ADHD prevalence estimates in Italian children and adolescents: A methodological issue

Abstract Background Attention deficit hyperactivity disorder (ADHD) is recognized as the most common, and most studied, developmental age disorder. Basic information, such as the most appropriate case definition and the best way to evaluate the disorder’s prevalence rate, however, remains an open issue. Methods A comprehensive meta-analysis on the epidemiology of ADHD in Italy, which was lacking from the literature, was therefore performed to attempt to estimate the actual prevalence rate of ADHD, highlighting conceptual and quantitative differences between clinical-diagnosis and survey-based symptoms studies. The Medline, Embase, and PsycINFO databases, and the grey literature, were searched up to January 2018. The review was laid out in three main sections: an overall prevalence estimate, an epidemiological profile of ADHD symptoms, and an attempt to define the actual rate of ADHD diagnosis, as emerged from Italian studies. Results A total of 15 unique studies were included. These contributed to estimating the prevalence of ADHD in 67,838 subjects aged 5–17, representing 9 of the 20 regions (45%) of Italy. Overall, the pooled prevalence of ADHD was 2.9% (range: 1.1–16.7%). When distinguishing studies based on case definition, however, we found an average prevalence estimate, based on symptoms criteria, of 5.9% (range: 1.4 to 16.7%) and a best-estimate prevalence rate of 1.4% (range: 1.1 to 3.1%). Conclusions Following the case definition for epidemiological studies of ADHD, counting only subjects with an ADHD diagnosis performed and confirmed by clinical assessment would reduce the wide variability in prevalence estimates, and, above all, would both describe the real rate of subjects suffering from ADHD disorder and avoid misdiagnosis

Occupational markers and pathology of the castrato singer Gaspare Pacchierotti (1740\u20131821)

Following the birth of modern opera in Italy in 1600, the demand for soprano voices grew up and the prepuberal castration was carried out to preserve the young male voice into adult life. Among the castrati, Gaspare Pacchierotti was probably one of the most famous. The remains of Pacchierotti were exhumed for the first time in 2013, for a research in the reconstruction of his biological profile, to understand the secrets behind his sublime voice and how the castration influenced the body. All the findings discovered, through anthropological and Computed Tomography analyses, are consistent both with the occupational markers of a singer and with the hormonal effects of castration. The erosion of cervical vertebrae, the insertion of respiratory muscles and muscles of the arms can be an effect of the bodily position and exercise during singing. The hormonal effect of castration were related to osteoporosis and to the disorders of spine

High-performance solution of the transport problem in a graphene armchair structure with a generic potential

We propose an efficient numerical method to study the transport properties of armchair graphene ribbons in the presence of a generic external potential. The method is based on a continuum envelope-function description with physical boundary conditions. The envelope functions are computed in the reciprocal space, and the transmission is then obtained with a recursive scattering matrix approach. This allows a significant reduction of the computational time with respect to finite difference simulations.Comment: 12 pages, 6 eps figures. Final published version. Comments and comparisons adde

Armchair graphene nanoribbons: PT-symmetry breaking and exceptional points without dissipation

We consider a single layer graphene nanoribbon with armchair edges in a longitudinally constant external potential and point out that its transport properties can be described by means of an effective non-Hermitian Hamiltonian. We show that this system has some features typical of dissipative systems, namely the presence of exceptional points and of PT-symmetry breaking, although it is not dissipative.Comment: 5 pages, 2 eps figure

Two slides signed by Filippo Pacini and preserved at the old section of the “Vincenzo Pinali” Medical Library of Padua University

The very rich old section of the “Vincenzo Pinali” Medical Library of the former Faculty of Medicine, University of Padua, keeps only few “objects” beyond its institutional purpose. Among the scientifically most interesting ones, two “relics” of Pacini can be mentioned. They are two slides equipped with a light green label on both the surfaces and with the inscription “Method of Filippo Pacini” and the signature “Filippo Pacini” on the recto. On the recto and verso there are also information concerning the place and the date of realization and a description of the preparation, understandably concise. The first slide, particularly well preserved, is kept between two glass panes in a little frame and it is entitled “Leucociti della Leucocitemia”, the coordinates “Florence, 12 Dec: 1864”, the signature and a schematic instruction to the correct reading of the preparation. On the verso Pacini decided to report some news about the “source” of cells. The second slide, stored in a metal box, is entitled “Ematococco”, the indications “Florence, 19 June 1865” and, in addition to the signature, basic but exhaustive information about the product. The methods of acquisition and conservation of precious relics are finally reconstructed. Considering the importance of Pacini’s preparations and their presence in different Institutions, we propose to take a census of them, as the basis of a virtual museum dedicated to the great Pistoiese

New Interpretation of Galileo\u2019s Arthritis and Blindness

Galileo Galilei (1564-1642) complained of several disorders during his life, the most important of which were chronic arthritic pains and bilateral blindness. These symptoms might result from an immune rheumatic disease, namely reactive arthritis (urethritis, uveitis, arthritis), when Galileo started suffering with an episode of fever in June 1593. Padua University owns the fifth lumbar vertebra of the great scientist and we performed a series of anthropological and radiographic analyses on it. The anthropological measurements showed that the shape of the vertebra was normal as to exclude significant diseases. The study through radiography and Computed Tomography showed only a mild arthrosis documented by small osteophytosis. Eventually the disease evolved into blindness with a pannus restricting the pupils (uveitis). These findings support the occurrence of reactive arthritis. Alternatively to urethral infection, Galileo could have suffered from Chlamydia pneumoniae infection in 1593, which was complicated by reactive arthritis a couple of weeks later. Thereafter he complained several episodes of recurrent arthritis, which eventually culminated into uveitis and bilateral blindness

Dose-effect and pharmacokinetics of estrogens given to correct bleeding time in uremia

Dose-effect and pharmacokinetics of estrogens given to correct bleeding time in uremia. Conjugated estrogens have a significant and long-lasting effect in shortening bleeding time in patients with end-stage renal disease. The studies so far available indicate that repeated estrogen administrations are necessary to short bleeding time in uremia in a dose range of 95 to 325mg. With the present study we wanted to establish whether single or repeated doses are required to induce a significant shortening of bleeding time in uremia, and the minimum cumulative dose of conjugated estrogens necessary to control bleeding time for a prolonged period of time, and to check whether the prolonged effect of estrogens on bleeding time in uremia is due to an accumulation of the drug or its metabolites in the blood. Fifteen uremics on chronic hemodialysis were studied. A pilot study carried out in five uremic patients indicated that single or repeated estrogen infusions of 0.3 mg/kg did not significantly influence bleeding time values. Therefore the subsequent studies have been carried out using daily infusion of 0.6 mg/kg. A single estrogen infusion of 0.6 mg/kg shortened bleeding time in all patients. The effect was transient and bleeding time returned to pre-infusion values within 72 hours. A 50% decrease of bleeding time or a shortening of bleeding time more than 30 to 15 minutes or less was obtained in all patients with four or five infusions (0.6 mg/kg) spaced 24 hours apart. The effect lasted for 14 days. At day 25 from the last infusion all the patients had bleeding time values comparable with the pre-infusion ones. Pharmacokinetic parameters of both estrone sulfate and equilin sulfate, the major components of the estrogen mixture we used, were comparable in both controls and uremics and can be described assuming a two compartmental model. After repeated administrations of conjugated estrogens no accumulation of estrone sulfate and equilin sulfate or their metabolites was detectable in blood in both uremics and controls

Inequalities in the Universal Right to Health

Child health inequalities violate children’s rights to optimal wellbeing. Different issues worldwide affect children’s physical and mental health as well as their development, influencing their future as adults. Inequities are avoidable inequalities. Despite improvements in the past two decades, the ambitious goals of global agendas have, for the most part, remained as expectations with regard to childhood rights, social justice, and health equity in practice. The concept of social determinants of health has become part of the common language in certain settings, but this is still too little to improve health in practice on a global scale, particularly for underprivileged subgroups of the community, as children and adolescents often are. Pediatric health professionals and their organizations are also responsible for guaranteeing children’s and adolescents’ right to health and better wellbeing, helping to reduce health inequalities

Intrauterine Exposures and Maternal Health Status during Pregnancy in Relation to Later Child Health: A Review of Pregnancy Cohort Studies in Europe

We show a description of pregnancy cohorts in the European region. Our investigation identified 66 pregnancy cohorts, mostly hosted in Western Central Europe. Among these 66 cohorts, 24 began recruitment before the year 2000, while six cohorts are still enrolling. The most common topics were lifestyle, environment and nutrition with allergies and neurodevelopment being a minority. We observed a pattern of positive correlations between data collected using medical records, structured interviews, and the collection of biological samples. Objectively assessed data were negatively correlated with self-administered questionnaires. Eight cohorts addressed intrauterine exposure, focusing on environmental pollutants such as endocrine-disrupting chemicals. The effects of these compounds on the developing foetus have been studied greatly, but more research on their effects is still needed. Many cohorts investigated genetics through the collection of biological samples from the mothers and children, to improve knowledge on the mother-to-child transmission of genetic information, antibodies, microbiota, etc. Paediatric epidemiology represents an important field of research since preserving healthy lives from conception onwards is the most efficient way to improve population health. According to our report, it seems that this field of research is well developed in Europe, where numerous high profile studies are currently ongoing