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Artificial intelligence (AI) is providing novel answers to long-standing clinical problems, and it is quickly changing pediatric urology. This thorough analysis focuses on current developments in AI technologies that improve pediatric urology diagnosis, treatment planning, and surgery results. Deep learning algorithms help detect problems with previously unheard-of precision in disorders including hydronephrosis, pyeloplasty, and vesicoureteral reflux, where AI-powered prediction models have demonstrated promising outcomes in boosting diagnostic accuracy. AI-enhanced image processing methods have significantly improved the quality and interpretation of medical images. Examples of these methods are deep-learning-based segmentation and contrast limited adaptive histogram equalization (CLAHE). These methods guarantee higher precision in the identification and classification of pediatric urological disorders, and AI-driven ground truth construction approaches aid in the standardization of and improvement in training data, resulting in more resilient and consistent segmentation models. AI is being used for surgical support as well. AI-assisted navigation devices help with difficult operations like pyeloplasty by decreasing complications and increasing surgical accuracy. AI also helps with long-term patient monitoring, predictive analytics, and customized treatment strategies, all of which improve results for younger patients. However, there are practical, ethical, and legal issues with AI integration in pediatric urology that need to be carefully navigated. To close knowledge gaps, more investigation is required, especially in the areas of AI-driven surgical methods and standardized ground truth datasets for pediatric radiologic image segmentation. In the end, AI has the potential to completely transform pediatric urology by enhancing patient care, increasing the effectiveness of treatments, and spurring more advancements in this exciting area. [ABSTRACT FROM AUTHOR]

Eosinophilic Esophagitis is an antigen-mediated inflammatory disease characterized by thickening of the esophageal wall, leading to dysphagia, vomiting, reflux, and abdominal pain. This disease can be treated with a therapeutic approach ranging from diet to pharmacological therapy. Jorveza® (budesonide) and Dupixent® (dupilumab) are treatments for Eosinophilic Esophagitis approved by the European Medicines Agency in adults but not in children. Budesonide-based extemporaneous oral liquid suspensions could be prepared for pediatric use. The main limit of this formulation is that budesonide needs a longer residence time on the esophageal mucosa to solubilize and diffuse in it to exert its local anti-inflammatory effect. Herein, we propose the development of an extemporaneous mucoadhesive oral budesonide solution for the pediatric population. A liquid vehicle containing hydroxypropyl-beta-cyclodextrin as a complexing agent and carboxymethylcellulose sodium as a mucoadhesive excipient was used to prepare budesonide-based formulations. A stable solution at a concentration of 0.7 mg/mL was successfully prepared and characterized. The formulation showed rheological and mucoadhesive properties suitable for an Eosinophilic Esophagitis local prolonged treatment. In this way, pharmacists can prepare stable budesonide-based mucoadhesive solutions, providing both patients and physicians with a new therapeutic option for Eosinophilic Esophagitis pediatric treatment. [ABSTRACT FROM AUTHOR]

Schools represent the ideal setting for educating children about the acquisition of active lifestyles seen not only from a health point of view but also from psycho-pedagogical and social perspectives. Based on evidence from scientific literature, there is a need to include physical activity in school routines, especially in primary schools, where the habits learned by children stay with them in their later years and adulthood. With the support of the school medicine service, schools become a favorable context for planning health education sessions aimed at students, with particular reference to prevention. Within teaching, it is necessary to consider the motor area as a fundamental tool for acquiring correct lifestyles, facilitating cognitive development, inclusiveness, and psycho-emotional and socio-relational factors. Schools can play a fundamental role, becoming the key to promoting physical activity at different times of the day, such as during class hours (with active breaks), during breaks, before and after lessons, and by integrating movement into teaching. This review is the result of an in-depth overview of the available literature on the relationship of schools with health and health promotion from a preventive perspective, with awareness of how the issue is being approached and the need for further future reflections that will go hand in hand with the coming changes. [ABSTRACT FROM AUTHOR]

The utilization of nanotechnology has brought about notable advancements in the field of pediatric medicine, providing novel approaches for drug delivery, disease diagnosis, and tissue engineering. Nanotechnology involves the manipulation of materials at the nanoscale, resulting in improved drug effectiveness and decreased toxicity. Numerous nanosystems, including nanoparticles, nanocapsules, and nanotubes, have been explored for their therapeutic potential in addressing pediatric diseases such as HIV, leukemia, and neuroblastoma. Nanotechnology has also shown promise in enhancing disease diagnosis accuracy, drug availability, and overcoming the blood–brain barrier obstacle in treating medulloblastoma. It is important to acknowledge that while nanotechnology offers significant opportunities, there are inherent risks and limitations associated with the use of nanoparticles. This review provides a comprehensive summary of the existing literature on nanotechnology in pediatric medicine, highlighting its potential to revolutionize pediatric healthcare while also recognizing the challenges and limitations that need to be addressed. [ABSTRACT FROM AUTHOR]

The pediatric population suffers from a lack of age-appropriate medicines leading to unsafe situations when off-labelled or unlicensed drugs are used. Assessing the best option to administrate medicines when manipulations are required is essential in order to improve child care. This study aimed to compare the accuracy of the administered dose provided by three dosage forms and their techniques of administration. Different techniques of administration were assessed, covering three oral dosage forms (commercially available tablets, capsules, oral suspensions) using two APIs not available in a children-adapted dosage form. Techniques of administration were simulated and administered doses were determined using HPLC-UV. Means were compared to the target dose while distributions of doses were compared between each technique. For both APIs, mean administered doses obtained with capsules and tablets were significantly different from the target dose, whereas there was no statistical difference with oral suspensions. Distributions of doses showed significant difference between the three dosage forms. This study demonstrates that manipulations of solid oral dosage forms provide dramatic underdosing leading to unsafe situations. Compounded oral suspension is the best option to avoid underdosing and dose variation. This solution should be prioritized when age-appropriate commercial medicines are not available. [ABSTRACT FROM AUTHOR]

This review aims to provide the state of the art on polymeric and lipid nanoparticles, used or suggested to approach pediatric diseases' problems and needs, and to inspire new researches in this field. Several drugs are currently not available in formulations suitable for pediatric patients. The United States Pediatric Formulation Initiative suggested applying new technologies to pediatric drug formulations, for instance, nanotechnology. The literature analysis showed that polymeric and lipid nanoparticles have been widely studied to treat pediatric diseases, and albumin nanoparticles and liposomes are already used in clinical practice. Nevertheless, these studies are focused almost exclusively on pediatric cancer treatment. Although nanomedicine may solve many needs of pediatric diseases and medicines, the unavailability of data on pharmacokinetics, safety and efficacy of both drugs and nanoparticles in pediatric patients limits the development of new pediatric medicines based on nanoparticles. Therefore, nanomedicine applied in pediatrics remains a significant challenge in the near future. [ABSTRACT FROM AUTHOR]

Eosinophilic esophagitis (EE) is a chronic immune/antigen-mediated esophageal inflammatory disease for which off-label topical corticosteroids (e.g., budesonide) are widely used in clinic. In general, thickening excipients are mixed with industrial products to improve the residence time of the drug on the esophageal mucosa. The compounding procedures are empirical and the composition is not supported by real physicochemical and technological characterization. The current study aimed to propose a standardized budesonide oral formulation intended to improve the resistance time of the drug on the esophageal mucosa for EE treatment. Different placebo and drug-loaded (0.025% w/w) formulations were prepared by changing the percentage of xanthan gum alone or in ratio 1:1 with guar gum. Both excipients were added in the composition for their mucoadhesive properties. The formulative space was rationalized based on the drug physicochemical stability and the main critical quality attributes of the formulation, e.g., rheological properties, syringeability, mucoadhesiveness and in vitro penetration of budesonide in porcine esophageal tissue. The obtained results demonstrated that gums allowed a prolonged residence time. However, the concentration of the mucoadhesive polymer has to be rationalized appropriately to permit the syringeability of the formulation and, therefore, easy dosing by the patient/caregiver. [ABSTRACT FROM AUTHOR]