Despite the advancements in medical knowledge and technology, the etiopathogenesis of bronchopulmonary dysplasia (BPD) is not yet fully understood although oxidative stress seems to play a role, leading to a very demanding management of these patients by the neonatologist. In this context, metabolomics can be useful in understanding, diagnosing, and treating this illness since it is one of the newest omics science that analyzes the metabolome of an individual through the investigation of biological fluids such as urine and blood. In this study, 18 patients admitted to the Neonatal Intensive Care Unit of the Cagliari University Hospital were enrolled. Among them, 11 patients represented the control group and 7 patients subsequently developed BPD. A sample of urine was collected from each patient at 7 days of life and analyzed through 1H-NMR coupled with multivariate statistical analysis. The discriminant metabolites between the 2 groups noted were alanine, betaine, trimethylamine-N-oxide, lactate, and glycine. Utilizing metabolomics, it was possible to detect the urinary metabolomics fingerprint of neonates in the first week of life who subsequently developed BPD. Future studies are needed to confirm these promising results suggesting a possible role of microbiota and oxidative stress, and to apply this technology in clinical practice.

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Nephrogenic syndrome of inappropriate antidiuresis (NSIAD), first described in 2005, is a rare genetic X-linked disease, presenting with hyponatremia, hyposmolarity, euvolemia, inappropriately concentrated urine, increased natriuresis, and undetectable or very low arginine-vasopressine (AVP) circulating levels. It can occur in neonates, infants, or later in life. NSIAD must be early recognized and treated to prevent severe hyponatremia, which can show a dangerous impact on neonatal outcome. In fact, it potentially leads to death or, in case of survival, neurologic sequelae. This review is an update of NSIAD 12 years after the first description, focusing on reported cases of neonatal and infantile onset. The different molecular patterns affecting the AVP receptor 2 (V2R) and determining its gain of function are reported in detail; moreover, we also provide a comparison between the different triggers involved in the development of hyponatremia, the evolution of the symptoms, and modality and efficacy of the different treatments available.

Group B Streptococcus (GBS) is considered the leading bacterial cause of neonatal infections and meningitis is the most serious manifestation. Its clinical manifestations are usually non-specific and its signs and symptoms may be subtle, unspecific, vague, atypical or absent. We report six clinical cases of GBS meningitis with early onset in three infants (first week of life) and late onset (after 1 month of life) in the remaining three. Prenatal GBS screening, performed on four infants, resulted positive only in one case. Cerebral ultrasonography showed high sensitivity in detecting early meningeal involvement confirmed by MRI in all infants. Our study describes the clinical characteristics, antibiotic sensitivity and outcome of the six cases. The results of our analysis emphasize the severity of GBS meningitis and show that cerebrovascular involvement is a common but poorly studied pathologic process in GBS meningitis. In addition, cranial ultrasonography plays an important role in detecting infarctions, cerebritis, hemorrhages or abscesses and in monitoring complications. Neonates with GBS meningitis are prone to adverse outcomes or sequelae. Mortality in GBS meningitis approaches 30% and neurologic sequelae are present in 25% of cases.