Aim of these revised recommendations for the general management of Kawasaki disease is to encourage its prompter recognition and warrant the most appropriate therapy, based on ascertained scientific data, raising awareness of the complications related to misdiagnosis or delayed treatment. A set of 20 synthetic operative statements is herein provided, including the definition of Kawasaki disease, its protean presentations, clinical course and seminal treatment modalities of all disease phases. The application of these recommendations should improve prognosis of Kawasaki disease and prevent the progression to permanent vascular abnormalities, thereby diminishing morbidity and mortality.

This second part of practical Guidelines related to Kawasaki disease (KD) has the goal of contributing to prompt diagnosis and most appropriate treatment of KD resistant forms and cardiovascular complications, including non-pharmacologic treatments, follow-up, lifestyle and prevention of cardiovascular risks in the long-term through a set of 17 recommendations. Guidelines, however, should not be considered a norm that limits the treatment options of pediatricians and practitioners, as treatment modalities other than those recommended may be required as a result of peculiar medical circumstances, patient’s condition, and disease severity or individual complications.

Introduction: Eating disorders (EDs) are severe psychiatric disorders that significantly impact the psychological and physiological well-being of affected individuals. Despite increasing prevalence in males over the past few decades, EDs are mainly considered a female disease. This retrospective study aims to evaluate the influence of gender on the clinical, laboratory, and developmental characteristics of EDs in pediatric patients. Material and methods: A retrospective study was conducted on patients referred to the EDs between 2019 and 2024 at Bambino Gesù Children’s Hospital, Rome, Italy. Gender differences were evaluated in the whole cohort and in a sub-cohort of males and females well matched for age. Results: In the whole cohort of 501 patients (age range 8–17 years), 45 were males and 456 were females. In male patients, EDs occurred at a younger age (12.65 vs. 14.65 years, p < 0.05). When considering the matched cohort, male patients showed more severe clinical conditions, as evidenced by a tendency to a lower BMI SDS at the onset, higher inflammatory parameters (ferritin and transaminase levels), and poorer nutritional status (vitamin D levels: 23.15 vs. 26.9 ng/mL, p < 0.05). However, male patients had a shorter hospital stay (14.8 vs. 19.9 days, p < 0.05) and showed a tendency to a greater clinical improvement. Differences in therapy were also observed, with fewer males receiving pharmacological treatment or nasogastric feeding. Conclusions: The results of the current study confirm the higher prevalence of EDs in females, even though they suggest EDs are not exclusively a female disease. Male gender may represent a risk factor for a worse clinical course and a younger onset. Further studies with a longer follow-up are required to understand the significant differences between females and males in this complex disorder.

Background: Social distancing and quarantine imposed by the authority during the COVID-19 pandemic caused restrictions, which had a negative impact on eating behavior, especially among adolescents. We proposed a retrospective study aimed to evaluate the effect of the COVID-19 pandemic on eating disorders risk and symptoms. Methods: In this study, a group of 127 pediatric patients (117 females and 10 males) with eating disorders admitted to the Bambino Gesù Children’s Hospital of Rome (Italy), in the period between August 2019 and April 2021, was analyzed. All patient data were collected from patients’ electronic medical records. Results: We found that 80.3% of patients were at the onset of eating disorders and that 26% of patients had familiarity for psychotic disorders. Often these patients had comorbidities and alterations in blood parameters such as leukocytopenia, neutropenia, hypovitaminosis and hormonal problems that could affect their future. Conclusions: Our findings could provide a framework for developing clinical and educational interventions to mitigate the short- and long-term negative impact of the pandemic on adolescent future health.

Differences between males and females in lipid profile are observed in distribution and trajectory during pediatric age and are more pronounced in hereditary lipid disorders such as familial hypercholesterolemia when absolute cholesterol levels are higher from birth onwards. A retrospective observational study was undertaken to explore the sex differences in lipid profiles of pediatric patients affected by heterozygous form of familial hypercholesterolemia (FH) and treated with statins. A cohort of 322 pediatric patients, aged 2-17 years, diagnosed with heterozygous FH and regularly followed in Rare Disease and Medical Genetics Unit of the Bambino Gesù Children’s Hospital of Rome (Italy) from 2015-2024, was enrolled in this study. A subgroup of 112 patients, aged 8–17 years, was treated with statins. For all patients, the lipid profile was assessed at diagnosis. For patients treated with statins, the lipid profile was assessed at diagnosis and after 1 year of statin therapy. Differences between males and females in lipid profile were observed in the subgroup of patients aged 8-17 years. Females had significantly (p < 0.05) higher TC, LDL-C and TG plasma values than males, and clinically they respond better to statin treatment. Conclusion: Personalized therapy, accounting for these differences, could enhance treatment outcomes and optimize long-term cardiovascular health in affected children. What is Known: • Familial hypercholesterolemia (FH) is characterized by elevated plasma level of total cholesterol from the birth. • If left untreated, FH can lead to premature atherosclerotic cardiovascular disease, and young female with FH are at high risk of developing it. • FH girls have higher levels of TC, LDL-C, and TG plasma values levels than boys in a previous study and this may contribute significantly to the total lifelong cholesterol burden in FH women. What is New: • Significant sex differences in lipid profile were confirmed in heterozygous FH (HeFH) patients aged 8-17 years: females had significantly higher TC, LDL-C and TG plasma values than males. • Early statin treatment in children with FH, and girls in particular, may impact cholesterol burden in FH patients.

Background: Since 2022, invasive Group A Streptococcus (GAS) infections have increased, mainly due to the spread of specific emm-types, such as emm1. As therapy may depend on the emm-type, rapid and cost-effective identification is crucial. Fourier-transform infrared spectroscopy (FTIR) has emerged as a promising alternative to sequencing for GAS typing. We applied machine learning (ML) to FTIR spectra to build a predictive model for emm-type identification. Methods: Twenty-four GAS strains were analyzed by whole-genome sequencing and FTIR. The model was trained on twenty-one strains (emm-types: 1, 3, 4, and 6), using leave-one-out cross validation (LOOCV). To test the model’s ability to avoid false positive results, the model was also tested with three strains belonging to emm-types not included in the training of the model (emm-types: 12, 89, and 75). Results: An artificial neural network trained for 400 cycles achieved the highest accuracy (90.7%) out of the thirteen different models tested. When the three strains belonging to emm-types not included in the model were predicted with this model, it produced low score values, confirming its ability to avoid false positive results. Conclusions: We developed a preliminary and proof-of-concept model capable of accurately predicting the four most-prevalent emm-types in our setting, including the highly virulent emm1. These findings support FTIR combined with ML as a rapid, low-cost tool for GAS typing, with potential for real-time clinical applications to guide timely treatment decisions. However, as a proof-of-concept study, the relatively small sample size and limited emm-type diversity underline the need for further validation with larger and more diverse datasets.