The digital child: A cross-sectional survey study on the access to electronic devices in paediatrics.

AIM: To explore the use of electronic devices in children and possible risk factors for smartphone ownership and cyberbullying. METHODS: A cross-sectional survey study was conducted involving 62 Italian general paediatricians who administered a close-ended questionnaire about the use of electronic devices to 1732 parents/caregivers. RESULTS: Data of 2563 children aged 0-14 years were collected. Investigating the electronic device use by parents/caregivers of children aged 0-1 years, 72.5% of mothers were revealed to have the habit to use a smartphone during breastfeeding and bottle-feeding. The ownership of a smartphone was found in 29.5% of children aged 2-14 years, 68.1% considering only children aged 10-14. A higher parental degree level was identified as a protective factor for smartphone ownership by children (OR 0.59; 95% CI 0.36-0.98; p = 0.04 for father; OR 0.51; 95% CI 0.33-0.78; p = 0.002 for mother). A higher risk of cyberbullying was found when caregivers did not use any restrictions on smartphone use (OR 11.92; 95% CI 3.41-41.68; p < 0.001). CONCLUSION: The absence of rules for smartphone use represents a risk factor for cyberbullying. In this context, the general paediatrician might play an important role in helping parents/caregivers and their children adopt safer use of electronic devices.

Change in Pediatric Health Care Spending and Drug Utilization during the COVID-19 Pandemic.

OBJECTIVE: To evaluate how the restrictive measures implemented during the SARS-CoV-2 pandemic have influenced the incidence of the most common children's diseases and the consumption of medications in 2020 compared to 2019. METHODS: We involved all family pediatricians of the local health authority of Latina, from which we requested data of monthly visits in 2019 and 2020 for six common diseases disseminated through droplets and contact, and the territorial and integrative pharmaceutical unit of the area, from which we requested data of the net expenditure regarding the most commonly used drugs at pediatric age. RESULTS: There was significant reduction in the incidence of the evaluated diseases and in the consumption of investigated drugs between 2019 and 2020 in the months when the restrictive measures were in place, with an attenuation of this effect during the months of the gradual loosening of those measures. CONCLUSION: Nonpharmaceutical intervention measures have caused changes in the diffusion of common pediatric diseases. We believe that the implementation of a reasonable containment strategy, even outside of the pandemic, could positively influence the epidemiology of infectious and allergic diseases in children, and healthcare system spending.

Evaluation of carboplatin pharmacokinetics in pediatric oncology by means of inductively coupled plasma mass spectrometry.

Carboplatin is widely used in pediatric oncology to treat different tumors. Aim of the present study was to assess the potential of sector field inductively coupled plasma mass spectrometry (SF-ICPMS) in evaluating the area under the plasma platinum concentration vs time curve in pediatric patients presenting solid tumors and treated with carboplatin 349-1000 mg m-2. Seventeen patients were enrolled and 23 courses of chemotherapy were evaluated. Plasma was ultrafiltered and free carboplatin was measured in ultrafiltrates as platinum by SF-ICP-MS. Comparison was made between different equations to obtain a target AUC. Limits of detection and of quantification, intra- and inter-day repeatability of the measurements, recovery of the 'free-carboplatin' confirmed SF-ICP-MS as a reliable technique in the quantification of serum platinum in anticancer carboplatin-based therapies.

Conservative therapy in intraocular retinoblastoma: response/recurrence rate.

PURPOSE: To evaluate the response/recurrence rate and the outcome in intraocular retinoblastoma treated with chemoreduction and focal therapy, the authors performed a retrospective review of their patients. METHODS: The series included 46 newly diagnosed patients with unilateral or bilateral intraocular retinoblastoma (58 eyes) receiving carboplatin/etoposide chemotherapy associated with focal therapy (laser or cryotherapy). The mean follow-up was 53 months (range 11-125). RESULTS: Fifty-one eyes (88%) presented with complete response after four to eight courses of chemotherapy combined with focal treatment. The response rate was 100% in group 1, 94% in group 2, 100% in group 3, 83% in group 4, and 70% in group 5 (5 vs. 1-4, P < 0.03; 5-4 vs. 1-3, P < 0.025). Twenty-nine eyes (57%) relapsed after a mean of 7 months (range 2-36). The relapse rate was 30% in group 1, 27.% in group 2, 67% in group 3, 80% in group 4, and 100% in group 5 (5 vs. 1-4, P < 0.001; 4-5 vs. 1-3, P < 0.001). Seven of 18 cases achieved a second complete response with further conservative treatment (total courses 8-14). Twenty-nine eyes (50%) were treated without external-beam radiotherapy or enucleation: 90% in group 1, 69% in group 2, 67% in group 3, 33% in group 4, and 6% in group 5 (5 vs. 1-4, P < 0.01; 5-4 vs. 1-3, P < 0.001). Ten eyes (17%) required external-beam radiotherapy and 21 eyes (36%) enucleation. The ocular salvage rate was 67%. CONCLUSIONS: Although all groups of patients with intraocular retinoblastoma responded to carboplatin/etoposide chemotherapy associated with focal therapy, all the cases in group 5 relapsed. This approach is questionable in group 5, in which could be justified to delay aggressive treatment in a very young child.

Tropisetron: optimal dosage for children in prevention of chemotherapy-induced vomiting.

The antiemetic efficacy and tolerability of Tropisetron (Navoban, Novartis Pharma Switzerland AG, Bern), a selective 5-hydroxytriptamine receptor antagonist, has been assessed in the prevention of acute vomiting in children receiving chemotherapy for solid tumors. Tropisetron iv was given 30 min before administration of chemotherapy at a dose of 5 mg in children <20 kg body weight and at a dose of 10 mg in those >20 kg. A total of 50 children were studied in 189 courses of chemotherapy. Control of emesis was defined as total in absence of acute vomiting, as major if 1 or 2 events of acute vomiting occurred, and as not controlled if >2 events of acute vomiting occurred. Response was studied, taking into account Tropisetron dosage, degree of emetogenicity of the chemotherapeutic agents in pretreated and non-pretreated patients, and according to age groups. Tropisetron, administered in a single daily dose of 8-12 mg/m(2), was found to be very effective in completely controlling acute emesis in 92% of the courses of moderately and highly emetogenic chemotherapy administered to pediatric patients with solid tumors. Moreover, Tropisetron, at this dosage, did not lead to any adverse effects.