Central precocious puberty during COVID-19 pandemic and sleep disturbance: an exploratory study

Background: Increased incidence of central precocious puberty (CPP) after coronavirus infectious disease-19 lockdown has been reported. Our study aims in investigating changes in CPP rates and in sleep patterns in CPP and healthy controls. Methods: CPP were retrospectively evaluated from April 2020 to April 2021. Parents of girls diagnosed with CPP during lockdown and of matched healthy controls filled out a questionnaire about sleep disturbances (SDSC questionnaire) and sleep schedules. Results: Thirty-five CPP and 37 controls completed the survey. Incidence of new CPP cases significantly increased in 2020–2021 compared to 2017–2020 (5:100 vs 2:100, p = 0.02). Sleep disturbance rates did not differ between CPP and healthy controls before lockdown. During lockdown, CPP reported higher rates of sleep disturbs for total score (p = 0.005), excessive somnolence (p = 0.049), sleep breathing disorders (p = 0.049), and sleep–wake transition disorders (p = 0.005). Moreover, CPP group more frequently shifted toward later bedtime (p = 0.03) during lockdown compared to controls. Hours of sleep and smartphone exposure around bedtime did not differ between groups. Conclusions: Our study confirms the observation of increased incidence of CPP after lockdown measures. Additionally, CPP showed higher rates of sleep disturbances and later bedtime compared to controls. The causality link between sleep disturbances and CPP should be further investigated to gain knowledge in this association

Some results of a radon survey in 207 Serbian schools

In this paper the results of radon concentration measurements performed in 207 schools in 7 communities of Southern Serbia are presented. The annual radon concentration varied from 17 Bqm-3 to 428 Bq m-3 with a median value of 96 Bq m-3. The arithmetic mean (AM) of the 207 annual averages was 118 Bq m-3 with a standard deviation (SD) of 78 Bq m-3. The best distribution fitting of radon concentration by log-normal function was obtained. The log-normal parameters are the following: geometric mean (GM) = Bq m-3, geometric standard deviation (GSD) = 1.9. In addition, a spatial distribution of the indoor radon concentration over the investigated areas is observed.JRC.E.8-Nuclear securit

Consensus statement of the Italian society of pediatric allergy and immunology for the pragmatic management of children and adolescents with allergic or immunological diseases during the COVID-19 pandemic

The COVID-19 pandemic has surprised the entire population. The world has had to face an unprecedented pandemic. Only, Spanish flu had similar disastrous consequences. As a result, drastic measures (lockdown) have been adopted worldwide. Healthcare service has been overwhelmed by the extraordinary influx of patients, often requiring high intensity of care. Mortality has been associated with severe comorbidities, including chronic diseases. Patients with frailty were, therefore, the victim of the SARS-COV-2 infection. Allergy and asthma are the most prevalent chronic disorders in children and adolescents, so they need careful attention and, if necessary, an adaptation of their regular treatment plans. Fortunately, at present, young people are less suffering from COVID-19, both as incidence and severity. However, any age, including infancy, could be affected by the pandemic. Based on this background, the Italian Society of Pediatric Allergy and Immunology has felt it necessary to provide a Consensus Statement. This expert panel consensus document offers a rationale to help guide decision-making in the management of children and adolescents with allergic or immunologic diseases

HtrA2/Omi Terminates Cytomegalovirus Infection and Is Controlled by the Viral Mitochondrial Inhibitor of Apoptosis (vMIA)

Viruses encode suppressors of cell death to block intrinsic and extrinsic host-initiated death pathways that reduce viral yield as well as control the termination of infection. Cytomegalovirus (CMV) infection terminates by a caspase-independent cell fragmentation process after an extended period of continuous virus production. The viral mitochondria-localized inhibitor of apoptosis (vMIA; a product of the UL37x1 gene) controls this fragmentation process. UL37x1 mutant virus-infected cells fragment three to four days earlier than cells infected with wt virus. Here, we demonstrate that infected cell death is dependent on serine proteases. We identify mitochondrial serine protease HtrA2/Omi as the initiator of this caspase-independent death pathway. Infected fibroblasts develop susceptibility to death as levels of mitochondria-resident HtrA2/Omi protease increase. Cell death is suppressed by the serine protease inhibitor TLCK as well as by the HtrA2-specific inhibitor UCF-101. Experimental overexpression of HtrA2/Omi, but not a catalytic site mutant of the enzyme, sensitizes infected cells to death that can be blocked by vMIA or protease inhibitors. Uninfected cells are completely resistant to HtrA2/Omi induced death. Thus, in addition to suppression of apoptosis and autophagy, vMIA naturally controls a novel serine protease-dependent CMV-infected cell-specific programmed cell death (cmvPCD) pathway that terminates the CMV replication cycle

The management of acute venous thromboembolism in clinical practice. Results from the European PREFER in VTE Registry

Venous thromboembolism (VTE) is a significant cause of morbidity and mortality in Europe. Data from real-world registries are necessary, as clinical trials do not represent the full spectrum of VTE patients seen in clinical practice. We aimed to document the epidemiology, management and outcomes of VTE using data from a large, observational database. PREFER in VTE was an international, non-interventional disease registry conducted between January 2013 and July 2015 in primary and secondary care across seven European countries. Consecutive patients with acute VTE were documented and followed up over 12 months. PREFER in VTE included 3,455 patients with a mean age of 60.8 ± 17.0 years. Overall, 53.0 % were male. The majority of patients were assessed in the hospital setting as inpatients or outpatients (78.5 %). The diagnosis was deep-vein thrombosis (DVT) in 59.5 % and pulmonary embolism (PE) in 40.5 %. The most common comorbidities were the various types of cardiovascular disease (excluding hypertension; 45.5 %), hypertension (42.3 %) and dyslipidaemia (21.1 %). Following the index VTE, a large proportion of patients received initial therapy with heparin (73.2 %), almost half received a vitamin K antagonist (48.7 %) and nearly a quarter received a DOAC (24.5 %). Almost a quarter of all presentations were for recurrent VTE, with >80 % of previous episodes having occurred more than 12 months prior to baseline. In conclusion, PREFER in VTE has provided contemporary insights into VTE patients and their real-world management, including their baseline characteristics, risk factors, disease history, symptoms and signs, initial therapy and outcomes

Understanding venous leg ulcers

Venous leg ulcers are open lesions between the knee and the ankle joint, which occur in the presence of venous insufficiency. There are theories to explain the causes of venous insufficiency, which ultimately leads to venous hypertension and can result in leg ulceration. Although many patients present with evidence of venous hypertension, others do not, except for the manifestation of the ulcer. There are risk factors associated with venous insufficiency and a holistic approach must be taken in order to influence the management approach of venous leg ulceration. This article discusses venous insufficiency as a disease process, and explores the nursing assessment process, when assessing venous leg ulcers related to venous insufficiency

Soil sickness and negative plant-soil feedback: A reappraisal of hypotheses

Soil sickness (SS) is the rise of negative conditions for plant vegetative and reproductive performances induced into the soil by the plant itself. In natural ecosystems, plant ecologists refer to SS as negative plant-soil feedback (NPSF). Scope of this review is to provide an updated picture of the current SS understanding by an explicit comparison between agro-ecosystems and natural plant communities. By an extensive analysis of literature we found that SS is pervasive in agro-ecosystems, occurring in 111 cultivated plants belonging to 41 taxonomic families. Concerning NPSF in natural plant communities, we found evidence of this phenomenon for a total of 411 vascular plants belonging to 72 plant families. NPSF occurs in most of the terrestrial ecosystems, including tropical and temperate forests, coastal sand dunes, old fields and grassland, deserts, as well as heathland and tundra. Three main hypotheses have been proposed to explain SS: (i) soil nutrient depletion or imbalance; (ii) buildup of soilborne pathogen and parasite populations, coupled with a shift in soil microbial community composition; (iii) release of phytotoxic and autotoxic compounds during decomposition of crop residues. Evidences from both agroecosystems and natural plant communities undoubtedly ruled out the nutrient deficiency as a primary causal factor. Moreover, the massive use of mineral fertilizers, especially under intensive cultivation systems, appears an incorrect strategy that only exacerbates the decline of soil quality by inducing acidification and salinization. Soilborne pathogens are often isolated from symptomatic plants and many autotoxic compounds have been identified and quantified from sick soil. However, both the pathogenic and autotoxicity hypotheses are still unable to fully explain the species-specificity, as well as the long durability of SS observed in field conditions. The recent discovery that extracellular DNA (exDNA) has self-inhibitory effects, support the autotoxicity hypothesis, nevertheless this is a totally new topic, and more solid and systematic field investigations are needed. A better understanding of the causes of SS is a necessary step to develop eco-friendly solutions to overcome this problem