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The article discusses a study on the vitamin D serum status of white and black mothers who live in northern Italy. The study subjects included 12 white women and 12 black women who were paired with their infants. Results of the evaluation revealed low levels of vitamin D serum in 12 white and 11 black mothers at term of pregnancy. There were also deficiencies in the vitamin D serum levels of their newborns. Results indicated that skin pigmentation did not have an impact on the vitamin D deficiencies of pregnant mothers.

Background: In 2021, the Task Force on Breastfeeding of the Italian Ministry of Health released a document calling for the provision of breastfeeding support in case of re-hospitalization of the child after birth. Since type and quality of breastfeeding support during re-hospitalization in Italian Pediatric Units (PUs) is largely unknown, the Breastfeeding Section of the Italian Society of Pediatrics (TASIP) conducted an ad hoc national survey., Methods: In March 2023, a specifically designed electronic questionnaire was sent to the Directors of 328 PUs, who were requested to fill it online., Results: Data from 161 PUs were received, with a response rate of 48.7%. Our results highlighted that 18.6% of units do not provide training on breastfeeding for healthcare professionals and 46% of PUs lack of an ad hoc policy on breastfeeding support in case of re-hospitalization of the child. Although 88.2% of PUs provide breast pumps to the mothers of the re-hospitalized young children, 34.8% lack of a protocol on the storage of expressed breast milk., Conclusions: Breastfeeding support for the mothers of hospitalized breastfed young children appears to be suboptimal in Italian PUs. Interventions aimed to structure and improve the quality of breastfeeding support for the mother-child dyad are needed, particularly developing protocols and providing a training on breastfeeding to the majority of healthcare professionals., (© 2024. The Author(s).)

The restrictive measures adopted worldwide against SARS-CoV-2 produced a drastic reduction in respiratory pathogens, including RSV, but a dramatic rebound was thereafter reported. In this multicenter retrospective observational study in 15 Pediatric Emergency Departments, all children <3 years old with RSV infection admitted between 1 September and 31 December 2021 were included and compared to those admitted in the same period of 2020 and 2019. The primary aim was to evaluate RSV epidemiology during and after the COVID-19 pandemic peak. The secondary aims were to evaluate the clinical features of children with RSV infection. Overall, 1015 children were enrolled: 100 in 2019, 3 in 2020 and 912 in 2021. In 2019, the peak was recorded in December, and in 2021, it was recorded in November. Comparing 2019 to 2021, in 2021 the median age was significantly higher and the age group 2-3 years was more affected. Admissions were significantly higher in 2021 than in 2020 and 2019, and the per-year hospitalization rate was lower in 2021 (84% vs. 93% in 2019), while the duration of admissions was similar. No difference was found in severity between 2019-2020-2021. In conclusion, after the COVID-19 pandemic, an increase in RSV cases in 2021 exceeding the median seasonal peak was detected, with the involvement of older children, while no difference was found in severity.

Vitamin B6 is a micronutrient required by the body. It acts as a coenzyme in biochemical reactions. Vitamin B6 toxicity is not caused by the intake of food-based sources. The few reported cases of vitamin B6 toxicity are always caused by overdosing of nutritional supplements. Chronic toxicity typically occurs with peripheral neuropathy such as paraesthesia, ataxia, and imbalance, paradoxically mimicking vitamin B6 deficiency. However, the prognosis is favorable, and symptoms usually show improvement once excessive vitamin B6 levels return to the physiological range. We report a newborn presenting with diffuse tremor at birth, interpreted as secondary to the mother's intake of high doses of a supplement containing vitamin B6 during pregnancy and breastfeeding. As expected, the newborn's serum levels of vitamin B6 were high. The tremors disappeared when the maternal supplement was stopped., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Andrea Guala et al.)

Introduction: Streptococcus agalactiae, a species of β-haemolytic streptococcus belonging to Lancefield's group B (GBS), is known as a common infecting agent transmitted to infants during childbirth, causing sepsis, meningitis, or both, with a high incidence of mortality. Following the observation of a great variability between regional laboratories both in the methodology and in the results of tests for the detection of GBS in pregnancy, with high percentages of false negative results, in 2010 the Department for Health Policies of Piedmont, Italian region, issued specific recommendations for adhere to international guidelines. Our aim was to assess whether the impact of the publication of the recommendations has been lasting over time., Methods: We analyzed the regional birth certificate register from 2006 to 2018, to evaluate the annual number of deliveries, the number of Streptococcus agalactiae tests in pregnancy and the percentage of positive culture results. We also evaluated the consistency of the percentage of positive tests with the expectations based on the guidelines and compared the two time periods before and after introduction of regional recommendations using a multivariate regression model., Results: The mean proportion of women tested for GBS vaginal-rectal swabs during pregnancy increased from 83.5% in 2006 to 90.7% in 2018 with the biggest rise in 2010, the t-test for the comparison of the two means was statistically significant ( p  < .001). The mean positivity rate increased from 12.7% to 19.2%, with a rise in 2010, with a significant t-test ( p  < .001)., Conclusion: The results suggested a significant impact of the recommendations on the compliance and results regarding the carrying out and culture of vagino-rectal swabs for GBS, with better appropriateness of peripartum antibiotic therapy and possible reduction of GBS related neonatal sepsis.

Background: Sudden unexpected postnatal collapse of presumably healthy neonates during early skin-to-skin contact is a rare, yet recognized occurrence, associated with a high risk of mortality and morbidity. A survey was conducted in 2012 in 30 delivery wards throughout Piedmont and the Aosta Valley to evaluate the environmental and logistical aspects that could be linked to SUPC. The survey was again conducted in 2016 in 28 delivery wards in Piedmont and the Aosta Valley in order to evaluate organizational improvements introduced after ministerial indications and recommendations by the Italian Society of Neonatology were published in 2014, in light of new findings regarding the phenomenon., Methods: A questionnaire specifically asking about the organization of delivery wards, and surveillance or supervision during early skin-to-skin contact, was sent to all of the hospitals taking part in the survey in both 2012 and 2016. The collected data were elaborated anonymously and the statistical analysis was performed by using the two by two table., Results: In 2012, 28 out of 30 delivery wards in Piedmont and Aosta, with a total of 31,074 newborns out of 35,435, were evaluated in all of the environmental and logistical aspects that might be cause for SUPC to occur. An identical survey was taken again in 2016; 26 out of 28 wards participated with a total of 27,484 newborns out of 30,339. In 2012, early skin-to-skin contact took place immediately in all the delivery rooms in 27 wards, and soon after in the post-partum room in one; in 11 out of 28 wards there was early skin-to-skin contact in the operating theater itself, following caesarean sections (11/26 in 2016). Routine newborn care was given after 3 h in 8 delivery wards (7/26 in 2016); after 2 h in 12 (7/26 in 2016); after 1 h in 2 (4/26 in 2016); after 30 min in 3 (2/26 in 2016); after 10 min in 1 (0/26 in 2016); after 1 or 2 min in 1 (0/26 in 2016) and at any time in one ward (6/26 in 2016)., Conclusion: Periodic surveys of delivery wards are useful for the assessment of all the aspects and risk factors that need to be changed in order to implement safe early skin-to-skin contact.

Rapunzel syndrome is a rare form of tricobezoar with a tail extending from the stomach into the small bowel; surgical removal is generally required. About 60 cases have been reported and described in the literature since 1968. We present the case of an 8-year-old girl who, during the course of a genetic consultation, was initially assigned with a clinical suspicion of ectodermal dysplasia. Surgical intervention, which resulted in the extraction of a tricobezoar of enormous size and extension, led us to the diagnosis of Rapunzel syndrome. The possibility of a tricobezoar should be considered in all cases of adolescent patients who present signs of intestinal occlusion or sub-occlusion, suffer from psychiatric disorders, and have a history of trichotillomania. Endoscopic methodology, medical imaging and clinical diagnostics are fundamental for a differential diagnosis. Psychiatric follow-up is advised to prevent recurrence., Competing Interests: Conflict of interest: the authors declare no potential conflict of interests.

Ficopomatus enigmaticus is an ubiquitous fouling reef-forming species, easy to sample and recognize, diecious with gamete spawning along different seasons in different salinity conditions. Due to its characteristics it could become a good candidate for the monitoring of both marine and brackish waters. The suitability of F. enigmaticus as a promising model organism in ecotoxicological bioassays was evaluated by a sperm toxicity and a larval development assay. The fertilization rate in different salinity conditions (range 5-35‰) was first assessed in order to detect the salinity threshold within which profitably perform the assays. Afterward copper (Cu 2+ ), cadmium (Cd 2+ ), sodium dodecyl sulfate (SDS) and 4-n-nonylphenol (NP) were used as reference toxicants in exposure experiments with spermatozoids (sperm toxicity assay) and zygotes (larval development assay). A dose-response effect was obtained for all tested toxicants along all salinity conditions except for 5‰ salinity condition where a too low (<30%) fertilization rate was observed. NP showed the highest degree of toxicity both in sperm toxicity and larval development assay. In some cases the results, expressed as EC 50 values at 35‰ salinity condition, were similar to those observed in the literature for marine organisms such as the sea urchin (Paracentrotus lividus) and the marine serpulid Hydroides elegans, while the exposure of F. enigmaticus spermatozoids' to Cd 2+ and NP resulted in toxicity effects several orders of magnitude higher than observed in P. lividus. Spermatozoids resulted to be slightly more sensitive then zygotes to all different toxicants., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Early skin-to-skin contact (SSC) after birth is a physiological practice that is internationally recommended and has well-documented importance for the baby and for the mother. This study aims to examine SSC with a cohort of mothers or fathers in the operating room after a Cesarean section (C-section) and its relationship with duration of breastfeeding. From January 1, 2012, to December 31, 2012, at the Castelli Hospital in Verbania, Italy, a Baby Friendly designated hospital, 252 consecutive women who had a C-section were enrolled in the study and followed for 6 months. The sample was later divided into three groups depending on the real outcomes in the operating room: SSC with the mother (57.5%), SSC with the father (17.5%), and no SSC (25%). Our study showed a statistical association between skin-to-skin contact with the mother and the exclusive breastfeeding rates on discharge. This effect is maintained and statistically significant at three and six months, as compared to the groups that had paternal SSC or no SSC. After a C-section, skin-to-skin contact with the mother can be an important practice for support, promotion, and duration of breastfeeding.

Novel photopolymerized network films based on a polysiloxane matrix containing varied amounts of polyoxyethylene (P3) or perfluorohexylethyl (F) dangling side chains were investigated. For films containing less than 10 wt % P3 and F, the wettability and elastic modulus were similar to those of the photopolymerized network matrix. However, angle-resolved X-ray photoelectron spectroscopy measurements proved that the surface of films with F dangling chains was highly enriched in fluorine depending on both the amount of P3 and F and their relative ratio in the films. The biological performance of the films was evaluated against a new widespread and invasive marine biofoulant, the serpulid Ficopomatus enigmaticus. The diatom Navicula salinicola was also assayed as a conventional model organism for comparison. Films richer in P3 better resisted the settlement and promoted the release of calcified tubeworms of F. enigmaticus.

Novel films were prepared by condensation curing reaction of a poly(dimethyl siloxane) (PDMS) matrix with bismuth neodecanoate and dibutyltin diacetate catalysts. An ecotoxicological study was performed on the leachates of the coatings using the bacterium Vibrio fischeri, the unicellular alga Dunaliella tertiolecta, the crustacean Artemia salina and the fish Sparus aurata (larvae) as testing organisms. A copper-based self-polishing commercial paint was also tested as reference. The results showed that the tin-catalysed coatings and the copper paint were highly toxic against at least two of the four test organisms, whereas bismuth-catalysed coatings did not show any toxic effect. Moreover, the same biological assessment was also carried out on PDMS coatings containing a surface-active fluorinated polymer. The toxicity of the entire polymeric system resulted only from the tin catalyst used for the condensation curing reaction, as the bismuth catalysed coatings incorporating the surface-active polymer remained atoxic toward all the tested organisms., (© 2013 Elsevier Inc. All rights reserved.)

Heel prick is an usual method performed to get a blood sample for newborn screening. Its wide use justifies the effort in reducing the pain as much as possible and some simple steps, including the use of spring heelsticks, are recommended by national and international guide-lines. But not all the heelsticks cause the same pain and allow to get enough blood for the screening. The aim of this work was to test six automatic heelstick devices with regard to the pain in heel prick measured with NIPS scale and, at the same time, to value their effectiveness in getting a blood sample suitable for filter paper for newborn screening. The following devices were assessed: Amnes Minilet Lancets, Wuxi Xinda Ltd, Exxe Safe Blade, Lifescan Stik Johnson & Johnson, One Touch Ultra Soft, Accu-Chek Safe T Pro Plus. The device Exxe Safe Blade statistically differs from all others: it is the least painful and it doesn't need any prick repetition.

Aim: In recent years many consensus conferences of scientific societies have reaffirmed the advantages of metered dose inhalator (MDI) and spacer administration compared to classic aerosol in acute asthma and maintenance therapy. Faced with a more than convincing documentation, the practitioners have shown a controversial attitude concerning this type of administration. At the same time, as a general acceptance of its superiority there is an inexplicable lack of use., Methods: This survey was carried out in 2006 and it involved pediatric hospital wards in Piedmont and Aosta Valley to evaluate the use of spacers in acute asthma in hospitalised children undergoing treatment. These results were compared to those obtained from another survey carried out in 2008 using identical questionnaires in the same departments in order to evaluate the implementation of such a practice., Results: In the two years between one survey and the other no increase in the use of MDI and spacer has been detected, but, on the contrary, a consistent decrease., Conclusion: Notwithstanding the amount of evidence concerning its superiority compared to nebulisers MDI and spacer is not commonly used for asthma therapy yet. A "promotional" multidisciplinary intervention could play a determining role in the implementation of such a practice.

The study aimed to assess the effect of juvenile simple adiposity on growth. The height (measured using a Hapenden stadiometer) of 1443 subjects (799 boys and 644 girls) aged from 6 to 16 was measured. The Quetelet index (QI) of adiposity was used; all subjects examined exceeded the 95th centile of the standard Cronk and Roche scale. Heights are expressed as standard deviation scores (SDS) and are compared to the British Standard. Adipose boys are taller than British boys up to the age of 12, then the difference lessens and the average heights of 15-year-old adipose boys are below the 50th centile of British growth charts. Female subjects showed a higher SDS from 6 to 8 years, after which the difference lessens gradually, and after 13 years the average height is below the 50th centile of British standards. Adipose boys are taller than normal boys during childhood; in prepuberty and puberty this difference lessens and during puberty they are shorter than British boys. This growth model is probably due to advanced skeletal maturity in adipose subjects with the result that at puberty growth lessens because it is exhausted. The wide epidemiological cross-sectional study confirms that growth is favourable in juvenile adiposity but does not alter adult height.

Essential adiposity positively influences growth during childhood, but little is known about its effects on final height. A study was performed in 39 subjects (20 males and 19 females, mean age 10.7 for males, and 8.2 years for females) affected by essential adiposity to assess height during and at the end of the developmental age. During childhood the height of adipose subjects included in the study exceeded the mean values for matched chronological ages from the British reference sample (0.716 SDS for males, 0.587 for females). In adulthood, this advantage was completely reversed: the height of males in the study was in line with mean values (0.069 SDS), whereas the females were slightly under the mean height of the reference group (0.165 SDS). Since height is known to be heavily influenced by genetic factors, the results have been corrected for genetic bias. Improved results are obtained following correction for genetic influence: males (0.890 SDS), females (0.584 SDS). In conclusion, childhood adiposity has a positive influence on growth during the developmental age, and also appears to have a positive influence on genetic potential, as may be deduced from the height of the parents, thus improving final height.