Rivista di formazione e aggiornamento di pediatri e medici operanti sul territorio e in ospedale. Fondata nel 1982, in collaborazione con l'Associazione Culturale Pediatri
Gli articoli più visti nel mese di Giugno 2026
163 kB3) Linee guida - Giugno 2026
Management della febbre nei primi 60 giorni di vita: fare meno, ma in sicurezza
- Cardace MG, Fiandri G, Baroni L, et al.
- Fever in neonates and infants younger than 60 days is one of the most frequent cause of admission to the Paediatric Emergency Room and a significant clinical challenge. Although the majority of infections in this age group are viral, a non-negligible risk of invasive bacterial infections (IBIs), including bacteremia and bacterial meningitis, persists. The clinical presentation is often nonspecific and physical examination alone has low sensitivity for identifying serious bacterial disease. This paper provides a summary of the most recent evidence on the management of febrile newborns and infants (<60 days), with particular reference to the guidelines of the American Academy of Pediatrics, and compares them with European and British approaches. AAP recommendations propose an age-stratified decision-making model (8-21, 22-28, and 29-60 days) integrating clinical assessment with inflammatory biomarkers, particularly procalcitonin, C-reactive protein and absolute neutrophil count. This strategy allows clinicians to tailor the indication for invasive testing, hospitalisation and empiric antibiotic therapy according to the neonate/infant’s risk profile, thereby reducing unnecessary interventions in low-risk infants without compromising patient safety. Available evidence shows that the combined use of inflammatory biomarkers, especially procalcitonin, has a high negative predictive value for IBIs and supports a more selective approach to lumbar puncture and hospitalisation. In conclusion, the management of febrile neonates and infants younger than 60 days should be based on a structured and cautious approach able to balance the need for early identification of serious bacterial infections with the goal of limiting unnecessary diagnostic and therapeutic interventions.
4) Editoriali - Giugno 2026
5) Farmacoriflessioni - Maggio 2026
Il salbutamolo nella gestione del wheezing in età pediatrica
- Marchetti F, Badina L, Pierantoni L.
- Wheezing is a frequent respiratory condition in early childhood that affects up to one third of children in the first three years of life and represents a common cause of primary care visits, Emergency Unit access and hospital admission. In Italy, the 2014 AIFA regulatory note introduced major restrictions on the use of inhaled salbutamol in children younger than 2 years, by limiting administration to pressurised metered-dose inhalers (MDI) with spacer and recommending lower doses than those suggested by the international guidelines, without differentiating between care settings or disease severity. This precautionary approach, based on limited and heterogeneous evidence, has generated an ongoing debate within the paediatric community. Evidence suggests that short-acting β2-agonists (SABA) may be effective in selected cases of acute bronchospasm in infants and young children, particularly in wheezing phenotypes suggestive of reversible airway obstruction. They are not indicated for isolated cough or viral upper respiratory infections, and are not recommended in bronchiolitis according to the international guidelines. Since 2024, shortages of salbutamol MDI in Italy and across Europe have further complicated this scenario and increased the risk of undertreatment. Recent evidence, including a meta-analysis of randomised controlled trials, supports the short-term safety of inhaled salbutamol in children under 2 years with acute wheezing, with no increase in serious adverse events and a more favourable safety profile with MDI compared with nebulisation. Overall, the current framework highlights a gap between regulatory constraints, clinical evidence, real-world practice and drug availability, and underscores the need for an evidence-based revision of existing recommendations.
6) La pagina gialla - Maggio 2026
a cura di Sara Lega8) Casi indimenticabili - Giugno 2026
Un’artralgia che co... vava qualcosa
- Stella A, Iacono A, Magno C, Fichera F, Schilleci A, Cassata N.
- The paper describes the case of a 4-year-old girl with Jacobsen syndrome and a history of highly selective eating, who presented with anaemia, arthralgia and a sudden refusal to bear weight following a minor knee injury. The condition, which proved to be a case of scurvy, highlights the clinical significance of severe nutritional deficiencies in paediatric patients with selective diets or developmental disorders.
8) Casi indimenticabili - Giugno 2026
Una tosse “ticcosa”
- Colonna F, Marsoni B.
- The paper describes the case of a 6-year-old girl with diurnal, drug-resistant tic (psychogenic) cough triggered by a traumatic hospitalisation. Once organic causes were ruled out, the issue was permanently resolved through psychotherapy combined with EMDR.
8) Casi indimenticabili - Giugno 2026
Dolore toracico e pericardite
- Fasiolo E.
- The paper describes the case of a 14-year-old boy who presented to the Emergency Room with positional chest pain and ECG changes. Based on his symptoms and rising CRP levels, he was discharged with a diagnosis of acute pericarditis and prescribed ibuprofen, colchicina and rest. At the follow-up visit two days later, the pain had reduced, but typical pericardial friction rubs were detected.