Glycopyrrolate is a competitive muscarinic receptor antagonist used in the treatment of sialorrhea, especially in pediatrics. Degradation research was conducted to better understand the stability of the active pharmaceutical ingredient (API). Using an HPLC-UV method, we evaluated the chemical stability of the oral solution of the galenic compound glycopyrrolate 0.5 mg/mL under different storage conditions. Method validation was performed according to the International Council for Harmonization (ICH) Q2(R2) guidelines. The results of the stability study of the galenic compound in different storage conditions, with the exception of those stored in glass containers at 45 °C for more than 3 months, were stable (100 ± 10% of the nominal concentration). The aim of this work was to study the stability of the galenic compound glycopyrrolate in two different types of containers and at three different storage temperatures. Glycopyrrolate showed degradation beyond the limits only in glass at 45 °C and after 2 months of storage. The results indicate that oral liquid dosage forms of glycopyrrolate are stable for at least 210 days when stored at room temperature or at 4 °C, in glass or PET, for at least 7 months, maintaining product quality according to the standards established by the European Pharmacopoeia, ensuring long-term coverage for pediatric patient therapies.

Recurrent acute otitis media (RAOM) in children is clinically defined as the occurrence of at least three episodes of acute otitis media over a course of 6 months. A further common pathological condition of interest in the context of pediatric otolaryngology is adenotonsillar hypertrophy (ATH), a common cause of obstructive sleep apnea syndrome. Aimed at unraveling the differential modulation of proteins in the two pathologies and at understanding the possible pathways involved in their onset, we analyzed the proteomic profile of the adenoids from 14 RAOM and ATH patients by using two-dimensional gel electrophoresis (2-DE) and mass spectrometry (MS). The 2-DE coupled with MS allowed us to identify 23 spots with significant (p-value < 0.05) changes in protein amount, recognizing proteins involved in neutrophil degranulation and glycolysis pathways.

Tonsils are secondary lymphoid organs that play a crucial role in the immunological response, with B cells being a major component involved in both innate and adaptive immunity. Periodic fever, aphthous stomatitis, pharyngitis, and adenitis (PFAPA) syndrome and obstructive sleep apnea syndrome (OSAS) are both common pediatric conditions involving tonsillar pathology. In both syndromes, the molecular pathways dysregulated in tonsillar B cells are still to be understood. The study aimed to unravel and compare the proteomic profiles of tonsillar CD19+ B cells isolated from pediatric patients with PFAPA (n = 6) and OSAS (n = 6) to identify disease-specific molecular signatures. B cells were isolated from the tonsillar tissue using magnetic microbeads (with a purity of 93.50%). Proteomic analysis was performed by nanoLC-MS/MS with both data-dependent (DDA) and data-independent acquisition (DIA) methods, followed by comprehensive bioinformatic analysis. By merging DDA and DIA datasets, a total of 18.078 unique proteins were identified. Differential expression analysis revealed 83 proteins increased and 49 proteins decreased in OSAS B cells compared to PFAPA B cells (fold change ≥ 1.5 or ≤0.6, p < 0.05). Distinct pathway enrichments were highlighted, including alterations in the regulation of PTEN gene transcription, circadian gene expression, inflammasome pathways (IPAF and AIM2), and the metabolism of angiotensinogen to angiotensin. Specific proteins such as p53, Hdac3, RPTOR, MED1, Caspase-1, Cathepsin D, Chymase, and TLR2 (validated by WB) were shown to be differentially expressed. These findings reveal distinct proteomic signatures in tonsillar B cells from patients with PFAPA and OSAS, offering novel insights into the pathophysiology and potential avenues for biomarker discovery.

The cough is one of the most common medical complaints affecting the general population. It is well known that persisting cough negatively affects subjects’ quality of life (QoL) and sleep quality. The aim of the current double blind, randomized, placebo-controlled, pilot study was to assess the effectiveness of a novel medical device in gummy format in reducing cough and improving QoL in adult subjects with acute persisting cough. Forty subjects were enrolled and randomized into two arms according to the treatment. Both the investigational product (IP) and placebo were administered orally, three times per day for 10 consecutive days. Cough symptoms and severity were measured by the Cough Clinical Score (CCS) consisting of a 6-point Likert scale, Leicester Cough Questionnaire (LCQ) and cough severity visual analogue scale (VAS). QoL was rated using the SF-36 (short form) questionnaire. Significant improvements were seen both in the daytime and nighttime cough score after 5 days and at the end of treatment in the IP group but not in those subjects taking the placebo. QoL and sleep disturbances were ameliorated significantly in the IP group only. In conclusion, IP was found safe, well-tolerated and effective in the management of persisting cough in adults.

Dysphagia, defined as the difficulty in swallowing a food or non-food bolus from the oral cavity to the stomach, is a significant disorder affecting neonates and children, with an incidence of 25-45% in normally developing children and up to 80% in those with developmental delays. This variability is due to the proper integration of physical and neurophysiological functions for a safe and effective oral feeding. The disorder may have serious repercussions on a child’s nutrition, growth and development, and it may lead to respiratory complications. Dysphagia can be classified as either oropharyngeal or esophageal. The article examines an illustrative clinical case of a premature neonate with severe dysphagia and neurological impairments and outlines the various stages of management and the speech therapy rehabilitation programme aimed to improve oral and swallowing functions. The treatment resulted in a progressive improvement that allowed the safe administration of semisolid foods for hedonic purposes that was supported by a gastrostomy for primary nutrition. Finally, the article discusses the importance of a tailored therapeutic approach for managing dysphagia in children, which includes speech therapy, dietary, medical and, if necessary, surgical interventions to enhance quality of life and reduce associated risks.

Obstructive Sleep Apnea Syndrome (OSAS) is associated with systemic inflammation and immune dysfunction, yet the specific metabolic alterations within immune cells remain poorly understood. In this exploratory study, we characterized the metabolome of peripheral mononuclear cells (PMNCs) from patients with OSAS and healthy controls to investigate potential immunometabolic signatures associated with the disease. Initial analyses identified 21 nominally differentially abundant metabolites between OSAS patients and controls, suggesting trends such as the depletion of carnitines and alterations in fatty acid and neurotransmitter metabolism. However, following correction for multiple testing (False Discovery Rate, FDR), only putatively annotated cis,cis-muconic acid remained statistically significant. Furthermore, pathway enrichment analysis highlighted exploratory trends primarily associated with SLC-mediated transmembrane transport and energy metabolism. Our findings indicate that while OSAS PMNCs exhibit metabolic shifts suggestive of cellular stress, most of these alterations represent nominal trends that require validation in larger cohorts. The robust identification of putatively annotated cis,cis-muconic acid highlights a potential target of interest. In this exploratory pilot study, given the absence of polysomnographic and objective hypoxia parameters in most participants, observed metabolic alterations are described as associated with, rather than directly caused by, intermittent hypoxia. Overall, this study provides a hypothesis-generating framework for future research on the immunometabolic consequences of OSAS.