Pulmonary Tuberculosis in Children: A Forgotten Disease?

Even today, tuberculosis in childhood is a disease that is often undiagnosed and undertreated. In the absence of therapy with antituberculosis drugs, children in the first years of life have a high degree of severe forms and mortality. In these children, symptoms are often not very specific and can easily be confused with other diseases of bacterial, viral or fungal etiology, making diagnosis more difficult. Nevertheless, the introduction of new diagnostic techniques has allowed a more rapid identification of the infection. Indeed, Interferon gamma release assay (IGRA) is preferred to the Mantoux, albeit with obvious limitations in children aged <2 years. While the Xpert Mtb/RIF Ultra test is recommended as an initial diagnostic investigation of the gastric aspirate and/or stools in children with signs and symptoms of pulmonary tuberculosis. The drugs used in the treatment of susceptible and resistant TB are the same as those used in adults but doses and combinations are different in the pediatric age. In children, brief therapy is preferable in both the latent infection and the active disease, as a significant reduction in side effects is obtained

Integrative Multiomics Approach to Skin: The Sinergy between Individualised Medicine and Futuristic Precision Skin Care?

The skin is a complex ecosystem colonized by millions of microorganisms, the skin microbiota, which are crucial in regulating not only the physiological functions of the skin but also the metabolic changes underlying the onset of skin diseases. The high microbial colonization together with a low diversity at the phylum level and a high diversity at the species level of the skin is very similar to that of the gastrointestinal tract. Moreover, there is an important communication pathway along the gut-brain-skin axis, especially associated with the modulation of neurotransmitters by the microbiota. Therefore, it is evident that the high complexity of the skin system, due not only to the genetics of the host but also to the interaction of the host with resident microbes and between microbe and microbe, requires a multi-omics approach to be deeply understood. Therefore, an integrated analysis, with high-throughput technologies, of the consequences of microbial interaction with the host through the study of gene expression (genomics and metagenomics), transcription (transcriptomics and meta-transcriptomics), and protein production (proteomics and meta-proteomics) and metabolite formation (metabolomics and lipidomics) would be useful. Although to date very few studies have integrated skin metabolomics data with at least one other 'omics' technology, in the future, this approach will be able to provide simple and fast tests that can be routinely applied in both clinical and cosmetic settings for the identification of numerous skin diseases and conditions. It will also be possible to create large archives of multi-omics data that can predict individual responses to pharmacological treatments and the efficacy of different cosmetic products on individual subjects by means of specific allotypes, with a view to increasingly tailor-made medicine. In this review, after analyzing the complexity of the skin ecosystem, we have highlighted the usefulness of this emerging integrated omics approach for the analysis of skin problems, starting with one of the latest 'omics' sciences, metabolomics, which can photograph the expression of the genome during its interaction with the environment

Insegnare la comprensione a scuola. Un percorso didattico sperimentale centrato sui testi e sul confronto “tra pari”

Reading literacy is a key competence for lifelong learning, nevertheless it is still critical for Italian students (Mullis, Martin, Foy, Hooper, 2017; INVALSI, 2018). The aim of this quasi-experimental study is identifying effective teaching strategies in order to foster reading comprehension. According to the individualized intervention centered on the reader methodology (Lumbelli, 2009) integrated with a collaborative pairs work activity and class discussion it was designed and carried out a didactic intervention for primary school students in order to stimulate both text integration and inferential skills. The analysis of the data showed a positive effect of the treatment tested, especially in the case of initially less competent students.La competenza nella lettura è considerata una competenza chiave per l’apprendimento permanente, tuttavia presenta elementi di criticità tra gli studenti italiani (Mullis, Martin, Foy, Hooper, 2017; INVALSI, 2018). La ricerca quasi-sperimentale qui presentata si colloca nel filone di studi finalizzati ad individuare strategie didattiche efficaci per il suo potenziamento. In particolare, è statorealizzato un intervento didattico rivolto a studenti di scuola primaria focalizzato sulle abilità di integrazione del testo e le abilità inferenziali. L’insegnamento sperimentale ha integrato elementi dell’intervento individualizzato centrato sul lettore (Lumbelli, 2009) con modalità di lavoro collaborativo in coppia e discussione in classe centrati sulle caratteristiche del testo e sulle sue specifiche richieste di integrazione. L’analisi dei dati evidenzia un effetto positivo della metodologia sperimentata, soprattutto con alunni inizialmente meno competenti

Insegnare la comprensione a scuola. Un percorso didattico sperimentale centrato sui testi e sul confronto “tra pari”

Reading literacy is a key competence for lifelong learning, nevertheless it is still critical for Italian students (Mullis, Martin, Foy, Hooper, 2017; INVALSI, 2018). The aim of this quasi-experimental study is identifying effective teaching strategies in order to foster reading comprehension. According to the individualized intervention centered on the reader methodology (Lumbelli, 2009) integrated with a collaborative pairs work activity and class discussion it was designed and carried out a didactic intervention for primary school students in order to stimulate both text integration and inferential skills. The analysis of the data showed a positive effect of the treatment tested, especially in the case of initially less competent students.La competenza nella lettura è considerata una competenza chiave per l’apprendimento permanente, tuttavia presenta elementi di criticità tra gli studenti italiani (Mullis, Martin, Foy, Hooper, 2017; INVALSI, 2018). La ricerca quasi-sperimentale qui presentata si colloca nel filone di studi finalizzati ad individuare strategie didattiche efficaci per il suo potenziamento. In particolare, è statorealizzato un intervento didattico rivolto a studenti di scuola primaria focalizzato sulle abilità di integrazione del testo e le abilità inferenziali. L’insegnamento sperimentale ha integrato elementi dell’intervento individualizzato centrato sul lettore (Lumbelli, 2009) con modalità di lavoro collaborativo in coppia e discussione in classe centrati sulle caratteristiche del testo e sulle sue specifiche richieste di integrazione. L’analisi dei dati evidenzia un effetto positivo della metodologia sperimentata, soprattutto con alunni inizialmente meno competenti

Aspetti di qualità dell’insegnante attraverso una scala di self efficacy

La ricerca di cui si riferisce saggiato la rappresentazione di professionalità docente e la competenza professionale percepita da insegnanti in servizio, anche allo scopo di individuare areee di bisogno formative. A tal fine, è stata tradotta e impiegata la scala di Tsachennen-Moran, nota anche come scala dell’Ohio (TSES 2001) che, se pure nata in contesti culturali diversi, sembra particolarmente adatta a sondare una costellazione di comportamenti professionali salienti dell’insegnante. Le 3 subscale che la compongono concernono rispettivamente le strategie didattiche, la gestione della classe, e la motivazione/coinvolgimento degli allievi. Per mettere in connessione l’autovalutazione (o competenza percepita) con la rappresentazione dell’insegnamento, si è proceduto a costruire uno strumento di rilevazione delle opinioni degli insegnanti che riproducesse puntualmente ciascuno degli item di autoefficacia e ad anteporlo alla scala di self-efficacy. Pertanto se gli item della scala TSES chiedono al rispondente di indicare in quale misura essi si ritengano “capaci di” svolgere determinate funzioni professionali, la scala dell’opinione costruita ad hoc chiede a ciascuno di indicare in quale misura “sia importante” per un insegnante “essere capace di”. Il questionario utilizzato ha indagato in forma anonima i dati anagrafici, i titoli di studio, di abilitazione e le eventuali specializzazioni, le esperienze lavorative nel campo dell’insegnamento, l’eventuale funzione di insegnante di sostegno ricoperta, il titolo di laurea, la classe di abilitazione, la consistenza dell’insegnamento esperito ed una vasta serie di difficoltà professionali incontrate (Veenman 1984, ). Nell’ultima parte sono state collocate le scale di autopercezione e quella di opinione. Il questionario descritto è stato sottoposto ai frequentanti dei corsi TFA, PAS, Specializzazione per il sostegno presso l’Università di Modena e Reggio Emilia negli anni 2013, 2014 e 2015, nel corso delle lezioni iniziali dei rispettivi corsi. I questionari raccolti sono circa 450: di questi circa 400 sono insegnanti in servizio. È su questa popolazione di ‘precari’ della scuola che il presente contributo si concentra. In primo luogo, dunque la ricerca ha testato la tenuta della scala di self efficacy TSES su un campione italiano. Verranno presentati pertanto i risultati dell’ analisi fattoriale esplorativa che ha saggiato la consistenza dei tre fattori (dimensioni) presso una popolazione di insegnanti italiani, e discusse le più rilevanti discrepanze. In secondo luogo l’importanza percepita delle diverse dimensioni dell’insegnamento (le 3 subscale) è posta in connessione con le più salienti variabili di sfondo del campione indagato

Metabolomic profiles and microbiota of GDM offspring: The key for future perspective?

Gestational diabetes mellitus (GDM), or any degree of glucose intolerance recognized for the first time during pregnancy, is one of the diseases that most frequently aggravates the course of gestation. Missed or late diagnosis and inadequate treatment are associated with high maternal and fetal morbidity, with possible short- and long-term repercussions. Estimates on the prevalence of GDM are alarming and increasing by about 30% in the last 10-20 years. In addition, there is the negative influence of the SARS-CoV-2 emergency on the glycemic control of pregnant women, making the matter increasingly topical. To date, knowledge on the metabolic maturation of newborns is still incomplete. However, in light of the considerable progress of the theory of "developmental origins of health and disease," the relevant role of the intrauterine environment cannot be overlooked. In fact, due to the high plasticity of the early stages of development, some detrimental metabolic alterations during fetal growth, including maternal hyperglycemia, are associated with a higher incidence of chronic diseases in adult life. In this context, metabolomic analysis which allows to obtain a detailed phenotypic portrait through the dynamic detection of all metabolites in cells, tissues and different biological fluids could be very useful for the early diagnosis and prevention of complications. Indeed, if the diagnostic timing is optimized through the identification of specific metabolites, the detailed understanding of the altered metabolic pathway could also allow better management and more careful monitoring, also from a nutritional profile, of the more fragile children. In this context, a further contribution derives from the analysis of the intestinal microbiota, the main responsible for the fecal metabolome, given its alteration in pregnancies complicated by GDM and the possibility of transmission to offspring. The purpose of this review is to analyze the available data regarding the alterations in the metabolomic profile and microbiota of the offspring of mothers with GDM in order to highlight future prospects for reducing GDM-related complications in children of mothers affected by this disorder

What to Expect from COVID-19 and from COVID-19 Vaccine for Expecting or Lactating Women

Recent studies identified pregnancy as a high-risk condition for the development of maternal-fetal complications in the case of the SARS-CoV-2 infection. Therefore, the scientific community is now considering pregnant women a "fragile" category that should be vaccinated with high priority. The number of pregnant women undergoing hospitalization since summer 2021, including Intensive Care Unit admission, is growing, as well as the risk of preterm birth. Evidence from both animals and humans suggest that, similarly to other vaccines routinely administered in pregnancy, COVID-19 vaccines are not crossing the placenta, do not increase the risk of miscarriage, preterm birth, stillbirth, the birth of small gestational age neonates, as well as the risk of congenital abnormalities. To date, the World Health Organization and scientific literature are promoting and encouraging the vaccination of all pregnant and lactating women. The aim of our narrative review is to present the available literature regarding this issue with the aim to provide appropriate answers to the most frequent requests, doubts, and fears that have led many expecting and lactating women not to become vaccinated during this pandemic period

Riattivare le energie di quartiere. Una Ricerca-Formazione con il Ce.I.S. di Reggio Emilia

Il contributo si concentra sul monitoraggio di un Progetto del Ce.I.S. di Reggio Emilia,in collaborazione con il DESU-UNIMORE, teso a riattivare energie di quartiere attraverso processi di comunità funzionali all’inclusione sociale di adulti e famiglie in difficoltà economica, prevalentemente di origine non italiana. L’articolo illustra il progetto e ne esamina il profilo educativo, in particolare di promozione della partecipazione e delle ricadute formative sulle persone coinvolte, ma anche sugli operatori (come contrasto alla povertà educativa nelle sue varie declinazioni). Sono presentati i risultati della ricerca che ha indagato, delle singole iniziative del progetto, i percorsi decisionali e operativi, i significati e vissuti esperiti dai partecipanti, le condizioni di efficacia/inefficacia. Vengono illustrati gli strumenti di indagine predisposti che si sono trasformati in supporti utilizzabili dagli operatori nel potenziamento delle esperienze progettate

Childhood Obesity and the Cryptic Language of the Microbiota: Metabolomics' Upgrading

The growing obesity epidemic in childhood is increasingly concerning for the related physical and psychological consequences, with a significant impact on health care costs in both the short and the long term. Nonetheless, the scientific community has not yet completely clarified the complex metabolic mechanisms underlying body weight alterations. In only a small percentage of cases, obesity is the result of endocrine, monogenic, or syndromic causes, while in much more cases, lifestyle plays a crucial role in obesity development. In this context, the pediatric age appears to be of considerable importance as prevention strategies together with early intervention can represent important therapeutic tools not only to counteract the comorbidities that increasingly affect children but also to hinder the persistence of obesity in adulthood. Although evidence in the literature supporting the alteration of the microbiota as a critical factor in the etiology of obesity is abundant, it is not yet fully defined and understood. However, increasingly clear evidence is emerging regarding the existence of differentiated metabolic profiles in obese children, with characteristic metabolites. The identification of specific pathology-related biomarkers and the elucidation of the altered metabolic pathways would therefore be desirable in order to clarify aspects that are still poorly understood, such as the consequences of the interaction between the host, the diet, and the microbiota. In fact, metabolomics can characterize the biological behavior of a specific individual in response to external stimuli, offering not only an eventual effective screening and prevention strategy but also the possibility of evaluating adherence and response to dietary intervention

Metabolomics in NEC: An Updated Review

Necrotizing enterocolitis (NEC) represents the most common and lethal acute gastrointestinal emergency of newborns, mainly affecting those born prematurely. It can lead to severe long-term sequelae and the mortality rate is approximately 25%. Furthermore, the diagnosis is difficult, especially in the early stages, due to multifactorial pathogenesis and complex clinical pictures with mild and non-specific symptoms. In addition, the existing tests have poor diagnostic value. Thus, the scientific community has been focusing its attention on the identification of non-invasive biomarkers capable of prediction, early diagnosis and discriminating NEC from other intestinal diseases in order to intervene early and block the progression of the pathology. In this regard, the use of "omics" technologies, especially metabolomics and microbiomics, could be a fundamental synergistic strategy to study the pathophysiology of NEC. In addition, a deeper knowledge of the microbiota-host cross-talk can clarify the metabolic pathways potentially involved in the pathology, allowing for the identification of specific biomarkers. In this article, the authors analyze the state-of-the-art concerning the application of metabolomics and microbiota analysis to investigate this pathology and discuss the future possibility of the metabolomic fingerprint of patients for diagnostic purposes