1,721,010 research outputs found
Severe and protracted diarrhea: results of the 3-year SIGEP multicenter survey. Working Group of the Italian Society of Pediatric Gastroenterology and Hepatology
No full textRepetitive acute pain in infants born preterm: an age-specific nonpharmacological approach
No full textPurpose of the study: to examine the age-related
effectiveness of simple non-pharmacological interventions
in reducing procedural pain in ex-preterm infants during
a series of repetitive immunizations.
Background: Infant pain is of critical interest, especially
with respect to premature infants often exposed to
protracted pain and recurring painful procedures. Despite
the accumulating evidence that preterm neonates are
highly sensitive to pain and that neonatal procedural pain
is harmful and may lead to changes in neural development,
treatment for painful procedures is limited. Children
born preterm routinely undergo a series of monthly
immunizations in order to prevent upper respiratory
infections. These painful immunizations impact on an
infant that experienced a mean of 14 stressful and painful
procedures a day, during the period of hospitalization,
which may have lasted for months. Given this, special
attention is required to the development and use of age
appropriate approaches that reduce the impact of painful
procedures and to improve the treatment of repetitive pain
in this particular group of vulnerable neonates.
Methods: A Single Case Experimental Desing was
used. 37 Italian children born pre-term were assigned to
four non-pharmacological interventions (1: 25% sucrose
solution in combination with oral stimulation by a pacifier;
2: visual–auditory distraction; 3: play interaction and
4: blowing soap bubbles). Reflecting the maturational level
of the infants, considering age corrected for gestational
age, each infant received the first intervention at his first
immunization (out of five) and whenever no pain relieve
was obtained, the next immunization was performed
with the second intervention. Assessment of video-taped
behaviour and crying, time to first cry, time to stop cry and
total time required for the immunization procedure were
used as outcome measures and assess by six independent
observers.
Results and Conclusions: following the maturation of
the infant, visual-auditory distraction (using the more complex capacity of visual auditory integration), play
interaction and blowing soap bubbles (using the capacity
to participate in interactive play) all proved to be effective
in delaying distress, reducing the facial display of pain and
especially in reducing the time necessary to calm and console
the infant. In addition, negative hospital experiences,
length of stay together with gestational age and weight at
birth should be considered important factors that influence
the initial reaction to the first immunization. Sucrose in
the presence of a pacifier significantly reduced pain and
distress up to an age of 60 weeks corrected for gestational
age. Furthermore these factors may underlie the extended
efficacy of oral sucrose combined with a pacifier by altering
the responsiveness of the immature nervous system
to adverse events. This observation extends the effects of
sucrose plus pacifier much beyond the period in which
they are effective in term neonates. Finally, adjusting the
method of non-pharmacological intervention according to
age and maturational level will not only lead to the highest
efficacy of pain management but will also lead to a reduction
in stress as well as in time spend for the medical staff
Going Beyond Counting First Authors in Author Co-citation Analysis
Full text linkThe present study examines one of the fundamental aspects of author co-citation analysis (ACA) - the way co-citation
counts are defined. Co-citation counting provides the data on which all subsequent statistical analyses and mappings
are based, and we compare ACA results based on two different types of co-citation counting - the traditional type that
only counts the first one among a cited work's authors on the one hand and a non-traditional type that takes into
account the first 5 authors of a cited work on the other hand. Results indicate that the picture produced through this non-traditional author co-citation counting contains more coherent author groups and is therefore considerably clearer. However, this picture represents fewer specialties in the research field being studied than that produced through the traditional first-author co-citation counting when the same number of top-ranked authors is selected and analyzed. Reasons for these effects are discussed
Severe and protracted diarrhoea (SPD): results of the 3-years SIGEP multicentric survey.
No full textBACKGROUND: The spectrum of severe and protracted diarrhea (SPD), previously defined as intractable diarrhea, has changed during the past several decades. Despite recent advances in determining the cause of SPD and in treatment, this syndrome still represents a challenge and is becoming a major problem affecting health care resources. This study was conducted to characterize the epidemiology, spectrum of causes, and the outcome of SPD in Italy in recent years.
METHODS: All the SPD cases seen at the major centers of pediatric gastroenterology in Italy during a 3-year period (1993-1996) were recruited in this multicenter, prospective survey.
RESULTS: Thirty-two children (26 boys and 6 girls; median age at the onset of SPD, 40 days) were enrolled in this study by 9 of 26 participating centers. Twelve were newly diagnosed cases, with an estimated SPD incidence rate in Italy of 0.64 to 0.92 x 10(-5) infants per year. The most common causes were autoimmune enteropathy (n = 8) and ultrastructural abnormalities of the enterocyte (n = 7), whereas food intolerance and postenteritis syndrome were less frequent (3 and 2 cases, respectively). Two children with autoimmune enteropathy fulfilled the criteria for the X-linked variant of this condition. At the end of the study period, 9 of 31 patients had recovered, 15 still had diarrhea, and 7 had died.
CONCLUSIONS: Severe and protracted diarrhea is a rare but challenging problem in Italy. Because parenteral nutrition or intestinal transplantation are the only options in a subset of cases (e.g., ultrastructural abnormalities of the enterocyte), infants with SPD should be referred to specialized centers where advanced diagnostic and therapeutic facilities are availabl
Variations on the Author
Full text link“Variations on the Author” discusses two of Eduardo Coutinho’s recent films (Um Dia na Vida, from 2010, and Últimas Conversas, posthumously released in 2015) and their contribution to the general question of documentary authorship. The director’s filmography is characterized by a consistent yet self-effacing form of authorial self-inscription: Coutinho often features as an interviewer that rather than express opinions propels discourses; an interviewer that is good at listening. This mode of self-inscription characterizes him as an author who is not expressive but who is nonetheless markedly present on the screen. In Um Dia na Vida, however, Coutinho is completely absent form the image, while Últimas Conversas, on the contrary, includes a confessional prologue that moves the director from the margins to the center of his films. This article examines the ways in which these works stand out in the filmography of a director who offers new insights into the notion of cinematic authorship
Case report: A case of Rabson–Mendenhall syndrome: long-term follow-up and therapeutic management with empagliflozin
Full text linkBackground: Rabson–Mendenhall syndrome (RMS), a rare disorder characterized by severe insulin resistance due to biallelic loss-of-function variants of the insulin receptor gene (INSR), presents therapeutic challenges (OMIM: 262190). This case study explores the efficacy of adjunctive therapy with sodium–glucose cotransporter 2 inhibitors (SGLT2is) in the management of RMS in an 11-year-old male patient with compound heterozygous pathogenic variants of INSR. Methods: Despite initial efforts to regulate glycemia with insulin therapy followed by metformin treatment, achieving stable glycemic control presented a critical challenge, characterized by persistent hyperinsulinism and variable fluctuations in glucose levels. Upon the addition of empagliflozin to metformin, notable improvements in glycated hemoglobin (HbA1c) and time in range (TIR) were observed over a 10-month period. Results: After 10 months of treatment, empagliflozin therapy led to a clinically meaningful reduction in HbA1c levels, decreasing from 8.5% to 7.1%, along with an improvement in TIR from 47% to 74%. Furthermore, regular monitoring effectively averted normoglycemic ketoacidosis, a rare complication associated with SGLT2 inhibitor therapy. Conclusion: This case highlights the potential of SGLT2i as adjunctive therapy in RMS management, particularly in stabilizing glycemic variability. However, further research is warranted to elucidate the long-term efficacy and safety of this therapeutic approach in RMS and similar insulin resistance syndromes
Appropriate Similarity Measures for Author Cocitation Analysis
Full text linkWe provide a number of new insights into the methodological discussion about author cocitation analysis. We first argue that the use of the Pearson correlation for measuring the similarity between authors’ cocitation profiles is not very satisfactory. We then discuss what kind of similarity measures may be used as an alternative to the Pearson correlation. We consider three similarity measures in particular. One is the well-known cosine. The other two similarity measures have not been used before in the bibliometric literature. Finally, we show by means of an example that our findings have a high practical relevance.information science;Pearson correlation;cosine;similarity measure;author cocitation analysis
Severe and protracted diarrhea: Results of the 3-year SIGEP Multicenter survey
No full textBackground: The spectrum of severe and protracted diarrhea (SPD), previously defined as intractable diarrhea, has changed during the past several decades. Despite recent advances in determining the cause of SPD and in treatment, this syndrome still represents a challenge and is becoming a major problem affecting health care resources. This study was conducted to characterize the epidemiology, spectrum of causes, and the outcome of SPD in Italy in recent years. Methods: All the SPD cases seen at the major centers of pediatric gastroenterology in Italy during a 3-year period (1993-1996) were recruited in this multicenter, prospective survey. Results: Thirty-two children (26 boys and 6 girls; median age at the onset of SPD, 40 days) were enrolled in this study by 9 of 26 participating centers. Twelve were newly diagnosed cases, with an estimated SPD incidence rate in Italy of 0.64 to 0.92 x 10-5 infants per year. The most common causes were autoimmune enteropathy (n = 8) and ultrastructural abnormalities of the enterocyte (n = 7), whereas food intolerance and postenteritis syndrome were less frequent (3 and 2 cases, respectively). Two children with autoimmune enteropathy fulfilled the criteria for the X-linked variant of this condition. At the end of the study period, 9 of 31 patients had recovered, 15 still had diarrhea, and 7 had died. Conclusions: Severe and protracted diarrhea is a rare but challenging problem in Italy. Because parenteral nutrition or intestinal transplantation are the only options in a subset of cases (e.g., ultrastructural abnormalities of the enterocyte), infants with SPD should be referred to specialized centers where advanced diagnostic and therapeutic facilities are available. (C) 1999 Lippincott Williams and Wilkins, Inc
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