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 Abstracts of the 8th Panhellenic e-Congress on Neonatology; Greece; October 23rd-25th, 2020 <p><strong>Selected Abstracts of the 8<sup>th</sup> Panhellenic e-Congress on Neonatology • Greece • October 23<sup>rd</sup>-25<sup>th</sup>, 2020</strong></p> <p class="p1"><span class="s1">The Congress has been organized by the Hellenic Neonatal Society.</span></p> <p class="p1"> </p> <p class="p1"><strong>ABS 1 • THE OUTCOME OF THE NEWBORNS IN OUR SUBURBAN HOSPITAL IN 2017-2018 •</strong> E. Tsentemidou, G. Katsaras, E. Bechlivali, K. Kappou, E. Oikonomou, P. Tsitsani (Athens, Edessa, Kilkis and Piraeus Nikaia, Greece)</p> <p class="p1"><strong>ABS 2 • CESAREAN SECTION AND INTRODUCTION OF FORMULA AS INHIBITORS FOR BREAST­FEEDING •</strong> G. Katsaras, E. Tsentemidou, A. Konstantinidi, A. Vladikas, E. Lazaridi, P. Tsitsani (Edessa, Athens and Piraeus Nikaia, Greece)</p> <p class="p1"><strong>ABS 3 • ALTERATIONS IN BIOCHEMICAL VARIABLES DUE TO BODY WEIGHT LOSS IN NEONATES •</strong> G. Katsaras, E. Tsentemidou, A. Konstantinidi, M. Shkira, E. Toulia, P. Tsitsani (Edessa, Athens, Piraeus Nikaia and Thessaloniki, Greece)</p> <p class="p1"><strong>ABS 4 • EPIDEMIOLOGICAL ANALYSIS OF NEONATAL JAUNDICE IN A SUBURBAN HOSPITAL •</strong> E. Tsentemidou, G. Katsaras, A. Vladikas, K. Verikokkou, A. Batsiou, P. Tsitsani (Athens, Edessa and Larissa Viopolis, Greece)</p> <p class="p1"><strong>ABS 5 • EARLY-TERM NEONATES: AN AGE GROUP WITH SPECIAL MORBIDITY •</strong> G. Katsaras, E. Tsentemidou, A. Konstantinidi, G. Ioannidou, E. Vouloumanou, P. Tsitsani (Edessa, Athens, Piraeus Nikaia, Thessaloniki and Athens Maroussi, Greece)</p> <p class="p1"><strong>ABS 6 • ALTERATIONS IN THROMBOELASTOMETRY VARIABLES IN NEONATES WITH RESPIRATORY DISTRESS SYNDROME •</strong> G. Katsaras, R. Sokou, A. Konstantinidi, A. Tsantes, S. Parastatidou, G. Ioakeimidis, G. Mitsiakos, N. Iakovidou, A. Tsantes (Edessa, Piraeus, Athens and Thessaloniki, Greece)</p> <p class="p1"><strong>ABS 7 • ENTEROVIRAL INFECTIONS IN THE NEONATAL PERIOD •</strong> M. Tsirigotaki, N. Anagnostatou, A. Manoura, P. Skoula, F. Maragoudakis, I. Goniotakis, E. Hatzidaki (Heraklion, Greece)</p> <p class="p1"><strong>ABS 8 • LIMITATIONS OF NON-INVASIVE PRENATAL TESTING IN DIAGNOSIS OF MICRODELETION SYNDROMES: A CASE PRESENTATION •</strong> M. Tsirigotaki, A. Manoura, A. Kleisarchaki, E. Saitakis, A. Vourdouba, N. Anagnostatou, E. Papadopoulou, E. Hatzidaki (Heraklion, Greece)</p> <p class="p1"><strong>ABS 9 • CONSERVATIVE MANAGEMENT OF A SUPERFICIAL NEONATAL PSEUDOANEURYSM: CASE REPORT •</strong> M. Tsirigotaki, E. Kehagias, N. Kholcheva, N. Matthaiou, N. Anagnostatou, I. Kakatsaki, E. Hatzidaki (Heraklion, Greece)</p> <p class="p1"><strong>ABS 10 • CONGENITAL DEPRESSION OF THE SKULL: A CASE PRESENTATION •</strong> M. Tsirigotaki, M. Raissaki, A. Kleisarchaki, N. Anagnostatou, E. Korakaki, M.C. Sariklaki, E. Hatzidaki (Heraklion, Greece)</p> <p class="p1"><strong>ABS 11 • GENETIC DISORDERS ASSOCIATED WITH AN­NULAR PANCREAS: A LITERATURE REVIEW •</strong> M. Tsirigotaki, O. Michopoulou, Ch. Thomou, A. Kleisarchaki, E. Korakaki, V. Kotsira, E. Hatzidaki (Heraklion, Greece)</p> <p class="p1"><strong>ABS 12 • DICHORIONIC, DIAMNIOTIC PREGNANCY COM­PLICATED BY TWIN ANEMIA POLYCYTHEMIA SEQUENCE •</strong> M. Tsirigotaki, Ch. Thomou, O. Michopoulou, I. Goniotakis, A. Vourdouba, E. Saitakis, E. Hatzidaki (Heraklion, Greece)</p> <p class="p1"><strong>ABS 13 • OUTCOMES OF NEONATES BORN TO MOTHERS WITH SUBSTANCE USE DISORDER •</strong> M. Tsirigotaki, A. Manoura, O. Michopoulou, F. Maragoudakis, G. Rouva, E. Hatzidaki (Heraklion, Greece)</p> <p class="p1"><strong>ABS 14 • A CASE REPORT OF A NEONATE WITH CONGENITAL HYPERINSULINISM •</strong> F. Balomenou, D. Rallis, A. Zisis, T. Palianopoulos, K. Lambropoulou, V. Giapros (Ioannina, Greece)</p> <p class="p1"><strong>ABS 15 • CASE REPORT: MALE NEONATE BORN WITH EPISPADIAS AND BLADDER EXSTROPHY •</strong> K. Dervinioti, A. Lagatoura (Zakynthos, Greece)</p> <p class="p1"><strong>ABS 16 • USE OF ULTRASOUND IN PNEUMOPERI­CARDIUM TREATMENT IN PRETERM NEO­NATES •</strong> V. Bempes, G. Mitsiakos, E. Babacheva, D. Gialamprinou, G. Tsakelidis, E. Diamanti (Thessaloniki, Greece)</p> <p class="p1"><strong>ABS 17 • RESPIRATORY MORBIDITY IN LATE PRETERM NEONATES (36-36<sup>6</sup> WEEKS OF GESTΑΤIONAL AGE) •</strong> E. Oikonomou, M. Flessa, A. Galanopoulou, I. Kondyli, A. Koukouletsos, A. Spiliopoulos, E. Katsikareli, P. Tsami, G. Vlassi, I. Koulouras (Patras, Greece)</p> <p class="p1"><strong>ABS 18 • “APPLE-PEEL” JEJUNAL ATRESIA IN A FEMALE NEONATE •</strong> E. Oikonomou, A. Galanopoulou, A. Spiliopoulos, A. Koukouletsos, E. Katsikareli, P. Tsami, I. Koulouras (Patras, Greece)</p> <p class="p1"><strong>ABS 19 • NEUROLOGICAL OUTCOME AT 18 MONTHS OF NEONATES SUBJECTED TO THERAPEUTIC HYPOTHERMIA •</strong> K. Tsoni, A. Geladari, P. Papakyriakidou, T. Stathopoulou, M. Farini, A. Thomaidou, A. Kontou, E. Agakidou, P. Karagianni, K. Sarafidis (Thessaloniki, Greece)</p> <p class="p1"><strong>ABS 20 • MICROCEPHALY: A REVERSIBLE SITUATION? CASE PRESENTATION •</strong> V. Sideri, A. Daskalaki, E. Kapsabeli, D. Briana, P. Triantafyllidou, N. Podimatas, K. Adamopoulos, P. Mexi, V. Papaevangelou, A. Dinopoulos (Athens, Greece)</p> <p class="p1"><strong>ABS 21 • SENSITIVITY OF COAGULASE NEGATIVE STAPHYLOCOCCI TO GLYCOPEPTIDES NEO­NATES WITH BLOOD STREAM INFECTIONS •</strong> A. Kontou, E. Chorafa, C. Zaras, K. Tsoni, A. Thomaidou, E. Roilidis, K. Sarafidis (Thessaloniki, Greece)</p> <p class="p1"><strong>ABS 22 • TWENTY YEARS OF CONTINUING EDUCATION ON NEONATAL PAIN. EFFECT ON GREEK NEONATOLOGISTS’ PERCEPTIONS ON PAIN AND ITS MANAGEMENT •</strong> E. Agakidou, T. Stathopoulou, K. Tsoni, A. Kontou, A. Thomaidou, M. Farini, S. Nikopoulos, P. Karagianni, K. Sarafidis (Thessaloniki, Greece)</p> <p class="p1"><strong>ABS 23 • EPIDEMIOLOGY AND CLINICAL CHARAC­TERISTICS OF NEONATES WITH CONGENITAL HEART DISEASE ADMITTED TO A NICU OVER 10 YEARS •</strong> E. Agakidou, A. Geladari, E. Karaiskou, S. Nikopoulos, V. Kourou, A. Sarantopoulou, N. Demiris, K. Sarafidis (Thessaloniki, Greece)</p> <p class="p1"><strong>ABS 24 • METABOLOMIC ANALYSIS OF BIOFLUIDS AT BIRTH FOR THE EARLY PREDICTION OF THE RISK FOR NECROTIZING ENTEROCOLITIS, SEPSIS AND MORTALITY •</strong> K. Besiri, O. Begou, H. Gika, E. Agakidou, M. Farini, E. Bataka, C. Nakas, P. Karagianni, K. Sarafidis (Thessaloniki and Volos, Greece)</p> <p class="p1"><strong>ABS 25 • LATE PRETERM NEONATES (36-36<sup>6</sup> WEEKS) ADMITTED IN NICU OF A TERTIARY HOSPITAL. CLINICAL CHARACTERISTICS OF THE NEW­BORNS AND THEIR MOTHERS •</strong> P. Tsami, A. Koukouletsos, M. Flessa, A. Galanopoulou, A. Spiliopoulos, E. Katsikareli, E. Oikonomou, I. Kondyli, G. Vlassi, I. Koulouras (Patras, Greece)</p> <p class="p1"><strong>ABS 26 • SHORT-TERM OUTCOME IN VERY LOW BIRTH WEIGHT PRETERM INFANTS (BG &lt; 1,500 G) •</strong> A. Kleisarhaki, A. Manoura, E. Korakaki, M. Tsirigotaki, C. Thomou, N-H. Anagnostatou, E. Hatzidaki (Heraklion, Greece)</p> <p class="p1"><strong>ABS 27 • DIABETES DURING PREGNANCY AND CLINI­CAL OUTCOME OF THE NEONATES OF OUR MATERNITY CLINIC – REPORT OF A 5-YEAR PERIOD •</strong> S. Gkantseva, P. Georgiadou, G. Karavana, E. Kalergi, A. Malliou, P. Perdikakis, M. Theodoraki (Piraeus and Tripoli, Greece)</p> <p class="p1"><strong>ABS 28 • DIFFUSE BASAL GANGLIA OR THALAMUS HYPERECHOGENICITY IN TERM INFANTS – CLINICAL IMPACT AND COAGULATION TEST •</strong> S. Gkantseva, P. Georgiadou, D. Lampropoulou, M. Papadopoulou, E. Liovarou, D. Zormpas, M. Theodoraki (Piraeus, Greece)</p> <p class="p1"><strong>ABS 29 • UMBILICAL HERNIA IN A NEONATE WITHOUT GESTATIONAL ULTRASOUND FINDINGS – CASE REPORT •</strong> S. Gkantseva, P. Georgiadou, M. Papadopoulou, G. Karavana, I. Loukas, M. Theodoraki (Piraeus, Greece)</p> <p class="p1"><strong>ABS 30 • RECURRENT EPISODES OF MASSIVE PUL­MONARY HEMORRHAGE IN A TERM NEONATE •</strong> P. Triantafyllidou, A. Daskalaki, E. Kapsabeli, V. Sideri, D. Briana, N. Podimatas, K. Adamopoulos, P. Mexi-Bourna, V. Papaevangelou, S. Rammos (Athens, Greece)</p> --- Various Authors Copyright (c) 2021 © Hygeia Press 2021-03-06 2021-03-06 10 1 e100151 e100151 10.7363/100151 Selected Abstracts of the 16th International Workshop on Neonatology, Virtual Edition (Cagliari, Italy; 29-30 October, 2020) & of the 16th International Congress on Neonatology and Pediatrics, On Demand (Cagliari, Italy; November 20-December 31, 2020) <p><strong>Selected Abstracts of the 16<sup>th</sup> International Workshop on Neonatology, Virtual Edition (Cagliari, Italy; 29-30 October 2020) &amp; of the 16<sup>th</sup> International Congress on Neonatology and Pediatrics, On Demand (Cagliari, Italy; November 20-December 31, 2020)</strong></p> <p> </p> <p class="p1"><strong>ABS 1 • ACRAL ERYTHEMA AND SWELLING IN A NEWBORN: A RARE PRESENTATION OF COW’S MILK PROTEIN ALLERGY •</strong> F. Mecarini, B. Cuomo, A. Casati, G. Di Giorgio, R. Navas, G. Bracaglia (Viterbo and Cagliari, Italy)</p> <p class="p1"><strong>ABS 2 • ANALYSIS OF THE ORGANIZATIONAL CLIMATE AND JOB SATISFACTION OF THE NURSING TEAM IN PEDIATRICS •</strong> M. Galletta, L. Deidda, I. Portoghese, M. Agus, A. Azara, A. Piana, I. Piras (Cagliari and Sassari, Italy)</p> <p class="p1"><strong>ABS 3 • LABORATORY MEDICINE IN THE ERA OF COVID-19 PANDEMIC: A CHALLENGE FOR CHILDREN AND PEDIATRICIANS •</strong> M. Mussap (Cagliari, Italy)</p> <p class="p1"><strong>ABS 4 • RESPIRATORY MANAGEMENT OF TRANS­FERRED CRITICAL NEWBORNS: HAS IT CHANGED OVER TIME? •</strong> C. Loddo, F. Cavallin, R.L. Peloso, E. Baraldi, D. Trevisanuto (Cagliari and Padua, Italy)</p> <p class="p1"><strong>ABS 5 • EFFECTS OF THE INTRODUCTION OF A STANDARD PROTOCOL FOR THE EVALUATION OF FEEDING INTOLERANCE IN PRETERM INFANTS •</strong> E. Maggiora, A. Coscia, E. Spada, F. Vignali, S. Rovei, M. Scrufari, S. Gazzi, A. De Risi, E. Bertino, F. Cresi (Turin, Italy)</p> <p class="p1"><strong>ABS 6 • OBSTETRICAL AND PERINATAL PREDIS­POSING FACTORS FOR PERSISTENCE OF DUCTUS ARTERIOSUS IN A COHORT OF PREMATURE INFANTS: A RETROSPECTIVE STUDY •</strong> N.A.M. Vitiello, N. Ibba, F. Bardanzellu, A. Melis, P. Neroni, V. Fanos (Cagliari, Italy)</p> <p class="p1"><strong>ABS 7 • THE USE OF HUMAN MILK IN THE NICU. 10 YEARS OF EXPERIENCE IN HUMAN MILK BANKING •</strong> P.A. Quitadamo, G. Palumbo, L. Cianti, A. Villani (San Giovanni Rotondo [Foggia], Italy)</p> <p class="p1"><strong>ABS 8 • KEY ROLE OF MATERNAL DIET DURING BREASTFEEDING: FROM EPIGENETICS TO FLAVOUR PREFERENCE DEVELOPMENT •</strong> A. Bosco, A. Dessì (Turin and Cagliari, Italy)</p> <p class="p1"><strong>ABS 9 • CEMENTOBLASTOMA IN A 15-YEAR-OLD GIRL •</strong> M. Mureddu, F. Ledda, G. Cerrone, G. Faa, C. Gerosa (Cagliari, Italy)</p> <p class="p1"><strong>ABS 10 • A 4-YEAR-OLD CHILD WITH DESQUAMATING RASH: ALWAYS REMEMBER STAPHYLOCOC­CAL-SCALDED SKIN SYNDROME •</strong> F. Mecarini, E. Goldoni, P. Marenzoni, E. Gatta, R. Navas, G. Bracaglia (Viterbo and Cagliari, Italy)</p> <p class="p1"><strong>ABS 11 • HYDROPS FETALIS DURING THE COVID-19 ERA •</strong> F. Bardanzellu, A. Melis, M.A. Marcialis, M.C. Pintus, V. Fanos (Cagliari, Italy)</p> <p class="p1"><strong>ABS 12 • THE DIFFICULTIES PERCEIVED BY PARENTS OF CHILDREN WITH AUTISM SPECTRUM DISORDERS IN THE HEALTHCARE SETTINGS. A PILOT STUDY •</strong> I. Piras, M. Agus, E. Montis, A. Azara, A. Piana, M. Galletta (Sassari and Cagliari, Italy)</p> <p class="p1"><strong>ABS 13 • DOUBTFUL CAT-SCRATCH DISEASE: THE IMPORTANCE OF HISTOLOGICAL EVALUATION •</strong> G. Cerrone, C. Betti, V. Aimola, F. Ledda, D. Fanni, C. Gerosa (Cagliari, Italy)</p> <p class="p1"><strong>ABS 14 • THE BIRTH OF A NEWBORN AND HIS MICROBIOME •</strong> E. Caboni, F. Bardanzellu, A. Melis, D.G. Peroni, A. Coscia, V. Fanos (Cagliari, Pisa and Turin, Italy)</p> <p class="p1"><strong>ABS 15 • CONGENITAL SKULL DEPRESSION IN A PRE­TERM INFANT: A CASE REPORT •</strong> C. Loddo, C. Fanni, E. Curridori, A. Melis, C. Porcu, M.A. Marcialis, V. Fanos (Cagliari, Italy)</p> <p class="p1"><strong>ABS 16 • BREASTFEEDING AND POST-PARTUM SUP­PORT: A STUDY OF 161 INFANTS AND THEIR MOTHERS FROM THE “SOS MAMI” SURGERY •</strong> S. Giorri, R. Pintus, A. Dessì (Cagliari, Italy)</p> <p class="p1"><strong>ABS 17 • POTENTIAL PITFALLS OF EtCO<sub>2</sub> MONITORING DURING PAEDIATRIC OUT-OF-HOSPITAL CAR­DIAC ARREST. A CASE REPORT •</strong> P. Isoni, G. Piras, I. Piras (Cagliari and Sassari, Italy)</p> <p class="p1"><strong>ABS 18 • INTERACTIONS BETWEEN PREECLAMPSIA AND COMPOSITION OF THE HUMAN MILK: WHAT DO WE KNOW? •</strong> C. Peila, E. Bertino, G. Maiocco, A. Coscia (Turin, Italy)</p> <p class="p1"><strong>ABS 19 • MULTIPLE ACCESSORY TRAGUS IN A 4-YEAR-OLD CHILD. CLUES OF A GOLDENHAR SYNDROME? •</strong> G. Pinna, J.S.A. Zanda, G. Cerrone, G. Faa, C. Gerosa (Cagliari, Italy)</p> <p class="p1"><strong>ABS 20 • NONINVASIVE MEASUREMENT OF BILIRUBIN IN TERM NEONATES •</strong> T. Itova, V. Atanasova (Ruse and Pleven, Bulgaria)</p> <p class="p1"><strong>ABS 21 • STAPHYLOCOCCAL SCALDED SKIN SYN­DROME IN A 20-DAY-OLD INFANT IN COVID-19 PANDEMIC: CASE REPORT •</strong> M.E. Yuliana, R. Sihombing, R. Muchtar (Jakarta, Indonesia)</p> --- Various Authors Copyright (c) 2020 © Hygeia Press 2020-12-17 2020-12-17 10 1 e100107 e100107 10.7363/100107 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 The COVID-19 pandemic and perinatology in Lithuania <p>During the first COVID-19 wave, there were not many cases in Lithuania, but the second wave impacted Lithuania quite strongly. <span class="s1">According to the morbidity rates, we became one of the worst affected countries in Europe. </span></p> <p>Perinatology, as one of the areas of healthcare, was also affected by this pandemic. We had to reorganize the working principles of the hospitals that provide perinatal medicine. Specialized, isolated wards, where <span class="s1">SARS-CoV-2-</span>infected women gave birth, were installed. However, once the second wave spread, these departments were not able to handle it anymore, so the <span class="s1">SARS-CoV-2</span>-infected women gave birth in almost all of the country’s hospitals. Out of the 25 hospitals that provide perinatal healthcare, there were <span class="s1">SARS-CoV-2-</span>infected women in 17 of them.</p> <p>In 2020, out of the country’s 2.794 million citizens, 151 SARS-CoV-2-infected women gave birth. Most of them were asymptomatic, and a few had light-to-medium symptoms. Two women had a severe form of COVID-19. All of the mothers who had <span class="s1">COVID-19 </span>recovered successfully.</p> <p>There were 10 SARS-CoV-2-infected babies in 2020 in Lithuania. Following the UENPS recommendations, the newborns were nursed in the rooms next to their mothers. The frequency of transmission of the virus was about 6.6% of all the SARS-CoV-2-positive mothers.</p> <p>COVID-19 changed the tactics of both delivery and newborn care in the hospital. Childbirth is a <span class="s1">significant </span>moment in a family. During the pandemic, the family-oriented policy suffered because <span class="s1">the second parent’s hospitalization </span>was not allowed anymore due to the restrictions. </p> <p><span class="s1">At the beginning of the pandemic, the Ministry of Health of the Republic of Lithuania, along with professional associations of perinatal medicine (the Lithuanian Association of Obstetricians and Gynecologists and the Lithuanian Neonatology As­sociation), published national guidelines.</span></p> Rasa Tamelienė Copyright (c) 2021 © Hygeia Press 2021-01-19 2021-01-19 10 1 e100150 e100150 10.7363/100150 Extraordinary daytime urinary frequency (EDUF): warning signs pediatricians should not miss in times of COVID-19 <p>COVID-19 pandemic has had deep negative impacts on mental health on both adults and children, leading to increased diagnosis of mental disorders, somatic symptoms and reactive disorders.</p> <p>Since emotional stress often underlies urological behavioral disorders, such as extraordinary daytime urinary frequency (EDUF), pediatricians need to be trained in “catching the symptoms” in order to achieve a proper diagnosis and to offer adequate support both to patients and their families.</p> Giuseppe Masnata Laura Corona Copyright (c) 2021 © Hygeia Press 2021-04-03 2021-04-03 10 1 e100156 e100156 10.7363/100156 Seven secrets of COVID-19: fever, ACE2 receptors, gut-lung axis, metabolomics, microbiomics, probiotics, diet <p class="p1"><span class="s1">The aim of this work is to investigate 7 secrets of COVID-19 (fever, ACE2 receptors, gut-lung axis, metabolomics, microbiomics, probiotics, diet), hoping to reveal a small part of some of these and to increase anyhow the knowledge on SARS-CoV-2 and its weaknesses to be able to defeat it.</span></p> <p class="p1"><span class="s1">In particular, in the opinion of the authors, significant improvements in contrasting the Coronavirus, and the pandemics that will follow, could derive from the use of “omics” disciplines, namely metabolomics (the stethoscope of the future) and microbiomics (an unrecognized player).</span></p> <p class="p1"><span class="s1">The discovery of new biomarkers using metabolomics could be used in clinical practice as predictive diagnostic tools or to evaluate the effectiveness and toxicity of a drug, in order to be able to provide the patient with a personalized, tailor-made medicine: precision medicine.</span></p> <p class="p1"><span class="s1">Our understanding of the role of the gut microbiome in COVID-19 infection remains in its infancy, but future research may potentially aid our understanding of viral infection, and create new ways in which we might treat and prevent it.</span></p> <p class="p1"><span class="s1">We strongly believe that the 3 M’s (Metabolomics, Microbiomics and Machine learning [Artificial Intelligence]) will be the right route to the future for risk assessment, early diagnosis, patient management and decision-making.</span></p> <p class="p1"><span class="s1">By now, probiotics could help, fighting face to face against the virus. Moreover, the diet may be a key driver in determining the severity of COVID-19 and further studies are needed to explore the secret language between diet, bacteria, viruses and metabolites in determining individualized susceptibility or resilience to COVID-19.</span></p> Vassilios Fanos Roberta Pintus Maria Cristina Pintus Michele Mussap Maria Antonietta Marcialis Copyright (c) 2021 © Hygeia Press 2021-01-20 2021-01-20 10 1 e100145 e100145 10.7363/100145 How and when maternal viral infections can be a contraindication to breastfeeding: a narrative review <p class="p1">The positive effects of breastfeeding on the health of infants and mothers are largely established. It is generally recommended that a mother should breastfeed exclusively for at least 6 months. Sometimes, however, this is not possible owing to a maternal disease. The purpose of this review was to understand the possibility and the mechanisms of transmission of viral agents to breastfed infants when the mother is infected and to evaluate whether and when breastfeeding can be harmful and, therefore, a real contraindication exists.</p> <p class="p1">In order to produce this narrative review, an extensive literature search was conducted on PubMed. The query included “breastfeeding”, “mother to child” and “transmission” as keywords and a filter for publication date – from 2014 to 2019. Additionally, the bibliography of the selected articles was reviewed to identify further pertinent studies, which were then included.</p> <p class="p1">Only the following maternal infections were found to represent an absolute contraindication to breastfeeding: Human Immunodeficiency Virus and Human T-Lymphotropic Virus, because of their possible transmission via milk, and Ebola Virus, in which transmission to the child seems to be linked more to the close proximity relationship itself than the presence of the virus in human milk.</p> <p class="p1">Other viruses – Herpes Simplex Virus, Varicella Zoster Virus and Hepatitis C Virus – constituted a source of contraindication only in specific high-risk circumstances.</p> <p class="p1">To date, for the remaining viruses reviewed in this paper – including Severe Acute Respiratory Syndrome Coronavirus 2, no evidence exists that warrants contraindication of breastfeeding.</p> <p class="p1">Health professionals who deal with pregnant and puerperal women, such as obstetricians, pediatricians or family medicine doctors, must be aware of these particularities in the management of breastfeeding women in order to provide correct information and better take care of their patients and their respective infants.</p> Alexandra Pimentel Susana Pissarra Gustavo Rocha Hercília Guimarães Copyright (c) 2021 © Hygeia Press 2021-03-16 2021-03-16 10 1 e100130 e100130 10.7363/100130 Association between atrial septal abnormalities (patent foramen ovale, atrial septal defect, interatrial septal aneurysm) and cryptogenic stroke in children <p class="p1">Among cardiac diseases, those defined as cardio-embolic generate blood clots that, when traveling in the bloodstream, can partially or completely obstruct brain vessels thus causing a transient ischemic attack or a stroke. Patency of foramen ovale, atrial septal defect, and interatrial septal aneurysm are well known cardiac anomalies whose clinical significance is still under debate. Usually diagnosed by echocardiography, they are often associated with otherwise unexplained (cryptogenic) stroke at a young age, including paediatric patients.</p> <p class="p1">Despite this widely reported in literature link, defining the exact pathogenetic mechanism by whom they are associated with systemic thromboembolism is difficult.</p> <p class="p1">In this practical review, we try to clarify their pathogenetic role in inducing cerebral ischemia. Related treatment options are discussed as well.</p> Yvonne Leonard Mariangela Marras Giuseppe Calcaterra Pier Paolo Bassareo Copyright (c) 2021 © Hygeia Press 2021-03-07 2021-03-07 10 1 e100154 e100154 10.7363/100154 Evaluation of serum calprotectin (MRP-8/MRP-14) levels in patients with juvenile idiopathic arthritis <p class="p1"><span class="s1"><strong>Aim: </strong>To compare the levels of serum calprotectin (sCal) in patients with juvenile idiopathic arthritis (JIA) depending on the type of therapy to assess the disease activity comprehensively for further treatment correction.</span></p> <p class="p1"><span class="s1"><strong>Material and methods:</strong> We determined the sCal levels in 74 JIA patients who had normal C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) levels. High-sensitivity C-reactive protein was evaluated in 16 patients. All children were divided into 2 groups depending on the type of therapy. Group I consisted of 33 children on methotrexate (MTX) therapy, 11 of which were in the state of clinical pharmacologic remission. Group II included 41 children treated with biological Disease-Modifying Antirheumatic Drugs (bDMARDs), 14 of which achieved the state of clinical pharmacologic remission. A results analysis was carried out according to the Mann-Whitney U test. A Spearman rank correlation was performed to define the type of correlation between the indicators.</span></p> <p class="p1"><span class="s1"><strong>Results:</strong> sCal level was 5.5 times higher in patients with JIA (3,300 μg/L), compared with healthy children (600 μg/L) (p = 0.015). The highest sCal level observed was among the patients in Group I, who received MTX exclusively both in the active phase of the disease (U = 71.5, p = 0.000006) and in the state of clinical pharmacologic remission (U = 11, p = 0.00034). There was a moderate positive correlation of sCal level and disease activity indices, such as the 27-joint Juvenile Arthritis Disease Activity Score (JADAS27) (Spearman’s rho = 0.58, p = 0.0001) and high-sensitivity CRP (Spearman’s rho = 0.56, p = 0.024).</span></p> <p class="p1"><span class="s1"><strong>Conclusions:</strong> sCal levels should be used to monitor the subclinical inflammatory activity in patients with JIA. The use of bDMARDs in JIA treatment is effective.</span></p> Tetiana Marushko Yuliia Holubovska Yeva-Emiliia Kulchytska Copyright (c) 2021 © Hygeia Press 2021-03-20 2021-03-20 10 1 e100140 e100140 10.7363/100140 Unusual extrapulmonary manifestations of covert COVID-19: a case series at a tertiary care hospital in Bali, Indonesia <p class="p1"><span class="s1">One of the most challenging issues in facing the Coronavirus Disease (COVID-19) pandemic relies on the considerable uncertainty of the extent of its involvement. The wide spectrum of manifestations, ranging from generally milder manifestations to Multisystem Inflammatory Syndrome, and the concurrence with other disease entities substantially obscure clinical diagnosis. Diagnostic pitfalls persisted despite advancement in diagnostic criteria and modalities. We present a case series of confirmed COVID-19 cases in a tertiary hospital in Bali, Indonesia, with fever as the sole presenting feature and diagnostic hint.</span></p> Ida Bagus Suparyatha Dyah Kanya Wati I Nyoman Budi Hartawan Vanessa Lini Gunawan Andreas Dhymas Dhyna Martha Kelana Ivy Cerelia Valerie Copyright (c) 2021 © Hygeia Press 2021-03-08 2021-03-08 10 1 e100147 e100147 10.7363/100147 Congenital cytomegalovirus infection: from suspicion to confirmation <p class="p1"><strong>Introduction: </strong>Congenital cytomegalovirus (CMV) infection is the most common intrauterine infection and the leading cause of sensorineural hearing loss in childhood. Maternal seroconversion during pregnancy carries a 30% to 75% risk of vertical transmission. Serological surveillance is not indicated. In a confirmed infection there is no effective treatment and, in seropositive pregnant women, reactivation and even reinfection by different strains may occur.</p> <p class="p1"><strong>Methods: </strong>A retrospective observational study (2008-2018) was conducted, analyzing children born in our hospital that maintained follow-up by suspected congenital CMV (cCMV) infection.</p> <p class="p1"><strong>Results:</strong> We identified 125 cases of children with suspected cCMV infection. In 91 (72.8%) cases, the mothers had positive IgM; in 23 of them a seroconversion was documented and 4 cases corresponded to reactivation. Only 13 of the pregnant women had immunity to CMV, but 3 of the confirmed cases came from this group. Almost 17% of mothers had an unknown serological status and, in these cases, the suspicion was raised by placental changes, identification of abnormalities on the transfontanellar ultrasound, fetal growth restriction or other clinical signs compatible with CMV infection. cCMV infection was confirmed in 12 cases, 4 of them with sensorineural hearing loss and/or psychomotor development delay.</p> <p class="p1"><strong>Discussion: </strong>Counseling all pregnant women on prevention strategies has proven to be an effective prophylactic measure. Even though universal screening for CMV in pregnant women remains unrecommended, studying children with suspected clinical signs allows early screening for vertical transmission and early detection of possible sequelae.</p> Teresa Pinheiro Teresa Caldeira Copyright (c) 2021 © Hygeia Press 2021-02-15 2021-02-15 10 1 e100121 e100121 10.7363/100121 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 Neurodevelopmental outcomes of children with periventricular leukomalacia: the role of infection and ischemia <p class="p1"><strong>Introduction:</strong> Periventricular leukomalacia (PVL) is an important cause of preterm newborn’s cerebral white matter disease. This study assessed neurodevelopmental outcomes of children with PVL and its etiologic subgroups.</p> <p class="p1"><strong>Methods:</strong> Retrospective review of medical records of children with PVL diagnosis born at a tertiary center between 1996 and 2016. Subjects were divided into two groups according to the most likely etiology of PVL (ischemic versus infectious) using a classification system of risk factors. The neurologic and development outcomes were reviewed.</p> <p class="p1"><strong>Results:</strong> A total of 34 newborns with a median gestational age of 29 weeks were selected. Sixteen newborns (51.6%) were included in the ischemic group, while 15 (48.4%) were included in the infectious group; a clear group classification was not possible in 3 cases. PVL was moderate to severe in 73.5% of cases. Cerebral palsy (CP) developed in 69.7% of the children, 29% had epilepsy and 15.6% were microcephalic. Children with moderate to severe PVL were significantly more impaired than children with mild PVL (p &lt; 0.05). Moderate to severe PVL was observed in 93.3% of the children in the infectious group and 71.4% in the ischemic group (p = 0.12). Children in the infectious group were more prone to abnormal development and CP, while children in the ischemic group had more epilepsy and hearing impairment than the infectious group.</p> <p class="p1"><strong>Discussion:</strong> Infection may be an important etiologic factor regarding severe forms of PVL. The infectious group presented a higher incidence of CP, which may be related to more severe white matter injuries. The ischemic group presented more epilepsy, suggesting the involvement of gray matter disease.</p> Sara Silva Leite Joana Matos Joana Grenha Ana Cristina Braga Ruben Rocha Copyright (c) 2021 © Hygeia Press 2021-04-30 2021-04-30 10 1 e100105 e100105 10.7363/100105 Polysomnography in preterm infants with perinatal pathology: first 5-year experience in Ukraine <p class="p1"><span class="s1"><strong>Background:</strong> Polysomnography (PSG) is an important component in comprehensive neuromonitoring that allows timely evaluation of the sleep maturation quality and diagnosis of Sleep-Related Breathing Disorders (SRBD) in preterm infants (PIs).</span></p> <p class="p1"><span class="s1"><strong>Aim:</strong> To determine PSG indices in PIs of different gestational age with perinatal pathology. </span></p> <p class="p1"><span class="s1"><strong>Methods:</strong> This was the first original single-center observational study conducted in Ukraine. The groups of observation consisted of a total of 61 PIs with perinatal pathology: 16 infants of 24-28 weeks (Group I), 33 infants of 29-32 weeks (Group II), and 12 infants of 33-36 weeks (Group III). Non-parametric methods were used for statistical analyses. </span></p> <p class="p1"><span class="s1"><strong>Results:</strong> A maximum level of Respiratory Disturbance Index during Quiet Sleep (p<sub>I-II</sub> = 0.016, p<sub>I-III</sub> = 0.014), and Respiratory Disturbance Index Total and Respiratory Disturbance Index during Active Sleep was found in Group I with an average postmenstrual age (PMA) of 36 weeks, as well as a maximum frequency of SRBD with predominance of hypopnea and obstructive apnea. A statistically valuable decrease in Respiratory Disturbance Index during Quiet Sleep was determined in Group II with an average PMA of 35 weeks, with a stable decrease in all other indices. Minimum values were found in of all the PSG indices in Group III with an average PMA of 38 weeks. Mean values of Arousal Index in all the groups of observation were higher than 20. The minimum level of oxygen saturation during SRBD was diagnosed in infants from Group I (p<sub>I-III</sub> = 0.0072).</span></p> <p class="p1"><span class="s1"><strong>Conclusions:</strong> Disorders of physiological sleep formation and pathological respiratory events during sleep were found in the majority of PIs with perinatal pathology, which stipulates the necessity to conduct careful monitoring of vital functions and differential treatment of various apnea types.</span></p> Dariia Kostiukova Anastasiya Babintseva Thomas Erler Yelyzaveta Shunko Maksym Roziaiev Copyright (c) 2021 © Hygeia Press 2021-03-15 2021-03-15 10 1 e100133 e100133 10.7363/100133 Predictors of preterm birth in Jimma town public hospitals, Jimma, Ethiopia <p class="p1"><strong>Background: </strong>Preterm birth is the most fundamental reason of adverse infant outcomes. Analyzing the preterm birth and its predictor helps health caregivers and policymakers to design better strategies. This study aims to assess predictors of preterm birth in Jimma town public hospitals.</p> <p class="p1"><strong>Method: </strong>Facility-based cross-sectional study was undertaken. Systematic sampling was used to select 319 study participants. Data was entered into EpiData version 3.1 and exported to SPSS® version 23 for analysis. Logistic regression was used to analyze the association between dependent and independent variables and variables with p-value &lt; 0.05 at 95% confidence interval (<span class="s1">95%CI</span>) in multivariable were considered statistically significant.</p> <p class="p1"><strong>Result: </strong>This study showed that 13.8% from the total 319 mothers gave a preterm birth. Place of residence (p = 0.003, AOR = 0.37, 95%CI [0.11, 0.65]), interpregnancy interval (p = 0.023, AOR = 3.91, 95%CI [1.25, 7.30]), history of preterm births (p = 0.000, AOR = 1.83, 95%CI [0.93, 4.85], pregnancy-induced hypertension (p = 0.000, AOR = 7.52, 95%CI [3.33, 14.23]), chronic disease (p = 0.000, AOR = 5.70, 95%CI [2.81, 8.01]), history of abortion (p = 0.038, AOR = 3.23, 95%CI [1.12, 10.42]) and age 40-44 (p = 0.04, AOR = 1.62, 95%CI [0.21, 14.59]), were found to be significant predictors of preterm birth.</p> <p class="p1"><strong>Conclusion: </strong>Place of residence, short pregnancy interval, pregnancy-induced hypertension, previous history of preterm birth, presence of chronic medical diseases, maternal age between 40 and 44 years, and having abortion history were significant predictors of preterm birth. Therefore, as an important recommendation, health professionals and hospital administrative staff should work with their maximum effort to decrease the magnitude of preterm births and on early identification and management of mothers at risk to have a preterm birth.</p> Ebissa Bayana Kebede Yonas Biratu Terfa Bonsa Amsalu Geleta Adugna Olani Akuma Copyright (c) 2021 © Hygeia Press 2021-02-07 2021-02-07 10 1 e100125 e100125 10.7363/100125 Catch-up growth in preterm neonates with bronchopulmonary dysplasia in the first 2 years of life <p class="p1">Bronchopulmonary dysplasia (BPD) is a serious problem in Neonatal Intensive Care Units (NICUs). It is a multifactorial disease that may influence the growth and development of preterm neonates. The aim of this retrospective case-control study of preterm infants with BPD who were born in our centre was to evaluate the growth of these infants in the first 2 years of life compared with healthy preterm infants and to determine risk factors associated with poor growth.</p> <p class="p1">Those with major congenital malformations, congenital TORCH infection, deceased before 36 weeks of postmenstrual age or during the first 28 days of life and those who were transferred during hospitalization and outborn neonates were excluded.</p> <p class="p1">A total of 90 preterm neonates were enrolled and 30 (33.3%) of them had BPD. At 12 months of corrected age, gestational age and pre-pregnancy mother’s weight were shown to be associated with short stature. Weight at birth was also associated with low weight and head circumference growth. At 12 months after term, no differences were found within the growth assessment.</p> <p class="p1">Our study showed that growth between 12 and 18 months of life in preterm infants with BPD was sufficient to catch up.</p> Daniela R. Couto Glória Gonçalves Gustavo Rocha Filipa Flor-de-Lima Hercília Guimarães Copyright (c) 2021 © Hygeia Press 2021-03-27 2021-03-27 10 1 e100119 e100119 10.7363/100119 Oct-4 is highly expressed in stem/progenitor cells and in primordial follicles of the fetal human ovary <p class="p1"><span class="s1">Oct-4 (Octamer-binding transcription factor 4) is a member of the POU (Pit-Oct-Unc) family. During development, Oct-4 is expressed in embryonic stem cells and in germ cell precursors. In this study, we investigated the expression of Oct-4 in the ovaries of human fetuses during gestation. The ovaries of 14 human fetuses and newborns, ranging in gestational age from 12 up to 38 weeks of gestation, were formalin-fixed, routinely processed and paraffin-embedded. Paraffin sections were immunostained with an anti-Oct-4 commercial antibody. Oct-4 expression was demonstrated in all the ovaries analyzed. Immunoreactivity for Oct-4 was detected in multiple stem/progenitor cells, including oogonia. Moreover, Oct-4 was expressed in oocytes, in primordial follicles. In ovarian stem/progenitor cells, Oct-4 was expressed in the nucleus, whereas in oocytes reactivity for Oct-4 was restricted to the cytoplasm. In the initial stages of gestation, the majority of Oct-4-positive precursor cells were detected in the external cortex. These preliminary data indicate Oct-4 as a major player in germ cell differentiation in the human ovary and as a useful marker for ovarian stem/progenitor cells. Given the ability of Oct-4 for the detection of ovarian stem/progenitor cells, further studies are needed in order to verify its ability to detect stem cells in adult ovaries.</span></p> Flaviana Cau Daniela Fanni Clara Gerosa Maria Carolina Botta Flaminia Bardanzellu Sara Aversa Ester Sorrentino Francesco Ronchi Cristiana Bellan Gavino Faa Massimo Castagnola Copyright (c) 2021 © Hygeia Press 2021-02-25 2021-02-25 10 1 e100118 e100118 10.7363/100118 Investigating and determining the risk factors of neonatal seizures in NICU patients in the South of Iran <p class="p1"><span class="s1"><strong>Introduction: </strong>The incidence of neonatal seizures has been reported at 1.8 to 8.6 in 1,000 live births. It seems that the brain of premature children is more susceptible to seizures. The causes of neonatal seizures comprise a range of neurological disorders, including hypoxic-ischemic encephalopathy (HIE), central nervous system infection, intracranial hemorrhage, and structural disorder of the brain. Among all, the most common cause is HIE. Given the risks and consequences of neonatal seizures, this study aimed to investigate their risk factors.</span></p> <p class="p1"><span class="s1"><strong>Methods: </strong>This is a descriptive cross-sectional study of 92 neonates, aged &lt; 28 days, admitted to Neonatal Intensive Care Unit (NICU) during the period from March 2011 to May 2014, with the diagnosis of seizures. Demographic data including age, sex, gestational age, birth weight, fifth minute Apgar score were extracted from patient files. Data were analyzed using SPSS® version 19 software. </span></p> <p class="p1"><span class="s1"><strong>Results: </strong>Of 92 cases, 12 (13.0%) had the fifth minute Apgar score above 8, 79 (85.9%) had Apgar score between 3 and 8, and 1 (1.1%) had Apgar score less than 3. Asphyxia was present in 63 (68.5%) infants. Seizure types were clonic in 41 (44.6%) cases, myoclonic in 20 (21.7%) cases, of mild type in 14 (15.2%) cases, and tonic in 17 (18.5%) cases. Metabolic disturbances revealed hypoglycemia in 7.6%, hypocalcemia in 2.2%, hyponatremia in 4.3%. Hereditary metabolic disorders were observed in 6.5% of patients.</span></p> <p class="p1"><span class="s1"><strong>Conclusion: </strong>HIE was the most common cause of neonatal seizures, and cerebral hemorrhage and metabolic disorders were other two major causes of seizures after HIE. The most common type of seizures was the clonic type. The results suggest that male gender and a postnatal age &lt; 2 weeks are associated with an increased risk of seizure in normal and premature infants.</span></p> Ali Khaje Seyed Hosein Soleimanzadeh Mousavi Maryam Golmohammadi Zeinab Tavakolikia Ghasem Miri-Aliabad Reza Keeykha Maryam Keykha Afshin Fayyazi Mohammadhosein Akhlaghpasand Copyright (c) 2021 © Hygeia Press 2021-02-12 2021-02-12 10 1 e100129 e100129 10.7363/100129 Symptomatic Meckel’s diverticulum in children: a 12-year survey <p class="p1"><strong>Introduction: </strong>Meckel’s diverticulum (MD) is usually asymptomatic but may be associated with severe complications that require awareness. This study aimed to assess the clinical and pathological features of symptomatic MD in children as well as the accuracy of [<sup>99m</sup>Tc]sodium pertechnetate scintigraphy.</p> <p class="p1"><strong>Methods:</strong> We retrospectively reviewed all symptomatic MD in pediatric patients treated between 2007 and 2018 at a tertiary center. Records included demographics, clinical presentation, scintigraphy with [<sup>99m</sup>Tc]sodium pertechnetate, surgical outcome, and histopathology.</p> <p class="p1"><strong>Results: </strong>There were 47 patients (93.6% males) with a median age of 4.31 [1.76-8.10] years. The most common clinical presentation was digestive bleeding (n = 25, 53.2%), followed by intestinal obstruction (n = 12, 25.5%) and diverticulitis (n = 10, 21.3%). The patients with digestive bleeding were younger than those with intestinal obstruction or diverticulitis (2.76 vs. 6.02 years). All patients with digestive bleeding underwent scintigraphy that revealed ectopic gastric mucosa in 23. From the 23 positive scintigraphy, there were 22 available histological exams, from which 21 revealed ectopic gastric mucosa; the 2 negative scintigraphy studies also revealed ectopic gastric mucosa. Therefore, scintigraphy revealed a sensitivity of 91.3% (21/23) in patients presenting digestive bleeding. In the conclusive histological exams (n = 41), ectopic mucosa was detected in 82.9% of cases: 96% in digestive bleeding, 71% in intestinal obstruction, and 60% in diverticulitis. With a median follow-up of 7.2 years, there were no mortality or major complications.</p> <p class="p1"><strong>Conclusion:</strong> Symptomatic MD predominated in males, the digestive bleeding occurring at younger ages. Scintigraphy demonstrated high sensitivity in the detection of ectopic gastric mucosa in patients with digestive bleeding. Overall symptomatic MD usually has ectopic mucosa. Although the surgical outcome is excellent, complications of MD should be kept in mind.</p> Sara Fonseca Francisco Mourão Maria Teresa Faria Sara Fernandes Ana Catarina Fragoso José Estevão-Costa Copyright (c) 2021 © Hygeia Press 2021-02-08 2021-02-08 10 1 e100114 e100114 10.7363/100114 Cord blood hematological reference values in term and late preterm infants from the Mediterranean island of Sardinia: a preliminary study <p class="p1"><span class="s1"><strong>Background:</strong> Even though umbilical cord blood (UCB) has become an important source of hematopoietic stem cells for transplant, little is known about normal hematological values at birth. The aim of our preliminary retrospective study was to determine reference values for the main hematological parameters of UCB, stratified by gender, gestational age and delivery route in the Sardinian neonatal population.</span></p> <p class="p1"><span class="s1"><strong>Method:</strong> In our retrospective study we reviewed hematological blood counts from UCB samples collected consecutively at the Neonatal and Obstetric Division of San Gavino Hospital, Sardinia, Italy, between January 1, 2013, and June 30, 2014. Unsuitable samples (insufficient blood amount, clotted or hemolyzed samples) were excluded from the analysis.</span></p> <p class="p1"><span class="s1"><strong>Results:</strong> A total of 439 UCB samples from newborn infants with gestational age ranging from 34 to 42 weeks were included in the study. Newborn infants from vaginal delivery and preterm infants showed higher erythrocyte and leukocytes values, while no differences in hematological values were found between males and females. Interestingly, reticulocyte hemoglobin content was specifically evaluated and its values were found not to be influenced by gender, gestational age, and delivery route. </span></p> <p class="p1"><span class="s1"><strong>Conclusions:</strong> These preliminary findings may contribute to define reference values for UCB hematological parameters in term and late preterm infants from the Mediterranean island of Sardinia, thus favoring a wider use of these parameters in the clinical management of the newborn.</span></p> Francesco Ronchi Annalisa Porcella Pietro Paolo Porcu Sergio Salis Cristian Locci Nadia Vacca Claudio Fozza Roberto Antonucci Copyright (c) 2020 © Hygeia Press 2020-11-30 2020-11-30 10 1 e100109 e100109 10.7363/100109 Mean platelet volume in asymptomatic chorioamnionitis-exposed infants. A retrospective case-control study <p class="p1"><span class="s1"><strong>Introduction: </strong>Maternal chorioamnionitis (CA) is a serious condition causing several neonatal morbidities and long-term neurodevelopmental sequelae in exposed infants. Current guidelines still recommend admission, laboratory evaluation, and antibiotic administration to all CA-exposed infants. The incidence of early-onset neonatal sepsis (EOS) is currently low, owing to the routine intrapartum antibiotic administration to mothers identified to be at risk of developing CA. New diagnostic tools for early diagnosis of sepsis in apparently healthy infants exposed to maternal CA are needed. Previous studies showed that mean platelet volume (MPV) is evolving as a potential inflammatory marker of neonatal sepsis. We aimed to study whether MPV can be used as an adjuvant diagnostic tool for EOS in asymptomatic CA-exposed infants. </span></p> <p class="p1"><span class="s1"><strong>Objective: </strong>To evaluate the role of MPV as an adjuvant biomarker of EOS in cases of asymptomatic CA-exposed infants.</span></p> <p class="p1"><span class="s1"><strong>Design:</strong> Retrospective case-control study.</span></p> <p class="p1"><span class="s1"><strong>Setting:</strong> A tertiary care Neonatal Intensive Care Unit (NICU).</span></p> <p class="p1"><span class="s1"><strong>Patients:</strong> Asymptomatic CA-exposed infants 37-40 weeks of gestation admitted between May 2016 and April 2019 to the NICU of Dubai Hospital, UAE.</span></p> <p class="p1"><span class="s1"><strong>Results:</strong> A total of 1,300 infants were admitted to NICU during the study period. Fifty-eight infants were included in the CA-exposed group and met the inclusion criteria, and 63 infants were matched as controls. No statistically significant differences were found in the MPV between the CA-exposed infants’ group and the control group. Similarly, no significant differences were noted in total white blood cell count, platelet count, and absolute neutrophil count between the two study groups. Inflammatory markers were significantly elevated in the CA-exposed group; however, blood cultures were sterile in all included infants.</span></p> <p class="p1"><span class="s1"><strong>Conclusions:</strong> MPV is not a sensitive marker of EOS in asymptomatic CA-exposed infants whose mothers received intrapartum antibiotic prophylaxis.</span></p> Atef Alshafei Moustafa Hassan Yaser El saba Anwar Khan Mahmoud Ahmed Copyright (c) 2020 © Hygeia Press 2020-12-28 2020-12-28 10 1 e100132 e100132 10.7363/100132 Synbiotic therapy in infantile colic resistant to conservative therapy: a clinical trial <p class="p1"><span class="s1"><strong>Background: </strong>Infantile colic is a disturbing problem for parents. The Rome IV criteria are the last modality for the diagnosis of colic. Available medications have variable effects on the treatment of colic. However, no definite treatment has been identified yet.</span></p> <p class="p1"><span class="s1"><strong>Aims: </strong>To our knowledge, few clinical trials have compared the efficacy of synbiotics in infantile colic, so the present study was conducted. </span></p> <p class="p1"><span class="s1"><strong>Material and methods:</strong> This study was performed on 120 infants (51.66% boys; mean age: 42.09 ± 21.14 days; mean birth weight: 3,155 ± 420 g) with the diagnosis of infantile colic resistant to conservative therapy. The infants were randomly divided into groups A and B. A synbiotic containing <em>B. infantis</em>, <em>L. reuteri</em>, <em>L. rhamnosus</em>, and fructooligosaccharides (FOS) (PediLact® [Zist-Takhmir Co., Tehran, Iran] drop) was administered to group A, while group B received a synbiotic containing <em>B. lactis</em> and FOS (BBCare® [Zist-Takhmir Co., Tehran, Iran] drop). The primary outcome was the response rate to each synbiotic, and the secondary outcome was the complications of each synbiotic. </span></p> <p class="p1"><span class="s1"><strong>Results: </strong>The response rate to both synbiotics was significant after 1 week of intervention (1.97 ± 0.91 [44.95%] versus 1.64 ± 0.77 [54.23%], p = 0.000). Both groups showed a significant response rate to each synbiotic after 1 month of intervention too (1.19 ± 0.84 [63.48%] versus 0.70 ± 0.48 [79.65%], p = 0.000). The response rate was significantly higher in group B compared to group A after 1 week (54.23% versus 44.95%) and after 1 month (79.65% versus 63.48%) of intervention. Neither synbiotic was associated with adverse effects.</span></p> <p class="p1"><span class="s1"><strong>Conclusion: </strong>The present study showed that both synbiotics were effective in the treatment of infantile colic. However, the synbiotic containing <em>B. lactis</em> was significantly more effective than the synbiotic containing <em>B. infantis</em>, <em>L. reuteri</em>, and <em>L. rhamnosus</em> in infantile colic. </span></p> Peymaneh Alizadeh Taheri Shima Rostami Kambiz Eftekhari Sedigheh Danesh Copyright (c) 2021 © Hygeia Press 2021-02-07 2021-02-07 10 1 e100128 e100128 10.7363/100128 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 A new approach to managing neonates born to mothers at risk for early-onset neonatal sepsis: is it cost-effective and can it reduce NICU admissions? <p class="p1"><strong>Introduction: </strong>In Minia University Hospital for Obstetrics and Gynecology and Pediatrics (Minia, Egypt), all neonates born to mothers with suspected or confirmed intrauterine inflammation or infection (triple I) or with group B <em>Streptococcus</em> (GBS) bacteriuria, were directly admitted to the neonatal intensive care unit (NICU) for clinical assessment and treatment of suspected sepsis for at least 48 hours, regardless of their clinical condition. Establishment of a risk-identification system for those high-risk neonates based on the EOS detection standard checklist may decrease NICU admissions and antibiotics exposure in asymptomatic neonates.</p> <p class="p1"><strong>Methods: </strong>We marginally altered a standard checklist outlined by The American College of Obstetricians and Gynecologists for the early discovery of neonates at risk for EOS. Participants of the study were inborn neonates ≥ 34 weeks born to mothers with suspected or confirmed triple I or with GBS bacteriuria, who received intrapartum antibiotic prophylaxis (IAP) at least 4 hours before delivery. Neonates for mothers at risk for EOS who did not get IAP were excluded from the study. Numerous sessions were conducted to teach nursing and medical staff to apply the standard checklist for the identification of EOS within the nursery. Symptomatic neonates were admitted directly to NICU for laboratory evaluation and intravenous antibiotics. Asymptomatic neonates were closely observed within the nursery.</p> <p class="p1"><strong>Results: </strong>From June 2017 to June 2019, there were 624 at-risk neonates recognized and assessed utilizing the standard checklist. Of these 624 neonates, 456 (73%) did not require admission to the NICU based on their risk assessment utilizing the standard checklist. Implementation of a standard checklist for at-risk neonates decreased NICU rates of admission by 50%, decreased pediatrician practice variability, decreased the number of laboratory procedures, promoted family bonding, increased rates of breastfeeding at hospital discharge, diminished financial burden on the hospital and community, and promoted antibiotic stewardship.</p> <p class="p1"><strong>Conclusion: </strong>This study concludes that utilization of the standard checklist for early identification of EOS can decrease the need for NICU admission of asymptomatic neonates at risk for EOS.</p> Nagwa Sabry Mahmoud H. Ibrahim Copyright (c) 2021 © Hygeia Press 2021-01-06 2021-01-06 10 1 e100122 e100122 10.7363/100122 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 Neonatal inflammatory skin and bowel disease type 2: a very rare disease associated with EGFR mutation <p class="p1">Homozygous Epidermal Growth Factor Receptor (EGFR) mutation is associated with neonatal inflammatory skin and bowel disease type 2.</p> <p class="p1"><span class="s1">We present the case of a preterm female infant with severe growth restriction and a severe and complex clinical course. She presented from birth with erosive and inflammatory skin lesions as well as several malformations (sparse scalp hair, craniofacial abnormalities, thin and long limbs, arachnodactyly, absence of subcutaneous fat, arthrogryposis and severe congenital heart disease). She developed recurrent skin and respiratory infections, failure to thrive, severe electrolyte imbalances and progressive heart failure. Neonatal inflammatory skin and bowel disease type 2 was suspected and directed genetic testing confirmed the presence of an EGFR gene mutation in homozygosity. Despite the optimization of medical therapy, the infant died of progressive cardiac failure at 3 months of age.</span></p> Mariana Lemos Joana S. Gonçalves Cátia R. Correia Ana Teresa Maria Copyright (c) 2020 © Hygeia Press 2020-12-02 2020-12-02 10 1 e100123 e100123 10.7363/100123 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 Multisystem Inflammatory Syndrome in Children (MIS-C) associated with Kawasaki Disease in a three-year-old girl with SARS-CoV-2 infection <p class="p1"><span class="s1">Kawasaki Disease (KD) is an acute and restrictive vasculitis. Studies have noted a viral association with the occurrence of this syndrome. This article </span><span class="s2">reports a child with several severe inflammatory syndrome symptoms associated </span><span class="s1">with COVID-19 and KD. The patient, a three-year-old Iranian Kurdish girl without a history of internal diseases and with no history of drug and food allergies, was referred to Imam Hasan hospital three days after diarrhea, nausea, and pain in the inner part of the left thigh. Scattered rashes around the face, neck, and arms during fever were significant. Reverse transcription polymerase chain reaction (RT-PCR) was positive for COVID-19, but the lung high-resolution computed tomography (HRCT) did not show involvement, so the diagnosis of KD associated with viral infection was suggested. In further studies, Wright and 2ME tests, Widal, and purified protein derivative (PPD) tests were declared negative. After intravenous immunoglobulin (IVIG), the patient’s fever continued, but other symptoms improved. </span></p> <p class="p1">Since COVID-19 is a new disease and our understanding of its numerous symptoms is evolving, we recommend physicians to be vigilant about secondary inflammatory syndromes that induce KD; rapid treatment with IVIG and steroids may improve patients’ conditions.</p> Koroush Yousefi Salar Poorbarat Amin Hoseinzadeh Sajad Rahimi Zohreh Abbasi Copyright (c) 2020 © Hygeia Press 2020-12-29 2020-12-29 10 1 e100110 e100110 10.7363/100110 Successful antibiotic treatment of liver abscess in an eight-year-old boy after perforated appendix <p class="p1">We present the case of an eight-year-old boy who was referred to our Clinic with acute abdomen. After ultrasound, which showed a perforated appendix, an urgent appendectomy was initiated. When the peritoneum was opened, the abdomen was full of pus. The appendix was positioned retrocecal and subhepatic, extensively coupled with the ascendant colon. Partial omentectomy and appendectomy were performed. On the tenth postoperative day, a contrast-enhanced ultrasound (CEUS) was performed. A subcapsular lesion of the right liver lobe of 30 mm diameter was observed. It was a liver abscess. Three weeks after intravenous therapy (clindamycin/gentamicin, piperacillin/tazobactam), the abscess has completely regressed.</p> Marko Bašković Antun Kljenak Ante Čizmić Dora Škrljak Šoša Katarina Vulin Ivana Đaković Copyright (c) 2021 © Hygeia Press 2021-01-09 2021-01-09 10 1 e100120 e100120 10.7363/100120 Congenital glaucoma – a severe form <p class="p1">Primary congenital glaucoma is a rare disease and results from malformations of the trabecular meshwork that determines the increase of intraocular pressure (IOP). It is characterized by a globe enlargement, corneal edema and opacification. It also is associated with rupture of Descemet’s membrane with Haab’s striae, thinning of the anterior sclera and iris atrophy, normally with IOP above 21 mmHg.</p> <p class="p1">We report a case of a full-term neonate girl in which a bilateral corneal opacity was observed. Ophthalmologic examination revealed corneal edema, Haab’s striae and IOP of 37.3 mmHg in the right eye and 40 mmHg in the left eye. To achieve control of IOP, she performed sequential interventions: bilateral trabeculotomy; trabeculectomy and iridectomy on the left eye; and finally bilateral drainage implant.</p> <p class="p1">In this patient, despite early diagnosis and multiple surgical interventions, the severe presentation and poor response to surgical treatment with maintenance of high IOP establishes an obscure prognosis. The child needs frequent follow-ups.</p> Mariana Portela Carmo Ferreira Tiago Fernandes Nicole Silva Copyright (c) 2021 © Hygeia Press 2021-02-14 2021-02-14 10 1 e100102 e100102 10.7363/100102 An unexpected association – cord hemangioma and patent urachus <p class="p1">A patent urachus is the presence of structures found early in pregnancy, which could be associated with other abnormality in 46% cases.</p> <p class="p1">Hemangiomas are benign tumors and are more common in the skin. Umbilical cord hemangiomas are very rare, with fewer than 50 cases described in the literature.</p> <p class="p1">Here we report a clinical case of a neonate with a prenatal diagnosis of an umbilical cord hemangioma and a patent urachus. We would like to draw attention to the differential diagnosis of cord masses, as well as to the importance of early diagnosis and the appropriate management of the newborn. To our knowledge, this is the first case reported of a newborn diagnosed with this association.</p> Ana Lachado Fábio Barroso Rafael Brás Maria do Céu Rodrigues Ana Coelho Ana Sofia Marinho Fátima Carvalho Elisa Proença Céu Mota Copyright (c) 2020 © Hygeia Press 2020-12-23 2020-12-23 10 1 e100112 e100112 10.7363/100112 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 Correspondence: the importance of supplication for parents in the Neonatal Intensive Care Unit <p class="p1"><span class="s1">The Neonatal Intensive Care Unit (NICU) often causes stress, anxiety and fear for parents during hospitalization of their infant. Religion and spirituality are important for many parents and to make the infant healthier and normal they pray God. Supplication is the spirit of worship and results from sincere belief. </span></p> <p class="p1"><span class="s1">We present religious and spiritual aspect of parents in the NICU to increase the awareness of NICU staff regarding the importance of spiritual care for parents. </span></p> <p class="p1"><span class="s1">In conclusion, we strongly suggest that NICU staff should support parents in the NICU for spiritual care, because it is the right of them. Health professionals should also be trained for spiritual support and care.</span></p> Hüseyin Çaksen Copyright (c) 2021 © Hygeia Press 2021-04-07 2021-04-07 10 1 e100157 e100157 10.7363/100157