Search

Background: Our study aimed to explore the way artificial intelligence (AI) utilization is perceived in pediatric medicine, examining its acceptance among patients (in this case represented by their adult parents), and identify the challenges it presents in order to understand the factors influencing its adoption in clinical settings. Methods: A structured questionnaire was applied to caregivers (parents or grandparents) of children who presented in tertiary pediatric clinics. Results: The most significant differentiations were identified in relation to the level of education (e.g., aversion to AI involvement was 22.2% among those with postgraduate degrees, 43.9% among those with university degrees, and 54.5% among those who only completed high school). The greatest fear among respondents regarding the medical use of AI was related to the possibility of errors occurring (70.1%). Conclusions: The general attitude toward the use of AI can be considered positive, provided that it remains human-supervised, and that the technology used is explained in detail by the physician. However, there were large differences among groups (mainly defined by education level) in the way AI is perceived and accepted.

Osteomyelitis pubis (OP) is a rare type of infection involving the pubic bones that often poses diagnostic and consecutive therapeutic problems. The infection can be mono or polymicrobial, bacterial, mycotic or bacillary with Staphylococcus aureus being the most common infectious agent involved. OP is generally seen in immune-suppressed patients of oncologic and diabetic population or in pediatric and geriatric subjects. The main symptom is represented by local pain with radiation to thighs which in later stages is accompanied by general non-specific symptoms such as malaise, fever and loss of appetite. The specificity-lacking initial presentation often leads to diagnostic delays which furthermore decrease the effectiveness of drug therapy, leading to higher chances of bone and joint destruction. Initial therapy consists of empirical antibiotherapy that should cover Staph. aureus; depending on culture results, the scheme should be changed accordingly. Moreover, symptomatic treatment of pain and inflammation consisting of NSAIDs, small dose glucocorticoids and minor opioids should be considered. Selected cases may benefit from surgical intervention when improvement or remission is considered improbable under drug therapy or when severe bony destructions are present.

Relapsing polychondritis (RP) is an auto-immune disease which affects the cartilaginous parts of sites like the ear, nose or upper respiratory tract. The condition can also involve other cartilage-containing structures such as the eyes, joints, the heart, kidneys and central nervous system. Early diagnosis of RPis essential for preventing significant damage to vital organs that can lead to increased morbi-mortality rates. First-line therapy in RP is systemic glucocorticoids, while in refractory cases monoclonal antibodies can be used despite scarcity of efficacy data available in published literature. The link between RP and neoplasia, especially hematological malignancy, should not be omitted when screening patients with suspicion of RP diagnosis. The onset of COVID-19 pandemic has generated a new source of immune mediated pathologies, such as small vessel vasculitis, immune thrombocytopenic purpura or Guillain-Barre syndrome and other auto-inflammatory syndromes triggered by COVID-19 seem to unveil. The present case depicts a female patient who presented with erythematous and painful areas of her right ear after priorly experiencing similar episodes in both ears and nose bridge shortly after having the COVID-19 vaccine booster dose.

Anti-MDA-5 dermatomyositis (DM) is a rare disease subtype characterized by rapidly progressive interstitial lung disease alongside skin, vascular and visceral involvement. The severity of the pulmonary disease is corelated with a weaker prognosis. A 31-year-old female patient was admitted for hand arthritis, upper girdle pain and multiple erythematous papular facial lesions on the face, digital ulcerations and Raynaud’s. The symptoms started immediately after the onset of the SARSCoV-2 infection. Positive anti-MDA5 and anti-centromere antibodies were identified, thus amyopathic DM - CREST syndrome overlap diagnosis was placed. Due to pulmonary involvement, corticosteroids, immunomodulatory drugs (mycophenolate mofetil, hydroxychloroquine, cyclophosphamide) were initiated, with no clinical benefits. Lack of response led to initiation of rituximab, oral tacrolimus and nintedanib with no apparent progression of the disease. Refractory cases require escalation of the standard therapeutic approach. SARS-CoV-2 infection can represent a trigger of autoimmunity in DM which needs to be further assessed.