Human milk (HM) represents the gold standard for infant’s nutrition, including preterm and very low birth weight (VLBW) infants, owing to its well-documented benefits in reducing neonatal morbidity and supporting long-term neurodevelopmental and metabolic outcomes. However, HM alone does not meet the nutritional requirements of VLBW infants as defined by current European Society for Paediatric Gastroenterology, Hepatology and Nutrition guidelines, making fortification with protein, energy, and micronutrients a widely adopted strategy in Neonatal Intensive Care Units. This article reviews the quantitative and qualitative aspects of HM fortification, with a focus on fortifiers currently available in Italy. From a quantitative standpoint, multicomponent fortifiers provide additional protein and carbohydrates within recommended osmolality limits, though evidence on optimal protein intake thresholds and fortification strategies remains inconclusive. Lipid supplementation, particularly with docosahexaenoic acid and arachidonic acid, is recommended to increase the caloric intake, to address long-chain polyunsaturated fatty acid deficiency and to support neurodevelopment. Regarding qualitative aspects, bovine milk-derived fortifiers remain the standard of care despite the fact that exposure to bovine milk-derived products is not optimal with respect to tolerance and the reduction of the risk of necrotizing enterocolitis. HM-derived fortifiers, despite their theoretical advantages, have not demonstrated clear superiority over bovine milk-derived products in terms of morbidity or growth outcomes, and raise significant ethical and economic concerns. Donkey milk-derived fortifiers represent an emerging and promising alternative, given their compositional similarity to HM, hypoallergenic properties, and preliminary clinical evidence showing improved feeding tolerance with comparable auxological and neurodevelopmental outcomes in VLBW infants. Future perspectives point toward the industrial development of donkey milk-based fortifiers as a clinically feasible and ethically sustainable alternative to current bovine milk-derived formulations.
Background: Therapeutic drug monitoring facilitates the individualiza tion of amikacin dosing for patients based on pharmacodynamics and pharmacokinetics. Its efficacy is measured by peak serum concentration (Cpeak) / minimum inhibitory concentration (MIC) ratio. This study aims to determine the efficacy of 15 mg/kg/day of amikacin in critically ill septic pediatric patients. Methods: This crosssectional analytic study involved 25 pediatric critically ill septic patients. All patients received amikacin based on clinical diagnosis and/or culture results. Amikacin Cpeak and MIC were measured. Results: Amikacin Cpeak was not achieved in 44% of the study group, with the MIC being at least 64 mcg/mL, leading to a very low Cpeak/MIC ratio. Conclusion: Critically ill pediatric patients who are administered amikacin require frequent monitoring and dose adjustment to achieve the target level, as subtherapeutic levels may contribute to resistance, while elevated levels are linked to nonoliguric acute kidney injury.
Genetic hemochromatosis (GH) and alpha-1 antitrypsin (AAT) deficiency (AATD) are two autosomal recessive disorders associated with an increased risk for liver injury. Among different AATD and GH genotypes, the M-Malton and the S variants are frequent in Sardinia, an Italian island of the Mediterranean Sea, suggesting that a possible relationship between these two metabolic disorders in chronic liver diseases should be considered. Here we report a case of liver cirrhosis associated with double heterozygosity for M-Malton AATD and H63D GH alleles. The histological observation revealed micronodular cirrhosis with focal micro- and macrovesicular steatosis with globules of AAT protein and iron overload. The clinical and laboratory picture led to listing the patient for orthotopic liver transplantation. Two sons, who were apparently healthy, on molecular testing showed a normal AAT genotype, whereas one of them was heterozygous for the H63D GH mutation. This clinical case underlines the importance of the diagnostic role played by the liver biopsy, in particular when rare genetic variants could be involved.
Background: Small for gestational age (SGA) infants may have reduced lipid tolerance during intravenous lipid emulsion (ILE) therapy. We compared triglyceride (TG) levels in SGA versus non-SGA neonates receiving ILE and explored associations with neonatal morbidities. Methods: This retrospective study included neonates who received ILE for at least 24 hours. TG levels were measured at approximately 24 hours of life and at 30-60 days. Statistical analyses compared TG levels, the incidence of hypertriglyceridemia (TG > 250 mg/dL), and the change in TG levels over time between the groups. Results: 165 neonates were included, 56 (33.9%) SGA and 109 (66.1%) non-SGA. The mean +/- SD gestational age at birth and birth weight were 34.2 +/- 3.0 vs. 29.8 +/- 2.6 weeks (p < 0.001), and 1,446 +/- 336 vs. 1,325 +/- 350 grams, respectively (p = 0.02). TG levels at 24 hours were significantly higher in the SGA group (144 [98, 189] vs. 85 [62, 116] mg/dL, p < 0.001). Incidence of hypertriglyceridemia was higher in SGA infants (10.7% vs. 1.8%, p = 0.019). Despite shorter duration of exposure (3.0 [2.0, 4.5] vs. 4.5 [3.0, 7.0] days, p < 0.001), a subgroup of SGA infants with follow-up data had higher TG levels at 30-60 days of life compared to non-SGA infants (106 [84, 155] vs. 70 [56, 91] mg/dL, p = 0.005). In multivariable analysis, SGA status, intraventricular hemorrhage, use of cardiotropic agents, and ClinOleic (vs. SMOFlipid) were independently associated with higher TG at 24 hours. Conclusion: SGA infants showed higher early TG levels and greater risk of hypertriglyceridemia during ILE, with elevations persisting at 30-60 days in the subgroup of SGA infants with followup data available. These findings support early TG monitoring and individualized lipid titration for SGA infants. Interpretation should consider the retrospective single-center design, baseline differences between SGA and non-SGA infants, and limited SGA follow-up sampling.
SATB2-associated syndrome (SAS) is a rare neurogenetic disorder characterized by intellectual disability, absent or limited speech, craniofacial and dental anomalies, and behavioral disturbances. While most cases are associated with normal hearing, some may present with atypical features. We describe an 8-year-old male with global developmental delay, absent verbal language, autism spectrum disorder, and bilateral moderate sensorineural hearing loss. Dysmorphic facial features and neuroimaging findings of enlarged perivascular spaces were also identified. Whole-exome sequencing ultimately revealed a heterozygous pathogenic SATB2 variant (c.1285C>T; p.Arg429*), confirming SAS. This case expands the phenotypic spectrum of SAS by reporting a rare association with sensorineural hearing loss and enlarged perivascular spaces. It emphasizes the importance of considering SAS in patients with global developmental delay and syndromic features and supports the utility of exome sequencing in achieving a definitive diagnosis.
Background: Antenatal care (ANC) is beneficial for preserving the health of mothers and babies. This study aimed to investigate the prevalence and outcomes of deliveries among women with different ANC statuses. Methods: This prospective study included 1,349 deliveries, classified into 3 groups: A, no ANC; B, full or partial ANC at another hospital without any documentation; and C, full ANC at our institute. Data were collected prospectively using a standardized data collection sheet. The primary outcomes were maternal and neonatal all-cause mortality. Secondary outcomes included maternal and neonatal morbidity indicators. Results: Of the 1,349 deliveries, 274 (20.3%) were among women with no ANC, who also had the highest mean patient age (30.1 +/- 6.2 years; p < 0.001). Mothers without ANC were more likely to be non-citizens and to have higher parity. Deliveries in this group were associated with significantly higher odds of maternal Intensive Care Unit (ICU) admission, neonatal ICU (NICU) admission, low birth weight, early neonatal death, and intrauterine fetal death compared with mothers who received adequate ANC. Outcomes for women with undocumented or partial ANC were comparable to those with adequate ANC, without statistically significant differences. Conclusion: Targeted initiatives should focus on high-risk populations to promote the importance of planned delivery and consistent ANC throughout pregnancy.
Reactive infectious mucocutaneous eruption (RIME) is a serious adverse mucocutaneous reaction that occurs primarily in children and adolescents after a viral or bacterial infection most commonly caused by Mycoplasma pneumoniae (formerly known as Mycoplasma-induced rash and mucositis [MIRM]). Although MIRM was first described as a new entity in 2015, recent updates to its nomenclature have expanded its scope to include other bacteria and viruses that can cause similar mucocutaneous reactions. While the case presented here involves a mucocutaneous reaction in response to a Mycoplasma infection, the updated nomenclature highlights the importance of recognizing and understanding this condition to better integrate it into the diagnosis of future mucocutaneous reactions. We present the case of a 16-year-old male adolescent who was admitted to the hospital with bilateral phlegmon, aphthous stomatitis, glossitis, bilateral conjunctivitis and papules on both foot soles. He had had a 10-day history of an airway infection, characterized by fever and cough. Diagnostic tests revealed elevated infectious markers and positive serologies for Mycoplasma pneumoniae. Based on these findings, the patient was admitted to the Pediatric Ward and diagnosed with RIME. He was treated with ceftriaxone, azithromycin, methylprednisolone, ocular ofloxacin, and a mucositis solution. The patient remained hospitalized for 7 days and showed progressive improvement, with complete resolution of symptoms after 4 weeks. Through this case, we aim to highlight the signs and symptoms of RIME, which can help ensure timely diagnosis and appropriate management of new cases.
Background: Despite improved survival in esophageal atresia with or without tracheoesophageal fistula (EA/TEF), complications remain common. We evaluated surgical outcomes at our institution over time and compared them to published benchmarks. Methods: We performed a retrospective single-center review of patients with EA/TEF treated between 2008 and 2023, comparing outcomes to a prior institutional cohort from 1975 to 1995. Patients were identified using ICD and CPT codes. Results: A total of 132 patients were included across both cohorts. Patient characteristics were similar between groups. Operative repair increased from 84% to 100% (p = 0.001). Stricture (40% vs. 37%) and TEF recurrence (7% vs. 10%) rates remained stable and comparable to benchmarks. Leak rate decreased from 19% to 12%, lower than benchmark reports. Overall mortality dropped significantly from 22% to 6% (p = 0.012). Among high-risk Waterston C infants, survival improved markedly from 38% to 79% (p = 0.015). Conclusion: EA/TEF survival has significantly improved, especially among high-risk infants with low birth weight and cardiac disease. While stricture and recurrence rates remain unchanged, leak rates have improved. These findings reflect evolving surgical practices and improved neonatal care.
The use of low-dose medicinal products, diluted and subjected to standardized succussion treatment or dynamization, has been recognized by the World Health Organization as a component of Traditional, Complementary and Integrative Medicine, and is widespread in more than 100 countries, with over 600 million users. It is based on holistic principles and on a unique production process. This article presents an overview of fundamental research, articulated along two lines: chemical-physical studies-which, thanks to advanced techniques such as Raman and UV-vis spectroscopy, nuclear magnetic resonance, and differential scanning calorimetry, have highlighted electromagnetic signatures and specific reorganizations of water molecules in dynamized dilutions; and biological studies, conducted in vitro (human cells and microglia) and in vivo (Lemna gibba, frog tadpoles, murine models), which document measurable effects independent of placebo. Some studies hypothesize mechanisms based on nanostructures and possible electromagnetic interactions. These hypotheses remain controversial and require further independent experimental confirmation. Finally, studies on the use of such medicinal products in developmental age are analyzed, discussing clinical implications, future perspectives, and methodological challenges, and underscoring the importance of rigorous standards to integrate the use of low-dose medicinal products subjected to standardized dynamization treatment into modern healthcare systems. Although not exhaustive, this article offers insights for further investigation and for the optimization of research protocols with a high level of methodological rigor.
Early postnatal life is a critical period for gut microbiota establishment and metabolic programming, particularly in infants born by cesarean section and fed with infant formula, two factors known to disrupt physiological microbial colonization. This exploratory pilot study aimed to provide a longitudinal characterization of microbiota and metabolome dynamics in infants born by elective cesarean section and formula-fed receiving Lactobif (R) (Buona S.p.a. Society Benefit, Sesto Fiorentino, Italy), a commercial probiotic formulation containing Lacticaseibacillus rhamnosus, LGG (R) (DSM33156) and Bifidobacterium longum subsp. infantis, Bifin02TM (DSM33361). A multiomics approach was applied, integrating 16S rRNA gene-based microbiota profiles with 1H NMR-based metabolomics of fecal and urinary samples collected before and during supplementation. Longitudinal analyses revealed dynamic shifts in gut microbial composition, notably a post-treatment increase in Bifidobacteriaceae and a reduction in Enterobacteriaceae, accompanied by changes in fecal metabolites associated with fermentation, including lactate, acetate, and propionate. An expansion of Veillonellaceae was also observed, suggesting the progressive emergence of a more functionally interconnected microbial ecosystem. Urinary metabolomic profiles showed time-dependent modulation of metabolites involved in energy metabolism, amino acid turnover, and microbial co-metabolism, reflecting systemic metabolic adaptation during early infancy. The longitudinal, multi-compartment design offers descriptive evidence of temporal positive changes in microbial composition and metabolic outputs, revealing both shared patterns and marked interindividual variability. The integrated analysis of microbiota and metabolomics data highlights the value of multi-biofluid, multi-omics strategies for capturing functional maturation of the gut ecosystem and supports the need for personalized approaches to early-life microbiome modulation.
Artificial intelligence (AI) is used in medicine to assist clinicians in diagnosing and treating patients with various medical conditions. It can have specific benefits for children with special needs, as it can assist in daily activities by enhancing support for these children. The incidence and prevalence of autism spectrum disorder (ASD) are rapidly increasing. ASD can be associated with other comorbid conditions involving multisystem medical and genetic disorders. AI can help with the early diagnosis and management of ASD and related comorbid conditions. This review aimed to study how AI can be used in patients with ASD and comorbidities. A narrative review was conducted to find the answer to the study. Electronic PubMed/Medline and Google Scholar databases were searched for peer-reviewed articles. Papers that were not written in the English language were excluded. Results of the study found that, along with providing autistic children the practice of identifying facial expressions, interacting socially, and responding appropriately to social cues, AI can help deal with complex comorbid conditions. AI heavily depends on large amounts of good-quality data, so it faces fundamental technological challenges, such as hallucinations, false results, data privacy, security, and ethical concerns. However, by addressing the challenges and limitations, AI can be a great tool for children with ASD and their families to navigate the associated comorbidities and improve the overall quality of life of these patients. Future research and collaboration of providers with policymakers and community partners can overcome the challenges for AI applications in patients with ASD and associated comorbidities.
McCune-Albright syndrome (MAS) is defined by the triad of caf & eacute;-au-lait macules, endocrinopathies, and polyostatic fibrous dysplasia (FD) of the bone. It results from somatic GNAS mutations leading to mosaic G alpha s activation. FD can result in bone deformities, fractures, and cranial nerve compression, including optic neuropathy. Optic nerve compression by FD may lead to visual disturbances or even blindness. We report a 13-year-old boy with MAS and left eye visual impairment due to optic nerve compression by FD. Endoscopic transnasal optic nerve decompression of the optic nerve was performed. Postoperatively, the patient exhibited slight visual improvement, though delayed intervention may have limited recovery. The case report highlights endoscopic decompression as a safe and effective approach for FD-related optic neuropathy, though optimal timing remains debated. Prophylactic intervention in high-risk cases warrants further investigation to prevent irreversible vision loss.
Selected Abstracts of the 21st International Workshop on Neonatology and Pediatrics; Cagliari (Italy); October 22nd-25th, 2025 EVOLUTION AND REVOLUTION IN NEONATOLOGY AND PEDIATRICS The Workshop has been organized with the patronage of the Autonomous Region of Sardinia, City of Cagliari, Azienda Ospedaliera di Cagliari, University of Cagliari, Board of Physicians of the Province of Cagliari, Albanian-Italian Pediatric Society (AIPS), AMBO (Alleanza per un Ambiente a misura di Bambino: alliance for a child-friendly environment), Board of Directors of Italian Pediatrics Schools, European Project Better4u, European Project Life Milch, National Coordination of Heads of Pediatric Departments (CONAPP), Italian Federation of Family Pediatricians (FIMP), Italian-Arabian Pediatric Society (IAPS), Italian-Romanian Pediatric Society (IRPS), Italian-Swedish Cultural Association (ACIS), Norman Group of Neonatal and Pediatric Nephrology, International Academy of Perinatal Medicine (IAPM), Italian Society of Pediatric Allergology and Immunology (SIAIP), Italian Society of Clinical Biochemistry (SIBioC), Italian Society of Gynecology of Infancy and Adolescence (SIGIA), Italian Society of Neonatology (SIN), “SIPO in the World” Association, Italian Society of Pediatric Psychology (S.I.P.Ped.), Italian Society for Research on Essential Oils (SIROE), Italian Society of Neonatal Nursing (SIN INF), “Pediatria Più” Association, Italian Society of Developmental Origins of Health and Disease (SI-DOHaD), Italian Society of Pediatricians (SIMPE). ABS 1. PLATELET TRANSFUSIONS IN NEONATES: IMPACT ON COAGULATION AND IMMUNOLOGICAL EFFECTS • D. Gialamprinou (Thessaloniki, Greece) ABS 2. PATTERNS AND ASSOCIATED FACTORS OF CONGENITAL ANOMALIES AMONG NEONATES IN 14 YEMENI GOVERNORATES (2021-2023): A CASE-CONTROL STUDY • H. Al-Atnah (Sana’a, Yemen) ABS 3. INTERNATIONAL STANDARDS FOR TWIN NEWBORN WEIGHT, LENGTH, AND HEAD CIRCUMFERENCE BY GESTATIONAL AGE AND SEX: THE INTERGROWTH-21ST CROSS-SECTIONAL STUDY • F. Giuliani, S. Deantoni, S. Gandino, A. Coscia, I. Stura, S.H. Kennedy, A.T. Papageorghiou, E. Bertino, G. Migliaretti, J. Villar for the International Fetal and Newborn Growth Consortium (INTERGROWTH-21st) (Turin and Moncalieri, Italy; Oxford, UK) ABS 4. IMPACT OF MATERNAL SARS-CoV-2 INFECTION ON NEONATAL URINARY METABOLOME: A LONGITUDINAL STUDY OVER THE FIRST MONTH OF LIFE • D. Gianotti, F. Cannas, N. Zuddas, A. Kindt, F. Cesare Marincola, V. Fanos (Genoa and Cagliari, Italy; Leiden, The Netherlands) ABS 5. ARTIFICIAL INTELLIGENCE IN NEONATOLOGY: WHERE ARE WE NOW? • K.K. Kopeć (Cagliari, Italy) ABS 6. A TWISTED TIBIA IN A PRETERM NEONATE • M. Olla, F. Zanco, F.F. Comisi, E. Esposito, C. Spiga, V. Fanos (Cagliari, Italy) ABS 7. SCHRÖDINGER’S FETUS • S. Nasikas, F.F. Comisi (Athens, Greece; Cagliari, Italy) ABS 8. UNEXPLAINED HYPOTONIA IN THE NEWBORN: A CASE THAT CHALLENGES FIRST IMPRESSIONS • E. Esposito, F.F. Comisi, M. Loi, P. Beretta, V. Marinelli, F. Lai, V. Fanos, S. Savasta (Cagliari, Italy) ABS 9. ACUTE MONOARTHRITIS IN A PEDIATRIC PATIENT: A CASE OF SALMONELLA-INDUCED REACTIVE ARTHRITIS • L. Saggioro, M. Casarotto, M.R. Ferrara, F. Marino, C. Lorenzetto, E. Madeddu, S. Bellonzi, F. Rigon, L. Calandriello, F. Sansone, E. Fiumana, S. Rugolotto (Rovigo and Padua, Italy) ABS 10. NUTRITIONAL MANAGEMENT OF THE NEWBORN WITH NECROTIZING ENTEROCOLITIS: A CASE REPORT • F. Zanco, E. Esposito, F.F. Comisi, M. Melis, V. Fanos (Cagliari, Italy) ABS 11. POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME IN PEDIATRIC AGE: A CASE REPORT • E. Madeddu, M.R. Ferrara, M. Casarotto, F. Marino, L. Saggioro, F. Rigon, S. Bellonzi, C. Lorenzetto, F. Sansone, L. Calandriello, S. Rugolotto (Rovigo, Padua, and Verona, Italy) ABS 12. INFANTILE COLIC AND INTESTINAL INFLAMMATION • B.M. Trapani (Paris, France) ABS 13. A STUDY IN CYCLES: CLINICAL CLUES FROM CHILDHOOD VOMITING • F.F. Comisi, E. Esposito, F. Zanco, M.G. Cuboni, C. Soddu, S. Savasta (Cagliari, Italy) ABS 14. WHEN BREATHING FAILS, BLAME THE HEART • S. Maninchedda, M.G. Cuboni, V. Lagona, P. Neroni, D. Manus, V. Fanos (Cagliari, Italy) ABS 15. UNUSUAL LOCALIZATION OF BARTONELLA HENSELAE: SPONDYLODISCITIS IN A FIVE-YEAR-OLD CHILD • F. Marino, M.R. Ferrara, M. Casarotto, F. Sansone, S. Bellonzi, C. Lorenzetto, F. Rigon, E. Fiumana, L. Saggioro, L. Calandriello, E. Madeddu, S. Rugolotto (Rovigo, Padua, and Verona, Italy) ABS 16. CLAVICLE FRACTURES AT BIRTH: EXPERIENCE FROM TWO CASE REPORTS • E. Esposito, F.F. Comisi, P. Beretta, F. Zanco, V. Fanos (Cagliari, Italy) ABS 17. HIDDEN IN PLAIN SIGHT: WHEN HERPES ISN’T THE ANSWER • F.F. Comisi, E. Esposito, F. Zanco, M.I. Cicalò, M. Pepe, R. Minelli, S. Savasta (Cagliari, Italy) ABS 18. SEPSIS-ASSOCIATED ENCEPHALOPATHY IN A SIX-MONTH-OLD INFANT • L. Calandriello, M. Casarotto, M.R. Ferrara, S. Bellonzi, C. Lorenzetto, F. Marino, F. Rigon, E. Fiumana, E. Madeddu, A. Mussari, L. Saggioro, F. Sansone, S. Rugolotto (Rovigo, Padua, and Verona, Italy) ABS 19. PREVENTING AND FACING OBESITY THROUGH THE BETTER4U EU-FUNDED PROJECT • M. Mauri, A. Noto, C. Piras, K.K. Kopeć, P. Baire, L. Atzori, V. Fanos (Cagliari, Italy) ABS 20. SUBSTANCES THAT MAY INCREASE THE RISK OF PRECOCIOUS PUBERTY IN CHILDREN • S. Vendemmia, G. Kuli Lito, D. Anca Plesca, M. Vendemmia (Aversa and Naples, Italy; Tirana, Albania; Bucharest, Romania) ABS 21. LOCKED EYE, PAINFUL HEAD: A RARE PEDIATRIC NEUROPATHY • M. Pepe, M.G. Cuboni, F.F. Comisi, E. Spreafico, V. Santi, M. Gherardini, A. Chabert, T. Foiadelli, S. Savasta (Cagliari and Pavia, Italy) ABS 22. WHEN SINUSITIS TURNS DANGEROUS: A PEDIATRIC CASE OF POTT’S PUFFY TUMOR WITH INTRACRANIAL EXTENSION • G. Sanna, M. Pepe, D. Murru, B. Percivale, G. Pintori, G. Masia, A.M. Monni, M. Loi, V. Corsi, C. Marcheselli, A. Cualbu (Cagliari and Nuoro, Italy) ABS 23. BOTULISM IN CHILDREN AND ADULTS • S. Vendemmia, G. Kuli Lito, D. Anca Plesca, B. Al-Zoubi, M. Vendemmia (Aversa and Naples, Italy; Tirana, Albania; Bucharest, Romania; Amman, Jordan) ABS 24. ANISAKIASIS • S. Vendemmia, G. Kuli Lito, D. Anca Plesca, B. Al-Zoubi, M. Vendemmia (Aversa and Naples, Italy; Tirana, Albania; Bucharest, Romania; Amman, Jordan) ABS 25. MRI BEYOND CT IN PEDIATRIC SPINAL TRAUMA: A CASE REPORT • M. Pepe, G. Sanna, D. Murru, B. Percivale, G. Pintori, G. Masia, A.M. Monni, M. Loi, V. Corsi, C. Marcheselli, A. Cualbu (Cagliari and Nuoro, Italy) ABS 26. SYSTEMIC LUPUS ERYTHEMATOSUS IN A PEDIATRIC PATIENT: A CASE WITH ONSET COMPLICATED BY CONCOMITANT VISCERAL LEISHMANIASIS • C. Trenta, C. Giardino, P. Currao, V. Ibba, S. Savasta (Cagliari, Italy) ABS 27. A (NOT SO) UNEXPECTED PERINATAL STROKE: WHY EARLY RISK IDENTIFICATION MATTERS • V. Lagona, M.G. Cuboni, S. Maninchedda, M. Melis, M. Loi, V. Fanos (Cagliari, Italy) ABS 28. PERIVIABILITY AND THE CINDERELLA EFFECT • S. Nasikas, F.F. Comisi (Athens, Greece; Cagliari, Italy) ABS 29. OSTEOMYELITIS OF THE CLAVICLE IN A PEDIATRIC PATIENT: A CASE REPORT • F. Zara, F. Marino, M.R. Ferrara, M. Casarotto, F. Sansone, S. Bellonzi, C. Lorenzetto, F. Rigon, E. Fiumana, L. Saggioro, L. Calandriello, E. Madeddu, S. Rugolotto (Padua, Rovigo, and Verona, Italy) ABS 30. A COMPLEX CLINICAL CASE ON THE MANAGEMENT OF LATE PRETERM INFANT • F. Zanco, E. Esposito, F.F. Comisi, A. Atzei, V. Fanos (Cagliari, Italy) ABS 31. TRANSIENT ELEVATION OF FECAL CALPROTECTIN IN AN INFANT: CASE REPORT • G. Trapani (Sanremo, Italy) ABS 32. PD-L1 EXPRESSION IN THE HUMAN PLACENTA AT THE MATERNAL-FETAL INTERFACE PROTECTS FETAL DEVELOPMENT, ESTABLISHING MATERNAL IMMUNOTOLERANCE • M. Piras, P. Ziranu, A. Pretta, M. Piludu, F. Cau, G.S. Porcu, G. Faa (Cagliari and San Gavino, Italy; Philadelphia, PA, USA) ABS 33. METABOLOMIC INSIGHTS AND RESEARCH GAPS IN RUGBY: FROM ACUTE RESPONSES TO RECOVERY • V. Bongiovanni, M. Caria, V. Fanos (Cagliari, Italy) ABS 34. WEST NILE AND USUTU VIRUSES • S. Vendemmia, G. Kuli Lito, D. Anca Plesca, M. Vendemmia (Aversa and Naples, Italy; Tirana, Albania; Bucharest, Romania) ABS 35. SPORTOMICS: BASKETBALL AND VOLLEYBALL • M. Caria, V. Bongiovanni, V. Fanos (Cagliari, Italy) ABS 36. EXPLORING UNCERTAINTY: LONG-TERM OUTCOMES AND NEUROPLASTICITY AFTER PRENATAL BRAIN HEMORRHAGE • V. Bongiovanni, M. Melis, V. Marinelli, V. Fanos (Cagliari, Italy) ABS 37. THE SYNDROME WITH A THOUSAND FACES: A PEDIATRIC PRESENTATION OF SJÖGREN’S SYNDROME • M. Rossi, S. Campus, V. Ibba, S. Savasta (Cagliari, Italy) ABS 38. NEONATAL TRANSPORT FROM THE ISLANDS: A COMPARISON BETWEEN SARDINIA AND THE AZORES • R. Pirisino, A. Atzei, R. Couto, V. Fanos (Cagliari, Italy; Angra do Heroísmo, Ilha Terceira, Azores, Portugal) ABS 39. ECHOES IN THE CSF: METABOLOMIC MARKERS OF ACUTE IMMUNE NEUROPATHIES • F.F. Comisi, R. Pintus, E. Esposito, V. Fanos (Cagliari, Italy) ABS 40. MATERNAL LIFESTYLES AND ENDOCRINE-DISRUPTING CHEMICALS: SARDINIAN COHORT IN THE EUROPEAN LIFE-MILCH PROJECT • F. Gola, S. Petza, R. Pintus, S. Angioni, P. Palanza, M.E. Street, A.M. Papini, A. Dessì, V. Fanos (Cagliari, Parma, and Sesto Fiorentino, Italy) ABS 41. PERINATAL INFLAMMATION: A CHALLENGE FOR FETAL NEURODEVELOPMENT • C. Loddo, R. Pintus, V. Fanos (Cagliari, Italy) ABS 42. ASSOCIATION OF ENDOTHELIN-1 AND CYTOKINE LEVELS WITH HYPERFIBRINOLYSIS OF PREGNANT WOMEN WITH PREECLAMPSIA AND THE DEFICITS IN FIBRINOGEN AND EXTRINSIC PATHWAY FACTORS OF THEIR NEONATES • C.G. Kontovazainitis, D. Gialamprinou, A. Fleva, A. Giannakou, M.E. Bessina, M. Varsami, T. Theodoridis, E. Diamanti, G. Mitsiakos (Thessaloniki, Greece) ABS 43. AMONG NEONATES BORN TO WOMEN WITH PREECLAMPSIA, BRONCHOPULMONARY DYSPLASIA IS ASSOCIATED WITH INTERLEUKIN 2 LEVELS AT BIRTH, WHILE NEONATAL THROMBOCYTOPENIA IS ASSOCIATED WITH MATERNAL INTERLEUKIN 2 AND ENDOTHELIN • C.G. Kontovazainitis, D. Gialamprinou, A. Fleva, A. Giannakou, M. Varsami, M.E. Bessina, A. Pouliakis, T. Theodoridis, E. Diamanti, G. Mitsiakos (Thessaloniki and Athens, Greece) ABS 44. PEDIATRIC ARTERIAL TORTUOSITY SYNDROME: CLINICAL AND GENETIC INSIGHTS FROM KOSOVO • A. Maloku, A. Mustafa, U. Rexha, R. Bejiqi (Prishtina and Gjakova, Republic of Kosovo) ABS 45. IRON-DEFICIENCY ANAEMIA IN PEDIATRIC CONGENITAL HEART DISEASE: A SIX-MONTH CLINICAL EVALUATION • A. Maloku, R. Bejiqi, A. Gerguri (Prishtina and Gjakova, Republic of Kosovo) ABS 46. SUCCESSFUL MANAGEMENT OF PEDIATRIC PITYRIASIS RUBRA PILARIS WITH ETANERCEPT: A CASE REPORT FROM PRISHTINA • A. Maloku, A. Gerguri, A. Batalli (Prishtina, Republic of Kosovo) ABS 47. TRUNCUS ARTERIOSUS: MANAGEMENT OF AN UNEXPECTED HEART • A. Abis, A. Atzei, G. Ottonello, P. Neroni (Cagliari, Italy) ABS 48. PEDIATRIC VOMITING: A CLINICAL CHALLENGE • A. Barsalini, L. Anedda, E. Erriu, G. Cherchi (Cagliari, Italy) ABS 49. BEYOND THE HEART: A COMPLEX CLINICAL CASE • E. Esposito, P. Beretta, F.F. Comisi, F. Zanco, P. Neroni, A. Dessì, V. Fanos (Cagliari, Italy) ABS 50. OCULAR FISHHOOK INJURY IN A 6-YEAR-OLD PATIENT • C. Sbaffi, D. Bonsanto, R. Puxeddu, M. D’Atri, G. Cherchi (Cagliari, Italy) ABS 51. LOOK BETTER TO SEE BEYOND: A DIAGNOSTIC CHALLENGE IN PEDIATRIC CHOROIDAL DETACHMENT • C. Giardino, A. Corrias, C. Soddu, S. Savasta (Cagliari, Italy) ABS 52. CASE REPORT OF AN EARLY PRETERM NEWBORN WITH PRENATAL DIAGNOSIS OF SHAAF-YANG SINDROME • A. Lai, D. Rizzo, M. Loi, V. Fanos (Cagliari, Italy) ABS 53. FLOPPY INFANT: MORE THAN JUST WEAKNESS • M. Rossi, A. Corrias, M. Marica, S. Savasta (Cagliari, Italy)
Selected Abstracts of the XI National Congress of SIMPEets (Italian Society of Pediatricians, Third Sector Organization, Società Italiana Medici Pediatri, Ente del Terzo Settore); Naples (Italy); November 28-30, 2025 NO ONE LEFT BEHIND. A NEW WAY OF BEING PEDIATRICIANS. GOOD CLINICAL AND SOCIAL PRACTICES [NESSUNO ESCLUSO. UN NUOVO MODO DI ESSERE PEDIATRI. LE BUONE PRATICHE CLINICHE E SOCIALI] ABS 1. NO ONE EXCLUDED: A NEW WAY OF BEING PEDIATRICIANS [NESSUNO ESCLUSO: UN NUOVO MODO DI ESSERE PEDIATRI] • M. Giuliano, G. Mele ABS 2. THE ESSENTIAL ROLE OF NUTRITION IN NEURODEVELOPMENT [ESSENZIALITÀ DELLA NUTRIZIONE PER IL NEUROSVILUPPO] • G. Trapani ABS 3. QUALITY MARKERS OF BOVINE MILK AND NUTRITIONAL WELL-BEING [MARCATORI DI QUALITÀ DEL LATTE E BENESSERE NUTRIZIONALE] • L. Cavallarin, S. Cirrincione, M. Giribaldi, C. Lamberti ABS 4. INFLUENZA VACCINATION BETWEEN APPROPRIATENESS AND COVERAGE: IS THE ROAD STILL LONG? [LA VACCINAZIONE ANTINFLUENZALE TRA APPROPRIATEZZA E COPERTURE: LA STRADA È ANCORA LUNGA?] • R. Russo ABS 5. KEY DETERMINANTS OF PEDIATRIC HEALTH AND NEURODEVELOPMENT [I DETERMINANTI CHIAVE PER LA SALUTE PEDIATRICA E IL NEUROSVILUPPO] • G. Squazzini ABS 6. INTERCEPTIVE ORTHODONTICS: WHY THE PEDIATRICIAN PLAYS A KEY ROLE [ORTODONZIA INTERCETTIVA: PERCHÉ IL PEDIATRA È FONDAMENTALE] • S. Zizzo, P. Manzo ABS 7. INFANTILE HEMANGIOMAS [GLI EMANGIOMI INFANTILI] • F. Barbato ABS 8. ELECTROCARDIOGRAPHY AT HAND IN THE FAMILY PEDIATRICIAN’S OFFICE [L’ELETTROCARDIOGRAMMA A PORTATA DI MANO NELL’AMBULATORIO DEL PEDIATRA DI FAMIGLIA] • F. De Luca, A. Putortì, M. Giuliano ABS 9. RARE DISEASES: THE ROLE OF GENETIC TESTING IN DIAGNOSIS AND GENETIC COUNSELING [MALATTIE RARE: IL RUOLO DEGLI ESAMI GENETICI AI FINI DIAGNOSTICI E DEL COUNSELING GENETICO] • M. Priolo ABS 10. RSV PROPHYLAXIS WITH NIRSEVIMAB IN BIRTH CENTERS OF THE CAMPANIA REGION: RESULTS FROM THE 2024-2025 SEASON [PROFILASSI ANTI-VRS CON NIRSEVIMAB NEI PUNTI NASCITA DELLA CAMPANIA: I RISULTATI DELLA STAGIONE 2024-2025] • A. Umbaldo, G. D’Uonno, F. Raimondi ABS 11. BIOACTIVE NUTRITIONAL COMPONENTS AND NEURODEVELOPMENTAL PROTECTION FROM ENVIRONMENTAL CONTAMINANTS [COMPONENTI NUTRIZIONALI BIOATTIVI E PROTEZIONE DEL NEUROSVILUPPO DAI CONTAMINANTI AMBIENTALI] • B.M. Trapani ABS 12. CARE: EMPATHIC ROBOTICS FOR THERAPY AND MONITORING [CARE: LA ROBOTICA EMPATICA PER TERAPIA E MONITORAGGIO] • C. Autorino, M. Staffa
Introduction and state of the art: Adolescence is an age characterized-as is well known-by sudden changes at the physical and psycho-cognitive levels, in which adolescents go through complex phases in which affective, emotional and especially social-relational difficulties are intertwined. The most recent orientations in developmental psychology, however, have shifted the focus of the approach to this fundamental phase of development, hitherto framed in the "critical" perspective of difficulties and stress to overcome. By adopting the paradigm of positive psychology, attention can be focused on good practices functional to the promotion of individual well-being, through training that starts from the acquisition of greater self-awareness and the potential to be implemented in order to achieve one's own well- being (psychological well-being) and, therefore, "happiness", a term used here net of the legitimate questions that such a complex state of mind poses in order to its very precise definition. Even in the ministerial guidelines of education in several European countries, including Italy, there is now a reversal of the previous promotion of a digital school and e-learning model, pointing to a general reduction in the use of electronic devices (PCs, tablets and cell phones) for educational purposes, in favor of more traditional forms and environments of learning, centered on cooperative learning and social learning. Project goals: The purpose of the project is to monitor and evaluate the psychological wellbeing of students, as well as the usefulness of the impact, for this purpose, of the mediation of a communicative model based on direct relationship with a public figure in the school context. Regarding the first point, it is intended to administer, adapting it appropriately, the Oxford Happiness Questionnaire (OHQ), an instrument used to detect the degree of happiness and subjective well-being of individuals. In the implementation of monitoring and of useful interventions in the pursuit of adolescents' wellbeing within the educational context, it is believed that a key and innovative role can be played by the active participation in the project of a reference figure for young people, such as a person from outside the school world, with his own successful human and professional educational experience, who offers young people a positive model of dialogue and direct confrontation. The goal is to complement and enrich the socio-affective interaction with adolescents with concrete and direct human input, not mediated by social media. In this direction, the testimony of one of the most sought-after and established international supermodels, known as a "beauty ambassador with a human side," engaged in volunteer work, philanthropic activities and collaborative projects in various school contexts and in pediatric long-term care wards, can help foster dialogue with adolescents and the exchange of experiences, expectations and ideas useful in overcoming those critical factors that hinder the well-being and serenity of adolescents, especially in contexts of social marginality and educational poverty. Type of intervention, materials and methods: The beneficiaries of the project are preadolescents and adolescents, and the planned interventions are implemented within schools, as places not only of curricular education, but understood as primary places of community life, socialization and protection of the health and mental and physical well-being of adolescents. The project involves the administration of the OHQ appropriately adapted to students in Italian schools participating in the Adolescent Well-Being School Project. The objective of this questionnaire is to measure happiness in general, that is, psychological wellbeing. If the OHQ can now boast of an effective use proven by a large number of studies in numerous countries, including non-European ones, the novelty of the present proposal consists mainly in the innovation of the administration context, through a different communicative model, which, playing intentionally with the term that gives the project its title, can also be represented by a supermodel in the role of mediator and facilitator of some phases of the action itself. This choice, as well as being original, is deliberately antithetical to the current trend, which privileges, especially in operations of this type and, more generally, in the context of the daily lives of adolescents, virtual and media relationships, with all the risks of socio-relational deprivation that have already been mentioned and which are, moreover, before everyone's eyes. The choice therefore falls on a mediating figure who can at the same time offer a concrete and evident testimony to a state of well-being that is also physical, insofar as it comes from a healthy lifestyle, in which, of course, care for nutrition and regular exercise practiced without excesses are included. Expected results: The ultimate goal is the diffusion and dissemination, among adolescents, of good practices of real and direct, healthy and constructive relationships, both in the peer relationship and in the relationship with family, educational institutions and society. The perspective is to provide support for the development and maturation, as early as adolescence, of skills and attitudes for the construction and maintenance of ongoing individual well-being, a perspective where the individual and autonomous propensity for lifelong learning is also complemented by the fundamental one for lifelong well-being.
Background: Gastroesophageal reflux disease (GERD)-related vomiting is a frequent cause of Emergency Department (ED) visits in infants; however, its role in brief resolved unexplained events (BRUE) remains unclear. Distinguishing physiological reflux from GERD-induced BRUE is challenging because descriptions of vomiting are often vague. This study examined the association between vomiting and BRUE, identified potential risk factors, and assessed whether vomiting requires further clinical evaluation. Methods: This retrospective cohort study evaluated 147 infants under 1 year of age who presented with vomiting at the Pediatric ED of our University Hospital between 2018 and 2019. The data included demographics, clinical symptoms, vomiting characteristics, and final diagnoses. In addition to the primary analysis, a secondary analysis was conducted specifically on infants diagnosed with BRUE based on clinical presentation. Results: A total of 147 infants with vomiting were included in the study, with a mean age of 6.19 +/- 3.15 months. The majority were boys (60%), 25 (17%) left without being seen, and 122 (83%) underwent a full evaluation. Vomiting was often accompanied by fever (23%), apnea (3%), color change (5%), and altered level of consciousness (4%). Most infants were discharged (59%); 23 (16%) were admitted to the Pediatric Medical Ward, and 12 (8%) required Pediatric Intensive Care Unit (PICU) admission. Among the 13 infants with BRUE (9%), 10 (77%) had comorbidities, 6 (46%) were admitted to the Pediatric Medical Ward, and 4 (31%) required PICU admission. The most common BRUE diagnoses were gastritis (31%), bronchopneumonia (23%), and sepsis (23%). Conclusion: Infants with vomiting should be carefully assessed for BRUE, particularly in the presence of other significant symptoms. Accurate event description is crucial for diagnosis. Larger studies are needed to optimize management, improve outcomes, and reduce unnecessary hospital admissions.
The growing expansion of modern high-throughput technologies has paved the way for precision medicine, which aims to stratify patients, personalize therapeutic indications, and potentially prevent long-term consequences. In this context, the presence of the patent foramen ovale (PFO) is reinterpreted, shifting from a benign anatomical variant to a possible indicator of cardiovascular and neurological vulnerability. The concept of perinatal programming offers an interpretative model for understanding how early environmental and biological conditions can modulate cardiovascular adaptation and predisposition to neurological disorders, such as migraine with aura (MWA). Numerous studies have shown a higher prevalence of PFO in patients with MWA, although only some patients benefit from percutaneous closure. This led to the creation of the MANET project (NRRP-MAD-2022-12376277), a pioneering model of precision medicine, in which the analysis of the metabolic profile of patients with MWA undergoing percutaneous PFO closure and the subsequent integration of platelet and endothelial data will be aimed at constructing a combined model of biomarkers capable of guiding the selection of patients with MWA who are potential beneficiaries of PFO closure, optimizing the therapeutic approach. These multidisciplinary and multicenter research projects represent an ideal lab for facilitating the transition from a vision focused exclusively on the morphology of atrial septal defects to a broader perspective that links developmental biology to neurological manifestations in adults.
Selected Lectures of the Round Table on “Antibiotic Resistance and Endocrine Disruptors”; Cagliari (Italy); October 25th, 2025 The Round Table on “Antibiotic Resistance and Endocrine Disruptors” is a Satellite Meeting of the 21st International Workshop on Neonatology and Pediatrics, Cagliari (Italy), October 22nd-25th, 2025. LECT 1. ANTIMICROBIAL RESISTANCE AND ENDOCRINE DISRUPTING CHEMICALS (EDCs) • M.E. Street, A.M. Shulhai, P. Palanza (Parma, Italy) LECT 2. NEW ANTIMICROBIALS FOR EMERGING AND RE-EMERGING PATHOGENS • A. Scano (Cagliari, Italy) LECT 3. ANTIBIOTIC RESISTANCE IN INTENSIVE CARE • G. Finco, L. Congiu, M. Musu, S. Sardo (Cagliari, Italy) LECT 4. ANTIBIOTIC RESISTANCE IN NEONATAL INTENSIVE CARE • F. Zanco, M. Melis, V. Fanos (Cagliari, Italy) LECT 5. UNDERSTAFFING AND OVERCROWDING IN NEONATAL INTENSIVE CARE UNITS • D. Pisano (Cagliari, Italy) LECT 6. ANTIBIOTIC RESISTANCE IN PEDIATRIC SURGICAL CARE: A NARRATIVE REVIEW INVESTIGATING AN EMERGING INVISIBLE SURGICAL CHALLENGE • B. Sanna, L. Mascia (Cagliari, Italy) LECT 7. ANTIBIOTIC RESISTANCE IN ANIMAL FARMING: THE ADVANTAGES OF ORGANIC FARMING • P. Armento (Sesto Fiorentino, Italy)
Selected Lectures of the Conference “New Approaches and Technologies – From Fetus to Adult”; Cagliari (Italy); October 25th, 2025 The Conference “New Approaches and Technologies – From Fetus to Adult” is a Satellite Meeting of the 21st International Workshop on Neonatology and Pediatrics, Cagliari (Italy), October 22nd-25th, 2025. LECT 1. NEW ASSISTED REPRODUCTIVE TECHNOLOGY (ART) TECHNIQUES TO INCREASE THE BIRTH RATE IN SARDINIA: MEDICAL-SOCIAL FREEZING AND HETEROLOGOUS FERTILIZATION • G. Monni (Cagliari, Italy) LECT 2. RENAL REGENERATIVE MEDICINE: WHAT DID WE LEARN? • G. Faa, V. Fanos (Cagliari, Italy) LECT 3. TRANSLATIONAL POTENTIAL OF ESSENTIAL OILS AND NANOCARRIERS IN ANTIMICROBIAL THERAPY: NOVEL STRATEGIES FROM FETAL TO ADULT LIFE • F. Mondello, M. Di Vito, M.L. Ricci (Rome, Italy) LECT 4. THE EUROPEAN LIFE MILCH PROJECT: WHERE DO WE STAND? • P. Palanza, V. Fanos, A.M. Papini, S. Perrone, T. Ghi, S. Paterlini, M.M. Brambilla, D. Baccolo, C. Scopa, A. Ardenghi, A.M. Shulhai, C. Caffarelli, F. Nuti, F. Fernandez, C. Sartori, F. Alberghi, B. Righi, M. Fontana, L. Filonzi, C. Petrolini, B. Piccolo, E. Turco, R. Pintus, C. Piras, S. Petza, A. Dessì, F. Nonnis Marzano, D. Ponzi, A. Pelosi, M.E. Street (Parma, Cagliari, Florence, and Reggio Emilia, Italy) LECT 5. METABOLOMICS AND NUTRITION • S. Alessandri (Rome, Italy) LECT 6. METABOLOMICS IN RHEUMATIC DISEASES • M. Valentini (Faenza, Italy) LECT 7. NEW APPROACHES IN AUTISM MANAGEMENT • M. Greco (Turin, Italy) LECT 8. METABOLIC DETERMINANTS IN FIBROMYALGIA SYNDROME STUDIED WITH THE EPIGENETIC METHOD • B. Pische, A. Scognamillo, G. Terziani, G. Fenu Pintori (Sassari and Brescia, Italy) LECT 9. METABOLOMICS AND MICROBIOMICS IN CLINICAL PRACTICE • C. Marzetti (Bologna, Italy ) LECT 10. THE EPIGENETIC REVOLUTION IN THE AGE OF POLLUTION: INDIVIDUAL RESPONSIBILITY TOWARDS FUTURE GENERATIONS • G. Terziani (Brescia, Italy) LECT 11. ARTIFICIAL INTELLIGENCE: FRIEND OR FOE? • A. Colangelo (Trento, Italy)
