Background. Superior mesenteric artery syndrome (SMAS) is a rare condition caused by the compression of the duodenum, which may occur in the case of fast weight loss. Currently, the relationship between superior mesenteric artery syndrome and anorexia nervosa is still unclear. The aim of this study is to identify the precocious clinical signs and symptoms of SMAS in patients affected by anorexia nervosa so as not to delay the diagnosis. Methods. We present the clinical case of a young female patient with anorexia nervosa complicated by SMAS. We performed a literature review of SMAS in children affected by anorexia nervosa between 1962 and 2023, according to the PRISMA Extension Guide for Scoping Reviews. Results. Reviewing the literature, 11 clinical cases were described for the pediatric age. The median age at diagnosis was 17 years (ranging from 13 to 18 years). The diagnosis of SMAS may be challenging as symptoms overlap those of anorexia, but it should be kept in mind mostly in cases of post-prandial abdominal pain, anxiety or depression, nausea, vomiting, and weight loss. Conclusion. Even specific clinical symptoms may act as flag tags to drive attention to this rare but potentially fatal condition.
Introduction. Evidence is consistent with increased screen viewing time among children and adolescents, and anticipation at the age at which children interact with media devices. Incorrect use of technology, as well as overuse, may lead to serious consequences. This study aims to revise scientific international literature and to describe the potential eye risks correlated to screen viewing time in the pediatric age. Materials and Methods. A review of the literature was performed according to the PRISMA 2020 guidelines, using the search terms “media device” and “eye” with the filter “age 0–18”. Results. Analyzing the international literature, we found 26 articles. Pre-myopia, myopia, digital eye strain, and acute acquired comitant esotropia were listed as potential and time-related consequences associated with the incorrect use of media devices among children and adolescents. Discussion. Family education on media device exposure and potential risk for children and adolescents’ sight in case of prolonged digital/screen exposure is required. During pediatric check controls, a dialogue with families on prolonged media device use at a close distance should be undertaken. Pediatricians and ophthalmologists should consider screen viewing time in case of ocular problems.
Pediatric sepsis presents a unique clinical challenge due to the distinct characteristics of the developing immune system. The immune response in children differs significantly from that in adults, exhibiting a unique combination of resistance, disease tolerance, and resilience. These factors influence the clinical presentation and prognosis of pediatric patients with sepsis. Over the past few years, various studies have explored the role of immunomodulatory therapies in managing sepsis, including the use of immunoglobulins, corticosteroids, monoclonal antibodies, and immunostimulatory treatments. However, the heterogeneity of the clinical presentations and individual responses makes it difficult to identify universally effective treatments. Recent research has highlighted the importance of a personalized approach based on specific biomarkers and patient phenotyping. Extracorporeal blood purification techniques have emerged as promising strategies for the modulation of hyperinflammation. However, strong evidence supporting their routine use in pediatric sepsis is lacking. This review provides a comprehensive overview of the current knowledge of the immune response in pediatric sepsis and discusses the main immunomodulatory strategies and future perspectives for personalized therapy. A deeper understanding of the immunological differences between children and adults could improve the prognosis and treatment efficacy, paving the way for new approaches to pediatric sepsis management.
Background: Anorexia nervosa (AN) is a complex psychiatric disorder that requires a multidisciplinary approach. The World Health Organization recognizes the therapeutic value of expressive arts, including drama, in enhancing emotional, cognitive, and relational domains in severe mental illnesses such as AN. Expressive arts interventions may improve emotional intelligence, empathy, and self-awareness while reducing anxiety and alexithymia. This study evaluated the impact of an adjunctive expressive arts program on alexithymia in pediatric inpatients with AN. Methods: We enrolled patients aged 11–18 years hospitalized for AN, according to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, Text Revision, at the Pediatric Unit of Bambino Gesù Children’s Hospital, Rome. The study period ran from December 2024 to April 2025. Participants attended drama therapy sessions and expressive arts workshops in a dedicated recreational space integrated into a multidisciplinary treatment plan. Alexithymia was assessed at admission and discharge using the Toronto Alexithymia Scale (TAS-20), with scores ≥ 61 indicating alexithymia. At the end of the program, participants completed a semi-structured satisfaction questionnaire to evaluate subjective experiences and mood. Results: Thirty patients met inclusion criteria. The TAS-20 scores were statistically different between pre-/post-theater activity (p < 0.001). The proportion of alexithymic participants declined from 73.3% at baseline to 26.7% at discharge. Most participants reported mood improvements: 66.6% “somewhat” and 26.7% “greatly.” Additionally, 90% reported improved peer relationships. Conclusions: Expressive arts, particularly drama-based interventions, may represent an effective adjunctive therapy for adolescents with AN, supporting emotional awareness, self-regulation, and social connectedness. Arts-based interventions are associated with nonverbal avenues for emotional processing and may promote neuroplasticity, representing valuable complementary strategies for AN treatment.
In the last years the use of digital media devices (MD) among adolescents has increased exponentially, becoming a central component of daily life for many