Current Insights on Early Life Nutrition and Prevention of Allergy

The incidence of allergic diseases in childhood appears to have significantly increased over the last decades. Since environmental factors, including diet, have been thought to play a significant role in the development of these diseases, there is great interest in identifying prevention strategies related to early nutritional interventions. Breastfeeding is critical for the immune development of newborns and infants through immune-modulating properties and it impacts the establishment of a healthy gut microbiota. However, the evidence for a protective role of breastfeeding against the development of food allergy in childhood is controversial, and there is little evidence to support the benefits of an antigen avoidance diet during lactation. Although it is not possible to draw a definitive conclusion about the protective role of breast milk against allergic diseases, exclusive breastfeeding is still recommended throughout the first 6 months of life due to associated health benefits. Furthermore, recommendations regarding complementary feeding in infancy have been significantly modified over the last few decades. Several studies have shown that delayed exposure to allergenic foods does not have a role in allergy prevention and recent guidelines recommend against delaying the introduction of complementary foods after 6 months of age, both in high- and low-risk infants. However, trials investigating this dietary approach have reported equivocal results so far. This review summarizes the available high-quality evidence regarding the efficacy of the principal dietary interventions proposed in early life to prevent allergic diseases in children

The burden of Candida species colonization in NICU patients: a colonization surveillance study

Fungal infections are an important cause of morbidity and mortality in neonatal intensive care units (NICUs). The identification of specific risk factors supports prevention of candidemia in neonates. Effective prophylactic strategies have recently become available, but the identification and adequate management of high-risk infants is still a priority. Prior colonization is a key risk factor for candidemia. For this reason, surveillance studies to monitor incidence, species distribution, and antifungal susceptibility profiles, are mandatory. Among 520 infants admitted to our NICU between January 2013 and December 2014, 472 (90.77%) were included in the study. Forty-eight out of 472 (10.17%) patients tested positive for Candida spp. (C.), at least on one occasion. All the colonized patients tested positive for the rectal swab, whereas 7 patients also tested positive for the nasal swab. Fifteen out of 472 patients (3.18%) had more than one positive rectal or nasal swab during their NICU stay. Moreover, 9 out of 15 patients tested negative at the first sampling, suggesting they acquired Candida spp. during their stay. Twenty-five of forty-eight (52.1%) colonized patients carried C.albicans and 15/48 (31.25%) C.parapsilosis. We identified as risk factors for Candida spp. colonization: antibiotic therapy, parenteral nutrition, the use of a central venous catheter, and nasogastric tube. Our experience suggests that effective microbiological surveillance can allow for implementing proper, effective and timely control measures in a highrisk setting

Transitional hemodynamics in infants of diabetic mothers by targeted neonatal echocardiography, electrocardiography and peripheral flow study

Objective: Metabolic alterations of intrauterine environment in diabetes mellitus (DM) lead to fetal cardiac dysfunctions that can persist after birth. The aim of the study was to assess the cardiovascular adaptation in infants born to diabetic mothers (IDM) with different degrees of glycometabolic control, in relation to revised guidelines for diagnosis of DM and quality improvements in neonatal care. Materials and methods: An observational case-control study was conducted on IDM with gestational, type 1 and type 2\ue2\u80\u89DM. Relevant maternal and neonatal anamnestic, clinical and laboratory data were analyzed. Electrocardiographic and echocardiographic analyses, including structural and systo-diastolic evaluation, were performed. Results: In 68 IDM enrolled, we observed a lower incidence of negative perinatal outcome than expected. Comparing to non-IDM, they presented larger fetal shunts, higher pulmonary pressures, early and atrial wave velocities. At 72\ue2\u80\u89hours, kinesis and heart rate variability remained low. Cerebral blood flow velocities were higher. The most serious impairment of transition was in pregestational IDM. Conclusion: Maternal DM impaired neonatal transitional hemodynamics also in asymptomatic IDM with good glycometabolic control. These results confirm the need for an early cardiologic and cerebrovascular evaluation, to identify IDM with delayed maturation at risk of worse long-term metabolic, cardiovascular, and neurodevelopmental outcome

Giacomo Serpotta e il "pareggiamento delle arti": la decorazione degli oratori fra manipolazione vitalistica e vocazione classicista

ABSTRACT GIACOMO SERPOTTA AND THE “EQUALIZATION OF THE ARTS”: DECORATION OF THE ORATORIES BETWEEN VITALISTIC MANIPULATION AND CLASSICIST VOCATION Ettore Sessa The value of the whole of Giacomo Serpotta's artistic vision in the orchestration of the figu¬rative apparatuses of his oratories was certainly one of the principal primers of his historical-critical raising in the modernist period. In 1901 Mauceri and in 1911 Ricci and Basile heighten a profile of it, however synthetic, of angling and above all of different breath from the rediscovery realized in positivist age. Classifiable, in fact, among the eighteenth century precedents of Gesamtkunstwerk aesthetical plant (according to a rather diffused custom within the artistic historiography of modernist culturaI area or of decadentist origin, as in different formalistic demonstrations of the wealthiest society Belle Époque) the progress of Serpottas artistic way towards tangible expressions of the idea of «the whole work of art» has a unmistakable im¬print of his and, at the same time, a feasibility thanks to the plasticism of gestures and to the uni¬tary multiplicity of his modeled. In his oratories arrangements the "realist" component, not exempted from hedonistic sensual witty remarks, acts on a foundation of Hellenic taste (also in the use of profiles and architectural elements). With wise modulation and with dosing diversified for intensity, according the nature of the subjects, combines history (see the «teatrini» with perspective sceneries, among which the Lepanto battle), micro history (from feminine allegorical subjects, to attractive dames modernly adorned with ends and brocades, to "picciotti" proudly ragged and to the anecdotal of the daily life), mysticism (from the devotional subjects to the allegories of the virtues), obscurity (from numerological components to philosophical attributes) and, finally, mythology (from the allegorical correspondences between Christianity and paganism to classical simbology). Despite the actual halving of this group of oratories (was destroyed by traumatic events as earthquakes and war actions, or by villainous demolitions big part of Serpottas works, among which the SS. Sacrament oratories to Kalsa and those of Saint Maria del Ponticello), the comparison among the palermitan examples reached us entire allows the individualization of the characters of originality typical of the generaI composition, over that of those figurative unanimously accredited among the most valid of the late- Baroque European sculpture. The typical scheme of these oratories, places with a strong secular imprint (predisposed as for cultural reunions how as for the preclusive congregational assemblies, to which the only ones not admitted affiliate were the artists), has as constants: the hall with a rectangular plant; the skiff or pavilion vault with plaster decorations dissimulating the constructive geometry; the sculptural wall register above of a high plinth; windows on the greatest sides (in number of three); two doors in the counterfacade, originally with desk for the assemblies in central position, below the principal devotional allegorical composition. The first oratory to which Giacomo Serpotta imposes an unitary imprint, except the cappellone only defined between 1717 and the following year) is that of SS. Rosary in S. Cita; he has worked since 1685 to 1688 on behalf of SS. Rosary Company. Serpotta is twenty nine, but already since almost ten years, after the apprenticeship with subordinate roles, he showed himself almost beginning in mute with the decorations of Madonna of the Pity church in Monreale, where he operated like Procopio De' Ferrari's collaborator, and perhaps with his interventions in 1678 in the lateral walls of S. Mercurio oratory, to which follow the 1679 decoration works in the Charity oratory in St. Bartholomeo of the Incurable people (no more existing), perhaps S. Pietro and S. Paolo statues dating back to 1680 for the greatest altar in Gancia church, the marble model for Charles H's equestrian monument for Messina (then realized in 1684) and during the two years 1683-1684 the scenic decorations for the transept altars of Carmine Maggiore church (where he collaborates with his brother Giuseppe and realizes the couples of twisted columns gilded and commented by a theory of plaster miniature scenes disposed according to a spiral development). Immediately after S. Cita oratory he realized, between 1688 and 1691, the decorative apparatuses of the Sacrament oratory in S. Nicolò to Kalsa (destroyed because of 1823 earthquake). Only eight years after the completion of this work (about which it was hypothesized that it were an advancement in comparison to the intervention in S. Cita) Giacomo Serpotta is entrusted by S. Francesco from Assisi and S. Lorenzo Companies to realize the complex allegorical and explanatory cycle of the plasters of S. Lorenzo orato¬ry. He worked partly on Giacomo Amato's sketches (to which are probably owed the reform interventions that confer to this oratory a great architectural "squaring" in comparison to others), completing the presbytery within 1706, while already from 1701 he is busy in the definition of the walls. In 1703 he began the counter facade with the monumental wall framework and high-relief representation of St. Lorenzo Martyrdom

The Terminal Oxidase Cytochrome bd Promotes Sulfide-resistant Bacterial Respiration and Growth

Hydrogen sulfide (H2S) impairs mitochondrial respiration by potently inhibiting the heme-copper cytochrome c oxidase. Since many prokaryotes, including Escherichia (E.) coli, generate H2S and encounter high H2S levels particularly in the human gut, herein we tested whether bacteria can sustain sulfide-resistant O2-dependent respiration. E. coli has three respiratory oxidases, the cyanide-sensitive heme-copper bo3 enzyme and two bd oxidases much less sensitive to cyanide. Working on the isolated enzymes, we found that, whereas the bo3 oxidase is inhibited by sulfide with half-maximal inhibitory concentration IC50=1.1±0.1μM, under identical experimental conditions both bd oxidases are insensitive to sulfide up to 58μM. In E. coli respiratory mutants, both O2-consumption and aerobic growth proved to be severely impaired by sulfide when respiration was sustained by the bo3 oxidase alone, but unaffected by ≤200μM sulfide when either bd enzyme acted as the only terminal oxidase. Accordingly, wild-type E. coli showed sulfide-insensitive respiration and growth under conditions favouring the expression of bd oxidases. In all tested conditions, cyanide mimicked the functional effect of sulfide on bacterial respiration. We conclude that bd oxidases promote sulfide-resistant O2- consumption and growth in E. coli and possibly other bacteria. The impact of this discovery is discussed

Prevalence of hypospadias in Italy according to severity, gestational age and birthweight: an epidemiological study

<p>Abstract</p> <p>Background</p> <p>Hypospadias is a congenital displacement of the urethral meatus in male newborns, being either an isolated defect at birth or a sign of sexual development disorders. The aim of this study was to assess the prevalence rate of hypospadias in different Districts of Italy, in order to make a comparison with other countries all over the world.</p> <p>Methods</p> <p>We reviewed all the newborns file records (years 2001–2004) in 15 Italian Hospitals.</p> <p>Results</p> <p>We found an overall hypospadias prevalence rate of 3.066 ± 0.99 per 1000 live births (82.48% mild hypospadias, 17.52% moderate-severe). In newborns Small for Gestational Age (birthweight < 10^thpercentile) of any gestational age the prevalence rate of hypospadias was 6.25 per 1000 live births. Performing multivariate logistic regression analysis for different degrees of hypospadias according to severity, being born SGA remained the only risk factor for moderate-severe hypospadias (p = 0.00898) but not for mild forms (p > 0.1).</p> <p>Conclusion</p> <p>In our sample the prevalence of hypospadias results as high as reported in previous European and American studies (3–4 per 1000 live births). Pathogenesis of isolated hypospadias is multifactorial (genetic, endocrine and environmental factors): however, the prevalence rate of hypospadias is higher in infants born small for gestational age than in newborns with normal birth weight.</p

The right to food and food diversity in the Italian Constitution

Il contributo analizza la tutela apprestata dalla Costituzione italiana al diritto al cibo che, pur non essendo espressamente menzionato, viene ricavato attraverso l'analisi di principi ed azioni sottese alla nostra Carta che ne riconoscono il valore: il principio lavorista, la lotta alla povertà, la retribuzione del lavoratore...

Multidisciplinary model for hospital-territory integrated management of patient with bone fragility: primary and secondary prevention of fractures according to severity and complexity.

The aim of this study was to promote the construction of a real network and a shared diagnostic and therapeutic management model between hospitals and out-of-hospital healthcare services to capture as many patients with bone fragility as possible. Starting from the analysis of the clinical competences present in the province of Pavia, the bone specialists (BSs) organized some educational events involving both general practitioners (GPs) and hospital specialists. The Fracture Liaison Service (FLS) model, the revision of Note 79, the national plan for chronicity and the health reform of the Lombardy Regional Authority supported the structure of our model, in which the roles of clinicians are well defined and based on the complexity and severity of patients. In our method the GP has a central role as clinical manager, facilitating patient management and communication between the specialists and the BS. In January 2019, the Therapeutic Care Diagnostic Path (PDTA) shared between 2 bone specialists (BSs), 9 GPs, as reference treaters, and a multidisciplinary group of 25 specialists of the Province of Pavia was defined. The strategic directions of the two largest public hospitals in Pavia have supported the PDTA, which was validated by the quality departments of the hospitals themselves. Finally, sixty GPs belonging to the network have joined the PDTA. This model is the first example of integrated management between hospitals and out-of-hospital healthcare services for the primary and secondary prevention of fragility fractures (FF), where the GPs play a pivotal role as managers and supervisors to ensure proper care to chronic patients according to their levels of severity

ASFISSIA PERINATALE:VALUTAZIONE CLINICO-EPIDEMIOLOGICA IN UN CAMPIONE DI NEONATI DI ≥ 34 SEG

Asfissia, late preterm, a termin