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Erythema nodosum is a panniculitis that can be triggered by many different stimuli. The paper describes the case of a child who presented with erythema nodosum as the unique clinical manifestation of cat scratch disease. Bartonella henselae infection usually presents with non-tender papule in the scratch line followed by subsequent onset of regional lymphadenopathy eventually associated with systemic symptoms. It can also present with atypical manifestation, such as erythema nodosum. The heterogeneity of the clinical presentations makes the disease to be underdiagnosed, whereby it is important to recognize atypical manifestations. Therefore, it is recommended to include Bartonella henselae serology in the diagnostic evaluation of erythema nodosum. more...

Italy was the first European country hit by SARS-CoV-2 infection, particularly northern regions. After the beginning of national lockdown (March 9th, 2020), we observed a significant decrease in pediatric emergency department consultations (daily pediatric visits; pre-lockdown, 16 (11–22); lockdown, 3 (1–3); phase 2, 3 (3–5), p more...

Background and aims High prevalence of hypovitaminosis D is worldwide reported among pregnant women and newborns. We assessed cord blood 25-hydroxyvitamin D3 [25(OH)D3] and 3-epi-25-hydroxyvitamin D3 (C3-epimer) levels in relation to assumed maternal risk factors for hypovitaminosis D. Methods We enrolled 246 term newborns during summer. 175/246 mothers were supplemented with a daily variable dosage (200-1,000 IU) of vitamin D3 during pregnancy. Cord blood 25(OH)D3 and C3-epimer concentrations were analyzed by high performance liquid chromatography tandem mass spectrometry. Results Median cord blood 25(OH)D3 levels were 23.4 ng/mL (16.9-28.8). The prevalences of vitamin D sufficiency (≥30.0 ng/mL), insufficiency (20.0-29.9 ng/mL), and deficiency ( Conclusions Cord blood vitamin D deficiency was common, particularly in newborns from mother not receiving vitamin D supplementation and with poor sun exposure. C3-epimer levels were high in cord blood, causing possible misclassification of vitamin D status if they were not distinguished from 25(OH)D3 concentrations. more...

High prevalence of hypovitaminosis D is worldwide reported among pregnant women and newborns. We assessed cord blood 25-hydroxyvitamin DWe enrolled 246 term newborns during summer. 175/246 mothers were supplemented with a daily variable dosage (200-1,000 IU) of vitamin DMedian cord blood 25(OH)DCord blood vitamin D deficiency was common, particularly in newborns from mother not receiving vitamin D supplementation and with poor sun exposure. C more...

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. more...

Vitamin D plays a pivotal role in the regulation of calcium-phosphorus metabolism, particularly during pediatric age when nutritional rickets and impaired bone mass acquisition may occur. Besides its historical skeletal functions, in the last years it has been demonstrated that vitamin D directly or indirectly regulates up to 1250 genes, playing so-called extraskeletal actions. Indeed, recent data suggest a possible role of vitamin D in the pathogenesis of several pathological conditions, including infectious, allergic and autoimmune diseases. Thus, vitamin D deficiency may affect not only musculoskeletal health but also a potentially wide range of acute and chronic conditions. At present, the prevalence of vitamin D deficiency is high in Italian children and adolescents, and national recommendations on vitamin D supplementation during pediatric age are lacking. An expert panel of the Italian Society of Preventive and Social Pediatrics reviewed available literature focusing on randomized controlled trials of vitamin D supplementation to provide a practical approach to vitamin D supplementation for infants, children and adolescents. more...

Background Vitamin D deficiency represents a global health problem, affecting children and adolescents worldwide. Objects To confirm that vitamin D deficiency can present as a spectrum of clinical pictures. Methods We diagnosed nutritional rickets in a 10-month-old infant of Senegal origin with several risk factors for vitamin D deficiency. As many of these factors affected also his cohabitant relatives, we evaluate infant’s family members (mother and 4 brothers) looking for other vitamin D deficiency-related comorbidities. Results 3 brothers had asymptomatic vitamin D deficiency and 2 of them (9.8 and 13.4 years-old) showed secondary hyperparathyroidism. The fourth brother (11.3 years-old) had nutritional rickets. Their mother was affected by osteomalacia. None of them received vitamin D supplementation. Conclusion Vitamin D deficiency may present as a spectrum of clinical pictures, representing a continuum ranging from asymptomatic/subtle conditions to overt rickets/osteomalacia. Immigrant families are at high risk for vitamin D deficiency at every age. If a case of symptomatic vitamin D deficiency is recognized, then the evaluation of the all family members is recommended, as they can have the same and/or other risk factors for vitamin D deficiency. more...

A previously reported protocol for the synthesis of the commercial dye [Bu4N]2[Ru(4-carboxy-4′-carboxylate-2,2′-bipyridine)2(NCS)2] (N719) was thoroughly optimized in terms of the amount of input materials needed, reaction times and temperatures achieving significant reductions in all the three synthetic steps. This optimization allowed a 81% reduction of the Sheldon's E factor of the overall process. more...

Background Scientific interest in the clinical aspects surrounding vitamin D has increased exponentially in recent years. Unfortunately, this interest is not currently associated with a proportional level of consensus. Indeed, the large number of studies in this field, which are often of low quality and secondary importance has confused even experts and driven them towards controversial positions. Objectives To shed light on this topic, we arranged a meeting with the aim of collecting the opinions of 50 experts in different specialties (“D..Battito Group”), including internists, endocrinologists, rheumatologists, pediatricians, geriatricians, dermatologists, gynecologists and nephrologists. This meeting dealt with specific questions regarding the management of hypovitaminosis D and aimed to investigate the opinions of Italian experts on this topic. Six key questions were addressed in the meeting. Methods After a short lecture and a 30 minutes discussion, all the experts expressed their opinions, which were recorded together with any specific commentary. Results The results of the meeting demonstrated the presence of insufficient agreement on many key questions regarding the management of vitamin D deficiency, even among clinical experts. Conclusion We hope that the various scientific societies will recognize and analyze the inconsistencies in their own positions and reach adequate consensus, especially on the tenets required for conducting proper and useful investigations on the topic, and that the results of these future new studies will be able to shed the needed light. Acknowledgement Abdel Jaber M, Benini C, Boner A, Bortolotti R, Brigo M, Catalano A, Ferlin A, Girasole G, Idolazzi L, Lello S, Maestri E, Martinis F, Muratore M, Olivari F, Peroni D, Romagnoli E, Ruggiero C, Saviola G, Sella S, Sfrappini M, Silveri F, Vantaggiato E, Venturin A, Zuccaro C. Disclosure of Interests Alessandro Giollo: None declared, Ombretta Viapiana Speakers bureau: Novartis, Abbvie, Eli-Lilly, Sanofi Genzyme, Angelo Fassio Speakers bureau: Abiogen Pharma, Francesco Bertoldo: None declared, Vania Teresa Braga: None declared, Maria Luisa Brandi: None declared, Stefano Calvieri: None declared, Luisella Cianferotti Speakers bureau: Abiogen Pharma, Bruno Farmaceutici, Shire, Annamaria Colao: None declared, Patrizia D’Amelio: None declared, Giovanni Mario D’Avola: None declared, Luca Degli Esposti: None declared, Bruno Frediani: None declared, Sandro Giannini: None declared, Andrea Giusti Grant/research support from: Abiogen Pharma, Consultant for: EffRx, Speakers bureau: Abiogen Pharma, Eli Lilly, AMGEN, Andrea Giustina: None declared, Stefano Gonnelli: None declared, Nazzarena Malavolta: None declared, Claudio Marcocci Grant/research support from: Shire, Speakers bureau: Shire and AbiogenPharma, Salvatore Minisola: None declared, Nicola Napoli: None declared, Ranuccio Nuti: None declared, Giovanni Passeri Grant/research support from: Abiogen Pharma and Chiesi Farmaceutici, Speakers bureau: Abiogen Pharma and Chiesi Farmaceutici, Maurizio Rossini: None declared, Luigi Sinigaglia: None declared, Francesco Vierucci: None declared, Davide Gatti Speakers bureau: Abiogen, Amgen, Janssen-Cilag, Mundipharma, Pfeizer more...