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Objectives To describe the ophthalmological characteristics in a Juvenile idiopathic arthritis (JIA) cohort and to evaluate how therapeutic advances have changed the course of the uveitis. Methods Analysis of a retrospective cohort study of consecutive JIA pediatric patients including JIA-associated uveitis (JIA-U) and comparison with a previous study in the same uveitis center assessed before the wide-spread of biological therapy. Results 49 JIA patients analyzed, of whom 18 JIA-U, compared with a JIA-U past cohort of 66 patients. Systemic corticosteroids were used significantly less in the current JIA-U group (p = 0.008) than in the past one. JIA-U present cohort were on therapy more frequently with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), than the past group (p = 0.039), mostly treated with methotrexate (93.3%). Furthermore, a larger use of biologic disease-modifying antirheumatic drugs (bDMARDs) was described in the current JIA-U group (p = 0.005) also associated with csDMARDs (p = 0.003). Adalimumab was used more (72.7%) in the present JIA-U cohort compared to a larger treatment with infliximab (61.5%) in the past (p = 0.005). Higher number of uveitis recurrences was observed in the previous cohort compared to the current one (p = 0.005). Fewer complications were described in this study than in the previous: posterior synechiae (p = 0.007), cataract (p

Objectives To describe the ophthalmological characteristics in a Juvenile idiopathic arthritis (JIA) cohort and to evaluate how therapeutic advances have changed the course of the uveitis. Methods Analysis of a retrospective cohort study of consecutive JIA pediatric patients including JIA-associated uveitis (JIA-U) and comparison with a previous study in the same uveitis center assessed before the wide-spread of biological therapy. Results The total of 49 JIA patients were analyzed, of whom 18 JIA-U, compared with a JIA-U past cohort of 66 patients. Systemic corticosteroids were used significantly less in the current JIA-U group (p = 0.008) than in the past one. JIA-U present cohort was on therapy more frequently with conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs) than the past group (p = 0.039), mostly treated with methotrexate (93.3%). Furthermore, a larger use of biologic disease-modifying anti-rheumatic drugs (bDMARDs) was described in the current JIA-U group (p = 0.005) also associated with csDMARDs (p = 0.003). Adalimumab was used more (72.7%) in the present JIA-U cohort compared to a larger treatment with infliximab (61.5%) in the past (p = 0.005). Higher number of uveitis recurrences was observed in the previous cohort compared to the current one (p = 0.005). Fewer complications were described in this study than in the previous: posterior synechiae (p = 0.007), cataract (p p p = 0.047). Conclusion Current therapies reduced the uveitis recurrences and ocular complications including cataract due also to the lower use of corticosteroids. The new close collaboration with the pediatric rheumatologic center in the same University has contributed to the care improvement and decrease of uveitis complications.

This work describes a methodology for the definition of indoor air quality monitoring plans in schools and above all to improve the knowledge and evaluation of the indoor concentration levels of some chemical pollutants. The aim is to guide interventions to improve the health of students and exposed staff connected with the activities carried out there. The proposed methodology is based on the simultaneous study of chemical (indoor/outdoor PM2.5, NO2, CO2) and physical (temperature, humidity) parameters by means of automatic analyzers coupled with gaseous compounds (benzene, toluene, ethylbenzene, xylenes, formaldehyde and NO2) sampled by denuders. The important novelty is that all the data were collected daily in two different situations, i.e., during school activities and no-school activities, allowing us to evaluate the exposure of each student or person. The different behaviors of all the measured pollutants during the two different situations are reported and commented on. Finally, a statistical approach will show how the investigated compounds are distributed around the two components of combustion processes and photochemical reactions.

Background The diagnostic and therapeutic approach to grass pollen allergy is now possible by detecting specific IgE (sIgE) to its allergenic components. Aim To evaluate the correlation between the sensitisation to different molecular Phleum pratense (Phl p) allergens and clinical efficacy of SLIT. Methods The pilot study included 36 patients affected by allergic rhinoconjunctivitis, all treated with SLIT actively. We performed serum analysis of sIgE to Phl p 1, 2, 4, 5, 6, 7, 11 and 12. The Average Rhinoconjunctivitis Total Symptom Score (ARTSS) and the Average Combined Score (ACS) were evaluated before and after one year of immunotherapy. Results Three different groups of sensitisation were defined based on the range of IgE reactivity to Phleum pratense allergens at baseline: group I (sIgE reactive to 1–3 allergens); group II (sIgE reactive to 4–5 allergens); and group III (sIgE reactive to 6–8 allergens). At T0 ACS was 1.79 ± 0.18 in group I; 1.81 ± 0.23 in group II; and 1.95 ± 0.34 in group III. At T1 ACS was 0.85 ± 0.55 in group I; 1.01 ± 0.31 in group II; and 1.44 ± 0.39 in group III. At T1 there was a significant improvement of ARTSS and ACS for group I ( p = 0.001). Conclusions Sublingual immunotherapy with a grass pollen is efficacious irrespective of the patients’ baseline sensitisation to either single or multiple grass pollen molecular allergens. We found that patients with few sensitisations have a greater improvement in combined symptom and medication score. SLIT improves the clinical course of allergic patients although new sensitisations may appear.

We report the case of 3 mediastinal teratomas, 1 intrapericardial immature and 2 mediastinal grade 0, diagnosed in the 38 th week of gestation (intrapericardial immature) in the last stage of pregnancy (mature mediastinal). The surgical resection of the masses was successfully undertaken shortly after birth. The histological description of tumor after excision has reported immature multicystic teratoma Grade 2 of 3, with immature neural tissue and without yolk sac tumor cells (for the intrapericardial case) and mature tissue grade 0 large masses, with all tissues represented at histology (for the extrapericardial case). All neonates showed a favorable postoperative course after excision.

During the last decades research all over the world has highlighted the deleterious effects of outdoor and indoor pollution on respiratory health of adults and children. The World Health Organization (WHO) “ Air quality guidelines for Europe ” played a fundamental role in providing information and guidance to authorities involved in the air pollution field and they are considered the key source on which the European Commission's directive on air quality is based. Children appear to be most vulnerable to the harmful effects of outdoor pollutants, which can cause both acute exacerbations, as well as chronic respiratory symptoms and diseases. Possible mechanisms include the induction of oxidative stress, and/or allergic sensitization, as well as increased susceptibility to infections. Cigarette smoke is one of the environmental pollutant influencing morbidity and death rate in childhood as responsible for adverse health effects in both prenatal and postnatal. There is growing epidemiological evidence that indoor allergen exposure may contribute to the development of allergic respiratory symptoms. In Italy the housing and social situation, with regard to the aspects related to exposure to secondhand smoke or the presence of fungal spores, moisture linked to household vapor and poor ventilation of the rooms are problems still not completely resolved. From a medical point of view the field of pediatrics has certainly made great strides in promoting the health of children and pediatricians to have a central role for pursuing this objective.

Mechanical circulatory support after congenital heart surgery is uncommon, but not unusual. Stunning of ischemic myocardium after cardiopulmonary bypass could occur due to many reasons. According to the literature, this complication is rare in our center, but some options about implantation of a postcardiotomy left ventricular assistance device (LVAD) in toddlers deserve attention. Furthermore, although the VAD has been a well-established therapy for larger adolescents and adult patients with advanced heart failure, current experience with the use of VAD for mechanical circulatory support in infants and young children with small body surface area is still limited. Keywords: congenital; left ventricle; mechanical support; inotropes (Published: 17 August 2012) Citation: Mechanical Circulatory Support 2012, 3 : 18867 - http://dx.doi.org/10.3402/mcs.v3i0.18867

We describe a case of a preterm newborn with congenital complete atrioventricular block (CAVB), delivered for distress by cesarean section, and undergone, at 1295 grams of weight, to permanent pacemaker implantation. The pacemaker has been inserted between the upper left rectus abdominal muscle and the posterior rectus sheath and connected by two epicardial leads on the left ventricle wall. The procedure has been successfull.

We report the case of an intrapericardial teratoma, diagnosed at 38 weeks of gestation. Echocardiography revealed a 38 x 39 mm multicystic pedunculated mass compressing the right atrium and the right ventricle, but without symptoms, associated with severe anterior pericardial effusion. Surgical resection of the mass was performed after birth successfully. The histological description of the tumor after excision was reported an immature multicystic teratoma grade 2 of 3, with immature neural tissue and without yolk sac tumor cells. The baby had a favorable postoperative course.

Diagnosis of CGD is made by demonstrating absent or markedly reduced oxidase activity in stimulated neutrophils. The screening test proposed is based upon the naked eye evaluation of the reduction of NBT on a solid surface. It seems to be a useful tool for rapid and inexpensive detection of CGD patients, especially for large-scale screening purposes. The test was carried out on forty-five subjects: two males affected by CGD, three female carriers and forty healthy donors. The test confirmed the results obtained with flow cytometric and NBT assays.

Protozoans of the genus Cryptosporidium may cause serious diarrhoeal illness in immunocompromised hosts and especially in HIV-infected patients. In this study we have evaluated the frequency of Cryptosporidium in stools of 51 HIV-infected patients with diarrhoea. Laboratory diagnosis of cryptosporidiosis was performed of faecal samples concentrated by a formalin-ether sedimentation technique and stained by a modified cold Ziehl-Neelsen method. Results demonstrated that 17 (33.3%) of these patients were infected with Cryptosporidium. Moreover, Cryptosporidium infection was the first clinical marker of AIDS in 7 cases. Our data show that the prevalence of this parasitosis in HIV-infected people seems to be higher in our region (Apulia, South Italy), compared to other areas of the world.