Congenital lung malformations: a nationwide survey on management aspects by the Italian Society of Pediatric Surgery.

INTRODUCTION: Over the years, congenital lung malformations (CLM) management remains a controversial topic in pediatric thoracic surgery. The Italian Society of Pediatric Surgery performed a national survey to study the current management variability among centers, trying to define national guidelines and a standardized approach of children with congenital lung malformations. METHODS: Following a National Society approval, an electronic survey including 35 items on post-natal management was designed, focusing on surgical, anesthesiology, radiology and pneumology aspects. The survey was conducted contacting all pediatric surgical units performing thoracic surgery. RESULTS: 39 pediatric surgery units (97.5%) participated in the study. 13 centers (33.3%) were classified as high-volume (Group A), while 26 centers (66.7%) were low volume (Group B). Variances in diagnostic imaging protocols were observed, with Group A performing fewer CT scans compared to Group B (p = 0.012). Surgical indications favored operative approaches for asymptomatic CLM and pulmonary sequestrations in both groups, while a wait-and-see approach was common for congenital lobar emphysema. Surgical timing for asymptomatic CLM differed significantly, with most high-volume centers operating on patients younger than 12 months (p = 0.02). Thoracoscopy was the preferred approach for asymptomatic CLM in most of centers, while postoperative long-term follow-up was not performed in most of the centers. CONCLUSION: Thoracoscopic approach seems uniform in asymptomatic CLM patients and variable in symptomatic children. Lack of uniformity in surgical timing and preoperative imaging assessment has been identified as key areas to establish a common national pattern of care for CLM.

Proteome Changes in Stem Tissues of Sunflower Lines Inoculated with Culture Filtrate of Sclerotinia sclerotiorum.

BACKGROUND: Sclerotinia sclerotiorum (Lib.) de Bary cause a deleterious disease on sunflower plants. Oxalic acid is the main pathogenicity factor of S. sclerotiorum. Two dimensional gel electrophoresis and mass spectrometry have been used in several studies to investigate molecular changes that occur in the plants in response to S. sclerotiorum infection. Comparing responses of resistant and susceptible lines upon pathogen infection provided novel information regarding defense mechanisms against this necrotrophic pathogen. OBJECTIVES: The present study reports proteome changes of partially resistant and susceptible sunflower lines under pathogen's culture filtrate treatment, resulting in the characterization of up- and down- regulated proteins. MATERIAL AND METHODS: Sunflower partially resistant and susceptible lines with two true leaves were exposed to fungus culture filtrate. The stems of treated and untreated plants were sampled at 24, 48 and 72 hours after treatment for two-dimensional electrophoresis. Twenty spots showed more than 1.5-fold change in abundance were subjected to MALDI/TOF-TOF MS for further analysis. RESULTS: The identified proteins were categorized into several classes including carbohydrate and energy metabolism (25%), cellular metabolic process (15%), stress response (15%), plant cell wall biogenesis (10%), photosynthesis (10%), protein metabolism (10%), unknown function (10%) and redox homeostasis (5%). CONCLUSIONS: Our proteomic investigation demonstrates an increase in the expression of proteins only in partially resistant line, such as proteins involved in carbohydrate metabolism and plant defense responses (malate dehydrogenase and peroxidase), metabolic process (adenosine kinase), regulating cell redox homeostasis (disulfide isomerase) and lignin biosynthetic process (laccase). Moreover, the expression of pyrroline-5-carboxylate reductase, involved in proline biosynthesis, was significantly changed in both sunflower lines in response to pathogen culture filtrate. Proteins which were only up-regulated in the partially resistant lines might have a significant role in mediating the defense against Sclerotinia and could be considered for enhancing resistance against this devastating pathogen.

Idiopathic neonatal hemoperitoneum presented as scrotal hematoma: it's a diagnostic challenge?

BACKGROUND: Idiopathic hemoperitoneum in the newborn is an entity very rarely encountered in clinical practice. CASE PRESENTATION: A case of scrotal hemorrhage (SH) associated with intrabdominal hemorrhaging and acute anemia is presented. Indications for early surgery included a massive scrotal hematoma, rapid onset of severe anemia, and unknown etiology. CONCLUSION: Clinical and diagnostic approaches in a case of neonatal scrotal hematoma should be given careful consideration as abdominal in origin, and a pre-operative computed tomography (CT) scan or magnetic resonance image (MRI) in addition to an abdominal/scrotal ultrasound should be added as part of the diagnostic work-up.

A Rare Case of Mesenteric Chylous Cyst in Infant: Case Report and Review of Literature.

The occurrence of a mesenteric cyst (MC) is common in adults while in children and in infants is rare. In adults mesenteric cysts are often asymptomatic and discovered incidentally; however, in children they commonly present with symptoms of abdominal pain or distension with fever and leucocytosis. We report on a rare case, in our experience, of Mesenteric Chylous cyst (MCC) in an infant with signs and symptoms of intestinal obstruction. Discussion of literature is also reported.

Sunflower (Helianthus annuus L.) Seed Hull Waste: Composition, Antioxidant Activity, and Filler Performance in Pectin-Based Film Composites.

Helianthus annuus L. seed hull is an abundant waste of the edible oil industry. To envisage potential applications of this waste, here, we aimed to analyze the chemical composition of milled sunflower hulls (SP), constituted mainly by 210 µm (51.4%) and 420 µm (27.6%) average mesh particle sizes. SP contained almost 30% of cellulose, 26.4% of lignin, 38.5% of neutral sugars, mainly hemicelluloses, and only 1.3% of proteins. The important lignin content and low pectin content (4.0% of uronic acids) present in SP were both ascribed to its low hydrophilic behavior and hydration capacity. Phenolic compounds were mostly proanthocyanidins (168 mg/100 g SP), with lower amounts of extractable (31.4 mg/100 g SP) phenolics (O-caffeoylquinic acid), all of them associated with the DPPH radical scavenging capacity (95 mg ascorbic acid equiv./100 g) and ferric reducing power (FRAP: 152 mg ascorbic acid equiv./100 g) shown by SP. Esterified ferulic acid (52.9 mg/100 g SP) was also found, mostly as monomers and trimers. SP of 53 µm particle size was then assayed as a filler (0, 5, 8, and 12% concentrations) in calcium low methoxyl pectin-based films, which showed antioxidant capacity (DPPH and FRAP assays) in an SP-concentration-dependent manner. SP showed homogeneous dispersion in composite films equilibrated at 57.7% relative humidity. Water content decreased while film thickness increased with SP concentration. When loaded at a 12% level, the presence of 53-µm SP decreased the water vapor permeability and increased the normal stress at film fracture. Sunflower hulls can then be applied to the development of active materials like 12% SP film, which can be proposed as a food slice antioxidant separator to be investigated in a future work.

Bedside surgery in the newborn infants: survey of the Italian society of pediatric surgery.

INTRODUCTION: This is the report of the first official survey from the Italian Society of Pediatric Surgery (ISPS) to appraise the distribution and organization of bedside surgery in the neonatal intensive care units (NICU) in Italy. METHODS: A questionnaire requesting general data, staff data and workload data of the centers was developed and sent by means of an online cloud-based software instrument to all Italian pediatric surgery Units. RESULTS: The survey was answered by 34 (65%) out of 52 centers. NICU bedside surgery is reported in 81.8% of the pediatric surgery centers. A lower prevalence of bedside surgical practice in the NICU was reported for Southern Italy and the islands than for Northern Italy and Central Italy (Southern

Iron allocation in leaves of Fe-deficient cucumber plants fed with natural Fe complexes.

Iron (Fe) sources available for plants in the rhizospheric solution are mainly a mixture of complexes between Fe and organic ligands, including phytosiderophores (PS) and water-extractable humic substances (WEHS). In comparison with the other Fe sources, Fe-WEHS are more efficiently used by plants, and experimental evidences show that Fe translocation contributes to this better response. On the other hand, very little is known on the mechanisms involved in Fe allocation in leaves. In this work, physiological and molecular processes involved in Fe distribution in leaves of Fe-deficient Cucumis sativus supplied with Fe-PS or Fe-WEHS up to 5 days were studied combining different techniques, such as radiochemical experiments, synchrotron micro X-ray fluorescence, real-time reverse transcription polymerase chain reaction and in situ hybridization. In Fe-WEHS-fed plants, Fe was rapidly (1 day) allocated into the leaf veins, and after 5 days, Fe was completely transferred into interveinal cells; moreover, the amount of accumulated Fe was much higher than with Fe-PS. This redistribution in Fe-WEHS plants was associated with an upregulation of genes encoding a ferric(III) -chelate reductase (FRO), a Fe(2+) transporter (IRT1) and a natural resistance-associated macrophage protein (NRAMP). The localization of FRO and IRT1 transcripts next to the midveins, beside that of NRAMP in the interveinal area, may suggest a rapid and efficient response induced by the presence of Fe-WEHS in the extra-radical solution for the allocation in leaves of high amounts of Fe. In conclusion, Fe is more efficiently used when chelated to WEHS than PS and seems to involve Fe distribution and gene regulation of Fe acquisition mechanisms operating in leaves.