Does chorioamnionitis worsen the outcome of preterm infants? A controversial issue

The term chorioamnionitis is used to describe an intrauterine status of infection/inflammation of either mixed fetal-maternal (choriodecidual space) or fetal origin (chorioamniotic membranes, amniotic fluid, umbilical cord). Histological, microbiological, biochemical and clinical criteria are used to define chorioamnionitis. Histopathological examination of the placenta is the gold standard for evaluating antenatal inflammatory processes that might influence fetal development. Chorioamnionitis is the leading cause of very preterm delivery and its incidence increases with decreasing gestational age. Therefore, it contributes to the high morbidity and mortality of infants born prematurely. In the last decades, several studies have been performed to assess a gestation-independent effect of chorioamnionitis on neonatal and long-term outcome with variable results. The discrepancy observed across studies may be attributable to differences in inclusion and exclusion criteria, disease definitions, methods, and whether potential confounding factors such as gestational age were considered. As underlined by several Authors, the increasingly widespread use of antenatal steroids may have contributed to improve neonatal outcome and can therefore partially explain the different results between studies. In the current review we aim to give an overview and synthesis of a vast amount of existing literature on the association between antenatal infection/inflammation and neonatal and long-term outcome

Classic Kaposi's sarcoma in morocco: clinico -epidemiological study at the national institute of oncology

<p>Abstract</p> <p>Background</p> <p>Classic Kaposi's sarcoma (CKS) is a rare disease likely associated with human herpes virus 8 (HHV-8) infection, and occurs predominantly in Jewish, Mediterranean and middle eastern men .There is a dearth of data in Moroccan patients with CKS regarding epidemiology, clinical characteristics and outcomes. This report examines a cohort of patients with CKS evaluated at the national institute of oncology over 11-year period.</p> <p>Methods</p> <p>A retrospective analysis of patients referred to the national institute of oncology with classical Kaposi sarcoma, between January 1998 and February 2008, was performed. Reviewed information included demographics, clinical and pathological staging, death or last follow-up.</p> <p>Results</p> <p>During the study period, 56 patients with a diagnosis of CKS have been referred to our hospital. There were 11(19,7%) females and 45 (80,3%) males (male-to-female ratio: 4:1). Mean age at diagnosis was 61,7 ± 15 (range: 15- 86 years). Nodules and/or plaques were the most frequent type of lesion. The most common location was the lower limbs, particularly the distal lower extremity (90%). In addition to skin involvement, visceral spread was evident in 9 cases. The most common visceral involvement sites were lymph nodes (44%), lung (22%), and gastrointestinal tract (22%). Associated lymphoedema was seen in 24 (42%) of the patients. There were 18 stage I patients (32,14%), 8: stage II (14,28%), 21 stage III(37,5%) and 9 stage IV (16,07%). A second primary malignancy was diagnosed in 6 cases (10,7%), none of the reticuloendothelial system.</p> <p>With a median follow-up of 45 months, 38 (67,8) patients are alive, of whom 25 (65,78%) patients with stable disease, five with progressive disease currently under systemic chemotherapy and 8(21,05%) are alive and free of disease, over a mean interval of 5 years.</p> <p>Conclusion</p> <p>This is the largest reported series in our context. In Morocco, CKS exhibits some special characteristics including a disseminated skin disease at diagnosis especially in men, a more common visceral or lymph node involvement and a less frequent association with second malignancies.</p

Istituzioni e politiche del turismo

Il volume ricostruisce l\u2019evoluzione delle istituzioni e delle politiche del turismo - immenso patrimonio storico, artistico e culturale che colloca l\u2019Italia al vertice di numerose classifiche internazionali - partendo dalle norme di diritto internazionale ed europeo, per poi passare al sistema costituzionale italiano di regionalismo avanzato. Fonti, competenze e profili organizzativi si intrecciano e si influenzano in un sistema di interdipendenze continuo, nel quale operano i soggetti pubblici e privati dell\u2019ordinamento europeo e nazionale, al contempo rafforzando progressivamente la tutela del viaggiatore/turista

The viral picture of well-being: Biggest concerns, losses, and unintended gifts of COVID-19 in the Philippines

The COVID-19 pandemic revealed more than anticipated about global human functioning and resiliency. This Philippines-based study replicated a recent U.S. COVID analysis on psychological well-being (PWB). Factors examined herein were grouped into categories for analysis: 1) predictors of PWB, 2) areas of greatest stress or worry (biggest concerns), 3) perceived or real losses across SES, and 4) identified unintended gifts across PWB. Participants (n = 1345) were volunteers who responded to an online survey from August to September 2021, peak of the Delta variant. Three general groups of predictors (biological, psychological, and socio-economic) contributed to PWB. A regression model containing a total of 11 variables was significant, F(11, 1092) = 116.02, p \u3c .00, explaining 53.9% of the variance. The model indicated PWB was significantly predicted by physical health, age, spirituality, emotional loneliness, social loneliness, sense of agency, and income. The strongest predictors of PWB were a sense of agency, social loneliness, and spirituality. Qualitative data analysis was conducted examining biggest concerns, losses due to COVID, and unintended gifts. Top ranking participant concerns were the health of family and friends, personal wellness, and governmental inefficiency/lack of concern. Losses compared to pre-COVID life were analyzed by SES group, with the most frequent responses being missing face-to-face interactions and the freedom to go/do what they please. Low SES groups were most likely to endorse missing everyday routine and experiencing changes in housing conditions due to the pandemic. Unintended gifts of COVID explored by PWB, high PWB individuals significantly appreciated intentional time with family and friends, deepening their spiritual lives, the ability to work from home, less pollution, and more time for physical exercise. Low PWB individuals reported nothing gained, except more time playing video games and watching TV. Those with higher PWB identified more unintended gifts of COVID and coped more actively