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The transition of adolescents with asthma is a complex pathway, which must meet the educational and psychosocial needs that characterize this delicate phase of life, to enable the adolescent to acquire the ability to self-manage the disease. Therefore, the transition process must consider the clinical characteristics of the adolescent with asthma to identify possible risk factors for the persistence of asthma and possible evolution into chronic obstructive pulmonary disease in adulthood, and also comorbidities and factors that may lead to failure to control symptoms, such as obesity, functional breathing disorders, psychiatric issues, vaping, smoking, and the social context. In fact, adolescence is characterized by the desire to become progressively independent from the family; while this can be a limitation in adherence to therapy and self-management of the disease, it can however be an opportunity for healthcare providers to support adolescents to develop the knowledge, skills, and confidence needed to manage the disease and cope with the changes typical of the age. Therefore, a multidisciplinary, person-centered approach would be desirable to address important psychological, cultural, and social aspects typical of this age. Recently published guidelines from the European Academy of Allergy and Clinical Immunology provide evidence-based recommendations to guide the transition process, which needs to be adapted in the Italian national and regional context. This review aims to discuss the peculiarities of the management of the asthmatic adolescent and the transition process in close collaboration with adult services, to share priorities and goals in terms of care. [ABSTRACT FROM AUTHOR]

Pediatric neurosurgery is a highly specialized branch of surgery in which surgical site infections (SSIs) are potentially serious complications that can also adversely affect a good surgical outcome, compromising functional recovery and, in some cases, even putting the patient's life at risk. The main aim of this consensus document is to provide clinicians with a series of recommendations on antimicrobial prophylaxis for neonates and children undergoing neurosurgery. The following scenarios were considered: (1) craniotomy or cranial/cranio-facial approach to craniosynostosis; (2) neurosurgery with a trans-nasal-trans-sphenoidal approach; (3) non-penetrating head injuries; (4) penetrating head fracture; (5) spinal surgery (extradural and intradural); (6) shunt surgery or neuroendoscopy; (7) neuroendovascular procedures. Patients undergoing neurosurgery often undergo peri-operative antibiotic prophylaxis, with different schedules, not always supported by scientific evidence. This consensus provides clear and shared indications, based on the most updated literature. This work has been made possible by the multidisciplinary contribution of experts belonging to the most important Italian scientific societies, and represents, in our opinion, the most complete and up-to-date collection of recommendations on the behavior to be held in the peri-operative setting in this type of intervention, in order to guide physicians in the management of the patient, standardize approaches and avoid abuse and misuse of antibiotics. [ABSTRACT FROM AUTHOR]

Aim: To determine (i) prevalence and the risk factors for acute kidney injury (AKI) in children hospitalised for febrile urinary tract infection (fUTI) and (ii) role of AKI as indicator of an underlying VUR. AKI, in fact, is favoured by a reduced nephron mass, often associated to VUR., Methods: This retrospective Italian multicentre study enrolled children aged 18 years or younger (median age = 0.5 years) discharged with a primary diagnosis of fUTI. AKI was defined using Kidney Disease/Improving Global Outcomes serum creatinine criteria., Results: Of 849 children hospitalised for fUTI (44.2% females, median age 0.5 years; IQR = 1.8), 124 (14.6%) developed AKI. AKI prevalence rose to 30% in the presence of underlying congenital anomalies of the kidney and urinary tract (CAKUT). The strongest AKI predictors were presence of CAKUT (OR = 7.5; 95%CI: 3.8-15.2; p = 9.4e-09) and neutrophils levels (OR = 1.13; 95%CI: 1.08-1.2; p = 6.8e-07). At multiple logistic regression analysis, AKI during fUTI episode was a significant indicator of VUR (OR = 3.4; 95%CI: 1.7-6.9; p = 0.001) despite correction for the diagnostic covariates usually used to assess the risk of VUR after the first fUTI episode. Moreover, AKI showed the best positive likelihood ratio, positive predictive value, negative predictive value and specificity for VUR., Conclusion: AKI occurs in 14.6% of children hospitalised for fUTI and is a significant indicator of VUR., (© 2024 The Authors. Acta Paediatrica published by John Wiley & Sons Ltd on behalf of Foundation Acta Paediatrica.)