Defining the clinical phenotype of COVID-19 in children.

On January 7, 2020, a novel coronavirus (SARS-CoV-2) was identified as the causative agent of a cluster of pneumonia of unknown origin detected in Wuhan City by Chinese authorities. Since SARS-CoV-2 discovery, the corresponding disease (COVID-19) has rapidly expanded throughout the globe, making as a consequence the World Health Organization (WHO) declaring a pandemic. As of May 19, 2020, over 4.806.299 cases of COVID-19 had been confirmed worldwide, with more than 318.599 deaths.

Italian survey on general pediatricians' approach to children with gastroesophageal reflux symptoms.

UNLABELLED: The aim of the present study was to investigate the current approach of Italian general pediatricians to children with gastroesophageal reflux (GER) symptoms, evaluating the implementation of the 2009 North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition (NASPGHAN)-European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) guidelines. One hundred randomly identified Italian general pediatricians were asked to complete a case report-structured questionnaire investigating their approach to infants, children, and adolescents with symptoms suggestive of GER. Only 2 % of them showed complete adherence to the guidelines. Thirty-nine percent of them diagnosed GER disease based on clinical symptoms, irrespective of the age of the child; 56 % prescribed proton pump inhibitors (PPIs) in infants with unexplained crying and/or distressed behavior and 38 % in infants with uncomplicated recurrent regurgitation and vomiting; 57 % prescribed PPIs in children younger than 8-12 years of age with vomiting and heartburn, without specific testing; and 54 % discontinued PPI therapy abruptly. The overall rate of pediatricians over-prescribing PPIs was 79 %. CONCLUSION: According to our findings, most Italian general pediatricians do not seem to follow the recommendations of the 2009 NASPGHAN-ESPGHAN reflux guidelines and often prescribe PPIs despite a lack of efficacy for the symptoms being treated. We are well aware that the guidelines address the average situation and that the evaluation of individual patients may frequently reveal reasons for opening criteria for exceptions. Nevertheless, the over-diagnosis of gastroesophageal reflux disease (GERD) places undue burden on both families and national health system which has not been impacted by the publication of international guidelines.

Longitudinal study of sleep behavior in normal infants during the first year of life.

STUDY OBJECTIVES: To longitudinally examine sleep patterns, habits, and parent-reported sleep problems during the first year of life. METHODS: Seven hundred four parent/child pairs participated in a longitudinal cohort study. Structured interview recording general demographic data, feeding habits, intercurrent diseases, family history, sleep habits, and parental evaluation of the infant's sleep carried out at 1, 3, 6, 9, and 12 months. RESULTS: Nocturnal, daytime, and total sleep duration showed a high inter-individual variability in the first year of life associated with changes in the first 6 months and stability from 6 to 12 months. Bedtime was at around 22:00 and remained stable at 6, 9, and 12 months of age. Approximately 20% of the infants had more than 2 awakenings and slept more often in the parent bed. Nearly 10% of the infants were considered as having a problematic sleep by parents and this significantly correlated with nocturnal awakenings and difficulties falling asleep. CONCLUSIONS: Sleep patterns change during the first year of life but most sleep variables (i.e., sleep latency and duration) show little variation from 6 to 12 months. Our data provide a context for clinicians to discuss sleep issues with parents and suggest that prevention efforts should focus to the first 3-6 months, since sleep patterns show stability from that time point to 12 months.