Hub-and-Spoke regional system supported by telehealth for managing coeliac disease in Liguria: a mixed-methods survey followed by an observational pilot study.

Background: Due to the need to reorganize the care network for the national screening mandated by law, a new healthcare model was required for the management of coeliac disease. The hub-and-spoke model is a new healthcare organizational system, here we describe its application (supported by telehealth), in the management of pediatric coeliac disease (CD) in Liguria. The results of the pilot phase are presented and the system's strengths and weaknesses discussed.

Evolution of SARS-CoV-2 epidemics in pediatric population in Liguria (North-west Italy) from March 2020 to December 2022: what could we have learned?

Introduction: This retrospective analysis aims to follow the course of SARS-CoV-2 infections in pediatric population residing in Liguria, North-west Italy, from March 2020 to December 2022 and to relate it to the regional and national containment measures adopted, to assess the representativeness of the infection rate observed at the national level and to analyze the vaccination rates in different pediatric groups.

Methods: First episodes of SARS-CoV-2 infections registered in the national surveillance system were extracted and further anonymously analyzed for subjects aging ≤ 19 years. The absolute number of cases diagnosed daily during each year was compared to the number of residents in the region and graphical representations were used to visualize the trends in infection rates both annually and weekly in each year.

Antibodies against Receptor Binding Domain of SARS-CoV-2 spike protein induced by BNT162b2 vaccine: results from a pragmatic, real-life study.

Background: As part of the fight against SARS CoV2 infection, vaccination program for health workers at Giannina Gaslini pediatric hospital (IGG) in Genoa, Italy, started on December 2020. We evaluated the anti-Spike protein response in healthcare workers after a complete vaccination scheme of 2 doses spaced by 3 weeks.

Methods: Immunoglobulin class G (IgG) against SARS-CoV-2 spike RBD were detected by means of a chemiluminescence immunoassay for quantitative IgG antibodies using Maglumi SARS-CoV-2-S-RBD IgG kit during the 3rd week after vaccination completion.

Impact of a diagnostic therapeutic educational pathway program for asthma management in preschool children.

Background: Preschool children with clinically-diagnosed asthma have a higher rate of emergency department visits and consume more resources for management than older children. However, no clinical trials have yet been performed measuring the impact of a combined diagnostic, therapeutic and educational pathway regimen for evaluation of wheezing control in children aged less than 6 years. The purpose of the present study was to assess the impact of a pediatric program developed in Italy, the Diagnostic Therapeutic Educational Pathway (DTEP), for asthma management in children less than 6 years old attending an asthma referral center.

Use of multiple metrics to assess antibiotic use in Italian children's hospitals.

Quantification of antibiotic utilization is an essential component of antibiotic stewardship programs. In this multicentric study, we used different metrics to evaluate inpatient antibiotic use in children. The study objectives were to describe point prevalence of antibiotic use by indication and patient characteristics, to evaluate DOTs, LOTs and PDDs, and to compare PDDs to DDDs, which assume average maintenance dose per day in adults.

Medicine and humanism in the time of COVID-19. Ethical choices.

The Covid-19 pandemic has been the most defining event of our era. The world of healthcare has experienced first-hand the dramatic situation of treating patients in the face of the dangers of contagion and limited resources. Difficult choices have everywhere been made alongside ethical reflection.

Evaluation of a Diagnostic Therapeutic Educational Pathway for Asthma Management in Children and Adolescents.

Limited evidence exists for the effectiveness of educational programs that improve pediatric asthma control in real-world settings. We aimed to assess the impact of a diagnostic, therapeutic, and educational pathway (DTEP) for asthma management in children and adolescents attending an asthma referral center. This is a retrospective population-based cohort study, including two groups of patients with asthma, aged 6-17 years and residing in the Local Health Authority (LHA) of Brescia, Italy: (a) the children who followed a DTEP (intervention group) and (b) all the children residing in the LHA who did not follow DTEP (control group).

A collaborative intervention to improve surgical antibiotic prophylaxis in children: results from a prospective multicenter study.

Purpose: The use of surgical antibiotic prophylaxis (SAP) in children is poorly characterized. Our aim was to evaluate the effectiveness of a quality improvement (QI) intervention targeting SAP in children, by means of a multicenter prospective intervention study, with a before and after design.

Methods: We prospectively investigated elective surgical procedures performed in children <18 years, prior to the QI intervention, after the intervention and at 9-month follow-up.

Surgical antibiotic prophylaxis in children: adherence to indication, choice of agent, timing, and duration.

Purpose: Surgical antibiotic prophylaxis (SAP) in children is poorly characterized. We investigated SAP for children undergoing elective surgical procedures.

Methods: We prospectively investigated elective surgical procedures performed in children <18 years, from November 2012 to February 2013, in three tertiary-care children's hospitals in Italy.

Application and implementation of the GINA asthma guidelines by specialist and primary care physicians: a longitudinal follow-up study on 264 children.

Aims: To implement GINA guidelines and to assess their impact on the management of childhood asthma.

Methods: A working group of primary care physicians (PCPs) and specialists developed a GINA-based clinical pathway. We then monitored the impact on 385 children (aged 0-15 years) referred to the respiratory outpatients clinic at the University Children's Hospital, Brescia, Italy by 179 PCPs between September 2003 and July 2005.