Respiratory Distress Syndrome Management in Delivery Room

The proper management of respiratory distress syndrome in the delivery room is a crucial step in the transition to extrauterine life, especially for preterm infants. In fact, it has been widely established that the optimization of the cardiovascular and the respiratory changes, which normally happen as soon as a term healthy baby is delivered, can have long-term effects. For this reason, every clinician approaching the delivery room should be aware of the consequences an inappropriate management could lead to and should know how to perform a proper resuscitation, using, where available, the most recent techniques. Regardless of the level of care provided by the hospital, there are some key interventions, which can be applied easily in every setting and are of crucial importance. In this chapter, we aim to provide a comprehensive overview of the most relevant measures to manage respiratory distress syndrome from the delivery room, starting from an explanation of the disease and moving toward the most recent evidence, from the basic concepts to the most advanced techniques to monitor fetal-neonatal transition

Prenatal Attachment in Twin Pregnancy

Twin births are associated with several medical, healthcare, socio-emotional, psychological and developmental consequences for families. Parents generally describe twin pregnancies as physically and emotionally difficult. Moreover, compared to singleton pregnancies, twin pregnancies are reported to carry higher maternal as well as perinatal morbidity and mortality. The aim of this chapter is to review literature on twin pregnancy and to give a comprehensive framework about parents’ experience of expecting twins. An important issue related to the psychological adjustment during twin pregnancies is prenatal attachment. During pregnancy, mothers use to think about their child-to-be, and they start to create representation of themselves as mothers. Prenatal attachment in twin pregnancies may differ from that in singleton ones. During a twin pregnancy, the mother-to-be has to deal with an identification process with two children at the same time and have to create a mental space that allow her to make representation of both children. The monitoring of these pregnancies is important for the creation and the consolidation of these maternal representations: ultrasound examinations revealed the fetal gender that facilitates naming the unborn twins and thinking to them as individuals and this is particularly important in the case of complicated twin pregnancies

Acute neonatal encephalopathy and seizures recurrence: A combined aEEG/EEG study

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A study on the possible merits of using symptomatic cases to trace the development of the COVID-19 pandemic

In a recent work we introduced a novel method to compute the effective reproduction number $R_t$ and we applied it to describe the development of the COVID-19 outbreak in Italy. The study is based on the number of daily positive swabs as reported by the Italian Dipartimento di Protezione Civile. Recently, the Italian Istituto Superiore di Sanit\`a made available the data relative of the symptomatic cases, where the reporting date is the date of beginning of symptoms instead of the date of the reporting of the positive swab. In this paper we will discuss merits and drawbacks of this data, quantitatively comparing the quality of the pandemic indicators computed with the two samples

Velocity time integral for right upper pulmonary vein in VLBW infants with patent ductus arteriosus

OBJECTIVE: Early diagnosis of significant patent ductus arteriosus reduces the risk of clinical worsening in very low birth weight infants. Echocardiographic patent ductus arteriosus shunt flow pattern can be used to predict significant patent ductus arteriosus. Pulmonary venous flow, expressed as vein velocity time integral, is correlated to ductus arteriosus closure. The aim of this study is to investigate the relationship between significant reductions in vein velocity time integral and non-significant patent ductus arteriosus in the first week of life. METHODS: A multicenter, prospective, observational study was conducted to evaluate very low birth weight infants

A simplified estimate of the Effective Reproduction Number RtR_t using its relation with the doubling time and application to Italian COVID-19 data

A simplified method to compute $R_t$, the Effective Reproduction Number, is presented. The method relates the value of $R_t$ to the estimation of the doubling time performed with a local exponential fit. The condition $R_t = 1$ corresponds to a growth rate equal to zero or equivalently an infinite doubling time. Different assumptions on the probability distribution of the generation time are considered. A simple analytical solution is presented in case the generation time follows a gamma distribution.Comment: Submitted to: The European Physical Journal Plus. Revised version according to reviewer's comment

Molecular evidence of Plasmodium vivax infection in Duffy negative symptomatic individuals from Dschang, West Cameroon

Background: Plasmodium vivax infection is known to be rare in West/Central Africa, the most accepted explanation being the lack of expression of erythroid Duffy antigen in the local human populations. Duffy negativity prevents the parasite to exploit the entry mechanism on the red blood cell surface. However, there are a growing number of reported vivax infections in Duffy-negative individuals. Data on P. vivax circulation in Cameroon are limited. The aim of the study was to evaluate the P. vivax presence, and its association with the Duffy genotype in West Cameroon. Results: Overall, 484 blood samples were collected consecutively from febrile outpatients attending the Dschang’s Hospital (West Cameroon) during a 3-months period. Plasmodium vivax infection was detected by PCR in 5.6% (n = 27/484) of the cases, representing 38.6% (n = 27/70) of all Plasmodium infections detected. All P. vivax infected individuals showed a Duffy-negative genotype, and the frequency of Duffy-positive individuals in the whole tested population was 1.7%. Conclusions: The results of this study confirm the circulation of P. vivax in Cameroon, as well as that the lack of expression of Duffy-antigen does not confer full protection against vivax malaria acquisition

A statistical analysis of death rates in Italy for the years 2015-2020 and a comparison with the casualties reported for the COVID-19 pandemic

We analyze the data about casualties in Italy in the period 01/01/2015 to 30/09/2020 released by the Italian National Institute of Statistics (ISTAT). The data exhibit a clear sinusoidal behavior, whose fit allows for a robust subtraction of the baseline trend of casualties in Italy, with a surplus of mortality in correspondence to the flu epidemics in winter and to the hottest periods in summer. While these peaks are symmetric in shape, the peak in coincidence with the COVID-19 pandemics is asymmetric and more pronounced. We fit the former with a Gaussian function and the latter with a Gompertz function, in order to quantify number of casualties, the duration and the position of all causes of excess deaths. The overall quality of the fit to the data turns out to be very good. We discuss the trend of casualties in Italy by different classes of ages and for the different genders. We finally compare the data-subtracted casualties as reported by ISTAT with those reported by the Italian Department for Civil Protection (DPC) relative to the deaths directly attributed to COVID-19, and we discuss the differences.Comment: 16 pages, 13 figure