Background: Although the long-term consequences of the Coronavirus Disease-2019 (COVID-19) pandemic are yet to be fully comprehended, a syndrome symptomatically akin to the COVID-19 disease has been defined, for children and adolescents, in February 2023 by the World Health Organization (WHO) as ‘post COVID-19 condition’ (PCC). Potential consequences of COVID-19 that affect developmental milestones in children and adolescents should be comprehended in their magnitude and duration. The aim is to investigate the most common symptoms and predictors or risk factors for pediatric PCC. Methods: In this umbrella review, the population of interest was defined as children and adolescents from 0 to 19 years old presenting PCC symptoms as defined by the WHO in the International Classification of Diseases. The intervention considered was general follow-up activity to monitor the patients’ recovery status. No comparator was chosen, and the outcomes were symptoms of PCC and predictors or risk factors of developing PCC. Methodological quality, risk of bias and the level of overlap between studies were assessed. A random-effects meta-analytic synthesis of respective estimates with inverse variance study weighting was carried out, for the primary studies included by the reviews retrieved, regarding predictors or risk factors reported. Results: We identified six eligible systematic reviews, five with meta-analyses, from three databases. The most common symptoms reported were fatigue and respiratory difficulties; female sex and older age were the most reported factors associated with the development of pediatric PCC. Conclusions: A deeper understanding of pediatric PCC requires well-designed and clearly defined prospective studies, symptom differentiation, and adequate follow-up.

Background: Electrochemotherapy (ECT) is a nonthermal locoregional treatment that enhances cytotoxic drug uptake through reversible electroporation and is increasingly used across different malignancies. Despite consistent evidence of clinical efficacy, uncertainties remain regarding its safety profile in heterogeneous clinical settings. This umbrella review synthesizes and critically appraises the available evidence on the efficacy and safety of ECT in oncological patients to inform clinical practice and future research. Methods: An umbrella review of systematic reviews and meta‐analyses was conducted in accordance with PRISMA and Joanna Briggs Institute guidance and registered in PROSPERO. Methodological quality and overlap were assessed using AMSTAR‐2 and the corrected covered area. Random‐effects meta‐analyses were performed to estimate pooled response and adverse event proportions, with subgroup and robustness analyses. Results: A total of 11 secondary studies were included. The pooled overall response rate to ECT was 78.6% (95% CI: 71.9%–84.0%) under a random‐effects model, with substantial heterogeneity across studies ( I ² = 88.2%). Subgroup analyses showed variability in overall response according to tumor type and treatment intent; however, no statistically significant between‐group differences were observed. The pooled proportion of adverse effects was 10% (95% CI: 0.0%–43.1%), with extreme between‐study heterogeneity ( I ² = 99.5%). Most reported adverse events were local and mild, whereas severe or systemic toxicities were uncommon. Conclusions: ECT is an effective locoregional treatment with high antitumor activity across multiple oncological indications. While safety outcomes were predominantly local and mild, interpretation of pooled toxicity estimates should account for variability in adverse event reporting. Overall consistent response patterns underscore its clinical relevance; however, further high‐quality prospective studies and standardized reporting are needed to guide broader implementation.

This study explores the organizational aspects of whole genome sequencing (WGS) implementation for pediatric patients with suspected genetic disorders in Italy, comparing it with whole exome sequencing (WES). Health professionals’ opinions were collected through an internet-based survey and analyzed using a qualitative summative content analysis methodology. Among the 16 respondents, most were clinical geneticists performing only WES, while 5 also used WGS. The key differences identified include higher needs for analyzing genome rearrangements following WES, greater data storage and security requirements for WGS, and WGS only being performed in specific research studies. No difference was detected in centralization and decentralization issues. The main cost factors included genetic consultations, library preparation and sequencing, bioinformatic analysis, interpretation and confirmation, data storage, and complementary diagnostic investigations. Both WES and WGS decreased the need for additional diagnostic analyses when not used as last-resort tests. Organizational aspects were similar for WGS and WES, but economic evidence gaps may exist for WGS in clinical settings. As sequencing costs decline, WGS will likely replace WES and traditional genetic testing. Tailored genomic policies and cost-effectiveness analyses are needed for WGS implementation in health systems. WGS shows promise for enhancing genetics knowledge and expediting diagnoses for pediatric patients with genetic disorders.

Background: The aftermath of COVID-19 is bringing about socio-economic consequences, such as diminished quality of life (QoL), decreased productivity, and considerable healthcare expenditures. Despite the emerging acknowledgment of a clinical syndrome following COVID-19 disease, known as Long COVID (LC), notable research gaps persist. This study aims to assess the epidemiological and economic impact of LC in both Italy and the United States (US). Methods: This ecological analysis comprises epidemiologic and economic data from 2020 to January 2023, regarding working-age individuals (18-64 years). An Italy/US incidence rate ratio (eIRR) was estimated to compute LC cases in each country. The product between the value of a year spent in good health, individual Quality-Adjusted Life Year (QALY) loss, and LC cases yielded total lost QoL. Temporary productivity loss (TPL) was calculated through the Human Capital Approach. All estimates were deemed significant at a p-value less than 0.05. Results: Up to date, the eIRR was 0.78 [0.43 - 0.91] implying 22% fewer LC cases in Italy with respect to the US. Total LC cases were 11 [8.7 - 13.5] and 1.8 [0.9 - 2.1] million in the US and Italy, respectively. The relative QALYs loss was 1.5 [0.8 - 3.1] and 0.2 [0.1 - 0.9] million. Reduced QoL cost roughly $189 [164 - 214] billion in the US and €6 [1 - 11] billion in Italy. TPL amounted to $37 [21 - 57] billion in the US and €2.8 [1.2 - 7.4] billion in Italy. Americans aged 30-39 years showed the largest income loss (26.6%), while in Italy it occurred in the age group 50-64 years (38%). Conclusions: LC places a substantial burden in Italy and the US, impacting both the productivity of the working-age population and influencing the younger generation, who constitute the future workforce. Our study underpins the necessity for comprehensive health policies, programs, and interventions alongside effective tertiary prevention strategies to tackle the challenges posed by LC. Key messages: • According to this analysis, both countries show significant productivity and quality-adjusted life years loss due to LC among working age individuals. • Steering the formulation of evidence-based sounding health policies to address LC burden, among working age individuals, both in Italy and in the US.

Introduction: Healthcare workers’ (HCW) quality of life and job satisfaction are critical for their well-being and performance, influencing patient outcomes and reducing burnout. Burnout, linked to excessive workloads, night shifts, and low income, is a recognized issue among HCW, exacerbated during the COVID-19 pandemic. This study aimed to explore work-life balance and professional satisfaction among members of the Physicians and Dental Surgeons Board of Rome (OMCeO Rome).Methods: A cross-sectional survey was conducted from March to June 2023 among OMCeO Rome members. An anonymous, digitally designed questionnaire assessed sociodemographic and professional data, perceived stress, and overall satisfaction using a Likert scale. Data were analyzed descriptively, and logistic regression identified predictors of satisfaction.Results: The survey included 1,104 respondents, predominantly aged over 50. Satisfaction levels were polarized: 47.4% reported high satisfaction, while 49.4% expressed low satisfaction. Night shifts and income below €100,000/year were significantly associated with lower satisfaction (OR 1.9 and OR 3.9, respectively). General practitioners/primary care paediatricians reported the highest stress levels, while self-employed professionals showed the lowest stress and intention to quit.Discussion: Work-life balance challenges, including night shifts and inadequate income, strongly influence HCW job satisfaction. Addressing these factors through administrative support, reduced workloads, and targeted interventions could mitigate burnout and improve care quality. Further studies should explore systemic and individual strategies to enhance HCW well-being and professional sustainability.