School readiness of moderately preterm children at preschool age

The study investigates the preschool readiness of moderately preterm children and, in particular, the likely presence of learning disabilities at preschool age. Its theoretical model detects linguistic comprehension and expression; memory-related metacognition and cognition skills; orientation and motor coordination skills; premathematics and preliteracy ones. The research project involved an experimental group made up of 55 moderately preterm children (mean age = 62 months, mean gestational age = 34.6 weeks), without any clinical neonatal complications, and low birth weight (M = 2,100 g, SD = 350 g); a control group made up of 55 full-term children without pre- and perinatal complications. The children’s primary school reference teachers were given a questionnaire (Observative Questionnaire for Early Identification of Learning Disabilities), which was aimed at identifying any likely social and cognitive skill deficits at preschool age. The data, submitted to nonparametric univariate variance, show how scores of moderately preterm children in the metacognition [U (n1 e n2 = 55) = 35, p = 0.04, r = 0.49] are statistically lower, other cognitive skills (memory, orientation, and visual–motor coordination) [U (n1 e n2 = 55) = 32, p = 0.02, r = 0.45], premathematics [U (n1 e n2 = 55) = 32, p = 0.02, r = 0.44], and the total score [U (n1 e n2 = 55) = 31, p = 0.02, r = 0.12]. Such data would seem to suggest the need for hypothesizing preventive training and educational paths as a prerequisite for the development of the school abilities

Heart failure and anti tumor necrosis factor-alpha in systemic chronic inflammatory diseases.

Tumor necrosis factor alpha (TNF-alpha) antagonists have emerged as an effective therapy for patients with diseases as Crohn's disease, rheumatoid arthritis, and other chronic systemic inflammatory diseases. In the last years, there has been a growing interest in the role that inflammatory cytokines, which sustain the pathogenesis of these diseases, plays in regulating cardiac structure and function, particularly in the progression of chronic heart failure. In fact there is an increase of anti-TNF alpha levels in advanced heart failure but the treatment with anti-TNF alpha has been shown to worsen the prognosis of heart failure in randomized controlled trials. Patients with rheumatoid arthritis have an increased risk for cardiovascular disease and anti-TNF alpha therapy seems to be beneficial on the risk of cardiovascular disease. In Crohn's disease the increased risk of cardiovascular disease is controversial and therefore it is impossible to demonstrate an effect in reduction of the risk; however, heart failure in patients treated with anti-TNF alpha, despite in a small proportion, has been observed. On the basis of this observation, anti-TNF alpha therapy is contraindicated in patients with Crohn's disease and III-IV New York Heart Association heart failure class

Restoration of peripheral blood natural killer and B cell levels in patients affected by rheumatoid and psoriatic arthritis during etanercept treatment

Etanercept (ETN) is an anti-tumour necrosis factor (TNF)-α agent used in rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Few studies focused on the effects of anti-TNF-α on peripheral blood cells. We aimed to evaluate peripheral blood cells in RA and PsA patients during ETN treatment and to explore their relationships with disease activity. RA (n = 82) and PsA (n = 32) patients who started ETN were included into the study and evaluated prospectively before the beginning of ETN therapy and after 14, 22, 54 and 102 weeks. Patients were studied in terms of disease activity score on 28 joints (DAS28), clinical response and laboratory findings. Natural killer (NK) cells, B cells and T cells were characterized by immunophenotyping. Both the RA and the PsA patients showed reduced NK and B cell count before ETN treatment compared with controls. A negative correlation was demonstrated between DAS28 and B cell count in RA patients at baseline. Sustained significant increase of NK and B cells up to normal levels was observed in RA and PsA patients along ETN treatment. Increase of NK cell count was associated with a good-moderate clinical response to ETN in both RA and PsA patients. During ETN treatment peripheral blood NK and B cells levels were restored in RA and PsA patients. Correlations between NK and B cells with disease activity were observed, suggesting that those effects could be mediated by ETN treatment.Etanercept (ETN) is an anti-tumour necrosis factor (TNF)-α agent used in rheumatoid arthritis (RA) and psoriatic arthritis (PsA). Few studies focused on the effects of anti-TNF-α on peripheral blood cells. We aimed to evaluate peripheral blood cells in RA and PsA patients during ETN treatment and to explore their relationships with disease activity. RA (n = 82) and PsA (n = 32) patients who started ETN were included into the study and evaluated prospectively before the beginning of ETN therapy and after 14, 22, 54 and 102 weeks. Patients were studied in terms of disease activity score on 28 joints (DAS28), clinical response and laboratory findings. Natural killer (NK) cells, B cells and T cells were characterized by immunophenotyping. Both the RA and the PsA patients showed reduced NK and B cell count before ETN treatment compared with controls. A negative correlation was demonstrated between DAS28 and B cell count in RA patients at baseline. Sustained significant increase of NK and B cells up to normal levels was observed in RA and PsA patients along ETN treatment. Increase of NK cell count was associated with a good-moderate clinical response to ETN in both RA and PsA patients. During ETN treatment peripheral blood NK and B cells levels were restored in RA and PsA patients. Correlations between NK and B cells with disease activity were observed, suggesting that those effects could be mediated by ETN treatment

Functioning of family system in pediatric oncology during treatment phase

The study focuses on parents\u2019 psychological implications caused by the treatment of their children su\ufb00ering from tumor. It investigates some speci\ufb01c mothers\u2019 resource factors such as their strategies of coping and the perception of their own family functioning in terms of cohesion and adaptability. The study was performed with 34 mothers of children su\ufb00ering from acute lymphoblastic leukemia(ALL),duringthetreatmentphase.TheusedtoolsweretheCopingOrientationtoProblem Experienced\u2014New Italian Version, to investigate coping strategies, and the Family Adaptability and Cohesion Evaluation Scale-III, to analyze both real and ideal perception of family functioning. The data related to coping, show how the involved mothers tend to mainly use the strategies of positive aptitude, orientation toward problem and social support ( F = 99.88, d f= 4, P< .01). The family functioning, in terms of adaptabilit y, is described as chaotic relating to both the real (\u3c72 = 13.29,d f =3, P=.004)andideal(\u3c72=11.52,d f=2, P=.003)family,whereasintermsof cohesion, itisperceivedaschie\ufb02ydisengagedintherealfamily(\u3c72 =12.3,d f=3, P=.006)andasenmeshed in the ideal one (\u3c72 = 12.58, d f= 3, P= .006). Statistically positive correlations were only detected between adaptability and avoidance ( r = 0.49, P< .01); adaptability and orientation toward problem (r = 0.36, P< .05); and adaptability and transcendent orientation ( r = 120.04, P< .05). Despitethecriticalsituation,themothershaveshownoptimisticview,careforproblemmanagementandcapabilitytoaskforhelp.Thesecopingstrategiesallowthetherapeuticalliancebetween families and health care workers, so useful for the quality of childcarThe study focuses on parents\u2019 psychological implications caused by the treatment of their children su\ufb00ering from tumor. It investigates some speci\ufb01c mothers\u2019 resource factors such as their strategies of coping and the perception of their own family functioning in terms of cohesion and adaptability. The study was performed with 34 mothers of children su\ufb00ering from acute lymphoblastic leukemia(ALL),duringthetreatmentphase.TheusedtoolsweretheCopingOrientationtoProblem Experienced\u2014New Italian Version, to investigate coping strategies, and the Family Adaptability and Cohesion Evaluation Scale-III, to analyze both real and ideal perception of family functioning. The data related to coping, show how the involved mothers tend to mainly use the strategies of positive aptitude, orientation toward problem and social support ( F = 99.88, d f= 4, P< .01). The family functioning, in terms of adaptabilit y, is described as chaotic relating to both the real (\u3c72 = 13.29,d f =3, P=.004)andideal(\u3c72=11.52,d f=2, P=.003)family,whereasintermsof cohesion, itisperceivedaschie\ufb02ydisengagedintherealfamily(\u3c72 =12.3,d f=3, P=.006)andasenmeshed in the ideal one (\u3c72 = 12.58, d f= 3, P= .006). Statistically positive correlations were only detected between adaptability and avoidance ( r = 0.49, P< .01); adaptability and orientation toward problem (r = 0.36, P< .05); and adaptability and transcendent orientation ( r = 120.04, P< .05). Despitethecriticalsituation,themothershaveshownoptimisticview,careforproblemmanagementandcapabilitytoaskforhelp.Thesecopingstrategiesallowthetherapeuticalliancebetween families and health care workers, so useful for the quality of childcar