Cardiorespiratory fitness: a comparison between children with renal transplantation and children with congenital solitary functioning kidney

Children with end-stage renal disease are known to have a cardiorespiratory fitness significantly reduced. This isconsidered to be an independent index predictive of mortality mainly due to cardiovascular accidents. The effectsof renal transplantation on cardiorespiratory fitness are incompletely known. We compared the maximal oxygenuptake (VO2 max) of children with a functioning renal transplant with that of children with congenital solitaryfunctioning kidney, taking into consideration also the amount of weekly sport activity

Pericardiectomy for Pleuropericardial Effusion Complicating Bacterial Pneumonia

Severe pericardial effusion is a rare complication of bacterial pneumonia and it usually disappears under medical treatment. Herein we report a case of a girl with a congenital immunodeficient syndrome and bacterial pneumonia, who developed recurrent and life-threatening pericardial effusion refractory to medical treatment. She was finally treated with pericardiectomy

Nuclear Magnetic Resonance and Molecular Dynamics Simulation of the Interaction between Recognition Protein H7 of the Novel Influenza Virus H7N9 and Glycan Cell Surface Receptors

Avian influenza A viruses, which can also propagate between humans, present serious pandemic threats, particularly in Asia. The specificity (selectivity) of interactions between the recognition protein hemagglutinin (HA) of the virus capsid and the glycoconjugates of host cells also contributes to the efficient spread of the virus by aerosol between humans. Some avian origin viruses, such as H1N1 (South Carolina 1918), have improved their selectivity for human receptors by mutation in the HA receptor binding site, to generate pandemic viruses. Molecular details and dynamics of glycan–HA interactions are of interest, both in predicting the pandemic potential of a new emerging strain and in searching for new antiviral drugs. Two complementary techniques, ¹H saturation transfer difference (¹H STD) nuclear magnetic resonance and molecular dynamics (MD) simulation, were applied to analyze the interaction of the new H7 (A/Anhui/1/13 H7N9) with LSTa [Neu5Ac α(2→3) Gal β(1→3) GlcNAc β(1→3) Gal β(1→4) Glc] and LSTc [Neu5Ac α(2→6) Gal β(1→4) GlcNAc β(1→3) Gal β(1→4) Glc] pentasaccharides, models of avian and human receptor glycans. Their interactions with H7 were analyzed for the first time using ¹H STD and MD, revealing structural and dynamic behavior that could not be obtained from crystal structures, and contributing to glycan–HA specificity. This highlighted aspects that could affect glycan–HA recognition, including the mutation H7 G228S, which increases H2 and H3 specificity for the human receptor. Finally, interactions between LSTc and H7 were compared with those between LSTc and H1 of H1N1 (South Carolina 1918), contributing to our understanding of the recognition ability of HAs

Applicazione delle nuove linee guida AARC per l'aspirazione endotracheale : impatto sui parametri vitali in pazienti sottoposti a rivascolarizzazione miocardica (BPAC)

RIASSUNTOIntroduzione : La manovra di bronco aspirazione è una procedura che espone il paziente critico a modificazioni dei parametri vitali. Le nuove linee guida AARC hanno enfatizzato sia l'importanza dell'identificazione corretta del momento in cui eseguire la procedura, sia l'utilizzo routinario del sistema chiuso. Obiettivo : Applicare le nuove linee guida AARC utilizzando un rilevatore sonoro per l'identificazione della presenza di secrezioni (TBA care©) e l'aspirazione a circuito chiuso ed analizzare l'andamento dei parametri vitali in una popolazione di pazienti cardiochirurgici. Materiali e metrodi: Lo studio è di tipo osservazionale. Sono stati investigati 15 pazienti sottoposti a BPAC, ricoverati in terapia intensiva cardiochirurgia. Sono stati registrati in continuo i seguenti parametri vitali HR, PAS, PAS*HR, ST varie derivazioni, SpO2, PEEP, RRv, TVc in quattro finestre temporali, 5 minuti prima della manovra di Broncoaspirazione, al momento della manovra (momento 0), a 5 minuti dalla stessa e 10 minuti dopo. Risultati : I parametri vitali rimangono sostanzialmente stabili nei quattro step investigati, con minime variazioni (Variazione percentuale durante la manovra rispetto al basale : HR +2,93%, PAS + 5,66%, SpO2 – 0,13%) . Non si sono registrate modificazioni del tratto ST. Si registra un aumento dell'indice di lavoro cardiaco, che però rientra a 5 minuti dall'esecuzione della manovra. Non si sono verificate desaturazioni arteriose. Conclusioni : Le alterazioni dei parametri vitali osservate, seppur minime, suggeriscono di mantenere il massimo monitoraggio emodinamico e respiratorio. Nella popolazione osservata, l'utilizzo di tecnologie per la diagnosi associate al sistema chiuso di broncoaspirazione ha evitato l'insorgenza di complicanze legate alla manovra.Parole chiave: aspirazione endotracheale, identificazione delle secrezioni, sistema chiuso, ventilazione meccanica, gestione delle secrezioniABSTRACT Introduction: Endotracheal suctioning is a procedure that exposes the patient to critical changes in vital signs. New AARC guidelines have emphasized both the importance of correct identification when to perform the procedure, and the routine use of closed system. Objective: To implement the new guidelines AARC using a sound detector for identifying the presence of secretions (TBA care ©) , closed suctioning circuit and analyze the performance of vital signs in a population of cardiac patients. Methods : The study is observational. Were investigated 15 patients undergoing CABG, cardiac surgery ICU. Were continuously recorded the following vital signs HR, SBP, SBP * HR, ST various leads, SpO2, PEEP, RRV, TVC in four time windows, 5 minutes before the suctioning maneuver at the time of operation (time 0), 5 minutes from the same and 10 minutes later. Results: Vital signs remain stable in the four steps investigated, with minor variations (percent change from baseline during the maneuver: HR +2.93% 5.66% PAS +, SpO2 - 0.13%). There were no ST segment changes. There is an increase in the cardiac work, but within 5 minutes from the execution of the maneuver. There were no arterial desaturation. Conclusions: The observed changes in vital signs, albeit small, suggest to keep the maximum hemodynamic and respiratory monitoring. The use of technologies for the diagnosis associated with the closed system of broncoaspiration has prevented the onset of complications related to the maneuver.Keywords: endotracheal suctioning, secretion detector, closed system, mechanical ventilation, secretion managemen

Proteinuria and albuminuria at point of care

Proteinuria is a key diagnostic and pathophysiological aspect of kidney dysfunction, influencing the progression of kidney and systemic diseases. Both general practitioners and specialists should be able to discriminate the relevance of proteinuria, starting from a urine sample, and eventually referring selected patients to a nephrologist for further diagnostic workup and treatment, because most kidney diseases are not symptomatic until renal function is lost or severely compromised. As the interpretation of proteinuria is dependent on the method used to detect it, the aim of this article was to review laboratory and point-of-care diagnostic methods for proteinuria in different settings, such as the prevention and follow-up of common chronic diseases (i.e., hypertension, diabetes, chronic kidney disease). Urine dipsticks remain the most widely used method for detecting proteinuria, although different types of proteinuria, extreme pH values and urine concentration may affect their results. Albumin to creatinine ratio and protein to creatinine ratio performed on a spot urine sample are reliable tests that can effectively replace 24-hour urine collection analysis in clinical practice

Privacy in trajectory micro-data publishing : a survey

We survey the literature on the privacy of trajectory micro-data, i.e., spatiotemporal information about the mobility of individuals, whose collection is becoming increasingly simple and frequent thanks to emerging information and communication technologies. The focus of our review is on privacy-preserving data publishing (PPDP), i.e., the publication of databases of trajectory micro-data that preserve the privacy of the monitored individuals. We classify and present the literature of attacks against trajectory micro-data, as well as solutions proposed to date for protecting databases from such attacks. This paper serves as an introductory reading on a critical subject in an era of growing awareness about privacy risks connected to digital services, and provides insights into open problems and future directions for research.Comment: Accepted for publication at Transactions for Data Privac

Enisamium Inhibits SARS-CoV-2 RNA Synthesis.

Pandemic SARS-CoV-2 causes a mild to severe respiratory disease called coronavirus disease 2019 (COVID-19). While control of the SARS-CoV-2 spread partly depends on vaccine-induced or naturally acquired protective herd immunity, antiviral strategies are still needed to manage COVID-19. Enisamium is an inhibitor of influenza A and B viruses in cell culture and clinically approved in countries of the Commonwealth of Independent States. In vitro, enisamium acts through metabolite VR17-04 and inhibits the activity of the influenza A virus RNA polymerase. Here we show that enisamium can inhibit coronavirus infections in NHBE and Caco-2 cells, and the activity of the SARS-CoV-2 RNA polymerase in vitro. Docking and molecular dynamics simulations provide insight into the mechanism of action and indicate that enisamium metabolite VR17-04 prevents GTP and UTP incorporation. Overall, these results suggest that enisamium is an inhibitor of SARS-CoV-2 RNA synthesis in vitro

Human (α2→6) and Avian (α2→3) Sialylated Receptors of Influenza A Virus Show Distinct Conformations and Dynamics in Solution

Differential interactions between influenza A virus protein hemagglutinin (HA) and α2→3 (avian) or α2→6 (human) sialylated glycan receptors play an important role in governing host specificity and adaptation of the virus. Previous analysis of HA–glycan interactions with trisaccharides showed that, in addition to the terminal sialic acid linkage, the conformation and topology of the glycans, while they are bound to HA, are key factors in regulating these interactions. Here, the solution conformation and dynamics of two representative avian and human glycan pentasaccharide receptors [LSTa, Neu5Ac-α(2→3)-Gal-β(1→3)-GlcNAc-β(1→3)-Gal-β(1→4)-Glc; LSTc, (Neu5Ac-α(2→6)-Gal-β(1→4)-GlcNAc-β(1→3)-Gal-β(1→4)-Glc] have been explored using nuclear magnetic resonance and molecular dynamics simulation. Analyses demonstrate that, in solution, human and avian receptors sample distinct conformations, topologies, and dynamics. These unique features of avian and human receptors in solution could represent distinct molecular characteristics for recognition by HA, thereby providing the HA–glycan interaction specificity in influenza.Finlombardia SPAConselho Nacional de Pesquisas (Brazil)National Institutes of Health (U.S.) (R37 GM057073-13)Singapore. National Research Foundation (Singapore-MIT Alliance for Research and Technology

Quality performance measures for small capsule endoscopy: Are the ESGE quality standards met?

Background and study aims The European Society of Gastrointestinal Endoscopy (ESGE) recently issued a quality performance measures document for small bowel capsule endoscopy (SBCE). The aim of this nationwide survey was to explore SBCE practice with ESGE quality measures as a benchmark. Patients and methods A dedicated per-center semiquantitative questionnaire based on ESGE performance measures for SBCE was created by a group of SBCE experts. One-hundred-eighty-one centers were invited to participate and were asked to calculate performance measures for SBCE performed in 2018. Data were compared with 10 ESGE quality standards for both key and minor performance measures. Results Ninety-one centers (50.3 %) participated in the data collection. Overall in the last 5 years (2014–2018), 26,615 SBCEs were performed, 5917 of which were done in 2018. Eighty percent or more of the participating centers reached the minimum standard established by the ESGE Small Bowel Working Group (ESBWG) for four performance measures (indications for SBCE, complete small bowel evaluation, diagnostic yield and retention rate). Conversely, compliance with six minimum standards established by ESBWG concerning adequate bowel preparation, patient selection, timing of SBCE in overt bleeding, appropriate reporting, reading protocols and referral to device-assisted enteroscopy was met by only 15.5%, 10.9%, 31.1%, 67.7%, 53.4%, and 32.2% of centers, respectively. Conclusions The present survey shows significant variability across SBCE centers; only four (4/10: 40 %) SBCE procedural minimum standards were met by a relevant proportion of the centers ( ≥ 80 %). Our data should help in identifying target areas for quality improvement programs in SBCE