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Topic Review
Beta Cell Dysfunction in Type 2 Diabetes
Traditionally a disease of adults, type 2 diabetes (T2D) has been increasingly diagnosed in youth, particularly among adolescents and young adults of minority ethnic groups. Especially, during the recent COVID-19 pandemic, obesity and prediabetes have surged not only in minority ethnic groups but also in the general population, further raising T2D risk. Regarding its pathogenesis, a gradually increasing insulin resistance due to central adiposity combined with a progressively defective β-cell function are the main culprits. Especially in youth-onset T2D, a rapid β-cell activity decline has been observed, leading to higher treatment failure rates, and early complications. In addition, it is well established that both the quantity and quality of food ingested by individuals play a key role in T2D pathogenesis. A chronic imbalance between caloric intake and expenditure together with impaired micronutrient intake can lead to obesity and insulin resistance on one hand, and β-cell failure and defective insulin production on the other.
  • 219
  • 22 May 2023
Topic Review
Reciprocal Interplay between Infections and Inherited Metabolic Disorders
Infections represent the main cause of acute metabolic derangements and/or the worsening of the clinical course of many inherited metabolic disorders (IMDs). The basic molecular mechanisms behind the role of infections in these conditions have not been completely clarified. Infective agents may affect cellular metabolic pathways, by mediation or not of an altered immune system. 
  • 217
  • 24 Oct 2023
Topic Review
Prebiotics, Probiotics, and Synbiotics in Pediatric Obesity
Childhood obesity, a real pandemic, represents, in fact, a major public health problem worldwide, with an increasing trend in prevalence during the last decades, especially in developed countries. Due to its associated short- and long-term complications, it carries an important burden not only for health services, but also for society, since it is associated with both psychosocial problems like bullying, resulting in school absences and consequent poor school results, and organic conditions such as metabolic syndrome with insulin resistance, cardiovascular disorders, hypertension, dyslipidemia, non-alcoholic fatty liver disease, obstructive sleep apnea, and even neoplasia.
  • 214
  • 22 Nov 2023
Topic Review
Pregnancy, Breastfeeding, and Vitamin D
Vitamin D metabolism manifests significant changes in pregnant women in comparison to the non-pregnant state, but several questions about the role of vitamin D in pregnancy remain unanswered. Vitamin D deficiency has been reported among pregnant women and nursing mothers globally, constituting a risk group for vitamin D deficiency. Vitamin D deficiency during pregnancy has been associated not only with pregnancy outcomes but also with the posterior physical and mental health of the offspring.
  • 211
  • 11 Jan 2024
Topic Review
Development of the Microbiome in Preterm Neonates
Researchers have established that the preterm neonate is born with an immature gastrointestinal tract. The preterm neonate is thus susceptible to various complications often seen in the neonatal intensive care unit, e.g., feeding intolerances, necrotizing enterocolitis, and hospital-acquired bloodstream infections. These complications can be life-threatening, and if survived, can have an unfavorable effect on the neonate’s growth and development.
  • 210
  • 13 Nov 2023
Topic Review
Neonatal Heart Rate in the Delivery Room
At birth, a newborn’s heart rate should be evaluated immediately to determine the need for resuscitation and stabilizing measures. As cardiopulmonary transition is affected by the cord management strategy, gestational age, and underlying condition, different heart rate intervention thresholds might be needed in different subgroups of newborn infants.
  • 209
  • 08 Oct 2023
Topic Review
Management Plan according to EOSS-P
hildhood obesity, affecting 29% of 7–9-year-olds across 33 European countries, is a significant public health challenge. Its persistence into adulthood poses grave health risks influenced by genetic, environmental, and socio-economic factors. Belgium introduced a new care pathway in December 2023, based on the Edmonton Obesity Staging System for Pediatrics (EOSS-P), addressing four health domains and staging obesity severity. This pathway operates across three levels: primary care physicians, Paediatric Multidisciplinary Obesity Management Centres (PMOCs), and Centers of Expertise for Paediatric Obesity Management (CEPOs). Each stage of EOSS-P demands tailored interventions. Early stages involve dietary interventions, physical activity promotion, and behavior modifications. As obesity severity progresses, treatments intensify, encompassing psychological support, anti-obesity medications, and, in some cases, bariatric surgery.
  • 207
  • 13 Mar 2024
Topic Review
Diet and Nutritional Interventions in Early Life
The infant gut microbiome plays a key role in the healthy development of the human organism and appears to be influenced by dietary practices through multiple pathways. First, maternal diet during pregnancy and infant nutrition significantly influence the infant gut microbiota. Moreover, breastfeeding fosters the proliferation of beneficial bacteria, while formula feeding increases microbial diversity. The timing of introducing solid foods also influences gut microbiota composition. In preterm infants the gut microbiota development is influenced by multiple factors, including the time since birth and the intake of breast milk, and interventions such as probiotics and prebiotics supplementation show promising results in reducing morbidity and mortality in this population.
  • 203
  • 27 Feb 2024
Topic Review
Basis for Treatment of  Patent Ductus Arteriosus
Ductus arteriosus (DA) serves a crucial role in utero by redirecting the oxygenated blood away from the fluid-filled fetal lungs, and towards the systemic circulation for optimal fetal development. Typically, in term infants, DA undergoes functional constriction and closure within 1–3 days after birth, followed by tissue remodeling to ensure permanent closure. However, the DA may remain persistently patent postnatally, especially in very preterm infants, and is commonly referred to as patent ductus arteriosus (PDA). Its prevalence is inversely proportional to gestational age; more than 60% of preterm infants under 28 weeks of gestational age (GA) continue to have PDA 7 days after birth or longer. 
  • 200
  • 05 Jan 2024
Topic Review
Intricate Factors Shaping Craniofacial Structure and Sleep-Disordered Breathing
Adenotonsillar hypertrophy has been well-acknowledged as the primary instigator of sleep-disordered breathing in the pediatric population. This condition spans a spectrum, from typical age-related growth that the immune system influences to persistent pathological hypertrophy. Reduction in air spaces, metabolic changes, neurobehavioral alterations, and chronic inflammation characterizes the latter form. As the go-to treatment, adenotonsillectomy has proven effective.
  • 194
  • 15 Sep 2023
Topic Review
Off-Label Prescribing in Pediatric Population
Off-label prescribing is widespread among pediatricians, and it is unlikely that this trend will soon be bound by a uniform legal framework. This is necessitated by the fact that there are four variables: the patient’s health condition, the physician’s experience and knowledge, the legislative measures (laws, directives, guidelines, and recommendations), and finally, the pharmaceutical industry. There is considerable concern worldwide about the use of off-label medicines in children. 
  • 188
  • 06 Dec 2023
Topic Review
Ventilator-Associated Pneumonia
Ventilator-associated pneumonia (VAP) is defined as pneumonia not present or incubating at the time of admission and occurring after more than 48 hours of mechanical ventilation (MV). This is the second-most common healthcare-associated infection (HAI) in neonatal intensive care units (NICUs). VAP is associated with increased morbidity and mortality, an increased length of stay in the NICU and hospital costs.
  • 179
  • 31 Jan 2024
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