"VALUTAZIONE DELLO STATO VITAMINICO E DEI FATTORI DI RISCHIO ASSOCIATI A IPOVITAMINOSI D IN UNA POPOLAZIONE MULTIETNICA DI MADRI E LORO NEONATI"

Obiettivo Determinare la prevalenza di ipovitaminosi D in donne in gravidanza e nei loro neonati e esaminare i fattori associati alla carenza di vitamina D. Metodi - Somministrazione di un questionario a donne sane in gravidanza a termine per rilevare dati socio-demografici, abitudini culturali e alimentari, fototipo cutaneo. - Assegnazione coppia madre-bambino a due gruppi: un gruppo a rischio (gruppo di studio) di donne in gravidanza con la pelle nera o che non espongono la loro pelle alla luce solare (n = 93) e un gruppo di controllo di donne in gravidanza senza fattori di rischio noti (n = 92) - Determinazione di calcio, fosforo, fosfatasi alcalina, fosfatasi alcalina ossea, vitamina D e livelli di ormone paratiroideo su campione di sangue venoso sangue di cordone ombelicale e materno. Risultati Livelli di vitamina D erano significativamente più bassi nelle donne del gruppo di studio rispetto al gruppo di controllo: 33,0 ng / ml vs 58,9 ng / ml (p <0,001). Il 29% delle donne in gravidanza a rischio aveva valori <20ng/ml, il 25% aveva un valore di 20-30ng/ml e solo il 46% aveva livelli sopra 30ng/ml. I livelli di PTH erano nettamente superiore nel gruppo di rischio rispetto al gruppo di controllo: 48,4 vs 33,0 (p <0.001). La concentrazione di 25OH-VitD3 era significativamente più bassa tra i bambini nel gruppo di studio rispetto al gruppo di controllo: 29.0 ng / ml vs 44.0 ng / ml (p <0.001). 46% dei bambini del gruppo a rischio aveva valori inferiori a 20ng/ml e solo il 38% aveva valori di protezione. 20 dei 27 neonati di madri con ipovitaminosi D del gruppo a rischio presentavano valori di vitamina D <20ng/ml, dimostrando una forte correlazione tra i livelli materni di VITD e quelli trovati nel sangue del cordone ombelicale. Conclusioni I nostri dati confermano che le donne con la pelle scura e di quelli che non si espongono al sole hanno livelli di vitamina D inferiori e loro bambini sono ad alto rischio di ipovitaminosi D. Una supplementazione con adeguate quantità di vitamina D durante la gravidanza è necessaria per prevenire la carenza di vitamina D neonatale. Secondo le linee guida di Endocrine Society, il fabbisogno consigliato di vitamina D per le donne in gravidanza è di 1400 UI al giorno. Allo stesso tempo è importante sottolineare l'utilità della somministrazione di vitamina D per tutti i bambini fin dai primi giorni di vita. L'apporto minimo consigliato è di 400 UI al giorno per il primo anno

Energy Production Analysis and Optimization of Mini-Grid in Remote Areas: The Case Study of Habaswein, Kenya

Rural electrification in remote areas of developing countries has several challenges which hinder energy access to the population. For instance, the extension of the national grid to provide electricity in these areas is largely not viable. The Kenyan Government has put a target to achieve universal energy access by the year 2020. To realize this objective, the focus of the program is being shifted to establishing off-grid power stations in rural areas. Among rural areas to be electrified is Habaswein, which is a settlement in Kenya’s northeastern region without connection to the national power grid, and where Kenya Power installed a stand-alone hybrid mini-grid. Based on field observations, power generation data analysis, evaluation of the potential energy resources and simulations, this research intends to evaluate the performance of the Habaswein mini-grid and optimize the existing hybrid generation system to enhance its reliability and reduce the operation costs. The result will be a suggestion of how Kenyan rural areas could be sustainably electrified by using renewable energy based off-grid power stations. It will contribute to bridge the current research gap in this area, and it will be a vital tool to researchers, implementers and the policy makers in energy sector

Secondary prevention of early-onset sepsis: A less invasive Italian approach for managing neonates at risk

Strategies to prevent early-onset sepsis (EOS) have led to a substantial decline in many countries. However, one of the most controversial topics in neonatology is the management of asymptomatic full-term and late preterm neonates at risk for EOS, and guidelines lack substantial consensus regarding this issue. A strategy for managing neonates, entirely based on serial physical examinations, has been developed in two Italian regions. This strategy seems safe, while reducing laboratory tests and unnecessary antibiotics. In the current commentary we provide area-based data concerning the prevention of EOS in 2 northern Italian regions, and we detail the results of their strategy for managing healthy-appearing newborns at risk for EOS

Secondary prevention of early-onset sepsis: A less invasive Italian approach for managing neonates at risk

Strategies to prevent early-onset sepsis (EOS) have led to a substantial decline in many countries. However, one of the most controversial topics in neonatology is the management of asymptomatic full-term and late preterm neonates at risk for EOS, and guidelines lack substantial consensus regarding this issue. A strategy for managing neonates, entirely based on serial physical examinations, has been developed in two Italian regions. This strategy seems safe, while reducing laboratory tests and unnecessary antibiotics. In the current commentary we provide area-based data concerning the prevention of EOS in 2 northern Italian regions, and we detail the results of their strategy for managing healthy-appearing newborns at risk for EOS

Relationship between Breast Cancer Surgical Treatment and Psychiatric Symptomatology: Which Sociodemographic and Clinical Factors Could Influence It? A Preliminary Study

This study aimed to investigate psychiatric symptomatology in a sample of patients affected by breast cancer undergoing surgery, evaluating the potential mediators on perceived stress levels, depression and hopelessness. The study was conducted on eighty-five patients with breast cancer, admitted consecutively to the Breast Unit of the IRCCS Ospedale Policlinico San Martino, between May 2018 and December 2019. Sociodemographic (age of diagnosis, gender, marital and occupational status, educational level, having children) and clinical (type and side of surgery, previous breast surgery, neoadjuvant chemotherapy and axillary dissection) characteristics were investigated through a semi-structured interview. The following rating scales were administered: Beck Depression Inventory, Beck Hopelessness Scale, and Perceived Stress Scale. Our findings indicate that the presence of children and of a partner was associated with a lower total score on the clinical dimensions evaluated. Furthermore, we found demolitive surgery to be a mediator between perceived stress and hopelessness, while history of previous breast surgery was found to be a mediator between demolitive surgery and perceived stress. In conclusion, patients affected by breast cancer undergoing more complex and demolitive surgery or with history of previous breast surgery should be mostly monitored from a psychological and psychiatric point of view from the beginning of treatments to evaluate the first manifestations of psychiatric symptomatology

Energy production analysis and optimization of Mini-Grid in remote areas: the case study of Habaswein, Kenya

Rural electrification in remote areas of developing countries has several challenges which hinder energy access to the population. For instance, the extension of the national grid to provide electricity in these areas is largely not viable. The Kenyan Government has put a target to achieve universal energy access by the year 2020. To realize this objective, the focus of the program is being shifted to establishing off-grid power stations in rural areas. Among rural areas to be electrified is Habaswein, which is a settlement in Kenya’s northeastern region without connection to the national power grid, and where Kenya Power installed a stand-alone hybrid mini-grid. Based on field observations, power generation data analysis, evaluation of the potential energy resources and simulations, this research intends to evaluate the performance of the Habaswein mini-grid and optimize the existing hybrid generation system to enhance its reliability and reduce the operation costs. The result will be a suggestion of how Kenyan rural areas could be sustainably electrified by using renewable energy based off-grid power stations. It will contribute to bridge the current research gap in this area, and it will be a vital tool to researchers, implementers and the policy makers in energy sector

Skeletal turnover, bone mineral density, and fractures in male chronic abusers of alcohol

Background: Chronic alcohol abuse is a risk factor for osteoporosis and fractures, whose pathogenesis is still unclear. We investigated the influence of alcoholism and other risk factors on calcium and skeletal metabolism, bone mineral density (BMD), and fractures. Materials and methods: In 51 chronic male alcoholics without liver failure and 31 healthy controls, serum total and ionised calcium, phosphate, creatinine, 25-hydroxy vitamin D (25OHD), PTH, total (ALP) and bone-specific (BALP) alkaline phosphatase, osteocalcin (BGP), carboxy-terminal telopepticle of type I collagen (beta-CTx), osteoprotegerin (OPG) and receptor activator of nuclear factor kappa B ligand (RANKL) were assessed. In patients only, we also measured serum testosterone, 17-beta estradiol, LH, and IGF-I. BMD was measured by dual energy x-ray absorptiometry at lumbar spine (LS-) and femur [neck (FN-) and total hip (TF-)]. Vertebral fractures were identified by a semiquantitative method on thoraco-lumbar spine x- ray, non-vertebral fractures (as life-style factors) by history. Results: Alcoholics were leaner, had significantly higher ALP and BALP, and lower BGP and 25OHD levels than controls. No significant difference in other calcium and bone metabolism parameters was found. OPG/RANKL ratio was significantly higher in alcoholics. Beta-CTx negatively correlated with abuse duration. OPG positively correlated with daily alcohol assumption and with indexes of liver cytolysis. Though LS-, FN- and TF-BMD of alcoholics and controls did not significantly differ, patients had a much higher prevalence of vertebral fractures. The same was found considering both vertebral and non-vertebral fractures. Conclusions: Ethanol-induced skeletal damage seems mainly dependent on negative effects on bone formation. Lifestyle factors and traumas likely contribute to the high fracture incidence of alcohol abusers, independently of BMD

Spreadsheet_1 – Supplemental material for Mid-term outcome after arthroscopic treatment of femoroacetabular impingement: development of a predictive score

<p>Supplemental material, Spreadsheet_1 for Mid-term outcome after arthroscopic treatment of femoroacetabular impingement: development of a predictive score by Luca Pierannunzii, Paolo Di Benedetto, Christian Carulli, Gennaro Fiorentino, Daniele Munegato, Manlio Panascì, Domenico Potestio, Filippo Randelli, Federico Della Rocca, Valentina Rosolen, Manuela Giangreco and Nicola Santori in HIP International</p