POSITIVE RELATIONS OF PHYSICAL FITNESS AND EXERCISE INTERVENTION PROGRAMS WITH MOTOR COMPETENCE AND HEALTH-RELATED QUALITY OF LIFE IN DEVELOPMENTAL COORDINATION DISORDER: A SYSTEMATIC REVIEW

Developmental Coordination Disorder (DCD) is an impairment in the development of motor coordination creating varied problems and difficulties in children’s and adolescent’s daily life activities. As a result, the avoidance of participating in physical activity leads in low levels of fitness and also in secondary social and emotional problems. Fitness levels in children and adolescents with DCD have been recognized as an important factor which influences their performance in daily activities and has a positive impact on their health-related quality of life (HRQOL). Surveys showed that every domain in HRQOL (motor, cognitive, emotional, social) is significantly lower in children with DCD compared to their peers. These data showed that intervention is very important for improving motor skill performance and HRQOL, too, in children and adolescents with DCD. The present study aimed to systematically review the literature published in peer reviewed journals and to summarize information about possible relationships between intervention approaches focused on physical fitness and exercise, participation in physical activity and HRQOL, in children and adolescents with DCD. Studies which examined the effect of fitness and exercise intervention programs on motor competence and HRQOL in children and adolescents with DCD were also, included. The review of the literature has shown that several intervention programs developed for DCD population, focusing to improve motor ability, derived from occupational therapy, physiotherapy, medicine, dietetics and education scientific areas. Generally, the present review focused on two basic approaches in clinical practice regarding intervention programs for DCD individuals: task-oriented and process-oriented approach. The task-oriented approach aims to improve the performance of a specific skill and on the other hand the process-oriented approach aims to identify the underlying processes or dysfunctions which the individual has not developed adequately according to his/her age, although they are considered to be necessary for successful performance and acquisition of motor skills. Children and adolescents with DCD seemed to report poorer ΗRQOL than their typically developing peers. However, HRQOL in children and adolescents with DCD needs further investigation. In addition, there is a need of research in interventions focused on fitness and exercise programs with an ultimate goal to improve motor ability and HRQOL too; through participation in such interventions children and adolescents with DCD, may be possible to break the negative cycle of physical activity avoidance, reversing it to a positive one. It is concluded that, there are possible positive relationships between fitness and exercise intervention programs, motor competence and HRQOL in children and adolescents with DCD. Future research should focus on examining whether and how such interventions may eliminate functional constraints leading to an engagement in the positive cycle of physical activity, with a further improvement in HRQOL in DCD population.  Article visualizations

Effects on the CMB from Compactification Before Inflation

Many theories beyond the Standard Model include extra dimensions, though these have yet to be directly observed. In this work we consider the possibility of a compactification mechanism which both allows extra dimensions and is compatible with current observations. This compactification is predicted to leave a signature on the CMB by altering the amplitude of the low l multipoles, dependent on the amount of inflation. Recently discovered CMB anomalies at low multipoles may be evidence for this. In our model we assume the spacetime is the product of a four-dimensional spacetime and flat extra dimensions. Before the compactification, both the four-dimensional space- time and the extra dimensions can either be expanding or contracting independently. Taking into account physical constraints, we explore the observational consequences and the plausibility of these different models

Acute ST-segment elevation myocardial infarction after amoxycillin-induced anaphylactic shock in a young adult with normal coronary arteries: a case report

BACKGROUND: Acute myocardial infarction (MI) following anaphylaxis is rare, especially in subjects with normal coronary arteries. The exact pathogenetic mechanism of MI in anaphylaxis remains unclear. CASE PRESENTATION: The case of a 32-year-old asthmatic male with systemic anaphylaxis, due to oral intake of 500 mg amoxycillin, complicated by acute ST-elevation MI is the subject of this report. Following admission to the local Health Center and almost simultaneously with the second dose of subcutaneous epinephrine (0.2 mg), the patient developed acute myocardial injury. Coronary arteriography, performed before discharge, showed no evidence of obstructive coronary artery disease. In vivo allergological evaluation disclosed strong sensitivity to amoxycillin and the minor (allergenic) determinants of penicillin. CONCLUSION: Acute ST-elevation MI is a rare but potential complication of anaphylactic reactions, even in young adults with normal coronary arteries. Coronary artery spasm appears to be the main causative mechanism of MI in the setting of "cardiac anaphylaxis". However, on top of the vasoactive reaction, a thrombotic occlusion, induced by mast cell-derived mediators and facilitated by prolonged hypotension, cannot be excluded as a possible contributory factor

Urticaria and infections

Urticaria is a group of diseases that share a distinct skin reaction pattern. Triggering of urticaria by infections has been discussed for many years but the exact role and pathogenesis of mast cell activation by infectious processes is unclear. In spontaneous acute urticaria there is no doubt for a causal relationship to infections and all chronic urticaria must have started as acute. Whereas in physical or distinct urticaria subtypes the evidence for infections is sparse, remission of annoying spontaneous chronic urticaria has been reported after successful treatment of persistent infections. Current summarizing available studies that evaluated the course of the chronic urticaria after proven Helicobacter eradication demonstrate a statistically significant benefit compared to untreated patients or Helicobacter-negative controls without urticaria (p < 0.001). Since infections can be easily treated some diagnostic procedures should be included in the routine work-up, especially the search for Helicobacter pylori. This review will update the reader regarding the role of infections in different urticaria subtypes

Epidemiology of intra-abdominal infection and sepsis in critically ill patients: “AbSeS”, a multinational observational cohort study and ESICM Trials Group Project

Purpose: To describe the epidemiology of intra-abdominal infection in an international cohort of ICU patients according to a new system that classifies cases according to setting of infection acquisition (community-acquired, early onset hospital-acquired, and late-onset hospital-acquired), anatomical disruption (absent or present with localized or diffuse peritonitis), and severity of disease expression (infection, sepsis, and septic shock). Methods: We performed a multicenter (n = 309), observational, epidemiological study including adult ICU patients diagnosed with intra-abdominal infection. Risk factors for mortality were assessed by logistic regression analysis. Results: The cohort included 2621 patients. Setting of infection acquisition was community-acquired in 31.6%, early onset hospital-acquired in 25%, and late-onset hospital-acquired in 43.4% of patients. Overall prevalence of antimicrobial resistance was 26.3% and difficult-to-treat resistant Gram-negative bacteria 4.3%, with great variation according to geographic region. No difference in prevalence of antimicrobial resistance was observed according to setting of infection acquisition. Overall mortality was 29.1%. Independent risk factors for mortality included late-onset hospital-acquired infection, diffuse peritonitis, sepsis, septic shock, older age, malnutrition, liver failure, congestive heart failure, antimicrobial resistance (either methicillin-resistant Staphylococcus aureus, vancomycin-resistant enterococci, extended-spectrum beta-lactamase-producing Gram-negative bacteria, or carbapenem-resistant Gram-negative bacteria) and source control failure evidenced by either the need for surgical revision or persistent inflammation. Conclusion: This multinational, heterogeneous cohort of ICU patients with intra-abdominal infection revealed that setting of infection acquisition, anatomical disruption, and severity of disease expression are disease-specific phenotypic characteristics associated with outcome, irrespective of the type of infection. Antimicrobial resistance is equally common in community-acquired as in hospital-acquired infection

Mediterranean diet and colorectal cancer risk : A pooled analysis of three Italian case-control studies

Background: Adherence to the Mediterranean diet (MD) is associated with a reduced risk of several cancers. However, studies conducted in Mediterranean regions are scanty. Methods: To investigate the relation between MD and colorectal cancer risk in Italy, we pooled data from three case-control studies, including a total of 3745 colorectal cancer cases and 6804 hospital controls. Adherence to the MD was assessed using an a priori Mediterranean Diet Score (MDS), based on nine components. Results: Compared with the lowest adherence to the MD (0-2 MDS), the odds ratio (OR) was 0.52 (95% confidence interval (CI) 0.43-0.62) for the highest adherence (7-9 MDS), with a significant inverse trend in risk (P<0.0001). The OR for a 1-point increment in the MDS was 0.89 (95% CI 0.86-0.91). The inverse association was consistent across studies, cancer anatomical subsites and strata of selected covariates. Conclusions: This Italian study confirms a favourable role of MD on colorectal cancer risk

Geographical and temporal distribution of SARS-CoV-2 clades in the WHO European Region, January to June 2020

We show the distribution of SARS-CoV-2 genetic clades over time and between countries and outline potential genomic surveillance objectives. We applied three available genomic nomenclature systems for SARS-CoV-2 to all sequence data from the WHO European Region available during the COVID-19 pandemic until 10 July 2020. We highlight the importance of real-time sequencing and data dissemination in a pandemic situation. We provide a comparison of the nomenclatures and lay a foundation for future European genomic surveillance of SARS-CoV-2.Peer reviewe

Challenges in the Implementation of the NeoOBS Study, a Global Pragmatic Observational Cohort Study, to Investigate the Aetiology and Management of Neonatal Sepsis in the Hospital Setting.

Neonatal sepsis is a significant cause of mortality and morbidity in low- and middle-income countries. To deliver high-quality data studies and inform future trials, it is crucial to understand the challenges encountered when managing global multi-centre research studies and to identify solutions that can feasibly be implemented in these settings. This paper provides an overview of the complexities faced by diverse research teams in different countries and regions, together with actions implemented to achieve pragmatic study management of a large multi-centre observational study of neonatal sepsis. We discuss specific considerations for enrolling sites with different approval processes and varied research experience, structures, and training. Implementing a flexible recruitment strategy and providing ongoing training were necessary to overcome these challenges. We emphasize the attention that must be given to designing the database and monitoring plans. Extensive data collection tools, complex databases, tight timelines, and stringent monitoring arrangements can be problematic and might put the study at risk. Finally, we discuss the complexities added when collecting and shipping isolates and the importance of having a robust central management team and interdisciplinary collaborators able to adapt easily and make swift decisions to deliver the study on time and to target. With pragmatic approaches, appropriate training, and good communication, these challenges can be overcome to deliver high-quality data from a complex study in challenging settings through a collaborative research network