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Simple Summary: Central nervous system (CNS) metastatic spread in neuroblastoma (NB) is rare and occurs more often at relapse/progression. In this retrospective study, we reviewed the CNS imaging of all the patients treated at the Bambino Gesù Children Hospital over a 25-year period. CNS metastasis in NB is confirmed to be rare, occurring in 4.7% of patients, and associated with advanced disease and bone skull involvement. In the last decade, the involvement of CNS at relapse has been observed more frequently, supporting the rising concern of the impact of immunotherapy in the pattern of relapse in high risk (HR) NB. Further studies are needed to confirm a higher CNS relapse risk in the immunotherapy era as well as the need for including CNS imaging in follow-up. Central nervous system (CNS) metastatic spread in neuroblastoma (NB) is rare and occurs more often at relapse/progression. We report on CNS involvement in high risk (HR) NB over 25 years. For this retrospective study, we reviewed the CNS imaging of all the patients treated at Bambino Gesù Children Hospital from 1 July 1996 to 30 June 2022. A total of 128 patients with HR NB were diagnosed over 26 years. Out of 128 patients, CNS metastatic spread occurred in 6 patients: 3 patients presented a metastatic spread at diagnosis, while in 3 patients, CNS was involved at relapse. Overall, the rate of occurrence of CNS spread is 4.7% with the same distribution at diagnosis and at relapse, namely 2.3%. Interestingly, CNS spread at diagnosis was observed only before 2012, whereas CNS was observed at relapse only after 2012, in the immunotherapy era. CNS metastases presented similar imaging features at diagnosis and at relapse, with a peculiar hemorrhagic aspect and mainly hemispheric localization in patients with bone skull involvement at the time of diagnosis. The outcome is dismal, and 3 out of 6 patients died for progressive disease. [ABSTRACT FROM AUTHOR]

Purpose: The use of medicines among newborns admitted to intensive care units is characterized by a high prevalence of off-label/unlicensed use and a wide variability in the absence of international guidelines. A prospective cross-sectional study was organized with the aim to analyse drug prescriptions among all 107 Italian level III neonatal intensive care units. Methods: An online questionnaire was used to collect detailed information for each newborn, and a classification was made about the license status of all prescriptions. In addition, prescriptions were analysed taking into account a practical guide prepared by the Italian Society of Neonatology (ISN). Results: The 1-day survey (May-July 2014) regarded 220 newborn infants admitted to 36/107 Italian neonatal intensive care units: 191 prematures and 29 born at term. In total, 720 prescriptions (corresponding to 79 different drugs) were analysed: 191 (26.5 %) followed the terms of the product license, 529 (73.5 %) were off-label or unlicensed: 193/220 newborns (87.7 %) received at least one off-label/unlicensed prescription. Antiinfectives were the most common medicine used, followed by respiratory drugs and antianaemics; in an off-label manner, the most common was cardiovascular and central nervous system (CNS) drugs, gastrointestinals and antiinfectives. The most common categories of off-label use were age (34.4 %) and dosing frequency (20.6 %). Compared to ISN practical guide, prescriptions adhered more frequently to indications (100 % for ampicillin/sulbactam, >80 % for ampicillin, fluconazole, fentanyl, ranitidine and vancomicin). Conclusions: Our results confirm the high prevalence of off-label/unlicensed drug use in the neonatal population and underline a better adherence to indications based on clinical practice, suggesting the need to update information contained in the data sheets of medicines. [ABSTRACT FROM AUTHOR]

This study was aimed at comparing adolescent and young adult (AYA) Hematopoietic Stem Cell Transplantation (HSCT) paediatric cancer survivors and a control group of healthy peers in terms of Health‐Related Quality of Life (HRQOL) and frequency of posttraumatic stress symptoms (PTSS). The participants were 32 AYA HSCT survivors and 28 matched healthy peers. The survivors were, on average, 19.4 years old (SD = 3.8), with an average age of 8.1 years (SD = 4.3) at diagnosis, and with a mean time, since treatment was completed, of 8.5 years (SD = 3.2). The majority of survivors (78.1%) did not show clinical PTSS, with intrusion symptoms most frequently reported in those who had undergone autologous HSCT (F = 3.3; df = 2; p = 0.05) and relapse presence in their treatment associated with more PTSS avoidance symptoms (r = 0.4; p = 0.002). Women reported more problems in the SF‐36 pain scale (t = 2.1; df = 31; p = 0.04) than men. Additionally, 87.5% of survivors fell below the 25th percentile in the SF‐36 general well‐being scale, and 70.8% had the same trend for the SF‐36 fatigue scale. Survivors reported better emotional well‐being (t = 2.6, df = 27, p = 0.01) and fewer limitations than their healthy peers (t = 2.5, df = 27, p = 0.02), while they perceived a lower life satisfaction referring to the past (t = −2.8, df = 27, p = 0.009). [ABSTRACT FROM AUTHOR]