@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 {10804, title = {Intranasal dexmedetomidine, as midazolam-sparing drug, for MRI in preterm neonates.}, journal = {Paediatr Anaesth}, volume = {28}, year = {2018}, month = {2018 08}, pages = {747-748}, issn = {1460-9592}, doi = {10.1111/pan.13454}, author = {Bua, Jenny and Massaro, Marta and Cossovel, Francesca and Monasta, Lorenzo and Brovedani, Pierpaolo and Cozzi, Giorgio and Barbi, Egidio and Demarini, Sergio and Travan, Laura} } @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 {10484, title = {Longitudinal Responses to Weighing and Bathing Procedures in Preterm Infants.}, journal = {J Perinat Neonatal Nurs}, volume = {31}, year = {2017}, month = {2017 Jan/Mar}, pages = {67-74}, abstract = {

Knowledge of the effects of nursing-induced stress on short-term outcomes in preterm infants is limited. Effects of 2 standard nursing procedures-weighing and bathing-on autonomic and motor stability of preterm infants were studied during their hospitalization. Outcomes were evaluated during and after the procedures. Eleven preterm infants were observed between 32 and 35 weeks{\textquoteright} postmenstrual age (PMA) (postnatal days range: 4-63). Neonatal responses were assessed according to the Synactive Theory of Development and nursing was performed taking into account Newborn Individualized Developmental Care and Assessment Program (NIDCAP) principles. Effects of the studied nursing procedures on infants{\textquoteright} stability during and after their execution were evaluated by nonparametric statistics. During monitored procedures, stress responses in autonomic and motor systems were observed at all PMAs. However, after 32 weeks{\textquoteright} PMA, preterm infants also showed an autonomic and motor stability recovery 5 minutes after procedure completion. Contrary to our hypothesis, preterm infants showed to be stressed by weighing and bathing procedures up to 35 weeks{\textquoteright} PMA. However, if facilitated and supported after nursing conclusion by interventions such as swaddling and nesting, according to NIDCAP principles, they recovered autonomic and motor stability by 5 minutes after ending procedures.

}, keywords = {Baths, Body Weight, Female, Humans, Infant Behavior, Infant Care, Infant, Newborn, Infant, Premature, Male, Neonatal Nursing}, issn = {1550-5073}, doi = {10.1097/JPN.0000000000000228}, author = {Bembich, Stefano and Fiani, Giulia and Strajn, Tamara and Sanesi, Cecilia and Demarini, Sergio and Sanson, Gianfranco} } @article {10496, title = {Theophylline increases diaphragmatic contractility in mechanically ventilated newborns.}, journal = {J Crit Care}, volume = {37}, year = {2017}, month = {2017 02}, pages = {264-265}, keywords = {Diaphragm, Humans, Infant, Newborn, Muscle Contraction, Theophylline}, issn = {1557-8615}, doi = {10.1016/j.jcrc.2016.10.001}, author = {De Cunto, Angela and Paviotti, Giulia and Bua, Jenny and Demarini, Sergio} } @article {8308, title = {Body mass index curves for Italian preterm infants are comparable with American curves for infants born before 34 weeks of gestational age.}, journal = {Acta Paediatr}, volume = {105}, year = {2016}, month = {2016 May}, pages = {483-9}, abstract = {

AIM: Body mass index (BMI)-for-age curves have been developed in the USA, but not compared with other populations. This study created gender-specific intrauterine BMI-for-age curves for Italian preterm infants and compared them with the USA version.

METHODS: Data on 92 262 newborn infants, born at 26-42 weeks of gestational age in the north-eastern Italian region of Friuli Venezia Giulia between 2005 and 2013, were analysed to create gender-specific BMI-for-age curves. Gender-specific and age-specific BMI Z scores for Italian infants were calculated using the parameters of the USA growth curves and the World Health Organization charts.

RESULTS: Gender-specific BMI-for-age at birth curves were developed for premature Italian infants from 26 gestational weeks. The comparison with the USA charts showed no significant difference in BMI percentiles in Italian infants born at <=33 gestational weeks, but infants born at >=34 gestational weeks had a significantly higher BMI than the USA population, by 0.2 standard deviations.

CONCLUSION: We developed the first European BMI-for-age at birth curves for premature infants. According to our findings, the Italian curves were comparable to the USA curves for the subgroup of infants born at <=33 gestational weeks, but not >=34 gestational weeks.

}, issn = {1651-2227}, doi = {10.1111/apa.13364}, author = {Paviotti, Giulia and Monasta, Lorenzo and Ronfani, Luca and Montico, Marcella and Copertino, Marco and De Cunto, Angela and Demarini, Sergio} } @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 {3630, title = {Making the first days of life safer: preventing sudden unexpected postnatal collapse while promoting breastfeeding.}, journal = {J Hum Lact}, volume = {31}, year = {2015}, month = {2015 Feb}, pages = {47-52}, abstract = {

Early and prolonged skin-to-skin contact (SSC) after birth between a mother and her newborn has been shown to generate beneficial effects on the mother-infant relationship and breastfeeding. Close mother-infant body contact immediately after birth positively enhances exclusive breastfeeding during the hospital stay, with a dose-response relationship. Skin-to-skin contact may ease the infant{\textquoteright}s transition to extra-uterine life and helps regulate the infant{\textquoteright}s body temperature and nursing behavior. However, reports of sudden unexpected postnatal collapse (SUPC) soon after birth, in healthy term neonates, in association with SSC, have raised concerns about the safety of this practice. Based on available evidence, we developed a surveillance protocol in the delivery room and postnatal ward of the Institute for Maternal and Child Health of Trieste (Italy). The aim of our protocol is (a) to promote safe mother and infant bonding and (b) to establish successful breastfeeding, without increasing the risk of SUPC. As there is no known effective intervention to prevent SUPC, our protocol has been conceived as a potential best practice.

}, issn = {1552-5732}, doi = {10.1177/0890334414554927}, author = {Davanzo, Riccardo and De Cunto, Angela and Paviotti, Giulia and Travan, Laura and Inglese, Stefania and Brovedani, Pierpaolo and Crocetta, Anna and Calligaris, Chiara and Corubolo, Elisa and Dussich, Valentina and Verardi, Giuseppa and Causin, Enrica and Kennedy, Jaquelyn and Marrazzo, Francesca and Strajn, Tamara and Sanesi, Cecilia 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 {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 {3534, title = {High-frequency percussive ventilation as rescue treatment in severe hypoxemic respiratory failure in term neonates.}, journal = {J Crit Care}, volume = {29}, year = {2014}, month = {2014 Aug}, pages = {662-3}, keywords = {Female, High-Frequency Ventilation, Humans, Male, Oxygen, Pulmonary Gas Exchange, Respiratory Insufficiency}, issn = {1557-8615}, doi = {10.1016/j.jcrc.2014.02.018}, author = {Paviotti, Giulia and Bua, Jenny and De Cunto, Angela and Travan, Laura and Demarini, Sergio} } @article {3535, title = {A neonate with a {\textquoteright}milky{\textquoteright} blood. What can it be?}, journal = {Arch Dis Child Fetal Neonatal Ed}, volume = {99}, year = {2014}, month = {2014 Nov}, pages = {F514}, keywords = {Female, Humans, Hyperlipoproteinemia Type IV, Infant, Newborn, Lipoprotein Lipase, Milk Proteins, Mutation}, issn = {1468-2052}, doi = {10.1136/archdischild-2014-305940}, author = {Bordugo, Andrea and Carlin, Eva and Demarini, Sergio and Faletra, Flavio and Colonna, Franco} } @article {3519, title = {Severe neonatal hyperbilirubinemia and UGT1A1 promoter polymorphism.}, journal = {J Pediatr}, volume = {165}, year = {2014}, month = {2014 Jul}, pages = {42-5}, abstract = {

OBJECTIVE: To assess whether UGT1A1 promoter polymorphisms associated with Gilbert Syndrome (GS) occur with a greater frequency in neonates with severe hyperbilirubinemia.

STUDY DESIGN: In a case-control study performed at a single hospital center in Italy, 70 case subjects with severe hyperbilirubinemia (defined as bilirubin level >=20~mg/dL or 340~μmol/L) and 70 controls (bilirubin level <12~mg/dL or 210~μmol/L) were enrolled. Both case and control subjects were full term newborns. Polymerase chain reaction analysis on blood spot was performed to determine the frequency of UGTA1A1 promoter polymorphisms in cases and controls.

RESULTS: No statistical difference in the prevalence of UGTA1A1 gene variants was found between cases and controls (P~=~1). Thirteen infants homozygous for (TA)7 polymorphism associated with GS were in the case group (18.6\%) and 14 in the control group (20.0\%). A heterozygous group was also equally distributed between cases (44.3\%) and controls (42.9\%). No (TA)8 repeat was found in the 2 groups.

CONCLUSIONS: In our study population, GS polymorphism alone does not appear to play a major role in severe neonatal hyperbilirubinemia in neonates without signs of hemolysis.

}, keywords = {Case-Control Studies, Female, Genotype, Gilbert Disease, Glucuronosyltransferase, Humans, Hyperbilirubinemia, Neonatal, Infant, Newborn, Male, Polymerase Chain Reaction, Polymorphism, Genetic, Prevalence, Promoter Regions, Genetic}, issn = {1097-6833}, doi = {10.1016/j.jpeds.2014.03.013}, author = {Travan, Laura and Lega, Sara and Crovella, Sergio and Montico, Marcella and Panontin, Elisa and Demarini, Sergio} } @article {3536, title = {When does postnatal catch-up fat occur in late preterm infants?}, journal = {Acta Paediatr}, volume = {103}, year = {2014}, month = {2014 Aug}, pages = {e325}, keywords = {Body Composition, Humans, Infant, Premature}, issn = {1651-2227}, doi = {10.1111/apa.12668}, author = {De Cunto, Angela and Paviotti, Giulia and Demarini, Sergio} } @article {1878, title = {Breastfeeding and neonatal weight loss in healthy term infants.}, journal = {J Hum Lact}, volume = {29}, year = {2013}, month = {2013 Feb}, pages = {45-53}, abstract = {

BACKGROUND: Neonatal weight loss is universally recognized, yet poorly understood. Limited professional consensus exists on the definition of lower limit of safe weight loss.

OBJECTIVE: Our aim was to assess the extent of neonatal weight loss and its association with selected clinical variables in a population of healthy term infants cared for using a specific protocol on weight loss.

METHODS: We retrospectively considered 1003 infants consecutively admitted to the regular nursery of the Institute for Maternal and Child Health "Burlo Garofolo" (Trieste, Italy). We studied the relationship of selected variables with neonatal weight loss recorded during the hospital stay. We also analyzed all readmissions in the first month of life as a result of weight loss and its complications.

RESULTS: We observed a mean absolute weight loss of 228 g {\textpm} 83g, and a mean percent weight loss of 6.7\% {\textpm} 2.2\%. Weight loss >= 10\% and > 12\% were 6\% and 0.3\%, respectively. In multivariate logistic regression, cesarean section, hot season, any formula feeding, and jaundice not requiring phototherapy were independently associated with neonatal weight loss >= 8\%. Conversely, low gestational age status was associated with lower weight loss. Readmission within the first month of life because of dehydration occurred in 0.3\% of infants.

CONCLUSIONS: Breastfeeding, compared to formula feeding, may not be a risk factor for greater early neonatal weight loss, at least in contexts in which weight is routinely monitored, breastfeeding is repeatedly assessed and appropriately supported, and careful supplementation is prescribed to limit and promptly treat excess weight loss and its related complications.

}, keywords = {Apgar Score, Breast Feeding, Delivery, Obstetric, Gestational Age, Humans, Infant, Newborn, Length of Stay, Patient Readmission, Retrospective Studies, Seasons, Weight Loss}, issn = {1552-5732}, doi = {10.1177/0890334412444005}, author = {Davanzo, Riccardo and Cannioto, Zemira and Ronfani, Luca and Monasta, Lorenzo and Demarini, Sergio} } @article {1952, title = {Breastfeeding at NICU discharge: a multicenter Italian study.}, journal = {J Hum Lact}, volume = {29}, year = {2013}, month = {2013 Aug}, pages = {374-80}, abstract = {

BACKGROUND: Human milk is the optimal form of nutrition for infants, especially sick or compromised infants, yet international data suggest that breastfeeding (feeding at the breast) and the use of expressed human milk (mother{\textquoteright}s and donor{\textquoteright}s milk) are limited in patients cared for in the neonatal intensive care unit (NICU).

OBJECTIVE: The goal of this study was to examine feeding status at hospital discharge among high risk infants.

METHODS: We used the 1991 World Health Organization infant feeding definitions, applied to the 72 hour period preceding discharge from the NICU. The study sample consisted of all high risk infants discharged from July 1, 2005, to June 30, 2006 from 13 Italian NICUs. Data on infant feeding in the last 72 hours were collected at discharge from the medical records.

RESULTS: We recorded data from 2948 subjects with a median gestational age of 35 weeks (IQR, 32-38), a median birth weight of 2200 g (IQR, 1630-2920) and a median length of stay of 16 days (IQR, 8-33). At discharge, 28\% of all infants were fed exclusively with human milk: 31\%, 25\%, 22\% and 33\% respectively in the <1500 g, 1500-2000 g, 2000-2499 g and >= 2500 g birth weight categories. The proportion of infants not fed with human milk varied from 6 to 82\% across different centers.

CONCLUSION: Our study found limited breastfeeding and use of human milk among the NICU infants at discharge. At discharge, infants with a birth weight 1500-2499 g were fed exclusively with human milk less than those in higher or lower birth weight categories.

}, keywords = {Breast Feeding, Humans, Infant, Low Birth Weight, Infant, Newborn, Infant, Premature, Intensive Care Units, Neonatal, Italy, Logistic Models, Multivariate Analysis, Patient Discharge}, issn = {1552-5732}, doi = {10.1177/0890334412451055}, author = {Davanzo, Riccardo and Monasta, Lorenzo and Ronfani, Luca and Brovedani, Pierpaolo and Demarini, Sergio} } @article {1860, title = {Human colostrum and breast milk contain high levels of TNF-related apoptosis-inducing ligand (TRAIL).}, journal = {J Hum Lact}, volume = {29}, year = {2013}, month = {2013 Feb}, pages = {23-5}, abstract = {

BACKGROUND: TNF-related apoptosis inducing ligand (TRAIL) is a pleiotropic cytokine, which plays a key role in the immune system as well as in controlling the balance of apoptosis and proliferation in various organs and tissues.

OBJECTIVE: To investigate the presence and levels of soluble TRAIL in human colostrum and milk.

METHODS: The levels of soluble human TRAIL were measured in human colostrum (day 2 after delivery) and breast milk (day 5 after delivery). The presence of TRAIL was also measured in infant formula.

RESULTS: Levels of soluble TRAIL in the colostrum and mature human milk were, respectively, at least 400 and 100 fold higher than those detected in human serum. No TRAIL was detected in formula.

CONCLUSION: Human soluble TRAIL is present at extremely high levels in human colostrum and human milk and might have a significant role in mediating the anti-cancer activity of human milk.

}, keywords = {Adult, Apgar Score, Colostrum, Female, Gestational Age, Humans, Infant Formula, Infant, Newborn, Milk, Human, TNF-Related Apoptosis-Inducing Ligand}, issn = {1552-5732}, doi = {10.1177/0890334412441071}, author = {Davanzo, Riccardo and Zauli, Giorgio and Monasta, Lorenzo and Vecchi Brumatti, Liza and Abate, Maria Valentina and Ventura, Giovanna and Rimondi, Erika and Secchiero, Paola and Demarini, Sergio} } @article {1801, title = {Congenital hemangiopericytoma.}, journal = {J Pediatr}, volume = {160}, year = {2012}, month = {2012 May}, pages = {878}, keywords = {Biopsy, Needle, Female, Gestational Age, Hemangiopericytoma, Humans, Immunohistochemistry, Infant, Newborn, Magnetic Resonance Imaging, Pregnancy, Prognosis, Risk Assessment, Soft Tissue Neoplasms, Treatment Outcome, Ultrasonography, Prenatal}, issn = {1097-6833}, doi = {10.1016/j.jpeds.2011.11.023}, author = {Travan, Laura and Demarini, Sergio and Del Frate, Giovanni and Zacchi, Alberto} } @article {1808, title = {Does the LATCH score assessed in the first 24 hours after delivery predict non-exclusive breastfeeding at hospital discharge?}, journal = {Breastfeed Med}, volume = {7}, year = {2012}, month = {2012 Dec}, pages = {423-30}, abstract = {

AIM: The aims of this study were to analyze the relationship between the LATCH score assessed in the first 24 hours after delivery and non-exclusive breastfeeding at discharge and to identify a cutoff for the LATCH score in order to identify women with higher risk of non-exclusive breastfeeding who may need additional breastfeeding support.

SUBJECTS AND METHODS: We conducted a prospective observational study in the Maternity Ward of the Institute for Maternal and Child Health "Burlo Garofolo" (Trieste, Italy) and collected data from 299 mother-infant dyads.

RESULTS: The rate of nonexclusive breastfeeding was inversely related to the LATCH score (p<0.001) with non-exclusive breastfeeding infants scoring less (6.9) than infants exclusively breastfed at discharge (7.6) (p=0.001). In multivariate analysis, non-exclusive breastfeeding was also associated with cesarean section, primiparity, and infant phototherapy. In order to support maternity staff in providing targeted interventions, we identified four LATCH score cutoffs associated with as many risk groups for non-exclusive breastfeeding at discharge.

CONCLUSIONS: The LATCH score is a useful tool to identify mother-infant pairs who might benefit from additional skilled support in specific subgroups at risk of non-exclusive breastfeeding at discharge. Future research is needed to explore if the LATCH score assessed in the first days of life can also predict the duration of breastfeeding.

}, keywords = {Adult, Breast Feeding, Female, Health Promotion, Humans, Infant, Newborn, Italy, Logistic Models, Multivariate Analysis, Patient Care Planning, Patient Discharge, Prospective Studies, Risk Assessment, ROC Curve, Sensitivity and Specificity, Social Support}, issn = {1556-8342}, doi = {10.1089/bfm.2011.0120}, author = {Tornese, Gianluca and Ronfani, Luca and Pavan, Carla and Demarini, Sergio and Monasta, Lorenzo and Davanzo, Riccardo} } @article {1809, title = {Effects of prone and supine position on cerebral blood flow in preterm infants.}, journal = {J Pediatr}, volume = {160}, year = {2012}, month = {2012 Jan}, pages = {162-4}, abstract = {

We evaluated the effect of prone and supine position on cerebral blood flow (CBF) in stable preterm infants. CBF, PO(2), and PCO(2) were measured in the two positions. Peripheral oxygenation increased and CBF decreased in prone position. We speculate that CBF autoregulation may compensate for increased peripheral oxygenation, by decreasing CBF.

}, keywords = {Cerebrovascular Circulation, Female, Humans, Infant, Newborn, Infant, Premature, Male, Prone Position, Regional Blood Flow, Supine Position}, issn = {1097-6833}, doi = {10.1016/j.jpeds.2011.08.056}, author = {Bembich, Stefano and Oretti, Chiara and Travan, Laura and Clarici, Andrea and Massaccesi, Stefano and Demarini, Sergio} } @article {1782, title = {Neonatal necrotizing tracheobronchitis.}, journal = {J Pediatr}, volume = {159}, year = {2011}, month = {2011 Oct}, pages = {699-699.e1}, keywords = {Bronchitis, Bronchoscopy, High-Frequency Ventilation, Humans, Infant, Newborn, Male, Necrosis, Respiratory Insufficiency, Respiratory Mucosa, Tracheitis}, issn = {1097-6833}, doi = {10.1016/j.jpeds.2011.04.043}, author = {Bua, Jenny and Trappan, Antonella and Demarini, Sergio and Grasso, Domenico and Schleef, Jurgen and Zennaro, Floriana} } @article {1783, title = {Non-invasive assessment of hemispheric language dominance by optical topography during a brief passive listening test: a pilot study.}, journal = {Med Sci Monit}, volume = {17}, year = {2011}, month = {2011 Dec}, pages = {CR692-7}, abstract = {

BACKGROUND: The Wada test is usually used for pre-surgical assessment of language lateralization. Considering its invasiveness and risk of complications, alternative methods have been proposed but they are not always applicable to non-cooperative patients. In this study we explored the possibility of using optical topography (OT)--a multichannel near-infrared system--for non-invasive assessment of hemispheric language dominance during passive listening.

MATERIAL/METHODS: Cortical activity was monitored in a sample of healthy, adult Italian native speakers, all right-handed. We assessed changes in oxy-haemoglobin concentration in temporal, parietal and posterior frontal lobes during a passive listening of bi-syllabic words and vowel-consonant-vowel syllables lasting less then 3 minutes. Activated channels were identified by t tests.

RESULTS: Left hemisphere showed significant activity only during the passive listening of bi-syllabic words. Specifically, the superior temporal gyrus, the supramarginal gyrus and the posterior inferior parietal lobe were activated.

CONCLUSIONS: During passive listening of bi-syllabic words, right handed healthy adults showed a significant activation in areas already known to be involved in speech comprehension. Although more research is needed, OT proved to be a promising alternative to the Wada test for non-invasive assessment of hemispheric language lateralization, even if using a particularly brief trial, which has been designed for future applications with non-cooperative subjects.

}, keywords = {Acoustic Stimulation, Adult, Cerebrum, Diagnostic Techniques and Procedures, Dominance, Cerebral, Female, Humans, Language, Male, Middle Aged, Oxyhemoglobins, Pilot Projects, Spectroscopy, Near-Infrared}, issn = {1643-3750}, author = {Bembich, Stefano and Demarini, Sergio and Clarici, Andrea and Massaccesi, Stefano and Grasso, Domenico Loenardo} } @article {1648, title = {Hot water and preparation of infant formula: how hot does it have to be to be safe?}, journal = {J Pediatr Gastroenterol Nutr}, volume = {50}, year = {2010}, month = {2010 Mar}, pages = {352-3}, keywords = {Guidelines as Topic, Hot Temperature, Humans, Infant, Infant Formula, Water, World Health Organization}, issn = {1536-4801}, doi = {10.1097/MPG.0b013e31819f65b1}, author = {Davanzo, Riccardo and Giurici, Nagua and Demarini, Sergio} } @article {1622, title = {Individual differences in prefrontal cortex activity during perception of bitter taste using fNIRS methodology.}, journal = {Chem Senses}, volume = {35}, year = {2010}, month = {2010 Nov}, pages = {801-12}, abstract = {

Although bitter taste has a crucial role in nutrition by preventing the ingestion of toxic foods, there are few studies on bitter taste neuroimaging. To identify cortical areas involved in bitter taste perception and to determine if individual differences in taste sensitivity to 6-n-propylthiouracil (PROP) are represented in the brain by different cortical activation patterns, we examined 48 healthy volunteers using functional near-infrared spectroscopy. Participants rated the perceived intensity of filter paper disks impregnated with PROP and NaCl during the imaging procedure and were then classified as PROP tasters and nontasters. We monitored cortical activity in both the anterior and posterior regions of the dorsolateral prefrontal cortex (DLPFC) and in the ventrolateral prefrontal cortex (VLPFC). No activity was detected in the anterior DLPFC in any of the participants. However, during the administration of PROP, significant cortical activation was detected in the more posterior regions of the left DLPFC and in the left and right VLPFC but only in PROP tasters. PROP nontasters showed no cortical activity in these areas. These data suggest that the prefrontal cortex is involved in the conscious perception of the bitter taste of PROP and that the pattern of activity is consistent with individual differences in the ability to taste this compound. Thus, the PROP phenotype is associated with fundamental differences in cortical taste processing.

}, keywords = {Adult, Eating, Female, Food Preferences, Humans, Individuality, Male, Perception, Phenotype, Prefrontal Cortex, Propylthiouracil, Sodium Chloride, Spectroscopy, Near-Infrared, Taste, Taste Threshold, Young Adult}, issn = {1464-3553}, doi = {10.1093/chemse/bjq080}, author = {Bembich, Stefano and Lanzara, Carmela and Clarici, Andrea and Demarini, Sergio and Tepper, Beverly J and Gasparini, Paolo and Grasso, Domenico L} } @article {1681, title = {Multiple segmental absence of intestinal musculature presenting as spontaneous isolated perforation in an extremely low-birth-weight infant.}, journal = {J Pediatr Surg}, volume = {45}, year = {2010}, month = {2010 Aug}, pages = {E25-7}, abstract = {

Defect of the intestinal musculature is a rare condition. It may cause intestinal perforation or obstruction. It manifests itself mainly in the neonatal period and usually affects preterm infants. We describe one such case, which was first diagnosed as a spontaneous isolated intestinal perforation. Emergency laparotomy was performed and showed multiple perforations, with accompanying peritonitis and ascites. Pathologic examination showed partial or complete absence of the musculature, particularly of the inner circular layer, with fibrous tissue in the regions of missing muscle, and abnormal vasculature. The myenteric plexus was absent in areas of muscle loss but present in other sites. These findings suggest that the absence of muscle may not represent a congenital malformation but may be secondary to ischemic injury.

}, keywords = {Diseases in Twins, Female, Humans, Ileum, Infant, Extremely Low Birth Weight, Infant, Newborn, Infant, Premature, Intestinal Atresia, Intestinal Perforation, Laparotomy, Muscle, Smooth, Myenteric Plexus, Rare Diseases}, issn = {1531-5037}, doi = {10.1016/j.jpedsurg.2010.05.029}, author = {Oretti, Chiara and Bussani, Rossana and Janes, Augusta and Demarini, Sergio} } @article {1649, title = {Storage of human milk: accepting certain uncertainties.}, journal = {J Hum Lact}, volume = {26}, year = {2010}, month = {2010 Aug}, pages = {233-4}, keywords = {Food Handling, Humans, Milk, Human, Refrigeration}, issn = {1552-5732}, doi = {10.1177/0890334410374601}, author = {Davanzo, Riccardo and Travan, Laura and Demarini, Sergio} } @article {1659, title = {Two cases of Noonan syndrome with severe respiratory and gastroenteral involvement and the SOS1 mutation F623I.}, journal = {Eur J Med Genet}, volume = {53}, year = {2010}, month = {2010 Sep-Oct}, pages = {322-4}, abstract = {

Noonan syndrome (NS) is an autosomal dominant, inherited disorder characterized by facial dysmorphism, congenital heart defects, and reduced postnatal growth. Dysregulated RAS-MAPK signalling is the common molecular basis for NS, a genetically heterogeneous disease. Germline mutations in genes encoding small GTPases of the RAS family (KRAS and NRAS), modulators of RAS function (PTPN11, SOS1 and SHOC2) or downstream signal transducers (RAF1) are causative for NS. SOS1 is the second major gene for NS after PTPN11. Compared to patients with mutations in other genes, SOS1 mutation-positive individuals in general tend to have a more favorable outcome, with less short stature and cognitive impairment. We describe two unrelated patients with NS carrying the same heterozygous SOS1 missense mutation (c.1867T > A/p.F623I). The phenotype of both patients is remarkable as they show uncommon clinical features such as pulmonary lymphangiectasis, congenital pleural effusions, severe feeding problems, and laryngomalacia. These findings may be related to the specific mutation present in our two patients, or be part of the SOS1 phenotype. Detailed clinical assessment of large cohorts of patients with NS and SOS1 mutation is required to clarify this initial observation.

}, keywords = {Child, Preschool, Genes, ras, Germ-Line Mutation, Heterozygote, Humans, Infant, Infant, Newborn, Male, Mutation, Missense, Noonan Syndrome, Phenotype, SOS1 Protein}, issn = {1878-0849}, doi = {10.1016/j.ejmg.2010.07.011}, author = {Fabretto, Antonella and Kutsche, Kerstin and Harmsen, May-Britt and Demarini, Sergio and Gasparini, Paolo and Fertz, Maria Cristina and Zenker, Martin} }