Childhood multisystem inflammatory syndrome associated with COVID-19 (MIS-C): Distinct from Kawasaki disease or part of the same spectrum?

One of the most challenging and intriguing phenomena observed during the COVID-19 pandemic has been the multisystem inflammatory syndrome in children (MIS-C). Patients with this condition present with some clinical features similar to those of Kawasaki disease (KD) and display signs and symptoms that are uncommon or rarely occur in this disorder, such as gastrointestinal complaints and myocarditis, often leading to myocardial failure and shock. In addition, patients\u2019 age is older than that of children with classic KD. Management is based on administering intravenous immunoglobulin, glucocorticoids, and anakinra in the most severe instances. It is still debated whether MIS-C and KD are different illnesses or represent a disease continuum

Deconstruction of the Corso Grosseto viaduct and setup of a testing site for full scale load tests

BRIDGE|50 is a research project recently launched in Italy in the context of the Torino-Ceres construction works jointly with Politecnico di Milano, Politecnico di Torino, public authorities and private companies. The aim of the BRIDGE|50 research project is to investigate the residual structural performance of the Corso Grosseto 50-year-old prestressed concrete bridge through an experimental campaign. The dismantling and demolition procedures of Corso Grosseto viaduct are presented in this paper, including the setup of the field laboratory where several deck beams and pier caps will be tested up to collapse

Definition and Validation of the American College of Rheumatology 2021 Juvenile Arthritis Disease Activity Score Cutoffs for Disease Activity States in Juvenile Idiopathic Arthritis

Export Date: 16 February 2023; Cited By: 10Peer reviewe

Novel biomarkers for prediction of outcome and therapeutic response in juvenile idiopathic arthritis

Introduction: The search for biomarkers in juvenile idiopathic arthritis (JIA) is a promising and rapidly expanding field of investigation. The biomarkers identified so far may help to dissect the clinical heterogeneity of the illness, measure the level of disease activity, predict clinical remission, relapse, response to medications, course over time, complications, and forestall disease flares. Areas covered: We provide a summary of the most recent advances in the development and application of biomarkers in JIA. We performed a PubMed search for significant articles combining predetermined keywords related to biomarkers in non-systemic and systemic JIA, chronic uveitis, and macrophage activation syndrome (MAS). The biomarkers available or under study are presented and discussed separately for non-systemic and systemic subtypes and for the two main disease complications, uveitis and MAS. Expert opinion: The incorporation of valid and reliable biomarkers in standard clinical care may help to design better patient-tailored treatment regimens and to improve the therapeutic strategies based on the treat-to-target approach. The establishment of biomarkers that predict the risk of disease flare may lead to define the optimal modalities for treatment discontinuation after the achievement of clinical remission

Digitalization Processes and Bridge Information Modeling for Existing Bridges

7noBridges constant assessment, monitoring and retrofitting are key aspects to prevent inadequate damage situations. Considering the importance of these processes, a new official guideline for Bridge evaluation, classification and monitoring has been issued in Italy. The usage of BIM methodology comes as a logical solution to store and manage all information related to the bridge surveillance process and create a unique database. In the present work, HBIM methodologies are implemented for the creation of a damage database and new approaches are tested for the application of the guidelines directly on the BIM environment. Using the dismantled structures of Largo Grosseto bridge as a case study and damage information previously recovered as input data, HBIM models are created using two different methodologies: Parametric modelling and Mesh-to-BIM process. Moreover, the utility of the database created is expanded thanks to the usage of visual programming tools. The evaluation of the modelling processes highlights the effectiveness of BIM for infrastructure monitoring and classification. The results obtained demonstrate the way towards a new BIM monitoring standard procedure for infrastructure surveillance processes.mixedembargoed_20221212Polania D.R.; Tondolo F.; Osello A.; Fonsati A.; De Gaetani C.; Trincianti C.; Gazulli D.Polania, D. R.; Tondolo, F.; Osello, A.; Fonsati, A.; De Gaetani, C.; Trincianti, C.; Gazulli, D

Deconstruction of the Corso Grosseto viaduct and setup of a testing site for full scale load tests

BRIDGE|50 is a research project recently launched in Italy in the context of the Torino-Ceres construction works jointly with Politecnico di Milano, Politecnico di Torino, public authorities and private companies. The aim of the BRIDGE|50 research project is to investigate the residual structural performance of the Corso Grosseto 50-year-old prestressed concrete bridge through an experimental campaign. The dismantling and demolition procedures of Corso Grosseto viaduct are presented in this paper, including the setup of the field laboratory where several deck beams and pier caps will be tested up to collapse

Pediatric SARS-CoV-2-Related Diplopia and Mesencephalic Abnormalities

ObjectiveThis case report describes a patient with mesencephalic MRI signal abnormality and diplopia, possibly associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection.MethodsWe describe a boy with binocular diplopia and nystagmus. The pattern of serology positivity and negative direct research of SARS-CoV-2 RNA in our patient allowed us to consider novel coronavirus as the trigger of possible immune-mediated phenomena against the central nervous system.ResultsDuring hospitalization, blood tests revealed a recent SARS-CoV-2 infection. MRI revealed hyperintensity of the mesencephalic tegmentum and periaqueductal region, consistent with an inflammatory lesion of the midbrain tegmentum. Viral and bacterial molecular screening on cerebrospinal fluid and isoelectrofocusing analysis, anti-myelin oligodendrocyte glycoprotein, anti-Aquaporine-4, and anti-N-methyl-d-Aspartate antibodies were negative. The patient was treated with steroids and immunoglobulin therapy with complete remission of neurologic symptoms.DiscussionThis report expands the spectrum of pediatric COVID-19-Associated neurologic symptoms and highlights a possible isolated neurologic COVID-19-related symptom

Paediatric rheumatologists do not score the physician’s global assessment of juvenile idiopathic arthritis disease activity in the same way

Abstract Objectives: To assess the heterogeneity in factors affecting physician’s global assessment of disease activity (PhGA) and in PhGA scoring of multiple JIA patient’s case scenarios. Methods: An electronic web-based questionnaire of factors potentially considered in PhGA was sent worldwide to members of PRINTO and the Pediatric Rheumatology Care and Outcomes Improvement Network (PR-COIN). The respondents were asked to rate from 0 to 100 the relevance of 17 factors possibly affecting PhGA scoring and to derive a PhGA score of 17 detailed JIA patient cases. The median and interquartile range was used to measure the heterogeneity in the scoring. To demonstrate the consistency among the PhGA scores of the patient cases provided by multiple physicians, we assessed the inter-rater reliability using intra-class correlation. Results: The questionnaire was completed by 491 respondents. A large individual variation was observed in the impact of different factors on PhGA when assessing JIA. For non-systemic JIA the presence of fever had the largest variation and swollen joint count had the smallest. For sJIA, the largest variation was seen in the presence of erosions and the smallest in the presence of fever. The intra-class correlation of the group for PhGA scoring of patient cases was 0.53 (95% CI 0.38, 0.72). Conclusions: In a sample of worldwide respondents, the scoring of the PhGA is divergent. Consensus on PhGA scoring guidelines is required to obtain a consistent assessment of patients