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Objective To describe the natural course of intestinal failure with onset in the neonatal period to provide data regarding the occurrence and to provide a population-based survey regarding the spectrum of underlying diseases. Study design We performed a retrospective chart review including infants admitted to the neonatal intensive care unit of 7 Italian tertiary care centers. Intestinal failure was defined as a primary intestinal disease that induces the need of total parenteral nutrition (PN) for more than 4 weeks or the need of partial PN for more than 3 months. Results The total number of live births during the study time within the enrolled institutions was 30 353, and the number of newborns admitted to the neonatal intensive care unit was 5088. Twenty-six patients satisfied the definition of intestinal failure; thus the occurrence rate of intestinal failure was 0.1% among live-birth newborns and 0.5% among infants at high risk. The main underlying diseases leading to intestinal failure in neonatal age were congenital intestinal defects (42.3%), necrotizing enterocolitis (30.8%), severe intestinal motility disorder (11.5%), intestinal obstruction (7.7%), structural enterocyte defects (3.8%), and meconium peritonitis (3.8%). After a follow-up of 36 months, 84.6% of patients achieved intestinal competence, 1 patient was still receiving home PN, 1 patient underwent transplantation, and 2 patients died. Cholestatic liver disease was diagnosed in 54% of observed children. Conclusion An understanding of the incidence, causes, and natural history of intestinal failure would be helpful to appropriately allocate resources and to plan clinical trials.

Chorioamnionitis is the inflammatory response to an acute inflammation of the membranes and chorion of the placenta. We provide a critical review of the relationship between chorioamnionitis and the risk of prematurity and adverse maternal-fetal outcome. Chorioamnionitis results as a major risk factor for preterm birth and its incidence is strictly related to gestational age. It is associated with a significant maternal, perinatal and long-term adverse outcomes. The principal neonatal complications are neonatal sepsis, pneumonia, bronchopulmonary dysplasia, perinatal death, cerebral palsy and intraventricular hemorrhage. The role in neonatal outcome is still controversial and more conclusive studies could clarify the relationship between chorioamnionitis and adverse neonatal outcome. Maternal complications include abnormal progression of labour, caesarean section, postpartum hemorrhage, abnormal response after use of oxytocin and placenta abruption. Prompt administration of antibiotics and steroids could improve neonatal outcomes.

In a calorimeter with silicon readout, the use of a combination of low- Z (Fe) and high- Z (Pb) materials as absorbers allows the transformation of the electron energy distribution of the incident showers in two media with different critical energies via the filtering effect. As a result, the visible electromagnetic energy and consequently the value of the e/mip ratio can be substantially reduced as a function of the thickness of the high- Z (Pb) material present in the absorber. Measurements of this effect for a set of Si/Fe+Pb calorimeter configurations are presented and discussed. The filtering effect makes possible the achievement of the compensation condition.

A mathematical model of a reactive distillation column, which takes into account chemical equilibrium, kinetics of liquid phase catalysed reaction and tray efficiency, has been developed. The case of two reactants A and B which form a light product C and a heavy one D is analysed. The main reaction of the process is strongly influenced by chemical equilibrium, thus D production is increased by feeding the light reagent A to the bottom of the column and stripping from the reacting liquid the light product C. The mathematical model consists of a system of algebraic equations that describe the mass and energy balances of the reacting and non-reacting trays of the column, coupled with the equations for vapor—liquid and chemical reaction equilibria and, for those components that are present at very low concentration in the liquid phase, the diffusion controlled mass—tranfer from the liquid to the vapor phase. The analysis is performed to enlighten the effects of various parameters and operating conditions, such as the number of the reacting trays and vapor feed flowrate, with aim of obtaining a guide for the minimisation of the energy consumption per unit heavy product D.

In a calorimeter with silicon readout, operated at the CERN-Proton Synchrotron, the use of a combination of low-Z (Fe) and high-Z (Pb) materials as absorbers allows the transformation of the electron energy distribution of the incident showers in two media with different critical energies via the filtering effect. As a result, a ratio varying from e/π>1 to e/π

In silicon sampling calorimeters, a local hardening effect occurs when inserting a small thickness of low-Z material next to the thin active layer. This effects, which modifies appreciably the electromagnetic response, allows the control of the relative responses to hadronic and electromagnetic showers. A thorough study of lateral shower profiles has been undertaken to improve the precision of the measurement of the absolute electromagnetic response. The main features of the local hardening effect as a function of the thickness of low-Z material are explained by a 1/E distribution of ionizing particles inside the shower, while those of the lateral profile are explained by an exponential radial distribution.

In an Si/U hadron calorimeter, using a combination of low-Z and high-Z materials for the absorber allows the reduction of the calorimeter response to the electromagnetic component of the incoming hadronic showers (the local hardening effect). As a result, a ratio varying from e/ pi >1 to e/ pi >

A detailed study of neutron irradiated n-type silicon detectors was carried out including leakage current measurements after first and second irradiation, annealing procedures optimization, deep level transient spectroscopy (DLTS), and thermally stimulated currents (TSC) analyses of the produced defects in the bulk of the detectors.

Experimental evidence has been found for a filtering effect on the soft electron component in electromagnetic showers when combinations of low-Z and high-Z materials are used as absorbers. The filtering effect can be fully exploited to reduce the electromagnetic calorimeter response, making it possible to achieve the compensation condition in a Si/Fe+Pb calorimeter with an effective interaction length almost equal to that of Fe. The action of Fe on Pb, by modifying the critical energy during the electromagnetic shower development, leads to a yield of soft electrons (and very few photons) that are stopped in subsequent absorber layers and/or absorbed by the G10 plates. Recent measurements performed with an enlarged Si/Fe+Pb calorimeter support the idea; the authors have shown that an electromagnetic energy smaller than the hadronic energy is possible once particular FePb configurations are used. >

In a hadron sampling calorimeter with silicon readout, a combination of plates of low-2 (Fe) and high-2 (Pb) materials used as absorbers enables the reduction of the calorimeter response to the electromagnetic component of the incoming hadronic showers. This reduction is produced by a filtering effect. As a result, a ratio, varying from eh > 1 to eh e 1 is obtained as a function of the low-2 material thickness, demonstrating the possibility to achieve the compensation condition (eh = 1).

In a calorimeter with silicon readout, the use of a combination of low-Z (Fe) and high-Z (Pb) materials as absorbers enables the transformation of the electron energy distribution of the incident showers in two media with different critical energies via the filtering effect. As a result, the electromagnetic energy and consequently the e/MIP ratio value can be substantially reduced as a function of the thickness of high-Z (Pb) material present in the absorber, making it possible to tune the e/ pi ratio and making possible the achievement of the compensation condition e/ pi =1. >

Objective: The aim of this study was to characterize the liver involvement in infants who have both neonatal asphyxia and neonatal cholestasis. Methods: We describe four asphyctic newborn infants (three born at term) who developed early (age 3.8 ± 2.1 days) intrahepatic neonatal cholestasis and in whom tests for causes of neonatal liver damage were negative. Results: The clinical picture and course were benign and similar to that of sporadic 'idiopathic' neonatal hepatitis. Clinical signs and abnormal liver function tests tended to normalize within the first year of life in all. Conjugated bilirubin became normal at 6 months after the onset of cholestasis, while liver enzymes tended towards normal values thereafter, within 1 year of follow-up. Liver biopsy (taken in one patient) showed a typical picture of giant cell hepatitis; ultrastructure was non-specific. Significance: Our results suggest that isolated asphyxia should be taken into account as a potential causal factor in term or pre-term asphyctic newborns who develop early 'idiopathic' neonatal cholestasis.

The birth of a neonate with congenital malformation for the parents determines often a process of adaptation with a phase of shock, a phase of incredibility and scare and, at last, one of adaptation and equilibration. The reactions of the parents and the difficulties they meet in the relation with the child depend mostly on the characteristics of the malformation and on the explanations and support they receive. The Health care personnel knows well that the communication of a diagnosis of a congenital malformation to the parents is frustrating. Both the Pediatrics and the Gynaecologist have to considerate seriously and consciously this relational question, considering that the communication is a interpersonal relationship and therefore flexible and changeable in every case. After this previous statement we consider it useful to report advises taken from the literature: the parents have to be informed at once the diagnosis is confirmed, possibly at the same time and in presence of the infant; the communication should be done both from the Pediatrics and the Gynaecologist, possibly at the same time; the communication should take place in a private atmosphere and with plenty of time.

The condition for obtaining a calorimetric response linear with energy for hadronic showers and an energy resolution that improves as the incident energy increases is the equalization of the electromagnetic (e) and the hadronic (pi) signal responses. This equalization is obtained by exploiting a local hardening effect realized through the insertion of low-Z thin plates between the high-Z absorbers and the active material in a hadronic calorimeter with silicon readout. This effect, which allows the reduction of the calorimeter response to the electromagnetic component of the incoming hadronic showers, has been investigated for different low-Z materials. The relevance of some aspects of this study to the radiation hardness of the calorimeters is also addressed.

The compensation condition (e/ π = 1) is discussed. It mainly determines the performances of the silicon calorimeters to be used at the next generation of hadronic colliders (LHC, UNK, SSC).

In a hadronic calorimeter with silicon readout, a combination of thin plates oflow- Z andhigh- Z materials used as absorbers enables the reduction of the calorimeter response to the electromagnetic component of the incoming hadronic showers (the “local hardening effect”). As a result, a ratio varying from e/π> 1 toe/π>is obtained as a function of thelow- Z material thickness, demonstrating the possibility of achieving the compensation condition(e/π= 1)by exploiting the local hardening effect.

in the assessment of uterine malformations and its contribution to operative management. Methods: Forty-four pre-menopausal patients with suspected uterine anomalies on 2D TVS were evaluated by 3D TVS, hysteroscopy, and if necessary by laparoscopy or MRI. Ultrasound volume of the uterus was obtained by free hand rotation of the probe on the longitudinal axis of the uterus. Three perpendicular planes were simultaneously shown on the screen and classification of the type of anomalies was effected on the coronal view of the uterus based on the outer shape and the angle of the fundal identation. This 3D TVS diagnosis was compared with the hysteroscopic and/or laparoscopic classification. Results: We correctly classified by 3D TVS 20 arcuate, 12 septate and 6 bicornuate uteri (concordance rate 86%). Using 3D ultrasound 4 septate uteri were classified by hysteroscopy as arcuate and 2 arcuate uteri as septate. Sensitivity for bicornuate uteri was 100%. Conclusions: 3D TVS allows accurate differentiation between uterine anomalies and is useful for a preoperative surgical planing.

Equalization between the electromagnetic and the hadronic signals is the condition for obtaining the linear response of a calorimeter to hadronic showers and an energy resolution that improves as the incident energy increases. In a calorimeter with silicon readout, the use of a combination of low- Z and high- Z materials as absorbers allows the transformation of the electron energy distribution of the incident showers in two media with different critical energies. As a result, the response of the calorimeter to incoming showers is modified to achieve the compensation condition ( e π =1) .

The SICAPO Collaboration project to build a perfectly compensating hadron calorimeter using silicon as the active medium, is described. The insertion of low-Z material (G10 plates) in front or at the rear of the silicon detectors allows fine tuning of the calorimeter response to electromagnetic showers. This is a new approach to obtaining compensation. The tuning can be exploited to obtain e/π = 1 (compensation condition). The expected performance ranks this calorimeter among the best candidates to face the severe constraints requested by the next generation of colliders.

The effects of nonnutritive sucking on transcutaneous oxygen tension, heart rate, and respiratory rate were studied sequentially in 14 sleeping preterm infants breathing room air. Transcutaneous oxygen tension increased during nonnutritive sucking in infants between 32 and 35 weeks postconceptional age, but not in those between 36 and 39 weeks. This response was not associated with a change in respiratory rate or sleep state, although heart rate tended to increase. These data offer further support for the beneficial effects of nonnutritive sucking in preterm infants.

The condition for obtaining the linear response of a calorimeter to hadronic showers and an energy resolution improving as the incident energy increases is the equalization between the electromagnetic and the hadronic signals. This equalization is obtained within a new approach exploiting a local hardening effect that is realized by inserting low-Z absorbers next to the silicon readout detectors. In this way, the calorimeter response to the electromagnetic component of the hadronic shower is reduced. A systematic investigation of the visible energy response for electromagnetic showers in Si/U and Si/W calorimeters has been carried out for incoming electron energies of 2, 4, and 6 GeV. The insertion of low-Z material (G10 plates) in front or at the rear of the silicon detectors allows a fine tuning of the calorimeter response.

Gastric teratoma is a rare, benign tumor. The 47th case, reported here, is the first in which an abdominothoracic localization has been found.

In this study the relationship of maternal smoking in pregnancy to low birth weight, fetal growth retardation, preterm delivery, and perinatal deaths has been investigated in a sample of 36,544 women with their single newborns, from 6 Italian centers (Triese, Milan, Parma, Rome, Naples, Bari), where a multicenter survey of perinatal preventive medicine (MPPI) was carried out, between 1973 and 1979, with the financial support of the Consiglio Nazionale dell Ricerche. The proportions of babies weighing 2500 g or less, and of babies with birth weight, head circumference or crown-heel length below the 10th centile were similar among nonsmokers and "stopped" smoker mothers, while they increased with increasing smoking levels. As regards head circumference and crown-heel length below the 10th centile, odds ratios are essentially the same before and after adjustment for age, parity, and socioeconomic class (about 1.5 for "1-10CGT" and up to 2.5 for "11+CGT"). Only slight increases have been observed in the odds ratios concerning low birthweight below the 10th centile (about 1.5 for "1-10CGT" and up to 3.5 for "11+CGT") after adjusting for the socioeconomic demographic variables (i.e. mainly removing the favourable effect of high socioeconomic class or low parity, which more frequently characterize smoker mothers). Owing to the lower smokers' frequencies, cigarette smoking estimated attributable risks concerning low birth weight and "small for dates" babies in the MPPI centres (between 4% and 19%) are considerably lower than those estimated in studies carried out in the US or Canada. Data analyzed in the present study do not indicate any relationship between maternal smoking and preterm delivery or perinatal deaths.

The authors briefly review the available data on nonnutritive sucking (NNS) in preterm infants focusing mainly on NNS as a form of intervention and on the relationship of NNS with cardiorespiratory control. The previous studies on the positive effects of NNS on weight gain and oxygenation called for deeper investigation on the mechanism involved. The authors report the main results of their work on this field. The effects of NNS on transcutaneous oxygen tension, heart rate and respiration were studied sequentially in 14 sleeping preterm infants breathing room air. Transcutaneous oxygenation tension increased during NNS in infants between 32 and 35 weeks postconceptional age, but not in those between 36 and 39 weeks. This response was not associated with a change in respiratory rate or sleep state, although heart rate tended to increase. A subsequent study however, demonstrated a small and transient increase of respiratory rate during NNS bursts. Although further longitudinal studies will be needed these data offer further support for the beneficial effects of NNS in preterm infants.

The incidence of asphyxia and mortality has been evaluated retrospectively in 716 breech newborns who were vaginally or by elective caesarean section delivered. In the group of 171 preterm infants the rate of asphyxia and mortality has been more elevated in the newborns vaginally delivered; in the group of 545 term infants has not been any difference between those who were delivered vaginally or by caesarean section. About the 50% of the term infants and only the 8% of the preterm infants were delivered by caesarean section. Consequently, we can deduce that the elective caesarean section would be used also in infants of GA less than or equal to 36 weeks.