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Nurses play a pivotal role during pediatric procedural sedation and their perspective is an important indicator for the quality of care. The aim of this study is to examine nurses' satisfaction comparing four different pharmacological regimens used for pediatric sedation outside of the operating room. A prospective observational study was conducted in a third-level pediatric teaching hospital, involving all the nurses with experience in the field of pediatric procedural sedation. A 13-item survey was used to assess the level of nurses' satisfaction for the quality of sedation with four different analgesic–sedative drugs. Fifty-one questionnaires were completed by pediatric nurses, with a median length of experience of 10 years. Regarding the overall quality of the sedation, the highest median satisfaction scores were observed for propofol (8, IQR 7–9), dexmedetomidine (8, IQR 6–8) and midazolam (8, IQR 7–9). Ketamine (5, IQR 3–7) displayed the lowest score. When asked to rate their level of perceived safety, nurses gave high scores to all the four drugs studied, with no statistically significant difference between them. Non-pharmacological techniques during procedural sedation were judged as important by 38 (74.5%) nurses. According to this sample of pediatric nurses, the best quality of procedural sedation in children outside of the operating room is obtained with propofol, dexmedetomidine and midazolam. During procedural sedation, nurses feel safe overall, regardless of the pharmacological regimen used. Moreover, they highlighted the relevance on non-pharmacological approaches in the preparation of the child for the procedure. [ABSTRACT FROM AUTHOR]

Although the effectiveness of probiotics has only been proven in specific conditions, their use in children is massively widespread because of their perception as harmless products. Recent evidence raises concerns about probiotics’ safety, especially but not only in the paediatric population due to severe opportunistic infections after their use. This review aimed at summarising available case reports on invasive infections related to probiotics’ use in children. For this purpose, we assessed three electronic databases to identify papers describing paediatric patients with documented probiotic-derived invasive infections, with no language restrictions. A total of 49 case reports from 1995 to June 2021 were identified. The infections were caused by Lactobacillus spp. (35%), Saccharomyces spp. (29%), Bifidobacterium spp. (31%), Bacillus clausii (4%), and Escherichia coli (2%). Most (80%) patients were younger than 2 years old and sepsis was the most observed condition (69.4%). All the patients except one had at least one condition facilitating the development of invasive infection, with prematurity (55%) and intravenous catheter use (51%) being the most frequent. Three (6%) children died. Given the large use of probiotics, further studies aiming at evaluating the real incidence of probiotic-associated systemic infections are warranted. [ABSTRACT FROM AUTHOR]

Remarkably, no association was found between HbA1c reduction and the use of CSII and FGM/CGM, physical activity or tele-visits during lockdown. Abbreviations BMI Body Mass Index CGM Continuous Glucose Monitoring CSII Continuous Subcutaneous Insulin Infusion FGM Flash Glucose Monitoring IQR Inter-Quartile Range SDS Standard Deviation Score T1DM Type 1 Diabetes Mellitus INTRODUCTION Despite the potential deleterious effect of COVID-19 lockdown on individuals with type 1 diabetes mellitus (T1DM), a stable or even improved glycaemic control has been reported in paediatric subjects treated with continuous subcutaneous insulin infusion (CSII) using continuous or flash glucose monitoring (CGM/FGM).1,2 To date, only two Indian studies evaluated the changes in HbA1c in paediatric individuals treated with multi-daily injections (MDI) with conflicting results.3,4 Additionally, although there are some weight gain reports in children during the lockdown, only one study focused on individuals with T1DM.3 The study aimed to evaluate the effects of the first COVID-19 lockdown on HbA1c and body mass index (BMI) in an unselected population of paediatric T1DM individuals treated with MDI and CSII, with or without CGM/FGM. HbA1c and BMI after lockdown for COVID-19 in children and adolescents with type 1 diabetes mellitus. [Extracted from the article]