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Introduction: Very few studies have been published on the clinical history and contagiousness of not hospitalized Covid-19 pediatric patients. Therefore, to get deeper in this topic, between October 2020 and March 2021, we carried out an observational study in the pediatric primary care setting in Italy. Methods: The study enrolled patients with Covid-19 disease (cases); patients with suspicious symptoms but negative swab; close contacts of Covid-19 cases. The follow-up was 28 days for patients with Covid-19 disease, 14 days for the other subjects enrolled. Results: 1947 patients aged 0-13 were enrolled: 465 with Covid-19 disease; 549 with suspicious symptoms but negative swab; 933 close contacts of Covid-19 cases. 130 subjects with Covid-19 were asymptomatic at the time of diagnosis. Among the others, in children aged 0-2 the most frequent symptom was rhinitis (41%) followed by fever (38%) and cough (31%). In children aged 3-13 the most frequent symptom was headache (30%) followed by rhinitis (23%), asthenia (18%), fever (16%), cough (11%). No symptoms alone were sufficient to induce or rule out the suspicion of the Covid-19 disease diagnosis. A multiple logistic regression analysis, conducted for the purpose, allowed to build a score capable of inducing disease suspicion in patients older than 2 years of age, based on: fever, rash, rhinitis, headache and asthenia. Conclusions: This study compared subjects with SARS-CoV-2 infection with unaffected subjects with similar symptoms and confirmed that it is impossible to clinically distinguish Covid-19 from other similar respiratory diseases in pediatric age. The obtained score, potentially useful and valid during the study period, could not be applied in other epidemiological scenarios.

The goal of this study was to evaluate the effectiveness of nebulized beclomethasone in preventing the recurrence of viral wheezing. METHODS: The study was designed as a randomized, double-blind, placebo-controlled trial. Outpatient children aged 1 to 5 years with at least 1 episode of viral wheezing in the last 12 months, presenting to any of 40 Italian pediatricians for an upper respiratory tract infection, were randomly allocated to receive beclomethasone 400 mg or placebo twice daily for 10 days. Medications were administered through a nebulizer. A clinical evaluation was performed by the pediatrician at the start and end of the treatment period. A subjective evaluation of symptoms and efficacy of treatment was performed by the parents. The primary endpoint was the incidence of viral wheezing diagnosed by the pediatricians during the 10-day treatment period. RESULTS: A total of 525 children were enrolled in the study, 521 of whom were visited at the end of the treatment period. Wheezing was diagnosed by the pediatricians in 47 children (9.0% (95% confi- dence interval: 6.7 to 11.3)), with no statistically significant differences between treatment groups (beclomethasone versus placebo relative risk: 0.61 (95% confidence interval: 0.35 to 1.08)).The treatment was considered helpful by 63% of parents (64% in the beclomethasone group vs 61% in the placebo group). In all, 46% of children still had infection symptoms at the end of the treatment period, with no differ- ences between groups. CONCLUSIONS: The findings from this study confirm that inhaled ste- roids are not effective in preventing recurrence of viral wheezing. Moreover, no benefits were found in reducing symptoms of respiratory tract infections. Pediatrics 2014;133:e505-e512 ABBREVIATIONS CI—confidence interval RCT—randomized controlled trial RR—relative risk URTI—upper respiratory tract infection Dr Clavenna conceptualized and designed the study, and drafted the initial manuscript; Drs Sequi and Cartabia conducted the statistical analyses, and reviewed and revised the manuscript; Drs Borghi and Fortinguerra were involved in the data management and reviewed and revised the manuscript; and Dr Bonati contributed to defining the protocol, supervised the study, and reviewed and revised the manuscript. All authors approved the final manuscript as submitted.

Background An evidence-based Consensus on the treatment of undescended testis (UT) was recently published, recommending to perform orchidopexy between 6 and 12 months of age, or upon diagnosis and to avoid the use of hormones. In Italy, current practices on UT management are little known. Our aim was to describe the current management of UT in a cohort of Italian children in comparison with the Consensus guidelines. As management of retractile testis (RT) differs, RT cases were described separately. Methods Ours is a retrospective, multicenter descriptive study. An online questionnaire was filled in by 140 Italian Family Paediatricians (FP) from Associazione Culturale Pediatri (ACP), a national professional association of FP. The questionnaire requested information on all children with cryptorchidism born between 1/01/2004 and 1/01/2006. Data on 169 children were obtained. Analyses were descriptive. Results Overall 24% of children were diagnosed with RT, 76% with UT. Among the latter, cryptorchidism resolved spontaneously in 10% of cases at a mean age of 21.6 months. Overall 70% of UT cases underwent orchidopexy at a mean age of 22.8 months (SD 10.8, range 1.2-56.4), 13% of whom before 1 year. The intervention was performed by a paediatric surgeon in 90% of cases, with a success rate of 91%. Orchidopexy was the first line treatment in 82% of cases, while preceded by hormonal treatment in the remaining 18%. Hormonal treatment was used as first line therapy in 23% of UT cases with a reported success rate of 25%. Overall, 13 children did not undergo any intervention (mean age at last follow up 39.6 months). We analyzed the data from the 5 Italian Regions with the largest number of children enrolled and found a statistically significant regional difference in the use of hormonal therapy, and in the use of and age at orchidopexy. Conclusions Our study showed an important delay in orchidopexy. A quarter of children with cryptorchidism was treated with hormonal therapy. In line with the Consensus guidelines, surgery was carried out by a paediatric surgeon in the majority of cases, with a high success rate.