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In these last 25 years, the Neonatal Emergency Transport (NET) service has been widely improved in Italy. To date, all National areas are covered by a NET service; 53 NET centers have been activated in all the Italian territory. Herein, the authors present an observational study to evaluate the rate of infantile mortality after introduction of NET in Sicily, and to study the efficiency of this service in reducing these rates of mortality in vulnerable neonates, transported from primary care birth centers to tertiary facilities to undergo to specialized NICU assistance. All neonates who required an emergency transport by NETS were included. No exclusions criteria were applied. Demographic and regional infantile mortality data, expressed as infant mortality rate, were selected by the official government database (ISTAT- National Statistic Institute—http://www.istat.it). All data were respectively divided into three groups: data concerning transport, clinical condition, and mortality of the transported patients. We transported by NET 325 neonates. The analysis of the infant mortality rate (per 1.000 live births) in Catania from 2016 to 2018 was reduced compared to the same rate calculated before NETS activation (4.41 index before 2016 vs 4.17 index after 2016). These data showed an increase in other provinces (Enna, Caltanissetta, and Agrigento). 61% of neonates showed a respiratory disease. During the study period the proportion of neonates with a Mortality Index for Neonatal Transportation—MINT

IIt is quite frequent in Emergency Department dealing with seizures or convulsive episodes, especially in pediatric age. Different could be the causes behind an epileeptic episode, usually distinguished in traumatic and non traumatic. Equally important, it should be always considered the negative impact that an acute-onset episode could have on children parents, relatives, or caregiver, even if they have a positive outcome in most cases. Different are the options available in a Pediatric Emergency Department (PED) to face a sudden event like seizure or convulsive status epilepticus but actually still no concert about which drug or which schedule should be used. This work means to describe and review a 5 years’ single-center experience on assessment and treatment of children admitted to the PED affected by febrile and afebrile seizures and status epilepticus.

Background Cardiovascular involvement in Cystic Fibrosis (CF) is a not rare condition, although the prevalence of subclinical pulmonary hypertension (PH) and cardiac dysfunction is not known in the early stages of CF progression. The aim of our study was to assess cardiac involvement in children and adults affected by cystic fibrosis compared with healthy subjects of same age using echocardiography. Methods Fifty-five patients, 25 adults and 30 children completed the study. We assessed FEV1 (Forced Expiratory Volume in one second), and carried out colour Doppler-echocardiography evaluating ejection fraction (EF) measurement of left ventricle, tricuspid annular plane systolic excursion (TAPSE) of right ventricle and pulmonary artery pressure (PAP). We compared the auxological, respiratory and cardiologic data with those of 16 adults and 34 children of the same age. Results We discovered significantly different values of PAP between patients and controls in both children (p = 0.0001, r = - 0.62) and adults (p = 0.0001, r = - 0.63), whereas the EF and TAPSE showed significantly different values in only adults (p = 0.0023 and p = 0.0194 respectively). We found in both children and adults with CF an inverse correlation between PAP and FEV1 (p = 0.000, p = 0.001), Erythrocyte Sedimentation Rate (ESR) and FEV 1 (p = 0.015, r = - 0.43; p = 0.009, r = - 0.51), and highly sensitive C-reactive protein (hs-CRP) and FEV 1 (p = 0.007, r = - 0.48; p = 0.001, r = - 0.60). In adults we also detected direct correlation between PAP and hs-CRP (p = 0.008, r = 0.51) and PAP and ESR (p = 0.009, r = 0.51). Conclusions In paediatric-aged CF patients there are already early signs of potential heart impairment, represented by an increase of pulmonary blood pressure, and in adult age the systolic function of right ventricle may be impaired. We hypothesise that such cardiac impairments may gradually arise due to preceding chronic inflammation related to prior degeneration of lung function and thus it is very important to keep patients clinically stable and address chronic inflammation as early as possible in the progression of CF.

We describe a case of leukemia/lymphoma of Burkitt’s type with relapsing meningeal disease treated with a combination of the intraventricular chimeric anti-CD20 monoclonal antibody rituximab and systemic high-dose cytarabine. Our patient is a 40-year-old male patient presenting with diplopia, dermal involvement, diffuse vertebral infiltration, bilateral pleural effusions, multiple lymphoadenopathies, and bone marrow blastic infiltration with the diagnosis of leukemia/lymphoma of Burkitt’s type. Cytmorphological analysis of the cer

Background and aims IFIs still pose major challenges in HSCT, and effective prophylaxis remains a matter of debate. The aim of this retrospective study was to evaluate the impact of aerosolized d-AmB on respiratory tract IFIs in a homogeneous cohort of allogeneic HSCT patients, transplanted at our institution. Patients and methods Since 1999, 81 consecutive patients were transplanted from matched related (N=61) or unrelated donor (MUD). Analysis was performed on 74 evaluable patients, in order to monitor the prevalence of respiratory tract IFIs within 40 days after HSCT, according to current guidelines (possible, probable, proven IFIs). Conventional antifungal prophylaxis was based on the association of fluconazole (400 mg/d), plus aerosolized d-AmB (15 mg bid) in 54 out of 74 cases (73%). All the patients were screened before transplant and monitored thereafter with CT or x-rays (paranasal sinuses, thorax), surveillance swabs and galactomannan antigenemia. Chi square test was performed to evaluate correlations between variables. Results Aerosolised d-AmB was administered to 70 patients for a median time of 15 days (range 1–45). Prolonged administration was not associated with increased severe bacterial infections, nor severe adverse events were observed; only a patient developed moderate bronchial spasm. In 13 pts, aerosolized d-AmB was delivered for less than 7 days, due to worsened clinical conditions, or poor compliance. In this group, proven IFIs were diagnosed in 2 patients (1 mucormycosis and 1 fusariosis), possible aspergillosis in one and probable aspergillosis in another one. A shortened administration ( Discussion Despite the low number of patients, prolonged aerosolized d-AmB seems to play a role in preventing respiratory tract IFIs, but a randomised controlled trial is recommended to verify the impact of this prophylaxis in the setting of allogeneic HSCT.