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Topic Review
Clinical Diagnosis and Genetics of Hemiplegic Migraine
Hemiplegic migraine (HM) is a rare form of migraine with an aura characterized by transient motor weakness or hemiparesis (motor aura). HM is also associated with other non-motor aura manifestations (visual, sensory, aphasic, or basilar-type/brainstem symptoms) and with other symptoms typically accompanying migraine, such as nausea, vomiting, photophobia, or phonophobia. A motor aura represents the peculiarity of HM compared to other forms of migraine with aura (MA), and its diagnostic criteria have been updated in the latest classification of headache disorders. HM can be sporadic (SHM) or familial (FHM), with autosomal dominant inheritance.
  • 333
  • 19 Jun 2023
Topic Review
Free Radical Disease in Newborn
Oxygen toxicity is mainly due to the production of oxygen radicals, molecules normally produced in humans and involved in a myriad of physiological reactions. In the neonatal period, an imbalance between oxidants and antioxidant defenses, the so-called oxidative stress, might occur, causing severe pathological consequences.
  • 330
  • 27 Mar 2023
Topic Review
Microbiota in Newborn from Birth to Weaning
Nutrients play a crucial role in enriching and diversifying the microbiota, derived not only from solid food but also from maternal dietary patterns during gestation.
  • 328
  • 29 Jan 2024
Topic Review
Lipoprotein(a) as a Marker of Cardiovascular Health Risk
Lipoprotein(a) [Lp(a)] is made up of apoprotein(a) [apo(a)] and LDL-like particle. The proportion of Lp(a) in each individual is genetically determined and is only minimally modifiable by environment or diet. Lp(a) has important pro-atherosclerotic and pro-inflammatory effects. For these reasons, high Lp(a) values are an important independent risk factor for cardiovascular disease and calcific aortic valve stenosis. Numerous studies have been performed in adults about the pathophysiology and epidemiology of Lp(a), much less information is available regarding Lp(a) in children and adolescents. Gaining information on these points is particularly important for deciding whether Lp(a) assay may be useful for defining the cardiovascular risk in children, in order to plan a prevention program early.
  • 323
  • 03 Jul 2023
Topic Review
Biofilm Infections in the Neonatal Intensive Care Units
Neonatal sepsis is an important cause of neonatal morbidity and mortality. A significant proportion of bacteria causing neonatal sepsis is resistant to multiple antibiotics, not only to the usual empirical first-line regimens, but also to second- and third-line antibiotics in many neonatal intensive care units (NICUs). NICUs have unique antimicrobial stewardship goals.
  • 321
  • 23 Feb 2023
Topic Review
Pedicle Screw Placement for Treating Adolescent Idiopathic Scoliosis
Posterior spinal fusion (PSF) and segmental spinal instrumentation (SSI) using pedicle screws (PS) is the most used procedure to correct adolescent idiopathic scoliosis. Computed navigation, robotic navigation, and patient-specific drill templates are available, besides the first described free-hand technique. None of these techniques are recognized as the gold standard. 
  • 313
  • 16 Oct 2023
Topic Review
PBPK Models in Postpartum Women and Breastfed Infants
Physiologically based pharmacokinetic (PBPK) modelling is a bottom-up approach to predict pharmacokinetics in specific populations based on medicine-specific and population-specific data, such as physiology - A contribution from the ConcePTION Project. 
  • 313
  • 17 Nov 2023
Topic Review
Primary Stabbing Headache in Children and Adolescents
Primary Stabbing Headache (PSH) is characterized by brief, focal, and paroxysmal pain (“stab”), occurring sporadically or in clusters. Data on pediatric cases are poor. The prevalence of PSH and probable PSH varies from 2.5 to 10% among children with primary headaches and it is higher among children aged less than 6 years old. The mean age of onset is between 7 and 11 years of age. Attack duration greatly varies, ranging from a few seconds to several minutes. The intensity of pain is usually from moderate to severe. Associated symptoms are infrequent but may be observed (mainly photophobia, vertigo, nausea, and vomiting). Neuroradiological findings are usually unremarkable; Electroencephalographic (EEG) may show sporadic epileptiform abnormalities (up to 30% of cases). Preventive therapy is anecdotal, including treatment with indomethacin, trazodone, valproate, and amitriptyline.
  • 313
  • 26 Feb 2024
Topic Review
Impact of Technologies on Diabetes-Related Comorbidities
Type 1 diabetes (T1D) is one of the most common chronic diseases in childhood, with a progressively increasing incidence. T1D management requires lifelong insulin treatment and ongoing health care support. The main goal of treatment is to maintain blood glucose levels as close to the physiological range as possible, particularly to avoid blood glucose fluctuations, which have been linked to morbidity and mortality in patients with T1D. 
  • 311
  • 11 Dec 2023
Topic Review
Butterflies and Ribbons in Multiple Gestation
In neonatology, multiple pregnancies are common. Unfortunately, it is not rare for one baby to die. Communication with parents in these circumstances has been demonstrated to be sub-optimal. Formal training programs for clinicians in NICUs, using either the Butterfly or Ribbon approaches, should be routinely offered. 
  • 305
  • 04 Sep 2023
Topic Review
Polysomnography in the Diagnosis of Sleep-Disordered Breathing
Obstructive sleep-disordered breathing (SDB) is a spectrum of different clinical conditions distinguished by upper-airway dysfunction during sleep with snoring and/or increased respiratory effort due to increased upper airway resistance and pharyngeal collapsibility. Diagnostic methods for SDB in children involve a combination of clinical assessment, medical history evaluation, questionnaires, and objective measurements. Polysomnography (PSG) is the diagnostic gold standard. It records activity of brain and tibial and submental muscles, heart rhythm, eye movements, oximetry, oronasal airflow, abdominal and chest movements, body position. Despite its accuracy, it is a time-consuming and expensive tool.
  • 302
  • 18 Aug 2023
Topic Review
Wilms Tumor (Nephroblastoma)
Wilms tumor (or nephroblastoma) is a malignant and solid neoplasm that derives from the primitive renal bud. It represents the most frequent primary tumor of the urogenital tract in childhood, and treatment consists of surgery and chemo-radiotherapy. 
  • 299
  • 19 Dec 2023
Topic Review
Bioavailability of Mature miRNAs in Digestive System
The endogenous miRNAs of breast milk are the products of more than 1000 nonprotein-coding genes, giving rise to mature small regulatory molecules of 19–25 nucleotides. They are incorporated in macromolecular complexes, loaded on Argonaute proteins, sequestrated in exosomes and lipid complexes, or present in exfoliated cells of epithelial, endothelial, or immune origins. Their expression is dependent on the stage of lactation; however, their detection depends on progress in RNA sequencing and the reappraisal of the definition of small RNAs. Some miRNAs from plants are detected in breast milk, opening the possibility of the stimulation of immune cells from the allergy repertoire. Each miRNA harbors a seeding sequence, which targets mRNAs, gene promoters, or long noncoding RNAs. Their activities depend on their bioavailability. Efficient doses of miRNAs are estimated to be roughly 100 molecules in the cytoplasm of target cells from in vitro and in vivo experiments. Each miRNA is included in networks of stimulation/inhibition/sequestration, driving the expression of cellular phenotypes. Three types of stress applied during lactation to manipulate miRNA supply were explored using rodent offspring: a foster mother, a cafeteria diet, and early weaning.
  • 298
  • 14 Nov 2023
Topic Review
Assessment of Oxidative Stress in Neonatal Brain Damage
Oxidative stress (OS) constitutes a pivotal factor within the mechanisms underlying brain damage, for which the immature brain is particularly vulnerable. This vulnerability is caused by the abundance of immature oligodendrocytes in the immature brain, which are highly susceptible to OS-induced harm. Consequently, any injurious process involving OS within the immature brain can lead to long-term myelination impairment. Among the detrimental repercussions of OS, protein carbonylation stands out as a prominently deleterious consequence. Noteworthy elevation of protein carbonylation is observable across diverse models of neonatal brain injury, following both diffuse and focal hypoxic–ischemic insults, as well as intraventricular hemorrhage, in diverse animal species encompassing rodents and larger mammals, and at varying stages of brain development. In the immature brain, protein carbonylation manifests as a byproduct of reactive nitrogen species, bearing profound implications for cell injury, particularly in terms of inflammation amplification. Moreover, protein carbonylation appears as a therapeutic target for mitigating neonatal brain damage. The administration of a potent antioxidant, such as cannabidiol, yields substantial neuroprotective effects. 
  • 295
  • 18 Oct 2023
Topic Review
Psychotic Episodes in Pregnancy
Psychotic episodes represent one of the most complex manifestations of various mental illnesses, and these encompass a wide variety of clinical manifestations that together lead to high morbidity in the general population. Various mental illnesses are associated with psychotic episodes; in addition, their incidence and prevalence rates have been widely described in the general population, their correct identification and treatment is a challenge for health professionals in relation to pregnancy. In pregnant women, psychotic episodes can be the consequence of the manifestation of a previous psychiatric illness or may begin during the pregnancy itself, placing not only the mother, but also the fetus at risk during the psychotic episode.
  • 294
  • 13 Apr 2023
Topic Review
Acupuncture in Children Frequent or Chronic Primary Headaches
Acupuncture is a spreading and promising intervention, which has proven to be very useful in the treatment and prevention of chronic pain, in particular chronic headaches, in adults. Despite the differences in tools, procedures, and application sites, acupuncture demonstrated a positive effect on both the frequency and intensity of headaches and was well tolerated.
  • 292
  • 18 Oct 2023
Topic Review
Tracheostomy in Severe Bronchopulmonary Dysplasia
Infants with the most severe forms of bronchopulmonary dysplasia (BPD) may require long-term invasive positive pressure ventilation for survival, therefore necessitating tracheostomy. Although life-saving, tracheostomy has also been associated with high mortality, postoperative complications, high readmission rates, neurodevelopmental impairment, and significant caregiver burden, making it a highly complex and challenging decision. However, for some infants tracheostomy may be necessary for survival and the only way to facilitate a timely and safe transition home. The specific indications for tracheostomy and the timing of the procedure in infants with severe BPD are currently unknown.
  • 292
  • 27 Nov 2023
Topic Review
Clinical Management and Therapy of Precocious Puberty
Puberty identifies the transition from childhood to adulthood. Precocious puberty is the onset of signs of pubertal development before age eight in girls and before age nine in boys, it has an incidence of 1/5000–1/10,000 with an F:M ratio ranging from 3:1 to 20:1. Precocious puberty can be divided into central, also known as gonadotropin-dependent precocious puberty or true precocious puberty, and peripheral, also recognized as gonadotropin-independent precocious puberty or precocious pseudopuberty. 
  • 291
  • 23 Oct 2023
Topic Review
The Cardiofaciocutaneous Syndrome
Cardiofaciocutaneous (CFC) syndrome is one of the rarest RASopathies characterized by multiple congenital ectodermal, cardiac and craniofacial abnormalities with a mild to severe ocular, gastrointestinal and neurological involvement. It is an autosomal dominant syndrome, with complete penetrance, caused by heterozygous pathogenic variants in the genes BRAF, MAP2K1/MEK1, MAP2K2/MEK2, KRAS or, rarely, YWHAZ, all part of the RAS-MAPK pathway. This pathway is a signal transduction cascade that plays a crucial role in normal cellular processes such as cell growth, proliferation, differentiation, survival, metabolism and migration. CFC syndrome overlaps with Noonan syndrome, Costello syndrome, neurofibromatosis type 1 and Legius syndrome, therefore making the diagnosis challenging.
  • 289
  • 06 Dec 2023
Topic Review
Bathing in Atopic Dermatitis in Pediatric Age
Atopic dermatitis is a chronic inflammatory skin disease. The treatment plays an important role in influencing the patients’ quality of life. The basic management consists of appropriate skin cleansing, including bathing and eventually using bathing additives. Recommendations regarding frequency and duration of bathing, water temperature and usefulness of bathing additives are widely different, often leading to confusion among patients. 
  • 284
  • 26 Feb 2024
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