A regional-based newborn hearing screening program: the Emilia-Romagna model after ten years of legislation.

Background: Hearing loss, occurring in 1-3/1,000 newborns in the well-babies population, is one of the most common congenital diseases, and hearing screening at birth still represents the only means for its early detection. Since 2011 the Emilia Romagna Regional Health Agency has recommended Newborn Hearing Screening for all babies at its birth points and for newborns moving to the region. The aims of this study are to analyze the results of this regional-based Newborn Hearing Screening program and to discuss the impact of the legislative endorsement on the organization. Material and methods: This is an observational retrospective chart study. The recordings of well-babies and babies at Neonatal Intensive Care Units were collected during the period from January 1st 2015 to December 31st 2020. The following data were included: Newborn Hearing Screening coverage, percentage of refer at otoacoustic emissions, prevalence and entity of hearing loss, unilateral/bilateral rate, presence of audiological risk factors. Results: More than 99% of a total of 198,396 newborns underwent the Newborn Hearing Screening test during the period January 1st 2015 to December 31st 2020, with a coverage ranging between 99.6% and 99.9%. Overall, the percentage of confirmed hearing loss cases was about 17-30 % of refer cases, 745 children received a diagnosis of hearing loss (prevalence 3.7/1,000). Considering profound hearing loss cases, these represent 13% of bilateral hearing loss. Conclusion: A regional-based Newborn Hearing Screening program is valuable and cost-effective. In our experience, the centralization of the data system and of the data control is crucial in order to implement its efficiency and effectiveness. Healthcare policies, tracking systems and public awareness are decisive for a successful programme implementation.

[Glycogenosis type II with early onset: peculiar features in a case report]. / Glicogenosi tipo II ad esordio precoce: aspetti peculiari di un caso clinico.

A case report of glycogenosis II with early infantile onset (type a) is presented and discussed. Some unusual features were observed. Pathological signs, involving the urinary tract, developed during the first days of life. Early instrumental evidence of myocardial disease and early onset of accompanying clinical signs were also seen. A further argument is proposed about guidelines for differential diagnosis of disease which can cause hypertrophic cardiomyopathy in infantile age.

[Biological and synthetic prostheses in gynecologic microsurgery]. / Le protesi biologiche e sintetiche in microchirurgia ginecologica.

Biological prostheses of human umbilical vein and synthetic prostheses of ePTFE were comparatively studied in the microsurgical anastomosis of the uterine horns in twenty rats. Patency rate after 30 days was 60% for umbilical vein and 75% for the ePTFE prostheses. Gross and histological examination of umbilical vein graft specimens showed minimal alteration with a smooth intimal surface. On the contrary tissue covering the inner surface from the adjacent ends of the uterine horns was noted in ePTFE prostheses.

[Experimental study of different techniques for partial resection of the ovary]. / Studio sperimentale di differenti tecniche di resezione parziale dell' ovaio.

The effects of leaving the ovarian cortex open after wedge resection were studied in a rabbit model. Twelve animals were operated: in one ovary the ovarian cortex was reattached with microsurgical sutures and in the contralateral it was left to heal by secondary intention. No significant differences were observed in adhesion formation and tissue reactivity between the two techniques. These data support the hypothesis that reattachment of the ovarian cortex is not necessary after conservative ovarian surgery and these findings could be useful in the laparoscopic treatment of benign ovarian pathology.

[Correlation between tryptophan, NEFA and albumins in the nephrotic syndrome]. / Studio delle correlazioni fra triptofano, NEFA e albumina nella sindrome nefrosica.

Many connections were considered between bound and free tryptophan and albumins, NEFA and other aminoacids in 18 proofs in ten subjects of paediatric age affected by nephrotic syndrome. A decrease of total tryptophan and a tendency to increase of free tryptophan were showed in our experience. NEFA, at normal concentrations, should not be responsible for this; and this could suggest that the binding sites on albumins for NEFA and tryptophan are different. Besides there is appearance of a positive correlation between albumins and bound tryptophan and a negative correlation between albumins and free tryptophan. These results can suggest that the reduction of the total tryptophan is due to the loss of the fractions bound to albumins, but urinary tryptophan is not increased in our studies. As the albumins get fewer, there is a lost in linked tryptophan and an increase of free tryptophan. A total reduction of other aromatic aminoacids can also explain, through a reduced intestinal absorption, the decrease of the tryptophan in the nephrotic syndrome.