Agents of platinum-based chemotherapy, such as cisplatin or carboplatin, are used in the treatment of a wide range of malignancies that affect children, such as brain tumors, osteosarcoma, neuroblastoma, hepatoblastoma, and germ cell tumors (GCTs). The Cyclophosphamide Equivalent Dose (CED) calculator for reproductive risk does not take platinum-based chemotherapy into account, despite the fact that it accounts for the majority of chemotherapy medications that are typically administered for pediatric GCTs. As a result, exposure to platinum-based drugs throughout infancy can have predictable long-term effects such as infertility, as well as other rare encounters such as lipoma formation and lipomatosis. Lipomas are the most prevalent benign soft tissue tumor subtype. They may be either solitary entities or engaged in multiple lipomatosis, which may have a familial origin or be an acquired disorder. Chemotherapy is a possible cause of lipomatosis. Chemotherapy based on cisplatin has been linked to a variety of long-term consequences, including kidney damage, neurotoxicity, and pulmonary toxicity, and may even create secondary cancers. However, lipoma development is known to occur in fewer than 1 in 100 individuals, and only a few examples of multiple cutaneous lipomatosis triggered by this therapy have been documented. Here we present a very rare case of lipomatosis in a pediatric patient with GCT under cisplatin therapy, which might be the third report of this kind affecting children.

(1) Background: Mild and moderate hemophilia, synonymous with non-severe hemophilia (NSH), are of constant interest for the clinicians. Bleeding occurs usually after trauma, injury, surgery, or inhibitor development, sometimes leading to a shift of the clinical phenotype from mild to severe, even with life-threatening and unexpected outcomes. (2) Methods: We performed a retrospective observational study conducted on 112 persons with congenital coagulopathies, 26 of them with NSH, admitted to our clinic in the period 2000 to 2022. For the diagnosis, we used laboratory studies (complete blood cell count, coagulation assays, biochemistry, thromboelastography, genetic tests) and imaging investigations (X-ray, ultrasound, CT, MRI). We selected four cases confronted with pitfalls of diagnosis and evolution in order to illustrate the sometimes provocative field of NSH. (3) Results: Confronted with challenging cases with under-, missed or delayed diagnosis and severe consequences, we aimed at presenting four such selected cases with mild or moderate hemophilia, real pitfalls in our clinical activity. (4) Conclusions: In the field of NSH, if not timely recognized, tending sometimes to remain ignored by caregivers and patients themselves, we can be confronted with challenging diagnostic situations and life-threatening bleeds.

Background: Telemedicine (TM) was studied, particularly during the COVID-19 pandemic, to ascertain its utility in delivering remote medical services. Study Question: What palliative care (PC) interventions can be provided through TM consultations compared with face-to-face (FF) consultations? What is their efficacy in reducing the intensity of suffering in the physical, emotional, social, and spiritual domains? What is the level of satisfaction with the care given? Study Design: Randomized controlled trial with 2 arms: TM consultations using Zoom and WhatsApp secure platforms (Intervention group) and FF consultations (Control group). Participants received 8 scheduled weekly consultations and on-demand consultations. Measures and Outcomes: The patients completed weekly Edmonton Symptom Assessment System, Problems and Needs in Palliative Care Short Form, and Patient Satisfaction Questionnaire Short Form monthly questionnaires. Statistical analyses were performed using GraphPad Prism 10.0.2. Results: Between July 2023 and January 2024, 26 patients with newly diagnosed advanced cancer were randomized, 23 completed the study and 3 died in the TM arm (attrition rate 11.53%). Enrolled participants had predominantly advanced head and neck cancer (30.76%) and digestive tract cancer (23.07%). Patients in the TM arm had a lower performance status compared with the FF group. One thousand one hundred sixty-eight PC interventions were performed, 628 (FF) versus 540 (TM). In the physical domain, 343 versus 266; in the emotional domain, 219 versus 206; in the social domain, 18 versus 18; in the spiritual domain, 48 versus 50. Higher reductions in symptom intensity scores were reported in the TM arm (100% for depression, anxiety, hemorrhage, dysphagia, and secretions; >90% for pain, nausea, and appetite; >80% for sleep, dyspnea, and constipation; and >70% for cough), with statistical significance for pain ( P = 0.0140), nausea ( P = 0.0148), depression ( P = 0.0318), and constipation ( P = 0.0100). High satisfaction scores (>80, range 18–90) were reported for both arms. Conclusions: This exploratory pilot study shows that TM PC interventions are feasible and lead to high reductions in intensity scores for symptoms, with high satisfaction scores.