Maternal and infant NR3C1 and SLC6A4 epigenetic signatures of the COVID-19 pandemic lockdown: when timing matters

Stress exposure during pregnancy is critically linked with maternal mental health and child development. The effects might involve altered patterns of DNA methylation in specific stress-related genes (i.e., glucocorticoid receptor gene, NR3C1, and serotonin transporter gene, SLC6A4) and might be moderated by the gestational timing of stress exposure. In this study, we report on NR3C1 and SLC6A4 methylation status in Italian mothers and infants who were exposed to the COVID-19 pandemic lockdown during different trimesters of pregnancy. From May 2020 to February 2021, 283 mother–infant dyads were enrolled at delivery. Within 24 h from delivery, buccal cells were collected to assess NR3C1 (44 CpG sites) and SLC6A4 (13 CpG sites) methylation status. Principal component (PC) analyses were used to reduce methylation data dimension to one PC per maternal and infant gene methylation. Mother–infant dyads were split into three groups based on the pregnancy trimester (first, second, third), during which they were exposed to the COVID-19 lockdown. Mothers and infants who were exposed to the lockdown during the first trimester of pregnancy had lower NR3C1 and SLC6A4 methylation when compared to counterparts exposed during the second or third trimesters. The effect remained significant after controlling for confounders. Women who were pregnant during the pandemic and their infants might present altered epigenetic biomarkers of stress-related genes. As these epigenetic marks have been previously linked with a heightened risk of maternal psychiatric problems and less-than-optimal child development, mothers and infants should be adequately monitored for psychological health during and after the pandemic

Change in metabolic profile after 1-year nutritional-behavioral intervention in obese children

Research findings are inconsistent about improvement of specific cardio-metabolic variables after lifestyle intervention in obese children. The aim of this trial was to evaluate the effect of a 1-year intervention, based on normocaloric diet and physical activity, on body mass index (BMI), blood lipid profile, glucose metabolism and metabolic syndrome. Eighty-five obese children aged 656 years were analyzed. The BMI z-score was calculated. Fasting blood samples were analyzed for lipids, insulin and glucose. The homeostatic model assessment of insulin resistance (HOMA-IR) was calculated and insulin resistance was defined as HOMA-IR >3.16. HOMA-\u3b2%, quantitative insulin sensitivity check index and triglyceride glucose index were calculated. The metabolic syndrome was defined in accordance with the International Diabetes Federation criteria. At the end of intervention children showed a reduction (mean (95% CI)) in BMI z-score ( 120.58 ( 120.66; 120.50)), triglycerides ( 120.35 ( 120.45; 120.25) mmol/L) and triglyceride glucose index ( 120.29 ( 120.37; 120.21)), and an increase in HDL cholesterol (0.06 (0.01; 0.11) mmol/L). Prevalence of insulin resistance declined from 51.8% to 36.5% and prevalence of metabolic syndrome from 17.1% to 4.9%. Nutritional-behavioral interventions can improve the blood lipid profile and insulin sensitivity in obese children, and possibly provide benefits in terms of metabolic syndrome

Cooled tip radiofrequency ablation of benign thyroid nodules: preliminary experience with two different devices

Background: Thyroid nodules are very common in general population. Even if benign, they may require a treatment in case of symptoms or cosmetic concerns. In the last years, minimally invasive treatments alternative to surgery have been developed, in particular ultrasound (US) guided radiofrequency ablation (RFA). Methods: Twenty-four patients (9 males; 15 females; mean age 57.9 years) were treated and divided in two groups (A and B) according to the RFA needle used (18 gauge needle, AMICA; 17 gauge needle, COVIDIEN). Nodules and patients characteristics, together with procedural data were registered pretreatment and at 1-month follow-up. US visibility of the needle, volume of the nodules, symptoms and cosmetic concerns, complications were registered. Results: Visibility of the needle was not significantly different in the two groups (P=0.0787). At 1 month the mean volume of the nodules dropped from 37.1 to 25 mL in group A and from 23.2 to 15.4 mL in group B; shrinkage rate (36.9% and 39.5%, respectively) was not significantly different (P=0.3137). Symptoms decreased from 3.1 to 1.4 in group A and from 4 to 1.6 in group B: no significant differences in reductions were observed (P=0.3305). Cosmetic score decreased from 3.7 to 3.4 in group A and from 3.9 to 3.6 in group B: no significant differences in reductions were observed (P=0.96). Total complication rate (18.2% in group A vs. 23.1% in group B) did not showed significant differences (P=0.5049). Conclusions: The two systems used in our study resulted equivalent in terms of US needle visibility, efficacy, symptom/cosmetic relief, safety. More patients and a longer follow-up are necessary to confirm our results

Is Brain-Derived Neurotropic Factor Methylation Involved in the Association Between Prenatal Stress and Maternal Postnatal Anxiety During the COVID-19 Pandemic?

BackgroundThe COVID-19 pandemic is a collective trauma that may expose susceptible individuals to high levels of stress. Pregnant women represent a high-risk population, considering that pregnancy is a period of heightened neuroplasticity and susceptibility to stress through epigenetic mechanisms. Previous studies showed that the methylation status of the BDNF gene is linked with prenatal stress exposure. The goals of this study were (a) to assess the association between pandemic-related stress and postnatal anxiety and (b) to investigate the potential role of maternal BDNF methylation as a significant mediator of this association. MethodsIn the present study, we report data on the association among pandemic-related stress during pregnancy, maternal BDNF methylation, and postnatal anxiety symptoms. Pandemic-related stress and postnatal anxiety were assessed through self-report instruments. BDNF methylation was estimated in 11 CpG sites in DNA from mothers' buccal cells. Complete data were available from 108 mothers. ResultsResults showed that pandemic-related stress was associated with an increased risk of postnatal anxiety, r = 0.20, p < 0.05. CpG-specific BDNF methylation was significantly associated with both prenatal pandemic-related stress, r = 0.21, p < 0.05, and postnatal maternal anxious symptoms, r = 0.25, p = 0.01. Moreover, a complete mediation by the BDNF CpG6 methylation emerged between pandemic-related stress during pregnancy and postnatal maternal anxiety, ACME = 0.66, p < 0.05. ConclusionThese findings suggest that BDNF epigenetic regulation by pandemic-related stress might contribute to increase the risk of anxiety in mothers. Policymakers should prioritize the promotion of health and wellbeing in pregnant women and mothers during the present healthcare emergency

Multicentre Italian study of SARS-CoV-2 infection in children and adolescents, preliminary data as at 10 April 2020

Data on features of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in children and adolescents are scarce. We report preliminary results of an Italian multicentre study comprising 168 laboratory-confirmed paediatric cases (median: 2.3 years, range: 1 day\u201317.7 years, 55.9% males), of which 67.9% were hospitalised and 19.6% had comorbidities. Fever was the most common symptom, gastrointestinal manifestations were frequent; two children required intensive care, five had seizures, 49 received experimental treatments and all recovered

Measure of body composition by MOC DEXA, in children and teenagers with eating disorders

Introduction Feeding has various characteristics and parameters including preferences of certain foods and eating habits, meal profile, regulation of the sense of hunger and satiety. In nutrition disorders (DCA) we find a constant alteration in the relationship between food and the individual with tendencies to hyper nutrition or as opposed to hypo nutrition. This can lead to the medium and long term compromising physical health and / or social psychic relationships. Therefore eating disorders are of primary importance in both the psychic and nutritional spheres and must be addressed in a multidisciplinary manner. Aim The aim of the study was to retrospectively examine a group of patients with DCA in order to analyze and characterize patients regarding their body composition, evaluated by MOC-DEXA, anthropometric parameters and hematochemical parameters Materials and methods The study included 28 patients (26 females and 2 males) of mean age of 13.6 years. These patients were characterized by the evaluation of clinical records and the collection of informed consent. The following parameters were analyzed for each patient: date of birth, origin, age at diagnosis, anthropometric parameters (weight, height, BMI), amenorrhea, quantification of physical activity, dose of 25 (OH) vitamin D, moc total body, left femoral muscle moc, spine moc and therapeutic pathway. Data was processed using excell programs and statistical analysis was performed using SPSS 15.0 for windows. Results The sample examined shows that the starting age in about 50% of cases is between 13 and 14 years. The average height of patients was 156.1 cm, weight 43.8 kg and BMI of 17.8 kg / m2. Physical activity averaged 4.64 hours / week. Dosage of 25 (OH) vitamin D was 25.4 ng / ml, while the therapeutic route consisted in the integration of dietary-nutritional, psychotherapeutic and pharmacological treatments. MOC showed the following mean results: BMC (Bone Mineral Content): 1560.5 g (s.d. \ub1 340.4) Total mass: 41280.2 g (s.d. \ub1 10946.8) Lean Mass: 31073.5 g (s.d. \ub1 5465.8) Fat Mass: 10056.2 g (s.d. = 4157.8) Fat mass%: 23.5 (s.d. \ub1 7.6). A comparison was also made between the group of patients with amenorrhea (n \ub0 18) and the menstrual patient group (n \ub0 8). The statistical analysis provided the following results: \u2022 Amenorrhea and weight: Amenorrhea patients had lower weight (p = 0.021) In our study we found a cut-off of weight corresponding to 43 Kg below which patients had amenorrhea \u2022 Amenorrhea and BMI: Amenorrhea patients have lower BMI values: 16.6 versus 19.6 (p = 0.034) \u2022 Amenorrhea and fat mass: Amenorrhea patients had lower fat mass: 8.2 g versus 13.9 g (p = 0.008) \u2022 Amenorrhea and fat%: patients with amenorrhea showed fat less than menstruating patients: 20.6% versus 30.8% (p = 0.004) \u2022 Amenorrhea and total mass: patients with amenorrhea had lower total mass than menstruating patients: 37078.9 g versus 46826.2 (p = 0.023) Discussion and Conclusions The results of our study show that the severity of the disease correlates well with early onset: earlier is the age of onset , more severe is the impairment in weight and body composition resulting in a reduction in lean mass and of bone mineral density but not in Fat mass amount. Our study shows that there are no menstruating patients with a weight below 43 kg, regardless of age and height. The weight t of 43 kg seems to be a true indicator to discriminate if there is or not amenorrhea. Amenorrhea remains an unfavorable prognostic factor that correlates with the severity of the disease, in fact, patients with amenorrhea have impaired body composition worse than patients with menstruation, with reduced bone mineral density of total mass and lean mass. A further study with more patients is therefore necessary to confirm the data which, however, already well correlates with the clinical status of the patients

Sutton's nevus and growth hormone therapy.

Growth hormone (GH) has been suggested to increase the growth of melanocytic nevi and the risk for melanoma in short children treated with substitutive therapy. On the contrary, in GH deficient patients the influence of GH treatment on the appearance and the long-term evolution of Sutton's nevus, a pigmented melanocytic lesion surrounded by a ring (halo) of depigmentation, that usually and progressively involves the nevus, is debated. The aim of this study was to investigate whether GH therapy causes an accelerated growth of Sutton's nevus. In our study, we evaluated 3 children with GH deficiency sharing Sutton's nevus to investigate the relationship between these melanocytic lesions and growth hormone. In case 1 the appearance of the nevus could be induced by hGH therapy. However, the lesion did not change in shape, colour and size even if he entered puberty during substitutive treatment. Moreover, Sutton's nevus is present in case 2, who is prepuberal and not yet treated with hGH. In case 3 Sutton's nevi occurred during GH treatment and after the onset of puberty, but didn't show any long-term change in both the number and size. No clear influence of both GH therapy and sexual steroids on Sutton's nevi was observed