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  • 1
    Online Resource
    Online Resource
    Prevalence and Molecular Typing of Carbapenemase-Producing Enterobacterales among Newborn Patients in Italy
    MDPI AG ; 2022
    In:  Antibiotics Vol. 11, No. 4 ( 2022-03-23), p. 431-
    Details
    In: Antibiotics, MDPI AG, Vol. 11, No. 4 ( 2022-03-23), p. 431-
    Abstract: The spread of carbapenemase-producing Enterobacterales (CPE), especially Klebsiella pneumoniae (K. pneumoniae) and Escherichia coli (E. coli), is a serious public health threat in pediatric hospitals. The associated risk in newborns is due to their underdeveloped immune system and limited treatment options. The aim was to estimate the prevalence and circulation of CPE among the neonatal intensive units of a major pediatric hospital in Italy and to investigate their molecular features. A total of 124 CPE were isolated from rectal swabs of 99 newborn patients at Bambino Gesù Children’s Hospital between July 2016 and December 2019. All strains were characterized by antimicrobial susceptibility testing, detection of resistance genes, and PCR-based replicon typing (PBRT). One strain for each PBRT profile of K. pneumoniae or E. coli was characterized by multilocus-sequence typing (MLST). Interestingly, the majority of strains were multidrug-resistant and carried the blaNDM gene. A large part was characterized by a multireplicon status, and FII, A/C, FIA (15%) was the predominant. Despite the limited size of collection, MLST analysis revealed a high number of Sequence Types (STs): 14 STs among 28 K. pneumoniae and 8 STs among 11 E. coli, with the prevalence of the well-known clones ST307 and ST131, respectively. This issue indicated that some strains shared the same circulating clone. We identified a novel, so far never described, ST named ST10555, found in one E. coli strain. Our investigation showed a high heterogeneity of CPE circulating among neonatal units, confirming the need to monitor their dissemination in the hospital also through molecular methods.
    Type of Medium: Online Resource
    ISSN: 2079-6382
    URL: Article
    DOI: 10.3390/antibiotics11040431
    Language: English
    Publisher: MDPI AG
    Publication Date: 2022
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    SSG: 15,3
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  • 2
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    Early Postnatal Ventricular Disproportion Predicts Outcome in Congenital Diaphragmatic Hernia
    American Thoracic Society ; 2023
    In:  American Journal of Respiratory and Critical Care Medicine Vol. 208, No. 3 ( 2023-08-01), p. 325-328
    Details
    In: American Journal of Respiratory and Critical Care Medicine, American Thoracic Society, Vol. 208, No. 3 ( 2023-08-01), p. 325-328
    Type of Medium: Online Resource
    ISSN: 1073-449X , 1535-4970
    URL: Article
    DOI: 10.1164/rccm.202212-2306LE
    RVK:
    XA 21200
    Language: English
    Publisher: American Thoracic Society
    Publication Date: 2023
    detail.hit.zdb_id: 1468352-0
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  • 3
    Online Resource
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    Fixed the gap, solved the problem? Eating skills in esophageal atresia patients at 3 years
    Oxford University Press (OUP) ; 2020
    In:  Diseases of the Esophagus Vol. 33, No. 1 ( 2020-01-16)
    Details
    In: Diseases of the Esophagus, Oxford University Press (OUP), Vol. 33, No. 1 ( 2020-01-16)
    Abstract: Although eating problems have been described as long-term morbidities of esophageal atresia (EA), there have been few studies exploring eating outcomes in children born with EA as primary aim. Parents of children operated on for EA in our Institution from January 2012 to January 2016, answered a telephone structured interview developed specifically to conduct the present study, assessing eating skills at 3 years of age. Clinical data were collected from children’s medical records. Parents (45 mothers and 6 fathers) of 51 children (male = 34; female = 17) with a median age of 3.5 years form the object of the study. Considering eating problems, parents reported that 23 children (45%) still have episodes of choking during meals at 3 years of age, 9 (45%) of these have more than one episode a week, and 19 parents (39%) reported higher levels of anxiety during mealtimes. Forty-four children (86%) were described by their parents as able to eat alone, 32 (65%) accepted all food textures and 45 (90%) was described as curious about food (3 years). Forty-three (86%) parents let their children eat with other people. Correlations showed that weaning age was significantly associated with number of dilatations (rs = 0.35, P = 0.012), days of mechanical ventilation (rs = 0.40, P  & lt; 0.001), and presence of gastrostomy tube at discharge (rs = 0.45, P  & lt; 0.001). Chewing age resulted associated with number of dilatations (rs = 0.34, P  & lt; 0.01) and days of mechanical ventilation (rs = 0.38, P  & lt; 0.01). Presence of choking episodes was associated with curiosity about food (rs = 0.29, P  & lt; 0.05), while frequent choking episodes were associated with higher parental anxiety during mealtimes (rs = 0.45, P  & lt; 0.05). In order to prevent delay in the achievement of eating developmental milestones in children operated on of EA, we advocate a dedicated preventive intervention from birth to follow-up.
    Type of Medium: Online Resource
    ISSN: 1120-8694 , 1442-2050
    URL: Article
    DOI: 10.1093/dote/doz102
    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2020
    detail.hit.zdb_id: 2004949-3
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  • 4
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    Growth and morbidity in infants with Congenital Diaphragmatic Hernia according to initial lung volume: A pilot study
    Elsevier BV ; 2022
    In:  Journal of Pediatric Surgery Vol. 57, No. 4 ( 2022-04), p. 643-648
    Details
    In: Journal of Pediatric Surgery, Elsevier BV, Vol. 57, No. 4 ( 2022-04), p. 643-648
    Type of Medium: Online Resource
    ISSN: 0022-3468
    URL: Article
    DOI: 10.1016/j.jpedsurg.2021.06.013
    RVK:
    XA 10000
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2022
    detail.hit.zdb_id: 2039299-0
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  • 5
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    Lung Ultrasound Score in Neonates with Congenital Diaphragmatic Hernia (CDH-LUS): A Cross-Sectional Study
    MDPI AG ; 2023
    In:  Diagnostics Vol. 13, No. 5 ( 2023-02-27), p. 898-
    Details
    In: Diagnostics, MDPI AG, Vol. 13, No. 5 ( 2023-02-27), p. 898-
    Abstract: Introduction: The use of a lung ultrasound (LUS) score has been described in the early phases of neonatal respiratory distress syndrome; however, there is still no data regarding the application of the LUS score to neonates with a congenital diaphragmatic hernia (CDH). The objective of this observational cross-sectional study was to explore, for the first time, the postnatal changes in LUS score patterns in neonates with CDH, with the creation of a new specific CDH-LUS score. Methods: We included all consecutive neonates with a prenatal diagnosis of CDH admitted to our Neonatal Intensive Care Unit (NICU) from June 2022 to December 2022 who underwent lung ultrasonography. Lung ultrasonography (LUS) was determined at scheduled time points: (T0) during the first 24 h of life; (T1) at 24–48 h of life; (T2) within 12 h of surgical repair; (T3) a week after the surgical repair. We used a modified LUS score (CDH-LUS), starting from the original 0–3 score. We assigned 4 as a score in the presence of herniated viscera in the hemithorax (liver, small bowel, stomach, or heart in the case of a mediastinal shift) in the preoperative scans or pleural effusions in the postoperative scans. Results: We included in this observational cross-sectional study 13 infants: twelve/13 had a left-sided hernia (2 severe, 3 moderate, and 7 mild cases), while one patient had a right-sided severe hernia. The median CDH-LUS score was 22 (IQR 16–28) during the first 24 h of life (T0), 21 (IQR 15–22) at 24–48 h of life (T1), 14 (IQR 12–18) within 12 h of surgical repair (T2) and 4 (IQR 2–15) a week after the surgical repair (T3). The CDH-LUS significantly dropped over time from the first 24 h of life (T0) to a week after the surgical repair (T3), according to ANOVA for repeated measures. Conclusion: We showed a significant improvement in CDH-LUS scores from the immediate postoperative period, with normal ultrasonographic evaluations a week after surgery in most patients.
    Type of Medium: Online Resource
    ISSN: 2075-4418
    URL: Article
    DOI: 10.3390/diagnostics13050898
    Language: English
    Publisher: MDPI AG
    Publication Date: 2023
    detail.hit.zdb_id: 2662336-5
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  • 6
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    Lung Transplantation for Late-Onset Pulmonary Hypertension in a Patient with Congenital Diaphragmatic Hernia
    Georg Thieme Verlag KG ; 2018
    In:  European Journal of Pediatric Surgery Reports Vol. 06, No. 01 ( 2018-01), p. e100-e103
    Details
    In: European Journal of Pediatric Surgery Reports, Georg Thieme Verlag KG, Vol. 06, No. 01 ( 2018-01), p. e100-e103
    Abstract: Lung hypoplasia and pulmonary hypertension (PH) in association with congenital diaphragmatic hernia (CDH) may cause fatal respiratory failure. Lung transplantation (Ltx) may represent an option for CDH-related end-stage pulmonary failure. The aim of this study is to report a patient with CDH who underwent Ltx or combined heart-lung transplantation (H-Ltx). Our patient was born at 33 weeks of gestation, with a prenatally diagnosed isolated left CDH. Twenty-four hours after birth, she underwent surgical repair of a type D defect (according to the CDH Study Group staging system). Postoperative course was unexpectedly uneventful, and she was discharged home at 58 days of life. Echocardiography before discharge was unremarkable. Periodic follow-up revealed gastroesophageal reflux (GER) and initial scoliosis. At the age of 10, she was readmitted for severe PH. Lung function progressively deteriorated, and at the age of 14, she underwent H-Ltx due to end-stage respiratory failure. After discharge, she developed recurrent respiratory tract infections, severe malnutrition, and drug-induced diabetes. Scoliosis and GER progressed, requiring posterior vertebral arthrodesis and antireflux surgery, respectively. Bronchiolitis obliterans further impaired her respiratory function, and though she had a second Ltx, she died at the age of 18, 4 and 1.5 years after the first and the second Ltx, respectively. Late-onset PH is an ominous complication of CDH. From our patient and the six further cases collected from the literature, Ltx may be considered as a last-resource treatment in CDH patients with irreversible and fatal respiratory failure, although its prognosis seems unfair.
    Type of Medium: Online Resource
    ISSN: 2194-7619 , 2194-7627
    URL: Article
    DOI: 10.1055/s-0038-1675377
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2018
    detail.hit.zdb_id: 2727310-6
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  • 7
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    Online Resource
    Early vasopressin infusion improves oxygenation in infants with congenital diaphragmatic hernia
    Frontiers Media SA ; 2023
    In:  Frontiers in Pediatrics Vol. 11 ( 2023-3-29)
    Details
    In: Frontiers in Pediatrics, Frontiers Media SA, Vol. 11 ( 2023-3-29)
    Abstract: Congenital Diaphragmatic Hernia (CDH) is a complex disease including a diaphragmatic defect, lung hypoplasia, and pulmonary hypertension. Despite its increasing use in neonates, the literature on the use of vasopressin in neonates is limited. The aim of this work is to analyze the changes in clinical and hemodynamic variables in a cohort of CDH infants treated with vasopressin. Methods Among CDH infants managed at the Neonatal Intensive Care Unit (NICU) of our hospital from May 2014 to January 2019, all infants who were treated with vasopressin, because of systemic hypotension and pulmonary hypertension, were enrolled in this retrospective study. The primary outcome was the change in oxygenation index (OI) after the start of the infusion of vasopressin. The secondary outcomes were the changes in cerebral and splanchnic fractional tissue oxygen extraction (FTOEc and FTOEs) at near-infrared spectroscopy, to understand the balance between oxygen supply and tissue oxygen consumption after the start of vasopressin infusion. We also reported as secondary outcomes the changes in ratio of arterial oxygen partial pressure (PaO2) to fraction of inspired oxygen (FiO2), heart rate, mean arterial pressure, serum pH, and serum sodium. Results We included 27 patients with isolated CDH who received vasopressin administration. OI dramatically dropped when vasopressin infusion started, with a significant reduction according to ANOVA for repeated measures ( p  = 0.003). A global significant improvement in FTOEc and FTOEs was detected ( p  = 0.009 and p  = 0.004, respectively) as a significant reduction in heart rate ( p  = 0.019). A global significant improvement in PaO2/FiO2 ratio was observed ( p   & lt; 0.001) and also at all time points: at 6 h since infusion ( p  = 0.015), 12 h ( p  = 0.009), and 24 h ( p  = 0.006), respectively. A significant reduction in sodium levels was observed as expected side effect ( p  = 0.012). No significant changes were observed in the remaining outcomes. Conclusion Our data suggest that starting early vasopressin infusion in CDH infants with pulmonary hypertension could improve oxygenation index and near-infrared spectroscopy after 12 and 24 h of infusion. These pilot data represent a background for planning future larger randomized trials to evaluate the efficacy and safety of vasopressin for the CDH population.
    Type of Medium: Online Resource
    ISSN: 2296-2360
    URL: Article
    DOI: 10.3389/fped.2023.1104728
    Language: Unknown
    Publisher: Frontiers Media SA
    Publication Date: 2023
    detail.hit.zdb_id: 2711999-3
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  • 8
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    How much does a liter of donor human milk cost? Cost analysis of operating a human milk bank in Italy
    Springer Science and Business Media LLC ; 2022
    In:  International Breastfeeding Journal Vol. 17, No. 1 ( 2022-12-20)
    Details
    In: International Breastfeeding Journal, Springer Science and Business Media LLC, Vol. 17, No. 1 ( 2022-12-20)
    Abstract: To date, 40 Human Milk Banks (HMB) have been established in Italy; however, recent cost analysis data for operating an HMB in Italy are not available in the literature. Methods This study was a cross-sectional study performed at “Bambino Gesù” Children’s Hospital in Rome, Italy in 2019. We assessed the one-year operational costs and, the per liter unit costs at our HMB. Results During the 2019 year we collected 771 l of human milk supplied by 128 donors. The total cost was € 178,287.00 and the average cost was € 231.00 per liter. € 188,716.00 would have been spent had the maximum capacity for 904 l been reached. We found a significant difference (€ 231.00 vs € 209.00 per liter, p  = 0.016) comparing the cost for collected liters in the year 2019 and the cost for the maximum capacity of the bank for that year of activity. Analyzing each cost item that determines the charge of donor human milk (DHM), the highest costs are the salaries of medical and paramedical staff, and then the costs related to transporting. If the HMB works at maximum capacity and manages a greater number of liters of milk, this can represent an important saving. Conversely, the price of consumables is modest (i.e., the price of a single-use kit for breast pumps was € 0.22 per unit). Conclusion The costs for a liter of DHM are quite high, but they must be related to the benefits, especially for preterm infants. Comparing the cost for collected liters in 2019 and the costs for the 2019 maximum capacity of the HMB, we calculated how much fixed costs of collection and distribution of DHM can be reduced, by increasing the volume of milk collected. To the best of our knowledge, this is the first complete cost analysis for an Italian Milk Bank. A thorough analysis could help to abate fixed costs and reduce the cost of a liter of DHM. The centralization of DHM can allow savings, rather than creating small HMBs scattered throughout the territory that would operate with lower milk volumes.
    Type of Medium: Online Resource
    ISSN: 1746-4358
    URL: Article
    DOI: 10.1186/s13006-022-00530-4
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
    detail.hit.zdb_id: 2227239-2
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  • 9
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    The NICU during COVID-19 Pandemic: Impact on Maternal Pediatric Medical Traumatic Stress (PMTS)
    Georg Thieme Verlag KG ; 2022
    In:  American Journal of Perinatology Vol. 39, No. 13 ( 2022-10), p. 1478-1483
    Details
    In: American Journal of Perinatology, Georg Thieme Verlag KG, Vol. 39, No. 13 ( 2022-10), p. 1478-1483
    Abstract: Objective The objective of this paper was to assess how hospital and outpatient clinic policies changes due to the coronavirus disease 2019 (COVID-19) pandemic impact pediatric medical traumatic stress (PMTS) symptoms in mothers of newborns admitted in a neonatal intensive care unit (NICU). Study Design Observational case-control study included the comparison between mothers of infants admitted in the NICU at birth during the COVID-19 pandemic and mothers of infants admitted in the NICU before the COVID-19 pandemic. The control group was selected matching 1:1 with the study group for the following infants' clinical variables: gender, type of pathology, gestational age, weight at birth, day of recovery, ventilator time days, and associated malformations. The Italian version of the Impact of Event Scale—Revised (IES-R) was used as a measure of PMTS. Result Mothers of the study group (50) scored significantly higher than mothers of the control group on three of four scales of IES-R (“IES-R total”: F = 6.70; p = 0.011; IES-R subscale “intrusion”: F = 7.45; p = 0.008; IES-R subscale “avoidance”: F = 8.15; p = 0.005). A significantly higher number of mothers in the study group scored above the IES-R total clinical cut-off compared with mothers of control group (72 vs. 48%; Chi2 = 6.00; p = 0.012). Conclusion The COVID-19 pandemic acted as superimposed stress in mothers of newborns admitted in the NICU at birth determining high levels of PMTS. Clinicians and researchers should identify and implement novel strategies to provide family-centered care during the COVID-19 pandemic and beyond. Key Points
    Type of Medium: Online Resource
    ISSN: 0735-1631 , 1098-8785
    URL: Article
    DOI: 10.1055/a-1717-4021
    Language: English
    Publisher: Georg Thieme Verlag KG
    Publication Date: 2022
    detail.hit.zdb_id: 2042426-7
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  • 10
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    Outcome of infants operated on for congenital pulmonary malformations : Outcome of Congenital Pulmonary Malformations
    Wiley ; 2016
    In:  Pediatric Pulmonology Vol. 51, No. 12 ( 2016-12), p. 1367-1372
    Details
    In: Pediatric Pulmonology, Wiley, Vol. 51, No. 12 ( 2016-12), p. 1367-1372
    Type of Medium: Online Resource
    ISSN: 8755-6863
    URL: Article
    DOI: 10.1002/ppul.23472
    Language: English
    Publisher: Wiley
    Publication Date: 2016
    detail.hit.zdb_id: 1491904-7
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