Lumbar Puncture and Meningitis in Infants with Proven Early- or Late-Onset Sepsis: An Italian Prospective Multicenter Observational Study.

: To evaluate the rates of lumbar puncture (LP) in infants with culture-proven sepsis. : We prospectively enrolled 400 infants with early- or late-onset sepsis due to Group B (GBS) or , diagnosed within 90 days of life. Rates of LP and potential variables associated with LP performance were evaluated.

Timing of Symptoms of Early-Onset Sepsis after Intrapartum Antibiotic Prophylaxis: Can It Inform the Neonatal Management?

The effectiveness of "inadequate" intrapartum antibiotic prophylaxis (IAP administered < 4 h prior to delivery) in preventing early-onset sepsis (EOS) is debated. Italian prospective surveillance cohort data (2003-2022) were used to study the type and duration of IAP according to the timing of symptoms onset of group B streptococcus (GBS) and culture-confirmed EOS cases. IAP was defined "active" when the pathogen yielded in cultures was susceptible.

Is Overtaking Group B in Early-Onset Neonatal Sepsis.

The widespread use of intrapartum antibiotic prophylaxis (IAP) to prevent group B (GBS) early-onset sepsis (EOS) is changing the epidemiology of EOS. Italian prospective area-based surveillance data (from 1 January 2016 to 31 December 2020) were used, from which we identified 64 cases of culture-proven EOS (, = 39; GBS, = 25) among 159,898 live births (annual incidence rates of 0.24 and 0.

Prognostic Risk Factors for Severe Outcome in the Acute Phase of Neonatal Hypoxic-Ischemic Encephalopathy: A Prospective Cohort Study.

In the first days after birth, a major focus of research is to identify infants with hypoxic-ischemic encephalopathy at higher risk of death or severe neurological impairment, despite therapeutic hypothermia (TH). This is especially crucial to consider redirection of care, according to neonatal outcome severity. We aimed to seek associations between some neonatal routine parameters, usually recorded in Neonatal Intensive Care Units, and the development of severe outcomes.

Understanding Factors in Group B Streptococcus Late-Onset Disease.

Group B streptococcus (GBS) infection remains a leading cause of sepsis, pneumonia, and meningitis in infants. Rates of GBS early onset disease have declined following the widcespread use of intrapartum antibiotic prophylaxis; hence, late-onset infections (LOGBS) are currently a common presentation of neonatal GBS dicsease. The pathogenesis, mode of transmission, and risk factors associated with LOGBS are unclear, which interfere with effective prevention efforts.

[Un neonato con un ginocchio congenito recurvato.].

Riassunto. Descriviamo un caso di un neonato con un ginocchio congenito recurvato. Il neonato non aveva altre malformazioni.

Prevalence of celiac disease serological markers in a cohort of Italian rheumatological patients.

Aim: To assess the prevalence of celiac disease (CD) serological markers in a cohort of patients referred to an Italian rheumatological outpatient clinic.

Background: Current guidelines do not suggest CD screening in patients with rheumatological diseases and these subjects are not considered to be at high risk for CD.

Methods: A total of 230 sera of rheumatological patients referred to the Division of Internal Medicine at the Department of Medical and Surgical Sciences between January 2005 and December 2013 were screened for CD by testing IgA antitransglutaminase (TTG IgA), IgG deamidated gliadin peptides (DGP IgG) and IgA antiendomysium (EMA) antibodies.

Corrigendum to "Two Mutations in Surfactant Protein C Gene Associated with Neonatal Respiratory Distress".

[This corrects the article DOI: 10.1155/2015/591783.].

Two mutations in surfactant protein C gene associated with neonatal respiratory distress.

Multiple mutations of surfactant genes causing surfactant dysfunction have been described. Surfactant protein C (SP-C) deficiency is associated with variable clinical manifestations ranging from neonatal respiratory distress syndrome to lethal lung disease. We present an extremely low birth weight male infant with an unusual course of respiratory distress syndrome associated with two mutations in the SFTPC gene: C43-7G>A and 12T>A.

Feeding intolerance in the preterm infant.

Feeding intolerance (FI), defined as the inability to digest enteral feedings associated to increased gastric residuals, abdominal distension and/or emesis, is frequently encountered in the very preterm infant and often leads to a disruption of the feeding plan. In most cases FI represents a benign condition related to the immaturity of gastrointestinal function, however its presentation may largely overlap with that of an impending necrotizing enterocolitis. As a consequence, individual interpretation of signs of FI represents one of the most uncontrollable variables in the early nutritional management of these infants, and may lead to suboptimal nutrition, delayed attainment of full enteral feeding and prolonged intravenous nutrition supply.

Strategies to improve feeding tolerance in preterm infants.

Postnatal growth restriction and failure to thrive is a major issue in preterm, especially extremely low-birth-weight infants. Optimization of enteral nutrition, without increasing the risk of necrotizing enterocolitis (NEC), has thus become a priority for the neonatologist, who often has to face the challenge of interpreting the clinical and prognostic significance of common and aspecific signs of feeding intolerance (FI). The neonatologist often prescribes enteral nutrition as if walking on a tightrope between the purposed attainment of full enteral feeding and the fear of NEC.

Blood transfusion in infants: techniques and adverse events.

High risk infants, especially preterm ones, often require the administration of blood products. Specific guidelines and recommendations on this topic are continually issued and updated and their clinical application is strongly supported, in order to optimize the transfusion practice in neonatal and pediatric patients. Blood transfusion in infants has, in fact, specific indications, requires special considerations on technical procedures, and deserves particular awareness of possible errors and potential adverse reactions.

Fortification of maternal milk for very low birth weight (VLBW) pre-term neonates.

Human milk is the best food for all neonates; however, in pre-term infants, especially those with a very low birth weight, it may lead to insufficient intake of protein and energy. The use of fortified human milk produces adequate growth in premature infants and satisfies the specific nutritional requirements of these babies. To improve the nutritional management of pre-term infants < or =35 weeks' gestational age, an individualised human milk fortification system based on the analysis of maternal milk was evaluated.

Different pre-term formulas for different pre-term infants.

Optimal nutrition is one of the most important aspects in the care of pre-term infants, especially for the gestationally youngest ones. These infants should receive a supply of nutrients that can sustain growth similar to that of a third trimester normal foetus. Traditional pre-term formulas do not ensure an optimal protein supply except when fed at high volumes, with an excess of fat and carbohydrates.

Galacto-oligosaccharides are bifidogenic and safe at weaning: a double-blind randomized multicenter study.

Objectives: The primary objective of this study was to determine the bifidogenic effect of galacto-oligosaccharides (GOS) in a follow-on formula and the effects on other intestinal bacteria. Secondary objectives were the effects on stool characteristics, growth, and general well-being.

Participants And Methods: In a multicenter, double-blind study, 159 healthy infants, formula-fed at enrollment (at 4-6 months), were randomized to an experimental follow-on formula supplemented with 5 g/L (GOS) (77 infants), or to a standard follow-on formula (control, 82 infants).

Which role for prebiotics at weaning?

It is now generally recognized that the intestinal microflora plays a key role for human health and well being. In fact, the gut ecosystem is involved in a number of biologic functions, such as direct and indirect antipathogen activity (nutritive competition, reduction of pH, production of short-chain fatty acids, maturation and protection of the mucosal barrier, etc), synthesis of vitamins, detoxification of potentially harmful substances, and maturation and regulation of the immune system. Weaning represents a crucial step in the development of the intestinal flora and, at the same time, corresponds to a very delicate phase of immunologic maturation.

Neonatal onset intestinal failure: an Italian Multicenter Study.

Objective: To describe the natural course of intestinal failure with onset in the neonatal period to provide data regarding the occurrence and to provide a population-based survey regarding the spectrum of underlying diseases.

Study Design: We performed a retrospective chart review including infants admitted to the neonatal intensive care unit of 7 Italian tertiary care centers. Intestinal failure was defined as a primary intestinal disease that induces the need of total parenteral nutrition (PN) for more than 4 weeks or the need of partial PN for more than 3 months.

Complementary feeding practices in preterm infants: an observational study in a cohort of Italian infants.

Background: There are no evidence-based guidelines for weaning preterm infants, and the timing of weaning and the diet offered tend to reflect tradition and marketing rather than medical advice.

Procedures: In a survey of complementary feeding practices in preterm infants conducted at the University Hospital of Ferrara, Italy, we evaluated the effect of sex, gestational age (GA), birth weight (BW), and milk feeding, and of the mother's age, education, and professional status, on weaning.

Results: Complete data were available for 156 infants.

Weaning preterm infants: an open issue.

Survival rates for very low birth weight (VLBW) and extremely low birth weight infants have substantially increased during the past few decades. Most of these infants pose new and difficult problems related in particular to neurodevelopmental outcome and growth impairment. In fact, a high percentage of very low birth weight infants fail to achieve their growth potential and experience postnatal growth restriction.

Brain maturation of preterm newborn babies: new insights.

Preterm birth still results in a high number of neurodevelopmental sequelae, although major forms of brain lesions--such as periventricular leukomalacia and intraventricular hemorrhage--are significantly reduced in this population of babies compared with a few years ago. This paper focuses on the possible reasons for this phenomenon. Some brain lesions, such as those affecting the periventricular white matter and the cerebellum, may be underestimated if magnetic resonance imaging is not used.

Advances in the management of digestive problems during the first months of life.

Unlabelled: A study was carried out on 168 full-term infants with digestive problems such as regurgitation and/or constipation to evaluate the efficacy of new infant formulas containing partially hydrolysed whey protein, modified vegetable oil with a high beta-palmitic acid content, prebiotic oligosaccharides and starch. Infants receiving the new formulas had an increase in stool frequency of 0.60 between day 1 and day 7 (95% CI 0.

Z-score of weight for age of infants with atopic dermatitis and cow's milk allergy fed with a rice-hydrolysate formula during the first two years of life.

Background: Recently, rice-based formulas have been widely used in hypoallergenic diets, but data on nutritional values are scarce.

Aim: To evaluate the growth of infants fed with a rice-based hydrolysate formula, compared to those infants fed with a soy formula or an extensively hydrolysed casein formula, in the first 2 y of life.

Methods: A total of 88 infants were enrolled between March 2002 and March 2004.

Considerations and approaches in determining the protein and energy composition of preterm infant formulas.

Optimal early nutritional support is considered a crucial issue in the care of the preterm infant, particularly of those with very low- or extremely low-brithweight. Unfortunately, this goal is seldom satisfactorily attained. Several conditions such as hypoxia, acidosis, patent ductus arteriosus, drug therapy, reduced intestinal motility may interfere with an adequate nutritional delivery in the early neonatal period.