Subcutaneous fat necrosis (SCFN) of the newborn is an uncommon dermatologic disorder characterized by firm, palpable subcutaneous nodules or plaques with or without erythema. Despite its benign course, SCFN may become complicated by extracutaneous manifestations. Hypercalcemia is considered a rare complication, but it is potentially fatal if unrecognized. During the last several years therapeutic hypothermia (TH) became an essential new therapeutic modality for severe neonatal asphyxia. We report a neonate who presented with SCFN and hypercalcemia following hypothermia therapy for hypoxic ischemic encephalopathy (HIE) and provide a review of the contemporary literature on the topic. We believe that this is important since the use of TH is rapidly increasing, and therefore, the possible side effects including SCFN and hypercalcemia may also become more prevalent. This prompts the need for awareness by treating physicians for this complication.

Aim To evaluate the effect of nutritional supplementation on height, weight and body composition in short and lean male preadolescents. Methods A randomised, double‐blinded, placebo‐controlled trial of nutritional supplementation of short and lean prepubertal 10–14.5‐year‐old boys. Primary outcomes included Δheight‐SDS and Δweight‐SDS. Secondary outcomes included changes in body composition and BMI‐SDS. Results Of 160 boys enrolled, 126 (80%) completed 6 months’ intervention. Baseline age, height‐SDS, weight‐SDS, BMI‐SDS, body composition and dietary intake were similar in the formula and placebo groups. ‘Good’ formula consumers (intake of ≥50% of the recommended dose, n = 30) gained significantly more in weight‐SDS, BMI‐SDS, fat‐free‐mass and muscle mass (p < 0.05) than did ‘poor’ consumers (n = 35) and the placebo group (n = 61). Only in the formula group, positive dose‐response correlations were found between consumption of the formula and changes in the outcome parameters examined, including Δheight‐SDS (r = 0.301, p = 0.015). Boys aged >11.4 years who were ‘good’ formula consumers maintained their Δheight‐SDS, while Δheight‐SDS declined in ‘poor’ consumers and the placebo group of the same age (p = 0.033). Conclusion Intervention with a multi‐nutrient, protein‐rich formula was effective in increasing weight‐SDS, fat‐free‐mass, muscle mass and BMI‐SDS in short and lean prepubertal male adolescents. Good consumption of the formula prevented Δheight‐SDS decline in the older participants.

Objective To describe clinical manifestations of SARS-CoV-2 infection in children, adolescents, and young adults with established type 1 diabetes and explore the effects of COVID-19 on glycemic control and disease course. Methods Observational study conducted at three pediatric diabetes clinics in Israel between mid-March-2020 and mid-March-2021. Included were young people with established type 1 diabetes, &lt;30years, who tested positive for SARS-CoV-2 (qRT-PCR). Data was collected from medical files, diabetes devices, and COVID-19 questionnaire. Outcome measures were analyzed by presence/absence of clinical symptoms (symptomatic/asymptomatic) and by age group (pediatric, &lt;19years/young adults, 19-30years). Results Of 132 patients, mean age 16.9±5.3years, with COVID-19 confirmed infection, 103 (78%) had related symptoms; the most common were headaches, fatigue, fever and loss of sense of smell. All had mild disease course, but four required hospitalization and two cases were directly related to COVID-19 infection (pleuropneumonia in a patient with immunodeficiency syndrome, one case of diabetic-ketoacidosis). Logistic regression analysis showed that age (OR=1.11, 95%CI, 1.01, 1.23; P=0.033), elevated glucose levels (OR=5.23, 95%CI, 1.12, 24.41; P=0.035) and comorbidities (OR=8.21, 95%CI, 1.00, 67.51; P=0.050) were positively associated with symptomatic infection. Persistent symptoms occurred in 16.5% of the cohort over a median of 6.7 months; age (OR=1.14, 95%CI, 1.01, 1.29; P=0.030) and elevated glucose levels (OR=3.42, 95%CI, 1.12, 10.40; P=0.031) were positively associated with persistent symptoms. Usually, no change was reported in glucose levels (64%) except for a temporary deterioration in glycemic control during the short infection period. Conclusions Young people with established type 1 diabetes experience mild COVID-19 infection. Elevated glucose levels during COVID-19 infection and older age were associated with prolonged disease course.