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Paediatric respiratory tract infections (RTIs) are among the most common reasons for both physician visits and hospital admissions, being associated with significant morbidity and mortality. Evidence suggests that vitamin D supplementation may enhance the immune system of the host. We performed a randomised controlled trial to evaluate the impact of vitamin D supplementation on recurrent respiratory tract infections (RRTIs) in children attending paediatric primary care. We enrolled 77 children, in a primary care setting, who had been diagnosed with recurrent respiratory tract infections (RRTIs) (= 6 RTIs per year). 40 of these patients were randomly assigned to the group which received a vitamin D supplement (400 UI/day) from October to March, whereas the remaining 37 patients did not receive any supplementation. The number of RTIs, the duration of respiratory symptoms, the use of antibiotics and the number of physician visits during the study were recorded by parents using a structured diary. Both groups of children had similar baseline characteristics. During the study, significant differences (p<0.05) were found in vitamin Dsupplemented group compared to the control group regarding the average number of RTIs (respectively 3.89 ± 2.49 vs. 6.35 ± 3.22), upper respiratory tract infections (URTIs) (2.97 ± 1.89 vs. 4.43 ± 2.85) and lower respiratory tract infections (LRTIs) (0.92 ± 1.14 vs. 1.92 ± 1.85), duration of respiratory symptoms in days (4.2 ± 2.61 vs. 6.86 ± 4.73), use of antibiotics (1.77 ± 1.35 vs. 3.7 ± 2.28) and number of physician visits (3.97 ± 2.32 vs. 6 ± 3.19). According to our data, vitamin D supplementation in children attending primary care settings may reduce the burden of RRTIs. Further and larger studies are needed to confirm our data. [ABSTRACT FROM AUTHOR]

Kasabach-Merritt Syndrome (KMS) is a rare clinical entity, found in 1% of angiomatous lesions, characterized by severe consumption coagulopathy/thrombocytopenia in association with highly aggressive neonatal vascular lesions. We describe a case of prenatally diagnosed vascular neoformation of the neck, revealed by obstetric ultrasound and then confirmed by fetal Magnetic Resonance, with subsequent onset of KMS at birth. The newborn was treated with Propanolol and Prednisone, without any benefit; Magnetic Resonance (MRI) at day 14 of life confirmed the hypervascularized lesion of about 6x7x6 cm on the right laterocervical site. Sirolimus therapy was then initiated leading to rapid improvement in thrombocytopenia and a volumetric reduction of the vascular lesion on MRI. After 12 months of treatment, MRI scan showed a further reduction in volume of the vascular lesion; also, the KMS-related thrombocytopenia was completely resolved: Sirolimus could represent the first line of treatment of vascular lesions in the neonatal age. [ABSTRACT FROM AUTHOR]

This is a retrospective cohort study with the aim of evaluating fluconazole efficacy in preventing invasive fungal infections in very low birth weight newborns, in our NICU setting. Neonates weighing less than 1500g at birth, born between January 2013 and December 2014, were enrolled in the study. The primary aim was to assess the prevalence of fungal infections. The secondary aim was to identify newborns with a higher risk of invasive fungal infections as well as the incidence of complications after invasive fungal infection. 59 newborns were included in the study. Routine fluconazole prophylaxis at the dose of 3mg/kg i.v. every 72 hours was administered to 47/59 (79,7%). The overall proportion of invasive fungal infections was 17%, with no significant difference between neonates who underwent fluconazole prophylaxis (19,1%) and those who did not (8,3%) (p = 0,4). Candida parapsilosis was the most common isolated strain (90%). Lower gestational age, lower birth weight, surgery interventions and delayed initiation of enteral feeding were associated with invasive fungal infections. All septic newborns developed complications: bronchopulmonary dysplasia, retinopathy of prematurity and periventricular leukomalacia. None died due to Candida infection. Our findings do not appear to support routine fluconazole prophylaxis in very-low-birth-weight infants. [ABSTRACT FROM AUTHOR]

Esophageal atresia is a relatively common congenital anomaly, which is often associated with other anomalies. We report a case of a newborn affected by esophageal atresia with significant post-operative and long-term complications, including feeding and swallowing disorders. [ABSTRACT FROM AUTHOR]

Background: Neonatal aortic arch thrombosis is a rare but life threatening condition. A correct diagnosis and an appropriate therapeutic approach are fundamental to prevent death or severe injuries. Case presentation: we report a case of spontaneous aortic arch thrombosis in a term newborn, who presented with suggestive signs of aortic coarctation immediately after birth. Despite the initiation of anticoagulant therapy, a massive increase in size of thrombus with evidence of coronary involvement was noted. Thrombolytic treatment was performed with thrombus resolution. Death occurred after a few days due to widespread brain haemorrhage. Conclusion: To date, no definitive guidelines have been published for the treatment of neonatal aortic arch thrombosis, and only anecdotal reports are available. A multidisciplinary approach is fundamental in order to evaluate the risk:benefit ratio of proposed medical and surgical interventions. Further studies are needed to improve consensus evidence based guidelines and ensure appropriate approaches to this condition. [ABSTRACT FROM AUTHOR]

Congenital third-degree (complete) atrioventricular block requires pacemaker implanta-tion where prenatal hydrops, low ventricular rate (<45 bpm) non-response to inotropes, and/or left ventricular dysfunction is present. A permanent pacemaker was implanted in a 1200g 9 day old preterm: the smallest newborn successfully subjected to this procedure, according to literature. [ABSTRACT FROM AUTHOR]