VISUOMOTOR INTEGRATION SKILLS IN CHILDREN AFFECTED BY OBSTRUCTIVE SLEEP APNEA SYNDROME: A CASE-CONTROL STUDY

Introduction: Sleep related breathing disorders (SRBD) consist of frequent and repetitive episodes of pharyngeal obstruction during sleep, with consequent intermittent hypoxia, sleep architecture fragmentation, daytime sleepiness and/or behavioural problems and executive impairment in children. When untreated, SRBD and obstructive sleep apnea syndrome (OSA) mainly, may impact school performance, cognition, metabolism, and cardiovascular function. Aim of the present study is assessing the visuomotor integration skills in children affected by OSA. Materials and methods: 57 subjects affected by mild-to severe OSA, PSG diagnosed according to international diagnostic criteria, (31 males and 26 females) (mean age 10.8; SD \ub1 2.49) and 83 healthy children (45 males and 38 females) (mean age 9.95; SD \ub1 1.87; p = 0.725). All subjects underwent assessment of motor coordination skills with Movement-ABC tests and visual-motor integration ability with Visual Motor Integration (VMI) test. Results: The subjects with OSA show a worse average performances in all items of Movement ABC (p <0.001) respect of controls. Specifically, children with OSAS show significantly higher values of total points (p <0.001), manual dexterity (p <0.001), ball skills (p <0.001) and balance (p <0.001). Accordingly, the average centile in OSA children at the MABC-test is significantly reduced compared with controls (p <0.001). (Table 1) On the other hand, the VMI test evaluation among children with OSAS shows worst result in total Visuo-Motor Integration (p <0.001), and in Motor Coordination sub-item (p <0.001) than controls. (Table 1). Conclusion: Our results also support for children and adolescents the hypothesis that executive functioning deficits might be linked primarily to the degree of severity nocturnal hypoxemia rather than daytime sleepiness, although several other studies are needed

Superinfections in patients treated with teicoplanin as anti SARSCoV2 AGENT

We read with interest the paper by Giacobbe et al. estimating a cumulative risk of developing at least one bloodstream infection (BSI) episode (largely due to Gram-positive pathogens) of almost 50% after 30 days at risk in (2) Similarly, Somers et al. reported an increased risk to develop bacterial superinfections, principally represented by Staphylococcus aureus ventilatory associated pneumonia (VAP), in critically ill patients infected with SARS-CoV-2 and treated with Tocilizumab. (1) We previously described a cohort of intubated patients affected by severe COVID-19pneumonia treated with the best available therapy (BAT), including Tocilizumab and associated with Teicoplanin. (3) This glycopeptide antibiotic was used with a double purpose: as antiviral agent for COVID-19 and as of possible S.aureus superinfection

Visual\u2013spatial training efficacy in children affected by migraine without aura: A multicenter study

Routinely in the clinical practice, children affected by migraine without aura (MwA) tend to exhibit severe and persistent difficulties within cognitive processes such as attention, memory, and visual\u2013motor integration (VMI) skills. The aim of this study was to assess the visual\u2013spatial and visual\u2013motor abilities among a sample of children with MwA and the effects of a specific computerized training. The study population was composed of 84 patients affected by MwA (39 girls and 45 boys; mean age: 8.91\ub12.46 years), and they were randomly divided into two groups (group A and group B) comparable for age (P=0.581), gender (P=0.826), socioeconomic status (SES), migraine frequency (P=0.415), and intensity (P=0.323). At baseline (T0), the two groups were comparable for movement assessment battery for children (M-ABC) and VMI performances. After 6 months of treatment (T1), group A showed lower scores in the dexterity item of M-ABC test (P<0.001) and higher scores in M-ABC global performance centile (P<0.001) and total (P<0.001), visual (P=0.017), and motor (P<0.001) tasks of VMI test than group B. Moreover, at T1, group A showed higher scores in total (P<0.001) and motor (P<0.001) tasks of VMI test and in M-ABC global performance centile (P<0.001) and lower scores in the dexterity item of M-ABC test (P<0.001) than at T0. Group B showed, at T1, performances comparable to T0 for all evaluations. As reported by recent studies about alteration MwA among children in motor abilities, our study confirmed these difficulties and the efficacy of a specific software training, suggesting a new rehabilitative proposal in childhood

Is teicoplanin a complementary treatment option for COVID-19? The question remains

We read with great interest the editorial by Baron et al. suggesting the potential use of teicoplanin as an alternative drug to treat patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) [1]. Indeed, this glycopeptide antibiotic, commonly used to treat Gram-positive bacterial infections, also showed potential complementary antiviral activity against severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East respiratory syndrome coronavirus (MERS-CoV) and Ebola virus, as previously highlighted by Zhou et al.; moreover, influenza A and B viruses and feline infectious peritonitis virus (FIPV) were reported as potential targets of teicoplanin and its chemical derivatives [2], [1], [2], [3]. Recently, additional studies have provided evidence that SARS-CoV-2, similarly to SARS-CoV, is a cathepsin L-dependent virus: in fact, these viruses require a multistep infection process including (i) receptor binding, (ii) change in spike (S) glycoprotein conformation, and finally (iii) cathepsin L proteolysis of the S protein, crucial for virus entry. Teicoplanin was found to specifically inhibit the activity of cathepsin L and potentially to play a critical role in blocking cell entry of the virus [2,6,7]

Effectiveness and safety of Nintendo Wii Fit PlusTM training in children with migraine without aura: a preliminary study

Background: Migraine without aura (MoA) is a painful syndrome, particularly in childhood; it is often accompanied by severe impairments, including emotional dysfunction, absenteeism from school, and poor academic performance, as well as issues relating to poor cognitive function, sleep habits, and motor coordination. Materials and methods: The study population consisted of 71 patients affected by MoA (32 females, 39 males) (mean age: 9.13±1.94 years); the control group consisted of 93 normally developing children (44 females, 49 males) (mean age: 8.97±2.03 years) recruited in the Campania school region. The entire population underwent a clinical evaluation to assess total intelligence quotient level, visual-motor integration (VMI) skills, and motor coordination performance, the later using the Movement Assessment Battery for Children (M-ABC). Children underwent training using the Wii-balance board and Nintendo Wii Fit Plus™ software (Nintendo Co, Ltd, Kyoto, Japan); training lasted for 12 weeks and consisted of three 30-minute sessions per week at their home. Results: The two starting populations (MoA and controls) were not significantly different for age (P=0.899) and sex (P=0.611). M-ABC and VMI performances at baseline (T0) were significantly different in dexterity, balance, and total score for M-ABC (P,0.001) and visual (P=0.003) and motor (P,0.001) tasks for VMI. After 3 months of Wii training (T1), MoA children showed a significant improvement in M-ABC global performance (P,0.001), M-ABC dexterity (P,0.001), M-ABC balance (P,0.001), and VMI motor task (P,0.001). Conclusion: Our study reported the positive effects of the Nintendo Wii Fit PlusTM system as a rehabilitative device for the visuomotor and balance skills impairments among children affected by MoA, even if further research and longer follow-up are needed

Chronic spontaneous urticaria: a low-grade disseminated intravascular coagulation only partially reversed by Omalizumab

Chronic spontaneous urticaria (CSU) is a disorder characterized by wheals and/or angioedema. The coagulation cascade and inflammation pathways are closely linked together. The aim of our study was first to investigate the dynamics of clot formation in plasma (Clot Waveform Analysis, CWA) in a group of 47 patients with CSU along with other coagulative parameters dedicated to the study of hypercoagulability, such as D-Dimer, F 1 + 2 peptide, Fibrinogen, Platelet count and Mean Platelet Volume (MPV). Secondly, 23 out of 47 patients were treated with Omalizumab at four administration intervals from T0 to T4. A statistically significant increase in Activated Partial Thromboplastin (aPTT) ratio, D-Dimer, F1 + 2, Platelet count and MPV was found when compared with 53 healthy controls (HC). In contrast, the 2nd Derivative of aPTT showed lower values than those of the HC. No differences were found between 1st derivative of aPTT and Fibrinogen. D-Dimer only showed a significant difference between T0 and T3. An activation of both coagulation and fibrinolysis along with a weaker clot acceleration may be in agreement with a low-grade DIC. The accelerated turnover of platelets expressed by both an increase in platelet count and MPV further supports this pathway in CSU. Omalizumab does not affect the relationship between the immune and the hemostatic systems

Borderline intellectual functioning and parental stress: An italian case-control study

Introduction: Borderline intellectual functioning (BIF) children comprises a group of subjects whit intelligence quotient (IQ) ranging 71-85, with a prevalence about 13.6%. Several studies pinpointed the role of parenting on BIF management. Aim of present study was evaluating with objective and validated tool the parental stress rate in mothers of an Italian sample of BIF children. Materials and methods: 26 BIF children (20 males and 6 females) aged 6-10 years (mean age 10.36\ub1 2.03), according to DSM-5 criteria, and 53 (42 males and 11 females) typical developing children (mean age 10.58 \ub1 1.97) were recruited for present study. Mothers of all enrolled children underwent an evaluation with Parental Stress Index (PSI) test. Results: The two studied groups were comparable for age (p = 0.646) and gender (p = 0.956). Table 1 shows comparison between BIF and Control groups among PSI-SF scale results (Table 1), specifically mothers of BIF children have a significantly higher levels of global parental stress (p <0.001 ), stress related to parenting (p <0.001), stress linked to difficult child (p <0.001) and stress related to parent-child interaction (p <0.001) than mothers of control children. (Table 1) Conclusion: Several reports showed the key role of BIF as risk factor for psychiatric troubles and poor long-term adjustment. Our findings emphasize the need to approach this condition also from a family point of view, stressing that care should not be limited to child rehabilitative treatment but must also involve a family centered intervention

Animals-assisted therapy: A brief review

In rehabilitative setting, the presence of animals can be considered as an important stimulus for verbal and social communication, and for mood regulation. Interaction with an animal is beneficial for children's development and numerous psychological tests have revealed that growing up with pets has a beneficial effect on children's self-esteem and self-confidence, can improve empathy, a sense of responsibility and cognitive development, as well as social status within the peer group

Neuropsychomotricity in water: A new rehabilitative tool for neruodevelop-mental disorders

Neuropsychomotricity in water is a rehabilitative practice that avails itself just of the liquid element, as a mediator of relationships: in water yes they upset all dynamics, be they relational, of equilibrium, of movement and perception, due to the fact that proprioceptive sensations, created by bodily contact with water, they are different than those generated by contact with air

Safety of polymyxin-B-based hemoperfusion in kidney and liver transplant recipients.

Abstract Infection represents one of the primary barriers to successful organ transplantation. Our principal end point was to use a new assay, Entotoxin Activity Assay (EAA), which was developed to rapidly detect endotoxin activity (EA) for an early diagnosis of this complication. We also sought to prove the validity and safety of endotoxin removal using polymyxin-B–based hemoperfusion (PMX-DHP). The criterion for inclusion in the study was suspected infection when a patient experienced at least 2 of the 4 criteria of the systemic inflammatory response syndrome. EAA was performed on 71 patients: 29 liver transplantations and 42 kidney transplantations. Twenty-eight patients (39.5%) with EA >0.60 underwent PMX-DHP treatment to remove endotoxins. Each treatment was performed for 2 hours with a blood flow of 100 mL/min. All of the patients were treated with PMX-DHP until achieving an E