Publications by authors named "Pession A"

Article Synopsis
  • Bacterial Lysates are used as immunostimulants to help prevent respiratory tract infections (RTIs) by enhancing both innate and adaptive immune responses.
  • Studies indicate that they can boost immune function, support epithelial barriers, and lead to increased production of specific antibodies without significant side effects.
  • However, many studies on Bacterial Lysates are low quality and lack rigorous controls, suggesting that more thorough and well-designed clinical trials are needed to confirm their effectiveness in preventing RTIs.
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Introduction: AADCd is an ultrarare, underdiagnosed neurometabolic disorder for which a screening test (3-OMD dosing on dried blood spot (DBS)) and targeted gene therapy (authorized in the EU and the UK) are available. Therefore, it is mandatory to raise awareness of presenting symptoms and signs among practitioners. Delivering scientifically sound information to promote screening of patients with the correct cluster of symptoms and signs would be critical.

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Inherited metabolic disorders (IMDs), previously considered as a paediatric sub-specialisation are more and more prevalent in adults, thanks to improved survival, and the expansion of diagnostic tools detecting attenuated-late onset forms in adulthood. Italy is one of the countries with the highest number of IMDs screened by dry blood spots in neonates, allowing them to receive early treatments and to reach adult age. Despite this, awareness of IMDs is still low by the adult medical community, with difficulties in transition and transfer of patients to adult services and unmet patient needs.

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Since the 1970s, Italian pediatric oncologists have collaborated through the Italian Association for Pediatric Hematology Oncology (AIEOP) network using a common centralized system for the registration of childhood cancer, known as Model 1.01 (Mod. 1.

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Background: Music Therapy (MT) is a non-pharmacological, art-based intervention that employs music experiences within a therapeutic alliance to attend to clients' physical, emotional, cognitive, and social requirements. This is the first study aiming at investigating the impact of MT on the psychological facets of children suffering from cancer.

Methods: The study, combining the AQR and m-YPAS assessment tools, evaluated behavioral, sound-musical, and interactive parameters in pediatric oncology patients undergoing MT sessions during hospitalization.

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Background: The use of Non-Pharmaceutical Interventions (NPIs), such as lockdowns, social distancing and school closures, against the COVID-19 epidemic is debated, particularly for the possible negative effects on vulnerable populations, including children and adolescents. This study therefore aimed to quantify the impact of NPIs on the trend of pediatric hospitalizations during 2 years of pandemic compared to the previous 3 years, also considering two pandemic phases according to the type of adopted NPIs.

Methods: This is a multicenter, quasi-experimental before-after study conducted in 12 hospitals of the Emilia-Romagna Region, Northern Italy, with NPI implementation as the intervention event.

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Article Synopsis
  • Kabuki Syndrome (KS) is a genetic disorder that can affect multiple systems in the body, leading to immunological issues like higher infection risk and autoimmune responses.
  • A study involving 39 KS patients revealed that many had congenital heart defects and a notable percentage suffered from autoimmune cytopenia, which was linked to thymectomy.
  • The findings indicated that a significant number of patients had low immunoglobulin levels, increasing the need for immunoglobulin therapy, while certain immune cell abnormalities were also noted, highlighting the complexity of KS-related immunological challenges.
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  • Spinal cord compression due to non-Hodgkin lymphoma (NHL) can present with acute myelopathy symptoms in kids.
  • This condition is rare, making it challenging to diagnose, but recognizing it early is essential.
  • The report discusses two pediatric cases to highlight the importance of considering NHL as a possible diagnosis in similar scenarios for better patient outcomes.
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Background: In Italy, there is a network of centres headed by the Italian Association of Pediatric Hematology and Oncology (AIEOP) for the diagnosis and treatment of paediatric cancers on almost the entire national territory. Nevertheless, migration of patients in a hospital located in a region different from that of residence is a widespread habit, sometimes motivated by several reasons. The aim of this paper is to assess the impact of migration of children with cancer to AIEOP centres in order to verify their optimal distribution throughout the national territory.

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  • * Due to the rarity of UCDs, clinical research is challenging and evidence for treatment guidelines is limited, leading experts in Italy to develop consensus-based management strategies for mild UCDs.
  • * Recommended management includes expanded newborn screening, early initiation of therapy (like low-protein diets and nitrogen scavengers), and long-term follow-up that focuses on growth, nutrition, and cognitive development.
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  • In a study of 183 unvaccinated children hospitalized for COVID-19 pneumonia, 10.4% had autoantibodies that neutralized type I interferons (IFNs), specifically targeting IFN-α2 and IFN-ω in varying combinations.
  • Among the children with autoantibodies, 3.8% neutralized higher levels of IFN-α2, while the rest had lower neutralization capabilities, and some uninfected children also displayed similar antibodies.
  • The presence of these autoantibodies significantly increased the odds of developing severe COVID-19 pneumonia, particularly those neutralizing higher concentrations of IFN-α2 compared to those neutralizing IFN-ω.
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  • Hypertension in children is a significant risk factor for cardiovascular issues later in life, making early detection essential to prevent organ damage.* -
  • The study assessed 92 children to observe the effects of hypertension on cardiac health, finding that overweight/obese individuals had higher blood pressure and an increased likelihood of cardiac hypertrophy compared to those with chronic kidney disease.* -
  • Results indicated a strong link between body weight and cardiac mass, suggesting that managing weight through diet and lifestyle changes from a young age could lessen future cardiovascular risks.*
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  • A study looked at the gut bacteria of kids who had stem cell transplants to see if having more diverse bacteria helps them survive better.
  • The kids with more diverse gut bacteria before the transplant had a higher chance of surviving and less chance of getting a serious condition called aGVHD.
  • The types of bacteria found in their guts differed too, with the healthier group having good bacteria that can help health, while the lower diversity group had more harmful bacteria.
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Background: The large-scale utilization of immunoglobulins in patients with inborn errors of immunity (IEIs) since 1952 prompted the discovery of their key role at high doses as immunomodulatory and anti-inflammatory therapy, in the treatment of IEI-related immune dysregulation disorders, according to labelled and off-label indications. Recent years have been dominated by a progressive imbalance between the gradual but constant increase in the use of immunoglobulins and their availability, exacerbated by the SARS-CoV-2 pandemic.

Objectives: To provide pragmatic indications for a need-based application of high-dose immunoglobulins in the pediatric context.

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An infant with a prenatal diagnosis of citrullinemia, who started standard treatment at birth (L-arginine; sodium benzoate and a personalized diet characterized by a low protein intake and supplementation of essential nutrients and amino acids), presented at 4 months of age with extended, progressive, and severe skin lesions consistent with acrodermatitis dysmetabolica. Guidelines for the diagnosis and management of urea cycle disorders underline that a low-protein diet places patients at risk of essential fatty acids, trace elements, and vitamin deficiency. At hospital admission, our patient had normal levels of zinc and alkaline phosphatases.

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Background: The Covid pandemic seems to have had several detrimental effects on managing patients affected by inherited metabolic diseases (IMD), although published data about the impact of COVID-19 on patients suffering from IMD are very scarce. The scope of our work was to evaluate adherence to the vaccination plan, the side effects experienced by our adult IMD patients, and the symptoms of the SARS-CoV-2 infection.

Results: Sixty-seven patients agreed to respond to a phone interview.

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Background: RASopathies are developmental disorders caused by dysregulation of the RAS-MAPK signalling pathway, which contributes to the modulation of multiple extracellular signals, including hormones and growth factors regulating energetic metabolism, including lipid synthesis, storage, and degradation.

Subjects And Methods: We evaluated the body composition and lipid profiles of a single-centre cohort of 93 patients with a molecularly confirmed diagnosis of RASopathy by assessing height, BMI, and total cholesterol, HDL, triglycerides, apolipoprotein, fasting glucose, and insulin levels, in the context of a cross sectional and longitudinal study. We specifically investigated and compared anthropometric and haematochemistry data between the Noonan syndrome (NS) and Mazzanti syndrome (NS/LAH) groups.

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Purpose: The aims of our retrospective study investigated the role of immune system in glioblastoma (GBM), which is the most aggressive primary brain tumor in adults characterized by a poor prognosis. The recurrence rate remains high, probably due to "immune-desert" tumor microenvironment (TME) making GBM hidden from the anti-tumoral immune clearance. Considering this, we aimed to create a panel of prognostic markers from blood and tumor tissue correlating with overall survival (OS) and progression-free survival (PFS).

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Article Synopsis
  • - This multicenter retrospective study investigated the effects of eltrombopag treatment in Italian children with chronic ITP, analyzing data from 56 patients across 17 centers.
  • - Patients were divided into three groups based on their treatment outcomes: those who stopped due to stable platelet counts, those who stopped due to ineffectiveness, and those who continued treatment.
  • - Results showed that 36% of patients stopped eltrombopag permanently, mainly due to inefficacy, but those who had stable platelet counts maintained improvement without further treatment, highlighting the significance of early treatment response.
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Shellfish is a leading cause of food allergy and anaphylaxis worldwide. Recent advances in molecular characterization have led to a better understanding of the allergen profile. High sequence homology between shellfish species and between shellfish and house dust mites leads to a high serological cross-reactivity, which does not accurately correlate with clinical cross-reactions.

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Background: GD and ASMD are lysosomal storage disorders that enter into differential diagnosis due to the possible overlap in their clinical manifestations. The availability of safe and effective enzymatic therapies has recently led many investigators to develop and validate new screening tools, such as algorithms, for the diagnosis of LSDs where the lack of disease awareness or failure to implement newborn screening results in a delayed diagnosis.

Results: the proposed algorithm allows for the clinical and biochemical differentiation between GD and ASMD.

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Background: Pediatric cancer presents mental and physical challenges for patients and their caregivers. However, parental distress has been understudied despite its negative impact on quality of life, disability, and somatic disorders. Parents of oncopediatric patients experience high levels of suffering with their resilience tested throughout their children's illness.

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Introduction: Narcolepsy Type 1 (NT1) is a rare hypersomnia of central origin linked to hypocretin deficiency, most frequently arising at pediatric age. NT1 could be associated with endocrine comorbidities involving the neuroendocrine axis, predominantly obesity, and Central Precocious Puberty (CPP). The primary aim of this study is the evaluation of endocrine and auxological parameters at diagnosis and during follow-up in patients with NT1, treated with Sodium Oxybate (SO) or not.

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Article Synopsis
  • Follicular Lymphoma (FL) often leads to cycles of remission and relapse, making it nearly incurable, and current prognostic scores don't work well for all patients.
  • This study analyzed 49 FL lymph node biopsies to explore the relationship between immune cell types in the tumor microenvironment and patient outcomes, focusing on specific markers like CD56 and CD163.
  • Results indicated that certain ratios of immune cells were linked to survival rates, suggesting enhancing macrophage characterization could improve prognosis for FL patients, but further research is needed.
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