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Aim: To assess efficacy of remifentanil in preterm newborns during mechanical ventilation. Methods: Remifentanil was administered by continuous intravenous infusion to provide analgesia and sedation in 48 preterm infants who developed respiratory distress and required mechanical ventilation. We examined the doses needed to provide adequate analgesia, extubation time after the discontinuation of opioid infusion, the presence of side effects and safety of the use. Results: Remifentanil provided adequate analgesia, with a significant reduction of NIPS and COMFORT score since 1 h after starting the infusion of remifentanil. The drug was initially administered at a dose of 0.075 μg/kg/min, but in 73% of newborns the latter had to be increased; at a dose of 0.094 ± 0.03 (mean ± standard deviation) μg/kg/min, 97% of the newborns received adequate analgesia and sedation. The time elapsed between the discontinuation of remifentanil infusion and extubation was 36 ± 12 min. Treatment was started between the 1st and the 17th day of life. The mean duration of therapy was 5.9 ± 5.7 days. No side effects on the respiratory or cardiovascular system were observed. Conclusion: Remifentanil is a manageable and effective opioid in the newborn undergoing mechanical ventilation, though randomized controlled trials and information about long-term outcomes are necessary.

Background Early discharge of mother/neonate dyad has become a common practice, and its effects are measured by readmission rates. We evaluated the safety of early discharge followed by an individualized Follow-up programme and the efficacy in promoting breastfeeding initiation and duration. Methods During a nine-month period early discharge followed by an early targeted Follow-up was carried out in term neonates in the absence of weight loss

Umbilical cord blood (UCB) is a source of stem cells for allogeneic haematopoietic transplantation in paediatric and adult patients with haematological malignancies and other indications. Voluntary donation is the basis for the success of unrelated UCB transplantation programmes. In the last few years a growing number of private banks offer their services to expectant parents, to store UCB for future use. The debate concerning UCB donation and private preservation has been ongoing for several years. The aims of this single centre study were to explore knowledge about UCB stem cells and attitudes towards voluntary UCB donation or private UCB preservation among both blood donors and pregnant women.This study was conducted at the "Sapienza" University of Rome. Two types of anonymous questionnaires were prepared: one type was administered to 1,000 blood donors while the other type was distributed to 300 pregnant women.Most blood donors as well as the majority of pregnant women had some general knowledge about UCB (89% and 93%, respectively) and were aware of the possibility of donating it (82% and 95%). However, the level of knowledge regarding current therapeutic use resulted generally low, only 91 (10%) among informed blood donors and 69 (31%) among informed pregnant women gave a correct answer. The survey revealed a preference for voluntary donation both among blood donors (76%) and among pregnant woman (55%). Indeed, a minority of blood donors (6.5%) and of pregnant women (9%) would opt to store UCB for private use.The study raises the following considerations: (i) the large support for UCB donation expressed by blood donors and by pregnant women suggests that UCB preservation does not represent an obstacle to the expansion of UCB donation and to development of unrelated transplantation programmes; (ii) information about UCB donation and preservation should be carefully given by professionals and institutions.

Oxidative stress and inflammation together play a crucial role in the obesogenic process, and imbalances in reactive oxygen species, free radicals and antioxidants have been reported as being major mechanisms underlying obesity-related co- morbidities. Obesity and oxidative stress may be present even within the first two decades of life, and chronic exposure to systemic inflammation may contribute to the onset and progression of cardiovascular disease and diabetes. Bioactive compounds present in blueberry have been shown to have many positive effects on human health. The present study was carried out in northern Italy on a population of 24 overweight and obese children (8-13 years), divided into three groups: the first consumed fresh blueberries, the second blueberry puree, while a third control group did not consume any blueberries. The children's anthropometric measures were taken and serum markers related to inflammation, CRP, ceruloplasmin, and complements C3 and C4 were measured during the eight weeks they ate either fresh blueberries or blueberry puree. BAP test (Biological Antioxidant Potential) values of the three groups were monitored throughout the entire study and correlated with inflammatory, metabolic and anthropometric markers. The results showed a higher increase in antioxidant levels in the group that ate fresh berries than in the group that ate puree, while the control group's BAP values decreased over the eight weeks of the study. Our results show that increased consumption of blueberries, hence antioxidant intake, may also have a positive effect on markers of inflammation and oxidative stress in overweight and obese patients during childhood.

Lutein has been shown to have antioxidant functions in newborns and with zeaxantin selectively taken up into the macula of the eye. We hypothesize that lutein administration may contribute to reducing the incidence of Retinopathy of Prematurity (ROP). This was a single center, double-blind randomized controlled study. Preterm infants with gestational age (GA) ≤ 32 weeks able to tolerate minimal enteral feeding before the seventh day of life (DOL) were enrolled; lutein and zeaxantin plasma concentrations and ROP occurrence and severity were evaluated. Sixty-three newborns were enrolled, 31 in the lutein group and 32 in the placebo group (one died before ROP assessment). The mean GA was 29.9 (± 1.9) weeks and the mean birth weight was 1331 (± 415) grams. There were no differences in the incidence of ROP at any stage between groups. Oxidative injury is probably an additional mechanism of damage of the developing retinal vessels, and it probably plays only a minor role in the pathogenesis of ROP. Supplementation with antioxidant substances might have beneficial effects noticeable only on larger samples of high risk neonates or at very high dosage. Further investigations would be needed to evaluate whether lutein supplementation can influence functional rather than anatomical outcomes in preterm infants.