Long-term home ventilation of children in Italy: A national survey.

BACKGROUND: Improved technology, as well as professional and parental awareness, enable many ventilator-dependent children to live at home. However, the profile of this growing population, the quality and adequacy of home care, and patients' needs still require thorough assessment. OBJECTIVES: To define the characteristics of Italian children receiving long-term home mechanical ventilation (HMV) in Italy. METHODS: A detailed questionnaire was sent to 302 National Health Service hospitals potentially involved in the care of HVM in children (aged <17 years). Information was collected on patient characteristics, type of ventilation, and home respiratory care. RESULTS: A total of 362 HMV children was identified. The prevalence was 4.2 per 100,000 (95% CI: 3.8-4.6), median age was 8 years (interquartile range 4-14), median age at starting mechanical ventilation was 4 years (1-11), and 56% were male. The most frequent diagnostic categories were neuromuscular disorders (49%), lung and upper respiratory tract diseases (18%), hypoxic (ischemic) encephalopathy (13%), and abnormal ventilation control (12%). Medical professionals with nurses (for 62% of children) and physiotherapists (20%) participated in the patients' discharge from hospital, though parents were the primary care giver, and in 47% of cases, the sole care giver. Invasive ventilation was used in 41% and was significantly related to young age, southern regional residence, longer time spent under mechanical ventilation, neuromuscular disorders, or hypoxic (ischemic) encephalopathy. CONCLUSIONS: Care and technical assistance of long-term HMV children need assessment, planning, and resources. A wide variability in pattern of HMV was found throughout Italy. An Italian national ventilation program, as well as a national registry, could be useful in improving the care of these often critically ill children

Association of the estrogen receptor 1 and 2 polymorphisms with fat distribution in heavy pigs

More than 80% of Italy's pig production is used in the production of traditional dry cured ham. Dry cured ham production requires fresh legs with at least 15 mm of fat coverage. For decades, Italian pigs have been selected for fatness, as legs constitute almost 60% of the commercial value of the animal. Lately, however, thigh prices have dropped, increasing the economic importance of the Longissimus dorsi (L. dorsi) to the pig industry. This research sought to identify genes that can modulate fat repartitioning, resulting in fat legs and lean L. dorsi. As estrogens are known to control the distribution of body fat in humans and rodents, we investigated the polymorphisms in the estrogen receptor 1 (ESRPvuII5700/4200) and estrogen receptor 2 (ESR2 A949G) genes in 612 pigs (278 females, 334 castrated males) and collected the following phenotypical data: carcass weight, lean percentage, leg weight, back fat and leg fat thickness. Castrated males of the ESRPvuII5700/5700 genotype had significantly more back fat (P<0.05) with no significant effect on leg fat. Conversely, ESRPvuII5700/5700 females had significantly less leg fat (P<0.05) with no significant effect on back fat. Both males and females of the ESR2 AA genotype had less leg fat (P<0.05) without any effect of the polymorphism on back fat. Our findings suggest that ESRPvuII5700/4200 and ESR2 A949G polymorphisms are associated with subcutaneous fat localization in pigs

Association of the Estrogen Receptor Gene PVUII Restriction Polymorphism with Fat Content in San Daniele Dry Cured Hams

In Italy more than 80% of pig production is destined to the traditional Italian dry cured ham market. Dry cured ham production requires fresh legs with at least 20 mm of fat coverage. For decades, Italian pigs were selected for fatness as hams constituted almost 60% of the commercial value of the animal. Lately, tight prices dropped and therefore Longissimus dorsi acquires economical importance for the pig industry. The aim of this research was to identify genes that might modulate fat repartition in order to have fat legs and lean L. dorsi. Estrogens are known to control the distribution of body fat mass in human and rodents. Therefore, we investigated the estrogen receptor PVUII polymorphism in 604 pigs (274 females, 330 castrated males) for which the following phenotypical data was collected: carcass weight, backfat thickness, leg weight, leg length and leg fat cover. Fatty acid profiles and IMF were recorded in the Bicipite femoris of 125 animals (62 females, 63 catrated males). Castrated males of the 11 genotype had significantly more backfat (P&lt;0.05) and longer legs (P&lt;0.05). No effect on the leg fat cover was observed. The bicipite femoris of castrated males of the 11 genotype has less IMF (P&lt;0.05), lower concentrations of palmic and oleic acids (P&lt;0.05). Our findings suggest that the ESR polymorphism is associated with fat distribution in pigs

Long-term home ventilation of children in Italy: A national survey

BACKGROUND: Improved technology, as well as professional and parental awareness, enable many ventilator-dependent children to live at home. However, the profile of this growing population, the quality and adequacy of home care, and patients' needs still require thorough assessment. OBJECTIVES: To define the characteristics of Italian children receiving long-term home mechanical ventilation (HMV) in Italy. METHODS: A detailed questionnaire was sent to 302 National Health Service hospitals potentially involved in the care of HVM in children (aged <17 years). Information was collected on patient characteristics, type of ventilation, and home respiratory care. RESULTS: A total of 362 HMV children was identified. The prevalence was 4.2 per 100,000 (95% CI: 3.8-4.6), median age was 8 years (interquartile range 4-14), median age at starting mechanical ventilation was 4 years (1-11), and 56% were male. The most frequent diagnostic categories were neuromuscular disorders (49%), lung and upper respiratory tract diseases (18%), hypoxic (ischemic) encephalopathy (13%), and abnormal ventilation control (12%). Medical professionals with nurses (for 62% of children) and physiotherapists (20%) participated in the patients' discharge from hospital, though parents were the primary care giver, and in 47% of cases, the sole care giver. Invasive ventilation was used in 41% and was significantly related to young age, southern regional residence, longer time spent under mechanical ventilation, neuromuscular disorders, or hypoxic (ischemic) encephalopathy. CONCLUSIONS: Care and technical assistance of long-term HMV children need assessment, planning, and resources. A wide variability in pattern of HMV was found throughout Italy. An Italian national ventilation program, as well as a national registry, could be useful in improving the care of these often critically ill children

Parental presence in Italian pediatric intensive care units: a reappraisal of current visiting policies

Parental presence in Italian pediatric intensive care units: a reappraisal of current visiting policie