Search Results (2,502)

Background and Objectives: Patients with type 2 diabetes mellitus (T2DM) are at a heightened risk of adverse outcomes from Coronavirus Disease 2019 (COVID-19). However, the influence of glycemic control on systemic inflammation and clinical severity remains incompletely understood. This study aimed to compare inflammatory markers, composite severity scores, and clinical outcomes between T2DM patients with COVID-19 who had well-controlled diabetes (hemoglobin A1c < 7%) versus those with poorly controlled diabetes (hemoglobin A1c ≥ 7%). Methods: We retrospectively reviewed 181 adult patients with T2DM and severe COVID-19 admitted to a tertiary hospital between January 2022 and December 2023. Patients were divided into two groups: well-controlled (n = 117) and poorly controlled (n = 64) T2DM. Baseline demographics, comorbidities, and laboratory parameters (C-reactive protein, interleukin-6, ferritin, neutrophil and lymphocyte counts, platelets, and calculated indices such as the neutrophil-to-lymphocyte ratio [NLR] and systemic immune-inflammation index [SII]) were collected. Composite severity scores (APACHE II, CURB-65, and NEWS) and clinical outcomes (ICU admission, mechanical ventilation, mortality, and length of stay) were compared. Statistical tests used included Student’s t-test or the Mann–Whitney U for continuous variables and chi-square for categorical variables, with p < 0.05 deemed significant. Results: The two groups did not differ significantly in age or duration of diabetes (p = 0.40 and p = 0.75, respectively). Patients with poorly controlled T2DM exhibited higher inflammatory markers (mean CRP of 93.4 mg/L vs. 78.6 mg/L, p = 0.002; IL-6 of 64.2 pg/mL vs. 52.8 pg/mL, p = 0.004) and elevated severity scores (APACHE II of 16.8 vs. 14.1, p = 0.001). Poor glycemic control was associated with higher ICU admissions (39.1% vs. 22.2%, p = 0.02) and mortality (14.1% vs. 6.0%, p = 0.05). Conclusions: In T2DM patients hospitalized with COVID-19, poor glycemic control correlates with heightened inflammatory responses, worse composite severity scores, and increased rates of unfavorable outcomes. These findings underscore the necessity of stringent glucose management to mitigate inflammation and improve prognoses in this vulnerable patient population. Full article

Carbapenemase-producing Klebsiella pneumoniae is responsible for multiple serious infections with high mortality rates. K. pneumoniae carbapenemases (KPCs) are the most commonly isolated carbapenemases worldwide. To study the epidemiological and molecular characteristics of KPC-producing K. pneumoniae (KPC-KP), we conducted a retrospective study at the University General Hospital of Ioannina, Greece. A total of 177 K. pneumoniae clinical strains from the period 2014–2015 were confirmed as KPC producers by polymerase chain reaction (PCR) and were further examined for the presence of bla_VIM, bla_NDM, bla_TEM, bla_SHV, and bla_CTX-M genes. Using the amplification refractory mutation system (ARMS) method, we identified the presence of the KPC-2 allele in 130 strains and the KPC-9 allele in 47. Strains from both allele groups belonged to the sequence type 258 (ST258). KPC-9 was responsible for a distinct outbreak, considered part of the broader KPC-2 outbreak. Molecular characterization of selected KPC-KP isolates from the period 2021–2022 revealed their continued presence in our hospital. Comparison of the antimicrobial susceptibility profiles of the two alleles showed a statistically significant increase in minimum inhibitory concentration (MIC) for ceftazidime (p = 0.03) and higher resistance to amikacin (p = 0.012) and colistin (p < 0.001) for KPC-9 compared to the KPC-2 allele. The two KPC alleles had similar mortality rates. This study demonstrates the heterogeneity of resistance genes in carbapenem-resistant K. pneumoniae (CR-KP) within a single-hospital setting and underscores the need for immediate containment measures. Full article

Background: With the COVID-19 pandemic, a rapid adoption of telemedicine became necessary. Data regarding its implementation in specialized hepatology/IBD care remain limited. This study evaluated telemedicine’s effectiveness and safety during the pandemic at a German tertiary center and explored its integration into future hybrid care models. Methods: In a retrospective study, we analyzed 3147 patient encounters at the outpatient clinic of the Department for Gastroenterology and Hepatology at the University Hospital Frankfurt between March and June 2020. We assessed patient characteristics, appointment adherence, and outcomes across the three specialized clinics: hepatology (n = 1963), liver transplant (n = 594), and IBD (n = 590). Multivariate regression analysis identified predictors of successful telemedicine utilization. Results: Out of all appointments, 1112 (35.3%) were conducted via telemedicine, with significantly different adoption rates across clinics (hepatology, 40.4%; liver transplant, 32.8%; IBD, 21.0%, p < 0.01). Adherence rates were comparable between telemedicine (91.3%) and in-person visits (90.5%). Multivariate analysis identified age (OR 1.009, 95%CI 1.004–1.014, p < 0.001), metabolic-associated steatotic liver disease (OR 1.737, 95%CI 1.400–2.155, p < 0.001), and post-liver transplant status (OR 1.281, 95%CI 1.001–1.641, p = 0.049) as independent predictors of successful telemedicine utilization. HBV/HDV coinfection (OR 0.370, 95%CI 0.192–0.711, p = 0.003) and required endoscopy (OR 0.464, 95%CI 0.342–0.630, p < 0.001) were associated with in-person care. Hospitalization rates were low and comparable across modalities, confirming telemedicine’s safety. Conclusions: This study demonstrates that telemedicine can be successfully implemented in specialized gastroenterology and hepatology care, with high compliance rates comparable to in-person visits. Patient characteristics and disease-specific factors influence the suitability for telemedicine, supporting a stratified approach to hybrid care models, which can optimize resource utilization while maintaining quality of care. Particularly stable MASLD patients, well-controlled post-transplant recipients beyond one year, and IBD patients in sustained remission can be properly managed through telemedicine with annual in-person assessments. Full article

Human parvovirus B19 (B19V) follows a well-documented cyclical epidemiology, with peaks occurring every 3–4 years. However, recent reports indicate an unusual resurgence in B19V infections across multiple countries, prompting increased surveillance. This study analyzed molecular diagnostic assay results from 826 unique-patient samples tested for B19V DNA between 2019 and 2024 at a large Italian tertiary-care hospital, covering pre-, during, and post-COVID-19 years. Overall, 80 of 826 patients (9.7%) tested positive for B19V DNA. A significant increase in positivity was observed in 2024 (23.4%), with a peak in May, representing an eightfold rise compared to 2019–2020. Despite this surge, the distribution of positive cases across population categories remained consistent with previous years, with 32 of 80 (40.0%) positive samples from pregnant women and 27 of 80 (33.8%) from hematology/oncology patients. Among 66 B19V DNA-positive patients with available serology, 4 of 66 (6.1%)—all immunocompromised—lacked detectable IgM/IgG despite high B19V DNA levels (7.8 log₁₀ IU/mL). These findings highlight the importance of integrating molecular and serological diagnostics, particularly in high-risk populations. Given the potential impact of the COVID-19 pandemic on B19V circulation, continued surveillance is essential to determine whether this resurgence represents a temporary fluctuation or a sustained epidemiological shift. Full article

(1) Background: Prehabilitation programs improve patients’ functional capacity before surgery by enhancing physical activity, nutrition, and psychological well-being, thereby reducing postoperative complications, hospital stays, and readmissions. We propose a centralized model led by an advanced practice nurse and internist to minimize consultations and reduce costs. (2) Methods: We studied 211 patients in a tertiary hospital in Madrid, with 135 enrolled in the centralized prehabilitation program and 76 in standard care (control). We compared complications, hospital stays, blood transfusions, and consultations, estimating costs using public pricing from Madrid’s healthcare authorities. (3) Results: The centralized model significantly reduced blood transfusions (p = 0.014), postoperative complications (p < 0.001), and hospital stays (p = 0.004), leading to annual savings of EUR 593,453.00. (4) Conclusions: A centralized surgical prehabilitation model decreases complications, hospital stays, readmissions, and consultations compared to standard care, significantly reducing healthcare costs. Full article

Background: Cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC) increases survival in peritoneal carcinomatosis, but complications may affect the long-term prognosis. We aimed to evaluate the postoperative evolution after CS + HIPEC, the appearance of adverse outcomes, and the associated risk factors. Methods: This was a retrospective observational study evaluating clinical practice in patients undergoing CS + HIPEC from 2016 to 2023 in a tertiary-level university hospital. The pre-, intra-, and postoperative variables were collected. The postoperative evolution, the appearance of postoperative complications, and the mortality were analyzed according to the perioperative data. Results: In total, 62.3% of the patients developed some kind of complication. Renal failure was related to the length of surgery [mean difference (md) 111 min, 95% CI 11–210, p = 0.029], postoperative vasoactive support [Odds Ratio (OR) 3.4, 95% CI 1.1–10.6, p = 0.033], and non-invasive mechanical ventilation (OR 5.5, 95% CI 1.5–20.5, p = 0.007). Respiratory failure was associated with renal replacement therapies (OR 13.8, 95% CI 1.3–143.9, p = 0.006), postoperative creatinine (md 0.27 mg·dL⁻¹, 95% CI 0.1–0.4, p = 0.001), and C-reactive protein (md 33.5 mcg·L⁻¹, 95% CI 0.1–66.8, p = 0.049). Infectious complications were related to the length of surgery (md 84 min, 95% CI 12–156, p = 0.024), non-invasive mechanical ventilation (OR 4.4, 95% CI 1.2–16.1, p = 0.018), and renal replacement therapies (OR 11.6, 95% CI 1.1–119.6, p = 0.012). The hospital stay was longer in patients with complications (md 14.8 ± 5.5 days, 95% CI 3.8–25.8, p = 0.009). The mortality rate at 12 months was 15.6%. The mortality risk factors were the preoperative hemoglobin (md −1.7 g·dL⁻¹, 95% CI −2.8–−0.7, p = 0.001) and creatinine (md −0.12 mg·dL⁻¹, 95% CI −0.21–−0.04, p = 0.007) and the postoperative hemoglobin (md −1.15 g·dL⁻¹, 95% CI 0.01–2.30, p = 0.049) and C-reactive protein (md 54.6 mcg·L⁻¹, 95% CI 18.5–90.8, p = 0.004). Intraoperative epidural analgesia was found to be a protective factor for 12-month mortality (OR 0.25, 95% CI 0.07–0.90 p = 0.027). A multivariate analysis performed after a univariate analysis showed that the only risk factor for overall mortality was not using intraoperative epidural analgesia. Conclusions: CS + HIPEC led to a high incidence of postoperative complications, but the occurrence of complications did not seem to affect postoperative survival. Full article

Background and Objectives: Secondary pulmonary fungal infections in coronavirus disease 2019 (COVID-19) remain underexplored despite emerging reports linking them to heightened morbidity. Comorbidities, steroid use, and prolonged hospital stays can predispose patients to opportunistic fungi. This study aimed to evaluate the impact of fungal coinfection on inflammatory markers, disease severity, antifungal resistance profiles, and outcomes in hospitalized COVID-19 patients. Methods: This retrospective observational study enrolled 280 adults (≥18 years) with real-time polymerase chain reaction (RT-PCR)-confirmed COVID-19 admitted to a tertiary care center (January 2023–December 2024). Patients were divided into a COVID-19-only group (n = 216) and a COVID–fungal group (n = 64) based on bronchoalveolar lavage, sputum, and/or blood culture positivity for fungal pathogens. Inflammatory markers (C-reactive protein (CRP), procalcitonin, the neutrophil-to-lymphocyte ratio, and the systemic immune inflammation index) and severity scores (Acute Physiology and Chronic Health Evaluation II, CURB-65 score, and the National Early Warning Score) were measured. We assessed antifungal susceptibilities and recorded ICU admissions, ventilation, hospital length of stay, and mortality. Results: Aspergillus fumigatus (31.3%), Candida albicans (28.1%), Cryptococcus neoformans (7.8%), Pneumocystis jirovecii (6.3%), and Mucorales (6.3%) dominated; Candida glabrata, Candida tropicalis, and mixed infections were also noted. Multidrug-resistant (MDR) isolates or resistance to triazoles occurred in 25.0% of cultures. The COVID-19–fungal group showed significantly higher CRP (85.7 vs. 71.6 mg/L, p < 0.001), procalcitonin (2.4 vs. 1.3 ng/mL, p < 0.001), and APACHE II scores (18.6 vs. 14.8, p < 0.001). intensive-care unit admissions (39.1% vs. 19.9%, p = 0.004) and mechanical ventilation (26.6% vs. 10.2%, p = 0.01) were more frequent with fungal coinfection. Mortality trended at a higher rate (15.6% vs. 7.4%, p = 0.06). Conclusions: Pulmonary fungal coinfections intensify the inflammatory milieu, elevate severity scores, and lead to more frequent ICU-level interventions in COVID-19 patients. Early identification, guided by culture-based and molecular diagnostics, alongside prompt antifungal therapy, could mitigate adverse outcomes. These findings underscore the critical need for proactive fungal surveillance and rigorous stewardship in managing severe COVID-19 pneumonia. Full article

Objective: To characterize facial fracture patterns and understand predictors of surgical repair and LOS with the objective of assisting providers in managing and understanding these complex injuries. Study Design: This is a retrospective cohort chart review study. Methods: A retrospective review was conducted for patients admitted with gunshot wounds (GSWs) to the head, neck, or face between January 2013 and March 2020 at a level one trauma tertiary care hospital. Univariate and multivariate analysis were performed to identify associations with surgical repair and LOS. Results: Of the 578 patients with head, neck, or facial GSWs, 204 survived and sustained facial fractures. The maxilla (n = 127, 62%), orbit (n = 114, 55%), and mandible (n = 104, 51%) were the most fractured. Operative rates differed by location (p < 0.001) with highest rates for fractures involving the mandible (76%). In univariate analysis, overall facial fracture surgery was associated with transfacial injuries; mandible, palate and nasal fractures; tracheostomy; gastrostomy tube placement; ICU admission; and a longer-than-24 h ICU stay (all p < 0.05). In multivariate analysis, predictors of surgical repair included a length of stay greater than 3 days (OR 2.9), transfascial injury (OR 3.7) and tracheostomy placement (OR 5.1; all p-values < 0.05), while nasal and mandible fractures were also associated with overall operative repair (OR 2.5 and 9.3, respectively; p-value < 0.05 for both). Univariate analysis showed that among patients with GSW injuries who underwent facial plastic reconstructive surgery (FPRS) with comorbid serious polytrauma, the inpatient LOS was predicted solely by the presence of subarachnoid, subdural and intracranial hemorrhage (p-value < 0.005). Subsequent multivariate analysis found that the only predictor for greater hospital LOS for patients who underwent surgical repair was earlier timing to FPRS of less than five days (OR 0.17) and placement of a gastrostomy tube (OR 7.85). Conclusions: Managing facial fractures in GSW patients requires complex medical decision making with a consideration of functional and esthetic outcomes in the context of concomitant injuries and overall prognosis. Certain characteristics such as ICU admission, longer hospital stay, trajectory of GSW, tracheostomy placement, and specific operative locations are associated with higher rates of operative repair. Inpatient hospitalization LOS for patients who underwent FPRS was predicted by timing from admission to surgical repair. Full article

Carbapenem-resistant Pseudomonas aeruginosa (CRPA) is a significant opportunistic human pathogen, posing a considerable threat to public health due to its antimicrobial resistance and limited treatment options. The incidence of CRPA is high in the Philippines; however, genomic analysis of CRPA in this setting is limited. Here, we provide the phenotypic and molecular characterization of 35 non-duplicate CRPA obtained from three tertiary hospitals in Metro Manila, Philippines, from August 2022 to January 2023. Six sequence types (STs), including international high-risk clones ST111 and ST357, were identified. This article highlights the first report in the Philippines on the identification of P. aeruginosa harboring Klebsiella pneumoniae Carbapenemase-2 (KPC-2), coproduced with Verona Integron-encoded Metallo-beta-lactamase-2 (VIM-2) and Oxacillinase-74 (OXA-74). Notably, this is also the first report of KPC in the Philippines identified in P. aeruginosa. New Delhi Metallo-beta-lactamase-7 (NDM-7), coproduced with Cefotaxime-Munich-15 (CTX-M-15) and Temoneira-2 (TEM-2), was also identified from a novel ST4b1c. The relentless identification of NDM in the Philippines’ healthcare setting poses a significant global public health risk. The initial detection of the P. aeruginosa strain harboring KPC exacerbated the situation, indicating the inception of potential dissemination of these resistance determinants within P. aeruginosa in the Philippines. Full article

Background/Objectives: The COVID-19 pandemic overwhelmed many health care facilities with patients, leading to an increased risk of potential transmission. Though the disease process was identical, the triaging system was unique at different sites, without a unified system for emergency department triaging globally. Proper implementation of pre-screening and triaging is of paramount importance in tertiary care settings to prevent nosocomial spread of infection. Methods: Each country has its own triage guidelines and Infection, Prevention, and Control policies developed by its health ministry and may face significant challenges in implementing them. Triage guidelines followed by two tertiary care hospitals in Detroit, United States of America and Manipal, India are compared during the early phases of the COVID-19 pandemic. Results: This paper offers a unique perspective of the challenges experienced with the hospital triage practices and provides solutions to address them. The future trajectory of COVID-19 epidemiology in both countries will be determined by the adherence to best practices in Infection Prevention and Control and triage protocols. The healthcare facility triage algorithm is constantly evolving in both settings as new evidence is being added to hospital epidemiology and infection prevention practices. Conclusions: Training healthcare workers on new triage protocols is required. It is critical for infectious disease doctors, clinical microbiologists, hospital epidemiologists, and Infection Prevention and Control (IPC) staff to collaborate with clinicians, nurses, and other ancillary staff in order to successfully implement the triage protocols. Developing and modifying guidelines for cleaning hospital triage areas and providing high throughput for patient care are also important lessons learned. Usage of face shields and the quality of Personal Protective Equipment (PPE) should be ensured for all healthcare workers (HCWs). Resilient staff and resilient hospital infrastructure are crucial for a sustainable response to future pandemics. Full article

This study investigates neonatal outcomes in singleton and multiple pregnancies following in vitro fertilization (IVF) using donor (IVF-D) versus autologous (IVF-A) material. A retrospective cohort analysis was conducted with 988 neonates born between 2017 and 2024 across three tertiary neonatal units in Romania. The primary outcomes included preterm birth, low birthweight, neonatal asphyxia, and congenital malformations. IVF-D pregnancies were associated with a higher prevalence of adverse neonatal outcomes, particularly in multiple gestations. Preterm birth and low birthweight were more frequent in the IVF-D group, with donor-conceived neonates exhibiting increased rates of neonatal ventilation and prolonged hospitalization. Additionally, congenital anomalies, particularly cardiac malformations, were more prevalent in IVF-D pregnancies, suggesting possible immunological and epigenetic influences. Despite these differences, overall neonatal survival was comparable between groups. These findings contribute to the existing literature on assisted reproductive technologies, emphasizing the need for further research to clarify the biological mechanisms influencing neonatal outcomes and to optimize the clinical management of IVF pregnancies using donor gametes. Full article

Background/Objectives: Bisphosphonates are effective in preventing osteoporotic fractures. However, the risk of atypical femur fractures (AFFs) increases with long-term bisphosphonate use. There are few existing publications on the analysis of clinical outcomes of atypical femur fracture cases in Chinese patients. Our objective was to review the clinical outcomes of AFF cases managed in a tertiary center in Hong Kong, China. Methods: Cases of AFF managed in the Prince of Wales Hospital from 2010 to 2024 were included. Data on demographics, type and duration of bisphosphonate use prior to AFF, fixation method, and mobility 1 year post-operation were retrospectively retrieved. One-way ANOVA was used to compare the duration of use prior to the development of AFF between different types of bisphosphonates. Results: Sixty-nine cases of AFF were included, with a mean age of 73.8 ± 9.7 years. A total of 95.6% of patients had a history of bisphosphonate use, with a mean duration of usage of 6.8 ± 5.6 years prior to the occurrence of AFF. The duration of bisphosphonate use prior to the development of AFF was comparable between alendronate, ibandronate, and a history of using more than one type of anti-resorptive agent. A non-union rate of 5.8% was observed in the current cohort, with 48.2% returning to pre-morbid mobility 1 year post-operation. Conclusions: AFF is more commonly seen in female patients with a history of bisphosphonate use. Considering the high success rate demonstrated in the current cohort, treating AFF with closed reduction followed by fixation with a long cephalomedullary device in dynamic locking together with immediate full-weight-bearing rehabilitation post-operation may be effective. Full article

(1) Background: Exploring real-world data (RWD) regarding immune-related adverse events (irAEs) is crucial to better understand the efficacy and safety of immunotherapy in cancer patient populations excluded from clinical trials. An analysis was conducted to evaluate the presumptive predictive causality between endocrine irAEs and the efficacy of immune check-point inhibitors (ICIs) in metastatic non-small-cell lung cancer (mNSCLC) patients treated in daily practice in Romania. (2) Methods: This was a retrospective cohort study of mNSCLC patients treated with ICIs in a tertiary level hospital in Romania for a period of almost seven years, from November 2017 till July 2024. Endocrine irAEs were well defined as any occurring autoimmune endocrinopathy during ICIs and related to immunotherapy. The hospital endocrinologist (M.C.C.O) diagnosed, treated, and followed these endocrine irAEs in a multidisciplinary approach. We investigated multiple medical variables to assess their impact on ICI effectiveness. Descriptive and statistical analyses were performed. (3) Results: Of 487 cancer patients treated with ICIs, we identified 215 mNSCLC patients who were evaluated for endocrine irAEs and co-medications during ICI therapy. Forty-seven (21.8%) patients experienced endocrine irAEs, thyroiditis being the most frequent and prevalent autoimmune endocrinopathy in 60% of cases. Endocrine irAEs were statistically significant, correlated with ICI efficacy (p = 0.002) for survival analysis. Steroids and proton-pump inhibitors used as co-medication during ICIs had a negative impact on response to therapy. (4) Conclusions: Endocrine irAEs might be considered predictive biomarkers for successful immunotherapy in mNSCLC patients. Co-medication during ICIs had a major influence on the effectiveness of these cutting-edge therapies. RWD plays an important role for oncology daily practice whenever clinical trial evidence is not available to guide decision. Full article

Background: Respiratory tract infections (RTIs) represent a frequent cause of inpatient admission in children’s hospitals, especially in the fall and winter seasons, resulting in major healthcare problems due to a lack of beds. The age and seasonal distribution of each pathogen seem to be multifactorial features that influence the course of infection. Other severity predictors appear to be the length of hospital stay, the presence or absence of oxygen demand, and the value of inflammatory markers. Methods: All inpatients from our children’s hospital between 2021 and 2023 who had a nasopharyngeal swab and presented with RTI symptoms were recruited for this retrospective cohort study. The parameters of interest were age, swab result, month of detection, CRP values, duration of hospitalization, presence of oxygen demand, and comorbidities. The data were analyzed using chi-square tests, paired t-tests and regression analysis to determine the associations of differences between the groups. Results: Detection of more than one respiratory pathogen in the same swab, apart from combinations with SARA-CoV-2, influenza, or RS-virus, was not associated with longer hospital stay, higher mean maximal CRP values, or oxygen demand compared to mono-infection with the same pathogens. In contrast, the detection of a pathogen versus no detection could be related to higher rates of oxygen demand and higher CRP values. Conclusions: Since co-infection with more than one virus, excluding those with epidemic potential, was not associated with a more severe course of RTIs, strict patient isolation seems to be dispensable for several viruses, as well as isolation of infected or colonized patients. Full article

Background/Objectives: Ventricular pre-excitation (VP) increases the risk of sudden cardiac death among children. While transcatheter ablation could potentially be therapeutic, it is not without risk, especially in smaller children. Accessory pathways (APs) may spontaneously lose anterograde conduction properties over time, making invasive treatment unnecessary. We aim to investigate the probability of spontaneous loss of VP during childhood, as well as the potential factors that may be associated with VP resolution. Methods: We conducted a retrospective study of patients with VP diagnosed before 12 years of age and referred to two Northern Italian tertiary care hospitals between 1993 and 2021. Patients with complex congenital heart disease were excluded. Our primary objective was to determine the likelihood of spontaneous resolution of VP. Results: Overall, 153 patients were included, with a median age at first diagnosis of 4.9 years (25th–75th percentile: 75 days–8.4 years) and a median follow-up of 4.9 years (25th–75th percentile: 1.8–8 years). Through left truncated Kaplan–Meier analysis, we estimated that anterograde conduction would persist in 53% and 33.8% of patients at the age of 1 and 16 years, respectively. Our findings revealed that the absence of symptoms and intermittent VP were associated with a higher likelihood of VP resolution. It is noteworthy that no major arrhythmic events were reported. Conclusions: Our study strongly supports the implementation of a conservative strategy in younger children with VP. Our findings indicate that a significant proportion of pediatric patients may experience spontaneous resolution of VP in the early years of their lives, making any invasive treatment unnecessary. Full article