Sleep Disorders in Infants and Toddlers with Hypoxic Ischemic Encephalopathy Treated with Therapeutic Hypothermia: A Case-Control Study Using the SDSC.

Background And Objectives: Sleep complaints are particularly relevant in the development of children, affecting cognitive development, neuropsychological functioning, and learning abilities. The aims of this study were as follows: (i) to determine the incidence of sleep disorders in low-risk infants and toddlers with hypoxic ischemic encephalopathy (HIE) treated with therapeutic hypothermia (TH), using the Italian version of the Sleep Disturbance Scale for Children (SDSC); and (ii) to compare the data with those of a healthy control group.

Materials And Methods: This is a cross-sectional case-control study involving a total of 167 infants and toddlers (aged 6-36 months) with HIE treated with TH and 160 typically developing infants assessed using the SDSC filled out by the mother.

Cord red blood cell transfusions for severe retinopathy in preterm neonates in Italy: a multicenter randomized controlled trial.

Background: Red blood cell (RBC) transfusions in preterm neonates are associated with retinopathy of prematurity (ROP).

Methods: BORN is a multicenter randomized trial investigating whether RBC transfusions from cord blood (CB-RBCs) instead of adult donors (A-RBCs) reduce ROP severity (NCT05100212). The study was conducted between December 2021 and November 2024 in 8 hospitals sited in 8 different Italian regions.

Feasibility LOck sOlutionS for Epicutaneo-caval catheters in Neonates: a "LOOSEN" pilot study.

Epicutaneo-caval catheters are vital in neonatal care but prone to occlusion and infection. This pilot study evaluated whether a one-hour saline lock, combined with proper flushing and anti-reflux connectors, affects catheter patency in neonates. Catheter patency was assessed using infusion pressure (pre and post lock) as a surrogate measure.

A Case of Hirata Syndrome in Pregnancy Induced by α-Lipoic Acid: Diagnosis and Management.

Background/objective: Insulin autoimmune syndrome (IAS), also known as "Hirata disease", is an uncommon cause of hypoglycemia, linked to the presence of insulin autoantibodies (IAAs) in subjects who are not taking insulin and with no evidence of histopathological abnormalities of the pancreatic islets.

Case Report: We report a case of a 25-year-old pregnant woman who displayed recurrent symptomatic hypoglycemia that began after treatment with α-lipoic acid. One episode of severe hypoglycemia was documented, which resulted in syncope.

A Prospective Study on the Systematic Application of the Safe Insertion Umbilical Venous Catheter (SIUVeC) Bundle.

: Inserting umbilical venous catheters is a common procedure in neonatal intensive care units. However, this maneuver is potentially associated with early and late complications, some of which can be severe. Several strategies have been described in the literature to minimize the risk of such complications.

Maternal Oncological Disease and Congenital Pneumonia Are New Independent Risk Factors for Surfactant Requirements in Late Preterm Infants.

Aim: The purpose of this study was to evaluate the incidence of respiratory distress syndrome (RDS) in late preterm (LPT) infants. We also aimed to identify the risk factors associated with surfactant requirement and the clinical outcomes associated with surfactant therapy.

Methods: We retrospectively analysed data from a single-centre neonatology unit at the Fondazione Policlinico Universitario Agostino Gemelli, IRCCS in Rome, Italy over a 4 year period.

Characterization of N-Terminal Acetylated α-Hemoglobin Stabilizing Protein (AHSP) by Top-Down High-Resolution Mass Spectrometry From Human Preterm Newborns Oral Fluid.

Rationale: Alpha-hemoglobin stabilizing protein (AHSP) is an erythroid-specific protein forming a stable complex with free α-hemoglobin, but not with β-hemoglobin or hemoglobin A (αβ), thus preventing harmful aggregation of α-hemoglobin during normal erythroid cell development and avoiding its pro-oxidant activity. Although its function has been extensively studied in erythroid cells, its presence in preterm newborns' oral fluid remains unexplored. Given the high susceptibility of preterm infants to hematological disorders, characterizing AHSP in their oral fluid could provide valuable insights into fetal erythropoiesis and its potential role as a biomarker for neonatal anemia and transfusion needs.

A Simplified, Regional Lung Ultrasound Score for Surfactant Administration in Neonatal RDS: A Prospective Observational Study.

Background: A total lung ultrasound score (tLUS) is a validated tool to describe parenchymal aeration, evaluate neonatal respiratory distress syndrome (RDS) progression and guide early surfactant replacement. tLUS derives from regional scores (rLUS) from predefined ultrasound views.

Research Question: This paper explores the relative contribution of rLUS to tLUS and their predictive power of surfactant need for RDS, individually and with additional variables.

Diaphragm Thickness and Contraction During Non-Invasive Ventilation: An Ultrasound Study.

Objectives: Non-invasive ventilation (NIV) is a widely used treatment for neonatal respiratory distress syndrome (RDS). Data on diaphragm contractility and thickness during NIV is scarce. We aimed to describe changes in diaphragm thickness/contractility during NIV and to explore associations with NIV discontinuation failure.

Early Enoxaparin Treatment in a Newborn with Cerebral Venous Sinus Thrombosis and Acute Cerebellar Hemorrhage.

Objective: To evaluate the management of anticoagulant therapy in neonates with cerebral sinus venous thrombosis (CSVT), focusing on potential benefits and risks.

Study Design: We report the case of a full-term neonate diagnosed with CSVT, highlighting the rationale for early anticoagulation with unfractionated heparin. A brief literature review supports our clinical decision-making, considering current evidence and expert consensus despite limited neonatal-specific guidelines.

Case Report: Hepatopulmonary fusion: to separate or not to separate? From a clinical case to A literature review.

Objective: Hepatopulmonary fusion (HPF) is a rare congenital malformation, frequently associated to right-sided congenital diaphragmatic hernia (CDHR). The presence of HPF often leads to a fatal outcome. The most effective approach to managing this condition remains uncertain due to the limited number of documented cases in the literature.

Neonatal Outcomes of Mothers with Syphilis During Pregnancy: A Retrospective Single Center Experience.

Background/objectives: Syphilis during pregnancy can be easily missed with potential severe outcomes of the newborns, including congenital syphilis (CS). We report the neonatal outcomes of a cohort of mothers with syphilis during pregnancy.

Methods: a retrospective cohort study in a referral university hospital in Rome, enrolling mother/newborn couples followed up from 2016 to 2023 by a multidisciplinary team including infectious disease specialists, obstetricians, microbiologists, neonatologists and pediatricians.

Case Report: Hypercalcemia, subcutaneous fat necrosis and nephrocalcinosis in neonates who undergo therapeutic hypothermia: a not so rare association, with different onset time.

Subcutaneous fat necrosis (SCFN) in newborns is an uncommon and self-limiting non-infectious panniculitis. It can occur in the first weeks of life in full-term newborns with hypoxic-ischemic encephalopathy who underwent therapeutic hypothermia. Hypercalcemia may develop and has been implicated as the cause of several complications as nephrocalcinosis.

Environmental maternal exposures and the risk of premature birth and intrauterine growth restriction: The Generation Gemelli study protocol of newborn exposome.

Background: The study of women exposures and child outcomes occurring in the first 1,000 days of life since conception enhances understanding of the relationships between environmental factors, epigenetic changes, and disease development, extending beyond childhood and spanning the entire lifespan. Generation Gemelli is a recently launched case-control study that enrolls mother-newborns pairs in one of the largest university hospitals in Italy, in order to examine the association between maternal environmental exposures and intrauterine growth restriction (IUGR) and the risk of premature birth. The study will also evaluate the association of maternal exposures and the health and growth of infants and children up to 24 months of age.

Clinical predictors for surfactant retreatment in preterm infants with respiratory distress syndrome: the results of a pooled analysis.

Background: The issue of retreatment with surfactant of infants with respiratory distress syndrome (RDS) has been poorly investigated. Our aim was to identify possible clinical predictors of the need for multiple doses of surfactant in a large cohort of very preterm infants.

Methods: Data were analyzed from three previous studies on infants born between 25 and 31 weeks of gestation with RDS who were treated with surfactant.

Advantage of bedside versus conventional operating room surgery in the management of term and preterm newborn infants: a single center retrospective observational study.

Purpose: To compare postoperative outcomes of bedside surgery (BS) with those of surgery performed in the operating room (ORS) in preterm and full-term neonates.

Methods: Data from neonates undergoing major surgical interventions were retrospectively evaluated. Primary outcome was the incidence of postoperative hypothermia.

Deep sedation in lateral position for preterm infants during cerebral magnetic resonance imaging: a pilot study.

Introduction: Respiratory adverse events are common during the sedation of preterm babies, often needing active airway support. During magnetic resonance imaging, this occurrence could extend the acquisition time, with a negative impact on the thermic and metabolic homeostasis. The aim of the study is to verify if lying in a lateral position instead of supine could improve the safe quality of sedation, without worsening the quality of imaging.

The Italian Perinatal Surveillance System SPItOSS: insights from Confidential Enquiries.

Background: An effective strategy to reduce perinatal mortality requires an active surveillance system. This includes monitoring cases, organizing multidisciplinary local audits, conducting Confidential Enquiries, identifying avoidable factors, and facilitating changes in the healthcare system. In 2017, the Italian Obstetric Surveillance System launched the SPItOSS pilot Perinatal Surveillance System.

Assessment of early attention in an Italian cohort of preschooler preterm children using the Early Childhood Attention Battery.

Purpose: This cross-sectional monocentric study aims to utilize the Early Childhood Attention Battery to investigate early attention patterns in young preterm children and ascertain the extent to which their attentional abilities diverge from those of term peers.

Methods: Inclusion criteria encompassed gestational age < 34 weeks, with assessments conducted between 3 and 5 years 11 months. Exclusion criteria included major brain lesions, significant motor or behavioral disorders, and intellectual functioning with IQ < 70.

Lung Recruitment Before Surfactant Administration in Extremely Preterm Neonates: 2-Year Follow-Up of a Randomized Clinical Trial.

Importance: A multicenter randomized clinical trial (RCT) showed a lung recruitment maneuver using high-frequency oscillatory ventilation just before surfactant administration (ie, intubate-recruit-surfactant-extubate [IN-REC-SUR-E]) improved the efficacy of treatment compared with the standard intubate-surfactant-extubate (IN-SUR-E) technique without increasing the risk of adverse neonatal outcomes.

Objective: To examine follow-up outcomes at corrected postnatal age (cPNA) 2 years of preterm infants previously enrolled in an RCT and treated with IN-REC-SUR-E or IN-SUR-E in 35 tertiary neonatal intensive care units.

Design, Setting, And Participants: This was a follow-up study of infants recruited into the primary RCT from 2015 to 2018 at 35 tertiary neonatal intensive care units (NICUs) in Italy.

Pathogenic G6PD variants: Different clinical pictures arise from different missense mutations in the same codon.

G6PD deficiency results from mutations in the X-linked G6PD gene. More than 200 variants are associated with enzyme deficiency: each one of them may either cause predisposition to haemolytic anaemia triggered by exogenous agents (class B variants), or may cause a chronic haemolytic disorder (class A variants). Genotype-phenotype correlations are subtle.

Cord blood transfusions in extremely low gestational age neonates to reduce severe retinopathy of prematurity: results of a prespecified interim analysis of the randomized BORN trial.

Background: Preterm infants are at high risk for retinopathy of prematurity (ROP), with potential life-long visual impairment. Low fetal hemoglobin (HbF) levels predict ROP. It is unknown if preventing the HbF decrease also reduces ROP.

Thymosin β and β Expression in Human Organs during Development: A Review.

This review summarizes the results of a series of studies performed by our group with the aim to define the expression levels of thymosin β and thymosin β over time, starting from fetal development to different ages after birth, in different human organs and tissues. The first section describes the proteomics investigations performed on whole saliva from preterm newborns and gingival crevicular fluid, which revealed to us the importance of these acidic peptides and their multiple functions. These findings inspired us to start an in-depth investigation mainly based on immunochemistry to establish the distribution of thymosin β and thymosin β in different organs from adults and fetuses at different ages (after autopsy), and therefore to obtain suggestions on the functions of β-thymosins in health and disease.

Enteral nutritional strategy during therapeutic hypothermia: who? when? what?

Background: There are no guidelines regarding enteral feeding (EF) of infants with hypoxic-ischemic encephalopathy (HIE) during and shortly after therapeutic hypothermia; consequently, clinical practice is, to date, still variable. The objective of this study is to assess whether a minimal EF strategy during therapeutic hypothermia may be associated with a shorter time to full EF of infants with HIE and to identify the clinical variables that independently affect the time to full EF.

Methods: A retrospective study, covering the period from 1 January 2015 to 30 June 2022 was performed at the Neonatal Intensive Care Unit of the Fondazione Policlinico Universitario "Agostino Gemelli" IRCCS, Rome, which compared infants with HIE who received minimal EF during therapeutic hypothermia with those who did not.