23 research outputs found
The Grammatica da Lingua Italiana para os Portuguezes by Antonio Prefumo: between the traditional and the conversational method
No full textWithin the Italian FL2 grammatical tradition, the 19th century is a very fruitful period. In other contributions, we have highlighted how several Portuguese and Italian figures connected to the circle of the S. Carlos Theatre in Lisbon act as preceptors and compose some grammars, which contain a strong normative part and, at the same time, connect themselves to the conversational tradition: among these works, the Grammatica da Lingua Italiana para os Portuguezes by Antonio Prefumo (Lisbon, 1829) plays a central role, as it goes through four editions over almost forty years. The paper analyses the social and intellectual context of production of this text, besides outlining the author’s profile and providing a philological reconstruction of the sources and models adopted. Furthermore, the paper attempts an analysis of the Grammatica that, on the one hand, highlights both the heritage of the vernacular and Enlightenment grammatical traditions and its innovative aspects and, on the other hand, compares the various editions through the study of their macro-textual areas. The methodology underlying our description follows that proposed by Swiggers (2006, 168) being based on four aspects: the analysis of the author, the audience, the subject described and its form. This approach places the author at the centre of a historical conjuncture in which the traditional grammatical method was associated with that of conversation, responding to the demand of an audience that increasingly approached the study of FL for practical reasons, rather than to meet the traditional educational demands of the upper classes
The contingent use of cell-free fetal DNA for prenatal screening of trisomies 21, 18, 13 in pregnant women within a national health service: A budget impact analysis
No full textObjective Non-invasive prenatal testing (NIPT) based on cell-free fetal DNA (cffDNA) is highly accurate in the detection of common fetal autosomal trisomies. Aim of this project was to investigate short-term costs and clinical outcomes of the contingent use of cffDNA for prenatal screening of trisomies 21, 18, 13 within a national health service (NHS). Methods An economic analysis was developed from the perspective of the Italian NHS to compare two possible scenarios for managing pregnant women: women managed according to the Standard of Care screening (SoC) vs a cffDNA scenario, where Harmony Prenatal Test was introduced as a second line screening choice for women with an “at risk” result from SoC screening. Results The introduction of cffDNA as a second line screening test, conditional to a risk 1:1,000 from SoC screening, showed a 3% increase in the detection of trisomies, with a 71% decrease in the number of invasive tests performed. Total short-term costs (pregnancy management until childbirth) decreased by € 19 million (from € 84.5 to 65.5 million). Conclusion The adoption of the Harmony Prenatal Test in women resulting at risk from SoC screening, implied a greater number of trisomies detection, together with a reduction of the healthcare costs
Delirium, Frailty, and Fast-Track Surgery in Oncogeriatrics: Is There a Link?
No full textBackground/Aims: Postoperative delirium (POD) is more frequent in elderly patients undergoing major cancer surgery. The interplay between individual clinical vulnerability and a series of perioperative factors seems to play a relevant role. Surgery is the first-line treatment option for cancer, and fast-track surgery (FTS) has been documented to decrease postoperative complications. The study sought to assess, after comprehensive geriatric assessment (CGA) and frailty stratification (Rockwood 40 items index), which perioperative parameters were predictive of POD development in elderly patients undergoing FTS for colorectal cancer. Methods: A total of 107 consecutive subjects admitted for elective colorectal FTS were enrolled. All patients underwent CGA, frailly stratification, Timed up & go (TUG) test, 4AT test for delirium screening, anesthesiologists physical status classification, and Dindo-Clavien classification. Results: The incidence of POD was 12.3%. Patients’ prevalent clinical phenotype was pre-frail. The multivariate analysis indicated physical performance (TUG in seconds) as the most significant predictor of POD for each second of increase. Conclusions: Only few procedure-specific studies have examined the impact of FTS for colorectal cancer on POD. This is the first study to investigate the risk factors for POD, in a vulnerable octogenarian oncogeriatric population submitted to FTS surgery and frailty stratification
Risk of Congenital Toxoplasmosis in Newborns from Mothers with Documented Infection: Experience from Two Referral Centres
No full textDuring pregnancy, primary Toxoplasma gondii infection can cause congenital toxoplasmosis (CT). We described the newborns’ outcomes from a multicentre cohort of mothers with seroconversion (SC) at different gestational ages. This retrospective observational study (from 2007 to 2018) was conducted in two Italian referral hospitals: Fondazione IRCCS Policlinico San Matteo in Pavia and Spedali Civili in Brescia. In total, 247 pregnant women were enrolled: seroconversions were enrolled: seroconversions documented as having occurred in the two months preceding pregnancy in 12 cases (4.9%; 95% CI 2.2–7.5%), and during pregnancy in 235 cases (95.1%; 95% CI 92.5–97.8%). SC is defined as the appearance of specific anti-Toxoplasma antibodies (IgM/IgG) during pregnancy in a previously seronegative woman. A total of 56 (22.5%; 95% CI 17.3–27.7%) newborns were lost to follow-up; thus, the outcome of 193 (77.5%; 95% CI 72.3–82.7%) newborns was analyzed. The overall transmission rate of T. gondii infection was 23.8% (95% CI 17.8–29.8%), 0% (95% CI 0.0–11.9%) among the 1st trimester SCs, 12.5% (95% CI 5.6–19.4%) among the 2nd trimester SCs, 53.8% (95% CI 41.7–66.0%) among the 3rd trimester ones. No CT were found in the group of periconceptional infection. Among the infected newborns, clinically manifest cases were 12 (26.1%; 95% CI 13.4–38.8%), including 1 case (2.2%; 95% CI 2.0–6.4%) of stillbirth and 11 symptomatic neonates (23.9%; 95% CI 11.6–36.2%). A total of 83 amniocentesis were performed (33.6%; 95% CI 27.7–39.5%), no complication was recorded and no false positive or false negative results were registered. The results are in line with the fetal risks reported in literature for T. gondii infection during pregnancy, even if at a lower percentage probably due to a prompt treatment
Identification of bi-allelic LFNG variants in three patients and further clinical and molecular refinement of spondylocostal dysostosis 3
No full text: Spondylocostal dysostosis (SCD), a condition characterized by multiple segmentation defects of the vertebrae and rib malformations, is caused by bi-allelic variants in one of the genes involved in the Notch signaling pathway that tunes the "segmentation clock" of somitogenesis: DLL3, HES7, LFNG, MESP2, RIPPLY2, and TBX6. To date, seven individuals with LFNG variants have been reported in the literature. In this study we describe two newborns and one fetus with SCD, who were found by trio-based exome sequencing (trio-ES) to carry homozygous (c.822-5C>T) or compound heterozygous (c.[863dup];[1063G>A]) and (c.[521G>T];[890T>G]) variants in LFNG. Notably, the c.822-5C>T change, affecting the polypyrimidine tract of intron 5, is the first non-coding variant reported in LFNG. This study further refines the clinical and molecular features of spondylocostal dysostosis 3 and adds to the numerous investigations supporting the usefulness of trio-ES approach in prenatal and neonatal settings
Immunological profile of pregnant women with preconception immunity with or without vertical transmission of human cytomegalovirus to the fetus: a retrospective observational study
No full textBackground
Vertical transmission of human cytomegalovirus (CMV) to the fetus (congenital CMV infection) can occur in pregnant women with preconception immunity. Maternal immunological features associated with congenital CMV infection have been poorly investigated. We aimed to characterise the immunological features of pregnant women with preconception immunity in cases with and without vertical transmission of human CMV to the fetus.
Methods
In this retrospective cohort study, we included pregnant women (aged >18 years) with preconception immunity enrolled between Sept 1, 2017, and Oct 15, 2020, in the Congenital Human Cytomegalovirus Infection in Lombardy (CHILd) study (Italy) with (congenital CMV group) and without (no-congenital CMV group) intrauterine human CMV transmission. Blood was collected at 13 weeks of gestation and at delivery. The following immune parameters were measured and compared between groups: serum neutralising titres, antibody-dependent cell cytotoxicity, human CMV-specific long-term memory T cells (interleukin [IL]-7R+ and IL-2+), and effector memory CD45RA+ (TEMRA) cells. Immune parameters were also compared with those of two groups of pregnant women with human CMV primary infection enrolled at Fondazione IRCCS Policlinico San Matteo (Pavia, Italy) in two previous studies: primary infection group 1 for antibody response (followed up for 12 months; enrolled between Feb 23, 2011, and Sept 1, 2015,) and primary infection group 2 for T-cell response (followed up for 24 months; enrolled between July 10, 2016, and March 18, 2020).
Findings
128 women were included in this study: 56 women from the CHILd study (16 women in the congenital CMV group and 40 women in the no-congenital CMV group) and 72 pregnant women with primary infection (40 in primary infection group 1 [15 with and 25 without vertical transmission] and 32 in primary infection group 2 [11 with and 21 without vertical transmission]). Higher neutralising activity (p≤0·022) but lower antibody-dependent cell cytotoxicity (p=0·0004) was observed in the congenital CMV group versus the no-congenital CMV group. Additionally, the congenital CMV group had a lower percentage of long-term memory T cells than the no-congenital CMV group (p≤0·022). No significant difference was found for TEMRA cells between congenital CMV and no-congenital CMV groups. Immunological parameters of the congenital CMV group were similar to those observed in primary infection groups 1 and 2 within 12–24 months after infection.
Interpretation
Immune women with intrauterine human CMV transmission have distinct immunological parameters (different from immune women without CMV transmission, but similar to women with primary infection) and might be those who had a primary human CMV infection within a few years earlier before maternal immunity development was completed. A vaccine able to elicit a fully developed maternal immunity to human CMV is likely to be protective for the fetus
