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Topic Review
Ethics of Vaccination in Childhood
Although vaccination is recognised as the top public health achievement of the twentieth century, unequivocal consensus about its beneficence does not exist among the general population. In countries with well-established immunisation programmes, vaccines are “victims of their own success”, because low incidences of diseases now prevented with vaccines diminished the experience of their historical burdens. Increasing number of vaccine-hesitant people in recent years threatens, or even effectively disables, herd immunity levels of the population and results in outbreaks of previously already controlled diseases. We aimed to apply a framework for ethical analysis of vaccination in childhood based on the four principles of biomedical ethics (respect for autonomy, nonmaleficence, beneficence and justice) to provide a comprehensive and applicable model on how to address the ethical aspects of vaccination at both individual and societal levels. We suggest finding an “ethical equilibrium”, which means that the degree of respect for parents’ autonomy is not constant, but variable; it shall depend on the level of established herd immunity and it is specific for every society. When the moral obligation of individuals to contribute to herd immunity is not fulfilled, mandatory vaccination policies are ethically justified, because states bear responsibility to protect herd immunity as a common good.
  • 1.1K
  • 08 Jun 2021
Topic Review
Respiratory Syncytial Virus Passive Immunoprophylaxis
Respiratory syncytial virus (RSV) is a non-segmented, single-stranded, negative-sense RNA virus belonging to the Pneumoviridae family. It represents the leading cause of acute respiratory tract infections in children worldwide. Treatment of RSV infections is primarily supportive, including hydration and oxygen supplementation.
  • 1.1K
  • 28 Apr 2021
Topic Review
Erythropoietin for Newborn Infants
Erythropoietin (Epo) is a 30.4 kDa glycoprotein and pleiotropic cytokine, first described by Carnot in 1906 and isolated by Goldwasser and Kung in 1971, successfully produced for clinical use.
  • 1.1K
  • 20 Apr 2022
Topic Review
Granulicatella spp.
Granulicatella spp. are non-motile, non-sporulating, facultatively anaerobic Gram-positive cocci. These organisms have been referred to by several names, such as “nutritionally deficient streptococci”, “vitamin-B dependent streptococci” and “pyridoxal-dependent streptococci”, because of their fastidious nutritional requirements, which can often make culture isolation challenging. Known to be a member of the normal microbiota of the human oral cavity and urogenital and intestinal tracts, similar to other streptococci, Granulicatella spp. can cause bacteremia, sepsis and infective endocarditis. Considering the difficulty in growing this organism on culture medium, the fact that it is now included among the bacteria known to be responsible for culture-negative infective endocarditis suggests that its pathogenic role could be highly underestimated. Moreover, being considered such a rare causative agent, it is not a target of standard antibiotic empiric treatment. 
  • 1.1K
  • 27 Dec 2022
Topic Review
COVID-19 Newborn Infection
It is already known how SARS-CoV-2 passed from human-to-human with the  exeption of mother-to fetous transmission of infection.  The foetus, theoretically may become infected from the mother by a blood-borne route through the placenta, during birth, through contact with maternal secretions and after birth during close contact with the mother or others. Mother-to-fetus transmission of the virus is unlikely and its mechanism is poorly understood. In a number of published studies, researchers have not based the diagnosis of COVID-19 in the newborn on developed diagnostic criteria, which makes it even more difficult to determine the frequency and pathomechanism of congenital infection. Still not much is known about complications of SARS-CoV-2 infection in pregnancy for the fetus and neonate, there are many questions that we still cannot answer. despite this, it has been possible to determine how to limit airborne transmission of the virus. By analysing the mode of delivery it is known that SARS-CoV-2 infection is not an indication for caesarean section. There are no data that provide a basis for restricting breastfeeding. It has been established that breastfeeding should be done with hand disinfection and wearing a mask.
  • 1.1K
  • 24 Jul 2023
Topic Review
Bioactive Factors in Human Breastmilk
Maternal milk, a complex fluid with several bioactive factors, is the best option for the newborn. Its dynamic composition is influenced by diverse factors such as maternal age, lactation period, and health status. 
  • 1.1K
  • 11 Aug 2022
Topic Review
Role of FA Metabolites and Inflammation during Pregnancy
Normal pregnancy relies on inflammation for implantation, placentation, and parturition, but uncontrolled inflammation can lead to poor maternal and infant outcomes. Maternal diet is one modifiable factor that can impact inflammation. Omega-3 and -6 fatty acids obtained through the diet are metabolized into bioactive compounds that effect inflammation. The downstream products of omega-3 and -6 fatty acids may influence physiology during pregnancy.
  • 1.1K
  • 17 Jan 2023
Topic Review
Twin-to-twin Transfusion Syndrome
The study aims to expound upon the imaging-based diagnostic methodologies aimed at identifying twin-to-twin transfusion syndrome (TTTS), a serious, somewhat rare prenatal condition which takes place in pregnancies where identical twins, or other multiples, share a placenta (monochorionic placenta), and highlighting how medico-legal outcomes can be affected by provable compliance with consolidated diagnostic best practices. In that regard, case law databases have been pored over (Justia, Lexis, Leagle), and five significant court cases have been examined and discussed, in an attempt to identify objective medico-legal standards of good practice and bring to the forefront relevant forensic dynamics. It is of utmost importance to produce a prompt diagnosis of TTTS: an early diagnosis is in fact critical in order to effectively treat and manage TTTS. By virtue of TTTS being a highly progressive condition, a delay in diagnosis can result in disastrous outcomes: just a few weeks delay in the diagnosis of TTTS can turn out fatal for both twins. Hence, most TTTS malpractice claims involve allegations of medical negligence: namely the failure to recognize the condition in a timely fashion, or to proceed with adequate diagnostic and therapeutic pathways.
  • 1.1K
  • 25 May 2021
Topic Review
Seizures and Newborn Infants
Seizures are common in newborn infants with hypoxic-ischemic encephalopathy and are highly associated with adverse neurodevelopmental outcomes. The impact of seizure activity on the developing brain and the most effective way to manage these seizures remain surprisingly poorly understood, particularly in the era of therapeutic hypothermia. Critically, the extent to which seizures exacerbate brain injury or merely reflect the underlying evolution of injury is unclear. Current anticonvulsants, such as phenobarbital and phenytoin have poor efficacy and preclinical studies suggest that most anticonvulsants are associated with adverse effects on the developing brain. Levetiracetam seems to have less potential neurotoxic effects than other anticonvulsants but may not be more effective. Given that therapeutic hypothermia itself has significant anticonvulsant effects, randomized controlled trials of anticonvulsants combined with therapeutic hypothermia, are required to properly determine the safety and efficacy of these drugs. Small clinical studies suggest that prophylactic phenobarbital administration may improve neurodevelopmental outcomes compared to delayed administration; however, larger high-quality studies are required to confirm this. In conclusion, there is a distinct lack of high-quality evidence for whether and to what extent neonatal seizures exacerbate brain damage after hypoxia-ischemia and how best to manage them in the era of therapeutic hypothermia. 
  • 1.0K
  • 22 Jul 2021
Topic Review
Zinc Nutritional Status in Patients with Cystic Fibrosis
Zinc is an essential nutrient for all forms of life and its deficiency affects the normal growth and development of human beings. Zinc deficiency can be both inherited and acquired. Although severe zinc deficiency is extremely uncommon in European populations, marginal deficiency may be much more prevalent and is associated with immune system dysfunction and restricted physical development. Serum zinc concentration (SZC)  was associated with the nutritional status, expressed as BMI (Body Mass Index) and weight-for-height score, and dietary zinc intake with energy intake and weight-for-height score. No patient with hypozincemia had dietary zinc deficiency. 
  • 1.0K
  • 19 Jan 2023
Topic Review
Probiotics in Children with Asthma
A type-2 immune response usually sustains wheezing and asthma in children. In addition, dysbiosis of digestive and respiratory tracts is detectable in patients with wheezing and asthma. Probiotics may rebalance immune response, repair dysbiosis, and mitigate airway inflammation. As a result, probiotics may prevent asthma and wheezing relapse. There is evidence that some probiotic strains may improve asthma outcomes in children.
  • 1.0K
  • 09 Jul 2022
Topic Review
Copper/Zinc Ratio in Childhood and Adolescence
Both copper (Cu) and zinc (Zn) are crucial micronutrients for human growth and development. Children and adolescents with acute and chronic conditions are at greater risk of developing elevated Cu/Zn ratios, related to altered nutritional, infectious, and inflammatory status.
  • 1.0K
  • 18 Jan 2023
Topic Review
Feeding and Infant Sleep
Inconsistent conclusions from infant sleep and feeding studies may influence parents feeding-related decisions. Exclusively breastfed infants (≤6 months-of-age) had a greater number of night wakings, but most studies reported no difference in night-time and 24 h sleep duration compared to formula-fed infants. However, after 6 months-of-age, most studies reported breastfed infants to sleep less in the night-time and over 24 h compared to formula-fed infants. Furthermore, studies reported no association between the timing of introduction to complementary foods and infant sleep duration (<12 months-of-age).
  • 1.0K
  • 11 Jan 2022
Topic Review
Tics and Emotions
Tics can be associated with neurological disorders and are thought to be the result of dysfunctional basal ganglia pathways. In Tourette Syndrome (TS), excess dopamine in the striatum is thought to excite the thalamo-cortical circuits, producing tics. When external stressors activate the hypothalamic-pituitary-adrenal (HPA) axis, more dopamine is produced, furthering the excitation of tic-producing pathways. Emotional processing structures in the limbic are also activated during tics, providing further evidence of a possible emotional component in motor ticking behaviors.
  • 1.0K
  • 17 Feb 2022
Topic Review
Children with Hemiplegia
It is a great research to know the importance of applying unimanual therapies with containment at home in children with hemiplegia.
  • 1.0K
  • 23 Feb 2021
Topic Review
Pathophysiological Concepts of Pulmonary Manifestation of Pediatric IBD
Pulmonary manifestation (PM) of inflammatory bowel disease (IBD) in children is a rare condition. The exact pathogenesis is still unclear, but several explanatory concepts were postulated and several case reports in children were published. Different pathophysiological concepts were identified, including the shared embryological origin, “miss-homing” of intestinal based neutrophils and T lymphocytes, inflammatory triggering via certain molecules (tripeptide proline-glycine-proline, interleukin 25), genetic factors and alterations in the microbiome.
  • 1.0K
  • 20 Jul 2022
Topic Review
Sleep Disturbances in Pediatric Cancer Patients
Sleep disturbances represent an understudied yet common source of distress among pediatric cancer patients and survivors, with deleterious effects on quality of life. Sleep issues stem from multiple risk factors, yet individual contributors are difficult to isolate, consequently impeding the identification of targets for intervention.
  • 999
  • 11 Jan 2022
Topic Review
VA ECMO use in Pediatric
In children with severe advanced heart failure where medical management has failed, mechanical circulatory support in the form of veno-arterial extracorporeal membrane oxygenation (VA ECMO) or ventricular assist device represents life-sustaining therapy.The two primary forms of mechanical circulatory support are veno-arterial extracorporeal membrane oxygenation (VA ECMO) and ventricular assist devices (VAD). The two technologies have unique advantages and disadvantages and could be considered as complementary devices and, at times, used in sequence as the clinical scenario dictates.
  • 996
  • 05 May 2021
Topic Review
Gut Virome in Childhood Diseases
Mammals are colonized by numerous microbes, collectively referred to as the microbiota. The microbiota forms a stable symbiotic relationship with the host and is indispensable for health maintenance. Although the eubacteria are the best characterized component of the human gut microbiota, it also includes commensal populations of viruses, fungi, multicellular parasites and archaea. Evidence highlights that the virome, consisting in DNA and RNA eukaryotic viruses, bacterial viruses (i.e., bacteriophages) and archaeal viruses, exerts a fundamental role in the host wellbeing. Indeed, alterations of the adult virome have been linked to increased disease susceptibility, suggesting that maintaining or restoring a structurally and functionally correct composition of the virome might represent in the near future a promising approach to prevent or cure different human diseases. Although the knowledge of childhood virome is currently very limited, modifications of the virome composition have been associated with several diseases during the pediatric age, such as inflammatory bowel disease, type 1 diabetes, malnutrition, diarrhea and celiac disease. 
  • 988
  • 14 May 2021
Topic Review
Breastfeeding and Vitamin D in Preventing Childhood Infections
Human milk is the best food for infants. Breastfeeding has been associated with a reduced risk of viral and bacterial infections. Breast milk contains the perfect amount of nutrients needed to promote infant growth, except for vitamin D. Vitamin D is crucial for calcium metabolism and bone health, and it also has extra-skeletal actions, involving innate and adaptive immunity. As exclusive breastfeeding is a risk factor for vitamin D deficiency, infants should be supplemented with vitamin D at least during the first year. The promotion of breastfeeding and vitamin D supplementation represents an important objective of public health. 
  • 988
  • 09 Mar 2022
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