Cardio-pulmonary function among children with mild or asymptomatic COVID-19 infection needing certification for return-to-play

Aim To explore the cardio-pulmonary function of children returning to play sports after mild or asymptomatic SARS-CoV-2 infection. Methods This is a consecutive case series conducted at the Institute for Maternal and Child Health, Trieste, Italy. Paediatric patients who accessed the Institute for cardiologic and pneumological evaluation before the return-to-play competitive sports were recruited, according to the Italian Sports Medical Federation recommendations. Echocardiogram, electrocardiogram, treadmill ECG test and pulmonary function tests were performed. Results One hundred and thirty-two patients (aged 8-17 years old, mean age 12.8 +/- 2.5) were recruited. Among these, 127 children were considered for the final analysis (49.6% females). Out of 127, 84 (66.1%) had a mild symptomatic form of SARS-CoV-2 infection, while 43 (33.9%) were asymptomatic. The main referred symptoms were fever (n = 37, 44%), asthenia (n = 14, 16.7%), rhinitis (n = 16, 19%), ageusia (n = 19, 22.6%), anosmia (n = 24, 28.6%), sore throat (n = 3, 3.6%), cough (n = 9, 10.7%), arthralgia-myalgia (n = 11, 13.1%), headache (n = 23, 27.4%) and gastrointestinal symptoms (n = 7, 8.3%). No child presented evidence of cardio-pulmonary function impairment after an average time of 77.3 days (SD 35) from SARS-CoV-2 swab positivity and a median of 68 days (IQ1 52, IQ3 92.5). Conclusion This preliminary study suggests that, in the absence of specific symptoms, the diagnostic yield of cardio-pulmonary tests before returning to play sports may be very low

Bilateral Finger Swelling in an Adolescent

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Adolescent with unilateral vision loss

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Chemical synthesis of a biodegradable PEGylated copolymer from ε-caprolactone and γ-valerolactone: evaluation of reaction and functional properties

This paper reports the chemical synthesis of methoxy poly(ethyleneglycol)-block-poly(ε-caprolactone-co-4-hydroxyvalerate) from ε-caprolactone and γ-valerolactone, a five-membered ring rarely used in chemical synthesis due to its low reactivity. This procedure enabled production of copolymers with controlled ratios of repeating units and molecular weights, as demonstrated by GPC, FT-IR and NMR characterization. Copolymer degradation rate was found to depend on macromolecular composition, and finely tuneable in a wide range of values. Similarly, hydrophilicity was dependent on γ-valerolactone content, and could be accurately controlled by varying the composition of the reaction feed. Importantly, this copolymer showed lower levels of acidic degradation products than other biodegradable polymers, thus resulting in improved biocompatibility. These encouraging results demonstrate the feasibility of the chemical synthesis of a novel and versatile material with interesting properties that fill a gap in the range of commercially available biodegradable polymers

Severe hyponatremia in children: a review of the literature through instructive cases

Hyponatriemia is the most common electrolyte disorder in the paediatric population. Symptoms are related to the time in which hyponatriemia has developed. The acute presentation could be dramatic, with neurological symptoms like headache, seizure, impaired mental status and even coma. It is essential for the physician to be aware of the possible causes of hyponatremia in the child in order to start a prompt treatment

Two-dimensional and three-dimensional left ventricular deformation analysis: a study in competitive athletes

Two-dimensional (2D) speckle-tracking echocardiography (STE) has clarified functional adaptations accompanying the morphological features of ‘athlete’s heart’. However, 2D STE has some limitations, potentially overcome by three-dimensional (3D) STE. Unfortunately, discrepancies between 2D- and 3D STE have been described. We therefore sought to evaluate whether dimensional and functional differences exist between athletes and controls and whether 2D and 3D left ventricular (LV) strains differ in athletes. One hundred sixty-one individuals (91 athletes, 70 controls) were analysed. Athletes were members of professional sports teams. 2D and 3D echocardiography and STE were used to assess LV size and function. Bland–Altman analysis was used to estimate the level of agreement between 2D and 3D STE. Athletes had greater 2D and 3D-derived LV dimensions and LV mass (p < 0.0001 for all), while 2D- and 3D-derived LV ejection fraction did not differ as compared with controls (p = 0.82 and p = 0.89, respectively). Longitudinal, radial, and circumferential strains did not differ between athletes and controls, neither by 2D nor by 3D STE. Three-dimensional longitudinal and circumferential strain values were lower (p < 0.0001 for both) while 3D radial strain was greater, as compared with 2D STE (p < 0.001). Bland–Altman plots demonstrated the presence of an absolute systematic error between 2D and 3D STE to analyse LV myocardial deformation. 3D STE is a useful and feasible technique for the assessment of myocardial deformation with the potential to overcome the limitations of 2D imaging. However, discrepancies exist between 2D and 3D-derived strain suggesting that 2D and 3D STE are not interchangeable

Study and fabrication of bioinspired Octopus arm mockups tested on a multipurpose platform

This paper illustrates a robotic approach to the study of the Octopus vulgaris arm. On the base of the embodied intelligence theory, a study on the interaction among materials, mechanisms and actuation systems has been conducted. Starting from the observation of the performances of the octopus and drawing inspiration by its functional anatomy, several mock-ups, made by different materials and actuated by different cable arrangements have been tested. For this purpose a versatile platform has been designed and built, where the various solutions have been mounted and compared. The final aim of the work is to replicate the main complex movements of the octopus in a robotic platform. In particular the reaching movement, which best represents the stereotyped motion pattern of the octopus arm, has been reproduced

Biomarkers of Neutrophil Activation in Patients with Symptomatic Chronic Peripheral Artery Disease Predict Worse Cardiovascular Outcome

: Neutrophils play a role in cardiovascular (CV) disease. However, relatively scant evidence exists in the setting of peripheral artery disease (PAD). The aims of this study were to measure biomarkers of neutrophil activation in patients with symptomatic chronic PAD compared with healthy controls, to assess their association with PAD severity, and to evaluate their prognostic value in patients with PAD. The following circulating markers of neutrophil degranulation were tested: polymorphonuclear neutrophil (PMN) elastase, neutrophil gelatinase-associated lipocalin (NGAL), and myeloperoxidase (MPO). Neutrophil extracellular traps (NETs) were quantified by measuring circulating MPO-DNA complexes. Patients with PAD underwent a comprehensive series of vascular tests. The occurrence of 6-month major adverse CV (MACE) and limb events (MALE) was assessed. Overall, 110 participants were included, 66 of which had PAD. After adjustment for conventional CV risk factors, PMN-elastase (adjusted odds ratio [OR]: 1.008; 95% confidence interval [CI]: 1.002-1.015; p = 0.006), NGAL (adjusted OR: 1.045; 95%CI: 1.024-1.066; p < 0.001), and MPO (adjusted OR: 1.013; 95%CI: 1.001-1.024; p = 0.028) were significantly associated with PAD presence. PMN-elastase (adjusted hazard ratio [HR]: 1.010; 95%CI: 1.000-1.020; p = 0.040) and MPO (adjusted HR: 1.027; 95%CI: 1.004-1.051; p = 0.019) were predictive of 6-month MACE and/or MALE. MPO displayed fair prognostic performance on receiver operating characteristic (ROC) curve analyses, with an area under the curve (AUC) of 0.74 (95%CI: 0.56-0.91) and a sensitivity and specificity of 0.80 and 0.65, respectively, for a cut-off of 108.37 ng/mL. MPO-DNA showed a weak inverse correlation with transcutaneous oximetry (TcPO2) on proximal foot (adjusted ρ -0.287; p = 0.032). In conclusion, in patients with symptomatic chronic PAD, enhanced neutrophil activity may be associated with an increased risk of acute CV events, rather than correlate with disease severity. Further research is needed to clarify the role of neutrophils in PAD natural history