Psychological Impact of a Prenatal Diagnosis of Congenital Heart Disease on Parents: Is It Time for Tailored Psychological Support?

The prenatal diagnosis of congenital heart disease (CHD) represents, for both parents, a particularly stressful and traumatic life event from a psychological point of view. The present review sought to summarize the findings of the most relevant literature on the psychological impact of prenatal diagnosis of CHD on parents, describing the most common mechanisms employed in order to face this unexpected finding. We also highlight the importance of counseling and the current gaps in the effects of psychological support on this population.

A rare case of pediatric cardiomyopathy: Alström syndrome identified by gene panel analysis.

Genetic investigation of early-onset Dilatative cardiomyopathy phenotype, including molecular autopsy, is the key to appropriate recognition and management of rare etiologies and atypical presentations and to offer genetic counseling to the family.

Integrated management of ash from industrial and domestic combustion: a new sustainable approach for reducing greenhouse gas emissions from energy conversion.

This work supports, for the first time, the integrated management of waste materials arising from industrial processes (fly ash from municipal solid waste incineration and coal fly ash), agriculture (rice husk ash), and domestic activities (ash from wood biomass burning in domestic stoves). The main novelty of the paper is the reuse of wood pellet ash, an underestimated environmental problem, by the application of a new technology (COSMOS-RICE) that already involves the reuse of fly ashes from industrial and agricultural origins. The reaction mechanism involves carbonation: this occurs at room temperature and promotes permanent carbon dioxide sequestration. The obtained samples were characterized using XRD and TGA (coupled with mass spectroscopy). This allowed quantification of the mass loss attributed to different calcium carbonate phases. In particular, samples stabilized using wood pellet ash show a weight loss, attributed to the decomposition of carbonates greater than 20%. In view of these results, it is possible to conclude that there are several environmental benefits from wood pellet ash reuse in this way. In particular, using this technology, it is shown that for wood pellet biomass the carbon dioxide conversion can be considered negative.

Evaluation of the Biotoxicity of Tree Wood Ashes in Zebrafish Embryos.

Ashes derived from biomass combustion and used as soil fertilizers can generate negative environmental and human health risks, related to leaching of heavy metals and other putative toxic elements. Tree wood ash composition may vary depending on geographical location and surrounding industrial processes. In this study, we evaluated the biotoxicity of lixiviated tree wood ash samples from trees of the Ash (Fraxinus), Cherry (Pronus), Hazel (Corylus), and Black locust (Robinia) genus collected in an industrialized region in Northern Italy. Elemental chemical analysis of the samples was performed by total reflection X-ray fluorescence technique and their biotoxicity was assessed in zebrafish (Danio rerio) embryos. Ashes from Ash, Cherry, and Hazel trees, but not Black locust trees, had a high concentration of heavy metals and other putative toxic elements. Accordingly, a dose-dependent increase in mortality rate and morphological and teratogenic defects was observed in zebrafish embryos treated with lixiviated Ash, Cherry, and Hazel tree wood samples, whereas the toxicity of Black locust tree wood ashes was negligible. In conclusion, lixiviated wood ashes from different plants show a different content of toxic elements that correlate with their biotoxic effects on zebrafish embryos. Tree wood ashes derived from biomass combustion may represent a potential risk for the environment and human health.

Safety of MF-59 adjuvanted vaccine for pandemic influenza: results of the vaccination campaign in an Italian health district.

BACKGROUND: The occurrence of pandemic H1N1 influenza in 2009 led health authorities to promptly start massive vaccination campaigns. Due to the need of shortening time for development and approval, the pandemic vaccine was prepared by mock-up strategy, and limited safety data were available upon starting vaccine administration. AIMS: To determine the frequencies and clinical features of adverse events (AEs) observed in a population of subjects of an Italian health district receiving pandemic vaccination. The risk for the development of at least one AE was calculated for patients receiving H1N1 vaccine only or H1N1+seasonal vaccine. METHODS: This prospective observational study was performed on the population of La Spezia Health District scheduled to receive pandemic MF-59-adjuvanted H1N1 vaccine. Subjects were enrolled at the time of vaccine administration and followed up at least for 6 months. The study population was stratified in two subgroups defined by administration of H1N1 vaccine only or H1N1+seasonal vaccine. AEs were recorded during the first hour following vaccine administration (early AEs) and through periodic telephonic interviews (delayed AEs). RESULTS: An overall number of 506 subjects receiving pandemic vaccine were enrolled (H1N1 only: 131 subjects; H1N1+seasonal: 375 subjects). 233 AEs occurred throughout the study period. Among them, 211 were resolved, while 22 were ongoing at the last available follow-up. Adjusted incidence rate ratio (IRR) for the development of at least one AE was 1.14 (0.77-1.69) for H1N1 only group vs H1N1+seasonal group. Patients with a nervous system AE were more frequent in the H1N1+seasonal group (adjusted IRR: 2.33; 95%CI: 1.04-5.23). Only two cases of ischemic stroke, both in the H1N1+seasonal vaccine group, occurred in patients with cardiovascular risk factors, were classified as serious AEs. CONCLUSIONS: In the present study, the MF59-adjuvanted H1N1 vaccine was generally well tolerated. AEs were usually transient and mild to moderate in intensity. Our findings support the validity of mock-up strategy for rapid development of a safe vaccine in the emergency of a pandemic influenza.