First Year Metabolic and Hormonal Behavior Define two Different Populations of SGA Newborn for Weight or Height

Context: Small-for-gestational-age (SGA) children have a particular metabolic and hormonal pattern at birth that changes rapidly.Objective: To evaluate the linear and weight growth in the first year of life in SGA children.Design: Prospective, monocentric cohort study.Setting: Real-world data collected from April 2012 to January 2016.Patients: SGA newborns uniformly defined by either growth or length lower than -2 SDs for gestational age.Interventions: All children were evaluated for 1 year after birth, at 3 days of life, then 3, 6, and 12 months after birth.Main outcome measures: Anthropometric parameters and biochemical variables, such as blood glucose, insulin, leptin, IGF-1, IGF binding protein-3 (IGFBP-3), and homeostasis model assessment - insulin resistance (HOMA-IR) index.Results: A total of 133 SGA children were enrolled. Length significantly improved 1 month after birth, whereas weight significantly increased only at 3 months after birth. Biochemical variables increased during the first year of life, showing a prediction by IGFBP-3 and HOMA-IR index. Then, the variables were divided considering either weight, length, or both, showing a different incidence. The biochemical variable changes recorded in the first step were maintained considering SGA children for weight or length, whereas they disappeared when weight and length were considered together.Conclusions: Our study shows a specific catchup growth for weight and length in SGA children. Moreover, we highlight that weight and length should be considered as independent parameters in SGA children, defining 2 different metabolic-hormonal populations with different conceivable predictive role in early catchup growth and in later growth and metabolic status

Universal Newborn Screening for Congenital Cytomegalovirus Infection - From Infant to Maternal Infection: A Prospective Multicenter Study

Introduction: Most infants at risk for cytomegalovirus (CMV)-associated sensorineural hearing loss (SNHL) are unrecognized because of the absence of a universal neonatal CMV screening. The search of CMV-DNA by molecular methods in salivary swabs was demonstrated to be a reliable approach. This study describes the results obtained by carrying out a universal screening for congenital CMV (cCMV) infection including all live-born newborns in three Italian sites, as well as the therapeutic interventions and clinical outcome of the CMV-infected neonates. Moreover, CMV maternal infection's characteristics were evaluated. Methods: To confirm or exclude cCMV infection, a CMV-DNA-positive result on a first salivary swab was followed by repeated saliva and urine samples collected within 21 days of age. Breast milk samples were also collected. The search of CMV-DNA was performed with a single automated quantitative commercial real-time PCR assay, regardless of the type of samples used. Results: A total of 3,151 newborns were enrolled; 21 (0.66%) of them were congenitally infected (median saliva viral load at screening, 6.65 [range, 5.03-7.17] log10 IU/ml). Very low/low viral load in screening saliva samples (median value, 1.87 [range, 1.14-2.59] log10 IU/ml) was associated with false-positive results (n = 54; 1.7%). CMV-DNA was detected in almost half of the breast milk samples of mother-infant pairs with a false-positive result, suggesting that contamination from breast milk may not be the only explanation in the study population. cCMV infection confirmation with the search of CMV-DNA in a urine sample proved to be the gold standard strategy, since false-positive results were observed in 4/54 (7.5%) of the repeated saliva samples. Symptomatic cCMV infection was observed in 3/21 (14.3%) infants; notably, one (4.7%) developed moderate unilateral SNHL at 5 months after birth. Finally, two symptomatic cCMV infections were associated with primary maternal infection acquired in the first trimester of gestation; one newborn with severe cCMV symptoms was born to a mother with no CMV checkups in pregnancy. Conclusion: Without universal neonatal CMV screening, some infected infants who develop late neurological sequelae may not be recognized and, consequently, they are not able to benefit early from instrumental and therapeutic interventions to limit and/or treat CMV disease

Ambiente, identità geografica, risorse

Il volume riassume i contributi di una ricerca del Dipartimento di Scienze Territorio relativi al Comune di Rozzano (MI) propedeutici alla stesura di piani e progetti di carattere urbanistico

Trasformazioni urbane e interesse pubblico. Spunti internazionali

Il dibattito disciplinare, politico e giuridico attorno all’equità dello scambio pubblico –privato fra promotori immobiliari e soggetti pubblici, in occasione delle maggiori trasformazioni urbane, ha investito, in forma discontinua, la pianificazione fin dalle origini, ma nel corso degli ultimi anni si è arricchito di spunti differenti. Alcuni intercettano questioni e principi di sussidiarietà orizzontale, altri si fanno carico di una nuova consapevolezza sulla finitezza del suolo, altri ancora si concentrano sull’estensione della nozione di interesse pubblico, ma tutti non possono ignorare la crisi del settore immobiliare da un lato e le gravi condizioni della finanza comunale dall’altro. Una compartecipazione pubblico / privata degli effettivi costi di ri-urbanizzazione (per la prevalenza dei processi di infilling, rispetto alla tradizionale modalità di espansione urbana), con il reinvestimento locale della tassazione, basata sul prelievo di parte dei profitti sotto forma di oneri di urbanizzazione, di contributi aggiuntivi e di opere negoziali, è la modalità comunemente perseguita in campo internazionale per garantire uno sviluppo sostenibile e durevole in termini ambientali ed economici, in un mercato sempre più evoluto e competitivo

Prospettive per l'assetto produttivo

Il volume contiene i materiali della ricerca del DST del Politecnico di Milano sulla periferia sud milanese e in particolare sul Comune di Rozzano, finalizzata alla costruzione di piani e politiche urbanistiche per quel territori

Sustainability Challenges in Redevelopments. Insights from the re-use of seven rail yards in Milan

In a time of climate change emergency, contemporary urban planning pursues the enhancement of natural elements combined with local and wide area green networks as an answer to ecological and environmental issues. Regenerating abandoned urban land follows a multifunctional and multiscale approach to the integration of open and green spaces with soft mobility networks and blue infrastructure in order to improve citizen wellbeing.In this perspective, the City of Milan has implemented regeneration policies based on the extension of parks and green connectivity since the first Urban Plan, PGT (Urban Plan) approved in 2012, and continued in the recently approved PGT 2030. As a crucial part of public policies the reuse of seven Milan rail yards suggests the possibility of matching urban redevelopment with a potential widespread regeneration of surrounding urban parts. International competitions for the rail yards have shown different aspects of regeneration aiming to stress the environmental priorities.The crucial question of this re-urbanisation process regards two aspects. The first is related to the ability of such transformations to regenerate urban settlements at the city and metropolitan scale. The second issue tries to investigate to what extent a public –driven approach can effectively achieve public interest