Sustained fetal tachycardias are rare but represent a high risk of mortality and morbidity. Consensus has yet to be found regarding their optimal management. The aim of this narrative review is to summarize the data available in the current literature regarding the efficacy and safety of medications used in the management of intrauterine tachyarrhythmias and to provide possible treatment protocols. In this review, we would like to emphasize the importance of a thorough evaluation of both the fetus and the mother, prior to transplacental antiarrhythmic drug initiation. Factors such as the hemodynamic status of the fetus, possible mechanisms of fetal arrhythmia, and concomitant maternal conditions are of primordial importance. As a possible treatment protocol, we would like to recommend the following: due to the risk of sustained supraventricular tachycardia (SVT), fetuses with frequent premature atrial beats should be evaluated more frequently by echocardiography. A careful hemodynamic evaluation of a fetus with tachycardia is primordial in forestalling the appearance of hydrops. In the case of atrial flutter (AFL), sotalol therapy could represent a first choice, whereas when dealing with SVT patients, flecainide should be considered, especially for hydropic patients. These data require consolidation through larger scale, non-randomized studies and should be handled with caution.

Our aim was to compare the global longitudinal and regional biventricular strain between infants with severe and critical pulmonary stenosis (PS), and controls; to compare pre- and post-procedural strain values in infants with severe and critical PS; and to assess the correlations between echocardiographic strain and conventional parameters. We conducted a retrospective single-center study. The comparisons of echocardiographic variables were performed using separate linear mixed models. The overall mean right ventricle (RV) regional strains measured before intervention in PS patients was significantly different when compared to the control group (p = 0.0324). We found a significant change in the left ventricle, RV, and inter-ventricular septum strain (IVS) values from basal to apical location (p < 0.05). IVS strain values showed a higher decrease in mean strain values from basal to apical in PS patients. There was no significant difference in means of baseline and post-interventional strain values in PS patients (p > 0.05). Following the strain analysis in patients with PS, we obtained statistically significant changes in the RV global-4-chamber longitudinal strain (RV4C). The RV4C, which quantifies the longitudinal strain to the entire RV, can be used in current clinical practice for the evaluation of RV function in infants with severe and critical PS. The longitudinal and segmental strain capture the pathological changes in the IVS, modifications that cannot be highlighted through a classical echocardiographic evaluation.

Congenital diaphragmatic hernia (CDH) is a relatively rare and severe developmental disease. Even with the most recent multidisciplinary therapies, the risk for neonatal mortality and morbidity remains high. Recent advancements in prenatal treatments, alongside experimental and clinical data, suggest that fetoscopic endoluminal tracheal occlusion (FETO) promotes lung development and offers a promising strategy against lung hypoplasia and pulmonary hypertension. It is the only existing direct mechanical therapy that intervenes in the regulation of pulmonary pressure. Its influence on lung development also interferes with tissue homeostasis and cell differentiation; it also enhances inflammation and apoptosis. Its physiopathology on cellular and molecular levels is still poorly understood. Unfortunately, the procedure also carries significant pregnancy-, maternal-, and fetus-related risks. Assessing a multifaceted intervention requires a collective view of all aspects. This scoping review uncovers potential materno-fetal procedure-related risks and highlights innovative solutions. Future research on lung development therapies in CDH may focus on the “dual hit” mechanism, combining molecular-targeting drugs and regenerative medicine with the mechanical nature of FETO for synergistic effects.

Data regarding reference intervals for strain parameters derived from 2D speckle-tracking echocardiography in full-term newborns are limited and still under development. Our objectives were to establish the level of reproducibility and reference intervals in assessing myocardial function using 2D speckle-tracking echocardiography for longitudinal and regional strain measurements. A total of 127 full-term newborns were examined to be included in the study, of which 103 were analyzed. We used two-dimensional acquisitions from apical four-chamber view of both ventricles and analyzed the autostrain function offline. We obtained interobserver agreement between the two observers ranging from good to excellent for all speckle-tracking parameters except for the strain of the medial portion of the left ventricle (LV) lateral wall and the strain measured on the basal portion of the inter-ventricular septum, which reflected a fair interobserver reproducibility (ICC = 0.52, 95% IC: 0.22–0.72 and ICC = 0.43, 95% IC: 0.12–0.67, respectively). The reference values obtained for the LV peak longitudinal strain were between −24.65 and −14.62, those for the right ventricle (RV) free wall were from −28.69 to −10.68, and those for the RV global four-chamber were from −22.30 to −11.37. In conclusion, two-dimensional peak longitudinal LV and RV strains are reproducible with good to excellent agreement and may represent a possible alternative for the cardiac assessment of healthy newborns in the clinical practice.

Background: Childhood extranodal B-cell non-Hodgkin’s lymphomas are often caused by Burkitt’s lymphoma (BL). Treatment usually involves intensive polychemotherapy, and recent prospective trials show significantly improved outcomes. Surgery primarily involves conducting biopsies; ablative interventions are not recommended. However, in cases of severe presentation, such as an acute abdomen, emergency surgery may be necessary. Methods: We present the case of a 17-year-old boy who underwent emergency surgery due to intestinal obstruction caused by a tumor mass. An exploratory laparoscopy was performed due to abdominal wall infiltrates, and a large intraabdominal mass was discovered in the ileocaecal region. The tumor and tumor infiltrates were successfully removed en bloc in a minimally invasive laparoscopy-assisted fashion. Results: The postoperative course was favorable, and chemotherapy was started. Histopathology confirmed the diagnosis of BL. Follow-up examinations, including a positron emission tomography (PET) scan, showed no tumor recurrence. More than two years later, the patient remains asymptomatic with negative PET scans. Conclusions: Laparoscopy-assisted removal can be useful for pediatric solid abdominal tumors with abdominal wall infiltrates that cause obstruction. Surgeons must assess indications and procedures based on imaging and findings during emergency interventions. The role of ablative MIS in pediatric BL is limited.

Background/Objectives: Benign bone tumors and tumor-like conditions are commonly encountered in the pediatric population, often discovered incidentally during radiographic evaluation or presenting with symptoms such as pain, swelling, or pathologic fractures. Despite their benign nature, these lesions can significantly impact bone integrity and function. The objective of this study was to characterize the epidemiology, histopathological spectrum and management of benign bone tumors in a pediatric population. Methods: We conducted a retrospective observational single-center study of pediatric patients diagnosed with benign bone tumors or tumor-like lesions between 2013 and 2023. Clinical presentations, radiological findings, histopathological diagnoses, and treatment modalities were reviewed. Biopsy results and surgical indications were analyzed to assess diagnostic yield and therapeutic strategies. Results: Among the 253 biopsies performed, 220 cases (86.6%) were diagnosed as benign tumors, with osteochondromas being the most common (62.3%). The majority of cases involved the appendicular skeleton, with a male predominance. Simple bone cysts, aneurysmal bone cysts, and nonossifying fibromas were also frequently observed. Pathological fractures were documented in 5.45% of cases. Surgical intervention was indicated in patients with symptomatic lesions, pathological fractures, or radiological signs of structural instability. Conclusions: Benign bone tumors and tumor-like lesions in pediatric patients, although non-malignant, may lead to significant skeletal complications. Our findings highlight the importance of structured diagnostic evaluation and individualized treatment planning based on lesion type, location and clinical presentation. Early radiological assessment combined with histopathological confirmation plays a key role in preventing complications and optimizing outcomes. A multidisciplinary approach remains essential in the comprehensive management of these conditions.