Purpose The coronavirus lockdown in Italy ended, but the postlockdown phase may be even more challenging than the outbreak itself if the impact on mental health is considered. To date, little evidence is available about the effect of lockdown release in terms of adolescent health from the perspective of an emergency department (ED). Methods We reviewed data on ED arrivals of adolescents and young adults (aged 13–24 years) in the weeks immediately before and after the Italian lockdown release in 2020, and in the same periods in 2019, with a focus on cases of severe alcohol abuse, psychomotor agitation, and other mental issues. Results The relative frequency of severe alcohol intoxications increased from .88% during the last part of the lockdown to 11.3% after lockdown release. When comparing these data with the same period in 2019, a highly significant difference emerged, with severe alcohol intoxications accounting for 11.31% of ED visits versus 2.96%, respectively. The relative frequency of ED arrivals related to psychomotor agitation or other mental health issues was not significantly increased after lockdown release. Conclusions This report suggests that emergency services should be prepared for a possible peak of alcohol intoxication-related emergencies in adolescents and young adults. The connection between alcohol abuse and mental health should not be overlooked.

Introduction: Pleuropulmonary blastoma (PPB) is a rare, aggressive mesenchymal tumor of childhood. The Italian Tumori Rari in Età Pediatrica (TREP) Registry was the first in Europe dedicated to prospective data collection on rare pediatric tumors. We analyzed data from an Italian series of patients with PPB, focusing on the role of the TREP Project. Methods: We considered patients aged 0–14 with histologically confirmed diagnosis, registered in population-based cancer registries (before 2000) or the TREP Registry (2000 to 2014), and analyzed data on clinical characteristics, treatment, and outcome. Event-free survival (EFS) and overall survival (OS) were estimated. Relevant prognostic factors were identified performing a univariate analysis. Results: Thirty-seven cases were included (7 type I, 13 type II, 17 type III). The average diagnosis rate rose from 1.10 to 1.73 cases/year after the TREP Project started. All patients underwent surgery, 33 received chemotherapy, and 9 had radiotherapy. The median follow-up was 8.7 years. For type I, II, and III, respectively, the 5-year OS was 85.7% (33.4–97.9), 52.7% (23.4–75.5), and 57.8% (31.1–77.3); the 5-year EFS was 85.7% (33.4–97.9), 52.7% (23.4–75.5), and 52.9% (27.6–73.0). Favorable prognostic factors for EFS were Intergroup Rhabdomyosarcoma Study (IRS) stage I ( p = 0.03) and T1 tumor ( p = 0.05). A total of 78.3% of patients who had chemotherapy after 2000 received a standardized treatment. Conclusions: The TREP Registry showed an excellent capacity for registering cases of PPB. Patients received homogeneous treatment after the TREP Project started. Long-term outcomes were excellent for type I and unsatisfactory for type II and III. Tumor invasiveness and IRS stage were of prognostic value.

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Short stature is a common referral in paediatric endocrinology. The role of the target height (TH) is fundamental in its diagnostic management. In order to investigate for growth hormone deficiency (GHD), one of the clinical criteria in several guidelines is a height <−1.5 standard deviation score (SDS) compared to TH. 1 Despite the importance of reliable measures, the calculation of TH is often entrusted to reported parental heights. Although previous studies showed a substantial error in referred heights, with a trend to overestimate it, 2,3 only two studies assessed the influence of both parents' reported heights on TH 4,5 and none of them, concurrently, considered children's data nor the impact of an inaccurate TH.This observational study aimed to verify whether parents of children referred for short stature tend to overestimate their height more than other parents and to verify how many children could be improperly tested for GHD. 1 | MATERIAL AND ME THODSWe consecutively enrolled 130 individuals referred to the Endocrine Unit of the Institute for Maternal and Child Health 'Burlo Garofolo' when both parents were present, divided into 2 categories (65 trios each) according to the reason for referral (independently from actual height): 'short stature' (SS) and 'no short stature' (noSS). Parents' age, nationality and self-reported height (R-PHt) were recorded after explaining that an accurate estimate of their height was required for their children's medical care. Parents and children were then measured (M-PHt and CHt, respectively) using a Harpenden stadiometer.TH was calculated with the formula: (paternal height + maternal height)/2 −6 for females and +6 for males using Growth Calculator 3 Software, as well as SDS for heights and TH according to Italian reference charts.Due to the nature of the study, we used existing institutional generic ethical approval and informed consent. The study was approved by the Institutional Review Committee (RC33/18).Data were presented as percentages, median and interquartile ranges. Mann-Whitney rank-sum tests and two-tailed Fisher's exact tests were performed to evaluate the relations between variables. Wilcoxon signed-rank test was used to check the differences of paired data. Bivariate and multivariate linear regressions were carried out to study associations between and among independent variables. A P-value < .05 was considered statistically significant.Statistical analysis was conducted using JMP™ software (v.15.1.0). | RE SULTSData on children and parents are reported in Table 1.The overall median discrepancy between R-PHt and M-PHt was 1.2 cm (range −9 ÷ 8.8), 35% of parents having a discrepancy >±2 cm, with no significant differences between mothers and fathers. Parents were concordant in misreporting in 62% of the cases (58% overestimation, 4% underestimation). The median difference between paternal and maternal discrepancy was 0.3 cm (IQR −1 ÷ 1.8) and maternal misreporting prevailed in 54% of the cases.The discrepancy between R-PHt and M-PHt was higher in parents w...

Background Italy was the first European country to experience a massive outbreak of Sars-coV-2 in March 2020. Severe measures were introduced to face the pandemic, significantly impacting all healthcare services, including pediatric palliative care (PPC) networks. We investigated how the Covid-19 pandemic modified the provision of PPC services in Friuli Venezia Giulia, Italy. Both the acute and long-term impacts on the families were addressed. Methods We administered a retrospective three-sections online questionnaire to the eligible families assisted by our regional PPC network. Inclusion criteria were: child needing specialistic PPC, adequate knowledge of the Italian language, being in charge of the PPC regional network of Friuli Venezia Giulia from February 1, 2020. The three sections examined the same issues in different periods: the pre-covid period (until February 29, 2020), the lockdown period (March 1, 2020, to April 30, 2020), and the post-lockdown period (May 2021). Results Twelve patients were included. During the lockdown period, 54.6% of children had to stop physiotherapy sessions, while, among those who continued, 80.0% experienced a reduction in the sessions’ frequency. In the post-lockdown period, 45.5% of children did not have physiotherapy as often as before the pandemic onset. Overall, the access to medical visits during the lockdown and after its end was significantly reduced (p = 0.01). The level of support perceived by the families descended from grade 3 (intermediate) in the pre-covid period to 2 (low) during the lockdown (p < 0.05) and returned to grade 3 in the post-lockdown period. Conclusion The COVID-19 pandemic and the related restrictions impacted the families and caused a transitory contraction of the perceived support. The most significant change was reduced access to medical visits and physiotherapy, which lasted over a year after the start of the pandemic.