La responsabilità del professionista intellettuale per le prestazioni eseguite a titolo gratuito e a titolo amichevole

: Tracciare il confine tra i vincoli giuridici e i rapporti giuridicamente irrilevanti è un compito che spesso risulta assai arduo. La progressiva giuridificazione dei rapporti e la prospettiva rimediale, a cui è informato il nostro ordinamento, inducono il diritto a reagire dinanzi ai gravi danni cagionati da prestazioni eseguite senza “animus obligandi”. Muovendo dal progetto preliminare del Codice europeo dei Contratti, il presente saggio si emancipa dalle categorie tradizionali della responsabilità contrattuale ed extracontrattuale. Offre una soluzione alternativa all’inquadramento della responsabilità dei professionisti intellettuali per le prestazioni rese a titolo gratuito e a titolo amichevole

Mental health problems among pregnant and non-pregnant youth

OBJECTIVE: To estimate the prevalence of mental health problems in primiparous adolescents and to compare their mental health profile with the profile of sexually active adolescents who have never gotten pregnant. METHODS: Cross-sectional study that compared two groups of adolescents aged 13 to 17 years from a city in Southern Brazil, 2003-2004. The sample included 207 primiparous who attended prenatal care programs in urban public services, and 308 sexually active students from state public schools who had never gotten pregnant. A screening instrument to identify mental health problems in adolescents (Brazilian version of the Youth Self-Report) was applied to the participants together with a questionnaire on risk factors for pregnancy in adolescence. Statistical analysis included Chi-square tests, Fisher's exact test, Mann Whitney's U and logistic regression models. RESULTS: Pregnant and non-pregnant adolescents did not differ in the prevalence of total mental health problems (24.6% vs. 27.3%; p=0.50). Compared to the group of never pregnant adolescents, the group of primiparous presented higher prevalence of anxious/depressive symptoms (24.2% vs. 15.3%; p=0.01) and withdrawn/depressed symptoms (13.0% vs., 4.5%; p<0.001) and there was a greater number of tobacco users (21.3% vs. 11.0%; p=0.002). These differences were confirmed by logistic regression models controlled for maternal education. CONCLUSIONS: Anxiety and depression symptoms and tobacco use were more frequent in pregnant adolescents in comparison to non-pregnant. These problems require special attention from prenatal care services in order to avoid potential damages for the health of mothers and their children.OBJETIVO: Estimar a prevalência de problemas de saúde mental em adolescentes primigestas e comparar seu perfil de saúde mental com o daquelas sexualmente ativas que nunca engravidaram. MÉTODOS: Estudo de corte transversal, comparativo entre dois grupos de adolescentes de 13 a 17 anos, em Marília, Estado de São Paulo, 2003-2004. A amostra incluiu 207 primigestas atendidas em programas de pré-natal de serviços públicos municipais urbanos e 308 estudantes de escolas estaduais, sexualmente ativas, que nunca engravidaram. Foram aplicados um instrumento de rastreamento para problemas de saúde mental em adolescentes (versão brasileira do Youth Self-Report) e um questionário sobre fatores de risco para gravidez na adolescência. A análise estatística incluiu testes de qui-quadrado, exato de Fisher, U de Mann Whitney e modelos de regressão logística. RESULTADOS: Adolescentes grávidas e não-grávidas não diferiram quanto à prevalência do total de problemas de saúde mental (24,6% vs. 27,3%; p=0,50). Comparado às adolescentes não-grávidas, o grupo das primigestas apresentou maior prevalência de sintomas de ansiedade/depressão (24,2% vs. 15,3%; p=0,01) e sintomas de retraimento/depressão (13,0% vs, 4,5%; p<0,001), além de maior número de fumantes (21,3% vs. 11,0%; p=0,002). Estas diferenças foram confirmadas em modelos de regressão logística, controlados para escolaridade da mãe. CONCLUSÕES: Foram mais freqüentes os sintomas de ansiedade e depressão e uso de tabaco em adolescentes primigestas em comparação com as adolescentes não-grávidas. Esses problemas requerem especial atenção dos serviços de pré-natal a fim de evitar possíveis prejuízos para a saúde das mães e de seus filhos.Faculdade de Medicina de Marília Disciplina de PsiquiatriaUniversidade Federal de São Paulo (UNIFESP) Escola Paulista de Medicina Departamento de PsiquiatriaUNIFESP, EPM, Depto. de PsiquiatriaSciEL

Accelerated cardiac aging in patients with congenital heart disease

An increasing number of patients with congenital heart disease (CHD) survive into adulthood but develop long-term complications including heart failure (HF). Cellular senescence, classically defined as stable cell cycle arrest, is implicated in biological processes such as embryogenesis, wound healing, and aging. Senescent cells have a complex senescence-associated secretory phenotype (SASP), involving a range of pro-inflammatory factors with important paracrine and autocrine effects on cell and tissue biology. While senescence has been mainly considered as a cause of diseases in the adulthood, it may be also implicated in some of the poor outcomes seen in patients with complex CHD. We propose that patients with CHD suffer from multiple repeated stress from an early stage of the life, which wear out homeostatic mechanisms and cause premature cardiac aging, with this term referring to the time-related irreversible deterioration of the organ physiological functions and integrity. In this review article, we gathered evidence from the literature indicating that growing up with CHD leads to abnormal inflammatory response, loss of proteostasis, and precocious age in cardiac cells. Novel research on this topic may inspire new therapies preventing HF in adult CHD patients

Thermographic Control of Pediatric Dental Patients During the SARS-CoV-2 Pandemics Using Smartphones

Objective: To evaluate the reliability of infrared (IR) thermal camera connected to smartphones, already used in medicine for diagnostic purposes, as an easy tool for access screening to pediatric dentistry services. Material and Methods: After the preventive telephone triage, thirty orthodontic patients (7-13 years) underwent temperature measurement in the office with two no-contact IR devices: forehead digital thermometer and thermal-camera connected to a smartphone (reference areas: forehead, inner canthi, ears). Measurements were compared and differences were statistically investigated with T student’s test (p&lt;0.01). Results: Forehead digital thermometer temperatures were superimposable to those recorded in ear areas and inner canthi with the thermal camera connected to a smartphone. Differences were not statistically significant even in comparison between the sexes. Forehead temperature values detected with a thermal camera are lower than those detected with a digital forehead thermometer. Conclusion: Thermal camera on a smartphone could be reliable in measuring body temperature. Mobile thermographic values of ears and inner canthi areas can be used as an alternative to forehead digital thermometer measurements. Further applications in pediatric dentistry of thermography on smartphones should be examined

Candidate HIV-1 Tat vaccine development: From basic science to clinical trials

No abstract available

Reconstruction of the swine pulmonary artery using a graft engineered with syngeneic cardiac pericytes

The neonatal heart represents an attractive source of regenerative cells. Here, we report the results of a randomized, controlled, investigator-blinded preclinical study, which assessed the safety and effectiveness of a matrix graft cellularized with cardiac pericytes (CPs) in a piglet model of pulmonary artery (PA) reconstruction. Within each of five trios formed by 4-week-old female littermate piglets, one element (the donor) was sacrificed to provide a source of CPs, while the other two elements (the graft recipients) were allowed to reach the age of 10 weeks. During this time interval, culture-expanded donor CPs were seeded onto swine small intestinal submucosa (SIS) grafts, which were then shaped into conduits and conditioned in a flow bioreactor. Control unseeded SIS conduits were subjected to the same procedure. Then, recipient piglets were randomized to surgical reconstruction of the left PA (LPA) with unseeded or CP-seeded SIS conduits. Doppler echocardiography and cardiac magnetic resonance imaging (CMRI) were performed at baseline and 4-months post-implantation. Vascular explants were examined using histology and immunohistochemistry. All animals completed the scheduled follow-up. No group difference was observed in baseline imaging data. The final Doppler assessment showed that the LPA’s blood flow velocity was similar in the treatment groups. CMRI revealed a mismatch in the average growth of the grafted LPA and contralateral branch in both treatment groups. Histology of explanted arteries demonstrated that the CP-seeded grafts had a thicker luminal cell layer, more intraparietal arterioles, and a higher expression of endothelial nitric oxide synthase (eNOS) compared with unseeded grafts. Moreover, the LPA stump adjacent to the seeded graft contained more elastin and less collagen than the unseeded control. Syngeneic CP engineering did not accomplish the primary goal of supporting the graft’s growth but was able to improve secondary outcomes, such as the luminal cellularization and intraparietal vascularization of the graft, and elastic remodeling of the recipient artery. The beneficial properties of neonatal CPs may be considered in future bioengineering applications aiming to reproduce the cellular composition of native arteries