Minerva Pediatrics最新文献

Multisystem inflammatory syndrome in children (MIS-C) is a rare hyperinflammatory and immunosuppressed condition affecting children exposed to COVID-19. MIS-C has been associated with an over-exaggerated innate and adaptive immune response characterized by a 'selective' cytokine production and T cell suppression. As COVID-19 information has evolved, the knowledge and field surrounding MIS-C is ever evolving. Thus, a comprehensive clinical review that concisely presents current literature findings regarding common clinical presentations and comparisons with similar conditions, associations with the COVID-19 vaccine effects and relevant epigenetic markers and evaluates treatment and long-term outcomes to help guide future studies is needed and provided.

Background: Despite several international initiatives aimed to contrast childhood overweight and obesity, these still represent a major public health problem. Recently, the World Health Organization called for a new type of preventive action, requiring stakeholders from both governments and civil society, to play a decisive role in shaping healthy environments, especially for children.

Methods: COcONUT (Children PrOmOting Nutrition throUgh Theatre) was a nutrition education project, involving children aged 5-12 years, aimed to raise awareness on healthy eating, through theatrical and practical workshops. Within this project we conducted an observational study assessing: 1) children adherence to the Mediterranean diet, using the KIDMED questionnaire; 2) parental nutritional knowledge and families' food habits using the ZOOM8 questionnaire. The non-parametric Wilcoxon and the McNemar's Test were used. Statistical significance was fixed P<0.05.

Results: Our data show a statistically significant improvement in Mediterranean Diet adherence among children (P=0.0004). Moreover, we found positive trends in some families' food habits, as for instance less perceived barriers in fruits/vegetables/pulses consumption, less perceived barriers in doing sports and less consumption of unhealthy snacks.

Conclusions: Our results confirm the important role played by funny and active learning in health promotion initiatives.

Acute post-viral cough is a common symptom, usually mild-moderate and self-resolving. However, acute cough may be particularly annoying, affecting sleep, and quality of life, also of the family. Thus, treatment is deemed necessary. Antitussive remedies may be pharmacological or non-pharmacological. Antitussive drugs are either central or peripheral. Central drugs are burdened with significant side effects and can cause abuse, especially in adolescents. Levodropropyzine, on the other hand, is an effective peripheral drug, as demonstrated by two meta-analyses, and has an optimal safety profile. Non-pharmacological remedies tend to be safe, but few substances have a documented degree of efficacy. Therefore, when managing children and adolescents with a post-viral cough, the practical approach may be based on levodropropizine use, which is preferable when the cough is particularly persistent and disturbs sleep.

Introduction: Debate exists regarding the ideal timing for surgery in Hirschsprung disease (HSCR) in various groups of age. The aim of this paper was to suggest a possible strategy to determine the optimal timing for reconstructive surgery in patients affected by HSCR.

Evidence acquisition: A systematic literature search of papers published on PubMed and Embase during the last decade, addressing "Hirschsprung," "preoperative enterocolitis," "preoperative mortality," "complications," and "timing" in all possible combinations, was performed.

Evidence synthesis: A total of 10 out of 170 identified papers addressed this issue in detail and were subsequently assessed for in-depth analysis. Our review confirmed that the most important issue to guide surgical timing is represented by HSCR Associated Enterocolitis (HAEC). Most authors suggest performing pull-through at around 3 months of age after effective bowel decompression, which should not be continued indefinitely to avoid complications.

Conclusions: Based on this systematic review we suggest the following: 1) healthy neonates should undergo surgical reconstruction at 3 months of age; 2) urgent surgery (levelling enterostomy) might be required in critically unwell patients, those with Total Colonic HSCR, or those in whom nursing proved to be ineffective; 3) surgery can be safely postponed only in older patients with a lower likelihood of HAEC (i.e. without previous HAEC occurrences) always avoiding long-lasting rectal irrigations.

Background: The first aim of this study was to compare Pediatric Emergency Department (PED) admissions for acute bronchiolitis during the 2022-2023 season to those of the season 2021-2022. The secondary aim was to assess the difference in the recurrence of bronchiolitis episodes in the same patient between the two seasons.

Methods: This is a retrospective, observational, cross-sectional study conducted at the PED of IRCCS A. Gemelli University Polyclinic Foundation (Rome, Italy). We included all children aged between 0 and 2 years admitted to PED with the diagnosis of bronchiolitis. We compared features of seasons 2021-2022 and 2022-2023.

Results: The median age of children enrolled during the 2022-23 season was 5 months (IQR: 2-8) compared to 7 months (IQR: 2-14) in the previous one (P=0.02). We observed in the last season a higher number of children admitted to PED with a high priority code and an increased therapeutic use of high-flow nasal cannula and inhaled adrenaline. During the 2022-23 season we found 31 (12.8%) children presenting more than one episode of bronchiolitis in the same epidemic season, compared to 16 (7.6%) children in the previous season (P=0.048).

Conclusions: Our data emphasize that the epidemiological features of bronchiolitis after COVID-19 outbreak have changed and are still evolving.