La colelitiasi in età pediatrica: esperienza di un singolo centro

La colelitiasi è considerata una malattia tipica dell'adulto e c'è l'errata percezione che i bambini colpiti dalla patologia rappresentino soltanto un'eccezione. Ciò non è vero e negli ultimi anni l' incidenza della litiasi biliare sembra essere aumentata proprio nelle fasce di età più piccole della popolazione. Gli studi però sulla colelitiasi in età pediatrica sono pochi e spesso si basano su dati multicentrici. Nel nostro lavoro analizzeremo la casistica dei pazienti che avevano afferito all'ambulatorio del servizio di epatogastroenterologia dell'ospedale di Pisa dal 1997 al 2012. Abbiamo valutato retrospettivamente le caratteristiche che presentavano i vari pazienti come fattori di rischio, presentazione clinica, dati ecografici e di laboratorio, eventuale comparsa di complicanze e gestione terapeutica. In questo modo abbiamo cercato attraverso la nostra esperienza monocentrica di suggerire un modello per la gestione di questi pazienti

Um modelo de controle de dispositivos através do barramento PCI: Core PCI

Dissertação (mestrado) - Universidade Federal de Santa Catarina, Centro Tecnológico. Programa de Pós-Graduação em Ciência da Computação.Este trabalho é direcionado ao desenvolvimento de um protocolo PCI, o qual foi aqui denominado, Core PCI. O Core PCI é um núcleo que contém os controles básicos de acesso a um dispositivo PCI de 32bits e 33Mhz. Ele foi desenvolvido para uso geral, por isso, somente foram implementados, os acessos a dispositivos de I/O, mapeados como RAM. Neste trabalho são descritos detalhes e características do barramento PCI, tais como: sinais do barramento, funcionamento do protocolo de transação de dados, configuração plug and play e inicialização dos dispositivos PCI no boot do computador. Também se encontram, detalhes de uma aplicação usando o Core PCI e um software de alto nível para controle da aplicação. O Core PCI foi desenvolvido em um chip FPGA, utilizando-se de uma linguagem de descrição de hardware VHDL e utilizando-se também de simuladores para o código VHDL. Ainda nest

Ações mediadoras de desenvolvimento do pensamento teórico em uma formação continuada remota e síncrona de professores do Ensino Fundamental I

O presente artigo é um recorte de uma dissertação de mestrado desenvolvida no âmbito do Programa de Pós-Graduação em Educação da Universidade Federal de São Paulo. Tal recorte analisará uma situação desencadeadora de aprendizagem (SDA) em uma formação continuada de professores que foi organizada em um contexto de uso de tecnologias de informação e comunicação (TICs) e de jogos digitais cujo conteúdo teórico ancora-se à álgebra nos anos iniciais. À vista dessa análise, adotou-se o método materialista-dialético e proposições da teoria Histórico-Cultural a fim de investigar as ações mediadoras que possibilitaram o surgimento de indícios de superação do pensamento empírico pelo do tipo teórico. Os resultados apontam que os procedimentos técnicos de comunicação/voz e de registro de símbolos pelo caderno digital, associados ao trabalho coletivo de professores com a mediação intencional do formador criaram condições que indicam um desenvolvimento do pensamento teórico mediado por nexos conceituais pertencentes à álgebra nos anos iniciais

The Past, Present, and Future of Non-Viral CAR T Cells

Adoptive transfer of chimeric antigen receptor (CAR) T lymphocytes is a powerful technology that has revolutionized the way we conceive immunotherapy. The impressive clinical results of complete and prolonged response in refractory and relapsed diseases have shifted the landscape of treatment for hematological malignancies, particularly those of lymphoid origin, and opens up new possibilities for the treatment of solid neoplasms. However, the widening use of cell therapy is hampered by the accessibility to viral vectors that are commonly used for T cell transfection. In the era of messenger RNA (mRNA) vaccines and CRISPR/Cas (clustered regularly interspaced short palindromic repeat-CRISPR-associated) precise genome editing, novel and virus-free methods for T cell engineering are emerging as a more versatile, flexible, and sustainable alternative for next-generation CAR T cell manufacturing. Here, we discuss how the use of non-viral vectors can address some of the limitations of the viral methods of gene transfer and allow us to deliver genetic information in a stable, effective and straightforward manner. In particular, we address the main transposon systems such as Sleeping Beauty (SB) and piggyBac (PB), the utilization of mRNA, and innovative approaches of nanotechnology like Lipid-based and Polymer-based DNA nanocarriers and nanovectors. We also describe the most relevant preclinical data that have recently led to the use of non-viral gene therapy in emerging clinical trials, and the related safety and efficacy aspects. We will also provide practical considerations for future trials to enable successful and safe cell therapy with non-viral methods for CAR T cell generation

Anxiety, depression, and glycemic control during Covid-19 pandemic in youths with type 1 diabetes.

Abstract Objectives Our study aims to assess the impact of lockdown during the coronavirus disease 2019 pandemic on glycemic control and psychological well-being in youths with type 1 diabetes. Methods We compared glycemic metrics during lockdown with the same period of 2019. The psychological impact was evaluated with the Test of Anxiety and Depression. Results We analyzed metrics of 117 adolescents (87% on Multiple Daily Injections and 100% were flash glucose monitoring/continuous glucose monitoring users). During the lockdown, we observed an increase of the percentage of time in range (TIR) (p<0.001), with a significant reduction of time in moderate (p=0.002), and severe hypoglycemia (p=0.001), as well as the percentage of time in hyperglycemia (p<0.001). Glucose variability did not differ (p=0.863). The glucose management indicator was lower (p=0.001). 7% of youths reached the threshold-score (≥115) for anxiety and 16% for depression. A higher score was associated with lower TIR [p=0.028, p=0.012]. Conclusions Glycemic control improved during the first lockdown period with respect to the previous year. Symptoms of depression and anxiety were associated with worse glycemic control; future researches are necessary to establish if this improvement is transient and if psychological difficulties will increase during the prolonged pandemic situation

Knowledge and use of e-cigarettes among nursing students: results from a cross-sectional survey in north-eastern Italy

Data on electronic cigarette (e-cigarette) use among health professional students, who can play a central role in promoting healthy habits and smoking cessation, are sparse. Moreover, the association between e-cigarettes and smoking habits is still debated. The present study aimed to investigate the diffusion of e-cigarette use among nursing students in north-eastern Italy and explore its association with tobacco smoking

Olaparib and Ceralasertib (AZD6738) in Patients with Triple-Negative Advanced Breast Cancer: Results from Cohort E of the plasmaMATCH Trial (CRUK/15/010)

Olaparib; Ceralasertib; Triple-negative advanced breast cancerOlaparib; Ceralasertib; Càncer de mama avançat triple negatiuOlaparib; Ceralasertib; Cáncer de mama avanzado triple negativoPurpose: Approximately 10% to 15% of triple-negative breast cancers (TNBC) have deleterious mutations in BRCA1 and BRCA2 and may benefit from PARP inhibitor treatment. PARP inhibitors may also increase exogenous replication stress and thereby increase sensitivity to inhibitors of ataxia telangiectasia and Rad3-related (ATR) protein. This phase II study examined the activity of the combination of PARP inhibitor, olaparib, and ATR inhibitor, ceralasertib (AZD6738), in patients with advanced TNBC. Patients and Methods: Patients with TNBC on most recent biopsy who had received 1 or 2 lines of chemotherapy for advanced disease or had relapsed within 12 months of (neo)adjuvant chemotherapy were eligible. Treatment was olaparib 300 mg twice a day continuously and celarasertib 160 mg on days 1–7 on a 28-day cycle until disease progression. The primary endpoint was confirmed objective response rate (ORR). Tissue and plasma biomarker analyses were preplanned to identify predictors of response. Results: 70 evaluable patients were enrolled. Germline BRCA1/2 mutations were present in 10 (14%) patients and 3 (4%) patients had somatic BRCA mutations. The confirmed ORR was 12/70; 17.1% (95% confidence interval, 10.4–25.5). Responses were observed in patients without germline or somatic BRCA1/2 mutations, including patients with mutations in other homologous recombination repair genes and tumors with functional homologous recombination deficiency by RAD51 foci. Conclusions: The response rate to olaparib and ceralasertib did not meet prespecified criteria for activity in the overall evaluable population, but responses were observed in patients who would not be expected to respond to olaparib monotherapy.This research was funded by the Stand Up to Cancer Campaign for Cancer Research UK (CRUK/15/010, C30746/A19505; to S. Martin, H. Johnson, L. Moretti) with additional support from AstraZeneca, Guardant Health, Bio-Rad and Asociación Española Contra el Cáncer (AECC, INVES20095LLOP; to A. Llop-Guevara). The ICR Clinical Trials and Statistics Unit is supported by the Cancer Research UK core programme grant (C1491/A25351; to L.S. Kilburn). This study represents independent research supported by the National Institute for Health Research (NIHR) Biomedical Research Centre at the Royal Marsden National Health Service Foundation Trust and the Institute of Cancer Research, London, UK. In addition, plasmaMATCH is supported by the NIHR Manchester Clinical Research Facility at the Christie Hospital, Manchester, UK, the NIHR UCLH Clinical Research Facility at University College London Hospitals NHS Foundation Trust, London, UK, the Cancer Research UK Cambridge Centre, Cambridge Biomedical Research Centre (BRC-1215–20014) and Cambridge Experimental Cancer Medicine Centre, Cambridge, UK. The RAD51 analysis was supported with grants from the Spanish Association of Cancer Research and Instituto de Salud Carlos III (ERAPERMED2019–215, CPII19/00033, and INVES20095LLOP). plasmaMATCH is supported at participating sites in England by the NIHR Clinical Research Network, in Scotland by the Chief Scientist Office, and in Wales by Health and Care Research Wales

Children with special health care needs attending emergency department in Italy: analysis of 3479 cases

Background: Although children with special health care needs (CSHCN) represent a minority of the population, they go through more hospitalizations, more admissions to the Emergency Department (ED), and receive a major number of medical prescriptions, in comparison to general pediatric population. Objectives of the study were to determine the reasons for admission to the ED in Italian CSHCN, and to describe the association between patient's demographic data, clinical history, and health services requirements. Methods: Ad hoc web site was created to collect retrospective data of 3479 visits of CSHCN to the ED in 58 Italian Hospitals. Results: Seventy-two percent of patients admitted to ED were affected by a previously defined medical condition. Most of the ED admissions were children with syndromic conditions (54%). 44.2% of the ED admissions were registered during the night-time and/or at the weekends. The hospitalization rate was of 45.6% among patients admitted to the ED. The most common reason for admission to the ED was the presence of respiratory symptoms (26.6%), followed by gastrointestinal problems (21.3%) and neurological disorders (18.2%). 51.4% of the access were classified as 'urgent', with a red/yellow triage code. Considering the type of ED, 61.9% of the visits were conducted at the Pediatric EDs (PedEDs), 33.5% at the Functional EDs (FunEDs) and 4.6% at the Dedicated EDs (DedEDs). Patients with more complex clinical presentation were more likely to be evaluated at the PedEDs. CSHCN underwent to a higher number of medical procedures at the PedEDs, more in comparison to other EDs. Children with medical devices were directed to a PedED quite exclusively when in need for medical attention. Subjects under multiple anti-epileptic drug therapy attended to PedEDs or FunEDs generally. Patients affected by metabolic diseases were more likely to look for medical attention at FunEDs. Syndromic patients mostly required medical attention at the DedEDs. Conclusions: Access of CSHCN to an ED is not infrequent. For this reason, it is fundamental for pediatricians working in any kind of ED to increase their general knowledge about CHSCN and to gain expertise in the management of such patients and their related medical complexity

The origin of the hot gas in the galactic halo: Testing galactic fountain models&apos; X-ray emission

We test the X-ray emission predictions of galactic fountain models against XMM-Newton measurements of the emission from the Milky Way&apos;s hot halo. These measurements are from 110 sight lines, spanning the full range of Galactic longitudes. We find that a magnetohydrodynamical simulation of a supernova-driven interstellar medium, which features a flow of hot gas from the disk to the halo, reproduces the temperature but significantly underpredicts the 0.5-2.0 keV surface brightness of the halo (by two orders of magnitude, if we compare the median predicted and observed values). This is true for versions of the model with and without an interstellar magnetic field. We consider different reasons for the discrepancy between the model predictions and the observations. We find that taking into account overionization in cooled halo plasma, which could in principle boost the predicted X-ray emission, is unlikely in practice to bring the predictions in line with the observations. We also find that including thermal conduction, which would tend to increase the surface brightnesses of interfaces between hot and cold gas, would not overcome the surface brightness shortfall. However, charge exchange emission from such interfaces, not included in the current model, may be significant. The faintness of the model may also be due to the lack of cosmic ray driving, meaning that the model may underestimate the amount of material transported from the disk to the halo. In addition, an extended hot halo of accreted material may be important, by supplying hot electrons that could boost the emission of the material driven out from the disk. Additional model predictions are needed to test the relative importance of these processes in explaining the observed halo emission.open2