Ruling out coronavirus disease 2019 in patients with pneumonia: The role of blood cell count and lung ultrasound

Coronavirus disease 2019 (COVID-19) is characterized by a distinctive blood leucocyte pattern and B-lines on lung ultrasound (LUS) as marker of alveolar-interstitial syndrome. We aimed to evaluate the accuracy of blood leucocyte count alone or in combination with LUS for COVID-19 diagnosis. We retrospectively enrolled consecutive patients diagnosed with community acquired pneumonia (CAP) at hospital admission to derive and validate cutoff values for blood cell count that could be predictive of COVID-19 before confirmation by the nucleic acid amplification test (NAAT). Cutoff values, generated and confirmed in inception (41/115, positive/negative patients) and validation (100/180, positive/negative patients) cohorts, were ≤17 and ≤10 cells/mm3 for basophils and eosinophils, respectively. Basophils and/or eosinophils below cutoff were associated with sensitivity of 98% (95%CI, 94–100) and negative likelihood ratio of 0.04 (95%CI, 0.01–0.11). In a subgroup of 265 subjects, the sensitivity of B-line on LUS was 15% lower (p < 0.001) than that of basophils and/or eosinophils below cutoff. The combination of B-lines with basophils and eosinophils below cutoff was associated with a moderate increase of the positive likelihood ratio: 5.0 (95%CI, 3.2–7.7). In conclusion, basophil and eosinophil counts above the generated cutoff virtually rule out COVID-19 in patients with CAP. Our findings can help optimize patient triage pending the NAAT results

L'assistenza ospedaliera ai bambini con malattie infettive

Verrà inserito in seguit

Clinical-pathological study of a case of infantile spino-cerebellar degeneration

Reports clinical and histological findings of a case of infantile spino-cerebellar degeneration. Beginning psychomotor development was normal. Parents first noted little movement of the upper right limb and inability to maintain a sitting position at 1 yr. Slow progressive psychomotor deterioration was associated with flaccid paralysis and muscle atrophy of the upper limbs. Death occurred at age 7. Histopathology showed cerebellar atrophy, grave atrophy of the anterior horn, of Clarke's column, of the nuclei of the X and XII cranial nerves, a degeneration of the pyramidal and spino-cerebellar tracts, and of the dentate nucleus and substantia nigra. Granular atrophy of the cerebellum can have a genetic basis and can also be caused by exogeneous chemical and physical agents and viral infections when they occur in a determinate period of embryonic development. The noxa, whether genetic or exogeneous, when intervening in the prenatal or immediate postnatal period, at the time of greatest proliferative activity and maturation of the granule cells, causes a destruction of this cellular population and alters intercellular relations which are at this time establishing themselves. (English summary) (35 ref) (PsycLIT Database Copyright 1980 American Psychological Assn, all rights reserved

Au-anti-Au immunocomplexes in neonatal Au-associated hepatitis.

N/

Clinical utilisation of transfer factor.

N/

Thermally assisted lubricity and negative work tails in sliding friction

We discuss and qualify the connection between two separate phenomena in the physics of nanoscale friction, general in nature and relevant to experiments. The first is thermally assisted lubricity (TAL), i.e., the low-velocity regime where a nanosized dry slider exhibits a viscouslike friction despite corrugations that would otherwise imply hard stick-slip friction. The second is the occurrence of negative dissipated work (NDW) events in sampling the work probability distribution. The abundance, or scarcity due to insufficient sampling, of these NDW events implies experimental fulfillment or violation of the celebrated Jarzynski equality (JE) of nonequilibrium statistical mechanics. We show, both analytically and in simulations of the one-dimensional point slider Prandtl-Tomlinson model, that a general crossover can be individuated as the total frictional work per cycle crosses kBT. Below such crossover, the TAL regime holds, the dissipation is essentially linear, and the numerical validation for the JE is feasible (i.e., does not require an exponentially large sampling size). Above it, the dissipation profile departs from linearity and gains its hard stick-slip features, and the mandatory sampling for the JE becomes exponentially large. In addition, we derive a parameter-free formula expressing the linear velocity coefficient of viscous friction, correcting previous empirically parameterized expressions. With due caution, the connection between friction and work tails can be extended beyond a single degree of freedom to more complex sliders, thus inviting realistic crosscheck experiments. Of importance for experimental nanofriction will be the search for NDW tails in the sliding behavior of trapped cold ions, and alternatively checking for TAL in the sliding pattern of dragged colloid monolayers as well as in forced protein unwinding

[Treatment of essential headache in developmental age with L-5-HTP (cross over double-blind study versus placebo)].

Thirty patients (mean age: 10.38 years) affected by primary headache were selected for a double-blind cross-over clinical trial. The patients were randomized into 2 homogeneous groups of 15 and treated for 12 weeks with L-5-HTP (100 mg/day) and placebo as per the following design: placebo - L-5-HTP (group A) and L-5-HTP - placebo (group B). Evaluation was carried out every 3 weeks by the Migraine Index supplying a general assessment of the attacks, i.e. severity, duration and frequency. The decrease in mean score values was directly proportional to L-5-HTP treatment, and statistical significance (Wilcoxon's test) was observed only for L-5-HTP in both groups, from 0.05 to 0.01. Improvement, as evaluated by CGI on percentage distribution of the patients, was homogeneous in both groups