264 results on '"Paola Cogo"'
Search Results
2. Septic Arthritis of the Atlanto-Occipital Joint Caused by S. Intermedius in a 5-Year-Old Girl: A Case Report
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Andrea Di Siena, Eva Passone, Federica Rodofile, Giada Piccinin, Lorenzo Cereser, Maria Merelli, and Paola Cogo
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Microbiology (medical) ,Infectious Diseases ,Pediatrics, Perinatology and Child Health ,atlanto-occipital joint ,torticollis ,S. intermedius ,septic arthritis - Published
- 2023
3. Which birth weight threshold to start parenteral nutrition? A single center experience
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Chiara Biagetti, Alessio Correani, Luca Antognoli, Ilaria Burattini, Rita D’Ascenzo, Maria Paola Bellagamba, Emanuela Andresciani, Angela Maria Felicita Garzone, Paola Cogo, and Virgilio P. Carnielli
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Nutrition and Dietetics ,Medicine (miscellaneous) - Published
- 2023
4. Confirmation of increased and more severe adolescent mental health-related in-patient admissions in the COVID-19 pandemic aftermath: A 2-year follow-up study
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Dario Marin, Gianfranco Di Gennaro, Margherita Baracetti, Rossella Zanetti, Matteo Balestrieri, Paola Cogo, and Marco Colizzi
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Risk factors ,Child and adolescent neuropsychiatry ,Psychopharmacological therapy - Published
- 2023
5. The care of critically ill infants and toddlers in neonatal intensive care units across Italy and Europe: our proposal for healthcare organization
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Nicola Pozzi, Paola Cogo, Corrado Moretti, Paolo Biban, Tiziana Fedeli, Luigi Orfeo, Eloisa Gitto, and Fabio Mosca
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Adult ,Early childhood intensive care units (ECICUs) ,Management of critically ill infants and toddlers ,Neonatal intensive care units (NICUs) ,Neonatologists ,Paediatric critical care medicine (PCCM) ,Paediatric intensive care units (PICUs) ,Critical Illness ,health care facilities, manpower, and services ,Infant, Newborn ,Infant ,Review ,Europe ,Italy ,Child, Preschool ,Intensive Care Units, Neonatal ,Pediatrics, Perinatology and Child Health ,Humans ,Child ,Delivery of Health Care - Abstract
Numerous studies have shown that critically ill infants and toddlers admitted to paediatric intensive care units (PICUs) have a lower mortality than those admitted to adult ICUs. In 2014, there were only 23 registered PICUs in Italy, most of which were located in the north. For this reason, in Italy and elsewhere in Europe, some neonatal ICUs (NICUs) have begun managing critically ill infants and toddlers. Our proposal for healthcare organization is to establish “extended NICUs” in areas where paediatric intensive care beds are lacking. While some countries have opted for a strict division between neonatal and paediatric intensive care units, the model of “extended NICUs” has already been set up in Italy and in Europe. In this instance, the management of critically ill infants and toddlers undoubtedly falls upon neonatologists, who, however, must gain specific knowledge and technical skills in paediatric critical care medicine (PCCM). Postgraduate residencies in paediatrics need to include periods of specific training in neonatology and PCCM. The Italian Society of Neonatology’s Early Childhood Intensive Care Study Group is supporting certified training courses for its members involving both theory and practice.Conclusion: Scientific societies should promote awareness of the issues involved in the intensive management of infants and toddlers in NICUs and the training of all health workers involved. These societies include the Italian Society of Neonatology, the European Society of Paediatric and Neonatal Intensive Care, and the Union of European Neonatal and Perinatal Societies. They should also act in concert with the governmental institutional bodies to establish the standards for the “extended NICUs.” What is Known:• The mortality of critically ill infants and toddlers admitted to PICUs is lower than that for those admitted to adult ICUs.• In Italy, there are only a handful of PICUs, located mainly in the north. What is New:• Critically ill infants and small toddlers can be managed in “extended NICUs” in areas with a lack of paediatric intensive care beds.• “Extended NICUs” is our proposal for healthcare organization to compensate for the paucity of paediatric intensive care beds, but neonatologists must be trained to provide them with specific knowledge and technical skills in PCCM.
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- 2022
6. Individual Cognitive Remediation Therapy and Individual Emotion Skills Training for anorexia nervosa: a case series study in a paediatric ward
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Dario Marin, Paola Cogo, Rossella Zanetti, Federica Tedde, and Lucia Giombini
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Purpose: Anorexia Nervosa (AN) is a life-threatening eating disorder (ED), with the highest incidence in young people (YP) aged 15-19 years. The COVID-19 pandemic impacted on the increase of AN cases requiring hospitalisation. Cognitive Remediation Therapy (CRT) and Cognitive Remediation and Emotion Skills Training (CREST) are brief interventions aimed at enhancing cognitive and emotion processing skills. They are feasible for adult and YP with AN in inpatient settings, but their use has not been yet explored in paediatric wards. Methods: A case series study with uncontrolled repeated measures design was conducted in a paediatric ward. Eight participants received two individual one-hour long CRT and then CREST sessions a week for ten weeks. A repeated measures design, consisting of neuropsychological tests and psychometric self-report questionnaires, was conducted at three time-points. Results: Significant differences (T0 vs T1) were found in cognitive flexibility [“Animal Sorting” t(7)=-3.208; p=0.015; “Response Set” (t(7)=-3.910; p=0.006);“Learning to learn” (t(7)=-4.259; p=0.004)]; in central coherence [“Central Coherence Index” t(7)=-2.401; p=0.047]; in executive functions [“Design” (t(7)=-3.208; p=0.015), “Semantic” (t(7)=-3.660; p=0.008), “Phonological fluency” (t(7)=-4.020; p=0.005), short-term verbal memory (t(5)=-11.00; p=Conclusions: Individual CRT in conjunction with individual CREST is a feasible intervention for YP with AN in a paediatric ward. Studies involving larger samples and control groups in paediatric wards are warranted.
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- 2022
7. Isolated and blocked adolescents: a study on the psychological effects of the COVID-19 outbreak
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Susanna FERUGLIO, Alessio MATIZ, Paola COGO, Enrico VIDAL, Andrea PASCHETTO, Franco FABBRO, and Cristiano CRESCENTINI
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Psychiatry and Mental health - Published
- 2022
8. SBI is uncommon in the absence of paediatricians' gut feeling and abnormal respiratory pattern
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Giorgio Cozzi, Antimo Tessitore, Manuela Giangreco, Paola Cogo, Elena Valentini, Simona Salis, Paola Pascolo, Egidio Barbi, Cozzi, Giorgio, Tessitore, Antimo, Giangreco, Manuela, Cogo, Paola, Valentini, Elena, Salis, Simona, Pascolo, Paola, and Barbi, Egidio
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Emergency department ,Infant ,General Medicine ,Gut feeling ,Bacterial Infections ,Abnormal respiratory pattern ,Severe bacterial infection ,Paediatric patients ,Italy ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Humans ,Paediatric patient ,Prospective Studies ,Pediatricians ,Child ,Emergency Service, Hospital - Abstract
According to the Italian national statistical institute, severe bacterial infections (SBI) in Italy are responsible for 1.7% of mortality under 5 years of age and their recognition is often challenging, especially in the first stages of the disease. We tried to estimate the prevalence of SBI in our target population and to identify signs and symptoms that could guide in the initial evaluation of a child with a possible SBI.We designed a prospective, multicentre study and enrolled patients aged 0-14 years at the first evaluation to the emergency department with an acute illness lasting a maximum of 5 days. The presence of variables suggestive of SBI was collected for every enrolled patient. One week after the enrolment, every patient was followed up by telephone.SBI is more likely to be detected with the 'gut feeling' in both univariate and multivariate models (univariate OR: 7.16, 95% CI: 4.08-12.56; multivariate OR: 5.34, 95% CI: 2.78-10.25), while abnormal breathing pattern resulted significative only in univariate model (OR 3.83, 95% CI: 1.98-7.40). Nevertheless, their associated sensitivity is low.SBI is uncommon in the absence of paediatricians' gut feeling and abnormal respiratory pattern.
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- 2022
9. The pandemic within the pandemic: the surge of neuropsychological disorders in Italian children during the COVID-19 era
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Elena, Bozzola, Pietro, Ferrara, Giulia, Spina, Alberto, Villani, Marco, Roversi, Massimiliano, Raponi, Giovanni, Corsello, Annamaria, Staiano, Francesco, Chiarelli, Federica, Cavallo, Farello, Giovanni, Nadia, Rossi, Carmela, Salladini, Sergio, Manieri, Mariapia, Mirauda, Giacomo, Biasucci, Andrea, Cella, Gianluca, Vergine, Angela, Troisi, Federico, Marchetti, Enrico, Valletta, Marcello, Stella, Marcello, Lanari, Duccio Maria Cordelli, Ilaria, Corsini, Jacopo, Pruccoli, Chiara, Ghizzi, Chiara, Franzonello, Egidio, Barbi, Alessandro, Amaddeo, Ilaria, Liguoro, Paola, Cogo, Giuliana, Morabito, Maria Rosaria Marchili, Carla, Brusco, Cristina, Mascolo, Riccardo, Borea, Emanuela, Piccotti, Tommaso, Bellini, Carlo, Agostoni, Raffaele, Badolato, Camilla, Dallavilla, Leonardo, Felici, Simone, Mattozzi, Guido, Pennoni, Elisabetta Mencaroni and, Bozzola E., Ferrara P., Spina G., Villani A., Roversi M., Raponi M., Corsello G., Staiano A., Chiarelli F., Cavallo F., Farello G., Rossi N., Salladini C., Manieri S., Mirauda M.P., Biasucci G., Cella A., Vergine G., Troisi A., Marchetti F., Valletta E., Stella M., Lanari M., Cordelli D.M., Corsini I., Pruccoli J., Ghizzi C., Franzonello C., Barbi E., Amaddeo A., Liguoro I., Cogo P., Morabito G., Marchili M.R., Brusco C., Mascolo C., Borea R., Piccotti E., Bellini T., Agostoni C., Badolato R., Dallavilla C., Felici L., Mattozzi S., Pennoni G., Mencaroni E., Bozzola, Elena, Ferrara, Pietro, Spina, Giulia, Villani, Alberto, Roversi, Marco, Raponi, Massimiliano, Corsello, Giovanni, and Staiano, Annamaria
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Adolescent ,COVID19 ,Neuropsychological disorder ,COVID-19 ,General Medicine ,Settore MED/38 ,Mental Health ,Italy ,Quarantine ,Children ,Neuropsychological disorders ,Humans ,COVID19, Children, Neuropsychological disorders ,Child ,Pandemics ,Human - Abstract
Background Quarantine and isolation measures during COVID-19 pandemic may have caused additional stress and challenged the mental health of the youth. Aim of the study is to investigate the COVID-19 pandemic impact on neuropsychological disorders (NPD) of Italian children and adolescents to provide general pediatric recommendations. Material and methods A retrospective multicenter observational study was planned by the Italian Pediatric Society (SIP) to explore the impact of COVID-19 on the access of children to pediatric Emergency Departments (pED) for the evaluation of neuropsychological symptoms, collecting the classification codes of diagnoses between March 1, 2019 and March 2, 2021. The period study was split into two sub-periods: a pre COVID-19 period (from March 1 2019 to March 1, 2020) and a COVID-19 period (from March 2, 2020 to March 2, 2021). As additional information, data on NPD hospitalizations in any pediatric department of the involved centers were recorded. Results During the study period, a total of 533,318 children were admitted to the pED involved in the study. Despite a 48.2% decline of pED admissions, there was a significant increase (83.1%) in patient admissions for NPD. The most frequent NPD conditions which increased during the COVID-19 pandemic were suicidal ideation (+ 147%), depression (+ 115%), eating disorder (+ 78.4%), and psychosis (+ 17.2%). During the pandemic period, a 39.5% increase in NPD hospitalizations was observed as well. The NPD disorders that mostly required hospitalizations were suicidal ideation (+ 134%), depression (+ 41.4%), eating disorder (+ 31.4%), and drug abuse (+ 26.7%). COVID-19 pandemic had a major impact on children's health, mainly on their NPD development. Neuropsychological assessment should be required at the primary level, in the pediatrician's office, to facilitate early capture of the sign of impairment and provide an adequate treatment. Conclusion SIP underlines the psychological consequences of COVID 19 pandemic on the youngest and recommends an early identification of NPD in the pediatric population to avoid other serious consequences for children's physical and mental health.
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- 2022
10. Where PICU Beds Are Lacking, the Model of 'Extended NICU' May Help to Treat Infants and Small Toddlers Who Are Critically Ill, Even During the COVID-19 Pandemic
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Nunzia Decembrino, Eloisa Gitto, Tiziana Fedeli, Ferdinando Spagnuolo, Luigi Orfeo, Corrado Moretti, Paola Cogo, and Nicola Pozzi
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Pulmonary and Respiratory Medicine ,Child, Preschool ,Critical Illness ,Intensive Care Units, Neonatal ,Infant, Newborn ,Infant ,Humans ,COVID-19 ,Cardiology and Cardiovascular Medicine ,Critical Care and Intensive Care Medicine ,Child ,Intensive Care Units, Pediatric ,Pandemics - Published
- 2022
11. Factors Associated With Initiation of Extracorporeal Cardiopulmonary Resuscitation in the Pediatric Population: An International Survey
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Aparna Hoskote, Aurélie De Mul, Simon Erickson, Eduardo da Cruz, Palisi, Espnic, Anzics Psg, Javier J. Lasa, Duy-Anh Nguyen, Paola Cogo, Oliver Karam, Ravi R. Thiagarajan, and Melania M. Bembea
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medicine.medical_specialty ,Myocarditis ,intensive care units ,medicine.medical_treatment ,Biomedical Engineering ,Biophysics ,heart failure ,Bioengineering ,cardiac arrest ,Intensive Care Units, Pediatric ,Biomaterials ,Extracorporeal Membrane Oxygenation ,respiratory insufficiency ,Extracorporeal membrane oxygenation ,medicine ,Humans ,Extracorporeal cardiopulmonary resuscitation ,Child ,Retrospective Studies ,Pediatric intensive care unit ,business.industry ,Septic shock ,Infant, Newborn ,International survey ,General Medicine ,medicine.disease ,Cardiopulmonary Resuscitation ,Heart Arrest ,Cardiac surgery ,pediatric ,cardiopulmonary resuscitation ,extracorporeal membrane oxygenation ,surveys and questionnaires ,Emergency medicine ,Candidacy ,business - Abstract
Although extracorporeal cardiopulmonary resuscitation (ECPR) is increasingly utilized in the pediatric critical care environment, our understanding regarding pediatric candidacy for ECPR remains unknown. Our objective is to explore current practice and indications for pediatric ECPR. Scenario-based, self-administered, online survey, evaluating clinical determinants that may impact pediatric ECPR initiation with respect to four scenarios: postoperative cardiac surgery, cardiac failure secondary to myocarditis, septic shock, and chronic respiratory failure in a former preterm child. Responders are pediatric critical care physicians from four societies. 249 physicians, mostly from North America, answered the survey. In cardiac scenarios, 40% of the responders would initiate ECPR, irrespective of CPR duration, compared with less than 20% in noncardiac scenarios. Nearly 33% of responders would consider ECPR if CPR duration was less than 60 minutes in noncardiac scenarios. Factors strongly decreasing the likelihood to initiate ECPR were out-of-hospital unwitnessed cardiac arrest and blood pH6.60. Additional factors reducing this likelihood were multiple organ failure, pre-existing neurologic delay,10 doses of adrenaline, poor CPR quality, and lactate18 mmol/l. Pediatric intensive care unit location for cardiac arrest, good CPR quality, 24/7 in-house extracorporeal membrane oxygenation (ECMO) team moderately increase the likelihood of initiating ECPR. This international survey of pediatric ECPR initiation practices reveals significant differences regarding ECPR candidacy based on patient category, location of arrest, duration of CPR, witness status, and last blood pH. Further research identifying prognostic factors measurable before ECMO initiation should help define the optimal ECPR initiation strategy.
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- 2021
12. Increased use of high-flow nasal cannulas after the pandemic in bronchiolitis: a more severe disease or a changed physician's attitude?
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Sergio Ghirardo, Giorgio Cozzi, Giovanna Tonin, Francesco Maria Risso, Laura Dotta, Alessandro Zago, Daniela Lupia, Paola Cogo, Nicola Ullmann, Antonella Coretti, Raffaele Badolato, Alessandro Amaddeo, Egidio Barbi, Renato Cutrera, Ghirardo, Sergio, Cozzi, Giorgio, Tonin, Giovanna, Risso, Francesco Maria, Dotta, Laura, Zago, Alessandro, Lupia, Daniela, Cogo, Paola, Ullmann, Nicola, Coretti, Antonella, Badolato, Raffaele, Amaddeo, Alessandro, Barbi, Egidio, and Cutrera, Renato
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Attitude of Health Personnel ,SARS-CoV-2 ,High-flow nasal cannula (HFNC) ,Oxygen Inhalation Therapy ,COVID-19 pandemic ,COVID-19 ,Infant ,Bronchiolitis ,Non-invasive ventilation (NIV) ,Respiratory syncytial virus (RSV) ,Oxygen ,Physicians ,Pediatrics, Perinatology and Child Health ,Cannula ,Humans ,Bronchioliti ,Child ,Pandemics ,Retrospective Studies - Abstract
After the SARS-CoV-2 pandemic, we noticed a marked increase in high-flow nasal cannula use for bronchiolitis. This study aims to report the percentage of children treated with high-flow nasal cannula (HFNC) in various seasons. The secondary outcomes were admissions for bronchiolitis, virological results, hospital burden, and NICU/PICU need. We conducted a retrospective study in four Italian hospitals, examining the medical records of all infants (p p Conclusion: This study shows a marked increase in respiratory support and intensive care admissions this last winter. While these severity indexes were all driven by medical choices, more reliable indexes such as intubation rate and length of stay did not change. Therefore, we suggest that there is a more aggressive treatment attitude rather than a more severe disease. What is Known:• COVID-19 pandemic deeply impacted bronchiolitis epidemiology, reducing hospitalizations to onetenth. In the 2021-2022 winter, bronchiolitis resurged to pre-pandemic numbers in Europe. What is New:• Bronchiolitis hospitalization rose much faster in the 2021-2022 winter period, peaking at a higher level. Respiratory supports and high-flow nasal cannula increased significantly compared to the pre-pandemic era.
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- 2022
13. Novel IGFALS mutations with predicted pathogenetic effects by the analysis of AlphaFold structure
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Alessandra Franzoni, Federica Baldan, Nadia Passon, Catia Mio, Daniela Driul, Paola Cogo, Federico Fogolari, Federica D’Aurizio, and Giuseppe Damante
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Short stature ,Endocrinology ,Endocrinology, Diabetes and Metabolism ,Mutation ,Exome ,IGFALS - Abstract
According to the American College of Medical Genetics (ACMG) classification, variants of uncertain significance (VUS) are gene variations whose impact on the disease risk is not yet known. VUS, therefore, represent an unmet need for genetic counselling. Aim of the study is the use the AlphaFold artificial intelligence algorithm to predict the impact of novel mutations of the IGFALS gene, detected in a subject with short stature and initially classified as VUS according to the ACMG classification.A short-stature girl and her parents have been investigated. IGFALS mutations have been detected through clinical exome and confirmed by Sanger sequencing. The potential presence of co-occurring gene alterations was investigated in the proband by whole exome and CGH array. Structure of the ALS protein (encoded by the IGFALS gene) was evaluated through the AlphaFold artificial intelligence algorithm.Two IGFALS variants were found in the proband: c.1349T C (p.Leu450Pro) and c.1363_1365delCTC (p.Leu455del), both classified as VUS, according to ACMG. Parents' analysis highlighted the in trans position of the two variants. AlphaFold showed that the mutated positions were found the concave side a horseshoe structure of the ALS protein, likely interfering with protein-protein interactions. According to a loss of function (LoF) effect of the two variants, reduced levels of the IGF1 and IGFBP-3 proteins, as well as a growth hormone (GH) excess were detected in the proband's serum.By using the AlphaFold structure we were able to predict two IGFALS gene mutations initially classified as VUS, as potentially pathogenetic. Our proof-of-concept showed a potential application of AlphaFold as tool to a better inform VUS interpretation of genetic tests.
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- 2022
14. Comparison of Lung Function in Healthy Nigerian Children Living in Nigeria and in the United Kingdom
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Michele Arigliani, Sooky Lum, Chiara Zuiani, Emma Raywood, Livingstone Gayus Dogara, Ramatu Zubair, Luigi Castriotta, Ashel Dache Sunday, Baba Inusa, and Paola Cogo
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Pulmonary and Respiratory Medicine ,Correspondence ,Respiratory Physiological Phenomena ,Black People ,Humans ,Nigeria ,Critical Care and Intensive Care Medicine ,Child ,Lung ,United Kingdom - Published
- 2022
15. DHA turnover in pregnant women using the natural abundance variation of
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Manuela, Simonato, Silvia, Visentin, Giovanna, Verlato, Erich, Cosmi, Alessio, Correani, Paola, Cogo, and Virgilio P, Carnielli
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The importance of DHA intake to support fetal development and maternal health is well established. In this pilot study we applied the natural abundance approach to determine the contribution of 200 mg/day of DHA supplement to the plasma DHA pool in 19 healthy pregnant women on a free diet.Women received DHA, from pregnancy week 20 until delivery, from an algal source (N=13, Algae group) or from fish oil (N=6, Fish group) with slightly different content of 13C.We measured plasma phospholipids DHA 13C:12C ratio (reported as δ13C) prior to supplementation (T0), after 10 (T1) and 90 days (T2) and prior to delivery (T3).The δ13C of DHA in algae and fish supplements were -15.8±0.2 mUr and -25.3±0.2 mUr (p0.001).DHA δ13C in the Algae group increased from -27.7±1.6 mUr (T0) to -21.9±2.2 mUr (T3) (p0.001), whereas there were not significant changes in the Fish group (-27.8±0.9 mUr at T0 and -27.3±1.1 mUr at T3, p=0.09).In the Algae group 200 mg/day of DHA contributed to the plasma phospholipid pool by a median value of 53% (31-75% minimum and maximum). This estimation was not possible in the fish group.Our results demonstrate the feasibility of assessing the contribution of DHA from an algal source to the plasma DHA pool in pregnant women by the natural abundance approach. Plasma δ13C DHA did not change when consuming DHA of fish origin, with almost the same δ13C value of that of the pre-supplementation plasma δ13C DHA.
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- 2022
16. Lung function between 8 and 15 years of age in very preterm infants with fetal growth restriction
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Luigi Castriotta, Maria Orsaria, Cristina Canciani, Paola Cogo, Maria Elena Ferrari, Luigi Cattarossi, Carlo De Pieri, Chiara Stocco, Lorenza Driul, Michele Arigliani, and Elena Valentini
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Male ,Spirometry ,congenital, hereditary, and neonatal diseases and abnormalities ,medicine.medical_specialty ,Adolescent ,Intrauterine growth restriction ,03 medical and health sciences ,0302 clinical medicine ,DLCO ,030225 pediatrics ,Diffusing capacity ,medicine ,Humans ,Child ,reproductive and urinary physiology ,Fetal Growth Retardation ,medicine.diagnostic_test ,Obstetrics ,business.industry ,Infant, Newborn ,Gestational age ,medicine.disease ,female genital diseases and pregnancy complications ,Respiratory Function Tests ,Bronchopulmonary dysplasia ,Infant, Extremely Premature ,Pediatrics, Perinatology and Child Health ,Gestation ,Small for gestational age ,Female ,business ,030217 neurology & neurosurgery - Abstract
BACKGROUND The impact of intrauterine growth restriction (IUGR) on lung function in very preterm children is largely unknown as current evidence is mainly based on studies in children born small for gestational age but not necessarily with IUGR. METHODS Spirometry, transfer factor of the lung for carbon monoxide (TLco), and lung clearance index (LCI) were cross-sectionally evaluated at 8.0-15.0 years of age in children born
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- 2021
17. The impact of COVID-19 on a tertiary care pediatric emergency department
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Anna Pusiol, Enrico Vidal, Ilaria Liguoro, Michela Vergine, Chiara Pilotto, and Paola Cogo
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Male ,medicine.medical_specialty ,Coronavirus disease 2019 (COVID-19) ,Pediatrics ,law.invention ,law ,Pandemic ,Quarantine ,Humans ,Medicine ,Pediatrics, Perinatology, and Child Health ,Child ,Pandemics ,Retrospective Studies ,Infectious disease ,Tertiary Healthcare ,business.industry ,Medical record ,Social distance ,COVID-19 ,Infant ,Outbreak ,Triage ,Emergency care ,Infectious disease (medical specialty) ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Emergency medicine ,Original Article ,Female ,Emergency Service, Hospital ,business - Abstract
The restrictive measures required to face the recent outbreak of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may impact patterns of healthcare utilization. Our aim was to provide an insight into the change in the use of a pediatric emergency department (ED) during the SARS-CoV-2 pandemic. The medical records of the children seen in our pediatric ED during March and April 2020 were retrospectively reviewed. Consequently, these were compared to the medical records of 2018 and 2019 from the same time period and from other control periods (January–February 2019 and 2020, and July–August 2018 and 2019). The total number of ED visits declined by 73% from 2019 to 2020 (3051 vs 818). Significant variations were observed in the distribution of children between triage categories: the proportion of patients who was given a green-code showed a 0.59-fold decrease in comparison to 2019 (95% CI 0.5–0.69), while a relative increase in the proportion of yellow codes was observed (OR 1.46, 95% CI 1.2–1.78). Conclusion: Quarantine measures significantly impacted on the total number of patients and on the reasons for visiting them in our pediatric ED. This substantial decrease in pediatric care may either be due to lower rates of acute infections because of social distancing, or to parents’ or caregivers’ reticence to risk exposure to SARS-CoV-2 in a health-care setting.What is known:• A recent outbreak of a novel coronavirus responsible for a severe acute respiratory syndrome is spreading globally.• Restrictive measures may impact patterns of healthcare utilization, as observed in other previous outbreaks.What is new:• This study shows significant variations in the distribution of children among triage categories during the COVID-19 pandemic.• Discharge diagnosis was significantly different as well, in particular a relative increase in the proportion of children presenting with traumatic injuries and a decrease of viral infections were observed. Supplementary Information The online version contains supplementary material available at 10.1007/s00431-020-03909-9.
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- 2021
18. Risk Factors of Persistent Hydrocephalus in Children with Brain Tumor: A Retrospective Analysis
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Chiara Pilotto, Serena D’Agostini, Paola Cogo, F. Tuniz, Eva Passone, Miran Skrap, Ilaria Liguoro, and Serena Scaravetti
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Male ,Pediatrics ,medicine.medical_specialty ,Tumor resection ,Brain tumor ,Logistic regression ,Children ,Hydrocephalus ,Risk factor ,Cerebrospinal fluid ,Risk Factors ,Retrospective analysis ,medicine ,Humans ,Prospective Studies ,Child ,Retrospective Studies ,Brain Neoplasms ,business.industry ,Infant ,Retrospective cohort study ,General Medicine ,medicine.disease ,Pediatrics, Perinatology and Child Health ,Female ,Surgery ,Neurology (clinical) ,business - Abstract
Object: Hydrocephalus is one of the main complications of brain tumors in children, being present in about 50% of cases at the time of the tumor diagnosis and persisting up to 10–40% of cases after surgical resection. This is a single-institution retrospective study on the variables that may predict the need for treatment of persistent hydrocephalus in pediatric patients presenting with a brain tumor. Methods: Retrospective case note review of 43 newly diagnosed brain tumors in children referred between April 2012 and January 2018 to our regional pediatric neuro-oncology service was carried out. Diagnosis of hydrocephalus was carried out using both preoperative and postoperative MRI to determine Evans’ index (EI) and the fronto-occipital horn ratio (FOHR) from each scan. Simple logistic regression was used to analyze categorical variables as appropriate. A p value Results: Forty-three children were analyzed, 26 males and 17 females with a median age at diagnosis 10.4 years (IQR: 5.2–13.5). Hydrocephalus was present in 22/43 children (51%) preoperatively; in 8/22 children (36%) with hydrocephalus undergoing tumor resection, hydrocephalus persisted also in the postoperative period. An EI >0.34 (p = 0.028) and an FOHR >0.46 (p = 0.05) before surgery were associated with a higher prevalence of persistent hydrocephalus and therefore to the need for a cerebrospinal fluid drain device in the postoperative phase. Conclusion: Preoperative identification of children at risk for developing persistent hydrocephalus would avoid delays in planning the permanent cerebrospinal fluid drain devices. This study finds that an EI >0.34 and an FOHR >0.46 at diagnosis could impact on the therapeutic management of children with hydrocephalus associated with brain tumors. Prospective and larger-scale studies are needed to standardize this approach.
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- 2021
19. Triptorelin-Induced Delayed Transient Arterial Hypertension: A Case Series with Review of Literature
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Francesca Franco, AnnaJolanda Gortan, Federica Rodofile, and Paola Cogo
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- 2023
20. WHO standards-based tools to measure service providers' and service users' views on the quality of hospital child care: Development and validation in Italy
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Marzia, Lazzerini, Ilaria, Mariani, Tereza Rebecca, de Melo E Lima, Enrico, Felici, Stefano, Martelossi, Riccardo, Lubrano, Annunziata, Lucarelli, Gian Luca, Trobia, Paola, Cogo, Francesca, Peri, Daniela, Nisticò, Wilson Milton, Were, Valentina, Baltag, Moise, Muzigaba, Egidio, Barbi, Francesca, Patané, Lazzerini, Marzia, Mariani, Ilaria, de Melo E Lima, Tereza Rebecca, Felici, Enrico, Martelossi, Stefano, Lubrano, Riccardo, Lucarelli, Annunziata, Trobia, Gian Luca, Cogo, Paola, Peri, Francesca, Nisticò, Daniela, Were, Wilson Milton, Baltag, Valentina, Muzigaba, Moise, and Barbi, Egidio
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paediatric ,Adolescent ,epidemiology ,paediatrics ,quality in health care ,Child ,Hospitals ,Humans ,Reproducibility of Results ,Surveys and Questionnaires ,World Health Organization ,Child Care ,Quality of Health Care ,Reproducibility of Result ,General Medicine ,Hospital ,Surveys and Questionnaire ,Human - Abstract
ObjectivesEvidence showed that, even in high-income countries, children and adolescents may not receive high quality of care (QOC). We describe the development and initial validation, in Italy, of two WHO standards-based questionnaires to conduct an assessment of QOC for children and young adolescents at inpatient level, based on the provider and user perspectives.DesignMultiphase, mixed-methods study.Setting, participants and methodsThe two questionnaires were developed in four phases equally conducted for each tool. Phase 1 which included the prioritisation of the WHO Quality Measures according to predefined criteria and the development of the draft questionnaires. In phase 2 content face validation of the draft questionnaires was assessed among both experts and end-users. In phase 3 the optimised questionnaires were field tested to assess acceptability, perceived utility and comprehensiveness (N=163 end-users). In phase 4 intrarater reliability and internal consistency were evaluated (N=170 and N=301 end-users, respectively).ResultsThe final questionnaires included 150 WHO Quality Measures. Observed face validity was excellent (kappa value of 1). The field test resulted in response rates of 98% and 76% for service users and health providers, respectively. Among respondents, 96.9% service users and 90.4% providers rated the questionnaires as useful, and 86.9% and 93.9%, respectively rated them as comprehensive. Intrarater reliability was good, with Cohen’s kappa values exceeding 0.70. Cronbach alpha values ranged from 0.83 to 0.95, indicating excellent internal consistency.ConclusionsStudy findings suggest these tools developed have good content and face validity, high acceptability and perceived utility, and good intrarater reliability and internal consistency, and therefore could be used in health facilities in Italy and similar contexts. Priority areas for future research include how tools measuring paediatric QOC can be more effectively used to help health professionals provide the best possible care.
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- 2022
21. DHA turnover in pregnant women using the natural abundance variation of 13C: a pilot study
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Manuela Simonato, Silvia Visentin, Giovanna Verlato, Erich Cosmi, Alessio Correani, Paola Cogo, and Virgilio Paolo Carnielli
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DHA ,Nutrition and Dietetics ,carbon 13 natural abundance ,isotope ratio mass spectrometer ,metabolism ,omega 3 supplementation ,pregnancy ,Medicine (miscellaneous) - Abstract
The importance of DHA to support fetal development and maternal health is well established. In this study, we applied the natural abundance approach to determine the contribution of 200 mg/d of DHA supplement to the plasma DHA pool in nineteen healthy pregnant women. Women received DHA, from week 20 until delivery, from an algal source (n 13, Algae group) or from fish oil (n 6, Fish group) with slightly different content of 13C. We measured plasma phospholipids DHA 13C:12C ratio (reported as δ13C) prior to supplementation (T0), after 10 (T1) and 90 days (T2) and prior to delivery (T3). The δ13C of DHA in algae and fish supplements were −15·8 (sd 0·2) mUr and −25·3 (sd 0·2) mUr (P < 0·001). DHA δ13C in the Algae group increased from −27·7 (sd 1·6) mUr (T0) to −21·9 (sd 2·2) mUr (T3) (P < 0·001), whereas there were not significant changes in the Fish group (–27·8 (sd 0·9) mUr at T0 and −27·3 (sd 1·1) mUr at T3, P = 0·09). In the Algae group, 200 mg/d of DHA contributed to the plasma phospholipid pool by a median value of 53 % (31–75 % minimum and maximum). This estimation was not possible in the Fish group. Our results demonstrate the feasibility of assessing the contribution of DHA from an algal source to the plasma DHA pool in pregnant women by the natural abundance approach. Plasma δ13C DHA did not change when consuming DHA of fish origin, with almost the same δ13C value of that of the pre-supplementation plasma δ13C DHA.
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- 2022
22. Detection and assessment of postoperative pain in children with cognitive impairment: A systematic literature review and meta-analysis
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Anna Pizzinato, Ilaria Liguoro, Anna Pusiol, Paola Cogo, Alvisa Palese, and Enrico Vidal
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Adult ,Male ,Pain, Postoperative ,Adolescent ,Reproducibility of Results ,Checklist ,Young Adult ,Anesthesiology and Pain Medicine ,Child, Preschool ,Humans ,Cognitive Dysfunction ,Female ,Child ,Pain Measurement - Abstract
Children with cognitive impairment (CI) are at risk of experiencing pain. Several specific pain rating scales have been developed to date. Thus, the aim of this meta-analysis was to estimate the degree of reliability of different pain assessment scales for the postoperative pain in children with CI.PubMed, Scopus and Web of Science databases were approached: all studies validating and/or using pain assessment tool in children (0-20 years) with CI published in English from the 1st of January 2000 to the 1st of January 2022 were included. Only studies reporting the interclass correlation coefficient (ICC) to evaluate the concordance between caregivers' and external researchers' scores were eligible.Twelve studies were included (586 children with CI, 60% males; weighted mean age 9.9 years - range 2-20). Five of them evaluated the Non-Communicating Children's Pain Checklist-Postoperative Version (NCCPC-PV) scale whereas four the original and revised Face, Legs, Activity, Cry, Consolability (FLACC) scale. The analysis showed an overall ICC value of 0.76 (0.74-0.78) for the NCCPC-PV scale, with a high heterogeneity index (IThe NCCPC-PV and FLACC pain rating scales showed the strongest evidence for validity and reliability for assessing postoperative pain in children with CI. However, due to the high heterogeneity of the studies available, these results should not be considered conclusive.This review is focused on the assessment of pain in children with CI in the postoperative period. Simplified observation-based pain assessment tools that rely on evaluating non-verbal expressions of pain should be recommended for children with difficulties to communicate their feelings. Even if there is a high degree of heterogeneity in clinical presentations among youth with CI, two tools (NCCPC-PV and FLACC) have emerged as reliable and valid in this population.
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- 2022
23. Diagnosis and management of urinary tract infections in children aged 2 months to 3 years in the Italian emergency units: the ItaUTI study
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Francesca, Cenzato, Milani, Gregorio P., Angela, Amigoni, Francesca, Sperotto, Bianchetti, Mario G., Carlo, Agostoni, Giovanni, Montini, Farello, Giovanni, Francesco, Chiarelli, Greco, Rita, Franco Di Lollo, Fabio Rocco Forte, Sergio, Manieri, Luigi, Carpino, Mimma, Caloiero, Anastasia, Cirisano, Salvatore, Bragh(`(o)), Roberto Della Casa, Felice, Nunziata, Carmine, Pecoraro, Rosario, Pacifico, Marcello, Lanari, Chiara, Ghizzi, Laura, Serra, Marcello, Stella, Giuseppe, Maggiore, Roberto, Fiorini, Icilio, Dodi, Andrea, Morelli, Lorenzo, Lughetti, Andrea, Cella, Gianluca, Vergine, Alessandro De Fanti, Danica, Dragovic, Daniele, Santori, Giorgio, Cozzi, Paola, Cogo, Marilena, Raponi, Riccardo, Lubrano, Mauro de Martinis, Antonio, Gatto, Maria Antonietta Barbieri, Antonino, Reale, Giorgio, Bracaglia, Emanuela, Piccotti, Riccardo, Borea, Alberto, Gaiero, Laura, Martelli, Alberto, Arrighini, Paola, Cianci, Claudio, Cavalli, Leonardina De Santis, Benedetta Chiara Pietra, Andrea, Biondi, Marco, Sala, Pogliani, Laura M., Simonetta, Cherubini, Marta, Bellini, Paola, Bruni, Giovanni, Traina, Paola, Tommasi, Paolo Del Barba, Sergio, Arrigoni, Salvini, Filippo M., Luca, Bernardo, Giuseppe, Bertolozzi, Silvia, Fasoli, Gian Luigi Marseglia, Emilio, Palumbo, Annalisa, Bosco, Gianpaolo, Mirri, Elisabetta, Fabiani, Ermanno, Ruffini, Luisa, Pieragostini, Martina, Fornaro, Gabriele, Ripanti, Donnina, Pannoni, Felici, Enrico, Anna, Perona, Eleonora, Tappi, Oscar Nis Haitink, Ivana, Rabbone, Pina Teresa Capalbo, Antonio, Urbino, Andrea, Guala, Gianluca, Cosi, Maria Gabriella Barracchia, Baldassarre, Martire, Fabio, Cardinale, Fulvio, Moramarco, Carmelo, Perrone, Angelo, Campanozzi, Valerio, Cecinati, Alessandro, Canetto, Ciro, Clemente, Antonio, Cualbu, Fabio, Narducci, Giuseppina, Mula, Pasquale, Bulciolu, Roberto, Antonucci, Giuseppe, Gramaglia, Giuseppe, Cavaleri, Carmelo, Salpietro, Giovanni, Corsello, Rosario, Salvo, Marcello, Palmeri, Maria Assunta Vitale, Ambra, Morgano, Susanna, Falorni, Diego, Peroni, Stefano, Masi, Alessio, Bertini, Angelina, Vaccaro, Pierluigi, Vasarri, Petra, Reinstadler, Massimo, Soffiati, Maurizio, Stefanelli, VERROTTI di PIANELLA, Alberto, Catherine, Bertone, Stefano, Marzini, Liviana Da Dalt, Simone, Rugolotto, Floriana, Scozzola, Luca Ecclesio Livio, Mauro, Cinquetti, Davide, Silvagni, Massimo Bellettato and, Cenzato F., Milani G.P., Amigoni A., Sperotto F., Bianchetti M.G., Agostoni C., Montini G., Farello G., Chiarelli F., Greco R., Di Lollo F., Rocco Forte F., Manieri S., Carpino L., Caloiero M., Cirisano A., Bragho S., Della Casa R., Nunziata F., Pecoraro C., Pacifico R., Lanari M., Ghizzi C., Serra L., Stella M., Maggiore G., Fiorini R., Dodi I., Morelli A., Lughetti L., Cella A., Vergine G., De Fanti A., Dragovic D., Santori D., Cozzi G., Cogo P., Raponi M., Lubrano R., de Martinis M., Gatto A., Barbieri M.A., Reale A., Bracaglia G., Piccotti E., Borea R., Gaiero A., Martelli L., Arrighini A., Cianci P., Cavalli C., De Santis L., Pietra B.C., Biondi A., Sala M., Pogliani L.M., Cherubini S., Bellini M., Bruni P., Traina G., Tommasi P., Del Barba P., Arrigoni S., Salvini F.M., Bernardo L., Bertolozzi G., Fasoli S., Marseglia G.L., Palumbo E., Bosco A., Mirri G., Fabiani E., Ruffini E., Pieragostini L., Fornaro M., Ripanti G., Pannoni D., Enrico F., Perona A., Tappi E., Nis Haitink O., Rabbone I., Capalbo P.T., Urbino A., Guala A., Cosi G., Barracchia M.G., Martire B., Cardinale F., Moramarco F., Perrone C., Campanozzi A., Cecinati V., Canetto A., Clemente C., Cualbu A., Narducci F., Mula G., Bulciolu P., Antonucci R., Gramaglia G., Cavaleri G., Salpietro C., Corsello G., Salvo R., Palmeri M., Vitale M.A., Morgano A., Falorni S., Peroni D., Masi S., Bertini A., Vaccaro A., Vasarri P., Reinstadler P., Soffiati M., Stefanelli M., Verrotti di Pianella A., Bertone C., Marzini S., Da Dalt L., Rugolotto S., Scozzola F., Ecclesio Livio L., Cinquetti M., Silvagni D., and Bellettato M.
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Catheter ,Urinary tract ,Emergency department ,Pediatrics, Perinatology and Child Health ,Guidelines ,Infants ,Infection ,Survey ,Urine ,Infant ,Guideline - Abstract
Urinary tract infections (UTIs) are among the most frequent bacterial diseases in infants and children. Physician adherence to recommendations is notoriously often poor, but no data are available on UTIs management in the emergency setting. In this multicenter national study, we investigated the policies regarding UTIs management in children aged 2 months to 3 years in Italian emergency units. Between April and June 2021, directors of the emergency units were invited to answer an online survey on the following items: diagnostic approach to children with fever without an apparent source, therapeutic approach to UTIs, the use of kidney and urinary tract ultrasound, and the criteria for hospitalization. A total of 121 (89%) out of 139 of invited units participated in the study. Overall, units manage children with a suspected or confirmed UTI according to available recommendations for most of the items. However, in almost 80% (n = 94) of units, a sterile perineal bag is used to collect urine for culture. When urine is collected by cathether, heterogeneity exists on the threshold of bacterial load considered for UTI diagnosis. Conclusions: Available recommendations on UTIs in children are followed by Italian emergency units for most of the items. However, the methods to collect urine specimens for culture, one of the crucial steps of the diagnostic work-up, often do not align with current recommendations and CFU thresholds considered for diagnosis largely vary among centers. Efforts should be addressed to validate and implement new child and family friendly urine collection techniques. What is Known:• Several guidelines are published on the management of children with suspected or confirmed urinary tract infection.• No data are available on the management of pediatric urinary tract infections in the emergency setting. What is New:• Almost 80% of the Italian emergency units employ a sterile perineal bag to collect urine for culture.• Diagnostic CFU thresholds largely vary among centers.
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- 2022
24. Infective Uvulitis in a Child
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Lisa Gamalero, Paola Cogo, Eva Passone, Anna Pusiol, Carlo De Pieri, and Elena Valentini
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medicine.medical_specialty ,Haemophilus Infections ,Streptococcus pyogenes ,medicine.drug_class ,Epiglottitis ,medicine.disease_cause ,Intravenous antibiotic therapy ,Group A ,Haemophilus ,medicine ,Humans ,Child ,Stomatitis ,biology ,Streptococcus ,business.industry ,fungi ,food and beverages ,Pharyngitis ,General Medicine ,biology.organism_classification ,medicine.disease ,Dermatology ,Uvula ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Emergency Medicine ,Corticosteroid ,Female ,Streptococcus pharyngitis ,business - Abstract
Infective uvulitis is a rare condition in children. In this report, we describe the case of a 4-year old-patient who presented a group A Streptococcus pharyngitis with uvulitis. No signs of epiglottitis were detected at nasal fibroscopy. She recovered rapidly with intravenous antibiotic therapy and 2 days of corticosteroid. Uvulitis is usually caused by group A Streptococcus or Haemophilus influentiae, but also other bacteria can be detected. Uvulitis can be isolated, or it can occur with epiglottitis and become an emergency.
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- 2022
25. Severe Bronchiolitis as a Cause of ARDS in Early Childhood. Pathophysiology and Strategies to Minimize Lung Injury
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Corrado Moretti, camilla gizzi, Caterina Barbara, Nicola Pozzi, Fabio Midulla, and Paola Cogo
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Bronchiolitis is one of the most frequent acute diseases of the lower respiratory tract in infants worldwide, and Respiratory Syncytial Virus remains the most common and aggressive viral disease. The course of the disease is usually benign, but its severity may change by evolving into parenchymal disease. In the more severe cases, its clinical and radiological characteristics may be consistent with acute respiratory distress syndrome. Management of these cases includes admission to paediatric intensive care and invasive mechanical ventilation. This paper reviews the definition of paediatric and neonatal acute respiratory distress syndrome, which was primarily designed and validated for adults. The article investigates the pathophysiology of paediatric acute respiratory distress syndrome further, describing how damage to the alveolar-capillary units, surfactant inactivation and inflammation occurs. Mechanisms that contribute to acute lung injury, such as volutrauma, barotrauma, stress and strain, are illustrated in detail, and an overview of the strategies that may help minimize neonatal lung injury and optimize ventilatory support is provided. These strategies include lung-protective mechanical ventilation, surfactant treatment, inhaled nitric oxide, high frequency oscillatory ventilation, recruiting manoeuvres, prone position and neuromuscular blocking agents. The objective is to help clinicians understand the peculiar pathophysiology of severe bronchiolitis and so guide them in preventing or attenuating lung injury during treatment. As such, this paper aims to contribute to defining optimal treatment of severe cases of bronchiolitis.
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- 2022
26. Protective continuous ventilation strategy during cardiopulmonary bypass in children undergoing surgery for congenital heart disease: a prospective study
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Massimo A Padalino, Luca Vedovelli, Manuela Simonato, Andrea Bandini, Greta Paganini, Laura Mezzalira, Nicola Faganello, Cristiana Carollo, Dario Gregori, Vladimiro Vida, and Paola Cogo
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Heart Defects, Congenital ,Pulmonary and Respiratory Medicine ,Cardiopulmonary bypass ,Respiration, Artificial ,Lung injury ,Ventilation ,Systemic inflammatory response syndrome ,Paediatric ,Child, Preschool ,Humans ,Surgery ,Prospective Studies ,Congenital heart disease ,Child ,Cardiology and Cardiovascular Medicine ,Lung - Abstract
OBJECTIVES The aim of this study was to evaluate if a ‘protective’ (low-tidal/low-frequency) ventilation strategy can shorten the postoperative ventilation time and minimize acute lung injury in children with congenital heart disease (CHD) undergoing repair with cardiopulmonary bypass (CPB). METHODS This is a single-centre prospective, interventional study, including children with CHD under the age of 5 years, undergoing open-heart surgery with a CPB >60 min, in hypothermia, haemodynamically stable, and without evident genetic abnormalities. Assist-control ventilation (tidal volume of 4 ml/kg, 10 breaths/min, positive end-expiratory pressure 5 cmH2O and FiO2 0.21) was applied in a cohort of patients during CPB. We compared clinical outcomes and in fully ventilated versus non-ventilated (control) patients. Propensity score was used to weigh ventilated and control groups to correct for the effect of other confounding clinical variables. Clinical and ventilation parameters and lung inflammatory biomarkers in tracheal aspirates were measured. The primary outcome was the postoperative intubation time of more or less than 48 h. RESULTS We included 140 children (53 ventilated, 87 non-ventilated) with different CHD. There were no deaths or adverse events in ventilated patients. Using a weighted generalized linear model, we found no sufficient evidence for an effect of intraoperative ventilation on postoperative intubation time [estimate 0.13 (95% confidence interval, –0.08; 0.35), P = 0.22]. CONCLUSIONS Continuous low-tidal/low-frequency mechanical ventilation during CPB is safe and harmless. However, no significant advantages were found when compared to non-ventilated patients in terms of postoperative ventilation time.
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- 2022
27. The impact of urbanization and wealth on house dust mite sensitization in children from north-central Nigeria
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Chiara Zuiani, Michele Arigliani, Ramatu Zubair, Livingstone Gayus Dogara, Luigi Castriotta, Ashel Dache Sunday, Reward Christopher Audu, Habibah Dadan-Garba, Zakary Sani, Baba Inusa, and Paola Cogo
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Male ,Allergy ,Epidemiology ,Pyroglyphidae ,Urbanization ,Nigeria ,Dust ,General Medicine ,Allergens ,House dust mite ,Cross-Sectional Studies ,Children ,Animals ,Humans ,Female ,Child ,Skin Tests - Abstract
The impact of socio-economic status on the risk of allergy in African children is not clear.This was a cross sectional study including children aged 6–14 years from urban and rural settings in north-central Nigeria. Participants underwent skin prick tests to house dust mite (HDM) and an interview investigating socio-economic status through the Family Affluence Scale (FAS) based on a score of 0–6.A total of 346 children were enrolled (52.8% boys; mean age ± SD 9.6 ± 2.0 years), including 142 (41% of total) rural and 204 (59% of total) urban pupils. Prevalence of HDM sensitivity was 2.8% (4/142) in the rural setting and 15.6% (32/204) in the urban setting (P Urbanization and increasing wealth are associated with a higher frequency of sensitization to HDM in Nigerian children.
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- 2022
28. Thioridazine requires calcium influx to induce MLL-AF6–rearranged AML cell death
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Silvia Campello, Paola Cogo, Elena Porcù, Manuela Simonato, Franco Locatelli, Katia Polato, Alessandro Massi, Sonia Minuzzo, Ambra Da Ros, Barbara Buldini, Claudia Tregnago, Martina Pigazzi, Giulia Borella, Romeo Romagnoli, Luca Simula, Giulia Borile, and Maddalena Benetton
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Programmed cell death ,Oncogene Proteins, Fusion ,medicine.medical_treatment ,Cell ,Hematopoietic stem cell transplantation ,acute myeloid leukemia ,Settore MED/04 ,Translocation, Genetic ,NO ,children ,AML ,In vivo ,safer drugs ,hemic and lymphatic diseases ,Precursor cell ,medicine ,Humans ,Child ,Clonogenic assay ,Myeloid Neoplasia ,Cell Death ,Thioridazine ,business.industry ,Histone-Lysine N-Methyltransferase ,Hematology ,medicine.disease ,Leukemia, Myeloid, Acute ,Leukemia ,medicine.anatomical_structure ,Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA ,Mechanism of action ,Cancer research ,Calcium ,medicine.symptom ,business ,Myeloid-Lymphoid Leukemia Protein - Abstract
In pediatric acute myeloid leukemia (AML), intensive chemotherapy and allogeneic hematopoietic stem cell transplantation are the cornerstones of treatment in high-risk cases, with severe late effects and a still high risk of disease recurrence as the main drawbacks. The identification of targeted, more effective, safer drugs is thus desirable. We performed a high-throughput drug-screening assay of 1280 compounds and identified thioridazine (TDZ), a drug that was highly selective for the t(6;11)(q27;q23) MLL-AF6 (6;11)AML rearrangement, which mediates a dramatically poor (below 20%) survival rate. TDZ induced cell death and irreversible progress toward the loss of leukemia cell clonogenic capacity in vitro. Thus, we explored its mechanism of action and found a profound cytoskeletal remodeling of blast cells that led to Ca2+ influx, triggering apoptosis through mitochondrial depolarization, confirming that this latter phenomenon occurs selectively in t(6;11)AML, for which AF6 does not work as a cytoskeletal regulator, because it is sequestered into the nucleus by the fusion gene. We confirmed TDZ-mediated t(6;11)AML toxicity in vivo and enhanced the drug’s safety by developing novel TDZ analogues that exerted the same effect on leukemia reduction, but with lowered neuroleptic effects in vivo. Overall, these results refine the MLL-AF6 AML leukemogenic mechanism and suggest that the benefits of targeting it be corroborated in further clinical trials.
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- 2020
29. SARS-COV-2 infection in children and newborns: a systematic review
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Maria Elena Ferrari, Margherita Bonanni, Anna Pusiol, Ilaria Liguoro, Agostino Nocerino, Chiara Pilotto, Enrico Vidal, and Paola Cogo
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Pediatrics ,medicine.medical_specialty ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Review ,03 medical and health sciences ,0302 clinical medicine ,030225 pediatrics ,Neonatal ,Pandemic ,Severity of illness ,Epidemiology ,Medicine ,Pediatrics, Perinatology, and Child Health ,030212 general & internal medicine ,Infectious disease (athletes) ,Pediatric intensive care unit ,Infectious disease ,COVID-19 ,Novel coronavirus ,business.industry ,Outbreak ,Sample size determination ,Pediatrics, Perinatology and Child Health ,business - Abstract
A recent outbreak of a novel Coronavirus responsible for a Severe Acute Respiratory Syndrome (SARS-CoV-2) is spreading globally. The aim of this study was to systematically review main clinical characteristics and outcomes of SARS-CoV-2 infections in pediatric age. An electronic search was conducted in PubMed database. Papers published between 1 January and 1 May 2020 including children aged 0–18 years were selected. Sixty-two studies and three reviews were included, with a total sample size of 7480 children (2428/4660 males, 52.1%; weighted mean age 7.6 years). Patients showed mainly mild (608/1432, 42.5%) and moderate (567/1432, 39.6%) signs of the infection. About 2% of children were admitted to the pediatric intensive care unit. The most commonly described symptoms were fever (51.6%) and cough (47.3%). Laboratory findings were often unremarkable. Children underwent a chest CT scan in 73.9% of all cases, and 32.7% resulted normal. Overall, the estimated mortality was 0.08%. A higher proportion of newborns was severely ill (12%) and dyspnea was the most common reported sign (40%). Conclusion: SARS-CoV-2 affects children less severely than adults. Laboratory and radiology findings are mainly nonspecific. Larger epidemiological and clinical cohort studies are needed to better understand possible implications of COVID-19 infection in children.What is Known:• A novel Coronavirus has been recently identified as responsible for a new Severe Acute Respiratory Syndrome (SARS-CoV-2) spreading globally.• There is limited evidence on SARS-CoV2 infection in children.What is New:• Systematically reviewed available evidence showed that children with SARS-CoV-2 infection may have a less severe pattern of disease in comparison to adults.• Blood tests and radiology findings are mainly nonspecific in children but may help to identify those who are severely ill. Electronic supplementary material The online version of this article (10.1007/s00431-020-03684-7) contains supplementary material, which is available to authorized users.
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- 2020
30. Optic Nerve Hypoplasia, Corpus Callosum Agenesis, Cataract, and Lissencephaly in a Neonate with a Novel COL4A1 Mutation
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Paolo Lanzetta, Nicolò Rassu, Silvia Pignatto, Paola Cogo, Lisa Grego, and Eva Passone
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Optic nerve hypoplasia ,Pathology ,medicine.medical_specialty ,business.industry ,Corpus Callosum Agenesis ,010102 general mathematics ,Lissencephaly ,medicine.disease ,01 natural sciences ,Porencephaly ,Hypoplasia ,03 medical and health sciences ,Ophthalmology ,Dysgenesis ,0302 clinical medicine ,030221 ophthalmology & optometry ,medicine ,Optic nerve ,0101 mathematics ,business ,Agenesis of the corpus callosum - Abstract
We report the case of a girl with a novel mutation of the COL4A gene (c.2716+2T>C) presenting microcephaly, parenchymal hemorrhages, lissencephaly, and bilateral cataracts, associated with agenesis of the corpus callosum and hypoplasia of the optic nerve. COL4A1, located on chromosome 13, encodes the α1 chain of type IV collagen, a key component of the basement membrane in various organs, such as eye, brain, kidneys, and muscles. Different mutations have been described and may remain asymptomatic or determine porencephaly, cerebral hemorrhages, renal cysts, hematuria, and dysgenesis of the anterior segment of the eye.
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- 2019
31. Tryptophan Metabolites, Cytokines, and Fatty Acid Binding Protein 2 in Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
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Anna Aldovini, Ugo Fiocco, Stefano Dall'Acqua, Aldo Baritussio, Leonardo Sartori, Paolo Sfriso, Paolo Agostinis, Manuela Simonato, Renzo Marcolongo, Paola Cogo, Caterina Zilli, Stefania Sut, Nicoletta Gallo, Stefano Comai, Romano Tenconi, Francesco Cavallin, and Daniela Bruttomesso
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medicine.medical_specialty ,Kynurenine pathway ,ME/CFS heterogeneity ,QH301-705.5 ,Encephalomyelitis ,3-Hydroxykynurenine ,Medicine (miscellaneous) ,Article ,General Biochemistry, Genetics and Molecular Biology ,chemistry.chemical_compound ,Kynurenic acid ,3-hydroxykynurenine ,biomarkers ,cytokines ,intestinal permeability ,kynurenine ,kynurenine pathway ,personalized medicine ,serotonin ,tryptophan metabolism ,Internal medicine ,medicine ,Chronic fatigue syndrome ,Biology (General) ,business.industry ,Tryptophan ,medicine.disease ,Endocrinology ,chemistry ,Serotonin ,business ,Kynurenine - Abstract
Patients with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) differ for triggers, mode of start, associated symptoms, evolution, and biochemical traits. Therefore, serious attempts are underway to partition them into subgroups useful for a personalized medicine approach to the disease. Here, we investigated clinical and biochemical traits in 40 ME/CFS patients and 40 sex- and age-matched healthy controls. Particularly, we analyzed serum levels of some cytokines, Fatty Acid Binding Protein 2 (FAPB-2), tryptophan, and some of its metabolites via serotonin and kynurenine. ME/CFS patients were heterogeneous for genetic background, trigger, start mode, symptoms, and evolution. ME/CFS patients had higher levels of IL-17A (p = 0.018), FABP-2 (p = 0.002), and 3-hydroxykynurenine (p = 0.037) and lower levels of kynurenine (p = 0.012) and serotonin (p = 0.045) than controls. Changes in kynurenine and 3-hydroxykynurenine were associated with increased kynurenic acid/kynurenine and 3-hydroxykynurenine/kynurenine ratios, indirect measures of kynurenine aminotransferases and kynurenine 3-monooxygenase enzymatic activities, respectively. No correlation was found among cytokines, FABP-2, and tryptophan metabolites, suggesting that inflammation, anomalies of the intestinal barrier, and changes of tryptophan metabolism may be independently associated with the pathogenesis of the disease. Interestingly, patients with the start of the disease after infection showed lower levels of kynurenine (p = 0.034) than those not starting after an infection. Changes in tryptophan metabolites and increased IL-17A levels in ME/CFS could both be compatible with anomalies in the sphere of energy metabolism. Overall, clinical traits together with serum biomarkers related to inflammation, intestine function, and tryptophan metabolism deserve to be further considered for the development of personalized medicine strategies for ME/CFS.
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- 2021
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32. NKX2.1 run‐on mutation associated to familial brain–lung–thyroid syndrome
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Nadia Passon, Paola Cogo, Dora Fabbro, Elena Cavaliere, Dario Marin, Rosa Gallo, Sara Carmela Credendino, Federica Baldan, Giuseppe Damante, Anna Jolanda Gortan, Miryam Carecchio, and Gabriella De Vita
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Adult ,Male ,Thyroid Nuclear Factor 1 ,Bioinformatics ,Text mining ,Chorea ,Cell Line, Tumor ,Brain-Lung-Thyroid Syndrome ,Genetics ,Congenital Hypothyroidism ,Medicine ,Humans ,Amino Acid Sequence ,Letters to the Editor ,Child ,Letter to the Editor ,Athetosis ,Genetics (clinical) ,Aged ,Respiratory Distress Syndrome, Newborn ,business.industry ,Middle Aged ,Mutation (genetic algorithm) ,Mutation ,Female ,business ,HeLa Cells - Published
- 2021
33. Perioperative Glial Fibrillary Acidic Protein Is Associated with Long-Term Neurodevelopment Outcome of Infants with Congenital Heart Disease
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Luca Vedovelli, Massimo A. Padalino, Paola Cogo, Valentina Tonazzo, Dario Gregori, Manuela Simonato, Elisa Cainelli, Michela Vergine, and Alessio Correani
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medicine.medical_specialty ,Heart disease ,neuropsychological outcome ,030204 cardiovascular system & hematology ,Logistic regression ,Pediatrics ,Article ,RJ1-570 ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,children ,law ,Internal medicine ,medicine ,Cardiopulmonary bypass ,Intelligence quotient ,Glial fibrillary acidic protein ,biology ,business.industry ,Neuropsychology ,Perioperative ,medicine.disease ,congenital heart disease ,Children ,Congenital heart disease ,Neuropsychological outcome ,glial fibrillary acidic protein ,Pediatrics, Perinatology and Child Health ,biology.protein ,Cardiology ,business ,cardiopulmonary bypass ,030217 neurology & neurosurgery ,Psychopathology - Abstract
Background: Brain injury, impaired brain maturation, and long-term neurodevelopmental disorders are common in infants with congenital heart diseases (CHD). We aimed to assess whether plasma glial fibrillary acidic protein (GFAP) can predict neurodevelopmental anomalies in CHD infants operated on cardiopulmonary bypass (CPB). Methods: We measured plasma GFAP in 38 infants at multiple CPB phases. Cognitive, neuropsychological, and psychopathological functioning were assessed 5.7 ± 2.2 years after surgery. We identified an impaired global neurodevelopmental index (NDI) when at least two domains were abnormal. The relationships between NDI, GFAP, and clinical variables were explored with non-supervised feature selection methods and modeled with a nested non-linear logistic regression. Results: Intelligence quotient scores were within the normal range in 84% of children, whereas 58% showed an abnormal NDI, with the greatest impairments in the psychopathological area. The plasma GFAP peak was 0.95 (0.44–1.57) ng/mL, and it was correlated with age, weight, duration of surgery phases, and CPB minimum temperature. In the regression model, the GFAP peak was associated with an impaired NDI with a possible flexible point toward NDI impairment at 0.49 ng/mL, keeping constant ICU stay, CPB duration, CHD anatomy, weight, and CPB minimum temperature. Conclusion: GFAP is a promising early marker of abnormal long-term neuropsychological development.
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- 2021
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34. Management of reduced vaccine coverage due to 6 years of failure to vaccinate: The Codroipo case, Italy
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L Brunelli, Federico Romanese, Erica Vacchiano, Laura Regattin, Tolinda Gallo, Marco Del Negro, Andrea Taddio, Mirella Campagnolo, Anna Fabbro, Maurizio Perna, Andrea Plazzotta, Patrizia Brunetti, Bruno Sacher, Paolo Pischiutti, Massimo Sigon, Giovanni Cattani, Giorgio Brianti, Mariarita Forgiarini, Tiziano Tommasini, Pier Paolo Benetollo, Silvio Brusaferro, Fabio Marchetti, Piero Pascolo, Stefano Miceli, Paola Cogo, Luca Paravano, Pierlanfranco D'Agaro, Matteo Bassetti, Agostino Nocerino, Luca Arnoldo, Francesca Valent, A Iob, Paolo Lubrano, Gianni Borghi, Brunelli, L., Romanese, F., Benetollo, P. P., Iob, A., Forgiarini, M., D'Agaro, P., Valent, F., Brusaferro, S., Arnoldo, L., Bassetti, M., Borghi, G., Brianti, G., Brunetti, P., Campagnolo, M., Cattani, G., Cogo, P., Del Negro, M., Fabbro, A., Gallo, T., Lubrano, P., Marchetti, F., Miceli, S., Nocerino, A., Paravano, L., Pascolo, P., Perna, M., Pischiutti, P., Plazzotta, A., Regattin, L., Sacher, B., Sigon, M., Taddio, A., Tommasini, T., and Vacchiano, E.
- Subjects
Vaccination Coverage ,Immunology and Microbiology (all) ,030231 tropical medicine ,Extraordinary vaccination campaign ,Failure to vaccinate ,Immunization ,Public health policy ,Public health reaction ,Vaccine preventable diseases ,Molecular Medicine ,Veterinary (all) ,Public Health, Environmental and Occupational Health ,Infectious Diseases ,Risk Assessment ,Disease Outbreaks ,03 medical and health sciences ,Vaccination failure ,0302 clinical medicine ,Environmental health ,Outcome Assessment, Health Care ,Humans ,Medicine ,Public Health Surveillance ,030212 general & internal medicine ,Immunization Schedule ,Vaccines ,General Veterinary ,General Immunology and Microbiology ,business.industry ,Environmental and Occupational Health ,Vaccination ,Outbreak ,Friuli venezia giulia ,Italy ,Vaccine-preventable diseases ,Public Health ,business ,Healthcare system - Abstract
During 2017 an alert was raised in relation to a possible vaccination failure occurred in Friuli Venezia Giulia Region (Italy) between 2009 and 2015, exposing multiple cohorts of children and the entire community to vaccine preventable diseases outbreak risk. The Codroipo case resulted in 20,441 vaccine doses being in doubt, thus prompting the healthcare system to react in order to revaccinate 5444 children through planning and implementing network actions and multiple channels of communication.
- Published
- 2019
35. Embrace the Complexity: Agnostic Evaluation of Children’s Neuropsychological Performances Reveals Hidden Neurodevelopment Patterns
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Elisa Cainelli, Luca Vedovelli, Dario Gregori, Agnese Suppiej, Massimo Padalino, Paola Cogo, and Patrizia Bisiacchi
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cognitive ,machine learning ,Pediatrics, Perinatology and Child Health ,hypoxic-ischemic encephalopathy ,cluster analysis ,congenital heart disease ,preterm - Abstract
The most common adverse pre/perinatal events have a great impact on neurodevelopment, with avalanche effects on academic performance, occupational status, and quality of life. Although the injury process starts early, the effects may become evident much later, when life starts to pose more challenging demands. In the present work, we want to address the impact of early insults from an evolutionary perspective by performing unsupervised cluster analysis. We fed all available data, but not the group identification, into the algorithm for 114 children aged 5–10 years, with different adverse medical conditions: healthy (n = 30), premature (n = 28), neonatal hypoxic-ischemic encephalopathy (n = 28), and congenital heart disease (n = 28). We measured general intelligence and many neuropsychological domains (language, attention, memory, executive functions, and social skills). We found three emerging groups that identify children with multiple impairments (cluster 3), children with variable neuropsychological profiles but in the normal range (cluster 2), and children with adequate profiles and good performance in IQ and executive functions (cluster 1). Our analysis divided our patients by severity levels rather than by identifying specific neuropsychological phenotypes, suggesting different developmental trajectories that are characterized by good resilience to early stressful events with adequate development or by pervasive vulnerability to neurodevelopmental disorders.
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- 2022
36. The maternal-fetal gradient of free and esterified phytosterols at the time of delivery in humans
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Eleonora Ponchia, Luca Vedovelli, Alessio Correani, Silvia Visentin, Virgilio P. Carnielli, Paola Cogo, Erich Cosmi, Manuela Simonato, and Sara D'Aronco
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Adult ,Male ,0301 basic medicine ,medicine.medical_specialty ,Campesterol ,Maternal blood ,Lathosterol ,030204 cardiovascular system & hematology ,Critical Care and Intensive Care Medicine ,Term delivery ,Cohort Studies ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,Obstetrics and gynaecology ,Pregnancy ,Internal medicine ,Humans ,Medicine ,Maternal-Fetal Exchange ,Nutrition and Dietetics ,Stigmasterol ,business.industry ,Cholesterol ,Infant, Newborn ,Phytosterols ,Cord blood ,Human placenta ,Delivery, Obstetric ,Fetal Blood ,medicine.disease ,030104 developmental biology ,Endocrinology ,chemistry ,Female ,lipids (amino acids, peptides, and proteins) ,business - Abstract
High dietary intakes of phytosterols (Phyto), such as those consumed by vegans and vegetarians, are not recommended for cholesterol-lowering in pregnant women (PW) because the safety of their use during pregnancy has not been fully established [1]. Information on Phyto in pregnancy is very limited.To characterize the maternal-fetal gradient of free and esterified Phyto at the time of delivery in humans.PW who had a term delivery at the Obstetrics and Gynecology Unit of the University Hospital of Padua (Padua, Italy), between November 2016 and March 2017, participated in the study. Fatty acids (FA), cholesterol (Chol), Chol metabolites (7-dehydrocholesterol, 7-DHChol; lathosterol, Latho; 7α-hydroxycholesterol, 7α-OHChol), and Phyto (campesterol, Camp; stigmasterol, Stigma; sitosterol, Sito) were measured in both maternal (MB) and cord blood (CB) at the time of delivery. Non-pregnant adult volunteers (Ref-NA) served as a reference.Thirty-four term PW and 12 Ref-NA signed informed consent and were studied. Plasma total Phyto concentrations in CB were up to 20-fold lower than in MB (p 0.05). Positive and significant correlations were found between total Phyto of MB-CB pairs (p 0.01), and between total FA and Camp of MB (p 0.05). Interestingly, free Chol to Chol ester ratio of CB did not differ from that of MB, and free Phyto to Phyto ester ratios were higher in CB than in MB (p 0.001). No differences were found between Phyto concentrations of MB and Ref-NA. However, free Chol to Chol ester ratio, and free Phyto to Phyto ester ratios were higher in MB than in Ref-NA (p 0.05). Chol synthesis, as indicated by 7-DHChol to 7α-OHChol, Latho to 7α-OHChol, and Latho to Sito ratios, was greatest in CB and lowest in Ref-NA.Our data suggest that free Phyto cross the human placenta more easily than Phyto ester. An elevated Stigma to Chol ratio in CB than in MB was also described for the first time. The impact of these findings on the neonatal outcomes remains to be elucidated.
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- 2018
37. Author response for 'NKX2 .1 run‐on mutation associated to familial brain–lung–thyroid syndrome'
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Gabriella De Vita, Sara C Credendino, G. Damante, Dario Marin, Paola Cogo, Rosa Gallo, Federica Baldan, Dora Fabbro, Miryam Carecchio, Anna Jolanda Gortan, Elena Cavaliere, and Nadia Passon
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business.industry ,Brain-Lung-Thyroid Syndrome ,Mutation (genetic algorithm) ,Cancer research ,Medicine ,business - Published
- 2021
38. Surfactant therapies for pediatric and neonatal ARDS
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Martin C. J. Kneyber, Daniele De Luca, Paolo Biban, Paola Cogo, Jesús Pérez-Gil, Malcolm G Semple, Peter C. Rimensberger, Giorgio Conti, and Pierre Tissières
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Bioquímica ,medicine.medical_specialty ,ARDS ,Review ,Acute respiratory distress ,Critical Care and Intensive Care Medicine ,Pediatrics ,Surface-Active Agents ,03 medical and health sciences ,0302 clinical medicine ,Neonate ,PARDS ,Surfactant ,medicine ,Humans ,030212 general & internal medicine ,Child ,Intensive care medicine ,Expert Testimony ,Neumología ,Children ,Respiratory Distress Syndrome ,Infant ,NARDS ,business.industry ,Research ,Infant, Newborn ,lcsh:Medical emergencies. Critical care. Intensive care. First aid ,Expert consensus ,lcsh:RC86-88.9 ,medicine.disease ,Preclinical data ,030228 respiratory system ,Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA ,Child, Preschool ,business ,Forecasting - Abstract
Pediatric (PARDS) and neonatal (NARDS) acute respiratory distress syndrome have different age-specific characteristics and definitions. Trials on surfactant for ARDS in children and neonates have been performed well before the PARDS and NARDS definitions and yielded conflicting results. This is mainly due to heterogeneity in study design reflecting historic lack of pathobiology knowledge. We reviewed the available clinical and preclinical data to create an expert consensus aiming to inform future research steps and advance the knowledge in this area. Eight trials investigated the use of surfactant for ARDS in children and ten in neonates, respectively. There were improvements in oxygenation (7/8 trials in children, 7/10 in neonates) and mortality (3/8 trials in children, 1/10 in neonates) improved. Trials were heterogeneous for patients’ characteristics, surfactant type and administration strategy. Key pathobiological concepts were missed in study design. Consensus with strong agreement was reached on four statements:There are sufficient preclinical and clinical data to support targeted research on surfactant therapies for PARDS and NARDS. Studies should be performed according to the currently available definitions and considering recent pathobiology knowledge.PARDS and NARDS should be considered as syndromes and should be pre-clinically studied according to key characteristics, such as direct or indirect (primary or secondary) nature, clinical severity, infectious or non-infectious origin or patients’ age.Explanatory should be preferred over pragmatic design for future trials on PARDS and NARDS.Different clinical outcomes need to be chosen for PARDS and NARDS, according to the trial phase and design, trigger type, severity class and/or surfactant treatment policy.We advocate for further well-designed preclinical and clinical studies to investigate the use of surfactant for PARDS and NARDS following these principles.
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- 2021
39. Surfactant lung delivery with LISA and InSurE in adult rabbits with respiratory distress
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Ilia Bresesti, Costanza Casiraghi, Laura Tigli, Virgilio P. Carnielli, Xabier Murgia, Arianna Mersanne, Chiara Catozzi, Pietro Franceschi, Matteo Storti, Riccardo Zecchi, Gianluca Lista, Manuela Simonato, Fabrizio Salomone, Paola Cogo, Paola Azzurra Maria LaVerde, and Francesca Ricci
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Settore CHIM/01 - CHIMICA ANALITICA ,medicine.medical_treatment ,Lung injury ,03 medical and health sciences ,0302 clinical medicine ,Pulmonary surfactant ,030225 pediatrics ,Medicine ,Animals ,Humans ,Continuous positive airway pressure ,Mechanical ventilation ,Respiratory Distress Syndrome, Newborn ,Lung ,Respiratory distress ,Continuous Positive Airway Pressure ,business.industry ,Surfactant protein C ,Pulmonary Surfactants ,respiratory system ,Basic Science Article ,Respiration, Artificial ,Disease Models, Animal ,medicine.anatomical_structure ,Anesthesia ,Pediatrics, Perinatology and Child Health ,Breathing ,Rabbits ,business ,030217 neurology & neurosurgery - Abstract
Background In preterm infants, InSurE (Intubation-Surfactant-Extubation) and LISA (less invasive surfactant administration) techniques allow for exogenous surfactant administration while reducing lung injury associated with mechanical ventilation. We compared the acute pulmonary response and lung deposition of surfactant by LISA and InSurE in surfactant-depleted adult rabbits. Methods Twenty-six spontaneously breathing surfactant-depleted adult rabbits (6-7 weeks old) with moderate RDS and managed with nasal continuous positive airway pressure were randomized to 3 groups: (1) 200 mg/kg of surfactant by InSurE; (2) 200 mg/kg of surfactant by LISA; (3) no surfactant treatment (Control). Gas exchange and lung mechanics were monitored for 180 min. After that, surfactant lung deposition and distribution were evaluated monitoring disaturated-phosphatidylcholine (DSPC) and surfactant protein C (SP-C), respectively. Results No signs of recovery were found in the untreated animals. After InSurE, oxygenation improved more rapidly compared to LISA. However, at 180' LISA and InSurE showed comparable outcomes in terms of gas exchange, ventilation parameters, and lung mechanics. Neither DSPC in the alveolar pool nor SP-C signal distributions in a frontal lung section were significantly different between InSurE and LISA groups. Conclusions In an acute setting, LISA demonstrated efficacy and surfactant lung delivery similar to that of InSurE in surfactant-depleted adult rabbits. Impact Although LISA technique is gaining popularity, there are still several questions to address. This is the first study comparing LISA and InSurE in terms of gas exchange, ventilation parameters, and lung mechanics as well as surfactant deposition and distribution. In our animal study, three hours post-treatment, LISA method seems to be as effective as InSurE and showed similar surfactant lung delivery. Our findings provide some clarifications on a fair comparison between LISA and InSurE techniques, particularly in terms of surfactant delivery. They should reassure some of the concerns raised by the clinical community on LISA adoption in neonatal units.
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- 2021
40. Chorioamnionitis alters lung surfactant lipidome in newborns with respiratory distress syndrome
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Paola Cogo, Manuela Simonato, Luca Vedovelli, Virgilio P. Carnielli, Luca Bonadies, Lukáš Najdekr, Warwick B. Dunn, Giovanna Verlato, and Sonia Giambelluca
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Male ,Metabolite ,Physiology ,Context (language use) ,Chorioamnionitis ,chemistry.chemical_compound ,Pregnancy ,Lipidomics ,Humans ,Medicine ,Respiratory system ,Respiratory Distress Syndrome, Newborn ,Respiratory distress ,business.industry ,Infant, Newborn ,Gestational age ,Pulmonary Surfactants ,Lipidome ,medicine.disease ,chemistry ,Pediatrics, Perinatology and Child Health ,Female ,business ,Infant, Premature - Abstract
BACKGROUND Chorioamnionitis is associated with preterm delivery and morbidities; its role in lung disease is controversial. The aim of this study is to assess the effect of chorioamnionitis on metabolite and lipid profiles of epithelial lining fluid in preterm newborns with respiratory distress syndrome (RDS). METHODS The study involved 30 newborns with RDS, born from mothers with or without histological chorioamnionitis (HCA): HCA+, N = 10; HCA-, N = 20. Patients had a gestational age ≤30 weeks; the groups were matched for age and birth weights. Tracheal aspirates were collected within 24 h after birth and analyzed using liquid chromatography/mass spectrometry-based untargeted lipidomics. RESULTS According to Mann-Whitney U tests, 570 metabolite features had statistically significantly higher or lower concentrations (p
- Published
- 2021
41. A multimodal approach to the study of children treated for posterior fossa tumor: A review of the literature and a pilot study
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Barbara Tomasino, Eva Passone, Ilaria Liguoro, Tiziana Zilli, Miran Skrap, Valentina Dolcemascolo, Tamara Ius, Marta Maieron, Maria Cristina De Colle, Paola Cogo, and Martina Venchiarutti
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Male ,medicine.medical_specialty ,Posterior fossa ,Infratentorial Neoplasms ,Pilot Projects ,Neuropsychological Tests ,Neurosurgical Procedures ,Enlarged fourth ventricle ,Humans ,Medicine ,Cognitive Dysfunction ,Child ,Retrospective Studies ,medicine.diagnostic_test ,business.industry ,Neuropsychology ,Magnetic resonance imaging ,Cognition ,Multimodal therapy ,General Medicine ,Executive functions ,Magnetic Resonance Imaging ,medicine.anatomical_structure ,Ventricle ,Child, Preschool ,Female ,Surgery ,Neurology (clinical) ,Radiology ,business - Abstract
Objective The aims of the present study were: (1) to review the literature on long-lasting cognitive sequelae in children treated for Posterior Fossa Tumor and (2) to investigate anatomic functional relations in a case series of 7 children treated for PFT using magnetic resonance imaging (MRI) post-processing methods. Methods We retrospectively analyzed MRIs of children who underwent complete surgical resection of PFT and performed extensive neuropsychological evaluation. Tumor, ventricular volumes, and VPS insertion site were drawn on T1 volumetric MRI scans and normalized to a pediatric template. Children showed worse performances on tasks tapping executive functions, memory, visuo-motor precision, and expressive language. Results Volumes of interest related to these functions showed a maximum overlap on the left vermis and the lateral ventricle enlargement, except for impaired narrative fluency –which was associated with left lateral ventricle enlargement– and narrative memory –which was related to the right vermis and the enlarged fourth ventricle. Conclusion Results suggest that anatomic functional relations in children treated for PFT are related to a combination of different pathophysiological factors.
- Published
- 2021
42. L’impatto dello stress genitoriale e della paura dell’ipoglicemia sul profilo glicometabolico di bambini con diabete di tipo 1
- Author
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Ilaria, Fonzo, Nerina, Fabbro, Calvo, Vincenzo, Francesca, Franco, Manuela, Zanatta, and Paola, Cogo
- Subjects
diabete di tipo 1, bambini, paura dell’ipoglicemia, stress genitoriale, emoglobina glicata ,stress genitoriale ,paura dell’ipoglicemia ,diabete di tipo 1 ,emoglobina glicata ,bambini - Published
- 2021
43. Secondary hyperparathyroidism is associated with postpartum blood pressure in preeclamptic women and normal pregnancies
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Gretta V Badillo-Pazmay, Cristiana Catena, Lorenza Driul, Valentina Fagotto, Giulio Romano, Gianluca Colussi, Paola Cogo, Leonardo A. Sechi, Daniele Darsiè, and Francesca Pezzutto
- Subjects
medicine.medical_specialty ,Ambulatory blood pressure ,Physiology ,Parathyroid hormone ,Blood Pressure ,030204 cardiovascular system & hematology ,vitamin D deficiency ,Preeclampsia ,03 medical and health sciences ,0302 clinical medicine ,Pre-Eclampsia ,Pregnancy ,Internal medicine ,Internal Medicine ,medicine ,Vitamin D and neurology ,Humans ,030212 general & internal medicine ,Vitamin D ,Child ,Calcium metabolism ,business.industry ,Postpartum Period ,Infant, Newborn ,Vitamin D Deficiency ,medicine.disease ,Urinary calcium ,Endocrinology ,Parathyroid Hormone ,Calcium ,Female ,Hyperparathyroidism, Secondary ,Secondary hyperparathyroidism ,Cardiology and Cardiovascular Medicine ,business - Abstract
BACKGROUND Preeclampsia has been associated with features of secondary hyperparathyroidism. In this study, we examine the relationships of calcium metabolism with blood pressure (BP) in preeclamptic women and in a control group of normal (NORM) pregnancies in the postpartum. METHODS Sixty-three consecutive preeclamptic women (age 35 ± 6 years) were studied 4 weeks after delivery. We collected clinical and lab information on pregnancy and neonates and measured plasma and urinary calcium and phosphate, plasma parathyroid hormone (PTH) and 25-hydroxy vitamin D [25(OH)D], and performed 24-h ambulatory BP monitoring. BP and calcium metabolism of 51 preeclamptic were compared with 17 NORM pregnant women that matched for age, race, and postpartum BMI. RESULTS 25(OH)D deficiency (
- Published
- 2021
44. Bloccati fuori e dentro
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Feruglio, Susanna, Alessio, Matiz, Andrea, Paschetto, Daniele, Fedeli, Enrico, Vidal, Paola, Cogo, Franco, Fabbro, and Cristiano, Crescentini
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lockdown ,COVID-19 ,salute mentale - Published
- 2021
45. Detecting neurodevelopmental trajectories in congenital heart diseases with a machine-learning approach
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Massimo A. Padalino, Luca Vedovelli, Patrizia Bisiacchi, Elisa Cainelli, Manuela Simonato, Michela Vergine, Corrado Lanera, and Paola Cogo
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Heart Defects, Congenital ,medicine.medical_specialty ,Heart disease ,Science ,Cardiology ,030204 cardiovascular system & hematology ,Group comparison ,Article ,Machine Learning ,03 medical and health sciences ,Cognition ,0302 clinical medicine ,Social skills ,Surveys and Questionnaires ,medicine ,Humans ,Psychology ,Prospective Studies ,Cardiac Surgical Procedures ,Multidisciplinary ,business.industry ,Brain maturation ,Neuropsychology ,medicine.disease ,Cardiac surgery ,Medicine ,Observational study ,business ,030217 neurology & neurosurgery ,Neuroscience ,Psychopathology ,Clinical psychology - Abstract
We aimed to delineate the neuropsychological and psychopathological profiles of children with congenital heart disease (CHD) and look for associations with clinical parameters. We conducted a prospective observational study in children with CHD who underwent cardiac surgery within five years of age. At least 18 months after cardiac surgery, we performed an extensive neuropsychological (intelligence, language, attention, executive function, memory, social skills) and psychopathological assessment, implementing a machine-learning approach for clustering and influencing variable classification. We examined 74 children (37 with CHD and 37 age-matched controls). Group comparisons have shown differences in many domains: intelligence, language, executive skills, and memory. From CHD questionnaires, we identified two clinical subtypes of psychopathological profiles: a small subgroup with high symptoms of psychopathology and a wider subgroup of patients with ADHD-like profiles. No associations with the considered clinical parameters were found. CHD patients are prone to high interindividual variability in neuropsychological and psychological outcomes, depending on many factors that are difficult to control and study. Unfortunately, these dysfunctions are under-recognized by clinicians. Given that brain maturation continues through childhood, providing a significant window for recovery, there is a need for a lifespan approach to optimize the outcome trajectory for patients with CHD.
- Published
- 2021
46. Blood urea in preterm infants on routine parenteral nutrition: A multiple linear regression analysis
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Rita D'Ascenzo, Virgilio P. Carnielli, Luca Antognoli, Maria Paola Bellagamba, Paola Cogo, Chiara Monachesi, Chiara Biagetti, Ilaria Giretti, Ilaria Burattini, Paolo Marchionni, and Alessio Correani
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Male ,0301 basic medicine ,Birth weight ,Physiology ,Gestational Age ,030209 endocrinology & metabolism ,Critical Care and Intensive Care Medicine ,Eating ,03 medical and health sciences ,chemistry.chemical_compound ,0302 clinical medicine ,medicine.artery ,Blood urea ,Birth Weight ,Humans ,Urea ,Medicine ,Amino Acids ,Infant Nutritional Physiological Phenomena ,Ductus Arteriosus, Patent ,Respiratory Distress Syndrome, Newborn ,030109 nutrition & dietetics ,Nutrition and Dietetics ,Respiratory distress ,business.industry ,Weight change ,Infant, Newborn ,Gestational age ,Preterm infants ,Umbilical artery ,medicine.disease ,Parenteral nutrition ,Amino acid ,chemistry ,Creatinine ,Infant, Small for Gestational Age ,Multivariate Analysis ,Linear Models ,Small for gestational age ,Female ,business ,Infant, Premature - Abstract
Summary Background Blood urea is considered a marker of amino acid utilization in preterm infants on routine parenteral nutrition. However, the association between blood urea and intravenous amino acid intake remains debated. Aims To evaluate the association between blood urea and both nutrition and clinical data, in a large cohort of preterm infants. Methods Consecutively admitted preterm infants with a gestational age of less than 32 weeks and a birth weight lower than 1250 g on routine parenteral nutrition from the first hour of life were studied. Clinical and nutrition data collected hourly during the hospitalization were used in multiple linear regression analysis. Results We studied 674 patients and 1863 blood urea determinations. Blood urea concentration was positively associated with blood creatinine concentration, intravenous amino acid intake, patent ductus arteriosus and respiratory distress syndrome, and negatively associated with intravenous non-protein energy intakes, daily weight change, gestational age, being small for gestational age, antenatal steroids therapy and reverse flow in the umbilical artery (p Conclusions From a nutrition perspective, in our large cohort of small preterm infants blood urea was positively correlated with intravenous amino acid intake and negatively correlated with intravenous non-protein energy intake. This is in line with current knowledge in human physiology and suggest that a reduction of intravenous amino acid intake based on blood urea concentrations was justified.
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- 2021
47. Stuck Outside and Inside: An Exploratory Study on the Effects of the COVID-19 Outbreak on Italian Parents and Children’s Internalizing Symptoms
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Franco Fabbro, Enrico Vidal, Susanna Feruglio, Alessio Matiz, Cristiano Crescentini, Andrea Paschetto, and Paola Cogo
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Coping (psychology) ,media_common.quotation_subject ,lcsh:BF1-990 ,Exploratory research ,050105 experimental psychology ,03 medical and health sciences ,0302 clinical medicine ,children ,Pandemic ,medicine ,Psychology ,0501 psychology and cognitive sciences ,resilience ,General Psychology ,Original Research ,media_common ,internalizing symptoms ,covid-19 ,parents ,05 social sciences ,Cognition ,Distress ,lcsh:Psychology ,Respondent ,Anxiety ,Psychological resilience ,medicine.symptom ,Covid-19 ,030217 neurology & neurosurgery ,Clinical psychology - Abstract
The Covid-19 outbreak and the subsequent lockdown have profoundly impacted families' daily life, challenging their psychological resilience. Our study aimed to investigate the immediate psychological consequences of the pandemic on Italian parents and children focusing on internalizing and post-traumatic symptoms. We also wanted to explore the impact of possible risk and resilience factors, e.g., lifestyle and behaviors, emotional and cognitive beliefs, on parents and children's reaction to the emergency distress. An online survey was administered during the country's nationwide lockdown to 721 Italian parents of at least one child aged between 6 and 18 years. The respondent completed the survey for himself/herself and his/her child. The survey included socio-demographic items and validated questionnaires on parents' post-traumatic stress symptoms, depression and anxiety levels, and on children's internalizing problems. Parents were asked to fill the questionnaires twice: once referring to the current emergency condition and once recalling how they and their child felt a few months before Covid-19 outbreak. Multiple regression analyses showed that specific demographic characteristics (i.e., sex and age) and psychological factors of children and parents, such as fear of contagion and the opportunity to think about possible secondary positive effects of the pandemic, had a predictive value on the presence of internalizing symptoms of both parents and children. Moreover, parents' behaviors during the lockdown period (i.e., employment status and sport practiced) were significantly related to their own internalizing symptoms; these symptoms, in turn, had a strong and positive predictive value on children's internalizing problems. Besides, analyses of variance showed that internalizing symptoms of parents and children were significantly higher during the Covid-19 pandemic than before it started. In addition to showing a direct effect of the pandemic on the psychological health of parents and children, the present results also give a series of important information on how parents perceive, and therefore influence, their children in this period of emergency. Our findings thus highlight the urgent need to provide parents with adequate support to take care of their own psychological wellbeing and to help their children coping with the direct and indirect effects of the pandemic.
- Published
- 2020
48. Is intravenous fish oil associated with the neurodevelopment of extremely low birth weight preterm infants on parenteral nutrition?
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Enrica Ferretti, Chiara Biagetti, Cecilia Proietti, Adriana Pompilio, Luca Antognoli, Rita D'Ascenzo, Paola Cogo, Alessio Correani, Virgilio P. Carnielli, and Ilaria Giretti
- Subjects
0301 basic medicine ,Central Nervous System ,Pediatrics ,medicine.medical_specialty ,Parenteral Nutrition ,Birth weight ,Neurodevelopment ,030209 endocrinology & metabolism ,Fish oil ,Critical Care and Intensive Care Medicine ,law.invention ,03 medical and health sciences ,0302 clinical medicine ,Child Development ,Fish Oils ,Randomized controlled trial ,law ,Lipid emulsion ,Omega-3 fatty acids ,medicine ,Humans ,Retrospective Studies ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Incidence (epidemiology) ,Infant, Newborn ,Preterm infants ,Gestational age ,Parenteral nutrition ,Low birth weight ,Docosahexaenoic acid ,Infant, Extremely Low Birth Weight ,medicine.symptom ,business ,Infant, Premature - Abstract
Summary Background & aims Preterm infants are at increased risk of long-term neurodevelopmental disabilities (NDD). Long chain n-3 fatty acids play a key role during the development of the central nervous system and some studies in preterm infants showed benefits of docosahexaenoic acid and arachidonic acid supplementation for visual and cognitive development. In recent years fish oil has been added to the fat blend of intravenous (IV) lipid emulsions (LE) but to date scanty data are available on neurodevelopmental outcome of preterm infants that received fish oil containing LE. We studied the effect of fish oil containing IV LE vs standard IV LE on neurodevelopment in a large cohort of preterm infants who received routine parenteral nutrition (PN) from birth. Methods We retrospectively reviewed the neurodevelopmental outcome of 477 preterm infants (birth weight (BW): 400–1249 g and gestational age (GA) at birth: 24+0 - 35+6 weeks (W)) admitted to our NICU between Oct-2008 and June-2017, who received routine PN with different LE, with and without fish oil (IV-FO vs CNTR). We compared neurodevelopment at 2 years corrected age by the Bayley III development scale and the incidence of NDD. Results Demographics, birth data and the incidence of the main clinical short-term outcomes of prematurity were similar in the two groups (IV-FO: n = 178, GA 197 ± 14 days, BW 931 ± 182 g; CNTR: n = 192, GA 198 ± 15 days, BW 944 ± 194 g). No differences were found in maternal demographics nor in parental education between the two groups. Cognitive score was not significantly different between IV-FO and CNTR (92 ± 15 vs 93 ± 13, p = 0.5). No differences were found in motor and language scores, and in the incidence of NDD in the two groups. Conclusions Contrary to our hypothesis, the use of fish oil containing LE in a large cohort of preterm infants on routine PN did not result in better neurodevelopment. Large randomized controlled trials powered for neurodevelopment are needed to clarify the impact of the widely used fish oil containing LE on neurodevelopment of preterm infants.
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- 2020
49. Hypertriglyceridemia and lipid tolerance in preterm infants with a birth weight of less than 1250 g on routine parenteral nutrition
- Author
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Ilaria Giretti, Chiara Monachesi, Luisita Marinelli, Ilaria Burattini, Chiara Biagetti, Virgilio P. Carnielli, Paola Cogo, Adriana Pompilio, Luca Antognoli, Rita D'Ascenzo, and Alessio Correani
- Subjects
0301 basic medicine ,Male ,medicine.medical_specialty ,Fat Emulsions, Intravenous ,Parenteral Nutrition ,Birth weight ,030209 endocrinology & metabolism ,Gestational Age ,Infant, Premature, Diseases ,Critical Care and Intensive Care Medicine ,Gastroenterology ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,medicine ,Birth Weight ,Humans ,Infant, Very Low Birth Weight ,Major complication ,Hypertriglyceridemia ,Lipid metabolism ,Parenteral nutrition ,Preterm infants ,Triglycerides ,Retrospective Studies ,030109 nutrition & dietetics ,Nutrition and Dietetics ,business.industry ,Incidence ,Infant, Newborn ,Gestational age ,medicine.disease ,Gestation ,lipids (amino acids, peptides, and proteins) ,Female ,business ,Infant, Premature - Abstract
Summary Objectives To study the association of hypertriglyceridemia and of lipid tolerance with clinical and nutritional data in preterm infants receiving routine parenteral nutrition. Design We retrospectively studied 672 preterm infants (gestational age 250 mg⋅dL−1. Lipid tolerance was defined as the ratio of plasma triglycerides to the intravenous lipid intake at the time of sampling. Variables associated to hypertriglyceridemia and to lipid tolerance were identified by multiple logistic and linear regression analyses. Results Hypertriglyceridemia occurred in 200 preterm infants (30%), ranging from 67% at 23 weeks to 16% at 31 weeks' gestation. In 138 infants (69%) hypertriglyceridemia occurred at a lipid intake of 2.5 g⋅kg−1 or less. Lipid tolerance was reduced especially in infants of less than 28 weeks’ gestation (14.3 ± 9.3 vs 18.8 ± 10.2, respectively, p Conclusion Preterm infants on routine parenteral nutrition were able to tolerate markedly lower intravenous lipid intakes than the recommended target values of current guidelines. Lipid tolerance was associated with some of the major complication of prematurity, possibly at risk of developing hypertriglyceridemia.
- Published
- 2020
50. In situ simulations in Pediatric Emergency Room (PER): resiliency and team work analysis. One year experience
- Author
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Eva Passone, Luigi Castriotta, Anna Pusiol, Marta Narduzzi, Stefano Usai, Paola Cogo, Ilaria Liguoro, Chiara Pilotto, Raffaello Tosolini, Federico Marzona, Anna Zanin, and Davide Cucchiaro
- Subjects
Pediatric emergency ,Teamwork ,business.industry ,media_common.quotation_subject ,Pediatrics, Perinatology and Child Health ,medicine ,Medical emergency ,medicine.disease ,business ,media_common - Published
- 2020
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