20 research outputs found
Increased Frequency of Diabetic Ketoacidosis: The Link With COVID-19 Pandemic
No full textAims: Diabetic ketoacidosis is the most severe metabolic derangement due to prolonged insulin deficiency as in type 1 diabetes. Diabetic ketoacidosis, a life-threatening condition, is often diagnosed late. A timely diagnosis is mandatory to prevent its consequences, mainly neurological. The COVID-19 pandemic and lockdown have reduced the availability of medical care and access to hospitals. The aim of our retrospective study was to compare the frequency of ketoacidosis at the diagnosis of type 1 diabetes between the lockdown-post lockdown period and the previous two calendar years, in order to evaluate the impact of the COVID-19 pandemic. Patients and Methods: We retrospectively assessed the clinical and metabolic data at the diagnosis of type 1 diabetes in children in the Liguria Region during 3 different time periods: calendar year 2018 (Period A), calendar year 2019 until February 23,2020 (Period B) and from February 24, 2020 onwards to March 31, 2021 (Period C). Results: We analyzed 99 patients with newly-diagnosed T1DM from 01/01/2018 to 31/03/2021. Briefly, a younger age at diagnosis of T1DM was observed in Period 2 compared to Period 1 (p = 0.03). The frequency of DKA at clinical onset of T1DM was similar in Period A (32.3%) and Period B (37.5%), while it significantly increased in Period C (61.1%) compared to Period B (37.5%) (p = 0.03). PH values were similar in Period A (7.29 ± 0.14) and Period B (7.27 ± 0.17), while they were significantly lower in Period C (7.21 ± 0.17) compared to Period B (p = 0.04). Conclusions: An increase in the frequency of diabetic ketoacidosis has been documented in newly diagnosed pediatric patients in the Liguria Region during and after the lockdown period compared to previous calendar years. This increase could have been caused by the delay in diagnosis following the restrictions imposed by the lockdown with consequently reduced access to health care facilities. More information on the risks of ketoacidosis is desirable by means of social and medical awareness campaigns
Glacial/interglacial changes of Southern Hemisphere wind circulation from the geochemistry of South American dust
No full textThe latitudinal displacement of the southern westerlies and associated climate systems is a key parameter for understanding the variations of Southern Hemisphere atmospheric circulation during the Late Quaternary Period. To increase understanding of past atmospheric circulation and of the paleo-environmental conditions associated with continental dust sources, we dig deeper into dust provenance in paleo-archives of the Southern Hemisphere. We present here a Sr?Nd isotopic and rare earth element study of surface sediments collected along a ∼4000 km latitudinal band from arid and semi-arid terrains in southern South America. Findings from terrains that served as paleo-dust suppliers are compared with modern dust collected from monitoring stations along the same latitudinal band, which affords a test on how actual present-day aeolian compositions compare to those of the past potential source areas. Moreover, the comparison between past and present-day datasets is useful for understanding present-day atmospheric circulation. Armed with a new comprehensive dataset, we revise previous interpretations of the provenance of dust trapped in the Antarctic ice and sediments deposited in the South Atlantic sector of the Southern Ocean. These comparisons support multiple source regions in southern South America that changed with climates. The findings reveal that, although Patagonia plays an important role in contributing dust to the higher latitudes, central Western Argentina and (to a lesser extent) the southern Puna region also emerge as potentially important dust sources during glacial times. The southern Altiplano appears to be a major contributor during interglacial periods as well. We rely in part on an understanding of modern wind?dust activities to conclude that the possible presence of southern South America source regions ? other than Patagonia ? in East Antarctic ice is consistent with an overall equatorward displacement during glacial times of both the mid-latitude westerlies and the subtropical jet stream.Fil: Gili, Stefania. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Centro de Investigaciones en Ciencias de la Tierra. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Centro de Investigaciones en Ciencias de la Tierra; ArgentinaFil: Gaiero, Diego Marcelo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Córdoba. Centro de Investigaciones en Ciencias de la Tierra. Universidad Nacional de Córdoba. Facultad de Ciencias Exactas Físicas y Naturales. Centro de Investigaciones en Ciencias de la Tierra; ArgentinaFil: Goldstein, Steven L.. Columbia University; Estados UnidosFil: Chemale, Farid. Universidade do Vale do Rio dos Sinos; BrasilFil: Jweda, Jason. Columbia University; Estados UnidosFil: Kaplan, Michael R.. Columbia University; Estados UnidosFil: Becchio, Raul Alberto. Universidad Nacional de Salta; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Koester, Edinei. Universidade Federal do Rio Grande do Sul; Brasi
Ground/satellite observations and atmospheric modeling of dust storms originating in the high Puna-Altiplano deserts (South America): Implications for the interpretation of paleo-climatic archives
No full textThis study provides a detailed description of the sources, transport, dispersion, and deposition of two major dust events originating from the high‐altitude subtropical Puna‐Altiplano Plateau (15?26°S; 65?69°W) in South America. A long and severe drought provided the right conditions for the onset of both events in July 2009 and 2010. Dust was transported SE and deposited over the Pampas region and was observed to continue to the Atlantic Ocean. Dust monitoring stations located downwind recorded both events, and samples were characterized through chemical and textural analysis. Through a combination of meteorological data and satellite observations (CALIPSO andMODIS detectors), we estimate the emission flux for the 2010 event. This estimate was used to constrain the Hybrid Single Particle Lagrangian Integrated Trajectory (HYSPLIT) transport model and simulate the dust event. Both satellite imagery and model results agree in the location and extension of the dust cloud. CALIPSO detected dust between ~6000 and ~8500 m a.s.l., which remained at this height during most of its trajectory. The dust cloud mixed with a strong convective system in the region, and the associated precipitation brought down significant amounts of dust to the ground. Dust particle size analysis for both events indicates that near the sources dust samples show median modes of 12.4?14.1 μm, similar to modes observed 1300 km away. Chemical composition of sediments from potential dust sources shows distinct signatures within the Puna‐Altiplano Plateau, the Puna sector being clearly different from the Altiplano area. In addition, both sources are markedly different from the Patagonian chemical fingerprint.These results have important implications to improve the interpretation of aleoenvironmental archives preserved on the Argentine loess, Antarctic ice cores, and Southern Ocean marine sediments.Fil: Gaiero, Diego Marcelo. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico - CONICET - Córdoba. Centro de Investigaciones en Ciencias de la Tierra; ArgentinaFil: Simonella, Lucio Esteban. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico - CONICET - Córdoba. Centro de Investigaciones en Ciencias de la Tierra; ArgentinaFil: Gassó, Santiago. Morgan State University; Estados UnidosFil: Gili, Stefania. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Cientifico Tecnológico - CONICET - Córdoba. Centro de Investigaciones en Ciencias de la Tierra; ArgentinaFil: Stein, A. F.. No especifíca;Fil: Sosa, P.. Universidad Nacional de Salta; ArgentinaFil: Becchio, Raul Alberto. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico - CONICET - Salta. Instituto de Investigaciones en Energía no Convencional; ArgentinaFil: Arce, J.. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Córdoba. Estación Experimental Agropecuaria;Fil: Marelli, H.. Instituto Nacional de Tecnología Agropecuaria. Centro Regional Córdoba. Estación Experimental Agropecuaria
It takes three to tango: the importance of microbes, host plant, and soil management to elucidate manipulation strategies for the plant microbiome
No full textThe world’s population is expected to grow to almost 10 billion by 2050, placing unprecedented demands on agriculture and natural resources. The risk in food security is also aggravated by climate change and land degradation, which compromise agricultural productivity. In recent years, our understanding of the role of microbial communities on ecosystem functioning, including plant-associated microbes, has advanced considerably. Yet, translating this knowledge into practical agricultural technologies is challenged by the intrinsic complexity of agroecosystems. Here, we review current strategies for plant microbiome manipulation, classifying them into three main pillars: (i) introducing and engineering microbiomes, (ii) breeding and engineering the host plant, and (iii) selecting agricultural practices that enhance resident soil and plant-associated microbial communities. In each of these areas, we analyze current trends in research, as well as research priorities and future perspectives.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author
Salbutamol for transient tachypnea of the newborn
No full textBackground: Transient tachypnea of the newborn is characterized by tachypnea and signs of respiratory distress. Transient tachypnea typically appears within the first two hours of life in term and late preterm newborns. Although transient tachypnea of the newborn is usually a self limited condition, it is associated with wheezing syndromes in late childhood. The rationale for the use of salbutamol (albuterol) for transient tachypnea of the newborn is based on studies showing that β-agonists can accelerate the rate of alveolar fluid clearance. Objectives: To assess whether salbutamol compared to placebo, no treatment or any other drugs administered to treat transient tachypnea of the newborn, is effective and safe in the treatment of transient tachypnea of the newborn in infants born at 34 weeks' gestational age or more. Search methods: We searched the Cochrane Central Register of Controlled Trials (CENTRAL, 2016, Issue 3), MEDLINE (1996 to March 2016), EMBASE (1980 to March 2016) and CINAHL (1982 to March 2016). We applied no language restrictions. We searched the abstracts of the major congresses in the field (Perinatal Society of Australia New Zealand and Pediatric Academic Societies) from 2000 to 2015 and clinical trial registries. Selection criteria: Randomized controlled trials, quasi-randomized controlled trials and cluster trials comparing salbutamol versus placebo or no treatment or any other drugs administered to infants born at 34 weeks' gestational age or more and less than three days of age with transient tachypnea of the newborn. Data collection and analysis: For each of the included trials, two review authors independently extracted data (e.g. number of participants, birth weight, gestational age, duration of oxygen therapy, need for continuous positive airway pressure and need for mechanical ventilation, duration of mechanical ventilation, etc.) and assessed the risk of bias (e.g. adequacy of randomization, blinding, completeness of follow-up). The primary outcomes considered in this review were duration of oxygen therapy, need for continuous positive airway pressure and need for mechanical ventilation. Main results: Three trials, which included 140 infants, met the inclusion criteria. All three trials compared a nebulized dose of salbutamol with placebo; in one of the three trials newborns were assigned to two different doses of the intervention. We found differences in the duration of oxygen therapy (mean difference (MD) -43.10 hours, 95% confidence interval (CI) -81.60 to -4.60). There were no differences in the need for continuous positive airway pressure (risk ratio (RR) 0.73, 95% CI 0.38 to 1.39; risk difference (RD) -0.15, 95% CI -0.45 to 0.16; 1 study, 46 infants) or the need for mechanical ventilation (RR 1.50, 95% CI 0.06 to 34.79; RD 0.03, 95% CI -0.08 to 0.14; 1 study, 46 infants). Tests for heterogeneity were not applicable for any of the analyses as only one study was included. Among secondary outcomes, we found no differences in terms of duration of hospital stay and tachypnea. The quality of the evidence was very low due to the imprecision of the estimates. One trial is ongoing. Authors' conclusions: At present there is insufficient evidence to determine the efficacy and safety of salbutamol in the management of transient tachypnea of the newborn. The quality of evidence was low due to paucity of included trials, small sample sizes and overall poor methodologic quality
Early Pediatric Benefit of Lutein for Maturing Eyes and Brain—An Overview
No full textLutein is a dietary carotenoid preferentially accumulated in the eye and the brain in early life and throughout the life span. Lutein accumulation in areas of high metabolism and oxidative stress such as the eye and the brain suggest a unique role of this ingredient during the development and maturation of these organs of common embryological origin. Lutein is naturally provided to the developing baby via the cord blood, breast milk and then infant diet. The presence of this carotenoid depends on fruit and vegetable intakes and its bioavailability is higher in breastmilk. This paper aims to review the anatomical development of the eye and the brain, explore the presence and selective deposition of lutein in these organs during pregnancy and infancy and, based on its functional characteristics, present the latest available research on the beneficial role of lutein in the pediatric population. The potential effects of lutein in ameliorating conditions associated with increase oxidative stress such as in prematurity will be also addressed. Since consumption of lutein rich foods falls short of government guidelines and in most region of the world infant formulas lack this bioactive, dietary recommendations for pregnant and breastfeeding women and their child can help to bridge the gap
Collinearity between potato (Solanum tuberosum L.) and wild relatives assessed by comparative cytogenetic mapping
No full textA major bottleneck to Introgressive hybridization is the lack of genome collinearity between the donor (alien) genome and the recipient crop genome. Structural differences between the homeologs may create unbalanced segregation of chromosomes or cause linkage drag. To assess large-scale collinearity between potato and two of its wild relatives (Solanum commersonii and S. chacoense), we used BAC-FISH mapping of sequences with known positions on the RH potato map. BAC probes could successfully be hybridized to the S. commersonii and S. chachoense pachytene chromosomes, confirming their correspondence with linkage groups in RH potato. Our study shows that the order of BAC signals is conserved. Distances between BAC signals were quantified and compared; some differences found suggest either small-scale rearrangements or reduction/amplification of repeats. We conclude that S. commersonii and S. chacoense are collinear with cultivated S. tuberosum on the whole chromosome scale, making these amenable species for efficient introgressive hybridization breeding.The accepted manuscript in pdf format is listed with the files at the bottom of this page. The presentation of the authors' names and (or) special characters in the title of the manuscript may differ slightly between what is listed on this page and what is listed in the pdf file of the accepted manuscript; that in the pdf file of the accepted manuscript is what was submitted by the author
Maxillofacial features and systemic malformations in expanded spectrum Hemifacial Microsomia
No full textHub-and-Spoke regional system supported by telehealth for managing coeliac disease in Liguria: a mixed-methods survey followed by an observational pilot study
No full textAbstract Background Due to the need to reorganize the care network for the national screening mandated by law, a new healthcare model was required for the management of coeliac disease. The hub-and-spoke model is a new healthcare organizational system, here we describe its application (supported by telehealth), in the management of pediatric coeliac disease (CD) in Liguria. The results of the pilot phase are presented and the system's strengths and weaknesses discussed. Methods A mixed-methods survey followed by an observational pilot study was performed. A multiphase approach was used including preparation setting, operative planning and application. The pilot phase involves a single primary center. The reduction of families’ expenditure and environmental impact was assessed using the Viamichelin calculator. Results A regional meeting followed by a survey (specifically developed for this study) and a needs analysis highlighted the priority to have an efficient, up to date and homogeneous model of care assistance throughout the network. A diagnostic and therapeutic care pathway (PDTC) was developed by the regional working group. The project involved 986 Ligurian families and allowed a 90% reduction in the distance traveled by families residing within the pilot center’s catchment area, saving €177 and 113 kg of CO2 on average per family per year. Conclusions The Gaslini Diffuso hub-and-spoke system for managing CD in Liguria exemplifies a commitment to enhancing healthcare efficiency and patient care, reducing environmental impact and cost for both family and healthcare system
Unmet needs of Italian centers for pediatric diabetes care: analysis of a survey among pediatric diabetologists facing the national screening program for Type 1 Diabetes
No full textBackgroundsThe incidence of Type 1 Diabetes (T1D) in children and adolescents is increasing by 3-4% per year. Children and adolescents with T1D (CwD) should receive person-centered, specialized treatment from a multidisciplinary team to ensure appropriate care. Italy is the first to implement a countrywide T1D screening program, which will raise the need for funding for specialized pediatric care. The study aims to update the organization of the Italian Centers for pediatric diabetes care.MethodsIn 2022, members of the 59 Italian Centers following CwD were invited to complete an email survey regarding the Centers' organization, characteristics, and activities. The questionnaire included information on responders, department organization, team composition, activities, and the organizational structures: department, ambulatory care services (AC), simple operational units (UOS), simple departmental operational units (UOSd), and complex operational units (UOC).ResultsThe data collected referred to the year 2022. According to the results, 21,318 people with diabetes were treated. Of these, 19,643 subjects (92.1%) have T1D (16,672 were CwD), 387 (1,8%) have Type 2 Diabetes, and 1,288 (6,1%) have other forms of diabetes. Compared to the 2012 survey, a 13% decrease (from 68 to 59 Centers) in the number of pediatric Centers caring for CwD was observed with a parallel increase of total (+ 6.6%) and average (+ 22%) number of CwD per Center. The estimated prevalence of T1D has increased (1.4 vs. 1.7 per 1,000 CwD-2012 vs. 2022). A reduction in numbers for AC (-22%) and UOS (-35%) was observed, whereas UOSd/UOC increased by 50%. Almost 35% of the dietitians and 40% of the psychologists were not permanent members of the multidisciplinary diabetes team.ConclusionsThe observed decrease in the overall number of pediatric diabetes Centers, the reduction in specialized and dedicated HCPs, and the concurrent increase in the number of treated CwD in the last ten years indicate an alarming situation for pediatric diabetes treatment in Italy. Furthermore, the projected rise in CwD due to the National T1D screening program emphasizes the need for increased resources for specialized pediatric care of CwD at all stages
