Sepsis represents one of the leading causes of death in newborns and infants, and prompt diagnosis is essential for achieving favorable outcomes. Regarding malnourished children with concurrent infection, most studies have focused, besides blood culture, on C-reactive protein and procalcitonin. Because malnutrition has a deleterious effect on cellular immune competence, the present study characterized the acute-phase response, including hematological indices, in response to sepsis. Among the examined laboratory biomarkers, procalcitonin and neutrophil-to-lymphocyte ratio were the most accurate discriminators between sepsis patients and those with bacterial infection. Moreover, these two parameters showed a gradual increase between sepsis, severe sepsis, and septic shock patients (p < 0.001). Subgroup analysis of the sepsis group revealed positive correlations of NLR with prolonged ICU stay (<0.001), acute organ dysfunction (0.038), mechanical ventilation (<0.001), and fatality (<0.001). In summary, our results suggest that the neutrophil-to-lymphocyte ratio can be used as an auxiliary diagnostic index in discriminating the presence and severity of bacterial sepsis in malnourished infants.

(1) Background: In cystic fibrosis (CF), the oral glucose tolerance test (OGTT) is recommended from 10 years old annually to screen and diagnose cystic fibrosis-related diabetes (CFRD). Alternative OGTT characteristics (glucose curve shape, time to glucose peak, one-hour glucose value, and three-hour glucose value with the new shape curve) were studied in other populations considered at high risk for diabetes; (2) Methods: The study analyses classical and alternative OGGT characteristics from 44 children (22 CF, 22 obese without CF), mean age: 12.9 ± 2.2 years evaluated in a single-center from Romania. (3) Results: In 59.1% of children with CF, the predominant OGTT pattern was: abnormal glucose metabolism or CFRD, with a monophasic curve shape, a late peak glucose level, and 1 h glucose ≥ 155 mg/dL, showing a very different pattern compared with sex and age-matched obese children. Statistical estimation agreement between the late glucose peak (K = 0.60; p = 0.005), the 1 h glucose ≥ 155 mg/dL during OGTT (K = 0.69, p = 0.001), and the classical method of interpretation was found. (4) Conclusions: Late peak glucose and 1 h glucose level ≥ 155 mg/dL during OGTT can be used for diagnosing the early glucose metabolism alteration in children with CF.

Background: Primary lactose intolerance (PLI) is characterized by the inability to digest lactose. Homozygotes for the lactase gene polymorphisms (CC or GG) are considered to be genetically predisposed to PLI. Still, symptoms may only be present later in life. The evidence supporting a link between PLI, dairy intake, and quality of life (QoL) is limited in children. Aim: This study investigates the link between LCT polymorphisms and suggestive symptoms and the influence of the genetic predisposition to PLI on dairy intake and QoL in Romanian children. Materials and methods: We recruited consecutive children evaluated in our ambulatory clinic. We asked all participants to complete a visual-analog symptoms scale, a dairy intake, and a QoL questionnaire. We used strip genotyping to identify genetic predisposition to PLI. Results: 51.7% of children had a CC genotype, and 34.5% also had a GG genotype. Most children reported no or mild symptoms. Dairy intake and QoL were similar across study groups. Conclusions: Our study shows that genetic predisposition does not necessarily assume the presence of specific symptoms. Genetic predisposition to PLI did not lead to dairy avoidance, nor did it negatively influence our children’s QoL.

Background: The risk factors for developing a severe form of COVID-19 in young children are poorly understood. Methods: A single-center retrospective study was conducted to quantify and analyze the clinical risk profile of children admitted to the Pediatric Clinic for Nutritional Recovery. Results: Overall, 51.5% (n = 17) of children were infected with SARS-CoV-2, all symptomatic, and five of them (29.4%) developed a severe form. A positive clinical pulmonary exam was only associated with the severe outcome (OR: 2.00; 95% CI, 0.33–5.66; p = 0.02). Other factors such as age under 3 months, prematurity, birth weight, malnutrition or positive history of congenital cardiac, neurodevelopmental, or genetic diseases, fever, temperature, cough, and digestive symptoms were not found to be significant risk factors. Conclusions: Clinical guidelines based on risk stratification for SARS-CoV-2 infection in children are needed in order to manage, monitor and establish priority access for some groups to high medical care.

Cystic fibrosis related diabetes (CFRD) is a redoubtable complication associated to cystic fibrosis, with an increasing frequency, directly proportional to children life expectancy. Although this complication has similar features with DM type 1 and some with type 2, the evolution and even the response to insulin therapy is different. It is also possible that other factors to influence the CFRD clinical expression and subsequently the disease evolution. Since its 1t diagnosis was associated with more frequent pulmonary exacerbations and with the deterioration of the respiratory status, therefore CFRD must be early and correctly diagnosed and managed. The aim of this paper is to present an overview of the recent updates and recommendations regarding this important CF complication.