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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]

Chromosome 14q11-q22 deletion syndrome (OMIM 613457) is a rare genomic disorder whose associated phenotype is heterogeneous, depending on the size, and, mostly, on the deleted region. We report the clinical and molecular characterization of a female newborn, whose phenotype was characterized by poor growth, dysmorphic facial features, subclinical hypothyroidism, and mild reduction of CD3CD8 Lymphocytes with increased CD4/CD8 ratio. By array-CGH, we identified a 4.08 de novo interstitial deletion of the 14q13.2q21.1 region, which includes 16 OMIM genes.Our patient phenotype is compared with other published cases, for a better classification of the 14q11-q22 deletion syndrome. We demonstrated that the 14q13.2q21.1 deletion, which encompasses NKX2-1, but not FOXG1 gene and HPE8 region, identifies a well defined, more benign, microdeletion syndrome. This report confirms that an early identification with accurate characterization of the genomic disorders is of great relevance, enabling proper genetic counseling of the reproductive risk, as well as disease prognosis, and patient management. © 2016 Wiley Periodicals, Inc. [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]

Introduction: Viral bronchiolitis is a common cause of lower respiratory tract infection in the first year of life, considered a health burden because of its morbidity and costs. Its diagnosis is based on history and physical examination and the role of radiographic examination is limited to atypical cases. Thus far, Lung Ultrasound (LUS) is not considered in the diagnostic algorithm for bronchiolitis. Methods: PubMed database was searched for trials reporting on lung ultrasound examination and involving infants with a diagnosis of bronchiolitis. Results: Eight studies were suitable. Conclusions: This review analyzed the current evidence about the potential usefulness of LUS in the clinical management of bronchiolitis. Literature supports a peculiar role of LUS in the evaluation of the affected children, considering it as a reliable imaging test that could benefit the clinical management of bronchiolitis. [ABSTRACT FROM AUTHOR]

Introduction: According to the 2016 Italian National Institute of Statistics (Istat) data in Italy, about 6.7% of all newborns are born prematurely. Due to the lack of data on current complementary feeding in preterm infants in Italy, the aim of the survey was to evaluate individual attitudes of primary care paediatricians, concerning the introduction of complementary foods in preterm infants. Methods: An internet-based survey was conducted among primary care paediatricians, working in Italy, regarding (1) timing of the introduction of complementary foods to preterm newborns; (2) type of complementary foods introduced; (3) vitamin D and iron supplementations. Results: A total of 347 primary care Italian paediatricians answered the questionnaire; 44% of responders based the timing of the introduction of solid food exclusively on an infant’s age, 18% on an infant’s neurodevelopmental status and 4% on the body weight; the remaining 34% based the timing on two or more of these aspects. The type of complementary foods did not comply with an evidence-based sequence; 98% of participants promoted vitamin D supplementation and 89% promoted iron supplementation with great diversity in timing and doses. Conclusions: Due to limited evidence, there is a great heterogeneity in the attitudes of primary care paediatricians concerning the introduction of complementary foods to preterm newborns. Further research is needed to provide evidence-based guidelines regarding weaning preterm newborns. [ABSTRACT FROM AUTHOR]