Seven years cognitive functioning and early assessment in extremely low birth weight children

Infants born preterm are at high risk for the onset of cognitive dysfunctions at school age. The aim of this study was to investigate the association between early neurodevelopmental assessment and the risk of adverse cognitive outcome in extremely low birth weight children. We enrolled all newborns (January 2002 - April 2007) consecutively admitted to our Institution, with a birthweight < 1000 g. Exclusion criteria were genetic abnormalities, severe neurofunctional impairment, and/or neurosensory disabilities. Ninety-nine children were assessed at 1 year of corrected age using the Griffiths Mental Development Scales Revised. The same children were re-assessed at school age through the Wechsler Intelligence Scale for Children. Children with impaired Griffiths General Quotient (i.e., < 1 SD) at 1 year of corrected age showed a significantly lower Full Scale Intelligence Quotient at 7 years of chronological age when compared to children who scored in the normal range at 1 year (p < 0.01). Considering the Griffiths Sub-quotients separately, a poor score in the Performance or in the Personal-Social Sub-quotients at 1 year was associated with significantly worse cognitive outcomes both in the Verbal and in the Performance Intelligence Quotients at 7 years (p < 0.01 and p < 0.05, respectively). A score < 1 SD in the Locomotor or in the Eye and Hand Coordination Sub-quotients were specifically associated with poorer Performance or Verbal Intelligence Quotients, respectively (p < 0.05). Our findings suggest that a poor score on the Griffiths Scales at 1 year is associated with a higher risk of cognitive impairment at school age. Larger confirmation studies are needed

Association between cholesterol gallstones and testosterone replacement therapy in a patient with primary hypogonadism

A 16-year-old boy had a past medical history of primary hypogonadism, due to bilateral anorchia. He presented with gallstones located in the gallbladder and a mild dilatation of the intrahepatic biliary tree. The histology study reported cholesterol gallstones. The patient had been treated with testosterone replacement therapy since infancy. We suggest a possible correlation between testosterone replacement therapy and the presence of cholesterol gallstones. Resumen: Tratamos a un niño de 16 años de edad con hipogonadismo primario debido a la anorquia bilateral, que presentó cálculos biliares en la vesícula biliar con una leve dilatación del árbol biliar intrahepático. La histología de los cálculos biliares confirmó la naturaleza de colesterol de los mismos. El niño fue tratado desde la infancia con terapia de reemplazo de testosterona. Sugerimos una posible correlación entre la terapia de reemplazo de testosterona y la presencia de cálculos biliares de colesterol. Keywords: Gallstones, Testosterone, Cholesterol, Primary hypogonadism, Therapy, Gallbladder, Palabras clave: Cálculos biliares, Testosterona, Colesterol, Hipogonadismo primario, Terapia, Vesícula bilia

Asociación de colelitiasis y terapia de reemplazo de testosterona en un paciente con hipogonadismo primario

Resumen: Tratamos a un niño de 16 años de edad con hipogonadismo primario debido a la anorquia bilateral, que presentó cálculos biliares en la vesícula biliar con una leve dilatación del árbol biliar intrahepático. La histología de los cálculos biliares confirmó la naturaleza de colesterol de los mismos. El niño fue tratado desde la infancia con terapia de reemplazo de testosterona. Sugerimos una posible correlación entre la terapia de reemplazo de testosterona y la presencia de cálculos biliares de colesterol. Abstract: A 16-year-old boy had a past medical history of primary hypogonadism, due to bilateral anorchia. He presented with gallstones located in the gallbladder and a mild dilatation of the intrahepatic biliary tree. The histology study reported cholesterol gallstones. The patient had been treated with testosterone replacement therapy since infancy. We suggest a possible correlation between testosterone replacement therapy and the presence of cholesterol gallstones. Palabras clave: Cálculos biliares, Testosterona, Colesterol, Hipogonadismo primario, Terapia, Vesícula biliar, Keywords: Gallstones, Testosterone, Cholesterol, Primary hypogonadism, Therapy, Gallbladde

Magnetic resonance imaging in central nervous system vasculitis in a patient affected by crioglobulin-negative hepatitis C virus infection: A likely correlation

A 56-year-old man with behavioural disorders and facial-brachio-crural right hemiparesis presented with a brain lesion studied with computed tomography, magnetic resonance imaging and brain biopsy, leading to the diagnosis of cerebral vasculitis. Hepatitis C virus (HCV) infection in a phase of activity, without cryoglobulins, was also detected. Brain biopsy, laboratory analysis and response to a specific therapy supported the diagnosis of central nervous system vasculitis that was HCV related

Neurodevelopmental Outcome and Adaptive Behavior in Preterm Multiples and Singletons at 1 and 2 Years of Corrected Age

Background: Recent literature has investigated the role of multiple birth on neurodevelopmental outcomes of premature infants, especially extremely preterm ones. Multiple gestations are often associated to increased neurodevelopmental disability. Actually, research findings are controversial. Objective: To compare the neurodevelopmental and behavioral outcomes of multiples and singletons in a cohort of preterm infants 6428 weeks gestational age at 1 and 2 years of corrected age. Methods: The study included 86 infants, born from January 2014 to September 2017 and enrolled in the follow-up program provided at authors\u2019 Institution. Exclusion criteria included: major brain lesions and malformations, severe neuro-sensorial deficits, genetic syndromes, single-twin survivors. Thirty four multiples were compared to 52 singletons, using the Griffiths Mental Development Scales and the Child Behavior Checklist 1\ubd\u20135. Statistical analysis was based on ANOVA techniques to test group differences. A p &lt; 0.05 was considered statistically significant. Results: The neurodevelopmental outcomes of multiples and singletons at 1 and 2 years of corrected age did not significantly differ at a general level (p &gt; 0.05). Multiples showed significantly lower mean scores than singletons at 1 year in Locomotor (87.15 \ub1 11.94 vs. 92.48 \ub1 11.59) and Personal-Social (84.88 \ub1 10.25 vs. 89.63 \ub1 8.19) subscales. Considering the behavioral outcomes, higher rates of externalizing problems were observed in multiples at 2 years (54.27 \ub1 9.64 vs. 49.31 \ub1 10.39). Conclusion: The slightly lower neurodevelopmental outcome showed by multiples, especially in the gross-motor and personal-social domains at 1 year, might be related to the specific environmental condition they experience. Multiple birth may affect mother\u2019s sensitivity to infant\u2019s needs and infant\u2019s acquisition of emotional and behavioral regulation. This affects the separation process and the acquisition of the independent walking and other gross-motor skills. Being multiples might also induce an hyperstimulation and this could explain their higher vulnerability to externalizing problems (impulsiveness, hyperactivity, attention deficits). Additionally, males are more affected by the multiple condition than females

Malignant Incidental Extracardiac Findings on Cardiac CT : Systematic Review and Meta-Analysis

OBJECTIVE. The objective of our study was to systematically review the evidence on incidental extracardiac findings on cardiac CT with a focus on previously unknown malignancies. MATERIALS AND METHODS. A systematic search was performed (PubMed, EMBASE, Cochrane databases) for studies reporting incidental extracardiac findings on cardiac CT. Among 1099 articles initially found, 15 studies met the inclusion criteria. The references of those articles were hand-searched and 14 additional studies were identified. After review of the full text, 10 articles were excluded. Nineteen studies including 15,877 patients (64% male) were analyzed. A three-level analysis was performed to determine the prevalence of patients with incidental extracardiac findings, the prevalence of patients with major incidental extracardiac findings, and the prevalence of patients with a proven cancer. Heterogeneity was explored for multiple variables. Pooled prevalence and 95% CI were calculated. RESULTS. The prevalence of both incidental extracardiac findings and major incidental extracardiac findings showed a high heterogeneity (I(2) > 95%): The pooled prevalence was 44% (95% CI, 35-54%) and 16% (95% CI, 14-20%), respectively. No significant explanatory variables were found for using or not using contrast material, the size of the FOV, and study design (I(2) > 85%). The pooled cancer prevalence for 10 studies including 5082 patients was 0.7% (95% CI, 0.5-1.0%), with an almost perfect homogeneity (I(2) < 0.1%). Of 29 reported malignancies, 21 (72%) were lung cancers; three, thyroid cancers; two, breast cancers; two, liver cancers; and one, mediastinal lymphoma. CONCLUSION. Although the prevalence of reported incidental extracardiac finding at cardiac CT was highly variable, a homogeneous prevalence of previously unknown malignancies was reported across the studies, for a pooled estimate of 0.7%; more than 70% of these previously unknown malignancies were lung cancers. Extracardiac findings on cardiac CT require careful evaluation and reporting

Bronchial artery hypertrophy is correlated with coronary artery disease

BACKGROUND: Bronchial arteries support the systemic pulmonary vasculature and physiologically communicate with pulmonary arteries and coronary arteries. While there is evidence supporting the link between pulmonary diseases and bronchial artery hypertrophy (BAH), few data on the correlation between coronary artery disease (CAD) and BAH have been published. PURPOSE: To evaluate a possible association between BAH and CAD in patients without known pulmonary diseases undergoing computed tomography coronary angiography (CTCA). MATERIAL AND METHODS: This retrospective study was approved by the local ethics committee. One hundred patients with varying degrees of CAD underwent CTCA. Patients were stratified into four groups as follows: group I, 25 patients without CAD or with non-significant CAD; group II, 25 untreated patients with significant CAD; group III, 25 stented patients; group IV, 25 patients with coronary artery bypass grafts. The number and diameter of bronchial arteries were recorded. Correlation between age, CAD, and BAH was estimated. RESULTS: One hundred and ninety-nine bronchial arteries were detected. Approximately 51% were hypertrophic (diameter, >1.5\u2009mm) with a mean diameter of 1.7\u2009\ub1\u20090.5\u2009mm. Seventy-six patients showed no pulmonary alterations; 24 were found to have previously undiagnosed pulmonary findings, six of which were severe. Presence and degree of CAD correlated with patients' mean age (60 in group I, 68 in group II, 65 in group III, 69 in group IV; P\u2009=\u20090.023), and mean bronchial artery transverse diameter (1.6\u2009mm, 1.7\u2009mm, 1.8\u2009mm, and 2.0\u2009mm, respectively; P\u2009=\u20090.009). The bronchial artery diameter was not associated with pulmonary findings (P\u2009=\u20090.390). CONCLUSION: There is an association between CAD and BAH. In patients with no pulmonary alterations, BAH could be caused by undiagnosed underlying CAD

Brain abnormalities in individuals with a desire for a healthy limb amputation: Somatosensory, motoric or both? a task-based fmri verdict

Body integrity dysphoria (BID), a long-lasting desire for the amputation of physically healthy limbs, is associated with reduced fMRI resting-state functional connectivity of somatosensory cortices. Here, we used fMRI to evaluate whether these findings could be replicated and expanded using a task-based paradigm. We measured brain activations during somatosensory stimulation and motor tasks for each of the four limbs in ten individuals with a life-long desire for the amputation of the left leg and fourteen controls. For the left leg, BID individuals had reduced brain activation in the right superior parietal lobule for somatosensory stimulation and in the right paracentral lobule for the motor task, areas where we previously found reduced resting-state functional connectivity. In addition, for somatosensory stimulation only, we found a robust reduction in activation of somatosensory areas SII bilaterally, mostly regardless of the stimulated body part. Areas SII were regions of convergent activations for signals from all four limbs in controls to a significantly greater extent than in subjects with BID. We conclude that BID is associated with altered integration of somatosensory and, to a lesser extent, motor signals, involving limb-specific cortical maps and brain regions where the first integration of body-related signals is achieved through convergence