1,720,965 research outputs found
Incidental finding of an isolated double-orifice mitral valve in an asymptomatic man
No full textDouble-orifice mitral valve (DOMV) is a very rare congenital anomaly that usually presents as mitral regurgitation. We present the case of a 39-year-old asymptomatic, healthy man with no previous medical history who was affected by isolated complete bridge type DOMV, incidentally detected by two-dimensional echocardiographic examination in the parasternal short-axis view. The mitral valve of the patient was normally functioning without any other coexistent cardiac abnormalities. Isolated DOMV was also confirmed by cardiac magnetic resonance imaging. The patient is now followed up to detect possible complications
Effects of anakinra on health-related quality of life in a patient with 1129G > A/928G > A mutations in MVK gene and heterozygosity for the mutation 2107C > A in CIAS1 gene
No full textMevalonate kinase deficiency impairs several aspects of the patient's quality of life, thus early diagnosis and treatment are required to improve health-related quality of life (HRQOL). A 15-year-old patient with double heterozygosity for the mutations 1129G > A and 928G > A in MVK gene, heterozygosity for the mutation 2107C > A in CIAS1 gene and hyper-IgD syndrome phenotype, has been treated with anakinra with a reduction of 50% in the number of fever episodes per month, a reduction of 33% in the days of fever for each attack and normal blood tests in the intercritical phase. The RAND 36-Item Health Survey has been used for the assessment of HRQOL before and after the treatment with anakinra. The patient's quality of life showed an overall improvement of 27%; results showed a better improvement in role limitations due to physical health (50%)
Effect of the treatment with β-glucan in women with cervical cytologic report of atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesions (L-SIL)
No full textThe aim of this study was to evaluate the effect of β-glucan in women with ASCUS or L-SIL, as detected by cervical cytologic screening.Aim: The aim of this study was to evaluate the effect of β-glucan in women with ASCUS or L-SIL, as detected by cervical cytologic screening.
Methods: A total of 356 women with ASCUS or L-SIL were enrolled and divided into two groups: 1) 176 patients, treated with topical β-glucan; and 2) 180 patients who were only followed-up. The treatment consisted of two cycles of topical β-glucan applied once a day for 20 consecutive days and treatment separated by ten days. The effect of β-glucan was evaluated comparing Pap cytology results and colposcopic findings between treated patients and controls after 6 and 12 months of follow-up.
Results: After 6 months from enrollment, 63.1% (111/176) of patients treated with β-glucan had a negative Pap smear versus 45% (81/180) of controls (P<0.001), and 43.4% (36/83) of treated patients versus 18.2% (14/77) of controls experienced the disappearance of colposcopic lesions (P=0.001). At the end of the 12-month follow up, 83.5% (147/176) of treated patients versus 60% (108/180) of controls had a negative Pap smear (P<0.001), and 55.4% (46/83) of treated patients versus 24.7% (19/77) of controls experienced the disappearance of colposcopic lesions (P<0.001). No side effects were observed in treated patients.
Conclusion: β-glucan increases the spontaneous regression rate of low-grade cytologic abnormalities as well as cervical findings
Early-onset sepsis risk calculator: a review of its effectiveness and comparative study with our evidence-based local guidelines
Full text linkBackground: According to most early-onset sepsis (EOS) management guidelines, approximately 10% of the total
neonatal population are exposed to antibiotics in the first postnatal days with subsequent increase of neonatal and
pediatric comorbidities. A review of literature demonstrates the effectiveness of EOS calculator in reducing
antibiotic overtreatment and NICU admission among neonates ≥34 weeks’ gestational age (GA); however, some
missed cases of culture-positive EOS have also been described.
Methods: Single-center retrospective study from 1st January 2018 to 31st December 2018 conducted in the
Division of Neonatology at Santa Chiara Hospital (Pisa, Italy). Neonates ≥34 weeks’ GA with birth weight ≤ 1500 g,
34–36 weeks’ GA neonates with suspected intraamniotic infection and neonates ≥34 weeks’ GA with three clinical
signs of EOS or two signs and one risk factor for EOS receive empirical antibiotics. Neonates ≥34 weeks’ GA with
risk factors for EOS or with one clinical indicator of EOS undergo serial measurements of C-reactive protein and
procalcitonin in the first 48–72 h of life; they receive empirical antibiotics in case of abnormalities at blood exams
with one or more clinical signs of EOS. Two hundred sixty-five patients at risk for EOS met inclusion criteria; they
were divided into 3 study groups: 34–36 weeks’ GA newborns (n = 95, group A), ≥ 37 weeks’ GA newborns (n =
170, group B), and ≥ 34 weeks’ GA newborns (n = 265, group A + B). For each group, we compared the number of
patients for which antibiotics would have been needed, based on EOS calculator, and the number of the same
patients we treated with antibiotics during the study period. Comparisons between the groups were performed
using McNemar’s test and statistical significance was set at p < 0.05; post-hoc power analysis was carried out to
evaluate the sample sizes.
Results: 32/265 (12.1%) neonates ≥34 weeks’ GA received antibiotics within the first 12 h of life. According to EOS
calculator 55/265 (20.7%) patients would have received antibiotics with EOS incidence 2/1000 live births (p < 0.0001).
Conclusion: Our evidence-based protocol entails a further decrease of antibiotic overtreatment compared to EOS
calculator. No negative consequences for patients were observed
Alimentazione complementare e crescita nel neonato pretermine: studio di coorte
No full textLa stragrande maggioranza dei neonati pretermine è a rischio di malnutrizione, che è associata ad
una restrizione della crescita (1). È stato ampiamente dimostrato che vi sono delle finestre temporali, nel corso dei primi
mesi di vita, per mettere in atto un approccio nutrizionale adeguato, che possa influenzare la crescita a lungo termine
(2). Le evidenze disponibili in letteratura hanno dimostrato che il timing di introduzione dell’alimentazione complementare
influenza la crescita, nei neonati a termine (3). Tuttavia, le linee guida internazionali si sono focalizzate solo su
neonati sani e a termine. Resta da definire un consenso, in letteratura scientifica, sull’adeguata tempistica di avvio della
nutrizione complementare, nel neonato pretermine (4).
Materiali e metodi: In uno studio di Coorte abbiamo valutato le conseguenze di un differente timing di introduzione
dell’alimentazione complementare sui parametri auxologici, a 12 mesi di età corretta. Abbiamo incluso i neonati con
età gestazionale ≤ 32 settimane e/o un peso alla nascita ≤ 1500 g, consecutivamente osservati presso l’Unità Operativa
Complessa di Neonatologia, Patologia e Terapia Intensiva Neonatale del Policlinico Umberto I, Università La Sapienza
di Roma. Abbiamo, quindi, studiato due Coorti: (i) alimentazione complementare precoce (prima dei 6 mesi di età corretta;
(ii) alimentazione complementare tardiva (dopo i 6 mesi di età corretta). I parametri di crescita (peso, lunghezza,
indice di massa corporea) sono stati misurati a 12 mesi di età corretta.
Risultati: Abbiamo arruolato 154 neonati nelle due Coorti, a 12 mesi di età corretta. Le caratteristiche cliniche di base
e il tasso di morbidità, delle due Coorti, erano simili. Non abbiamo riscontrato differenze statisticamente significative
per quanto riguarda i parametri di crescita standardizzati, tra le due Coorti di studio. I risultati sono stati confermati
dall’analisi multivariata.
Conclusioni: Il timing di introduzione dell’alimentazione complementare non influenza la crescita, dei neonati pretermine,
nei primi 12 mesi di vita. I nostri risultati suggeriscono la necessità di ulteriori studi per definire l’appropriato
approccio nutrizionale, nel neonato pretermine, dopo la dimissione
The effects of industrial chemicals bonded to plastic materials in newborns: A systematic review
No full textBackground: Phthalates are a family of industrial chemicals noncovalently bonded to plastic materials to enhance flexibility and durability. These compounds are extensively used in a variety of consumer products and even in many medical devices. Newborns present a higher susceptibility to phthalates. Objective: To assess the short- and long-term health consequences of exposure to phthalates during the neonatal period. Methods: Systematic review in accordance with the PRISMA statements. Eligible articles in English language were searched in MEDLINE, Scopus, ISI Web of Science, and Ovid databases using the following terms: “phthalate”, “newborn”, and “neonate”. Unpublished data were searched in ClinicalTrials.gov website. All in vivo studies of any design published before May 16th, 2023 and fulfilling the following criteria were included: 1) investigations in which preterm and/or term newborns underwent one or more measurement of concentrations of phthalates on biological samples taken during the neonatal period; 2) studies in which quantitative measurement of phthalates was related to any kind of health outcome. Subgroup analysis was conducted by type of outcome. The quality assessment was performed according to the criteria from the “NIH Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies”. Results: 11,895 records were identified; finally, 5 articles were included for review. A mixture of phthalates was associated with improved performance on the NNNS summary scales of Attention, Handling, and Non-optimal reflexes before NICU discharge. At 2 months’ corrected age, some phthalates were positively associated with problem-solving and gross motor abilities; increased levels of mono (2-ethylhexyl) phthalate, mono (2-ethyl-5-carboxypentyl) phthalate, and sum of di (2-ethylhexyl) phthalate (DEHP) metabolites (∑3DEHP and ∑4DEHP) were associated with worse fine motor performance. Furthermore, DEHP was associated with transient alteration of gut microbiota and increased IgM production after vaccine. A linear positive association between a mixture of phthalates and slope of the first growth spurt was even reported in preterm newborns. No relationship emerged between phthalates and bronchopulmonary dysplasia. Three studies out of 5 had fair quality. Conclusion: Given some methodological issues and the paucity of related studies, further investigations of flawless quality aimed at clarifying the relationship between early exposure to phthalates and health outcomes are needed
Symptoms of post-traumatic stress disorder in parents of preterm newborns. a systematic review of interventions and prevention strategies
No full textBackground: Preterm birth and subsequent NICU admission can be a traumatic experience for parents who may subsequently develop post-traumatic stress (PTS) disorder (PTSD). Given that developmental issues are common among children of parents with PTSD, interventions for prevention and treatment are essential.Objective: To assess the most effective non-pharmacological interventions to prevent and/or treat PTS symptoms in parents of preterm newborns.Methods: Systematic review performed in accordance with the PRISMA statements. Eligible articles in English language were searched in MEDLINE, Scopus, and ISI Web of Science databases using the following medical subject headings and terms: "stress disorder, post-traumatic," "parents," "mothers," "fathers," "infant, newborn," "intensive care units, neonatal," and "premature birth." The terms "preterm birth" and "preterm delivery" were also used. Unpublished data were searched in website. All intervention studies published until September 9th, 2022 and including parents of newborns with gestational age at birth (GA(b))Results: Sixteen thousand six hundred twenty-eight records were identified; finally, 15 articles (1,009 mothers, 44 fathers of infants with GA(b) = 36(6/7) weeks) were included for review. A good standard of NICU care (effective as sole intervention: 2/3 studies) and education about PTSD (effective in association with other interventions: 7/8 studies) could be offered to all parents of preterm newborns. The 6-session Treatment Manual is a complex intervention which revealed itself to be effective in one study with low risk of bias. However, the effectiveness of interventions still remains to be definitively established. Interventions could start within 4 weeks after birth and last 2-4 weeks.Conclusion: There is a wide range of interventions targeting PTS symptoms after preterm birth. However, further studies of good quality are needed to better define the effectiveness of each intervention
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
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
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