Publications by authors named "Marco Maglione"

: The impact of the coronavirus disease 2019 (COVID-19) pandemic on health was significant worldwide. The measures adopted to limit the spread of the virus had an indirect effect on the epidemiology of other infectious diseases with similar mechanisms of inter-human transmission. The present literature review analyzed the scenario of pediatric acute respiratory infections in the post-lockdown period compared to the pre-pandemic and lockdown periods.

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Objectives: Animal-related injuries (ARIs) represent a common reason for emergency department (ED) visits in children. Limited data regarding treatment in Italian EDs are available. The aims of the study were to assess the epidemiological features of these patients and to investigate the association between their characteristics and therapeutic approaches, particularly antibiotic prescription.

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: Solid organ transplant recipients (OTR) have been recently involved in exercise prescription programs in order to reduce the high prevalence of cardiovascular diseases. The normal systolic and diastolic cardiac function is fundamental to personalizing the prescription. Diastolic dysfunction can be associated to a higher risk of cardiovascular events and left atrial (LA) strain is an emerging parameter in the evaluation of diastolic compromising, especially in subjects with preserved ejection fraction.

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Acute fulminant myocarditis is a rare event in children, accounting for about 10% of all cases of acute myocarditis. Its lack of specific onset patterns and unpredictable evolution make diagnosis and prompt treatment challenging. We observed six cases of fulminant myocarditis admitted to our Pediatric Emergency Unit (Campania region, Sothern Italy) within a very short timeframe (50 days, from July to September 2024).

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Article Synopsis
  • Acute myocarditis cases in kids are increasing in Italy, with 65 suspected cases reported in 2024, largely linked to parvovirus B19 infection.
  • Among these cases, 29 children needed intensive care and there were eight fatalities, emphasizing the severity of the situation.
  • The study suggests a need for better diagnosis, enhanced monitoring, and standardized treatment strategies, as only about one-third of affected children received effective intravenous immunoglobulins.
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Article Synopsis
  • Endothelial-cell-specific molecule-1 (ESM-1), also known as endocan, is identified as a significant biomarker for inflammation and cardiovascular risk in COVID-19 patients, particularly in the context of Multisystem Inflammatory Syndrome in children (MIS-C).
  • In a study comparing ESM-1 levels between MIS-C patients and healthy controls, MIS-C patients showed significantly higher levels of ESM-1, suggesting its potential diagnostic value.
  • The research indicates that ESM-1 not only correlates with other inflammatory markers but is also associated with cardiac complications, highlighting its role in assessing cardiovascular risks in MIS-C patients and aiding in treatment strategies.
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Aims: Assessment of intracardiac flow dynamics has recently acquired significance due to the development of new measurement methods based on echocardiography. Recent studies have demonstrated that cardiac abnormalities are associated with changes in intracardiac vortical flows. Yet, no previous study assessed the impact of aortic stenosis (AS) on intracardiac vortices.

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Background: Although, in most children with asthma, good symptom control is achieved with a low to moderate dose of inhaled corticosteroids, a small group of patients still experiences frequent symptoms, and even severe exacerbations, impairment of lung function, and reduced quality of life. Some of these subjects with severe asthma require biologic drugs as add-on therapy. In the past decade, numerous monoclonal antibodies have been approved for children or adolescents with severe asthma, in addition to their increasing use in adult asthma.

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Since January 2024, Italy experiences a pertussis outbreak, primarily affecting neonates and unvaccinated infants at high risk of severe complications and mortality; 11 major paediatric centres noted 108 hospitalisations and three deaths by 10 May. The outbreak reflects increased circulation of and non-adherence to immunisation recommendations during pregnancy. Public health interventions, including maternal immunisation, vaccination of infants as early as possible and post-exposure prophylaxis, are critical for reducing the burden of pertussis and preventing further mortality.

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Background: Cardiovascular diseases in the context of renal and liver transplants remain the leading cause of morbidity and mortality. Physical exercise at a moderate intensity is allowed to contrast the risk profile. Echocardiographic evaluation is essential to stratifying potential cardiotoxicity by the standard and, more recently, the deformation and dynamic study of the intracardiac vortex.

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The diagnosis of Kawasaki disease (KD) is challenging and often delayed mainly in case of young infants and in presence of an incomplete disease and atypical features. Facial nerve palsy is one of the rare neurologic symptoms of KD, associated with a higher incidence of coronary arteries lesions and may be an indicator of a more severe disease. Here, we describe a case of lower motor neuron facial nerve palsy complicating KD and perform an extensive literature review to better characterize clinical features and treatment of patients with KD-associated facial nerve palsy.

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may present with a wide variety of symptoms, including neurological manifestations. We investigated clinical, demographic, laboratory, neurophysiological and imaging characteristics of SARS-CoV-2-positive children with seizures and analyzed differences between children admitted during the periods with prevalent circulation of the Alpha/Delta and Omicron variants, respectively. Patients' characteristics were analyzed according to the presence or absence of seizures and then according to the SARS-CoV-2 variants.

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Multisystem inflammatory syndrome in children (MIS-C) is a rare, severe complication of COVID-19. A better knowledge of immunological, cellular, and genetic characteristics of MIS-C could help better understand the pathogenesis of the disease and contribute to identifying specific diagnostic biomarkers and develop targeted therapies. We studied 37 MIS-C children at hospital admission and 24 healthy controls analyzing serum cytokines (IFN-α, IFN-β, IFN-γ, IL-6, IL-10, IL-17A, IL-12p70 and TNF), lymphocyte populations by flow cytometry and 386 genes related to autoimmune diseases, autoinflammation and primary immunodeficiencies by NGS.

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Background: The pathogenesis of the novel described multisystem inflammatory syndrome in children (MIS-C) and Kawasaki disease (KD) is still debated as it is not clear if they are the same or different nosological entities. However, for both the diseases a rapid and unequivocal diagnosis is mandatory to start the therapy before the onset of severe complications. In this study, we aimed to evaluate the white cell populations in MIS-C and KD as potential markers to discriminate between the two diseases.

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Several reports highlighted how public health measures aimed at limiting severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2) circulation have likely contributed to reducing the circulation of other respiratory viruses, particularly during the first year of the COVID-19 pandemic. We evaluated the epidemiology of acute respiratory infections in a large cohort of hospitalized children during the third year of the pandemic (2021−2022). We retrospectively analyzed data from the health records of children (<14 years) hospitalized for acute respiratory infections between 1 July 2021 and 31 March 2022.

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Endothelial hyperinflammation and vasculitis are known hallmarks of acute COVID-19 and multisystem inflammatory syndrome in children (MIS-C). They are due to the direct effect of the virus on endothelial cells enhanced by pro-inflammatory modulators and may cause venous/arterial thrombosis. Therefore, it is essential to identify patients with endothelial damage early in order to establish specific therapies.

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Article Synopsis
  • HyperDoppler is a new echocardiographic technique designed to assess blood flow dynamics within the heart, specifically looking at vortex flow in the left ventricle (LV).
  • The study included 200 patients, including normal individuals, athletes, and those with heart failure, to evaluate the technique's effectiveness and consistency in measuring vortex flow characteristics.
  • Results showed that HyperDoppler is highly feasible (94.5% success rate) and reliable, with excellent repeatability in measuring vortex flow metrics, allowing for differentiation between healthy individuals and heart failure patients.
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