The temperament of preterm infant in preschool age

Background: The study deals with the characteristics of temperament of preterm infants during their preschool age in order to not only investigate likely \u201cdifficult or problematic profiles\u201d, guided by impairments driven by their preterm birth, but also to provide guidelines for the activation of interventions of prevention, functional to improve the quality of preterm infant\u2019s life. Methods: The study involved a group of 105 children where 50 preterm children at the average age of 5 years and 2 months, enrolled in preschools of Palermo. The research planned the child reference teachers to be administered a specific questionnaire, the QUIT, made up of 60 items investigating six specific typical dimensions of temperament (Motor control activity - related to the ability of practicing motor control activity; Attention - related to the ability of guiding and keeping the focus of attention on a certain stimulus; Inhibition to novelty - regarding with emotional reactivity in front of environmental stimuli; Social orientation - meant in terms of attention and interest towards social stimuli; Positive and negative emotionality - regarding the tendency to mainly express positive or negative emotions. Results: The results show in general how preschool-aged preterm infants, identified by such a study, compared with full-term children, are characterized by \u201cnormal\u201d temperament based on a strong inclination and orientation in mainly expressing positive feelings. Yet, an impairment of the areas most relating to attention and motor control activity seems to emerge. Conclusions: The data suggest specific interventions for preterm infant development and their reference systems and, at the same time, can guide paediatrician and neonatologist dealing with preterm infants, in focalizing and monitoring, even since health status assessments, specific areas of development that, since preschool age, can highlight the presence of real forerunners of maladjustments and likely configurations of cognitive, emotional or behaviour disadaptive functioning

A study of maternal competence in preterm birth condition, during the transition from hospital to home: An early intervention program’s proposal

The study was conducted with 104 mothers (average age 32.5 years, SD 6.1) of preterm infants (very and moderately preterm but still healthy) to monitor the perceived maternal role competence from the time of hospitalisation to post-discharge, in order to define an intervention program to support mothers during this transition. A targeted Q-Sort tool (Maternal Competence Q-Sort in preterm birth) was applied at two different times as a self-observation tool for parenting competence in neonatology. A tendency towards dysregulation of the maternal role competence was detected, mainly in terms of low self-assessment and was found to worsen during post-discharge, particularly with regard to caregiving ability. This study suggests the importance of accompanying parenting competence in preterm birth conditions, not only during hospitalisation in the Neonatal Intensive Care Unit (NICU) but also following discharge in order to promote the development of premature infants. This paper reports in the last part a specific integrated psychoeducational intervention program (psychologist and nurses), which we defined precisely in light of the suggestions offered by the study data on perceived maternal competence created with the Q-sort

Restoration of peripheral blood natural killer and B cell levels in patients affected by rheumatoid and psoriatic arthritis during etanercept treatment

Etanercept (ETN) is an anti-tumour necrosis factor (TNF)-α agent used in rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Few studies focused on the effects of anti-TNF-α on peripheral blood cells. We aimed to evaluate peripheral blood cells in RA and PsA patients during ETN treatment and to explore their relationships with disease activity. RA (n = 82) and PsA (n = 32) patients who started ETN were included into the study and evaluated prospectively before the beginning of ETN therapy and after 14, 22, 54 and 102 weeks. Patients were studied in terms of disease activity score on 28 joints (DAS28), clinical response and laboratory findings. Natural killer (NK) cells, B cells and T cells were characterized by immunophenotyping. Both the RA and the PsA patients showed reduced NK and B cell count before ETN treatment compared with controls. A negative correlation was demonstrated between DAS28 and B cell count in RA patients at baseline. Sustained significant increase of NK and B cells up to normal levels was observed in RA and PsA patients along ETN treatment. Increase of NK cell count was associated with a good-moderate clinical response to ETN in both RA and PsA patients. During ETN treatment peripheral blood NK and B cells levels were restored in RA and PsA patients. Correlations between NK and B cells with disease activity were observed, suggesting that those effects could be mediated by ETN treatment.Etanercept (ETN) is an anti-tumour necrosis factor (TNF)-α agent used in rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Few studies focused on the effects of anti-TNF-α on peripheral blood cells. We aimed to evaluate peripheral blood cells in RA and PsA patients during ETN treatment and to explore their relationships with disease activity. RA (n = 82) and PsA (n = 32) patients who started ETN were included into the study and evaluated prospectively before the beginning of ETN therapy and after 14, 22, 54 and 102 weeks. Patients were studied in terms of disease activity score on 28 joints (DAS28), clinical response and laboratory findings. Natural killer (NK) cells, B cells and T cells were characterized by immunophenotyping. Both the RA and the PsA patients showed reduced NK and B cell count before ETN treatment compared with controls. A negative correlation was demonstrated between DAS28 and B cell count in RA patients at baseline. Sustained significant increase of NK and B cells up to normal levels was observed in RA and PsA patients along ETN treatment. Increase of NK cell count was associated with a good-moderate clinical response to ETN in both RA and PsA patients. During ETN treatment peripheral blood NK and B cells levels were restored in RA and PsA patients. Correlations between NK and B cells with disease activity were observed, suggesting that those effects could be mediated by ETN treatment

Long-term ustekinumab therapy of psoriasis in patients with coexisting rheumatoid arthritis and Sjögren syndrome. Report of two cases and review of literature

Background: Inteleukin (IL)12 and IL23 are two main cytokines involved in the pathogenesis of immune-mediated disease. IL12 is produced by macrophages and B lymphocytes and mediates differentiation of Th1 lymphocytes, while IL23 is a pro-inflammatory cytokine essential for the differentiation of Th17 cells. Ustekinumab is a human monoclonal antibody directed against the p40 protein subunit shared by IL12 and IL23, therefore it blocks the signal transmission of both cytokines. Main observations: We present two cases and discuss the long-term efficacy of ustekinumab as a treatment of psoriasis in patients affected by autoimmune diseases, rheumatoid arthritis and Sjögren’s syndrome, who presented with severe psoriasis after anti-TNF treatment. Conclusions: To the best of our knowledge, these are the first cases reported in the literature describing the long-term good efficacy of ustekinumab not only on paradoxical forms of psoriasis induced by anti-TNF-α drugs, but also on the articular involvement in a patient affected by RA and in a patient affected by Sjögren syndrome

Functioning of family system in pediatric oncology during treatment phase

The study focuses on parents\u2019 psychological implications caused by the treatment of their children su\ufb00ering from tumor. It investigates some speci\ufb01c mothers\u2019 resource factors such as their strategies of coping and the perception of their own family functioning in terms of cohesion and adaptability. The study was performed with 34 mothers of children su\ufb00ering from acute lymphoblastic leukemia(ALL),duringthetreatmentphase.TheusedtoolsweretheCopingOrientationtoProblem Experienced\u2014New Italian Version, to investigate coping strategies, and the Family Adaptability and Cohesion Evaluation Scale-III, to analyze both real and ideal perception of family functioning. The data related to coping, show how the involved mothers tend to mainly use the strategies of positive aptitude, orientation toward problem and social support ( F = 99.88, d f= 4, P< .01). The family functioning, in terms of adaptabilit y, is described as chaotic relating to both the real (\u3c72 = 13.29,d f =3, P=.004)andideal(\u3c72=11.52,d f=2, P=.003)family,whereasintermsof cohesion, itisperceivedaschie\ufb02ydisengagedintherealfamily(\u3c72 =12.3,d f=3, P=.006)andasenmeshed in the ideal one (\u3c72 = 12.58, d f= 3, P= .006). Statistically positive correlations were only detected between adaptability and avoidance ( r = 0.49, P< .01); adaptability and orientation toward problem (r = 0.36, P< .05); and adaptability and transcendent orientation ( r = 120.04, P< .05). Despitethecriticalsituation,themothershaveshownoptimisticview,careforproblemmanagementandcapabilitytoaskforhelp.Thesecopingstrategiesallowthetherapeuticalliancebetween families and health care workers, so useful for the quality of childcarThe study focuses on parents\u2019 psychological implications caused by the treatment of their children su\ufb00ering from tumor. It investigates some speci\ufb01c mothers\u2019 resource factors such as their strategies of coping and the perception of their own family functioning in terms of cohesion and adaptability. The study was performed with 34 mothers of children su\ufb00ering from acute lymphoblastic leukemia(ALL),duringthetreatmentphase.TheusedtoolsweretheCopingOrientationtoProblem Experienced\u2014New Italian Version, to investigate coping strategies, and the Family Adaptability and Cohesion Evaluation Scale-III, to analyze both real and ideal perception of family functioning. The data related to coping, show how the involved mothers tend to mainly use the strategies of positive aptitude, orientation toward problem and social support ( F = 99.88, d f= 4, P< .01). The family functioning, in terms of adaptabilit y, is described as chaotic relating to both the real (\u3c72 = 13.29,d f =3, P=.004)andideal(\u3c72=11.52,d f=2, P=.003)family,whereasintermsof cohesion, itisperceivedaschie\ufb02ydisengagedintherealfamily(\u3c72 =12.3,d f=3, P=.006)andasenmeshed in the ideal one (\u3c72 = 12.58, d f= 3, P= .006). Statistically positive correlations were only detected between adaptability and avoidance ( r = 0.49, P< .01); adaptability and orientation toward problem (r = 0.36, P< .05); and adaptability and transcendent orientation ( r = 120.04, P< .05). Despitethecriticalsituation,themothershaveshownoptimisticview,careforproblemmanagementandcapabilitytoaskforhelp.Thesecopingstrategiesallowthetherapeuticalliancebetween families and health care workers, so useful for the quality of childcar

Evaluation of Clinical and Ultrasonographic Parameters in Psoriatic Arthritis Patients Treated with Adalimumab: A Retrospective Study

Objectives. The aim of this study was to evaluate clinical and US-PD parameters in PsA during adalimumab treatment. Methods. A retrospective study has been conducted in forty patients affected by moderate-to-severe peripheral PsA. Clinical, laboratory, and US-PD evaluations were performed at baseline, after 4, 12, and 24 weeks of treatment. They included erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), visual analogue scale (VAS), Health Assessment Questionnaire (HAQ) modified for Spondyloarthritis, Psoriasis Area Severity Index (PASI) score, the 28-joint Disease Activity Score (DAS 28), and US-PD assessment. US-PD findings were scored according to a semiquantitative scale (ranging 0–3) for synovial proliferation (SP), joint effusion (SE), bone erosions (BE), and PD. Results. Data obtained for clinical, laboratory findings and US-PD evaluation showed statistical significant improvement in all the measures performed except for BE. A significant parallel decrease in SE, SP, and PD values were demonstrated. Conclusion. This study demonstrated that US-PD is a valid technique in monitoring the response to adalimumab in moderate-to-severe PsA

Green tea and pomegranate extract administered during critical moments of the production cycle improves blood antiradical activity and alters cecal microbial ecology of broiler chickens

Phytobiotics are usually tested in feed and throughout the production cycle. However, it could be beneficial to evaluate their effects when administered only during critical moments, such as changes in feeding phases. The aim of the trial was to investigate the effect of a commercial plant extract (PE; IQV-10-P01, InQpharm Animal Health, Kuala Lumpur, Malaysia) on growth performance, blood antiradical activity and cecal microbiome when administered in drinking water to broiler chickens during the post-hatching phase and at each change of diet. In the experiment, 480 1-day-old male broiler chicks were assigned to two groups in a 50-day trial. Broilers received drinking water (C) or drinking water plus PE (T) at a rate of 2 mL/L on days 0 to 4, 10\u201311 and 20\u2013 21. PE did not affect performance and water intake, while total antiradical activity was improved (p &lt; 0.05). A greater abundance of lactic acid bacteria (false discovery rate (FDR) &lt; 0.05) was found in the T group and the result was confirmed at a lower taxonomic level with higher Lactobacillaceae abundance (FDR &lt; 0.05). Our findings suggest that PE administration during critical moments of the production cycle of broiler chickens may exert beneficial effects at a systemic level and on gut microbial ecology

Retinal functional changes measured by frequency-doubling technology in patients treated with hydroxychloroquine.

BACKGROUND: Antimalarial drugs such as chloroquine (CQ) and hydroxychloroquine (HCQ) are mainly used in the treatment of rheumatologic diseases, and their use may be associated with irreversible retinal toxicity. Previous studies indicate early paracentral visual field loss (Humphrey 10-2) in patients taking HCQ". These paracentral defects appear before changes in other clinical parameters as visual acuity and fundoscopy. The mechanism of CQ toxicity remains unclear. It was reported that toxic doses of CQ administered for as long as 4.5 years to Rhesus monkeys caused an initial dramatic effect on ganglion cells, followed later by photoreceptors and RPE degeneration. The purpose of this study is to explore early retinal functional changes measured by frequency-doubling technology (FDT) in patients treated with hydroxychloroquine (HCQ). METHODS: Forty-eight eyes of 48 subjects treated with hydroxychloroquine (HCQ), with no signs of retinal toxicity, and 36 eyes of 36 age and sex-matched healthy subjects were enrolled in this cross-sectional, prospective, observational, case control study. Functional testing included frequency-doubling Humphrey-matrix perimetry (FDP), white-on-white Humphrey visual field perimetry (HFA), using the 24-2 and 10-2 threshold programs, multifocal electroretinogram (mfERG, Veris 4.9) and low contrast sensitivity (CS) measurement. RESULTS: FDP mean deviation (MD) was found to be significantly reduced in HCQ-treated patients compared to controls both in the 24-2 (-1.38 ± 2.41 dB vs 0.21 ± 1.83 dB, p < 0.01) and in the 10-2 program (-0.97 ± 2.88 dB vs 0.15 ± 1.72 dB, p < 0.01). FDP pattern standard deviation (PSD) was found to be significantly worse in HCQ-treated patients compared to controls both in the 24-2 (2.70 ± 0.65 dB vs 2.41 ± 0.31 dB, p < 0.01 and in the 10-2 program (2.86 ± 0.48 dB vs 2.48 ± 0.39 dB, p < 0.01). HFA PSD and CS was also significantly reduced in HCQ patients, while response amplitude densities (RAD) were similar between patients and controls. A statistically significant difference in the ratio of the 5°-10° RAD and the 0°-2.5° RAD (0.31 ± 0.08 vs 0.36 ± 0.07 respectively, p < 0.05) was found between groups. CONCLUSION: Frequency doubling perimetry could be useful to detect early retinal impairment in patients treated with hydroxychloroquine

Il PON Reti e Mobilità e gli obiettivi di Sostenibilità: il ruolo del Piano di Monitoraggio Ambientale

The National Operative Program (PON) “Reti e mobilità” has been approved by European Commission on the 7th of December 2007. The strategic approach of the PON, exclusively devoted to the socalled “convergence regions” of Italy (Campania, Calabria, Sicilia, Puglia), aims to: 1. improve the modal balance by an economic, social and environmental perspective; 2. develop the inter-modality in order to move towards the integration of convergence area into the network of the European transport system; 3. improve the mobility and the accessibility, also to reduce the traffic congestion; 4. increase the efficiency related to security standards, to management techniques and to the quality of transportation services in the sector of freight; 5. guarantee the reduction of environmental impacts through a global improvement of the efficiency of the transport systems. In such a way it is clear that the PON “Reti e mobilità” takes greatly into account the Sustainability principles recognized at European scale as attested by the budget, namely over the 70% of the entire fund, associated with low-impacts infrastructures (railways and harbors). The PON has been submitted to the SEA procedure, following what the 2001/42/CE Directive establishes. The Environmental Report of PON devotes great attention to the monitoring activity as shown by the reported recommendation about the need for adequate measures for the environmental monitoring, also in order to apply corrective measures during the implementation of the program. By this point of view, a first and important step has been the elaboration of the “Environmental Monitoring Plan” (EMP) that represents the main methodological document for the following implementation of the monitoring activity. This paper, after a brief presentation of the program and of the objectives of Sustainability that the Programs aims to pursue through the realization of specific projects, is devoted to introduce the Environmental Monitoring Plan of the PON that has been approved by the Ministry of the Infrastructures and Transport -in charge as Management Authority of the PON- in February 2011. In detail, the PMA represents the tool through which, the Management Authority, that has specific responsibilities and functions in terms of monitoring and environmental assessment of the program, controls the significant impacts on the environment caused by the implementation of the PON and verify the level of achievement of the established objectives of environmental sustainability. The structure of EMP is based on three main aspects: 1) the adoption of the results of other interesting experiences carried out by experts institutions on the topic; 2) an approach favoring the creation of an “integrated” monitoring system with the others Operative Programs activated at regional scale; 3) the implementation of a cooperation and shared process with all the directly-involved actors