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  1. Article ; Online: Nasal Dermoid Fistula.

    Muzzi, Enrico / Zago, Alessandro / Barbi, Egidio / Cozzi, Giorgio

    The Journal of pediatrics

    2023  Volume 262, Page(s) 113357

    MeSH term(s) Humans ; Dermoid Cyst/diagnosis ; Dermoid Cyst/surgery ; Nose Neoplasms ; Nose ; Fistula/diagnostic imaging
    Language English
    Publishing date 2023-02-21
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 3102-1
    ISSN 1097-6833 ; 0022-3476
    ISSN (online) 1097-6833
    ISSN 0022-3476
    DOI 10.1016/j.jpeds.2023.01.022
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  2. Article: The Risks of Phosphate Enemas in Toddlers: A Life-Threatening Unawareness.

    Zago, Alessandro / Occhipinti, Alessandro Agostino / Bramuzzo, Matteo / Ceconi, Viola / Colacino, Vincenzo / Barbi, Egidio / Poropat, Federico

    Children (Basel, Switzerland)

    2024  Volume 11, Issue 3

    Abstract: Background: While oral laxatives represent the first-line treatment of fecal impaction, enemas are frequently used in clinical practice in pediatric emergency departments (PEDs) and by family pediatricians (FPs).: Objectives: Phosphate-containing ... ...

    Abstract Background: While oral laxatives represent the first-line treatment of fecal impaction, enemas are frequently used in clinical practice in pediatric emergency departments (PEDs) and by family pediatricians (FPs).
    Objectives: Phosphate-containing enemas (PcEs) are commonly employed, even causing the risk of rare but lethal toxicity. We investigated pediatricians' awareness of PcE risks.
    Methods: We conducted an online survey by sending a multiple-choice questionnaire to the referents of 51 PEDs and 101 FPs. We collected and compared the answers with recommendations reported by the Italian Drug Agency (AIFA) and the available literature about PcE administration.
    Results: Of the institutions and pediatricians receiving the questionnaire, 23 PEDs (45%) and 63 FP (62.3%) participated in the survey. Of PEDs, 95% and 33.0% of FPs treated fecal impaction with PcE. Moreover, 54% of PEDs and 86.0% of FPs did not provide treatment according to the AIFA recommendations for the daily dose.
    Conclusions: This study shows limited pediatricians' awareness of the potential risks related to PcE.
    Language English
    Publishing date 2024-03-15
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2732685-8
    ISSN 2227-9067
    ISSN 2227-9067
    DOI 10.3390/children11030349
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  3. Article ; Online: Multi-centre study concluded that the severe acute respiratory syndrome coronavirus 2 was not a primary cause of bronchiolitis in infants.

    Milani, Gregorio P / Marchisio, Paola / Agostoni, Carlo / Alberti, Ilaria / Buonsenso, Danilo / Morello, Rosa / Zago, Alessandro / Cozzi, Giorgio

    Acta paediatrica (Oslo, Norway : 1992)

    2024  Volume 113, Issue 3, Page(s) 544–546

    MeSH term(s) Infant ; Humans ; SARS-CoV-2 ; Bronchiolitis ; Bronchiolitis, Viral/complications ; Respiratory Syncytial Virus Infections ; Acute Disease
    Language English
    Publishing date 2024-01-02
    Publishing country Norway
    Document type Multicenter Study ; Journal Article
    ZDB-ID 203487-6
    ISSN 1651-2227 ; 0365-1436 ; 0803-5253
    ISSN (online) 1651-2227
    ISSN 0365-1436 ; 0803-5253
    DOI 10.1111/apa.17086
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  4. Article ; Online: Children with mild hyponatremia at the emergency department are at higher risk of hospitalization.

    Pintaldi, Stefano / Zago, Alessandro / Pizzolon, Carlo / Magni, Elena / Cozzi, Giorgio / Andrade, Stefanny / Barbi, Egidio / Amaddeo, Alessandro

    BMC pediatrics

    2023  Volume 23, Issue 1, Page(s) 318

    Abstract: Background: Mild hyponatremia is frequently encountered in the pediatric emergency department (PED). Although usually of little clinical concern, its prognostic meaning as a possible marker of more severe disease has not yet been well established.: ... ...

    Abstract Background: Mild hyponatremia is frequently encountered in the pediatric emergency department (PED). Although usually of little clinical concern, its prognostic meaning as a possible marker of more severe disease has not yet been well established.
    Methods: We retrospectively analyzed data from children and adolescents who performed a blood sample with plasmatic sodium measurement on admission to the PED of IRCCS "Burlo Garofolo" Pediatric Hospital in Trieste, Italy, in 2019. We compared the rate, length of admissions and laboratory characteristics of patients with hyponatremia to those with normal sodium.
    Results: Among 807 subjects, hyponatremia (sodium < 135 mEq/L) was present in 17.6%, being mild (between 130 and 134 mEq/L) in 16.5%. Hyponatremic patients were younger, more frequently males, with an infection diagnosis, mainly of the respiratory tract and viral aetiology. They presented higher C-reactive protein (CRP) levels and erythrocyte sedimentation rates (ESR). Compared to normonatremic individuals, hyponatremic patients presented a higher risk of underlying infection (aOR 2.02; 95%CI 1.33-3.08), hospital admission (aOR 1.72; 95%CI 1.06-2.48), and a hospital stay of > 5 days (aOR 1.99; 95%CI 1.03-3.85). When considering only subjects with mild hyponatremia, we found similar results.
    Conclusion: Hyponatremia and mild hyponatremia in the PED are associated with an increased admission rate and extended hospital stays. Mild hyponatremia should be considered a warning sign for a possibly more serious condition.
    MeSH term(s) Male ; Adolescent ; Humans ; Child ; Hyponatremia/diagnosis ; Hyponatremia/epidemiology ; Hyponatremia/etiology ; Retrospective Studies ; Hospitalization ; Sodium ; Emergency Service, Hospital
    Chemical Substances Sodium (9NEZ333N27)
    Language English
    Publishing date 2023-06-23
    Publishing country England
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 2041342-7
    ISSN 1471-2431 ; 1471-2431
    ISSN (online) 1471-2431
    ISSN 1471-2431
    DOI 10.1186/s12887-023-04109-8
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  5. Article ; Online: Increased bronchiolitis burden and severity after the pandemic: a national multicentric study.

    Ghirardo, Sergio / Ullmann, Nicola / Zago, Alessandro / Ghezzi, Michele / Minute, Marta / Madini, Barbara / D'Auria, Enza / Basile, Cecilia / Castelletti, Francesca / Chironi, Federica / Capodiferro, Agata / Andrenacci, Beatrice / Risso, Francesco Maria / Aversa, Salvatore / Dotta, Laura / Coretti, Antonella / Vittucci, Anna Chiara / Badolato, Raffaele / Amaddeo, Alessandro /
    Barbi, Egidio / Cutrera, Renato

    Italian journal of pediatrics

    2024  Volume 50, Issue 1, Page(s) 25

    Abstract: Background: The coronavirus 2019 (COVID-19) related containment measures led to the disruption of all virus distribution. Bronchiolitis-related hospitalizations shrank during 2020-2021, rebounding to pre-pandemic numbers the following year. This study ... ...

    Abstract Background: The coronavirus 2019 (COVID-19) related containment measures led to the disruption of all virus distribution. Bronchiolitis-related hospitalizations shrank during 2020-2021, rebounding to pre-pandemic numbers the following year. This study aims to describe the trend in bronchiolitis-related hospitalization this year, focusing on severity and viral epidemiology.
    Methods: We conducted a retrospective investigation collecting clinical records data from all infants hospitalized for bronchiolitis during winter (1st September-31th March) from September 2018 to March 2023 in six Italian hospitals. No trial registration was necessary according to authorization no.9/2014 of the Italian law.
    Results: Nine hundred fifty-three infants were hospitalized for bronchiolitis this last winter, 563 in 2021-2022, 34 in 2020-2021, 395 in 2019-2020 and 483 in 2018-2019. The mean length of stay was significantly longer this year compared to all previous years (mean 7.2 ± 6 days in 2022-2023), compared to 5.7 ± 4 in 2021-2022, 5.3 ± 4 in 2020-2021, 6.4 ± 5 in 2019-2020 and 5.5 ± 4 in 2018-2019 (p < 0.001), respectively. More patients required mechanical ventilation this winter 38 (4%), compared to 6 (1%) in 2021-2022, 0 in 2020-2021, 11 (2%) in 2019-2020 and 6 (1%) in 2018-2019 (p < 0.05), respectively. High-flow nasal cannula and non-invasive respiratory supports were statistically more common last winter (p = 0.001 or less). RSV prevalence and distribution did not differ this winter, but coinfections were more prevalent 307 (42%), 138 (31%) in 2021-2022, 1 (33%) in 2020-2021, 68 (23%) in 2019-2020, 61 (28%) in 2018-2019 (p = 0.001).
    Conclusions: This study shows a growth of nearly 70% in hospitalisations for bronchiolitis, and an increase in invasive respiratory support and coinfections, suggesting a more severe disease course this winter compared to the last five years.
    MeSH term(s) Infant ; Humans ; Pandemics ; Retrospective Studies ; Coinfection/epidemiology ; Bronchiolitis/epidemiology ; Bronchiolitis/therapy ; Hospitalization ; Respiratory Syncytial Virus Infections/epidemiology ; Respiratory Syncytial Virus Infections/therapy
    Language English
    Publishing date 2024-02-13
    Publishing country England
    Document type Multicenter Study ; Journal Article
    ZDB-ID 2088556-8
    ISSN 1824-7288 ; 1720-8424
    ISSN (online) 1824-7288
    ISSN 1720-8424
    DOI 10.1186/s13052-024-01602-3
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  6. Article ; Online: Increased use of high-flow nasal cannulas after the pandemic in bronchiolitis: a more severe disease or a changed physician's attitude?

    Ghirardo, Sergio / Cozzi, Giorgio / Tonin, Giovanna / Risso, Francesco Maria / Dotta, Laura / Zago, Alessandro / Lupia, Daniela / Cogo, Paola / Ullmann, Nicola / Coretti, Antonella / Badolato, Raffaele / Amaddeo, Alessandro / Barbi, Egidio / Cutrera, Renato

    European journal of pediatrics

    2022  Volume 181, Issue 11, Page(s) 3931–3936

    Abstract: After the SARS-CoV-2 pandemic, we noticed a marked increase in high-flow nasal cannula use for bronchiolitis. This study aims to report the percentage of children treated with high-flow nasal cannula (HFNC) in various seasons. The secondary outcomes were ...

    Abstract After the SARS-CoV-2 pandemic, we noticed a marked increase in high-flow nasal cannula use for bronchiolitis. This study aims to report the percentage of children treated with high-flow nasal cannula (HFNC) in various seasons. The secondary outcomes were admissions for bronchiolitis, virological results, hospital burden, and NICU/PICU need. We conducted a retrospective study in four Italian hospitals, examining the medical records of all infants (< 12 months) hospitalized for bronchiolitis in the last four winter seasons (1 September-31 March 2018-2022). In the 2021-2022 winter season, 66% of admitted children received HFNC versus 23%, 38%, and 35% in the previous 3 years. A total of 876 patients were hospitalized in the study periods. In 2021-2022, 300 infants were hospitalized for bronchiolitis, 22 in 2020-2021, 259 in 2019-2020, and 295 in 2018-2019. The percentage of patients needing intensive care varied from 28.7% to 18%, 22%, and 15% in each of the four considered periods (p < 0.05). Seventy-seven percent of children received oxygen in the 2021-2022 winter; vs 50%, 63%, and 55% (p < 0.01) in the previous 3 years. NIV/CPAP was used in 23%, 9%, 16%, and 12%, respectively. In 2021-2020, 2% of patients were intubated; 0 in 2020-2021, 3% in 2019-2020, and 1% in 2018-2019.
    Conclusion: This study shows a marked increase in respiratory support and intensive care admissions this last winter. While these severity indexes were all driven by medical choices, more reliable indexes such as intubation rate and length of stay did not change. Therefore, we suggest that there is a more aggressive treatment attitude rather than a more severe disease.
    What is known: • COVID-19 pandemic deeply impacted bronchiolitis epidemiology, reducing hospitalizations to onetenth. In the 2021-2022 winter, bronchiolitis resurged to pre-pandemic numbers in Europe.
    What is new: • Bronchiolitis hospitalization rose much faster in the 2021-2022 winter period, peaking at a higher level. Respiratory supports and high-flow nasal cannula increased significantly compared to the pre-pandemic era.
    MeSH term(s) Attitude of Health Personnel ; Bronchiolitis/epidemiology ; Bronchiolitis/therapy ; COVID-19/epidemiology ; COVID-19/therapy ; Cannula ; Child ; Humans ; Infant ; Oxygen ; Oxygen Inhalation Therapy ; Pandemics ; Physicians ; Retrospective Studies ; SARS-CoV-2
    Chemical Substances Oxygen (S88TT14065)
    Language English
    Publishing date 2022-09-09
    Publishing country Germany
    Document type Journal Article
    ZDB-ID 194196-3
    ISSN 1432-1076 ; 0340-6199 ; 0943-9676
    ISSN (online) 1432-1076
    ISSN 0340-6199 ; 0943-9676
    DOI 10.1007/s00431-022-04601-w
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  7. Article ; Online: SARS-CoV-2-related bronchiolitis: a multicentre international study.

    Cozzi, Giorgio / Sovtic, Aleksandar / Garelli, Davide / Krivec, Uros / Silvagni, Davide / Corsini, Ilaria / Colombo, Marco / Giangreco, Manuela / Giannattasio, Antonietta / Milani, Gregorio Paolo / Minute, Marta / Marchetti, Federico / Gatto, Antonio / Debbia, Carla / Gortan, Anna Jolanda / Massaro, Marta / Hatziagorou, Elpis / Ravidà, Domenico / Diamand, Raz /
    Jones, Elizabeth / Visekruna, Jelena / Zago, Alessandro / Barbi, Egidio / Amaddeo, Alessandro / Cortellazzo Wiel, Luisa

    Archives of disease in childhood

    2023  Volume 108, Issue 9, Page(s) e15

    Abstract: Background: Bronchiolitis is the main acute lower respiratory tract infection in infants. Data regarding SARS-CoV-2-related bronchiolitis are limited.: Objective: To describe the main clinical characteristics of infants with SARS-CoV-2-related ... ...

    Abstract Background: Bronchiolitis is the main acute lower respiratory tract infection in infants. Data regarding SARS-CoV-2-related bronchiolitis are limited.
    Objective: To describe the main clinical characteristics of infants with SARS-CoV-2-related bronchiolitis in comparison with infants with bronchiolitis associated with other viruses.
    Setting, patients, interventions: A multicentre retrospective study was conducted in 22 paediatric emergency departments (PED) in Europe and Israel. Infants diagnosed with bronchiolitis, who had a test for SARS-CoV-2 and were kept in clinical observation in the PED or admitted to hospital from 1 May 2021 to 28 February 2022 were considered eligible for participation. Demographic and clinical data, diagnostic tests, treatments and outcomes were collected.
    Main outcome measures: The main outcome was the need for respiratory support in infants testing positive for SARS-CoV-2 compared with infants testing negative.
    Results: 2004 infants with bronchiolitis were enrolled. Of these, 95 (4.7%) tested positive for SARS-CoV-2. Median age, gender, weight, history of prematurity and presence of comorbidities did not differ between the SARS-CoV-2-positive and SARS-CoV-2-negative infants. Human metapneumovirus and respiratory syncytial virus were the viruses most frequently detected in the group of infants negative for SARS-CoV-2.Infants testing positive for SARS-CoV-2 received oxygen supplementation less frequently compared with SARS-CoV-2-negative patients, 37 (39%) vs 1076 (56.4%), p=0.001, OR 0.49 (95% CI 0.32 to 0.75). They received less ventilatory support: 12 (12.6%) high flow nasal cannulae vs 468 (24.5%), p=0.01; 1 (1.0%) continuous positive airway pressure vs 125 (6.6%), p=0.03, OR 0.48 (95% CI 0.27 to 0.85).
    Conclusions: SARS-CoV-2 rarely causes bronchiolitis in infants. SARS-CoV-2-related bronchiolitis mostly has a mild clinical course.
    MeSH term(s) Infant ; Child ; Humans ; SARS-CoV-2 ; Retrospective Studies ; COVID-19/complications ; COVID-19/epidemiology ; Bronchiolitis/diagnosis ; Bronchiolitis/epidemiology ; Bronchiolitis/therapy ; Hospitalization
    Language English
    Publishing date 2023-05-02
    Publishing country England
    Document type Multicenter Study ; Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 524-1
    ISSN 1468-2044 ; 0003-9888 ; 1359-2998
    ISSN (online) 1468-2044
    ISSN 0003-9888 ; 1359-2998
    DOI 10.1136/archdischild-2023-325448
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