Iatrogenic Anetoderma of Prematurity: A Case Report and Review of the Literature

Anetoderma is a skin disorder characterized by focal loss of elastic tissue in the mid dermis, resulting in localized areas of macular depressions or pouchlike herniations of skin. An iatrogenic form of anetoderma has been rarely described in extremely premature infants and has been related to the placement of monitoring devices on the patient skin. Because of the increasing survival of extremely premature infants, it is easy to foresee that the prevalence of anetoderma of prematurity will increase in the next future. Although it is a benign lesion, it persists over time and can lead to significant aesthetic damage with need for surgical correction. Sometimes the diagnosis can be difficult, especially when the atrophic lesions become evident after discharge. Here, we report on a premature infant born at 24 weeks of gestation, who developed multiple anetodermic patches of skin on the trunk at the sites where electrocardiographic electrodes were previously applied. The knowledge of the disease can encourage a more careful management of the skin of extremely premature babies and aid the physicians to diagnose the disease when anetoderma patches are first encountered later in childhood

Encephalomyocarditis virus infection in an Italian zoo

A fatal Encephalomyocarditis virus (EMCV) infection epidemic involving fifteen primates occurred between October 2006 and February 2007 at the Natura Viva Zoo. This large open-field zoo park located near Lake Garda in Northern Italy hosts one thousand animals belonging to one hundred and fifty different species, including various lemur species. This lemur collection is the most relevant and rich in Italy. A second outbreak between September and November 2008 involved three lemurs. In all cases, the clinical signs were sudden deaths generally without any evident symptoms or only with mild unspecific clinical signs. Gross pathologic changes were characterized by myocarditis (diffuse or focal pallor of the myocardium), pulmonary congestion, emphysema, oedema and thoracic fluid. The EMCV was isolated and recognized as the causative agent of both outbreaks. The first outbreak in particular was associated with a rodent plague, confirming that rats are an important risk factor for the occurrence of the EMCV infection

Portable microcontroller-based instrument for near-infrared spectroscopy

Near Infrared Spectroscopy (NIRS) can be employed to noninvasively and continuously measure in-vivo local changes in haemodynamics and oxygenation of human tissues. In particular, the technique can be particularly useful for muscular functional monitoring. We present a portable NIRS research-grade acquisition system prototype, strictly dedicated to low-noise measurements during muscular exercise. The prototype is able to control four LED sources and a detector. Such a number of sources allows for multipoint measurements or for multi-wavelength spectroscopy of tissue constituents other than oxygen, such as cytochrome aa3 oxidation. The LEDs and the detector are mounted on separate probes, which carry also the relevant drivers and preamplifiers. By employing surface-mount technologies, probe size and weight are kept to a minimum. A single-chip mixed-signal RISC microcontroller performs source-to-detector multiplexing with a digital correlation technique. The acquired data are stored on an on-board 64 K EEPROM bank, and can be subsequently uploaded to a personal computer via serial port for further analysis. The resulting instrument is compact and lightweight. Preliminary tests of the prototype on oxygen consumption during tourniquet-induced forearm ischaemia show adequate detectivity and time response

Microcontroller-based digital front-end for near-infrared spectroscopy

Near Infrared Spectroscopy (NIRS) can be employed to noninvasively and continuously measure in-vivo local changes in haemodynamics and oxygenation of human tissues. Monitoring of these parameters is particularly useful both for basic research and during surgery, when a continuous and real-time measurement can help to avoid permanent damage to the tissues. We present a modular acquisition system in which each subsystem, from the case to the single acquisition front-end is designed to meet all the requirements of a research-grade instrument, dedicated to intraoperatory measurements. Part of the modules of the acquisition system has been dedicated to multipoint NIRS. A module prototype has been developed, which is able to control four LED sources and two detectors. On each front-end a RISC microcontroller performs source and detector multiplexing with a digital correlation technique. A number of such modules can be independently addressed through a bus by a PC-based workstation (integrated on the instrument) for data collection, processing and visualization. Preliminary tests of the prototype on tourniquet-induced forearm ischaemia show adequate detectivity and time response. The operating parameters derived from the prototype will be employed in the design of a high channel count module, which will exploit the capabilities of a digital signal processor (DSP), for spatially mapped brain oxygenation monitoring

Preliminary study of muscle contraction assessment by NIR spectroscopy

NIR spectroscopy allows monitoring of muscle oxygenation and perfusion during contraction. The knowledge of modifications of blood characteristics in body tissues has relevant clinical interest. A compact and reliable device, which makes use of two laser diodes at 750 and 810 nm coupled with the skin surface through optical fibres, was tested. NIR and surface EMG signals during isokinetic contractions were studied. A set of parameters was analysed in order to obtain information about metabolic modifications during muscle fatigue

Clinical use of NIR laser reflectometry

The potential of optical measurement techniques in the near infrared spectral range becomes increasingly recognized. Continuous wave laser reflectometry is a non-invasive and sensitive method to determine perfusion and oxygenation variations of a specific organ in-vivo. The knowledge of physiological and pathological changes of blood characteristics in body tissues has relevant clinical interest. The improvements of optical and electronic devices offer new possibilities to design reliable and precise instruments to satisfy medical users demand. The results of a collaboration between instrumental designer and physicians are presented. A new method for measuring skeletal muscle oxygenation during exercise and evaluating rehabilitation effects was developed. Two laser diodes generate the wavelengths to select oxygenated and deoxygenated hemoglobin and a fiber optic probe connects the instrument to the patient

The epidemiology of atopic dermatitis in Italian schoolchildren

BACKGROUND: Atopic dermatitis (AD) is common in children in industrialized countries. Only one large population study on its prevalence has been conducted in Italy, based on self-report questionnaire. The present study was designed to estimate the prevalence of AD in schoolchildren in Italy by dermatologists' assessment and by UK Working Party criteria, and to investigate associated symptoms and factors. METHODS: Cross-sectional survey on a random sample of 9-year-old schoolchildren from seven Italian cities. Children were examined by experienced dermatologists. Parents and teachers answered standardized questionnaires. RESULTS: Of the 1369 children examined, 88 had a diagnosis of AD, with an estimated point prevalence of 5.8% (95% CI 4.5-7.1) in the reference population. The reported lifetime prevalence was 15.2 (95% CI 12.2-18.2) for AD, 11.9% (95% CI 9.0-14.8) for asthma, and 17.6% (95% CI 14.6-20.7) for rhino-conjunctivitis. The strongest associated factor was the presence of AD in at least one parent. No association of AD with maternal smoking during pregnancy, birth weight, maternal age at the time of the child birth and breast-feeding was observed. The environmental characteristics of the house and the school did not correlate with the prevalence of AD. Episodes of lower respiratory tract infections were associated with asthma, and to a lower extent also with AD and rhinitis. CONCLUSIONS: The prevalence of doctor-diagnosed AD in Italian schoolchildren is comparable to those reported for other developed countries. Family history of atopy was the single most important associated factor, while the complex interplay of environmental factors remains to be elucidated