Massimiliano Galdiero, Marilena Galdiero - Università della Campania “L. Vanvitelli” – Dipartimento di Medicina Sperimentale – Sezione di Microbiologia e Microbiologia clinica

From book "Lo Zibaldone del terzo millennio" (Salvatore Vendemmia, Maria Vendemmia), Cuzzolin Ed., 2020

COVID-19 è una malattia emergente da betacoronavirus che è venuta alla luce per la prima volta a Wuhan, nella provincia di Hubei in Cina, all'inizio del dicembre 2019, ma in un lampo ha raggiunto un'entità pandemica. Al 25 ottobre 2020 si registra un impressionante numero globale di 42.512.186 casi di COVID-19, inclusi 1.147.301 decessi. La pandemia, causata dal virus della sindrome respiratoria acuta severa (SARS-CoV-2), rappresenta una grave minaccia per la sanità pubblica poiché l'infezione comporta un ampio spettro di manifestazioni cliniche che possono variare da uno stato iniziale asintomatico che può progredire in polmonite fino alla sindrome da distress respiratorio acuto (ARDS, dall'inglese Acute Respiratory Distress Syndrome) seguita da sindrome da disfunzione multiorgano (MODS, dall'inglese Multiple Organ Dysfunction Syndrome) e finanche morte.

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Dear friends and colleagues,

Implementation Guidance: a strategy to eliminate violent punishment of children – now available in eight languages!

Prohibiting corporal punishment sends a strong message that violence in childrearing is not acceptable. But law reform alone will not eliminate violent punishment, and action must be taken to put the law into practice. This Implementation Guidance describes five broad steps in moving from prohibition to elimination of corporal punishment and the building of non-violent childhoods.

We are pleased to tell you that the Guidance is now available in Arabic, Chinese (Mandarin), English, French, Portuguese, Russian, Serbian and Spanish.

While 63 States - plus several nations and territories - have enacted prohibition of corporal punishment, efforts to put the law into practice are varied. As we get closer to 2030 and the deadline for achieving SDG Target 16.2 ‘ending all forms of violence against children’, all States must take decisive action to prohibit and eliminate violent punishment as a priority.

Contact us if you would like to work together to produce a translation in another language.

30 April – International Day to #EndCorporalPunishment

Between 25-30 April we will again raise our voices to call for the end of corporal punishment, the most common form of violence against children. For governments, this is an important opportunity to state or confirm their commitment to prohibiting and eliminating violent punishment of children. For other organisations and individuals, it is a chance to make a statement, publish an article, hold an event, launch a campaign, or do something even more creative!

We will send out an advocacy pack at the end of February, but you can start planning now!

Working together to end corporal punishment - survey

Finally, there is still time to complete our 4-minute survey about your work and the challenges and opportunities in ending corporal punishment. Deadline: Friday 18 February 2022. All your responses are so helpful in understanding the global situation and planning the way forward.

English - https://www.surveymonkey.co.uk/r/V7LPS5K
French - https://www.surveymonkey.co.uk/r/85HWJXK
Spanish - https://www.surveymonkey.co.uk/r/L8ZPVT7

With best wishes,
Bess Herbert, Advocacy Specialist - Corporal Punishment
bess.herbert@end-violence.org
Sonia Vohito, Legal Policy Specialist – Corporal Punishment
sonia.vohito@end-violence.org

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Vassilios Fanos - Terapia Intensiva Neonatale AOU Cagliari; Università degli Studi di Cagliari
Maria Cristina Pintus - Terapia Intensiva Neonatale AOU Cagliari
Roberta Pintus - Università degli Studi di Cagliari; Corresponding Author
Maria Antonietta Marcialis - Terapia Intensiva Neonatale AOU Cagliari

From book "Lo Zibaldone del terzo millennio" (Salvatore Vendemmia, Maria Vendemmia), Cuzzolin Ed., 2020

I polmoni sani non sono sterili (Barcik2020). Fino al 2010 si pensava che fosse un organo sterile (come ad esempio la placenta) e che fosse abitato da microrganismi (batteri, virus, funghi) al suo interno, solo in condizioni patologiche quali fibrosi cistica, enfisema, bronchiectasie, o polmonite.
Nell’ultimo decennio è stato dimostrato che il polmone normale ha un suo specifico microbiota. È molto più piccolo in termini numerici, rispetto al microbiota intestinale, ma è un microbiota unico che può influenzare la salute e le malattie. Con un numero stimato di 10–100 batteri per 1.000 cellule umane, il tratto respiratorio inferiore è una delle superfici meno popolate da batteri dell’intero corpo umano (EnaudR2020).

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Robert Sacy - Professor of Pediatrics Beirut University, Head of pediatric Programm at Quarantina governemental Hospital; President of an NGO ASSAMEH BIRTH AND BEYOND, Thesaurer UMEMPS, President IAPS

From book "Lo Zibaldone del terzo millennio" (Salvatore Vendemmia, Maria Vendemmia), Cuzzolin Ed., 2020

Lebanon was called in the bible land of milk and honey, Switzerland of the Middle-East, Pearl of the Middle-East, and Land of Gods.
Pope Jean-Paul 2 said about Lebanon, It is more than a country, it is a message.
Everyone enjoy living there because of the country natural beauty active financial market. good climate, rich culture, active financial market.

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Spatariu Luminița, Eugenia Buzoianu, Sorina Chindriș, Doina Anca Pleșca - University of Medicine and Pharmacy “Carol Davila”, “Dr. Victor Gomoiu” Children’s Clinical Hospital, Bucarest, Romania

From book "Lo Zibaldone del terzo millennio" (Salvatore Vendemmia, Maria Vendemmia), Cuzzolin Ed., 2020

Clinical and epidemiological characteristics in children confirmed with SARS CoV-2 infection in a non-COVID-19 pediatric clinical hospital from Romania in the first 6 months of the pandemy

The entire world has been facing the challenge of the new Pandemic with its epicenter in Wuhan, China, since December 2019. Current knowledge about SARS CoV-2 infection is still in its infancy and many questions have been awaiting an answer but what is apparently obvious, at least so far, is the low incidence of the disease among the pediatric population.

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Basim Alzoubi - Head of Pediatric Directorate in MOH; President of Jordan Pediatric Society; Consultant, pediatric endocrinologist; Vice-President IAPS; Amman, Jordan

From book "Lo Zibaldone del terzo millennio" (Salvatore Vendemmia, Maria Vendemmia), Cuzzolin Ed., 2020

Jordan is an Arabic country strategically located at the crossroads of Asia, Africa and Europe in the middle east. It was part through its history of many civilizations and empires like the Nabataean, the Greek, the Roman, and the Islamic who built many famous cities in Jordan like Petra, Jerash, Philadelphia (Amman) and many castles and palaces.
Jordan economy is relatively small and depends mainly on agriculture, phosphates, potash; tourism; and foreign aids. The country is a major tourist destination because it has many tourism attractions like Petra which is one of the 7 wonders in the world, the Greek-Roman ancient cities, the Dead Sea which is the lowest point on the earth, Jordan river where Jesus was baptized and many others.

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Enver Hasanoğlu – MD.; FAAP; General Secretary of TNPS, UMEMPS; President of UNIPSTR; President - Elect of IPA

From book "Lo Zibaldone del terzo millennio" (Salvatore Vendemmia, Maria Vendemmia), Cuzzolin Ed., 2020

First of all, I would like to thank my dear friend Prof. Salvatore Vendemmia for giving me the chance to write in this book. I graduated from Istanbul University Istanbul Medical Faculty in 1969. In 1973, I graduated from Hacettepe University Faculty of Medicine as a specialist in Pediatrics. In addition to being a pediatrician and conducting academic activities, I worked in positions of the Dean of the Faculty of Medicine and the Rector of the Gazi University. I have participated in national and international scientific organizations (Fig. 1). I had been on the board of the IPA (International Pediatric Association). In March 2019, I was elected as the next IPA president in Panama (Fig. 2, 3). I was the president of the Turkish National Pediatric Society (TNPS); I am still working as a secretary-general.

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Khalaf Hussein Hasan – Graduate of college of medicine at University of Mosul 1990, Finished MBChB 1990, DCH 2000, Arab Board of Pediatrics 2000, President Joint Iraqi – Italian Pediatric Association (JIIPA)

From book "Lo Zibaldone del terzo millennio" (Salvatore Vendemmia, Maria Vendemmia), Cuzzolin Ed., 2020

I moved to Duhok at Iraqi Kurdistan Region after finishing my Post graduate education.
We started the Department of Pediatrics at University of Duhok and at same time we start to open Hivi Pediatric Teaching Hospital as small hospital with limited facilities.
Now the hospital if fully equipped with both PICU and NICU, Pediatric Surgical ward and emergency room.
The hospital is receiving patients from Duhok as well as internally displaced people from all over Iraqi and Syrian refugees.
Regarding the university we started the Child Mental health Department in collaboration with Upsala University / Sweden.

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Dr.ssa Flaminia Bardanzellu,
Scuola di Specializzazione in Pediatria
Terapia Intensiva Neonatale
AOU Cagliari
(Direttore: Prof. Vassilios Fanos)

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The promising role of metabolomics in the analysis of amniotic fluid (AF) highly depends on its ability to describe and characterize the interactions between the mother and the fetus during prenatal development.
Among pre- and perinatally collected biofluids, AF represents an ideal substrate to provide dynamic information regarding fetal organogenesis and metabolism through pregnancy, since it originates from both maternal and fetal tissues and contains products deriving from placenta, fetal skin, lungs, gastric fluid and fetal urine. AF metabolome has been investigated by several authors, both in human and animal models.
In our review, available at the link http://dx.doi.org/10.1080/14789450.2019.1615892, we provide an update of the most recent studies (2015-2018) analyzing the role of AF metabolomics in the assessment of feto-maternal health; we also synthetized such results in a detailed table.
This recent ‘omics’ technology has been applied to investigate physiological pregnancies but even fields such as prematurity, bronchopulmonary dysplasia, fetal malformations, chromosomopathies, maternal diseases, placental inflammation or infections, gestational diabetes mellitus (GDM), maternal diet or fetal exposure to exogenous substances (exposomics), opening the way to innovative interpretations of congenital and perinatal conditions.
Up to now, due to the great steps forward in metabolomics, a whole pattern of metabolites can be simultaneously measured, resulting more useful than a single analyte value.
Thus, according to reported results, AF metabolome can provide interesting information in healthy or complicated pregnancies and, in the future, it could also allow the improvement of clinical management and therapeutic approach in several critical situations, potentially modifying the pregnancy fate.
Metabolomics seems a really useful tool to perform early and personalized therapeutic perinatal interventions, tailored on the needs of each feto-maternal dyad. It results very relevant, since congenital and perinatal disease includes a group of crucial conditions potentially affecting the long-term outcome of each newborn.
However, these fields still result in the early stage of their development and many studies are still needed to clarify the interpretation and clinical correlation of such metabolites. In particular, a validation on larger numbers of pregnancies is required. Moreover, AF samples should be selected in the most accurate and homogeneous way, taking into account that many metabolic patterns undergo spontaneous variability across the different phases of gestation.
Finally, metabolomics could be enriched by other ‘omics’ sciences, such as microbiomics, evaluating the possible interactions occurring between microbial communities in AF, exposomics, proteomics, genomics and epig¬enetic factors, to improve the knowledge of pregnancy physiopathological pathways.

Dr.ssa Flaminia Bardanzellu,
Scuola di Specializzazione in Pediatria
Terapia Intensiva Neonatale, Patologia Neonatale e Nido
AOU Cagliari
(Direttore: Prof. Vassilios Fanos)

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Nephrogenic Syndrome of Inappropriate Antidiuresis (NSIAD) has been described for the first time in 2005. It is a rare X-linked disease characterized by hyponatremia, hyposmolarity, euvolemia, inappropriately concentrated urine, increased natriuresis and low or undetectable Arginine-Vasopressine (AVP) circulating levels. It can occur in neonates, infants or even later in adulthood; familiar cases have been also reported. NSIAD must be promptly diagnosed and correctly managed in order to avoid a severe hyponatremia and the related negative consequences, especially in neonates, since it potentially leads to death or, in case of survival and in the most severe forms, even to an impaired neurological development. NSIAD is characterized by a renal inability to dilute urine due to a “gain of function” mutation in Arginine-Vasopressine receptor type 2 (V2R) which results constitutively activated; it is a monogenic disease mostly involving males, even if heterozygous females can be symptomatic due to the mechanism of lionization. The differential diagnosis with Syndrome of Inappropriate Secretion of Antidiuretic Hormone (SIADH) can be made through the detection of a decrease in AVP. Up to now, the real prevalence of such syndrome is unknown, since it can be completely underestimated, especially late onset and mildly symptomatic cases. After the first described cases, other affected patients have been identified, including neonates, infants or older people. A delayed presentation may depend on the possible persistence in asymptomatic status until adulthood and activation by occasional triggers, i.e. infections, excessive hydration, pregnancy or intense physical exercise. NSIAD can show a variable spectrum of onset symptoms, although the most common neonatal presentation is characterized by acute hyponatremia and seizures. Our medical staff identified and published first case of NSIAD with neonatal onset, probably triggered by perinatal asphyxia-induced oliguria and consequent fluid overload. Our recent review on this topic is available at the link https://www.ncbi.nlm.nih.gov/pubmed/29546600 and deals with the literature found in MEDLINE using nephrogenic syndrome of inappropriate antidiuresis, NSIAD, NSIAD neonatal onset, neonatal euvolemic hyponatremia, AVP, V2R, AVPR2 gene, seizures and vaptans as key words. As first, we report in detail all the molecular mechanisms leading to V2R gain of function and describe the genetic mutations associated with NSIAD. Our review demonstrates that NSIAD presentation is variable, ranging from early neurological symptoms and eventual permanent impairment to cases of asymptomatic adults, diagnosed after different triggers. NSIAD must be now taken into account in cases of hyponatremia without oedemas and associated with normal renal, adrenal and thyroid functions and current literature suggests that the evolution of NSIAD over time and response to treatment is variable and is rarely predictable. In conclusion, a deep knowledge of NSIAD helps to clarify disease mechanisms and may provide new information to perform an individualize treatment. We hope that future therapy will be based on each patient’s needs, to provide the best assistance and the safest outcome.

Dr.ssa Flaminia Bardanzellu,
Scuola di Specializzazione in Pediatria
Terapia Intensiva Neonatale, Patologia Neonatale e Nido
AOU Cagliari
(Direttore: Prof. Vassilios Fanos)

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Human endometrium is a dynamic tissue characterized by an extraordinary regenerative ability since it can cyclically grow, improve its thickness and therefore repair and regenerate itself during the reproductive life of each woman. In these mechanisms, endometrial stem cells (ESCs), undifferentiated auto-renewable cells able to generate more differentiated daughter cells, play a fundamental role.
Unfortunately, it has been also demonstrated that an autonomous de-regulated function of ESCs is involved in the pathogenesis and progression of several diseases, such as endometriosis, Asherman’s syndrome, intrauterine adhesions, dysfunctional endometrium but even malignant conditions, including human leiomyomas and cancer.
Therefore, endometrial auto-regeneration is not exempt from negative effects, coexisting with the good one as two sides of the same coin and constituting the risk behind the fundamental protective and regenerative mechanisms allowing reproduction and therefore the miracle of life itself.
Regarding this topic, our research group recently published a review entitled “Regenerating the Womb: The Good, Bad and Ugly Potential of the Endometrial Stem Cells” doi: 10.2174/2468424408666180705125036, discussing the recent literature found in MEDLINE with endometrial stem cells, endometriosis, leiomyomas, endometrial cancer, menstrual blood-derived stem cells as key-words.
In such paper we provide a complete and updated description of the stem cells (SCs) present in this tissue, both locally residing and also derived from other organs and tissues (such as bone marrow derived SCs), also taking into account the differences and the surface markers found during endometriosis, malignant transformation and cancer. Moreover, we analyze the enormous regenerative potential of human endometrium derived SCs, including the highly promising menstrual blood derived SCs (MenSCs) which can be collected in a non invasive way.
In fact, since ESCs and MenSCs show a high proliferation rate and a low immunogenic and tumorigenic power, they are widely used in tissue engineering, representing a great opportunity for clinical application, such as intra-thecal administration in multiple sclerosis, muscle repairing in Duchenne muscular dystrophy, pancreatic islets reconstitution in murine diabetic model, regeneration of cardiomyocytes after ischemia, treatment of premature ovarian failure or intrautherine adhesions and many other fields. We report the features and results of several trials investigating endometrial/menstrual blood derived stem cells in therapeutic applications in Table 1. of our previously mentioned article.
In conclusion, we believe that in the next future, an improved knowledge of endometrial and menstrual blood-derived SCs features and their enormous potential, could allow promising and beneficial therapeutic applications, also determining the best way to choose the donor and program the collection, to conserve and process the taken cells, to modify or adapt them for the desired application and minimizing the risks potentially correlated with ESCs transformation. Such new therapeutic strategies could be helpful in several human diseases including conditions affecting many young woman and leading to infertility.

Dr.ssa Flaminia Bardanzellu,
Scuola di Specializzazione in Pediatria
Terapia Intensiva Neonatale, Patologia Neonatale e Nido
AOU Cagliari
(Direttore: Prof. Vassilios Fanos)

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Human breast milk is a unique fluid whose composition depends on several factors, such as genetics, geographical origins, environment, lactation stage, gestational age, maternal alimentation and nutritional status. It is considered the best source for infant nutrition for at least six months of life, since it contains proteins, lipids, sugars, immune cells and bioactive molecules providing nutrition, exerting anti-inflammatory and anti-infective functions, promoting a correct formation of the immune system and sustaining organ development during the peculiar period of postnatal adaptation. The enormous potential of human milk (HM) and the whole list of its benefits does not result fully clarified up to now, although many studies and research focus on such topic. Recently, the innovative and non-invasive “omics” technologies resulted very promising to explore HM features and composition, improving our knowledge of such mediators’ influence on breastfed newborns and their outcome. In our review, available at the following link https://www.ncbi.nlm.nih.gov/pubmed/28783113, we discuss the recent literature found in MEDLINE using omics, transcriptomics, proteomics, metabolomics, microbiomics, pasteurization, growth factors, human milk, human colostrum and preterm newborns as key words. Our aim is to provide new evidence in terms of “omics” technologies in HM, also underlining the presence and the functions of several growth factors (GF) and the importance of HM pasteurization compared to more recently introduced techniques. The results of our review are schematically reported below. Transcriptomics, applied to mammary exfoliated cells, helps to demonstrate the activation of different patterns of genes according to the lactation stage; a significant variation also can occur during mastitic infection, in order to support milk production, the involution of the gland or an anti-inflammatory effect depending on the necessities. This results very interesting, taking into account that these RNA may directly influence intestinal mucosa of breastfeed neonate. Through a proteomic approach, we describe the characteristics and variability of HM proteins and peptides, especially comparing samples collected from preterm delivering mothers, mothers affected by gestational diabetes mellitus, mothers of macrosomic fetuses and even in case of intrauterine growth restriction (IUGR). Interestingly, HM from mothers of preterms results higher in total proteins, fat, carbohydrates and free amino acids content, showing a different proteome if compared with HM of full term neonates. Recent data also underline as the transmission of cytokines through HM could be involved in the protective effect against necrotizing enterocolitis or sepsis related to breastfeeding. Several metabolomics studies have been performed on HM, evaluating metabolite changes during different lactation stages. HM metabolome, results related to gestational age, lactation phase, IUGR and exposure to exogenous substances, since it can vary according to on the necessities of each neonate. In addition, many microbic-derived metabolites constitute a linking-ring connecting metabolomics to microbiomics. HM results a great source of commensal bacteria for newborns, representing a dynamic ecosystem changing during lactation; therefore, microbiomics is very promising to investigate these connections and interactions and the related effects. The presence of many GF has been demonstrated in HM, showing a crucial role during extrauterine adaptation and sustaining the development of many organs and tissues. It is very interesting to underline that their level is higher in the samples collected from mothers of extremely low birth weight newborns and that GF could present potential interactions with the stem cells detected in HM. Pasteurization represents the most effective technique for HM viral inactivation, such as cytomegalovirus. However, it impairs HM components and the best technique to make HM safe and adequate for the vulnerable category of premature newborns is still under evaluation. Up to now, this is the first review describing HM metabolome, microbiota, bioactive factors and their variations during lactation stages, also providing some correlations of such mediators with their possible in vivo effects and the impact on neonatal outcome.

Cristina Panisi – Istituto Sacra Famiglia, Varese
Ernesto Burgio - ECERI (European Cancer and Environment Research Institute – Bruxelles)

In recent decades the Western world has been the scene of a profound epidemiological transformation, characterized on the one hand by an evident decline in the incidence of acute diseases caused by exogenous causes (infectious and parasitic diseases), on the other by an equally rapid increase in chronic conditions, degenerative, inflammatory and neoplastic diseases, with a worrying anticipation of the age of onset (Landrigan et al 2005, Burgio 2011). The phenomenon concerns, in particular, endocrine-metabolic diseases (obesity "pandemic", Burgio et al. 2015a); neurodevelopmental disorders (Fombonne 2009) and neurodegenerative diseases (Brookmeyer et al 2007); immunomediated diseases (allergies, autoimmune diseases, celiac disease, Bach 2002); diseaes of the genital and reproductive sphere (Virtanen et al 2005); cancer - in particular children (Burgio 2013a). All these conditions show a parallel growth trend, a real "epidemiological transition", a transformation that is difficult to explain on the basis of traditional epidemiological and etiopathogenetic models. The epigenetic mechanisms provide a more plausible explanation of the phenomenon, compared to genetic models in the strict sense (Gluckman and Hanson 2004). These mechanisms are important topics addressed within pediatric scientific societies in recent years, (First Thousand Days of Life).

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