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2. Adolescent gender dysphoria management: position paper from the Italian Academy of Pediatrics, the Italian Society of Pediatrics, the Italian Society for Pediatric Endocrinology and Diabetes, the Italian Society of Adolescent Medicine and the Italian Society of Child and Adolescent Neuropsychiatry

Author

Calcaterra, V, Tornese, G, Zuccotti, G, Staiano, A, Cherubini, V, Gaudino, R, Fazzi, E, Barbi, E, Chiarelli, F, Corsello, G, Esposito, S, Ferrara, P, Iughetti, L, Laforgia, N, Maghnie, M, Marseglia, G, Perilongo, G, Pettoello-Mantovani, M, Ruggieri, M, Russo, G, Salerno, M, Striano, P, Valerio, G, Wasniewska, M, Agosti, M, Agostoni, C, Aiuti, A, Azzari, C, Badolato, R, Balduzzi, A, Baraldi, E, Canani, R, Biffi, A, Biondi, A, Bisogno, G, Pierri, N, Carnielli, V, Cianfarani, S, Cogo, P, Corvaglia, L, Dani, C, Di Salvo, G, Fagioli, F, Fanos, V, Ferrero, G, Francavilla, R, Galli, L, Gazzolo, D, Giaquinto, C, Giordano, P, Gitto, E, Grosso, S, Guarino, A, Indrio, F, Lanari, M, Lionetti, P, Locatelli, F, Lombardo, F, Maffeis, C, Marino, B, Midulla, F, Del Giudice, E, Del Giudice, M, Montini, G, Parenti, G, Parisi, P, Peroni, D, Perrotta, S, Piacentini, G, Pietrobelli, A, Raimondi, F, Ramenghi, U, Ravelli, A, Romano, C, Rossi, F, Rossi, P, Damiano, V, Spalice, A, Suppiej, A, Troncone, R, Verrotti, A, Null, N, Calcaterra, Valeria, Tornese, Gianluca, Zuccotti, Gianvincenzo, Staiano, Annamaria, Cherubini, Valentino, Gaudino, Rossella, Fazzi, Elisa Maria, Barbi, Egidio, Chiarelli, Francesco, Corsello, Giovanni, Esposito, Susanna Maria Roberta, Ferrara, Pietro, Iughetti, Lorenzo, Laforgia, Nicola, Maghnie, Mohamad, Marseglia, Gianluigi, Perilongo, Giorgio, Pettoello-Mantovani, Massimo, Ruggieri, Martino, Russo, Giovanna, Salerno, Mariacarolina, Striano, Pasquale, Valerio, Giuliana, Wasniewska, Malgorzata, Agosti, Massimo, Agostoni, Carlo Virginio, Aiuti, Alessandro, Azzari, Chiara, Badolato, Raffaele, Balduzzi, Adriana, Baraldi, Eugenio, Canani, Roberto Berni, Biffi, Alessandra, Biondi, Andrea, Bisogno, Gianni, Pierri, Nicola Brunetti, Carnielli, Virginio, Cianfarani, Stefano, Cogo, Paola, Corvaglia, Luigi, Dani, Carlo, Di Salvo, Giovanni, Fagioli, Franca, Fanos, Vassilios, Ferrero, Giovanni Battista, Francavilla, Ruggiero, Galli, Luisa, Gazzolo, Diego, Giaquinto, Carlo, Giordano, Paola, Gitto, Eloisa, Grosso, Salvatore, Guarino, Alfredo, Indrio, Flavia, Lanari, Marcello, Lionetti, Paolo, Locatelli, Franco, Lombardo, Fortunato, Maffeis, Claudio, Marino, Bruno, Midulla, Fabio, Del Giudice, Emanuele Miraglia, Del Giudice, Michele Miraglia, Montini, Giovanni, Parenti, Giancarlo, Parisi, Pasquale, Peroni, Diego, Perrotta, Silverio, Piacentini, Giorgio, Pietrobelli, Angelo, Raimondi, Francesco, Ramenghi, Ugo, Ravelli, Angelo, Romano, Claudio, Rossi, Francesca, Rossi, Paolo, Damiano, Vincenzo Salpietro, Spalice, Alberto, Suppiej, Agnese, Troncone, Riccardo, Verrotti, Alberto, null, null, Calcaterra, V, Tornese, G, Zuccotti, G, Staiano, A, Cherubini, V, Gaudino, R, Fazzi, E, Barbi, E, Chiarelli, F, Corsello, G, Esposito, S, Ferrara, P, Iughetti, L, Laforgia, N, Maghnie, M, Marseglia, G, Perilongo, G, Pettoello-Mantovani, M, Ruggieri, M, Russo, G, Salerno, M, Striano, P, Valerio, G, Wasniewska, M, Agosti, M, Agostoni, C, Aiuti, A, Azzari, C, Badolato, R, Balduzzi, A, Baraldi, E, Canani, R, Biffi, A, Biondi, A, Bisogno, G, Pierri, N, Carnielli, V, Cianfarani, S, Cogo, P, Corvaglia, L, Dani, C, Di Salvo, G, Fagioli, F, Fanos, V, Ferrero, G, Francavilla, R, Galli, L, Gazzolo, D, Giaquinto, C, Giordano, P, Gitto, E, Grosso, S, Guarino, A, Indrio, F, Lanari, M, Lionetti, P, Locatelli, F, Lombardo, F, Maffeis, C, Marino, B, Midulla, F, Del Giudice, E, Del Giudice, M, Montini, G, Parenti, G, Parisi, P, Peroni, D, Perrotta, S, Piacentini, G, Pietrobelli, A, Raimondi, F, Ramenghi, U, Ravelli, A, Romano, C, Rossi, F, Rossi, P, Damiano, V, Spalice, A, Suppiej, A, Troncone, R, Verrotti, A, Null, N, Calcaterra, Valeria, Tornese, Gianluca, Zuccotti, Gianvincenzo, Staiano, Annamaria, Cherubini, Valentino, Gaudino, Rossella, Fazzi, Elisa Maria, Barbi, Egidio, Chiarelli, Francesco, Corsello, Giovanni, Esposito, Susanna Maria Roberta, Ferrara, Pietro, Iughetti, Lorenzo, Laforgia, Nicola, Maghnie, Mohamad, Marseglia, Gianluigi, Perilongo, Giorgio, Pettoello-Mantovani, Massimo, Ruggieri, Martino, Russo, Giovanna, Salerno, Mariacarolina, Striano, Pasquale, Valerio, Giuliana, Wasniewska, Malgorzata, Agosti, Massimo, Agostoni, Carlo Virginio, Aiuti, Alessandro, Azzari, Chiara, Badolato, Raffaele, Balduzzi, Adriana, Baraldi, Eugenio, Canani, Roberto Berni, Biffi, Alessandra, Biondi, Andrea, Bisogno, Gianni, Pierri, Nicola Brunetti, Carnielli, Virginio, Cianfarani, Stefano, Cogo, Paola, Corvaglia, Luigi, Dani, Carlo, Di Salvo, Giovanni, Fagioli, Franca, Fanos, Vassilios, Ferrero, Giovanni Battista, Francavilla, Ruggiero, Galli, Luisa, Gazzolo, Diego, Giaquinto, Carlo, Giordano, Paola, Gitto, Eloisa, Grosso, Salvatore, Guarino, Alfredo, Indrio, Flavia, Lanari, Marcello, Lionetti, Paolo, Locatelli, Franco, Lombardo, Fortunato, Maffeis, Claudio, Marino, Bruno, Midulla, Fabio, Del Giudice, Emanuele Miraglia, Del Giudice, Michele Miraglia, Montini, Giovanni, Parenti, Giancarlo, Parisi, Pasquale, Peroni, Diego, Perrotta, Silverio, Piacentini, Giorgio, Pietrobelli, Angelo, Raimondi, Francesco, Ramenghi, Ugo, Ravelli, Angelo, Romano, Claudio, Rossi, Francesca, Rossi, Paolo, Damiano, Vincenzo Salpietro, Spalice, Alberto, Suppiej, Agnese, Troncone, Riccardo, Verrotti, Alberto, and null, null

Abstract

Background In response to the imperative need for standardized support for adolescent Gender Dysphoria (GD), the Italian Academy of Pediatrics, in collaboration with the Italian Society of Pediatrics, the Italian Society for Pediatric Endocrinology and Diabetes, Italian Society of Adolescent Medicine and Italian Society of Child and Adolescent Neuropsychiatry is drafting a position paper. The purpose of this paper is to convey the author's opinion on the topic, offering foundational information on potential aspects of gender-affirming care and emphasizing the care and protection of children and adolescents with GD.Main body Recognizing that adolescents may choose interventions based on their unique needs and goals and understanding that every individual within this group has a distinct trajectory, it is crucial to ensure that each one is welcomed and supported. The approach to managing individuals with GD is a multi-stage process involving a multidisciplinary team throughout all phases. Decisions regarding treatment should be reached collaboratively by healthcare professionals and the family, while considering the unique needs and circumstances of the individual and be guided by scientific evidence rather than biases or ideologies. Politicians and high court judges should address discrimination based on gender identity in legislation and support service development that aligns with the needs of young people. It is essential to establish accredited multidisciplinary centers equipped with the requisite skills and experience to effectively manage adolescents with GD, thereby ensuring the delivery of high-quality care.Conclusion Maintaining an evidence-based approach is essential to safeguard the well-being of transgender and gender diverse adolescents.

Published
2024

3. Validation of Indirect Calorimetry in Children Undergoing Single-Limb Non-Invasive Ventilation: A Proof of Concept, Cross-Over Study

Author

D’Oria, V, Spolidoro, G, Agostoni, C, Montani, C, Ughi, L, Villa, C, Marchesi, T, Babini, G, Scalia Catenacci, S, Donà, G, Guerrini, M, Chidini, G, Calderini, E, Langer, T, D’Oria, Veronica, Spolidoro, Giulia Carla Immacolata, Agostoni, Carlo Virginio, Montani, Cinzia, Ughi, Ludovica, Villa, Cristina, Marchesi, Tiziana, Babini, Giovanni, Scalia Catenacci, Stefano, Donà, Giada, Guerrini, Marta, Chidini, Giovanna, Calderini, Edoardo, Langer, Thomas, D’Oria, V, Spolidoro, G, Agostoni, C, Montani, C, Ughi, L, Villa, C, Marchesi, T, Babini, G, Scalia Catenacci, S, Donà, G, Guerrini, M, Chidini, G, Calderini, E, Langer, T, D’Oria, Veronica, Spolidoro, Giulia Carla Immacolata, Agostoni, Carlo Virginio, Montani, Cinzia, Ughi, Ludovica, Villa, Cristina, Marchesi, Tiziana, Babini, Giovanni, Scalia Catenacci, Stefano, Donà, Giada, Guerrini, Marta, Chidini, Giovanna, Calderini, Edoardo, and Langer, Thomas

Abstract

Background: The accurate assessment of resting energy expenditure (REE) is essential for personalized nutrition, particularly in critically ill children. Indirect calorimetry (IC) is the gold standard for measuring REE. This methodology is based on the measurement of oxygen consumption (VO2) and carbon dioxide production (VCO2). These parameters are integrated into the Weir equation to calculate REE. Additionally, IC facilitates the determination of the respiratory quotient (RQ), offering valuable insights into a patient's carbohydrate and lipid consumption. IC validation is limited to spontaneously breathing and mechanically ventilated patients, but it is not validated in patients undergoing non-invasive ventilation (NIV). This study investigates the application of IC during NIV-CPAP (continuous positive airway pressure) and NIV-PS (pressure support). Methods: This study was conducted in the Pediatric Intensive Care Unit of IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, between 2019 and 2021. Children < 6 years weaning from NIV were enrolled. IC was performed during spontaneous breathing (SB), NIV-CPAP, and NIV-PS in each patient. A Bland-Altman analysis was employed to compare REE, VO2, VCO2, and RQ measured by IC. Results: Fourteen patients (median age 7 (4; 18) months, median weight 7.7 (5.5; 9.7) kg) were enrolled. The REE, VO2, VCO2, and RQ did not differ significantly between the groups. The Limits of Agreement (LoA) and bias of REE indicated good agreement between SB and NIV-CPAP (LoA +28.2, -19.4 kcal/kg/day; bias +4.4 kcal/kg/day), and between SB and NIV-PS (LoA -22.2, +23.1 kcal/kg/day; bias 0.4 kcal/kg/day). Conclusions: These preliminary findings support the accuracy of IC in children undergoing NIV. Further validation in a larger cohort is warranted.

Published
2024

4. Risk factors and scores for prediction of coronary artery aneurysms in Kawasaki disease: a European monocentric study

Author

La Vecchia, A, Stracquadaino, R, Mauri, L, Baselli, L, Abdallah, R, Cucchetti, M, Colli, A, Agostoni, C, Dellepiane, R, La Vecchia, Adriano, Stracquadaino, Rita, Mauri, Lucia, Baselli, Lucia Augusta, Abdallah, Rozan, Cucchetti, Martina, Colli, Anna Maria, Agostoni, Carlo, Dellepiane, Rosa Maria, La Vecchia, A, Stracquadaino, R, Mauri, L, Baselli, L, Abdallah, R, Cucchetti, M, Colli, A, Agostoni, C, Dellepiane, R, La Vecchia, Adriano, Stracquadaino, Rita, Mauri, Lucia, Baselli, Lucia Augusta, Abdallah, Rozan, Cucchetti, Martina, Colli, Anna Maria, Agostoni, Carlo, and Dellepiane, Rosa Maria

Abstract

Background: Japanese Kawasaki disease (KD) risk scores cannot be adopted in non-Japanese patients. In North American populations a baseline coronary artery Z-score > 2 and the Son score are associated with coronary artery aneurysms (CAAs) at 4 and 8 weeks from disease onset. In European populations, the Kawanet and Kawanet-echo scores are associated with intravenous immunoglobulin resistance. This study aims to evaluate the association between KD risk scores and baseline coronary artery Z-scores with CAAs at one, two, and six months in a European population. Methods: Historical cohort study of all the children diagnosed with KD in a tertiary care hospital in Milan, Italy, between 1st January 2015 and 31st May 2021. Univariate and multivariate (adjusting for age and corticosteroid therapy) logistic regression analyses were used to study the association between the risk scores, a baseline Z-score ≥ 2 and ≥ 2.5 with CAAs. Results: Eighty-nine patients were diagnosed with KD at our Centre, and 12 were excluded based on the exclusion criteria. We included 77 patients, 51 (66%) males, and 26 (34%) females, with a median age at presentation of 27 months (IQR 13–46). A baseline Z-score ≥ 2 was correlated with CAAs at one and two-month follow-ups (odds ratio (OR) 10, 95% confidence interval (CI) 2–72, and OR 18, CI 3-357) but not at six-month follow-up. The Son score showed an association with one and two-month follow-up CAAs (OR 3, CI 1.3-7, and OR 3, CI 1.3-8) but not with a six-month follow-up. Conclusions: Patients with a baseline Z-score ≥ 2 are at higher risk for CAAs in the long term. The Son score should be tested in larger European samples. Further studies should keep the observational periods longer than 8 weeks from KD onset.

Published
2024

5. Clinical and laboratory parameters associated with febrile seizure recurrence within the first 24 h: a ten-year cohort study

Author

Castellazzi, M, La Vecchia, A, Scali, M, Agostoni, C, Di Pietro, G, Milani, G, Castellazzi, Massimo Luca, La Vecchia, Adriano, Scali, Martina, Agostoni, Carlo, Di Pietro, Giada, Milani, Gregorio Paolo, Castellazzi, M, La Vecchia, A, Scali, M, Agostoni, C, Di Pietro, G, Milani, G, Castellazzi, Massimo Luca, La Vecchia, Adriano, Scali, Martina, Agostoni, Carlo, Di Pietro, Giada, and Milani, Gregorio Paolo

Abstract

Introduction: We assessed clinical and laboratory parameters associated with early recurrence of febrile seizure in patients presenting at the Emergency Department with a first episode. Methods: Case series of patients admitted to the emergency department with the first episode of febrile seizure for ten consecutive years. Exclusion criteria were focal features and prolonged duration (>15 min). Results: We included 693 patients, 284 (41%) female. Median age of 20 (IQR 15–27) months. Fifty-two (8%) patients had a recurrence within 24 h. At univariate analysis, patients with recurrent seizures had higher use of antipyretics (88% vs. 74%, P = 0.03, OR 2.6, 95% CI: 1.1–7.7), higher median maximal body temperature (39.3 °C, IQR 38.9–39.9, vs. 38.9, IQR 38.4–39.3, P < 0.001, OR 2.3, 95% CI: 1.5–2.6) and presented with a lower proportion of respiratory tract infections (54% vs. 70%, P = 0.02) compared to patients without recurrence. A maximal body temperature equal to or higher than 39 °C was associated with a higher recurrence (11% vs. 4%, P < 0.001, OR 2.9, 95% CI: 1.6–5.6). Hyponatremia was not associated with a risk of recurrence. The multivariate analysis confirmed a direct association with body temperature (OR 2.3, 95% CI: 1.5–3.7, P < 0.001), and an inverse association with respiratory tract infections (OR 0.4, 95% CI: 0.2–0.9, P = 0.01), while antipyretic use was not correlated (OR 1.9, 95% CI: 0.8–5.2, P = 0.2). Conclusions: High body temperature and respiratory tract infections were (directly and inversely) associated with recurrences. Consideration of these conditions might help for anticipating the probability of recurrence.

Published
2024

6. Adequate calcium intake during long periods improves bone mineral density in healthy children. Data from the Childhood Obesity Project

Author

Closa-Monasterolo, R., Escribano, J., Ferré, N., Gispert-Llauradó, M., Luque, V., Rubio-Torrents, C., Zaragoza-Jordana, M., Beyer, J., Fritsch, M., Haile, G., Handel, U., Hannibal, I., Koletzko, B., Kreichauf, S., Pawellek, I., Schiess, S., Verwied-Jorky, S., von Kries, R., Weber, M., Dobrzańska, A., Gruszfeld, D., Janas, R., Wierzbicka, A., Socha, P., Stolarczyk, A., Socha, J., Carlier, C., Dain, E., Goyens, P., Van Hees, J.N., Hoyos, J., Langhendries, J.P., Martin, F., Poncelet, P., Xhonneux, A., Perrin, E., Agostoni, C., Giovannini, M., Dionigi, A. Re, Riva, E., Scaglioni, S., Vecchi, F., Verducci, E., Closa-Monasterolo, Ricardo, Zaragoza-Jordana, Marta, Ferré, Natàlia, Luque, Veronica, Grote, Veit, Koletzko, Berthold, Verduci, Elvira, Vecchi, Fiammetta, and Escribano, Joaquin

Published
2018
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7. Micronutrient intake adequacy in children from birth to 8 years. Data from the Childhood Obesity Project

Author

Closa-Monasterolo, R., Escribano, J., Ferré, N., Gispert-Llauradó, M., Rubio-Torrents, C., Luque, V., Zaragoza-Jordana, M., Beyer, J., Fritsch, M., Haile, G., Handel, U., Hannibal, I., Koletzko, B., Kreichauf, S., Pawellek, I., Schiess, S., Verwied-Jorky, S., von Kries, R., Weber, M., Dobrzańska, A., Gruszfeld, D., Janas, R., Wierzbicka, A., Socha, P., Stolarczyk, A., Socha, J., Carlier, C., Dain, E., Goyens, P., Van Hees, J.N., Hoyos, J., Langhendries, J.P., Martin, F., Poncelet, P., Xhonneux, A., Perrin, E., Agostoni, C., Giovannini, M., Re Dionigi, A., Riva, E., Scaglioni, S., Vecchi, F., Verducci, E., Zaragoza-Jordana, Marta, Closa-Monasterolo, Ricardo, Luque, Veronica, Ferré, Natàlia, Grote, Veit, Koletzko, Berthold, Pawellek, Ingrid, Verduci, Elvira, ReDionigi, Alice, Socha, Jerzy, Stolarczyk, Anna, Poncelet, Pascale, Rousseaux, Déborah, and Escribano, Joaquin

Published
2018
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8. Diagnosis and management of urinary tract infections in children aged 2 months to 3 years in the Italian emergency units: the ItaUTI study

Author

Cenzato, F, Milani, G, Amigoni, A, Sperotto, F, Bianchetti, M, Agostoni, C, Montini, G, Farello, G, Chiarelli, F, Greco, R, Di Lollo, F, Rocco Forte, F, Manieri, S, Carpino, L, Caloiero, M, Cirisano, A, Bragho, S, Della Casa, R, Nunziata, F, Pecoraro, C, Pacifico, R, Lanari, M, Ghizzi, C, Serra, L, Stella, M, Maggiore, G, Fiorini, R, Dodi, I, Morelli, A, Lughetti, L, Cella, A, Vergine, G, De Fanti, A, Dragovic, D, Santori, D, Cozzi, G, Cogo, P, Raponi, M, Lubrano, R, de Martinis, M, Gatto, A, Barbieri, M, Reale, A, Bracaglia, G, Piccotti, E, Borea, R, Gaiero, A, Martelli, L, Arrighini, A, Cianci, P, Cavalli, C, De Santis, L, Pietra, B, Biondi, A, Sala, M, Pogliani, L, Cherubini, S, Bellini, M, Bruni, P, Traina, G, Tommasi, P, Del Barba, P, Arrigoni, S, Salvini, F, Bernardo, L, Bertolozzi, G, Fasoli, S, Marseglia, G, Palumbo, E, Bosco, A, Mirri, G, Fabiani, E, Ruffini, E, Pieragostini, L, Fornaro, M, Ripanti, G, Pannoni, D, Enrico, F, Perona, A, Tappi, E, Nis Haitink, O, Rabbone, I, Capalbo, P, Urbino, A, Guala, A, Cosi, G, Barracchia, M, Martire, B, Cardinale, F, Moramarco, F, Perrone, C, Campanozzi, A, Cecinati, V, Canetto, A, Clemente, C, Cualbu, A, Narducci, F, Mula, G, Bulciolu, P, Antonucci, R, Gramaglia, G, Cavaleri, G, Salpietro, C, Corsello, G, Salvo, R, Palmeri, M, Vitale, M, Morgano, A, Falorni, S, Peroni, D, Masi, S, Bertini, A, Vaccaro, A, Vasarri, P, Reinstadler, P, Soffiati, M, Stefanelli, M, Verrotti di Pianella, A, Bertone, C, Marzini, S, Da Dalt, L, Rugolotto, S, Scozzola, F, Ecclesio Livio, L, Cinquetti, M, Silvagni, D, Bellettato, M, Cenzato F., Milani G. P., Amigoni A., Sperotto F., Bianchetti M. G., Agostoni C., Montini G., Farello G., Chiarelli F., Greco R., Di Lollo F., Rocco Forte F., Manieri S., Carpino L., Caloiero M., Cirisano A., Bragho S., Della Casa R., Nunziata F., Pecoraro C., Pacifico R., Lanari M., Ghizzi C., Serra L., Stella M., Maggiore G., Fiorini R., Dodi I., Morelli A., Lughetti L., Cella A., Vergine G., De Fanti A., Dragovic D., Santori D., Cozzi G., Cogo P., Raponi M., Lubrano R., de Martinis M., Gatto A., Barbieri M. A., Reale A., Bracaglia G., Piccotti E., Borea R., Gaiero A., Martelli L., Arrighini A., Cianci P., Cavalli C., De Santis L., Pietra B. C., Biondi A., Sala M., Pogliani L. M., Cherubini S., Bellini M., Bruni P., Traina G., Tommasi P., Del Barba P., Arrigoni S., Salvini F. M., Bernardo L., Bertolozzi G., Fasoli S., Marseglia G. L., Palumbo E., Bosco A., Mirri G., Fabiani E., Ruffini E., Pieragostini L., Fornaro M., Ripanti G., Pannoni D., Enrico F., Perona A., Tappi E., Nis Haitink O., Rabbone I., Capalbo P. T., Urbino A., Guala A., Cosi G., Barracchia M. G., Martire B., Cardinale F., Moramarco F., Perrone C., Campanozzi A., Cecinati V., Canetto A., Clemente C., Cualbu A., Narducci F., Mula G., Bulciolu P., Antonucci R., Gramaglia G., Cavaleri G., Salpietro C., Corsello G., Salvo R., Palmeri M., Vitale M. A., Morgano A., Falorni S., Peroni D., Masi S., Bertini A., Vaccaro A., Vasarri P., Reinstadler P., Soffiati M., Stefanelli M., Verrotti di Pianella A., Bertone C., Marzini S., Da Dalt L., Rugolotto S., Scozzola F., Ecclesio Livio L., Cinquetti M., Silvagni D., Bellettato M., Cenzato, F, Milani, G, Amigoni, A, Sperotto, F, Bianchetti, M, Agostoni, C, Montini, G, Farello, G, Chiarelli, F, Greco, R, Di Lollo, F, Rocco Forte, F, Manieri, S, Carpino, L, Caloiero, M, Cirisano, A, Bragho, S, Della Casa, R, Nunziata, F, Pecoraro, C, Pacifico, R, Lanari, M, Ghizzi, C, Serra, L, Stella, M, Maggiore, G, Fiorini, R, Dodi, I, Morelli, A, Lughetti, L, Cella, A, Vergine, G, De Fanti, A, Dragovic, D, Santori, D, Cozzi, G, Cogo, P, Raponi, M, Lubrano, R, de Martinis, M, Gatto, A, Barbieri, M, Reale, A, Bracaglia, G, Piccotti, E, Borea, R, Gaiero, A, Martelli, L, Arrighini, A, Cianci, P, Cavalli, C, De Santis, L, Pietra, B, Biondi, A, Sala, M, Pogliani, L, Cherubini, S, Bellini, M, Bruni, P, Traina, G, Tommasi, P, Del Barba, P, Arrigoni, S, Salvini, F, Bernardo, L, Bertolozzi, G, Fasoli, S, Marseglia, G, Palumbo, E, Bosco, A, Mirri, G, Fabiani, E, Ruffini, E, Pieragostini, L, Fornaro, M, Ripanti, G, Pannoni, D, Enrico, F, Perona, A, Tappi, E, Nis Haitink, O, Rabbone, I, Capalbo, P, Urbino, A, Guala, A, Cosi, G, Barracchia, M, Martire, B, Cardinale, F, Moramarco, F, Perrone, C, Campanozzi, A, Cecinati, V, Canetto, A, Clemente, C, Cualbu, A, Narducci, F, Mula, G, Bulciolu, P, Antonucci, R, Gramaglia, G, Cavaleri, G, Salpietro, C, Corsello, G, Salvo, R, Palmeri, M, Vitale, M, Morgano, A, Falorni, S, Peroni, D, Masi, S, Bertini, A, Vaccaro, A, Vasarri, P, Reinstadler, P, Soffiati, M, Stefanelli, M, Verrotti di Pianella, A, Bertone, C, Marzini, S, Da Dalt, L, Rugolotto, S, Scozzola, F, Ecclesio Livio, L, Cinquetti, M, Silvagni, D, Bellettato, M, Cenzato F., Milani G. P., Amigoni A., Sperotto F., Bianchetti M. G., Agostoni C., Montini G., Farello G., Chiarelli F., Greco R., Di Lollo F., Rocco Forte F., Manieri S., Carpino L., Caloiero M., Cirisano A., Bragho S., Della Casa R., Nunziata F., Pecoraro C., Pacifico R., Lanari M., Ghizzi C., Serra L., Stella M., Maggiore G., Fiorini R., Dodi I., Morelli A., Lughetti L., Cella A., Vergine G., De Fanti A., Dragovic D., Santori D., Cozzi G., Cogo P., Raponi M., Lubrano R., de Martinis M., Gatto A., Barbieri M. A., Reale A., Bracaglia G., Piccotti E., Borea R., Gaiero A., Martelli L., Arrighini A., Cianci P., Cavalli C., De Santis L., Pietra B. C., Biondi A., Sala M., Pogliani L. M., Cherubini S., Bellini M., Bruni P., Traina G., Tommasi P., Del Barba P., Arrigoni S., Salvini F. M., Bernardo L., Bertolozzi G., Fasoli S., Marseglia G. L., Palumbo E., Bosco A., Mirri G., Fabiani E., Ruffini E., Pieragostini L., Fornaro M., Ripanti G., Pannoni D., Enrico F., Perona A., Tappi E., Nis Haitink O., Rabbone I., Capalbo P. T., Urbino A., Guala A., Cosi G., Barracchia M. G., Martire B., Cardinale F., Moramarco F., Perrone C., Campanozzi A., Cecinati V., Canetto A., Clemente C., Cualbu A., Narducci F., Mula G., Bulciolu P., Antonucci R., Gramaglia G., Cavaleri G., Salpietro C., Corsello G., Salvo R., Palmeri M., Vitale M. A., Morgano A., Falorni S., Peroni D., Masi S., Bertini A., Vaccaro A., Vasarri P., Reinstadler P., Soffiati M., Stefanelli M., Verrotti di Pianella A., Bertone C., Marzini S., Da Dalt L., Rugolotto S., Scozzola F., Ecclesio Livio L., Cinquetti M., Silvagni D., and Bellettato M.

Abstract

Urinary tract infections (UTIs) are among the most frequent bacterial diseases in infants and children. Physician adherence to recommendations is notoriously often poor, but no data are available on UTIs management in the emergency setting. In this multicenter national study, we investigated the policies regarding UTIs management in children aged 2 months to 3 years in Italian emergency units. Between April and June 2021, directors of the emergency units were invited to answer an online survey on the following items: diagnostic approach to children with fever without an apparent source, therapeutic approach to UTIs, the use of kidney and urinary tract ultrasound, and the criteria for hospitalization. A total of 121 (89%) out of 139 of invited units participated in the study. Overall, units manage children with a suspected or confirmed UTI according to available recommendations for most of the items. However, in almost 80% (n = 94) of units, a sterile perineal bag is used to collect urine for culture. When urine is collected by cathether, heterogeneity exists on the threshold of bacterial load considered for UTI diagnosis. Conclusions: Available recommendations on UTIs in children are followed by Italian emergency units for most of the items. However, the methods to collect urine specimens for culture, one of the crucial steps of the diagnostic work-up, often do not align with current recommendations and CFU thresholds considered for diagnosis largely vary among centers. Efforts should be addressed to validate and implement new child and family friendly urine collection techniques.What is Known:• Several guidelines are published on the management of children with suspected or confirmed urinary tract infection.• No data are available on the management of pediatric urinary tract infections in the emergency setting.What is New:• Almost 80% of the Italian emergency units employ a sterile perineal bag to collect urine for culture.• Diagnostic

Published
2022

10. Distance learning, technological devices, lifestyle and behavior of children and their family during the COVID-19 lockdown in Lombardy: a survey

Author

Picca, M, Manzoni, P, Milani, G, Mantovani, S, Cravid, C, Mariani, D, Mezzopane, A, Marinello, R, Bove, C, Ferri, P, Macchi, M, Agostoni, C, Picca M., Manzoni P., Milani G. P., Mantovani S., Cravid C., Mariani D., Mezzopane A., Marinello R., Bove C, Ferri P., Macchi M., Agostoni C., Picca, M, Manzoni, P, Milani, G, Mantovani, S, Cravid, C, Mariani, D, Mezzopane, A, Marinello, R, Bove, C, Ferri, P, Macchi, M, Agostoni, C, Picca M., Manzoni P., Milani G. P., Mantovani S., Cravid C., Mariani D., Mezzopane A., Marinello R., Bove C, Ferri P., Macchi M., and Agostoni C.

Abstract

Background: The COVID-19 pandemic and the subsequent national lockdowns, school closures and distance learning may have had both negative and positive effects on physical and mental health of children. Methods: A cross-sectional study was conducted on a large group of children between 1 and 10 years old in Lombardy, Italy (n = 3392). Their parents filled in a survey answering single or multiple-choice questions about their offspring’s behavior changes (including sleep, dietary habits, emotional disturbances), relationship with siblings, parents and peers, the use of digital technologies, and distance learning experience during the lockdown. Results: Parents reported lifestyles and emotional alterations during the lockdown. The modifications of family relationships, parents’ remote working, and screen time were associated with sleep, emotional and behavioral modifications. Distance learning was overall considered adequate. Conclusions: This study reported the most updated data on the effects of COVID-19 pandemic lockdown on children between 1 and 10 years of age in a large sample of Italian schoolchildren. The results of this study point out that pediatricians and authorities should support relationships within families during the COVID-19 pandemic. Parents’ remote working might play an important role for this purpose.

Published
2021

12. Contributors

Author

Agostoni, C., primary, Andreae, D., additional, Berti, C., additional, Bhutta, Z.A., additional, Boccella, J.H., additional, Carvalho, R.S., additional, Catassi, C., additional, Closa-Monasterolo, R., additional, Czerkies, L.A., additional, Dattilo, A.M., additional, de Waard, M., additional, Escribano Subias, J., additional, Ferré Pallas, N., additional, Giannì, M.L., additional, Huysentruyt, K., additional, Imdad, A., additional, Kalhoff, H., additional, Kalliomaki, M., additional, Kersting, M., additional, Koletzko, B., additional, Kouwenhoven, S.M., additional, Laitinen, K., additional, Lassi, Z., additional, Lionetti, E., additional, Luque Moreno, V., additional, Mokkala, K., additional, Mosca, F., additional, Nowak-Węgrzyn, A., additional, Oken, E., additional, Palmer, D.J., additional, Perng, W., additional, Reidy, K.C., additional, Ross, E., additional, Saavedra, J.M., additional, Salaam, R., additional, Squatrito, C., additional, van Goudoever, J.B., additional, Vandenplas, Y., additional, Vickers, M.H., additional, and Young, B.E., additional

Published
2017
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13. Breast milk composition and infant nutrient intakes during the first 12 months of life

Author

Grote, V., Verduci, E., Scaglioni, S., Vecchi, F., Contarini, G., Giovannini, M., Koletzko, B., and Agostoni, C.

Subjects
Breast milk -- Nutritional aspects, Infants -- Food and nutrition, Food/cooking/nutrition, Health
Abstract

BACKGROUND/OBJECTIVES: The objective of this study was to quantify human milk supply and intake of breastfed infants up to age 12 months. In addition, human milk composition was quantified per energetic macronutrient and fatty-acid composition in a subsample of lactating mothers. SUBJECTS/METHODS: One hundred and seventy-four Italian breastfed children were followed using test-weighing and 3-day food protocols from birth to age 12 months. From a subsample of 30 mothers breast milk samples were collected at child ages one (T1), two (T2), three (T3) and six (T6) months, and were analyzed for the amount of protein, digestible carbohydrates, total lipids and fatty-acid composition. RESULTS: One hundred and forty-two (82%) filled in at least one 3-day food protocol within the first 12 months of life and complied with test-weighing of all milk feeds. The number of valid food protocols declined from 126 infants at 1 month to 77 at 12 months of age. Only galactose, non-protein nitrogen and protein decreased significantly from age 1 to age 6 months of lactation. Maternal body mass index and age affected fatty-acid levels in human milk. Median human milk intake decreased from 625 ml at T1, over 724 ml at T3 to 477 ml/day at T6. Average energy and %energy from protein intake per day increased from 419 kcal (s.d. 99) and 8.4% (1.0) at T1, respectively, to 860 kcal (145) and 16.1% (2.6) at T12. CONCLUSIONS: These data provide a reference range of nutrient intakes in breastfed infants and may provide guidance for defining optimal nutrient intakes for infants that cannot be fully breastfed. European Journal of Clinical Nutrition (2016) 70, 250-256; doi:10.1038/ejcn.2015.162; published online 30 September 2015, INTRODUCTION Infants should be exclusively breastfed during the first months of life with continued breastfeeding after timely introduction of complementary feeding. (1) In addition to providing a generally adequate nutrient [...]

Published
2016
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15. Insulin Like Growth Factor Regulation of Body Mass in Breastfed and Milk Formula Fed Infants : Data from the EU Childhood Obesity Programme

Author

EU Childhood Obesity Study Team, Socha, P., Janas, R., Dobrzañska, A., Koletzko, B., Broekaert, I., Brasseur, D., Sengier, A., Giovannini, M., Agostoni, C., Monasterolo, R. Closa, Méndez, G., Back, Nathan, editor, Cohen, Irun R., editor, Kritchevsky, David, editor, Lajtha, Abel, editor, Paoletti, Rodolfo, editor, Koletzko, Berthold, editor, Dodds, Peter, editor, Akerblom, Hans, editor, and Ashwell, Margaret, editor

Published
2005
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16. Children with covid-19 in pediatric emergency departments in Italy

Author

Parri, N, Lenge, M, Buonsenso, D, Cantoni, B, Arrighini, A, Romanengo, M, Urbino, A, Da Dalt, L, Verdoni, L, Limoli, G, Musolino, A, Pilotto, C, La Fauci, G, Chiossi, M, Agostiniani, R, Plebani, A, Barbieri, M, Lanari, M, Masi, S, Giacalone, M, Leo, M, Falconi, M, Indolfi, G, D'Antiga, L, Mazza, A, De Martiis, D, Bertolozzi, G, Marchisio, P, Chidini, G, Calderini, E, Agostoni, C, Gori, A, Bondone, C, Dona, D, Todeschini, M, Scilipoti, M, Cogo, P, Ginocchio, F, Russotto, V, Biban, P, Stera, G, Margherita, M, Maiandi, S, Tubino, B, Chiaretti, A, Zampogna, S, Mazzuca, A, Parri N., Lenge M., Buonsenso D., Cantoni B., Arrighini A., Romanengo M., Urbino A., Da Dalt L., Verdoni L., Limoli G., Musolino A. M., Pilotto C., La Fauci G., Chiossi M., Agostiniani R., Plebani A., Barbieri M. A., Lanari M., Masi S., Giacalone M., Leo M. C., Falconi M., Indolfi G., D'Antiga L., Mazza A., De Martiis D., Bertolozzi G., Marchisio P., Chidini G., Calderini E., Agostoni C., Gori A., Bondone C., Dona D., Todeschini M., Scilipoti M., Cogo P., Ginocchio F., Russotto V. S., Biban P., Stera G., Margherita M., Maiandi S., Tubino B., Chiaretti A., Zampogna S., Mazzuca A., Parri, N, Lenge, M, Buonsenso, D, Cantoni, B, Arrighini, A, Romanengo, M, Urbino, A, Da Dalt, L, Verdoni, L, Limoli, G, Musolino, A, Pilotto, C, La Fauci, G, Chiossi, M, Agostiniani, R, Plebani, A, Barbieri, M, Lanari, M, Masi, S, Giacalone, M, Leo, M, Falconi, M, Indolfi, G, D'Antiga, L, Mazza, A, De Martiis, D, Bertolozzi, G, Marchisio, P, Chidini, G, Calderini, E, Agostoni, C, Gori, A, Bondone, C, Dona, D, Todeschini, M, Scilipoti, M, Cogo, P, Ginocchio, F, Russotto, V, Biban, P, Stera, G, Margherita, M, Maiandi, S, Tubino, B, Chiaretti, A, Zampogna, S, Mazzuca, A, Parri N., Lenge M., Buonsenso D., Cantoni B., Arrighini A., Romanengo M., Urbino A., Da Dalt L., Verdoni L., Limoli G., Musolino A. M., Pilotto C., La Fauci G., Chiossi M., Agostiniani R., Plebani A., Barbieri M. A., Lanari M., Masi S., Giacalone M., Leo M. C., Falconi M., Indolfi G., D'Antiga L., Mazza A., De Martiis D., Bertolozzi G., Marchisio P., Chidini G., Calderini E., Agostoni C., Gori A., Bondone C., Dona D., Todeschini M., Scilipoti M., Cogo P., Ginocchio F., Russotto V. S., Biban P., Stera G., Margherita M., Maiandi S., Tubino B., Chiaretti A., Zampogna S., and Mazzuca A.

Published
2020

20. Persistence of Lockdown Consequences on Children: A Cross-sectional Comparative Study

Author

Picca, M, Manzoni, P, Corsello, A, Ferri, P, Bove, C, Braga, P, Mariani, D, Marinello, R, Mezzopane, A, Senaldi, S, Macchi, M, Cugliari, M, Agostoni, C, Milani, G, Picca, Marina, Manzoni, Paola, Corsello, Antonio, Ferri, Paolo, Bove, Chiara, Braga, Piera, Mariani, Danila, Marinello, Roberto, Mezzopane, Angela, Senaldi, Silvia, Macchi, Marina, Cugliari, Marco, Agostoni, Carlo, Milani, Gregorio Paolo, Picca, M, Manzoni, P, Corsello, A, Ferri, P, Bove, C, Braga, P, Mariani, D, Marinello, R, Mezzopane, A, Senaldi, S, Macchi, M, Cugliari, M, Agostoni, C, Milani, G, Picca, Marina, Manzoni, Paola, Corsello, Antonio, Ferri, Paolo, Bove, Chiara, Braga, Piera, Mariani, Danila, Marinello, Roberto, Mezzopane, Angela, Senaldi, Silvia, Macchi, Marina, Cugliari, Marco, Agostoni, Carlo, and Milani, Gregorio Paolo

Abstract

Lockdown during the COVID-19 pandemic had a significant psychological impact on children and adolescents. This study compared lockdown effects on children aged 1–10 years in 2020 and 2021. Two structured questionnaires were administered to 3392 parents in 2020, and 3203 in 2021. Outcomes considered for the data analysis included sleep changes, episodes of irritability, attention disturbances, distance learning and number of siblings. For data analysis, children were divided into two groups: pre-scholar (1–5 years old) and older ones. The lockdown was associated with a significant increase in sleep disturbances in 2020 and persisted after a year. The high prevalence of mood changes persisted unchanged in children under the age of 10 in 2020 and in 2021. Even if strengthened family ties seemed to mitigate the negative impact of lockdowns in 2020, this effect appeared absent or at least reduced in 2021. Irritability and rage in children were perceived to have increased in 2021 compared to 2020. A significant reduction in digital device use was observed in 2021 compared to 2020. Overall, the most harmful consequences of the lockdown in 2020 were still observed in 2021. Further studies are needed to analyze possible psychological effects that the generation who experienced the pandemic during early childhood may have, particularly in their future adolescence, in order to identify possible intervention practices to support families.

Published
2022

23. Association between fatty acids profile and cerebral blood flow: An exploratory fNIRS study on children with and without ADHD

Author

Grazioli, S, Crippa, A, Mauri, M, Piazza, C, Bacchetta, A, Salandi, A, Trabattoni, S, Agostoni, C, Molteni, M, Nobile, M, Grazioli S., Crippa A., Mauri M., Piazza C., Bacchetta A., Salandi A., Trabattoni S., Agostoni C., Molteni M., Nobile M., Grazioli, S, Crippa, A, Mauri, M, Piazza, C, Bacchetta, A, Salandi, A, Trabattoni, S, Agostoni, C, Molteni, M, Nobile, M, Grazioli S., Crippa A., Mauri M., Piazza C., Bacchetta A., Salandi A., Trabattoni S., Agostoni C., Molteni M., and Nobile M.

Abstract

Polyunsaturated fatty acids (PUFAs) biostatus has been proposed as possible attention deficit hyperactivity disorder (ADHD) diagnosis biomarker. The present exploratory study aimed to investigate the association between PUFAs biostatus and cerebral cortex metabolism measured by functional Near Infrared Spectroscopy (fNIRS) in a sample of children with and without ADHD. 24 children with ADHD and 22 typically developing (TD) peers, aged 8–14, were recruited. Linoleic, arachidonic, docosahexaenoic and eicosapentaenoic acids levels were evaluated in whole blood. All children underwent fNIRS while performing an n-back working memory task. Between groups comparisons revealed lower levels of arachidonic acid in children with ADHD and stronger NIRS signal in TD participants, especially when completing more difficult tasks. Correlations conducted between fNIRS activation and PUFA biostatus revealed several associations between hemodynamic changes in the frontoparietal regions and fatty acids profile across participants. This result was also confirmed by the multiple hierarchical regression analyses that remarked an inverse effect of eicosapentaenoic acid levels on oxyhemoglobin values in right frontoparietal region. Such preliminary findings, if confirmed, would suggest that PUFAs could play a role in atypical neurodevelopment.

Published
2019

24. Children with Covid-19 in Pediatric Emergency Departments in Italy

Author

Parri, N., Lenge, M., Buonsenso, D., Cantoni, B., Arrighini, A., Romanengo, M., Urbino, A., Da Dalt, L., Verdoni, L., Limoli, G., Musolino, A. M., Pilotto, C., La Fauci, G., Chiossi, M., Agostiniani, R., Plebani, A., Barbieri, M. A., Lanari, M., Masi, S., Giacalone, M., Leo, M. C., Falconi, M., Indolfi, G., D'Antiga, L., Mazza, A., De Martiis, D., Bertolozzi, G., Marchisio, P., Chidini, G., Calderini, E., Agostoni, C., Gori, A., Bondone, C., Dona', D., Todeschini, M., Scilipoti, M., Cogo, P., Ginocchio, F., Russotto, V. S., Biban, P., Stera, G., Margherita, M., Maiandi, S., Tubino, B., Chiaretti, A., Zampogna, S., Mazzuca, A., Parri N., Lenge M., Buonsenso D., Cantoni B., Arrighini A., Romanengo M., Urbino A., Da Dalt L., Verdoni L., Limoli G., Musolino A.M., Pilotto C., La Fauci G., Chiossi M., Agostiniani R., Plebani A., Barbieri M.A., Lanari M., Masi S., Giacalone M., Leo M.C., Falconi M., Indolfi G., D'Antiga L., Mazza A., De Martiis D., Bertolozzi G., Marchisio P., Chidini G., Calderini E., Agostoni C., Gori A., Bondone C., Dona D., Todeschini M., Scilipoti M., Cogo P., Ginocchio F., Russotto V.S., Biban P., Stera G., Margherita M., Maiandi S., Tubino B., Chiaretti A., Zampogna S., and Mazzuca A.

Subjects
Pediatric emergency, 2019-20 coronavirus outbreak, medicine.medical_specialty, China, Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, 030204 cardiovascular system & hematology, Betacoronavirus, COVID-19, Child, Humans, Italy, SARS-CoV-2, Coronavirus Infections, Emergency Service, Hospital, Pandemics, Hospital, 03 medical and health sciences, 0302 clinical medicine, Correspondence, Pandemic, medicine, Viral, 030212 general & internal medicine, Emergency Service, Betacoronaviru, business.industry, Coronavirus Infection, Pneumonia, General Medicine, Family medicine, Cohort, business, Human
Abstract

This letter describes a cohort of 100 children younger than 18 years of age with RT-PCR-confirmed Covid-19 who were assessed in 17 pediatric emergency departments in Italy. The descriptive results are compared with previously published results involving children in China and the United States.

Published
2020
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25. Multicentre Italian study of SARS-CoV-2 infection in children and adolescents, preliminary data as at 10 April 2020

Author

Garazzino, S., Montagnani, C., Dona, D., Meini, A., Felici, E., Vergine, G., Bernardi, S., Giacchero, R., Vecchio, A. L., Marchisio, P., Nicolini, G., Pierantoni, L., Rabbone, I., Banderali, G., Denina, M., Venturini, E., Krzysztofiak, A., Badolato, R., Bianchini, S., Galli, L., Villani, A., Castelli-Gattinara, G., Salvini, F., Abbagnato, L., Castagnola, E., Dodi, I., Ghitti, C., Lippi, P., Agostiniani, R., Cherubini, S., Valentini, P., Gianino, P., Vaccaro, A., Manzoni, P., Verna, P., Comberiati, P., Di Filippo, P., Gallia, P., Battezzati, G., Fiore, L., Dalmazzo, C., Tappi, E., Lazzerini, M., Tovo, P. -A., Scolfaro, C., Pruccoli, G., Ramenghi, U., Giaquinto, C., da Dalt, L., Tornese, G., Berlese, P., Plebani, A., Manno, E. C., Santilli, V., Lancella, L., Cursi, L., Campana, A., Bozzola, E., Bosis, S., Lanari, M., Pecoraro, C., Del Barba, P., Nicastro, E., Esposito, S., Zuccotti, G. V., Corsello, G., Cardinale, F., Tocco, A. M., Ballardini, G., Agostoni, C., Chiappini, E., Indolfi, G., Anna, B., Cazzato, S., Zavarise, G., Pignata, C., Marchetti, F., Garazzino S., Montagnani C., Dona D., Meini A., Felici E., Vergine G., Bernardi S., Giacchero R., Vecchio A.L., Marchisio P., Nicolini G., Pierantoni L., Rabbone I., Banderali G., Denina M., Venturini E., Krzysztofiak A., Badolato R., Bianchini S., Galli L., Villani A., Castelli-Gattinara G., Salvini F., Abbagnato L., Castagnola E., Dodi I., Ghitti C., Lippi P., Agostiniani R., Cherubini S., Valentini P., Gianino P., Vaccaro A., Manzoni P., Verna P., Comberiati P., Di Filippo P., Gallia P., Battezzati G., Fiore L., Dalmazzo C., Tappi E., Lazzerini M., Tovo P.-A., Scolfaro C., Pruccoli G., Ramenghi U., Giaquinto C., da Dalt L., Tornese G., Berlese P., Plebani A., Manno E.C., Santilli V., Lancella L., Cursi L., Campana A., Bozzola E., Bosis S., Lanari M., Pecoraro C., Del Barba P., Nicastro E., Esposito S., Zuccotti G.V., Corsello G., Cardinale F., Tocco A.M., Ballardini G., Agostoni C., Chiappini E., Indolfi G., Anna B., Cazzato S., Zavarise G., Pignata C., Marchetti F., Garazzino, S., Montagnani, C., Dona, D., Meini, A., Felici, E., Vergine, G., Bernardi, S., Giacchero, R., Vecchio, A. L., Marchisio, P., Nicolini, G., Pierantoni, L., Rabbone, I., Banderali, G., Denina, M., Venturini, E., Krzysztofiak, A., Badolato, R., Bianchini, S., Galli, L., Villani, A., Castelli-Gattinara, G, Tornese, G, Filippo Salvini, Laura Abbagnato, Elio Castagnola, Icilio Dodi, Cesare Ghitti, Paola Lippi, Rino Agostiniani, Simonetta Cherubini, Piero Valentini, Paola Gianino, Angelina Vaccaro, Paolo Manzoni, Paola Verna, Pasquale Comberiati, Paola Di Filippo, Paola Gallia, Gianna Battezzati, Ludovica Fiore, Cristina Dalmazzo, Eleonora Tappi, Marta Lazzerini, PierAngelo Tovo, Carlo Scolfaro, Giulia Pruccoli, Ugo Ramenghi, Carlo Giaquinto, Liviana Da Dalt, Gianluca Tornese, Paola Berlese, Alessandro Plebani, Emma Concetta Manno, Veronica Santilli, Laura Lancella, Laura Cursi, Andrea Campana, Elena Bozzola, Samantha Bosis, Marcello Lanari, Carmine Pecoraro, Paolo Del Barba, Emanuele Nicastro, Silvia Garazzino, Carlotta Montagnani, Daniele Donà, Antonella Meini, Enrico Felici, Gianluca Vergine, Stefania Bernardi, Roberta Giacchero, Andrea Lo Vecchio, Paola Marchisio, Giangiacomo Nicolini, Luca Pierantoni, Ivana Rabbone, Giuseppe Banderali, Marco Denina, Elisabetta Venturini, Andrzej Krzysztofiak , Raffaele Badolato, Sonia Bianchini, Luisa Galli, Alberto Villani , Guido Castelli-Gattinara, Susanna Esposito, Gian Vincenzo Zuccotti, Giovanni Corsello, Fabio Cardinale, Anna Maria Tocco, Giuseppina Ballardini, Carlo Agostoni, Elena Chiappini, Giuseppe Indolfi, Bussolini Anna, Salvatore Cazzato, Giorgio Zavarise, Claudio Pignata, Federico Marchetti, Lo Vecchio, A., and Castelli-Gattinara, G.

Subjects
Male, Pediatrics, Epidemiology, Protease Inhibitor, Comorbidity, medicine.disease_cause, Clinical Laboratory Technique, Severe Acute Respiratory Syndrome, Disease Outbreaks, Feces, 0302 clinical medicine, Settore MED/38 - Pediatria Generale E Specialistica, COVID-19 Testing, Retrospective Studie, Pandemic, 030212 general & internal medicine, Viral, Child, Coronavirus, Pediatric, Disease Outbreak, Coinfection, Hospitals, Pediatric, Settore MED/38, Hospitals, Diarrhea, Treatment Outcome, SARS-CoV-2 infection, children, covid-19, hydroxychloroquine, pneumonia, Adolescent, Antiviral Agents, Betacoronavirus, COVID-19, Child, Preschool, Chronic Disease, Clinical Laboratory Techniques, Coronavirus Infections, Female, Fever, Humans, Immunocompromised Host, Infant, Infant, Newborn, Italy, Noninvasive Ventilation, Pandemics, Pneumonia, Viral, Protease Inhibitors, Retrospective Studies, SARS-CoV-2, medicine.symptom, Rapid Communication, Human, medicine.medical_specialty, Coronaviru, 03 medical and health sciences, 030225 pediatrics, Virology, Intensive care, medicine, Preschool, Antiviral Agent, Betacoronaviru, business.industry, Coronavirus Infection, Public Health, Environmental and Occupational Health, Retrospective cohort study, medicine.disease, Newborn, Pneumonia, Fece, business
Abstract

Data on features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children and adolescents are scarce. We report preliminary results of an Italian multicentre study comprising 168 laboratory-confirmed paediatric cases (median: 2.3 years, range: 1 day–17.7 years, 55.9% males), of which 67.9% were hospitalised and 19.6% had comorbidities. Fever was the most common symptom, gastrointestinal manifestations were frequent; two children required intensive care, five had seizures, 49 received experimental treatments and all recovered.

Published
2020

29. Effect of anakinra on mortality in patients with COVID-19: a systematic review and patient-level meta-analysis

Author

Kyriazopoulou, E. Huet, T. Cavalli, G. Gori, A. Kyprianou, M. Pickkers, P. Eugen-Olsen, J. Clerici, M. Veas, F. Chatellier, G. Kaplanski, G. Netea, M.G. Pontali, E. Gattorno, M. Cauchois, R. Kooistra, E. Kox, M. Bandera, A. Beaussier, H. Mangioni, D. Dagna, L. van der Meer, J.W.M. Giamarellos-Bourboulis, E.J. Hayem, G. Netea, M.G. van der Meer, J.W.M. Giamarellos-Bourboulis, E.J. Volpi, S. Sormani, M.P. Signori, A. Bozzi, G. Minoia, F. Aliberti, S. Grasselli, G. Alagna, L. Lombardi, A. Ungaro, R. Agostoni, C. Blasi, F. Costantino, G. Fracanzani, A.L. Montano, N. Peyvandi, F. Sottocorno, M. Muscatello, A. Filocamo, G. Papadopoulos, A. Mouktaroudi, M. Karakike, E. Saridaki, M. Gkavogianni, T. Katrini, K. Vechlidis, N. Avgoustou, C. Chalvatzis, S. Marantos, T. Damoulari, C. Damoraki, G. Ktena, S. Tsilika, M. Koufargyris, P. Karageorgos, A. Droggiti, D.-I. Koliakou, A. Poulakou, G. Tsiakos, K. Myrodia, D.-M. Gravvani, A. Trontzas, I.P. Syrigos, K. Kalomenidis, I. Kranidioti, E. Panagopoulos, P. Petrakis, V. Metallidis, S. Loli, G. Tsachouridou, O. Dalekos, G.N. Gatselis, N. Stefos, A. Georgiadou, S. Lygoura, V. Milionis, H. Kosmidou, M. Papanikolaou, I.C. Akinosoglou, K. Giannitsioti, E. Chrysos, G. Mavroudis, P. Sidiropoulou, C. Adamis, G. Fragkou, A. Rapti, A. Alexiou, Z. Symbardi, S. Masgala, A. Kostaki, K. Kostis, E. Samarkos, M. Bakakos, P. Tzavara, V. Dimakou, K. Tzatzagou, G. Chini, M. Kotsis, V. Tsoukalas, G. Bliziotis, I. Doumas, M. Argyraki, A. Kainis, I. Fantoni, M. Cingolani, A. Angheben, A. Cardellino, C.S. Castelli, F. Serino, F.S. Nicastri, E. Ippolito, G. Bassetti, M. Selmi, C. International Collaborative Group for Anakinra in COVID-19

Abstract

Background: Anakinra might improve the prognosis of patients with moderate to severe COVID-19 (ie, patients requiring oxygen supplementation but not yet receiving organ support). We aimed to assess the effect of anakinra treatment on mortality in patients admitted to hospital with COVID-19. Methods: For this systematic review and individual patient-level meta-analysis, a systematic literature search was done on Dec 28, 2020, in Medline (PubMed), Cochrane, medRxiv, bioRxiv, and the ClinicalTrials.gov databases for randomised trials, comparative studies, and observational studies of patients admitted to hospital with COVID-19, comparing administration of anakinra with standard of care, or placebo, or both. The search was repeated on Jan 22, 2021. Individual patient-level data were requested from investigators and corresponding authors of eligible studies; if individual patient-level data were not available, published data were extracted from the original reports. The primary endpoint was mortality after 28 days and the secondary endpoint was safety (eg, the risk of secondary infections). This study is registered on PROSPERO (CRD42020221491). Findings: 209 articles were identified, of which 178 full-text articles fulfilled screening criteria and were assessed. Aggregate data on 1185 patients from nine studies were analysed, and individual patient-level data on 895 patients were provided from six of these studies. Eight studies were observational and one was a randomised controlled trial. Most studies used historical controls. In the individual patient-level meta-analysis, after adjusting for age, comorbidities, baseline ratio of the arterial partial oxygen pressure divided by the fraction of inspired oxygen (PaO2/FiO2), C-reactive protein (CRP) concentrations, and lymphopenia, mortality was significantly lower in patients treated with anakinra (38 [11%] of 342) than in those receiving standard of care with or without placebo (137 [25%] of 553; adjusted odds ratio [OR] 0·32 [95% CI 0·20–0·51]). The mortality benefit was similar across subgroups regardless of comorbidities (ie, diabetes), ferritin concentrations, or the baseline PaO2/FiO2. In a subgroup analysis, anakinra was more effective in lowering mortality in patients with CRP concentrations higher than 100 mg/L (OR 0·28 [95% CI 0·17–0·47]). Anakinra showed a significant survival benefit when given without dexamethasone (OR 0·23 [95% CI 0·12–0·43]), but not with dexamethasone co-administration (0·72 [95% CI 0·37–1·41]). Anakinra was not associated with a significantly increased risk of secondary infections when compared with standard of care (OR 1·35 [95% CI 0·59–3·10]). Interpretation: Anakinra could be a safe, anti-inflammatory treatment option to reduce the mortality risk in patients admitted to hospital with moderate to severe COVID-19 pneumonia, especially in the presence of signs of hyperinflammation such as CRP concentrations higher than 100 mg/L. Funding: Sobi. © 2021 Elsevier Ltd

Published
2021

30. Sustainable and personalized nutrition: From earth health to public health

Author

Agostoni, C, Boccia, S, Banni, S, Mannucci, P M, Astrup, Arne, Agostoni, C, Boccia, S, Banni, S, Mannucci, P M, and Astrup, Arne

Abstract

Sustainable nutrition, equaling earth health, involves a personalized approach designed in terms of precision and avoidance of still cogent but unjustified dogmas, equaling public health. For instance, current dietary recommendations continue to dwell on the need to limit as much as possible the intake of saturated fatty acids (SFA), notwithstanding the mounting evidence that the effects of food on health cannot be predicted from the content of single nutrients without considering the overall macronutrient composition and the role of the food matrix. The traditional recommendation to restrict SFA ignores that their effects on health depend on the interaction between naturally occurring food components and those introduced by food processing. It is warranted to modify the still widely promoted dietary guidelines based upon such single nutrients as SFA and instead personalize dietary habits on the basis of the whole pattern of the food matrix. Accordingly, the double edge of malnutrition, that involves deficiency as well as excess and materializes in many individuals throughout their life course, might be tackled by implementing sustainability, with the additional effect of overcoming global inequalities. Within this context SFA may regain their position of tasty and cheap sources of energy to be adapted to each individual lifestyle.

Published
2021

33. Maternal smoking habits are associated with differences in infants' long-chain polyunsaturated fatty acids in whole blood: a case-control study

Author

Agostoni, C., Riva, E., Giovannini, M., Pinto, F., Colombo, C., Rise, P., Galli, C., and Marangoni, F.

Subjects
Unsaturated fatty acids -- Research, Unsaturated fatty acids -- Physiological aspects, Smoking in pregnancy -- Research, Smoking in pregnancy -- Physiological aspects, Lipids -- Research, Lipids -- Physiological aspects, Infants -- Research, Infants -- Physiological aspects
Published
2008

34. Fluid therapy in mechanically ventilated critically ill children: the sodium, chloride and water burden of fluid creep

Author

Langer, T, D'Oria, V, Spolidoro, G, Chidini, G, Scalia Catenacci, S, Marchesi, T, Guerrini, M, Cislaghi, A, Agostoni, C, Pesenti, A, Calderini, E, Langer, Thomas, D'Oria, Veronica, Spolidoro, Giulia C I, Chidini, Giovanna, Scalia Catenacci, Stefano, Marchesi, Tiziana, Guerrini, Marta, Cislaghi, Andrea, Agostoni, Carlo, Pesenti, Antonio, Calderini, Edoardo, Langer, T, D'Oria, V, Spolidoro, G, Chidini, G, Scalia Catenacci, S, Marchesi, T, Guerrini, M, Cislaghi, A, Agostoni, C, Pesenti, A, Calderini, E, Langer, Thomas, D'Oria, Veronica, Spolidoro, Giulia C I, Chidini, Giovanna, Scalia Catenacci, Stefano, Marchesi, Tiziana, Guerrini, Marta, Cislaghi, Andrea, Agostoni, Carlo, Pesenti, Antonio, and Calderini, Edoardo

Abstract

Background: Fluid therapy is a cornerstone of pediatric intensive care medicine. We aimed at quantifying the load of water, sodium and chloride due to different fluid indications in our pediatric intensive care unit (PICU).We were particularly interested in the role of fluid creep, i.e. fluid administered mainly as the vehicle for drugs, and the association between sodium load and water balance. Methods: Critically ill children aged ≤ 3 years and invasively ventilated for ≥48 hours between 2016 and 2019 in a single tertiary center PICU were retrospectively enrolled. Need for renal replacement therapy, plasmapheresis or parenteral nutrition constituted exclusion criteria. Quantity, quality and indication of fluids administered intravenously or enterally, urinary output and fluid balance were recorded for the first 48 hours following intubation. Concentrations of sodium and chloride provided by the manufacturers were used to compute the electrolyte load. Results: Forty-three patients (median 7 months (IQR 3-15)) were enrolled. Patients received 1004±284 ml of water daily (153±36 ml/kg/day), mainly due to enteral (39%), creep (34%) and maintenance (24%) fluids. Patients received 14.4±4.8 mEq/kg/day of sodium and 13.6± 4.7 mEq/kg/day of chloride, respectively. The majority of sodium and chloride derived from fluid creep (56 and 58%). Daily fluid balance was 417±221 ml (64±30 ml/kg/day) and was associated with total sodium intake (r2 = 0.49, p <0.001). Conclusions: Critically ill children are exposed, especially in the acute phase, to extremely high loads of water, sodium and chloride, possibly contributing to edema development. Fluid creep is quantitatively the most relevant fluid in the PICU and future research efforts should address this topic in order to reduce the inadvertent water and electrolyte burden and improve the quality of care of critically ill children.

Published
2020

35. Prediction of Resting Energy Expenditure in Children: May Artificial Neural Networks Improve Our Accuracy?

Author

Cosmi, V, Mazzocchi, A, Milani, G, Calderini, E, Scaglioni, S, Bettocchi, S, D'Oria, V, Langer, T, Spolidoro, G, Leone, L, Battezzati, A, Bertoli, S, Leone, A, Amicis, R, Foppiani, A, Agostoni, C, Grossi, E, Cosmi, Valentina De, Mazzocchi, Alessandra, Milani, Gregorio Paolo, Calderini, Edoardo, Scaglioni, Silvia, Bettocchi, Silvia, D'Oria, Veronica, Langer, Thomas, Spolidoro, Giulia C I, Leone, Ludovica, Battezzati, Alberto, Bertoli, Simona, Leone, Alessandro, Amicis, Ramona Silvana De, Foppiani, Andrea, Agostoni, Carlo, Grossi, Enzo, Cosmi, V, Mazzocchi, A, Milani, G, Calderini, E, Scaglioni, S, Bettocchi, S, D'Oria, V, Langer, T, Spolidoro, G, Leone, L, Battezzati, A, Bertoli, S, Leone, A, Amicis, R, Foppiani, A, Agostoni, C, Grossi, E, Cosmi, Valentina De, Mazzocchi, Alessandra, Milani, Gregorio Paolo, Calderini, Edoardo, Scaglioni, Silvia, Bettocchi, Silvia, D'Oria, Veronica, Langer, Thomas, Spolidoro, Giulia C I, Leone, Ludovica, Battezzati, Alberto, Bertoli, Simona, Leone, Alessandro, Amicis, Ramona Silvana De, Foppiani, Andrea, Agostoni, Carlo, and Grossi, Enzo

Abstract

The inaccuracy of resting energy expenditure (REE) prediction formulae to calculate energy metabolism in children may lead to either under- or overestimated real caloric needs with clinical consequences. The aim of this paper was to apply artificial neural networks algorithms (ANNs) to REE prediction. We enrolled 561 healthy children (2-17 years). Nutritional status was classified according to World Health Organization (WHO) criteria, and 113 were obese. REE was measured using indirect calorimetry and estimated with WHO, Harris-Benedict, Schofield, and Oxford formulae. The ANNs considered specific anthropometric data to model REE. The mean absolute error (mean ± SD) of the prediction was 95.8 ± 80.8 and was strongly correlated with REE values (R2 = 0.88). The performance of ANNs was higher in the subgroup of obese children (101 ± 91.8) with a lower grade of imprecision (5.4%). ANNs as a novel approach may give valuable information regarding energy requirements and weight management in children.

Published
2020

36. Appetite Control in Breastfed and Formula Fed Infants

Author

EU Childhood Obesity Study Team, Gruszfeld, D., Janas, R., Socha, J., Koletzko, B., Broekaert, I., Brasseur, D., Sengier, A., Giovannini, M., Agostoni, C., Monasterolo, R. Closa, Luque, V., Back, Nathan, editor, Cohen, Irun R., editor, Kritchevsky, David, editor, Lajtha, Abel, editor, Paoletti, Rodolfo, editor, Koletzko, Berthold, editor, Dodds, Peter, editor, Akerblom, Hans, editor, and Ashwell, Margaret, editor

Published
2005
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43. Polyunsaturated fatty acids are associated with behavior but not with cognition in children with and without Attention Deficit Hyperactivity Disorder (ADHD): an Italian study

Author

Crippa, A, Agostoni, C, MAURI, MADDALENA, Molteni, M, Nobile, M, Crippa, A, Agostoni, C, Mauri, M, Molteni, M, and Nobile, M

Subjects
ADHD, fatty acids, cognition, behavior, quality of life
Abstract

Objective: This study aimed to investigate the relationship between polyunsaturated fatty acids (PUFAs) status, cognitive, and behavioral traits of ADHD in school-aged children. Method: Seventy-three children with and without ADHD were assessed with cognitive tasks and behavioral rating scales including quality of life and global functioning at baseline of an intervention trial (clinicaltrials.gov NCT01796262). Correlation analyses were performed between the cognitive tasks/behavioral ratings and blood PUFA levels. Results: Children with ADHD had lower levels of DHA, omega-3 index, and total PUFA. PUFAs were positively associated with behavior but not consistently related to cognitive domains. Conclusion: The present study confirms that children with ADHD display abnormal fatty acid profiles within an Italian setting. Furthermore, PUFAs were associated with behavior but not with cognition. Accordingly, for the first time, lower blood levels of PUFA were associated not only with symptoms of ADHD but also with a poorer quality of life.

Published
2018

49. How much protein is safe?

Author

Agostoni, C, Scaglioni, S, Ghisleni, D, Verduci, E, Giovannini, M, and Riva, E

Published
2005

50. Critical and emerging topics in dietary carbohydrates and health

Author

Dall'Asta, Margherita, Del Rio, D., Tappy, L., Poti, F., Agostoni, C., Brighenti, F., Dall'Asta M. (ORCID:0000-0002-0558-0337), Dall'Asta, Margherita, Del Rio, D., Tappy, L., Poti, F., Agostoni, C., Brighenti, F., and Dall'Asta M. (ORCID:0000-0002-0558-0337)

Abstract

Multiple factors may affect the metabolic fate of carbohydrates. Today, well-standardised and accepted methods may allow for the definitions of the changes in the glucose and insulin curves following the ingestion of either carbohydrate-based and other foods. More debate is still raised on the clinical meaning of these classifications when used at a population level, while emphasis is raised on the approach to carbohydrate metabolism on an individual basis. Within these ranges of applications, other compounds, such as plant polyphenols, may favourably add synergic effects through the modulation of carbohydrate digestion and glucose metabolic steps, resulting in lowering postprandial glucose and insulin levels. Finally, a growing knowledge suggests that the balance of dietary fructose and individual physical activity represent the key point to address the compound towards either positive, energy sparing effects, or a degenerative metabolic burden. The carbohydrate quality within a whole dietary and lifestyle pattern may therefore challenge the individual balance towards health or disease.

Published
2019

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