Child healthcare services offered by the Vatican City State in its national territory and in extra-territorial neighboring Italian areas

Pediatric healthcare activity related to the Vatican City State is carried out at secondary and tertiary levels in the two main pediatric territorial and extra-territorial medical centers, which are administered by the Vatican: the Bambino Gesu Pediatric Hospital and the Mother and Child pediatric Department of the Casa Sollievo della Sofferenza Medical Center. Both centers are recognized by the Italian State and internationally with the formal legal status of Scientific Institutes for Clinical Research. The relations established between the Holy See, in the person of the Secretary of State, the Board of Directors, the President of the Board, and the Board of Auditors regulate the management of the two medical centers. The child healthcare and research activity of the two Vatican State administered medical centers is described in this article

Development of the Gastrointestinal Tract in Newborns as a Challenge for an Appropriate Nutrition: A Narrative Review

The second and third trimesters of pregnancy are crucial for the anatomical and functional development of the gastrointestinal (GI) tract. If premature birth occurs, the immaturity of the digestive and absorptive processes and of GI motility represent a critical challenge to meet adequate nutritional needs, leading to poor extrauterine growth and to other critical complications. Knowledge of the main developmental stages of the processes involved in the digestion and absorption of proteins, carbohydrates, and lipids, as well as of the maturational phases underlying the development of GI motility, may aid clinicians to optimize the nutritional management of preterm infants. The immaturity of these GI systems and functions may negatively influence the patterns of gut colonization, predisposing to an abnormal microbiome. This, in turn, further contributes to alter the functional, immune, and neural development of the GI tract and, especially in preterm infants, has been associated with an increased risk of severe GI complications, such as necrotizing enterocolitis. Deeper understanding of the physiological colonization patterns in term and preterm infants may support the promotion of these patterns and the avoidance of microbial perturbations associated with the development of several diseases throughout life. This review aims to provide a global overview on the maturational features of the main GI functions and on their implications following preterm birth. We will particularly focus on the developmental differences in intestinal digestion and absorption functionality, motility, gut–brain axis interaction, and microbiomes

Behavioral and Emotional Disorders in Children during the COVID-19 Epidemic.

Since December 2019, health systems around the globe have struggled with an increasing number of cases of a viral respiratory syndrome that emerged in China. The cause is a new strain in the coronavirus family, provisionally named 2019 novel coronavirus (2019-nCoV), SARS-CoV-2 or COVID-19.The European Paediatric Association–Union of National European Paediatric Societies and Associations (EPA-UNEPSA) has established a collaborative working group with key Chinese academic institutions and medical centers with the purpose of facilitating the reciprocal exchange of information and sharing scientific knowledge. The aim of this commentary by the China-EPA-UNEPSA working group is to raise awareness regarding children’s psychological needs during epidemics and report early data collected in the COVID19–affected areas in China during the current outbreak, emphasizing the role of families and caregivers in the timely recognition and management of negative emotions

Plasma levels of conjugated bile acids in newborns after a short period of parenteral nutrition.

Background: Patients receiving parenteral nutrition (PN) frequently exhibit liver dysfunction. The authors previously reported that plant sterols of lipid emulsions added to the nutritional solution of newborns receiving PN accumulate in plasma and cell membranes and may contribute to the development of cholestasis. Conjugated bile acids (BA) have been shown to be useful markers of cholestasis. Plasma levels of several BA in newborns were quantified after administration of PN for less than 2 weeks. Methods: Plasma samples from 15 healthy control infants (CN), 22 patients who had received PN for 3-15 days (T1), and 9 patients scheduled to receive PN (T0) were analyzed. After a simple extraction procedure, plasma BA were analyzed by liquid chromatography-tandem mass spectrometry using a quantitative isotope dilution method. Results: The concentrations of BA did not differ significantly between controls and patients before PN (CN vs T0), with the exception of glycocholic acid (GCA; 2.30 ± 2.60 ??M vs 7.29 ± 5.39 ??M, respectively). There was a significant difference in several BA between controls and patients after PN (2.30 ± 2.60 ??M vs 7.61 ± 6.46 ??M for GCA, respectively; 4.02 ± 3.49 ??M vs 11.88 ± 11.05 ??M for taurocholic acid [TCA], respectively; and 4.81 ± 3.49 ??M vs 13.58 ± 12.22 ??M for taurochenodeoxycholic + taurodeoxycholic + tauroursodeoxycholic acids [TCDCA+TDCA+TUDCA], respectively). Conclusions: In newborns receiving PN, a short period of PN is associated with an early increase of some conjugated BA. These results suggest that GCA, TCA, and TCDCA+TDCA+TUDCA levels could be used as early markers of PN-related cholestasis

7-Й ЕВРОПЕЙСКИЙ КОНГРЕСС ПЕДИАТРОВ EUROPAEDIATRICS-2015: 13–16 МАЯ 2015 г., ФЛОРЕНЦИЯ, ИТАЛИЯ

.

Advocating for Children Trapped in the Midst of Armed Conflicts.

Natural and human-made disasters, including civil unrest, terrorism, biological and chemical threats, and war, have affected the world on a recurring basis. These events have caused suffering and misery to populations and have revealed a low degree of self-sufficiency and a high degree of unpreparedness on the part of governments to deal with the consequences.1 Natural and human-made adversity typically generate public health crises and economic instability, with lasting negative effects on the socioeconomic status of populations of all ages. These adverse effects affect children, who are among the most marginalized and vulnerable members of society and rarely consulted when communities make decisions that directly affect them. War is one of the world's most devastating events, requiring short-term interventions and complex long-term recovery planning, articulated in 4 phases—mitigation, preparedness, response and recovery—that focus on the rights of children who are in vulnerable circumstances and, therefore, at greater risk of harm. This commentary, authored by members of the board of directors of the European Pediatric Association–Union of National Pediatric Societies and Associations (EPA-UNEPSA), briefly discusses the plight of children exposed to situations of terror and horror during war, including severe loss and disruption in their lives, which can result in the lasting effects of post-traumatic stress disorder. Our goal is to raise awareness among pediatricians and public health authorities of the importance of developing programs directed toward the rehabilitation of children affected by war, including social healing and peace culture education, as a key approach to primary prevention of the recurrence of war

The Importance of Strengthening Mother and Child Health Services during the First 1000 Days of Life: The Foundation of Optimum Health, Growth and Development

The first 1000 days of a child's life, spanning from the time of conception until 2 years of age, are a unique period of laying down the foundations of optimum health, growth, and development across the lifespan. However, the first 1000 days are also a period of enormous vulnerability. How mothers and children are cared for during this crucial time has a profound influence on a child's ability to grow, learn, and thrive.1 The role of the first 1000 days of life is well-described. However, investments in this key period are scarce and the provision of adequate health care services id insufficient. The aim of this report is to further raise the attention of decision-makers and health care officers and professionals, including pediatricians, pediatric surgeons, obstetricians, nurses, midwives, dieticians, and lactation consultants, on the importance of investing in health care services to support and empower parents and families during a most critical period of their children's life. In particular, we encourage the adoption of integrated strategies to establish adequate preventive efforts and a perspective shift to strengthen or develop where lacking, efficient health care services dedicated to the first 1000 days of life as the first line of prevention

The Importance of Continuing Breastfeeding during Coronavirus Disease-2019: In Support of the World Health Organization Statement on Breastfeeding during the Pandemic.

There are many questions and concerns about the coronavirus disease 2019 (COVID-19), including its implications for breastfeeding. This commentary draws on a statement and recommendations recently issued by the Regional Office for Europe of the World Health Organization with the contribution of the European Pediatric Association-Union of National European Pediatric Societies and Associations and other main European pediatric organizations.1 Our aim is to provide pediatricians with further guidance on breastfeeding and related safety measures during COVID-19, particularly in instances where a mother has or may have COVID-19

Lifelong Negative Influence of School Violence on Children.

violence in the school environment is a constant concern for educators and parents and is a serious and often lifelong burden for the young victims. School violence is not just a limited problem, variously affecting specific or isolated communities in economic advantaged or disadvantaged areas, but a global modern phenomenon involving, to various degrees, one of the core social institutions of our society.The European Paediatric Association-Union of National European Paediatric Societies and Associations (EPA/UNEPSA), through the working group on social pediatrics, supported by its European national pediatric societies members, is currently developing dedicated projects to investigate the physical, psychological, and social impacts of school violence on European children and its possible lifelong risks. The purpose of this commentary is to raise awareness on this issue among healthcare professionals involved in childcare and to emphasize the importance of their participation in programs that are developed to monitor and prevent the negative, personal, and social impact