This meta-analysis aimed to assess the prevalence of respiratory viruses among children under the special conditions of the COVID-19 pandemic. Five databases were systematically searched to assess the pooled prevalence of various respiratory viruses in different age groups, regions, seasons, and in patients with and without confirmed SARS-CoV-2 coinfection. Moreover, we looked at the virus distribution in the first and second half of the pandemic and countries with distinct economic status. Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines were followed, and the systematic review was registered on PROSPERO (CRD42022379297). Enterovirus/rhinovirus and human respiratory syncytial virus (HRSV) were the most prevalent pathogens among children. The prevalence of HRSV increased in the second half of the pandemic. The prevailing viruses vary according to the SARS-CoV-2-coinfection status, season, region, and country´s economic status. This meta-analysis shows the epidemiology of respiratory viruses other than SARS-CoV-2 in children aged 0 to 12 years during the COVID-19 pandemic. Because major events, such as a pandemic, can alter epidemiology patterns, it is important to know them to improve health education measures, develop vaccines and medicines for vulnerable groups, as a guide for prevention strategies, and help with clinical decisions.

The importance of fluid resuscitation therapy during the early stages of sepsis management is a well-established principle. Current Surviving Sepsis Campaign (SSC) guidelines recommend the early administration of intravenous crystalloid fluids for sepsis-related hypotension or hyperlactatemia due to tissue hypoperfusion, within the first 3 h of resuscitation and suggest using balanced solutions (BSs) instead of normal saline (NS) for the management of patients with sepsis or septic shock. Studies comparing BS versus NS administration in septic patients have demonstrated that BSs are associated with better outcomes including decreased mortality. After initial resuscitation, fluid administration has to be judicious in order to avoid fluid overload, which has been associated with increased mortality, prolonged mechanical ventilation, and worsening of acute kidney injury. The “one size fits all” approach may be “convenient” but it should be avoided. Personalized fluid management, based on patient-specific hemodynamic indices, provides the foundations for better patient outcomes in the future. Although there is a consensus on the need for adequate fluid therapy in sepsis, the type, the amount of administered fluids, and the ideal fluid resuscitation strategy remain elusive. Well-designed large randomized controlled trials are certainly needed to compare fluid choices specifically in the septic patient, as there is currently limited evidence of low quality. This review aims to summarize the physiologic principles and current scientific evidence regarding fluid management in patients with sepsis, as well as to provide a comprehensive overview of the latest data on the optimal fluid administration strategy in sepsis.

Colonoscopy remains the cornerstone of colorectal cancer prevention and surveillance, but the procedure’s effectiveness is entirely dependent upon various quality indicators, such as detection rates, withdrawal time, adequate bowel preparation, cecal intubation rate and patient outcomes. Despite progress in endoscopic techniques, challenges persist in maintaining endoscopists’ consistent performance and improving quality metrics. Artificial intelligence (AI) has emerged as a “game changer” in the gastroenterology field, offering the opportunity to significantly increase colonoscopy quality. This review highlights the role of AI-driven technologies such as deep learning, computer vision, and real-time feedback mechanisms in optimizing key quality indicators of colonoscopy. The implementation of AI in colonoscopy may reduce human error, improve endoscopist’s consistency in real-time decision making, ensuring higher reliability and standardization during the procedure. Furthermore, AI has the potential to reshape how endoscopists perform and evaluate procedures, while improved lesion characterization may enable more precise selection for resection, reducing morbidity and the incidence of interval cancers. The review also addresses challenges and limitations in AI integration, including cost-effectiveness and its impact on endoscopist training. AI holds substantial promise for advancing colonoscopy quality and elevating overall patient care, paving the way for more effective and personalized medical approaches.

We aimed to determine the diagnostic yield and outcome of patients receiving antithrombotic drug therapy subjected to small bowel capsule endoscopy (SBCE) for the investigation of small bowel bleeding (SBB). A multicenter retrospective analysis of collected data from all patients undergoing SBCE for the investigation of SBB from March 2003 to June 2023 was performed. The diagnostic yield of SBCE was defined as the detection of positive findings that could explain the cause of the patient’s bleeding. Rebleeding was defined as evidence of bleeding within 1 year after the index episode. During the study period, 8401 patients underwent SBCE for SBB investigation. Bleeding lesions were detected in 1103/2535 (43.5%) antithrombotic users, compared to 1113/5866 (18.9%) in nonusers (p < 0.00001). Following capsule endoscopy, a therapeutic intervention was possible in 390/2216 (17.5%) patients with a bleeding lesion. Rebleeding occurred in 927 (36.5%) of antithrombotic users (36.5%), compared to 795 (13.5%) of nonusers (13.5%, p < 0.00001). Both the diagnostic yield of SBCE and the rebleeding rates were higher in patients with SBB receiving antithrombotics. Therapeutic intervention was possible in a real-world setting only for a minority of patients with positive findings.

Pneumonia remains a major global health concern, causing significant morbidity and mortality among adults. This narrative review assesses the optimal duration of antimicrobial treatment in adults with community-acquired pneumonia (CAP), hospital-acquired pneumonia (HAP), and ventilator-associated pneumonia (VAP). Current evidence about the impact of treatment duration on clinical outcomes demonstrates that shorter antibiotic courses are non-inferior, regarding safety and efficacy, compared to longer courses, particularly in patients with mild to moderate CAP, which is in line with the recommendations of international guidelines. Data are limited regarding the optimal antimicrobial duration in HAP patients, and it should be individually tailored to each patient, taking into account the causative pathogen and the clinical response. Shorter courses are found to be as effective as longer courses in the management of VAP, except for pneumonia caused by non-fermenting Gram-negative bacteria; however, duration should be balanced between the possibility of higher recurrence rates and the documented benefits with shorter courses. Additionally, the validation of reliable biomarkers or clinical predictors that identify patients who would benefit from shorter therapy is crucial. Insights from this review may lead to future research on personalized antimicrobial therapies in pneumonia, in order to improve patient outcomes.

Background/Objectives: Entero-enteric fistula (EEF) formation following multiple magnet ingestion is a rare but severe complication among pediatric patients. The widespread availability of neodymium magnets in toys has increased incidence of ingestion and subsequent gastrointestinal injuries. This systematic review aims to summarize the clinical features, diagnostics, management and outcomes of pediatric EEF cases related to magnet ingestion and report our institution’s experience with four such cases. Methods: A systematic review was conducted using PubMed/Medline (January 1995–February 2025), focusing on EEF after ingestion of ≥2 magnets in patients ≤18 years old. Studies reporting original EEF cases were included. Data extraction included demographics, clinical presentation, diagnostic imaging, intervention type, fistula number/location, hospital stay, complications and outcomes. Four institutional cases were also analyzed. Results: Sixty-nine studies encompassing 130 pediatric patients were included. Median age was 3.3 years; 58% were male. The most common symptoms were abdominal pain (43%) and vomiting (29%). Abdominal X-ray identified magnets in all cases. Surgical intervention was required in 95.5%, while 5.5% were treated endoscopically. Ileal and jejunal fistulas were most common. Postoperative complications occurred in 19%, including bowel obstruction, infection and one death. Our four cases, aged 2 months to 5 years, each required surgery, with one patient readmitted for obstruction managed conservatively. Conclusions: Despite the case heterogeneity of this review, EEF is a potentially life-threatening complication of multiple magnet ingestion in children. Prompt diagnosis with abdominal X-ray and timely surgical management are essential. Increased clinical suspicion and public awareness are crucial for prevention and early intervention.