Parents with binge eating disorders: Which are the influences on adult-child feeding interactions and on the child’s behavioral/emotional functioning?

Feeding during the first years of life represents one of the main domains of adult-child interactions and plays a crucial role in children’s later development. It has been suggested that some kinds of adult psychopathology are more likely to compromise early feeding exchanges. This is the case of parental Binge Eating Disorder (BED) which has resulted to be associated with poor parent–infant interactions during feeding and with children’s emotional and behavioral problems during infancy. The present study aimed to investigate, through a longitudinal research design, the influence of maternal and paternal BED diagnosis on parent–infant feeding interactions and on later children’s behavioral/emotional functioning. The study involved 408 families divided into four groups, according to the presence or absence of BED diagnosis in the parents: Group 1 included families with both parents diagnosed with BED, Group 2 and 3 included families with one parent diagnosed with BED, Group 0 was a healthy control. The assessment took place at two different points, when the children were respectively 18 (T1) and 36 months (T2). Feeding interactions were assessed through the Scale for the Assessment of Feeding Interactions (SVIA) while the children’s behavioral/emotional functioning was evaluated through the Child Behavior Check-List (CBCL). When compared to healthy controls, the groups with one or both parents diagnosed with BED showed higher scores on the SVIA and on the CBCL internalizing and externalizing scales, suggesting more difficulties in adult–child feeding interactions and in the children’s behavioral/emotional functioning. Maternal and paternal BED diagnosis resulted to have a direct effect on feeding interactions and an indirect effect on behavioral/emotional difficulties at 36 months, mediated by the quality of feeding exchanges, both at 18 and 36 months. Moreover the influence of maternal and paternal BED diagnosis resulted to assume a different weight over time. The presence of BED diagnosis in one or both parents appears to affect negatively the quality of adult–infant feeding exchanges and children’s behavioral/emotional functioning over time, thus affecting later child development. These results appear particularly important since they can help to understand more in depth the influence of parental BED diagnosis on child development and on family functioning

L'assorbimento del glucosio in dialisi peritoneale: strumenti utili per il team multidisciplinare

Dialysis patients are often affected by protein energy wasting and the maintenance of an optimal nutritional state is a difficult goal to achieve. Moreover protein energy wasting is one of the strongest risk factors for mortality in chronic dialysis patients. To estimate glucose absorption in peritoneal dialysis is essential to determine patient's dietary energy requirements and to prevent possible metabolic complications. The currently accepted methods of estimating glucose absorption are two. The first one is based on the average glucose absorption of continuous ambulatory peritoneal dialysis (CAPD) and is calculated with the Grodstein et al. formula. The second one is based on the Peritoneal equilibration test curves (D/D0 formula, Bodnar et al.) and takes into account transport characteristics. None of the two formulas perfectly calculated the absolute glucose absorption, even if the D/D0 is much closer to the true value, compared to Grodstein et al. formula. In this paper we described the multidisciplinary management experience of peritoneal dialysis patients, with a focus on the estimation of the patient's energy requirements. Analyzing glucose absorption in a systematic way and monitoring the changes in glucose absorption during the time could significantly contribute to adjusting nutritional treatment. However it is always necessary to critically evaluate the results obtained by both formulas

Renal transplant: gender differences

Renal transplantation represents the best treatment for end-stage kidney disease, leading to improved quality of life and life-expectancy for most of the patients. However, gender disparities are evident both in access and in outcomes of kidney transplantation. Women on dialysis are less likely to be on the waiting list for kidney transplantation and to receive an organ from a deceased donor or living donor. Several biological and sociocultural aspects could explain this disparity. On the contrary, more women than men are living kidney donors. Italian women are the first organ donors for living transplants in Europe. The gender difference in living donation is certainly affected by different comorbidities, but such a marked trend highlights a greater predisposition to donate of women, especially in the family context. Some differences are also found in kidney outcomes, even not fully understood. Our paper analyzes the main differences in different aspects of kidney transplantation related to gender, including nutritional aspects

Salute renale per tutti e ovunque: riflessioni al femminile sul tema centrale della Giornata Mondiale del Rene 2020

The goal of the World Kidney Day 2020 (WKD) is "the promotion of public health by ensuring universal, equitable and sustainable access to care, making access to health for all people and social categories equitable". Chronic Kidney Disease (CKD) is a complex and "demanding" health problem for patients and professionals, particularly in the more advanced stages of the disease. In addition to factors such as the so-called systemic conditions and risk factors, sex-related factors intervene in women, which can further complicate the CKD trend. For these reasons, one of the objectives of the World Kidney Day is that prevention and early treatment are included in the Universal Health Coverage (UHC) and that common strategies are implemented to promote awareness of this pathology. The woman has always played a central role in the "coordination" of family life and "taking care", a role transversal to the different ethnic groups, as evidenced also by the data relating to living kidney donation. This article gives a reflection on some issues related to prevention and treatment of CKD from a female perspective, such as what strategies to identify to implement prevention in the family starting from nutrition, such as the advice for the preparation of a diet plan respectful of the traditions of the country of origin, the identification and treatment of risk factors in order to implement strategies aimed at prevention dedicated to the female world and which style distinguishes the female approach to care | (Gender_nephrology

Telemedicina tra clinica e nutrizione nella Malattia Renale Cronica (MRC): appunti di esperienze al femminile

In Italy, starting from 2015, the date of publication of the guidelines on the 2014-2020 Digital Growth Strategy, technological evolution in medicine has provided encouraging results. The term telemedicine is now in common use, and it is also indicated at an encyclopedic level as "the set of technical and health care monitoring tools, created through systems designed to provide quick access to both medical specialists and patients, regardless of the place where they are respectively located". Nowadays, in the COVID era, the need for social distancing has highlighted the contribution of digital technology to healthcare in terms of access to care and healthcare spending. With regard to chronic kidney disease, telemedicine has always proved essential in improving patients' quality of life, as in the case of peritoneal dialysis. The remote management and monitoring of patients undergoing peritoneal dialysis has not only proved to radically change and improve patients' quality of life in replacement therapy, but has also reduced costs. There are some situations in which telemonitoring can guarantee the maintenance of an adequate quality of life for patients in the different stages of the disease. Thanks to the constant commitment of some groups of professionals where the largest part is represented by the "pink quota", it was possible to experiment and implement evaluation protocols for the renal patient in conservative and replacement treatment in some of the most central aspects of care: medical and dietary therapy

First-line systemic therapy for metastatic castration-sensitive prostate cancer: An updated systematic review with novel findings

Although both docetaxel and androgen-receptor-axis-targeted (ARAT) agents have yielded survival improvements in combination with androgen deprivation therapy (ADT) compared to ADT alone in metastatic castration-sensitive prostate cancer (mCSPC) patients, the optimal therapeutic choice remains to be established. We analyzed estimates of the hazard ratios for death (OS-HRs) in patients treated in the first-line setting enrolled in the GETUG-AFU15, CHAARTED, STAMPEDE, LATITUDE, ENZAMET, and TITAN trials. Overall, men with mCSPC receiving ADT with vs. without either an ARAT agent or docetaxel as first-line systemic therapy showed a pooled OS-HR of 0.69 (95 % CI: 0.61-0.78), with significant heterogeneity (p = 0.045, I2 = 52.5 %). Network meta-analysis showed an OS-HR in patients receiving an ARAT agent vs. docetaxel of 0.78 (95 %CI: 0.67-0.91). In conclusion, the evidence analysed indicates that an ARAT agent may provide improved OS outcomes compared to docetaxel. Prospective randomized trials are warranted

Protocol of the Italian Radical Cystectomy Registry (RIC): a non-randomized, 24-month, multicenter study comparing robotic-assisted, laparoscopic, and open surgery for radical cystectomy in bladder cancer

Bladder cancer is the ninth most common type of cancer worldwide. In the past, radical cystectomy via open surgery has been considered the gold-standard treatment for muscle invasive bladder cancer. However, in recent years there has been a progressive increase in the use of robot-assisted laparoscopic radical cystectomy. The aim of the current project is to investigate the surgical, oncological, and functional outcomes of patients with bladder cancer who undergo radical cystectomy comparing three different surgical techniques (robotic-assisted, laparoscopic, and open surgery). Pre-, peri- and post-operative factors will be examined, and participants will be followed for a period of up to 24\u2009months to identify risks of mortality, oncological outcomes, hospital readmission, sexual performance, and continence

Protocol of the Italian Radical Cystectomy Registry (RIC): a non-randomized, 24-month, multicenter study comparing robotic-assisted, laparoscopic, and open surgery for radical cystectomy in bladder cancer

Background: Bladder cancer is the ninth most common type of cancer worldwide. In the past, radical cystectomy via open surgery has been considered the gold-standard treatment for muscle invasive bladder cancer. However, in recent years there has been a progressive increase in the use of robot-assisted laparoscopic radical cystectomy. The aim of the current project is to investigate the surgical, oncological, and functional outcomes of patients with bladder cancer who undergo radical cystectomy comparing three different surgical techniques (robotic-assisted, laparoscopic, and open surgery). Pre-, peri- and post-operative factors will be examined, and participants will be followed for a period of up to 24 months to identify risks of mortality, oncological outcomes, hospital readmission, sexual performance, and continence. Methods: We describe a protocol for an observational, prospective, multicenter, cohort study to assess patients affected by bladder neoplasms undergoing radical cystectomy and urinary diversion. The Italian Radical Cystectomy Registry is an electronic registry to prospectively collect the data of patients undergoing radical cystectomy conducted with any technique (open, laparoscopic, robotic-assisted). Twenty-eight urology departments across Italy will provide data for the study, with the recruitment phase between 1st January 2017-31st October 2020. Information is collected from the patients at the moment of surgical intervention and during follow-up (3, 6, 12, and 24 months after radical cystectomy). Peri-operative variables include surgery time, type of urinary diversion, conversion to open surgery, bleeding, nerve sparing and lymphadenectomy. Follow-up data collection includes histological information (e.g., post-op staging, grading, and tumor histology), short- and long-term outcomes (e.g., mortality, post-op complications, hospital readmission, sexual potency, continence etc). Discussion: The current protocol aims to contribute additional data to the field concerning the short- and long-term outcomes of three different radical cystectomy surgical techniques for patients with bladder cancer, including open, laparoscopic, and robot-assisted. This is a comparative-effectiveness trial that takes into account a complex range of factors and decision making by both physicians and patients that affect their choice of surgical technique. Trial registration: ClinicalTrials.gov , NCT04228198 . Registered 14th January 2020- Retrospectively registered

Acute complications and mortality in hospitalized patients with coronavirus disease 2019: a systematic review and meta-analysis.

BACKGROUND The incidence of acute complications and mortality associated with COVID-19 remains poorly characterized. The aims of this systematic review and meta-analysis were to summarize the evidence on clinically relevant outcomes in hospitalized patients with COVID-19. METHODS MEDLINE, EMBASE, PubMed, and medRxiv were searched up to April 20, 2020, for studies including hospitalized symptomatic adult patients with laboratory-confirmed COVID-19. The primary outcomes were all-cause mortality and acute respiratory distress syndrome (ARDS). The secondary outcomes included acute cardiac or kidney injury, shock, coagulopathy, and venous thromboembolism. The main analysis was based on data from peer-reviewed studies. Summary estimates and the corresponding 95% prediction intervals (PIs) were obtained through meta-analyses. RESULTS A total of 44 peer-reviewed studies with 14,866 COVID-19 patients were included. In general, risk of bias was high. All-cause mortality was 10% overall (95% PI, 2 to 39%; 1687/14203 patients; 43 studies), 34% in patients admitted to intensive care units (95% PI, 8 to 76%; 659/2368 patients; 10 studies), 83% in patients requiring invasive ventilation (95% PI, 1 to 100%; 180/220 patients; 6 studies), and 75% in patients who developed ARDS (95% PI, 35 to 94%; 339/455 patients; 11 studies). On average, ARDS occurred in 14% of patients (95% PI, 2 to 59%; 999/6322 patients; 23 studies), acute cardiac injury in 15% (95% PI, 5 to 38%; 452/2389 patients; 10 studies), venous thromboembolism in 15% (95% PI, 0 to 100%; patients; 3 studies), acute kidney injury in 6% (95% PI, 1 to 41%; 318/4682 patients; 15 studies), coagulopathy in 6% (95% PI, 1 to 39%; 223/3370 patients; 9 studies), and shock in 3% (95% PI, 0 to 61%; 203/4309 patients; 13 studies). CONCLUSIONS Mortality was very high in critically ill patients based on very low-quality evidence due to striking heterogeneity and risk of bias. The incidence of clinically relevant outcomes was substantial, although reported by only one third of the studies suggesting considerable underreporting. TRIAL REGISTRATION PROSPERO registration ID for this study is CRD42020177243 ( https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=177243 )

Histone Post-Translational Modifications and CircRNAs in Mouse and Human Spermatozoa: Potential Epigenetic Marks to Assess Human Sperm Quality

Spermatozoa (SPZ) are motile cells, characterized by a cargo of epigenetic information including histone post-translational modifications (histone PTMs) and non-coding RNAs. Specific histone PTMs are present in developing germ cells, with a key role in spermatogenic events such as self-renewal and commitment of spermatogonia (SPG), meiotic recombination, nuclear condensation in spermatids (SPT). Nuclear condensation is related to chromatin remodeling events and requires a massive histone-to-protamine exchange. After this event a small percentage of chromatin is condensed by histones and SPZ contain nucleoprotamines and a small fraction of nucleohistone chromatin carrying a landascape of histone PTMs. Circular RNAs (circRNAs), a new class of non-coding RNAs, characterized by a nonlinear back-spliced junction, able to play as microRNA (miRNA) sponges, protein scaffolds and translation templates, have been recently characterized in both human and mouse SPZ. Since their abundance in eukaryote tissues, it is challenging to deepen their biological function, especially in the field of reproduction. Here we review the critical role of histone PTMs in male germ cells and the profile of circRNAs in mouse and human SPZ. Furthermore, we discuss their suggested role as novel epigenetic biomarkers to assess sperm quality and improve artificial insemination procedure