Journal of Pediatric and Neonatal Individualized Medicine (JPNIM) <p>The <strong>Journal of Pediatric and Neonatal Individualized Medicine (JPNIM)</strong> is a peer-reviewed interdisciplinary journal which provides a forum on new perspectives in pediatric and neonatal medicine. The aim is to discuss and to bring readers up to date on the latest in research and clinical pediatrics and neonatology. Special emphasis is on developmental origin of health and disease or perinatal programming and on the so-called ‘-omic’ sciences. Systems medicine blazes a revolutionary trail from reductionist to holistic medicine, from descriptive medicine to predictive medicine, from an epidemiological perspective to a personalized approach. The journal will be relevance to clinicians and researchers concerned with personalized care for the newborn and child. Also medical humanities will be considered in a tailored way.</p> <p>Article submission (original research, review papers, invited editorials and clinical cases) will be considered in the following fields: fetal medicine, perinatology, neonatology, pediatrics, developmental programming, psychology and medical humanities.</p> en-US Journal of Pediatric and Neonatal Individualized Medicine (JPNIM) 2281-0692 <p>© Hygeia Press</p> <p> </p> <h3>Copyright and publishing rights</h3> <p>Regarding copyright, before publication, Authors declare that, in consideration of the action of JPNIM in reviewing and editing their submission, they transfer, assign, or otherwise convey all copyright ownership, including any and all rights incidental thereto, exclusively to the JPNIM Publisher (Hygeia Press di Corridori Marinella).</p> <div> <div> <div> <div> <div> <p>Authors have the opportunity to reuse figures, tables and selected text up to 250 words from their article as finally published, providing that full and accurate credit shall be given to publication in JPNIM and that modifications are noted (otherwise no changes may be made).</p> </div> </div> </div> </div> </div> Selected Lectures of the 16th International Congress on Neonatology and Pediatrics, On Demand; Cagliari (Italy); November 20th-December 31st, 2020 <p><strong>Selected Lectures of the 16<sup>th</sup> International Congress on Neonatology and Pediatrics, On Demand • Cagliari (Italy) • November 20<sup>th</sup>-December 31<sup>st</sup>, 2020</strong></p> <p>&nbsp;</p> <p><br><strong>LECT 1 • THE IMPACT OF ASSISTED REPRODUCTION, INTRAUTERINE GROWTH RESTRICTION AND PREMATURITY ON THE NEURODEVELOPMENT OF TWINS •</strong> D.D. Briana (Athens, Greece)</p> <p><strong>LECT 2 • PFAPA (PERIODIC FEVER – APHTHOUS STOMATITIS – PHARYNGITIS – ADENOPATHY) SYNDROME: LIGHTS IN THE DARK? •</strong> S. Manti, G.F. Parisi, M. Papale, P. Barone, S. Leonardi (Catania, Italy)</p> <p><strong>LECT 3 • EARLY LIFE INTERVENTIONS AND IMMUNE HEALTH RELEVANCE FOR SPECIALIZED NUTRITION •</strong> J. Garssen (Utrecht, The Netherlands)</p> <p><strong>LECT 4 • COVID-19 AND KAWASAKI SYNDROME: WHAT WE KNOW •</strong> P.P. Bassareo (Dublin, Ireland)</p> <p><strong>LECT 5 • HUMAN MILK AS A MAGIC FLUID •</strong> A. Dessì (Cagliari, Italy)</p> <p><strong>LECT 6 • NEUROPROTECTION OF NEONATAL BRAIN TODAY •</strong> G. Buonocore (Siena, Italy)</p> <p><strong>LECT 7 • PROBIOTICS: ARE ALL THE SAME? •</strong> R. Francavilla, V.N. Dargenio, F. Cristofori (Bari, Italy)</p> <p><strong>LECT 8 • VITAMIN D: FROM ROOTS TO METABOLOMICS •</strong> M. Puddu (Cagliari, Italy)</p> <p><strong>LECT 9 • RESPIRATORY SYNCYTIAL VIRUS: PRESENT AND FUTURE •</strong> L. Bonadies, A. Galderisi, E. Priante, V. Mardegan, E. Baraldi (Padua, Italy)</p> <p><strong>LECT 10 • GROWTH: NATURE OR NURTURE? WHERE DOES INEQUALITY BEGIN? •</strong> E. Bertino, G. Maiocco, S. Sottemano (Turin, Italy)</p> <p><strong>LECT 11 • OMICS IN AUTISM •</strong> M. Mussap (Cagliari, Italy)</p> <p><strong>LECT 12 • PLACENTA AND NEONATAL INFECTION: INTRIGUING CONNECTIONS •</strong> G. Faa, S. Angioni, V. Vallascas, M. Moi, F. Ledda, P. Van Eyken, D. Fanni, C. Gerosa (Cagliari, Italy, and Genk, Belgium)</p> <p><strong>LECT 13 • METABOLOMICS AND HUMAN MILK •</strong> V. Fanos, F. Bardanzellu, M. Puddu (Cagliari, Italy)</p> --- Various Authors Copyright (c) 2020 © Hygeia Press 2020-11-08 2020-11-08 10 1 e100146 e100146 10.7363/100146 Management of preterm low birth weight infants in Dhaka: a comparison between Standard Care and Kangaroo Mother Care <p class="p1"><span class="s1">In Bangladesh, government healthcare facilities are adopting Kangaroo Mother Care (KMC) more extensively for preterm low birth weight (LBW) infants to reduce neonatal deaths in the country. A quasi-experimental study was carried out to compare KMC and Standard Care (SC) outcomes for preterm LBW babies. Data were collected from December 2017 to June 2018. The study focused on the preterm neonates admitted to Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital, Dhaka. A total of 25 neonates under KMC and 25 neonates under SC were enrolled from the initial study population. The study revealed that during the length of hospital stay, the incidence of hypothermia (4% in KMC vs. 24% in SC) and hyperthermia (8% in KMC vs. 32% in SC) and clinical late-onset sepsis (36% in KMC vs. 64% in SC) were significantly lower among neonates of KMC. Times to first feed (1.80 ± 0.40 in KMC vs. 2.20 ± 0.42 in SC) and to full enteral feeding (8.32 ± 2.49 in KMC vs. 19.56 ± 6.80 in SC) were also found to be significantly shorter among KMC neonates. Moreover, KMC mothers show adequate breastfeeding more often than in SC group (88% in KMC vs. 64% in SC). On the other hand, a higher proportion of SC neonates compared to KMC neonates were found to have feeding intolerance (56% in SC vs. 8% in KMC), hyperglycaemia (24% in SC vs. 4% in KMC) and apnoea (32% in SC vs. 8% in KMC). Finally, mean hospital stay (12.04 ± 2.74 days in KMC vs. 25.24 ± 7.20 days in SC) and mean treatment cost (9,508 ± 4,142 Taka in KMC vs. 35,064 ± 13,352 Taka in SC) were found to be significantly lower for KMC. In conclusion, KMC seems to be a safe and effective method of care for preterm LBW infants in a limited resources health care setting.</span></p> Mousumi Akter Salamat Khandker Mohammad Shaheen Nadira Mehriban Sk Akhtar Ahmad Copyright (c) 2020 © Hygeia Press 2020-11-18 2020-11-18 10 1 e100111 e100111 10.7363/100111 An urgent need to review the approach to a febrile child in the COVID-19 era? <p class="p1"><strong>Background: </strong>There have been reports of a new hyperinflammatory syndrome in children defined as the Paediatric Inflammatory Multisystem Syndrome temporally associated with COVID-19 (PIMS-TS). Our hospital has experienced a great proportion of children attending an Emergency Department (ED) with possible PIMS-TS so far reported in the UK.</p> <p class="p1"><strong>Objectives:</strong> We describe the clinical and biochemical findings in children with possible PIMS-TS in the context of a local ED.</p> <p class="p1"><strong>Settings:</strong> Queen Elizabeth Hospital (QEH), Woolwich, a District General Hospital (DGH) in South London.</p> <p class="p1"><strong>Participants: </strong>From 14<sup>th</sup> March to 18<sup>th</sup> May 2020, children presenting to QEH and transferred to tertiary care for possible PIMS-TS, with a history of fever and hyperinflammatory symptoms, raised inflammatory markers and without a clear clinical or microbial cause were identified. Demographic data, clinical and laboratory data were recorded as median [range].</p> <p class="p1"><strong>Results: </strong>17 children (12 male) were identified aged 11 [1-16] years. 17/17 had a fever; other common symptoms were conjunctival injection, rash and gastrointestinal symptoms. Lymphopenia and raised inflammatory markers were evident. 15/17 were tested with nasopharyngeal and oropharyngeal SARS-CoV-2 PCR swabs and 15/15 were negative. Before transfer, one child required intubation and four required inotropes. All children were transferred to a tertiary unit, 10 within the first 24 hours. After transfer, 2/17 had microbial causes evident on urine/stool culture.</p> <p class="p1"><strong>Conclusions:</strong> PIMS-TS is proving challenging to diagnose in a DGH ED because of heterogeneity of symptoms and laboratory markers, overlapping with other diseases, and cardiac complications despite deceptively benign presentations. There is an urgent need to review the approach to a febrile child in this setting, to optimise identification of PIMS-TS. Prognostic markers and risk stratification methods would help paediatricians working in the ED and general paediatric wards.</p> Rashmi S. D'Souza Joana Freitas Victoria Rainsley Felix Mason Julia Kenny Jessica Thomas Copyright (c) 2020 © Hygeia Press 2020-11-25 2020-11-25 10 1 e100103 e100103 10.7363/100103 Normal postnatal outcome in an r(X) mosaic male fetus with retained XIST gene <p class="p1"><span class="s1">We report the case of a pregnant woman who underwent prenatal diagnosis by chorionic villi sampling for increased risk of trisomy 21 due to advanced age and abnormal results of the first trimester combined screening test. </span></p> <p class="p1"><span class="s1">Karyotype analysis of the chorionic villi sampling showed a normal male karyotype (46,XY) in16 metaphases derived from the trophoblast culture and a mosaic in the mesenchymal culture for the presence of a supernumerary marker chromosome (SMC) in 6 metaphases (47,XY,+mar[6]/46,XY[16]). </span></p> <p class="p1"><span class="s1">To evaluate the presence of a real mosaicism, karyotype analysis was repeated on amniocytes derived from a single primary culture, confirming the presence of an abnormal cell line with a mosaicism of 27% (47,XY+mar[4]/46,XY[11]). </span></p> <p class="p1"><span class="s1">The distribution and the extent of the mosaicism were better characterized by the analysis of fetal blood, which allowed the definition of the SMC as an X derivative with a ring structure present at mosaic in 24% of the peripheral lymphocytes (47,XY,r(X)[23]/46XY[73]). </span></p> <p class="p1"><span class="s1">CGH-array on fetal blood-derived DNA defined the extent for 43 Mb of the X chromosome duplication from Xp21.1 to Xq21.1. </span></p> <p class="p1"><span class="s1">FISH analysis, using X centromeric and <em>XIST</em> probes, confirmed the X derivation of the marker and the inclusion of the <em>XIST</em> gene within the duplicated fragment. </span></p> <p class="p1"><span class="s1">Ultrasound fetal evaluation was unremarkable and the woman, counseled positively for the conservation of the <em>XIST</em> gene, decided to continue the pregnancy, proceeding to term. </span></p> <p class="p1">The woman delivered an apparently normal male baby who, at the follow-up to 13 months, appears morphologically and developmentally normal.</p> Maura Mingoia Francesca Sessini Daniela Gasperini Paolo Moi Copyright (c) 2020 © Hygeia Press 2020-11-27 2020-11-27 10 1 e100113 e100113 10.7363/100113 Orange discoloration of the skin in mother and newborn with SARS-CoV-2 infection: is hypercarotenosis a sign of COVID-19? <p class="p1">Coronavirus disease (COVID-19) is caused by severe acute respiratory syndrome Coronavirus 2 (SARS-CoV-2) and represents a potentially fatal disease. Recently, dermatological manifestations have been reported to be signs of COVID-19. We describe a case of a newborn and her mother affected by SARS-CoV-2, that developed hypercarotenosis (HC) about 5 weeks after delivery. The aim of this report is to identify the pathological mechanism of this association and to underline the importance of investigating any dubious skin manifestation in case of contact with patients with suspected or confirmed COVID-19, because it may be a clinical sign of infection. Even if not previously described in the literature, this case report suggests a possible association between HC and SARS-CoV-2 infection.</p> Dario Alario Giorgio Bracaglia Giulia Franceschini Fabio Arcangeli Federico Mecarini Copyright (c) 2020 © Hygeia Press 2020-11-20 2020-11-20 10 1 e100101 e100101 10.7363/100101 Correspondence: the donation of human milk during the COVID-19 pandemic <p><strong>Dear Editor,</strong></p> <p>In previous epidemics, it has been shown that the use of breast milk represents one of the first crucial measures to be taken in emergencies.</p> <p>On the occasion of the World Day for the Donation of Human Milk, which was celebrated on May 22, the Italian Society of Neonatology (SIN) reaffirmed the importance of Human Milk Banks (HMBs), reassuring mothers about the safety of donation at HMBs, also in this pandemic period.</p> <p>In the Neonatal Intensive Care Unit (NICU) of San Giovanni Rotondo, Italy, we found that the restrictive measures did not represent a reason to limit breastfeeding nor donation. We have been close to nursing and donating mothers, providing constant support from the HMB and NICU staff, with practical advice and psychological closeness.</p> <p>In particular, in the February-May period, the crucial one of the pandemic, 15 donors donated 91.25 liters. In comparison with the average of previous years of donation data to the HMB, the balance is even in favor of the current year. In fact, in 2019, in the same period, 12 mothers were recruited and 58.7 liters were collected and, in 2018, the donor women were 10 but they donated 119.5 liters.</p> <p>As manager of the HMB, I found it useful to report the experience of our HMB and our NICU on this specific aspect, and I hope that other HMBs can do the same. I believe that these testimonies can represent an element of hope, encouragement and reflection. Solidarity did not end with the lockdown.</p> Pasqua Anna Quitadamo Copyright (c) 2020 © Hygeia Press 2020-11-08 2020-11-08 10 1 e100131 e100131 10.7363/100131 Correspondence: early identification of COVID-19 positive outpatient children, is it useful? <p>The differential diagnosis between COVID-19 and the common cold, or allergic cough, or mild respiratory symptoms with or without fever is not easy for Primary Care Pediatricians (PCPs).<br />According to the official Italian report “<em>Rapporto ISS COVID-19 n. 58/2020</em>” of August 21<sup>st</sup>, 2020, all children with COVID-19 common symptoms and/or a corporal temperature higher than 37.5°C, are considered as suspected cases and have to be tested with a nasopharyngeal swab. <br />We have identified risk factors that could be useful in PCPs' clinical practice to define priorities in addressing children to the proper diagnostic procedure. <br />For the physical and mental health of the children and their families and to allow the PCPs to fulfill their duty, it is important to look for less invasive tools to perform the proper diagnosis. This should also allow children to go to school and to go on with their daily life.</p> Gianfranco Trapani Osama Al Jamal Copyright (c) 2020 © Hygeia Press 2020-11-22 2020-11-22 10 1 e100104 e100104 10.7363/100104