Diagnosis of type 1 diabetes (T1D) in a child is often associated with anger, denial, fear, and depression from the parents. The aim of the study was to improve parents’ adaptation to the diagnosis of diabetes of their child. Sixty-two parents (29 mothers, 33 fathers) of 36 children with type 1 diabetes (meanage=11.3‐3.3years; diabetesduration>1year; HbA1c=57±11mmol/mol) participated in a three-day educational working group pilot intervention study. Intervention was based on the reexamination of the traumatic event of diagnosis of T1D through spatial and time-line anchorage, retracing of the future, emotional awareness, and interactive discussion. Relaxing technique, diaphragmatic breathing, and guided visualization were used by 2 psychologists and 1 pediatric endocrinologist. The study was approved by EC and participants filled a consent form. At baseline and after intervention, parents filled in a questionnaire including Diabetes-Related Distress (DRD), Parent Health Locus of Control Scale (PHLOC), Parent Stress Index Short Form (PSI-SF), Hypoglycemia Fear Survey-Parents (HFS-P) and Hypoglycemia Fear Survey-Parents of Young Children (HFS-P-YC), and Health Survey Short Form-36 (SF-36). Three months after the intervention, both parents reported a reduction in the “difficult child” subscale of the PSI-SF (p<0.05) and increased scores of social functioning of the SF-36 (p<0.05). DRD score was significantly reduced in mothers (p=0.03), while the “parental distress” subscale of the PSI-SF was significantly improved in fathers (p=0.03). This weekend-based parent group intervention seems to reduce stress and improve social functioning of parents of children and adolescents with type 1 diabetes.

A new chemiluminescence immunoassay method (CLIA) for detecting IgA anti-transglutaminase (atTG IgA) in celiac disease (CD) has prompted inquiries into its diagnostic performance. We conducted a systematic review and meta-analysis comparing CLIA with traditional enzyme-linked immunosorbent assay (ELISA) and fluorescence enzyme immunoassay (FEIA). We searched PubMed, Medline, and Embase databases up to March 2024. The diagnostic references were intestinal biopsy and ESPGHAN guidelines. We calculated the sensitivity and specificity of atTG IgA assessed by CLIA and the odds ratio (OR) between the assays. Eleven articles were eligible for the systematic review and seven for the meta-analysis. Sensitivity and specificity of atTG IgA CLIA-assay were 0.98 (95% CI, 0.95–0.99) and 0.97 (95% CI, 0.94–0.99), respectively. The sensitivity of atTG IgA antibody detection did not significantly vary across the three assay modalities examined (CLIA vs. ELISA OR: 1.08 (95% CI, 0.56–2.11; p = 0.8); CLIA vs. FEIA OR: 6.97 (95% CI, 0.60–81.03; p = 0.1). The specificity of atTG IgA assessed by FEIA was higher than for CLIA (OR 0.17 (95% CI, 0.05–0.62); p < 0.007). According to the systematic review, normalization of atTG IgA levels in CD patients following a gluten-free diet was delayed when using CLIA compared to ELISA and FEIA methods. Conflicting findings were reported on the antibody threshold to use in order to avoid biopsy confirmation.

Background: Methemoglobinemia (MetHb) is a rare and potentially life-threatening condition caused by oxidation of ferrous hemoglobin (Fe2+) to the ferric (Fe3+) state, making it incapable of binding oxygen and resulting in cyanosis and tissue ischemia. Case presentation: This case presentation describes a 1-year-old boy who developed sudden cyanosis and reduced consciousness disorder. An initial assessment showed decreased oxygen saturation (SpO2 85%) despite oxygen therapy, while point-of-care venous blood gas (VBG) analysis assessed high rates of MetHb (72.7%). Methylene blue and ascorbic acid were administered, resulting in in rapid clinical recovery and normalized VBG test results. The trigger for this condition was not identified, however the most likely cause of poisoning was attributed to food oxidants. Conclusion: Starting from the description of a clinical case, this paper discusses the causes and mechanisms of possible poisoning and reviews recent guidelines for methemoglobinemia management.

Background: Picky eating (PE), also termed food selectivity, is one of the most common feeding concerns in childhood. Although often a transient developmental stage, persistent or severe selectivity may lead to nutritional deficiencies, growth impairment, and psychosocial consequences. Methods: This narrative review is based on literature searches conducted in April 2025 across PubMed, Web of Science, Embase, Medline, and Google Scholar. Articles published between 2015 and 2025 were included if they addressed the epidemiology, etiology, assessment, or management of PE in children aged 0–18 years. Additional seminal references predating this period were also considered. Results: Prevalence estimates of PE vary widely (13–50%), with peak incidence between ages two and six. Contributing factors include genetic predisposition, sensory sensitivities, temperament, family feeding practices, environmental influences, and adverse feeding experiences. Distinction from avoidant/restrictive food intake disorder (ARFID) and pediatric feeding disorder (PFD) is essential, as these conditions carry greater risk of nutritional and psychosocial impairment. Assessment relies on caregiver-report instruments, clinical observation, growth monitoring, and targeted nutritional evaluation. Effective management integrates parental education, responsive feeding strategies, repeated exposure to novel foods, and, when indicated, nutritional supplementation or referral to multidisciplinary teams. Sensory-based therapies, behavioral interventions, and psychoeducational programs show particular benefit in persistent cases. Conclusions: While most children outgrow PE without adverse outcomes, a subset remains at risk of long-term nutritional compromise and psychosocial difficulties. Early recognition, family-centered guidance, and evidence-based interventions are essential. Future research should refine diagnostic criteria, develop culturally sensitive assessment tools, and evaluate innovative therapies to improve outcomes.

Background: Glycogen storage disease type XII is a rare metabolic disease resulting from Aldolase A deficiency that causes muscle glycogen accumulation, with crisis of rhabdomyolysis and hemolytic anemia. In the very few cases described, rhabdomyolysis crises are caused by fever and/or exercise and can accompany acute hemolytic anemia. Although currently there is no therapy available for this disease, the guidelines for the management of other forms of glycogen storage diseases recommend a nutritional therapy in order to avoid hypoglycemia or prevent exercise-induced rhabdomyolysis. Case presentation: In this case report we describe a new phenotype of the disease in a 14-year-old boy, characterized by seizures and rhabdomyolysis. Beside an antiepileptic treatment, we propose a new therapeutic approach based on ketogenic diet in order to supply an energetic substrate for skeletal muscle and neurons. Conclusions: The anti-epileptic therapy and the dietetic approach were well tolerated by the patient who showed good compliance. This led to a deceleration of the disease with no other acute episodes of seizures and rhabdomyolysis, without any side effects observed.

The Hawthorne effect describes outcome changes driven by awareness of observation rather than active intervention. In celiac disease (CeD), improvements reported in placebo or control arms suggest that observation may influence objective outcomes. We aimed to analyze the Hawthorne and other trial-related effects in treated CeD, focusing on histological changes of the small intestinal mucosa. We conducted a systematic review and meta-analysis following PRISMA 2020 guidelines. PubMed and ClinicalTrials.gov were searched from inception to October 2025 for studies enrolling patients with CeD on a gluten-free diet (GFD) reporting outcomes in placebo or control arms. Outcomes were synthesized qualitatively, and by a random-effects meta-analysis of pooled within-group changes in villous height-crypt depth (Vh/Cd) ratio. Ten studies were included in the qualitative synthesis, and three studies (168 participants) provided histological data. Placebo or control groups showed improvements in symptoms, dietary adherence markers, and mucosal morphology. Meta-analysis demonstrated a significant increase in Vh/Cd ratio (median difference +0.25; 95% CI 0.11-0.39; p < 0.001) with low heterogeneity. This improvement suggests significant gluten contamination of the pre-trial GFD. In treated CeD, structured monitoring is associated with meaningful histological improvement independent of active intervention, that should be considered when interpreting trial outcomes.