1,721,015 research outputs found
La melatonina nei disturbi del sonno in bambini e adolescenti con problemi neurocomportamentali
No full textMelatonin, a neurohormone produced by the pineal gland, regulates the sleep-wake circadian rhythm. Sleep disorders are prevalent in children, especially those with neurodevelopmental disorders like autism and other neurodisabilities and affect about 50-75% of this population. The use of melatonin to improve sleep in this population has been debated for over 20 years, with recent re-views addressing its efficacy and safety. Melatonin significantly improves sleep latency and total sleep time in children with autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), and other neurodevelopmental disorders. However, its effectiveness in reducing night awakenings is limited. Short-term use shows no significant association with serious adverse effects, though mild side effects like headache, nausea, drowsiness, and mood changes are common. Long-term safety data are limited but suggest no significant impact on puberty onset or bone health. Dosing and timing of melatonin administration vary widely, and individualized treatment plans are recommended. The use of melatonin should be accompanied by behavioural interventions, and potential side effects should be monitored closely
Widespread rash in a 45-year-old woman after moxifloxacin administration
No full textA 45-year-old African woman presented with fever, throat pain, and a rapidly deteriorating rash after taking moxifloxacin for ten days. She exhibited extensive erythematous and purpuric macules, blisters, and significant mucosal involvement, covering 40% of her body surface area
A model to investigate SNPs' interaction in GWAS studies
No full textGenome-wide association studies (GWAS) are able to identify the role of individual SNPs in influencing a phenotype. Nevertheless, such analysis is unable to explain the biological complexity of several diseases. We elaborated an algorithm that starting from genes in molecular pathways implicated in a phenotype is able to identify SNP-SNP interaction's role in association with the phenotype. The algorithm is based on three steps. Firstly, it identifies the biological pathways (gene ontology) in which the genes under analysis play a role (GeneMANIA). Secondly, it identifies the group of SNPs that best fits the phenotype (and covariates) under analysis, not considering individual SNP regression coefficients but fitting the regression for the group itself. Finally, it operates an analysis of SNP interactions for each possible couple of SNPs within the group. The sensitivity and specificity of our algorithm was validated in simulated datasets (HapGen and Simulate Phenotypes programs). The impact on efficiency deriving from changes in the number of SNPs/patients under analysis, linkage disequilibrium and minor allele frequency thresholds was analyzed. Our algorithm showed a strong stability throughout all analysis operated, resulting in an overall sensitivity of 81.67 % and a specificity of 98.35 %. We elaborated a stable algorithm that may detect SNPs interactions, especially those effects that pass undetected in classical GWAS. This method may contribute to face the two relevant limitations of GWAS: lack of biological informative power and amount of time needed for the analysis
Parvovirus B19 infection in children: a comprehensive review of clinical manifestations and management
Full text linkParvovirus B19 (B19V) is a significant pathogen responsible for a wide range of clinical manifestations, particularly in children and pregnant women. While B19V is most commonly recognized as the cause of Fifth disease, a mild erythematous illness in children, its clinical impact extends far beyond this condition. B19V can lead to severe complications, including transient aplastic crisis in individuals with chronic hemolytic anemias, arthralgia, and more severe joint diseases. During pregnancy, B19V infection poses serious risks, such as spontaneous abortion, non-immune hydrops fetalis, and fetal anemia, particularly when infection occurs between 9 and 20 weeks of gestation. Moreover, B19V is associated with a variety of organ system involvements, including cardiac, neurological, hepatic, and renal complications. These manifestations can range from mild to life-threatening, necessitating a broad spectrum of therapeutic approaches, including symptomatic care, immunoglobulins, corticosteroids, and supportive therapies. Despite the significant clinical burden posed by B19V, no specific antiviral treatment or vaccine is currently available, making early recognition and prompt management crucial for improving patient outcomes. This review provides a comprehensive overview of the diverse clinical presentations of B19V infection, with a focus on pediatric and pregnancy-related complications. It underscores the need for ongoing research into targeted therapies and highlights the importance of vigilant clinical management to mitigate the severe consequences of this pervasive virus
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
Dexmedetomidine as a Promising Neuroprotective Sedoanalgesic in Neonatal Therapeutic Hypothermia: A Systematic Review and Meta-Analysis
Full text linkBackground: Hypoxic-ischemic encephalopathy (HIE) is a leading cause of neonatal mortality and neurodevelopmental disabilities. Therapeutic hypothermia (TH) is the standard of care, but optimized sedoanalgesic strategies remain critical. Dexmedetomidine shows promise as an alternative to traditional sedatives, but its role in this context remains systematically underexplored. Objective: This meta-analysis evaluates the safety and efficacy of dexmedetomidine in neonates undergoing TH for HIE. Methods: A systematic search of Medline, Scopus, EMBASE, WOS, ClinicalTrials, and Cochrane Library identified studies published from January 2014 to October 2024. Studies focusing on dexmedetomidine in neonatal TH with relevant outcomes were included. Selection followed PRISMA guidelines, with independent quality assessments. The protocol was registered in PROSPERO (CRD42024605817). Results are presented as meta-analyses or evidence-based discussions when pooling was unfeasible. Results: Seven studies involving 609 neonates were included: four cohort studies (n = 486) and three case series (n = 123). Dexmedetomidine provided comparable sedation to traditional agents (MD = -0.01 [-0.68 - 0.66], p = 0.99) and significantly reduced seizure risk (OR 0.31 [0.10 - 0.98], p < 0.05) with a non-inferior safety profile. Trends suggested shorter duration of mechanical ventilation and time to full enteral feeding. Substantial heterogeneity in dosing protocols highlights the need for standardization. Conclusions: Dexmedetomidine appears to be a safe and promising sedative in neonatal TH for HIE, with potential neuroprotective, respiratory, and gastrointestinal benefits. Despite limited evidence and the absence of randomized clinical trials, its non-inferior efficacy and safety warrant further exploration and urges the development of standardized dosing protocols
Otomastoidite, trombosi venosa cerebrale e ipertensione endocranica: alcune condivisioni sulla gestione
No full textVariations 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
Le diverse facce del parvovirus B19
No full textParvovirus B19 (B19V) is classically known as the etiologic
agent of Fifth disease, typically characterised by mild symp
toms (as fever, myalgias and headache), confluent erythema
on the cheeks (“slapped cheeks”) and subsequent symmetri
cal reticulated rash on the body. However, in some cases,
the B19V rash may have different features and the infection
may be associated with potentially serious complications.
The paper presents a case of a 5-year-old child with an atyp
ical skin manifestation of B19V (pustular rash) and a severe
course of infection with cardiac involvement. Although, in
most cases the typical skin expression of B19V is Fifth dis
ease, the rash may also occur in other forms, such as morbil
liform, confluent, vesicular or pustular. Furthermore, the infec
tion, usually benign and self-limiting, may be associated with
severe manifestations involving multiple organ systems (car
diac, neurological, hepatic, and renal)s with need of differ
ent treatment strategies (symptomatic, immunoglobulin, corti
costeroid, or other forms of care). Early recognition and time
ly intervention are critical to improving the outcome of pa
tients with B19V-related complications
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