@article {10801, title = {Infant Analgesia With a Combination of Breast Milk, Glucose, or Maternal Holding.}, journal = {Pediatrics}, volume = {142}, year = {2018}, month = {2018 Sep}, abstract = {

OBJECTIVES: We studied neonatal cortical brain response to 4 types of nonpharmacological analgesia (oral glucose, expressed breast milk, maternal holding plus oral glucose, breastfeeding). We aimed to assess the differential effect of oral solutions (glucose, breast milk) given alone or combined with the maternal-infant relationship (holding, breastfeeding).

METHODS: Eighty healthy term newborns undergoing a heel stick were randomly assigned to 4 parallel groups of 20 infants each: group 1, infants received a glucose solution on a changing table; group 2, infants received expressed breast milk on a changing table; group 3, infants received a glucose solution in their mothers{\textquoteright} arms; and group 4, infants were breastfed by their mothers. Cortical activation in parietal, temporal, and frontal cortices was assessed by multichannel near-infrared spectroscopy. Pain expression was also evaluated.

RESULTS: Oral glucose alone or combined with maternal holding was associated with no cortical activation during heel stick. Expressed breast milk was associated with localized bilateral activation of somatosensory and motor cortices ( < .01). Breastfeeding was associated with extensive bilateral activation of somatomotor, somatosensory, and right parietal cortices ( < .01). Pain expression was lower with the maternal-infant relationship ( = .007).

CONCLUSIONS: Oral glucose, either alone or combined with maternal holding, appears to block or weaken cortical pain processing. Breast milk alone is associated with localized cortical activation. Breastfeeding is associated with extensive activation and may act by extending cortical processing. Maternal relationship, both combined with oral glucose and in breastfeeding, shows the greatest analgesic effect, although the neural patterns involved are distributed differently.

}, issn = {1098-4275}, doi = {10.1542/peds.2017-3416}, author = {Bembich, Stefano and Cont, Gabriele and Causin, Enrica and Paviotti, Giulia and Marzari, Patrizia and Demarini, Sergio} } @article {10470, title = {Bolus feeding has no effect on cerebral hemodynamics, irrespective of gestational age.}, journal = {J Matern Fetal Neonatal Med}, volume = {30}, year = {2017}, month = {2017 May}, pages = {1029-1031}, abstract = {

OBJECTIVE: By multichannel near-infrared spectroscopy, we studied if gestational age has any influence on preterm cerebral hemodynamics, during bolus feeding.

METHODS: Oxy-haemoglobin (HbO), as cerebral blood flow estimate, and the ratio between HbO and total haemoglobin (HbO/HbTot), as cerebral oxygenation estimate, were assessed in 40 stable premature infants, during a 10 min bolus feeding.

RESULTS: We found no effect of any of the gestational ages studied (25-34 weeks) either on cerebral blood flow or on oxygenation, during a bolus feeding procedure.

CONCLUSIONS: Bolus feeding appears not to affect cerebral hemodynamics of uncritically preterm infants, irrespective of gestational age.

}, keywords = {Cerebrovascular Circulation, Enteral Nutrition, Female, Gestational Age, Heart Rate, Humans, Infant, Newborn, Infant, Premature, Intensive Care Units, Neonatal, Male, Oxygen, Oxyhemoglobins, Spectroscopy, Near-Infrared}, issn = {1476-4954}, doi = {10.1080/14767058.2016.1199672}, author = {Bembich, Stefano and Cont, Gabriele and Bua, Jenny and Orlando, Chiara and Di Benedetto, Donatella and Demarini, Sergio} } @article {10545, title = {Higher growth, fat and fat-free masses correlate with larger cerebellar volumes in preterm infants at term.}, journal = {Acta Paediatr}, volume = {106}, year = {2017}, month = {2017 Jun}, pages = {918-925}, abstract = {

AIM: Smaller cerebellar volumes in very low-birthweight (VLBW) infants at term have been related to adverse cognitive outcomes, and this study evaluated whether these volumes were associated with a growth in body composition during hospital stays.

METHODS: We prospectively recruited 42 VLBW infants from an Italian neonatal unit between January 2013 and August 2015. Cerebellar volumes and body composition were measured by magnetic resonance imaging (MRI) and air-displacement plethysmography, respectively, at 40 weeks of gestational age and anthropometric and nutritional data were collected. We also included 20 term-born controls.

RESULTS: The mean gestational age and birthweight of the VLBW infants were 29.4 ({\textpm}1.9) weeks and 1120 ({\textpm}290) g. There was a positive correlation between cerebellar volumes and daily weight gain from birth to term (R = 0.26, p = 0.001), weight (R = 0.25, p = 0.001), length (R = 0.16, p = 0.01), fat mass (R = 0.15, p = 0.01) and fat-free mass at term (R = 0.20, p = 0.003). In multiple regression analysis, daily weight gain, mechanical ventilation and postconceptional age at MRI were independently associated with cerebellar volumes. Anthropometric data and cerebellar volumes were similar between VLBW and control infants.

CONCLUSION: Higher growth, higher fat mass and fat-free mass were associated with larger cerebellar volumes in VLBW infants at term.

}, keywords = {Body Composition, Cerebellum, Child Development, Female, Humans, Infant, Newborn, Infant, Premature, Infant, Very Low Birth Weight, Male, Nutritional Status, Organ Size, Prospective Studies, Regression Analysis}, issn = {1651-2227}, doi = {10.1111/apa.13829}, author = {Paviotti, Giulia and De Cunto, Angela and Zennaro, Floriana and Boz, Giulia and Travan, Laura and Cont, Gabriele and Bua, Jenny and Demarini, Sergio} } @article {10476, title = {Presentation of acute suppurative parotitis in a newborn with incessant crying.}, journal = {Arch Dis Child Fetal Neonatal Ed}, volume = {102}, year = {2017}, month = {2017 Mar}, pages = {F125}, keywords = {Acute Disease, Anti-Bacterial Agents, Crying, Female, Humans, Infant, Newborn, Parotitis, Staphylococcal Infections, Staphylococcus aureus}, issn = {1468-2052}, doi = {10.1136/archdischild-2016-312070}, author = {Velkoski, Angelika and Amoroso, Stefano and Brovedani, Pierpaolo and Cont, Gabriele and Trappan, Antonella and Travan, Laura} } @article {8349, title = {The cortical response to a noxious procedure changes over time in preterm infants.}, journal = {Pain}, volume = {157}, year = {2016}, month = {2016 Sep}, pages = {1979-87}, abstract = {

The aim of the study was to investigate whether cortical response to a repeated noxious procedure may change over time in preterm infants. Possible reasons for change are: (1) advancing maturation of central nervous system; and (2) increasing experience with noxious procedures during hospital stay. Sixteen preterm infants were recruited, with a postmenstrual age (PMA) ranging between 29 and 36 weeks. Newborns were assessed during a heel-prick procedure, once a week for at least 3 consecutive times. Multichannel near-infrared spectroscopy was used to detect cortical activation, by measuring increase in cortical oxy-haemoglobin (HbO2). Parietal, temporal, and posterior frontal areas were monitored bilaterally. By regression analysis, we studied the effect of (1) increasing PMA and (2) increasing number of heel pricks, on the magnitude of cortical activation. We observed a bilateral nociceptive event-related activation of the posterior frontal cortex, mainly contralateral to the side pricked. Additionally, we found a significant positive effect of PMA, as HbO2 progressively increased in the posterior frontal cortex (P < 0.001), bilaterally, over time. Conversely, the degree of cortical activation decreased as the number of noxious events increased (P < 0.002). We conclude the following: (1) Preterm newborns showed a significant activation of the posterior frontal cortex in association with noxious stimuli; (2) Cortical activation was progressively greater with increasing PMA; (3) There was an inverse relationship between cortical activation and the number of heel pricks. We speculate that such findings may be due to both endogenous cortical maturation and experience-dependent neuroplasticity of the developing brain (eg, synaptogenesis, synaptic pruning).

}, issn = {1872-6623}, doi = {10.1097/j.pain.0000000000000605}, author = {Bembich, Stefano and Marrazzo, Francesca and Barini, Alice and Ravalico, Paola and Cont, Gabriele and Demarini, Sergio} } @article {8289, title = {Isolated hypoplasia of abdominal wall muscles associated with fetal ascites.}, journal = {Congenit Anom (Kyoto)}, volume = {56}, year = {2016}, month = {2016 Jul}, pages = {184-186}, abstract = {

We report the case of an infant born after parvovirus B19-induced fetal hydrops, who presented at birth with bilateral abdominal wall laxity, which was more evident on the flanks. Imaging exams revealed congenital hypoplasia of oblique abdominal muscles not associated with other anatomical abnormalities except for small liver calcifications. We review the medical literature and identify similar cases associated with fetal ascites. We propose that isolated hypoplasia of abdominal wall muscles can be associated with fetal ascites from various causes, and represents a separate condition from prune belly syndrome.

}, issn = {1741-4520}, doi = {10.1111/cga.12156}, author = {Travan, Laura and Naviglio, Samuele and Cont, Gabriele and Brovedani, Pierpaolo and Davanzo, Riccardo and Demarini, Sergio} } @article {3604, title = {Cerebral oxygenation with different nasal continuous positive airway pressure levels in preterm infants.}, journal = {Arch Dis Child Fetal Neonatal Ed}, volume = {100}, year = {2015}, month = {2015 Mar}, pages = {F165-8}, abstract = {

OBJECTIVES: This study evaluates the effect of varying nasal continuous positive airway pressure (NCPAP) level on cerebral blood flow (CBF) and oxygenation in preterm infants.

METHODS: Oxy-haemoglobin (HbO2) and total haemoglobin (HbTot), as CBF estimates, and the ratio between HbO2 and HbTot (HbO2/HbTot), as cerebral oxygenation estimate, were assessed by near-infrared spectroscopy in 26 stable preterm newborns at a postmenstrual age between 26 and 33 weeks. Baseline HbO2, HbTot and HbO2/HbTot values were initially collected with NCPAP at 5 cm H2O and then compared with values obtained with NCPAP levels at both 3 and 8 cm H2O.

RESULTS: Compared with 5 cm H2O, cerebral HbO2, HbTot and HbO2/HbTot remained unchanged both after increasing (to 8 cm H2O) and decreasing (to 3 cm H2O) the NCPAP level. This result was observed both in regional areas (24 sites) and in the overall monitored area (frontal and parietal cortex). Compared with 8 cm H2O, peripheral oxygen saturation significantly decreased at 3 cm H2O (p=0.021). Heart rate did not change.

CONCLUSIONS: No differences in CBF and cerebral oxygenation were observed with NCPAP levels in the range 3-8 cm H2O despite a decrease in peripheral oxygenation with 3 cm H2O.

}, keywords = {Cerebrovascular Circulation, Continuous Positive Airway Pressure, Female, Hemoglobins, Humans, Infant, Newborn, Infant, Premature, Intensive Care, Neonatal, Male, Nasal Cavity, Oxygen, Oxygen Consumption, Oxyhemoglobins, Spectroscopy, Near-Infrared}, issn = {1468-2052}, doi = {10.1136/archdischild-2014-306356}, author = {Bembich, Stefano and Travan, Laura and Cont, Gabriele and Bua, Jenny and Strajn, Tamara and Demarini, Sergio} } @article {7710, title = {Impact of Surgery for Neonatal Gastrointestinal Diseases on Weight and Fat Mass.}, journal = {J Pediatr}, volume = {167}, year = {2015}, month = {2015 Sep}, pages = {568-71}, abstract = {

OBJECTIVE: To compare growth, fat mass (FM), and fat-free mass in surgical infants vs matched controls at similar postconceptional age (PCA).

STUDY DESIGN: Anthropometric and body composition measurements by air-displacement plethysmography (PeaPod-Infant Body Composition System; LMI, Concord, California) were performed at the same PCA in 21 infants who received gastrointestinal surgery and in 21 controls matched for gestational age, birth weight, and sex.

RESULTS: Despite similar anthropometry at birth, postsurgical infants were shorter (50.4 [4.7] cm vs 53.2 [4.1] cm, P = .001), lighter (3516 [743] g vs 3946 [874] g, P < .001), and had lower FM content (\%FM 14.8 [4.7]\% vs 20.2 [5.8]\%, P < .0001) than their peers at similar PCA (43 [4] weeks). All surgical infants but 1 (20/21) received parenteral nutrition (PN). Mean PN duration was 40 (30) days. Five infants in the control group received PN because of prematurity for 15 (9-30) days. Nine infants in the surgical group and 1 in the control group had PN-associated cholestasis.

CONCLUSIONS: Neonates having surgery for gastrointestinal diseases were shorter, had lower weight, and lower FM content than their peers, despite receiving more PN. Body composition evaluation and monitoring may help optimize growth in these newborns.

}, issn = {1097-6833}, doi = {10.1016/j.jpeds.2015.06.013}, author = {De Cunto, Angela and Paviotti, Giulia and Travan, Laura and Bua, Jenny and Cont, Gabriele and Demarini, Sergio} } @article {7742, title = {Maternal holding vs oral glucose administration as nonpharmacologic analgesia in newborns: a functional neuroimaging study.}, journal = {JAMA Pediatr}, volume = {169}, year = {2015}, month = {2015 Mar}, pages = {284-5}, keywords = {Administration, Oral, Analgesia, Blood Specimen Collection, Female, Functional Neuroimaging, Glucose, Humans, Infant, Newborn, Mother-Child Relations, Pain, Pain Management, Spectroscopy, Near-Infrared}, issn = {2168-6211}, doi = {10.1001/jamapediatrics.2014.3052}, author = {Bembich, Stefano and Cont, Gabriele and Baldassi, Giulio and Bua, Jenny and Demarini, Sergio} } @article {7745, title = {Orofacial granulomatosis in children: think about Crohn{\textquoteright}s disease.}, journal = {Dig Liver Dis}, volume = {47}, year = {2015}, month = {2015 Apr}, pages = {338-41}, abstract = {

BACKGROUND: The term orofacial granulomatosis is conventionally used to describe patients with granulomatous lesions affecting the orofacial tissues, in absence of intestinal lesions. Lip swelling and facial swelling are the most common clinical signs. Despite the fact that histologically it is not distinguishable from Crohn{\textquoteright}s disease, and that both diseases have a chronic/recurrent course, the relationship between orofacial granulomatosis and Crohn{\textquoteright}s disease is still debated.

METHODS: Herein we present five cases of orofacial granulomatosis.

RESULTS: All patients presented concomitant Crohn{\textquoteright}s disease, supporting the hypothesis that orofacial granulomatosis and Crohn{\textquoteright}s disease may be one single disease. Thalidomide was effective in inducing remission of oral and intestinal symptoms in all five cases and could be considered a valid treatment opportunity for these patients.

CONCLUSIONS: Orofacial granulomatosis and Crohn{\textquoteright}s disease may be part of the same disease; both may respond to thalidomide.

}, keywords = {Adolescent, Biopsy, Child, Colonoscopy, Crohn Disease, Diagnosis, Differential, Female, Granulomatosis, Orofacial, Humans, Immunosuppressive Agents, Male, Thalidomide}, issn = {1878-3562}, doi = {10.1016/j.dld.2014.12.012}, author = {Lazzerini, Marzia and Martelossi, Stefano and Cont, Gabriele and Bersanini, Chiara and Ventura, Giovanna and Fontana, Massimo and Zuin, Giovanna and Ventura, Alessandro and Taddio, Andrea} } @article {7721, title = {Pain activates a defined area of the somatosensory and motor cortex in newborn infants.}, journal = {Acta Paediatr}, volume = {104}, year = {2015}, month = {2015 Nov}, pages = {e530-3}, issn = {1651-2227}, doi = {10.1111/apa.13122}, author = {Bembich, Stefano and Brovedani, Pierpaolo and Cont, Gabriele and Travan, Laura and Grassi, Veronica and Demarini, Sergio} } @article {3496, title = {Can body mass index accurately predict adiposity in newborns?}, journal = {Arch Dis Child Fetal Neonatal Ed}, volume = {99}, year = {2014}, month = {2014 May}, pages = {F238-9}, abstract = {

Body mass index (BMI) is correlated with body fatness and risk of related diseases in children and adults. Proportionality indexes such as BMI and ponderal index (PI) have been suggested as complementary measures in neonatal growth assessment. Yet, they are still not used in neonates and their correlation with fatness is unknown. The aim of the study was to test the hypothesis that BMI z-score would predict neonatal adiposity. Body composition measurements (ie, fat mass, fat-free mass) by air displacement plethysmography (PEA POD, LMI, Concord-USA), weight and length were obtained in 200 infants >=36 weeks{\textquoteright} gestational age (GA) at birth. Linear regression analysis showed a direct association between BMI z-score and \%fat mass (r(2)=0.43, p<0.0001). This association was confirmed independently from sex, GA and maternal prepregnancy BMI. BMI z-score predicted adiposity better than PI. However, both BMI z-score and PI were poor predictors of adiposity at birth.

}, keywords = {Adiposity, Adult, Anthropometry, Body Composition, Body Mass Index, Cross-Sectional Studies, Female, Gestational Age, Humans, Infant, Newborn, Male, Mothers, Plethysmography, Predictive Value of Tests, Regression Analysis, Reproducibility of Results, Sex Factors}, issn = {1468-2052}, doi = {10.1136/archdischild-2013-305386}, author = {De Cunto, Angela and Paviotti, Giulia and Ronfani, Luca and Travan, Laura and Bua, Jenny and Cont, Gabriele and Demarini, Sergio} } @article {3605, title = {Differences in time course activation of dorsolateral prefrontal cortex associated with low or high risk choices in a gambling task.}, journal = {Front Hum Neurosci}, volume = {8}, year = {2014}, month = {2014}, pages = {464}, abstract = {

Prefrontal cortex plays an important role in decision making (DM), supporting choices in the ordinary uncertainty of everyday life. To assess DM in an unpredictable situation, a playing card task, such as the Iowa Gambling Task (IGT), has been proposed. This task is supposed to specifically test emotion-based learning, linked to the integrity of the ventromedial prefrontal cortex (VMPFC). However, the dorsolateral prefrontal cortex (DLPFC) has demonstrated a role in IGT performance too. Our aim was to study, by multichannel near-infrared spectroscopy, the contribution of DLPFC to the IGT execution over time. We tested the hypothesis that low and high risk choices would differentially activate DLPFC, as IGT execution progressed. We enrolled 11 healthy adults. To identify DLPFC activation associated with IGT choices, we compared regional differences in oxy-hemoglobin variation, from baseline to the event. The time course of task execution was divided in four periods, each one consisting of 25 choices, and DLPFC activation was distinctly analyzed for low and high risk choices in each period. We found different time courses in DLPFC activation, associated with low or high risk choices. During the first period, a significant DLPFC activation emerged with low risk choices, whereas, during the second period, we found a cortical activation with high risk choices. Then, DLPFC activation decreased to non-significant levels during the third and fourth period. This study shows that DLPFC involvement in IGT execution is differentiated over time and according to choice risk level. DLPFC is activated only in the first half of the task, earlier by low risk and later by high risk choices. We speculate that DLPFC may sustain initial and more cognitive functions, such as attention shifting and response inhibition. The lack of DLPFC activation, as the task progresses, may be due to VMPFC activation, not detectable by fNIRS, which takes over the IGT execution in its second half.

}, issn = {1662-5161}, doi = {10.3389/fnhum.2014.00464}, author = {Bembich, Stefano and Clarici, Andrea and Vecchiet, Cristina and Baldassi, Giulio and Cont, Gabriele and Demarini, Sergio} } @article {1785, title = {Delayed diagnosis of glycogen storage disease type III.}, journal = {J Pediatr Gastroenterol Nutr}, volume = {54}, year = {2012}, month = {2012 Jan}, pages = {122-4}, keywords = {Delayed Diagnosis, Diagnostic Errors, Glycogen Storage Disease Type I, Glycogen Storage Disease Type III, Humans, Infant, Liver, Male}, issn = {1536-4801}, doi = {10.1097/MPG.0b013e318228d806}, author = {Minen, Federico and Cont, Gabriele and De Cunto, Angela and Martelossi, Stefano and Ventura, Alessandro and Maggiore, Giuseppe and Faletra, Flavio and Gasparini, Paolo and Cassandrini, Denise} } @article {1685, title = {Refractory iron-deficiency anaemia in a child with portal cavernoma.}, journal = {Gut}, volume = {60}, year = {2011}, month = {2011 Mar}, pages = {317, 377}, keywords = {Anemia, Iron-Deficiency, Antihypertensive Agents, Child, Hemangioma, Cavernous, Humans, Hypertension, Portal, Ileal Diseases, Male, Propranolol, Vascular Neoplasms}, issn = {1468-3288}, doi = {10.1136/gut.2009.184697}, author = {Pastore, Serena and Londero, Margherita and Cont, Gabriele and Di Leo, Grazia and Ventura, Alessandro} }