Background: This systematic review aimed to synthesize the existing evidence on the use of Streptococcus salivarius (S. salivarius) probiotics as prophylactic or therapeutic tools for pediatric oral, dental, and respiratory diseases. Methods: A comprehensive search was carried out across multiple databases using the following terms: S. salivarius, probiotic, children, pediatric. Results: The systematic literature search identified 613 publications, which were meticulously screened, and, ultimately, 15 suitable citations were included in this systematic review. Three strains of S. salivarius (M18, K-12, 24SMB) were used, and they all demonstrated positive benefits in pediatric pathology. Conclusions: Administration of S. salivarius has benefits, is effective, and is convenient (cost-effective) in pediatric prophylaxis. Oral administration as a chewable tablet or powder of S. salivarius M18 for 3 months is able to reduce the incidence of black stains, plaque, and tooth decay in children. S. salivarius K-12 treatment decreased the occurrence of pharyngeal, recurrent, and streptococcal disease, and the benefits also extend to a reduction of nonstreptococcal diseases, including tracheitis, viral pharyngitis, rhinitis, flu, laryngitis, acute otitis media, and enteritis. Administration of S. salivarius 24SMB as an intranasal spray was able to reduce the risk of acute otitis media in children prone to this condition.

Background/Objectives: Sleep disturbances are among the most prevalent and persistent comorbidities in children and adolescents with autism spectrum disorder (ASD), affecting up to 83% of this population. These disturbances not only impact the quality of life but are increasingly recognized as significant contributors to behavioral dysregulation. Methods: This systematic review synthesizes evidence from 26 studies published between 2010 and 2024, examining the association between sleep problems and behavioral outcomes in individuals with ASD aged 2 to 18 years. Results: The findings reveal consistent associations between sleep-onset insomnia, night walking, bedtime resistance, and various behavioral difficulties, including aggression, hyperactivity, and emotional dysregulation. Internalizing symptoms and exacerbation of core ASD features were also linked to chronic sleep problems. Studies employing objective sleep measures, such as actigraphy and polysomnography, further supported these associations by identifying disruptions in sleep architecture correlated with behavioral severity. While most included studies were of moderate to high methodological quality, the limited number of randomized controlled trials and heterogeneity of sleep and behavior assessment tools highlight the need for standardization. Conclusions: Overall, the review emphasizes the importance of routine sleep evaluation in ASD clinical care and supports targeted sleep interventions as a potential strategy to reduce behavioral problems and improve developmental outcomes.

The aim of this systematic literature review was to assess the data regarding neuromarkers used to evaluate the impact of cardiovascular surgery on neurodevelopmental pattern of children with congenital heart defects. A systematic search was performed on PubMed and Google Scholar databases. Out of 713 publications screened, 10 studies (471 patients) met the inclusion criteria. The included studies were coded on several variables: number and heterogeneity of patients (age, congenital heart defects), exclusion of patients with conditions that predispose to neurological impairment, neuroimaging workup pre- and post-surgery, neurodevelopmental assessment, interventions (part of a different study), and follow-up period. Results were reported according to PRISMA guidelines. Findings include: neuron-specific enolase and brain-derived neurotrophic factor are not reliable neuromarkers, for protein S100B different results were reported, for activin A there is lack of evidence, and glial fibrillary acidic protein could represent a reliable neuromarker for acute brain-injury. Directions for future research are discussed.

Background/Objectives: Researchers have proposed two novel impedance-pH parameters, mean nocturnal baseline impedance (MNBI) and the post-reflux swallow-induced peristaltic wave (PSPW) index, to enhance the diagnosis of gastroesophageal reflux disease (GERD) and enable better predictions of the effectiveness of anti-reflux therapies. This systematic review aims to synthesize the available evidence on the utility of the PSPW index and MNBI as diagnostic tools for pediatric GERD. Methods: A systematic search of studies reporting PSPW index and MNBI values in patients with GERD was performed in PubMed, Embase, Clarivate, Scopus, Cochrane and Google Scholar databases from their beginning until April 2024. The following terms were used: GERD, children, pediatric, PSPW and MNBI. Results: Eight studies were included, describing 479 patients ranging from 2 months to 17 years old over an 8-year period in 12 pediatric centers. Four studies demonstrated that children with pathological acid exposure have a significantly lower MNBI, with a good discriminatory ability to diagnose GERD. The PSPW index showed lower values in patients with reflux hypersensitivity (RH) compared to those with functional heartburn (FH). Conclusions: Patients with pathological acid exposure tend to exhibit lower MNBI and PSPW index values compared to those with normal acid exposure. MNBI and the PSPW index show promise as diagnostic tools in distinguishing between different GERD phenotypes. Further research is needed to establish standardized diagnostic criteria and optimize the clinical applicability in GERD diagnosis and management.

Background: Early detection of autism spectrum disorder (ASD) is essential, as the first two years of life represent a critical window of neuroplasticity during which timely interventions can improve developmental outcomes. Traditional diagnostic methods, such as ADOS and ADI-R, rely on caregiver reports and structured observations, limiting ecological validity and accessibility. Eye-tracking (ET) offers a non-invasive, scalable approach to assess early atypical gaze patterns. Objectives: This systematic review and meta-analysis synthesized evidence on the diagnostic accuracy of ET for early ASD detection and its potential as an adjunctive screening tool. Methods: A comprehensive search of PubMed, Scopus, Web of Science, Medline, and the Cochrane Library identified studies published between January 2015 and July 2025. Eligible studies evaluated ET in infants and toddlers (≤36 months) for early ASD identification, following PRISMA guidelines. Results: Out of 513 records, 57 studies were included. Most studies reported reduced fixation on social stimuli, atypical gaze following, and preference for geometric over social images in infants later diagnosed with ASD. Pooled effect sizes indicated a moderate-to-large difference between ASD and typically developing groups in social fixation time (Hedges’ g ≈ 0.65, 95% CI: 0.48–0.82, I² = 58%). Studies integrating machine learning algorithms (n = 14) achieved improved sensitivity (up to 89%) and specificity (up to 86%) compared with conventional gaze metrics. Conclusions: Overall, ET shows strong potential as an early adjunctive screening method for ASD. Nonetheless, methodological heterogeneity and lack of standardized protocols currently limit clinical translation, underscoring the need for multi-center validation and task standardization.

Introduction: The objectives of this study were to assess the role of neuromarkers like glial fibrillary acidic protein (GFAP), brain-derived neurotrophic factor (BDNF), protein S100 (pS100), and neuron-specific enolase (NSE) as diagnostic markers of acute brain injury and also as prognostic markers for short-term neurodevelopmental impairment. Methods: Pediatric patients with congenital heart defects (CHDs) undergoing elective cardiac surgery were included. Neurodevelopmental functioning was assessed preoperatively and 4–6 months postoperatively using the Denver Developmental Screening Test II. Blood samples were collected preoperatively and postoperatively. During surgery, regional cerebral tissue oxygen saturation was monitored using near-infrared spectroscopy (NIRS). Results: Forty-two patients were enrolled and dichotomized into cyanotic and non-cyanotic groups based on peripheric oxygen saturation. Nineteen patients (65.5%) had abnormal developmental scores in the non-cyanotic group and eleven (84.6%) in the cyanotic group. A good diagnostic model was observed between NIRS values and GFAP in the cyanotic CHD group (AUC = 0.7). A good predicting model was observed with GFAP and developmental scores in the cyanotic CHD group (AUC = 0.667). A correlation was found between NSE and developmental quotient scores (r = 0.09, p = 0.046). Conclusions: From all four neuromarkers studied, only GFAP was demonstrated to be a good diagnostic and prognostic factor in cyanotic CHD patients. NSE had only prognostic value.