Atopic dermatitis (AD) affects 20% of children, with persistent itching and repeated scratching that may interfere with daily activity and impair quality of life. Given the chronicity of the disease and its significant impact on quality of life, many parents and patients are interested in identifying alternative and "natural" therapies for the prevention and treatment of AD, such as nutritional supplements and dietary modifications. This article provides a narrative overview of dietary and nutritional interventions for the prevention and treatment of AD. Using PubMed Clinical Queries with the filter "Therapy," scope "Broad," and the keywords "atopic eczema" and "atopic dermatitis," the following dietary and nutritional interventions from recent meta-analyses and randomized clinical trials in the prevention and treatment of AD in children were reviewed up to May 2025: empirical maternal antigen avoidance, elimination diet in infants, hydrolyzed milk formula, gamma-linolenic acid (GLA), omega-3, vitamin D, vitamin E, and probiotics. There is evidence that patients with AD have lower serum 25(OH) vitamin D levels, but maternal vitamin D supplementation does not decrease the risk of AD in offspring. For treatment, there is some evidence suggesting that vitamin D can decrease disease severity. There is no strong evidence supporting the use of GLA, omega-3, vitamin E, or other micronutrient supplementation for the prevention or treatment of AD. Evidence regarding the use of probiotics is limited by methodological issues in meta-analyses attempting to pool studies that use different strains and species. Given the chronic nature of the disease and its significant impact on quality of life, many patients and parents are interested in alternative and "natural" therapies for AD, such as nutritional supplements and dietary modifications. There is substantial interest in primary prevention of AD, particularly through maternal and perinatal nutritional interventions. Some probiotics show a modest reduction in AD incidence, and formulations containing multiple bacterial strains appear to be more effective. The use of blood-specific IgE or skin prick tests to guide dietary exclusions with the goal of improving disease severity or control remains controversial, with very limited evidence of benefit. Many patients and parents are interested in alternative therapies such as nutritional supplements and dietary modifications due to the chronic, non-curable nature of AD and its associated quality-of-life impairment. There is also considerable interest in primary prevention through maternal and perinatal nutritional interventions, although strong evidence of efficacy is lacking. Some probiotics demonstrate beneficial effects with modest reductions in the rate of AD.

Managing parental food avoidance anxiety and concerns about their children, especially those with atopic disease, can be challenging and, at times, frustrating. The purpose of this article is to describe the usage of a simple schematic algorithm to counsel food-phobic parents. Anonymized brief cases are described to illustrate the utility of the EAT graphic algorithm, which is designed to counsel parents in managing concerns about food-avoidance anxiety. The application of the EAT algorithm in five diverse cases successfully guided dietary decisions, reduced unnecessary food avoidance, and aligned parental management with clinical evidence. The EAT algorithm provides an easy-to-understand visual schematic that can empower clinicians to counsel parents effectively, potentially reducing unnecessary testing and promoting a more normalized diet.

Neonatal sepsis (NS) is a leading cause of morbidity and mortality in newborns, particularly in developing countries, where early and accurate diagnosis remains challenging. Conventional sepsis markers, such as C-reactive protein (CRP) and hematological indices, lack sensitivity and specificity. This study aimed to evaluate serum apolipoproteinA (Apo A) and apolipoprotein B (Apo B) as potential diagnostic biomarkers in neonatal sepsis. This case-control study included 160 neonates with sepsis (confirmed by clinical assessment, sepsis screening, and blood culture) and 80 healthy neonates as controls. Patients were classified by sepsis severity (sepsis vs. severe sepsis) and onset (early vs. late). Serum Apo A and Apo B titres were measured using an enzyme-linked immunosorbent assay. Serum Apo A was significantly lower in septic neonates than in controls (p < 0.001), with the lowest titres observed in severe sepsis. Apo B was significantly elevated in septic neonates, particularly in severe cases (p < 0.001). Apo A, at a cut-off of ≤57.6 mg/dL, yielded 80% sensitivity, 90% specificity, and an area under the curve (AUC) of 0.939, whereas Apo B, at a cut-off of >7.98 mg/dL, yielded 99.4% sensitivity, 75% specificity, and an AUC of 0.998. Apo A negatively correlated with hematocrit, WBC count, and neutrophil shift, while Apo B showed a negative correlation with hematocrit (p < 0.05). Data suggest that the relationship between apolipoprotein levels and sepsis can also provide insights into inflammatory pathways associated with neonatal infections. Increased understanding of these pathways can inform the therapeutic approaches, in which the modulation of lipid metabolism becomes fundamental to managing sepsis results. Therefore, the incorporation of monitoring Apo A and Apo B levels can serve as pragmatic biomarkers to evaluate not only the presence of sepsis but also the potential response to treatment protocols, thus advancing the path toward Personalized Medicine in the Neonatal Intensive Care Unit. Serum Apo A and Apo B titres are valuable adjunct diagnostic markers for NS. Apo A reduction reflects the acute-phase response, while Apo B elevation may indicate altered lipid metabolism in severe infection.

Total parenteral nutrition (TPN) is essential for growth in very-low-birthweight (VLBW) infants. The worldwide variation in TPN dosing strategies warrants investigation. This study compared clinical outcomes of aggressive, rapid-increase, and standard TPN dosing strategies in VLBW infants. A systematic review and network meta-analysis were conducted following the PRISMA NMA guideline. Searches were performed in PubMed, Scopus, Web of Science, CINAHL, CENTRAL, and ProQuest. Dosing strategies were classified as aggressive (higher starting dose), rapid-increase (standard start with rapid escalation), and standard (NICE-based). Outcomes were analyzed using a Frequentist model in RStudio v4.4.1. Nine randomized controlled trials were included. Compared with aggressive and standard strategies, the rapid-increase strategy was associated with a shorter time to regain birth weight (MD = -1.43 days; 95% CI -2.82 to -0.05; P-score = 0.80). The rapid-increase strategy was also associated with a shorter length of hospitalization (MD = -0.38 days; 95% CI -6.56 to 5.80; P-score = 0.54). Regarding safety outcomes, the rapid-increase strategy had the lowest proportions of mortality (Prop = 0.043), retinopathy (Prop = 0.124), and sepsis (Prop = 0.141), but a higher proportion of patent ductus arteriosus (PDA) (Prop = 0.508). The rapid-increase approach demonstrated the most favorable balance between efficacy and safety outcomes among the included trials, although the small number of studies is a limitation. Rapid-increase TPN, using the recommended starting dose but achieving maintenance more quickly, may offer clinical advantages for VLBW infants. Further long-term studies are needed to confirm developmental and metabolic impacts.

Pinworm infestation is an important public health problem worldwide, especially among children 5 to 10 years of age in developing countries with temperate climates. The problem is often overlooked because of its mild or asymptomatic clinical manifestations. The purpose of this article was to familiarize pediatricians with the diagnosis and management of pinworm infestation. A search was conducted in August 2023 in PubMed Clinical Queries using the key terms "Enterobius vermicularis," OR "enterobiasis," OR "pinworm." The search strategy included all clinical trials, observational studies, and reviews published within the past 10 years. Only papers published in the English literature were included in this review. The information retrieved from the above search was used in the compilation of the present article. Enterobiasis is a cosmopolitan parasitosis caused by Enterobius vermicularis. It affects approximately 30% of children worldwide and up to 60% of children in some developing countries. Predisposing factors include poor socioeconomic conditions, inadequate sanitation, poor personal hygiene, and overcrowding. Children aged 5 to 14 years have shown the highest prevalence of enterobiasis.. Egg transmission is mainly by the fecal-oral route. Approximately 30 to 40% of infested patients do not show any clinical symptoms of the disease. For symptomatic patients, the most common presenting symptom is nocturnal pruritus ani. The diagnosis of E. vermicularis infection is best established by the cellophane tape test. The sensitivity of one single test is around 50%; however, the sensitivity increases to approximately 90% with tests performed on three different mornings. If a worm is visualized in the perianal area or the stool, a pathological examination of the worm will yield a definitive diagnosis. As pinworms and eggs are not usually passed in the stool, examination of the stool is not recommended. The drugs of choice for the treatment of pinworm infestation are mebendazole (100 mg), pyrantel pamoate (11 mg/kg, maximum 1 g), and albendazole (400 mg), all of the above-mentioned drugs are given in a single dose and repeated in two weeks. Mebendazole and albendazole are both adulticidal and ovicidal, whereas pyrantel pamoate is only adulticidal. Given their safety and effectiveness, mebendazole and albendazole are currently the best available drugs for the treatment of pinworm infestation. For pregnant women, pyrantel is preferred to mebendazole and albendazole. Treatment of all household members should be considered, especially if there are multiple or repeated symptomatic infections because reinfection is common even when effective medication is given. In spite of effective treatment of pinworm infestation, recurrences are common. Recurrences are likely due to repeated cycles of reinfection (particularly, autoinfection) because of the short life span of adult pinworms. Good personal hygiene, such as frequent handwashing, especially after bowel movements and before meals, clipping of fingernails, avoidance of finger-sucking, nail-biting, and scratching in the anogenital area, are important preventive measures. Treatment of all household members should be considered, especially if there are multiple or repeated symptomatic infections.

The birth of a baby is a significant milestone for both parents, marking a major life transition into parenthood. In high-risk situations, such as preterm delivery, this event disrupts functional adaptation and greatly impacts parents' ability to recognize and effectively respond to their newborn's physiological and developmental needs. Positive interactions and sensitive responses to an infant's needs enable parents to foster development, supporting regulatory processes and establishing healthy social interaction patterns. The Newborn Behavioral Observation (NBO) Early Intervention is a prevention-focused follow-up program initiated shortly after birth during a developmental window when the infant's brain is highly receptive to environmental influences, maximizing its impact on infant development. Recent applications of the NBO intervention in at-risk contexts have shown promising effects on both infant development and the parent-infant relationship. This educational mini-review aims to summarize the main findings and future prospects of using the NBO to support the transition to parenthood from birth through the first months of life, particularly in high-risk environments such as intensive care units.

Familial Hypercholesterolemia (FH) is one of the best-characterized inborn errors of metabolism, with an estimated prevalence of 1:250 in the general population. Only approximately 10% of the affected subjects are diagnosed and, therefore, under medical care, including drug therapy or, in severe cases, apheresis. Screening at the age of 6-10 years would be useful and cost-effective. There is enough evidence that children and adolescents with FH should be treated in order to reduce elevated Total cholesterol and LDL-c levels and, therefore, avoid the risk of early cardiovascular diseases. As FH was described more than 130 years ago, it is surprising that the knowledge of that very important metabolic disorder is insufficient. The present report describes clinical and pathophysiological characteristics and nutritional and medical therapies in children with familial hypercholesterolemia.

The aim of the present survey was to analyze the knowledge and skills in medical paper writing of physicians who attended the course "how to write successfully a scientific paper." A blind survey was used to analyze participants' knowledge on the topic of the course "how to write successfully a scientific paper." Before starting the workshop, participants anonymously filled out the input questionnaire containing 12 preliminary data questions. The three-hour course included a lecture on the steps of creating and writing a scientific article with examples. At the end, all participants anonymously completed the exit questionnaire consisting of 18 questions. Differences and associations between the collected data were analyzed using appropriate statistical tests. The survey included 22 participants, most of whom were women (16, 72.7%). The participants' educational level was proportional to their age. 12 of the participants had an intermediate level, while the others reported higher English proficiency. Half of the participants had never published an article. A significant difference was observed between English level and being the first author of an article published in a scientific journal (p = 0.044). Before class, only 13.6% of participants knew that guidelines are mandatory for making clinical decisions according to evidence- based medicine. There was a significant positive correlation between sex and current affiliation (p = 0.038). A negative correlation was observed between sex and article publication (p = 0.037). A positive correlation was observed between English level and current affiliation (p = 0.020). There was a negative correlation observed between previous sources of learning scientific article writing and having already published an article (p = 0.025). A positive correlation was found between reading an article and publishing it (p = 0.046). Statistical analysis showed a significant difference between reading frequency, number of published articles, being the first author, and knowing the title of a scientific article (p = 0.036, p = 0.027, and p = 0.030, respectively). The results of the questionnaires revealed discrepancies in prior research engagement and understanding of scientific concepts and rules. This survey highlights the importance of the course "how to successfully write a scientific article" in improving participants' knowledge of scientific work and the process of creating an article for submission to medical journals.

To perform a systematic review and meta-analysis compiling data on the prevalence of bruxism in children and adolescents with cerebral palsy. Searches were carried out in PubMed/Medline, Web of Science, and Scopus databases to identify the articles published by February 2023. Two independent reviewers, and in duplicate, employed a two-stage process to select publications. The same two reviewers performed the data extraction. Studies were included when the following eligibility criteria were met: performed in children and/or adolescents with cerebral palsy and reporting bruxism. Potentially eligible studies were read in full and excluded that: not presented numerical data on the prevalence of bruxism; not reported how the bruxism was assessed; not reported data about the cerebral palsy; and not an observational study. The risk assessment of bias was assessed by the Newcastle- Ottawa Scale. After reading the titles and abstracts of the 358 identified articles, eight articles from 1966 to 2020 were included. The main reason for not including the studies was not to report data about bruxism (59.3%), and 44.5% were excluded for not reporting data from patients with cerebral palsy. The studies were carried out in schools, university hospitals, or centers for patients with special needs (Brazil, the United States, and Egypt). The pooled prevalence of bruxism in children and adolescents with cerebral palsy was 46% (95%CI: 0.38-0.55) after removing one study. The pooled prevalence of bruxism in children with cerebral palsy can be considered high since almost half of the studied population is affected by this condition. PROSPERO #CRD42021225781.

Over the past decades, an increased importance has been given to gastrointestinal (GI) endoscopy in the management of children with inflammatory bowel diseases (IBD), considering that mucosal healing has been recognized as the optimal endpoint in the treat-to-target paradigm. The recent advances in technology and anesthesia have facilitated the comprehensive evaluation of the GI tract. In this review, we will discuss the role of ileocolonoscopy, upper GI endoscopy, and device-assisted enteroscopy in the work-up and management of pediatric Crohn's disease (CD) and ulcerative colitis, with particular attention on non-invasive endoscopic techniques, such as wireless capsule endoscopy. We will also analyze the most commonly used endoscopic scoring systems, including small bowel scoring systems and endoscopic recurrence grading of neo-terminal ileum CD. Moreover, we will focus on the endoscopic management of complications, such as strictures, that commonly require surgery. Lastly, we will discuss cancer surveillance in children with IBD, with particular consideration of the role of high-definition endoscopic equipment and chromoendoscopy in dysplasia detection rates.