandemic, the epidemiology of respiratory tract infections has changed and has been better traced by more frequent and less expensive molecular and antigenic tests. The main aim of this retrospective study was to evaluate the epidemiology of respiratory infections among children hospitalized in Perugia during the epidemic seasons of 2018-2019 and 2023-2024, comparing clinical severity, hospitalization length, diagnostic and therapeutic interventions.

Methods: We retrospectively analysed hospital records of all patients admitted to our clinic from October 2018 to March 2019 and from October 2023 to March 2024.

Results: In the post-COVID-19 era, hospitalizations for respiratory infections increased proportionally to other hospitalization causes, remaining the most common ones. Length of hospital stay was shorter, with no difference based on age, C-Reactive Protein levels or symptoms at admission. A change of respiratory infection epidemiology after the COVID-19 pandemic has been witnessed also in our setting: Respiratory Syncytial Virus and Influenza played a central role, displaying earlier peaks and severe clinical pictures. Increased use of molecular testing allowed for prompt etiological diagnoses, likely contributing to shorter inpatient stays and fewer antibiotic prescriptions, thus reducing economic burden for each patient and promoting improved antibiotic stewardship.

Conclusion: In our setting, respiratory infections still accounted for the majority of pediatric hospitalizations during the autumn/winter seasons. A comprehensive testing strategy for etiological diagnosis of respiratory infections in hospitalized patients seemed to be cost-effective by reducing hospital stay and antibiotic prescriptions. This study may inform healthcare policy by emphasizing the importance of etiological diagnosis and the economic burden of inappropriate treatments.