Delivery in pregnant women infected with SARS-CoV-2: A fast review

Background: Few case reports and clinical series exist on pregnant women infected with SARS-CoV-2 who delivered. Objective: To review the available information on mode of delivery, vertical/peripartum transmission, and neonatal outcome in pregnant women infected with SARS-CoV-2. Search strategy: Combination of the following key words: COVID-19, SARS-CoV-2, and pregnancy in Embase and PubMed databases. Selection criteria: Papers reporting cases of women infected with SARS-CoV-2 who delivered. Data collection and analysis: The following was extracted: author; country; number of women; study design; gestational age at delivery; selected clinical maternal data; mode of delivery; selected neonatal outcomes. Main results: In the 13 studies included, vaginal delivery was reported in 6 cases (9.4%; 95% CI, 3.5\u201319.3). Indication for cesarean delivery was worsening of maternal conditions in 31 cases (48.4%; 95% CI, 35.8\u201361.3). Two newborns testing positive for SARS-CoV-2 by real-time RT-PCR assay were reported. In three neonates, SARS-CoV-2 IgG and IgM levels were elevated but the RT-PCR test was negative. Conclusions: The rate of vertical or peripartum transmission of SARS-CoV-2 is low, if any, for cesarean delivery; no data are available for vaginal delivery. Low frequency of spontaneous preterm birth and general favorable immediate neonatal outcome are reassuring

Il ruolo emergente dei civic food networks nell'innovazione attorno al cibo.

Nell’ultima decade nuovi atteggiamenti verso la produzione e il consumo di cibo hanno portato alla ricerca di nuove forme organizzative, fondate su una cooperazione sempre più stretta tra produttori e consumatori, che in misura crescente fa riferimento ad obiettivi condivisi di sostenibilità sociale e ambientale. Queste nuove interazioni si sono mostrate in grado di dar vita a significativi processi di cambiamento nelle pratiche alimentari. All’interno di questi processi, in tempi più recenti si sono distinte le iniziative promosse da cittadini-consumatori che, riappropriandosi di un ruolo autonomo e attivo, coinvolgono i produttori in una nuova dimensione di cittadinanza alimentare. Questa nuova consapevolezza rappresenta spesso il primo passo per lo sviluppo di più complessi network. Nella letteratura più recente questi nuovi network alimentari sono riuniti sotto la denominazione di “Civic Food Networks”. Questi network ed i processi di innovazione da essi innescati sono significativi anche perché espressione di potenziali cambiamenti nei meccanismi di governance del sistema agro-alimentare. Questo articolo si propone di contribuire alla riflessione sul potenziale innovativo di questi CFN presentando i risultati di un caso di studio. In esso vengono analizzati il processo di sviluppo di uno di questi network e la sua capacità di promuovere e guidare processi di innovazione (la transizione verso modelli più sostenibili), focalizzando l'attenzione sui meccanismi di apprendimento sociale

Differential diagnosis between Marfan syndrome and Loeys–Dietz syndrome type 4: A novel chromosomal deletion covering tgfb2

Marfan syndrome (MFS) and Loeys–Dietz syndrome type 4 (LDS4) are two hereditary connective tissue disorders. MFS displays ectopia lentis as a distinguishing, characterising feature, and thoracic aortic ectasia, aneurysm, dissection, and systemic features as manifestations overlapping with LDS4. LDS4 is characterised by the presence of hypertelorism, cleft palate and/or bifid uvula, with possible ectasia or aneurysms in other arteries. The variable age of onset of clinical manifestations makes clinical diagnosis more difficult. In this study, we report the case of a patient with Marfan syndrome diagnosed at our centre at the age of 33 on the basis of typical clinical manifestations of this syndrome. At the age of 38, the appearance of ectasia of the left common iliac artery and tortuosity of the iliac arteries suggested the presence of LDS4. Next Generation Sequencing (NGS) analysis, followed by Array-CGH, allowed the detection of a novel chromosomal deletion including the entire TGFB2 gene, confirming not only the clinical suspicion of LDS4, but also the clinical phenotype associated with the haploinsufficiency mechanism, which is, in turn, associated with the deletion of the entire gene. The same mutation was detected in the two young sons. This emblematic case confirms that we must be very careful in the differential diagnosis of these two pathologies, especially before the age of 40, and that, in young subjects suspected to be affected by MFS in particular, we must verify the diagnosis, extending genetic analysis, when necessary, to the search for chromosomal alterations. Recently, ectopia lentis has been reported in a patient with LDS4, confirming the tight overlap between the two syndromes. An accurate revision of the clinical parameters both characterising and overlapping the two pathologies is highly desirable