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.

Brain positron emission tomography (PET) in chronic fatigue syndrome: preliminary data.

Chronic fatigue syndrome (CFS) has been widely studied by neuroimaging techniques in recent years with conflicting results. In particular, using single-photon emission computed tomography (SPECT) and perfusion tracers, hypoperfusion has been found in several brain regions, although the findings vary across research centers. The objective of this study was to investigate brain metabolism of patients affected by CFS, using [18F]fluorine-deoxyglucose (18FDG) positron emission tomography (PET). We performed 18FDG PET in 18 patients who fulfilled the criteria of the working case definition of CFS. Twelve of the 18 patients were females; the mean age was 34 +/- 15 years (range, 15-68) and the median time from CFS diagnosis was 16 months (range, 9-138). Psychiatric diseases and anxiety/neurosis were excluded in all CFS patients. CFS patients were compared with a group of 6 patients affected by depression (according to DSM IV-R) and 6 age-matched healthy controls. The CFS patients were not taking any medication at the time of PET, and depressed patients were drug-free for at least 1 week before the PET examination. The PET images examined 22 cortical and subcortical areas. CFS patients showed a significant hypometabolism in right mediofrontal cortex (P = 0.010) and brainstem (P = 0.013) in comparison with the healthy controls. Moreover, comparing patients affected by CFS and depression, the latter group showed a significant and severe hypometabolism of the medial and upper frontal regions bilaterally (P = 0.037-0.001), whereas the metabolism of brain stem was normal. Brain 18FDG PET showed specific metabolism abnormalities in patients with CFS in comparison with both healthy controls and depressed patients. The most relevant result of our study is the brain stem hypometabolism which, as reported in a perfusion SPECT study, seems to be a marker for the in vivo diagnosis of CFS.

The course of depression in elderly outpatients.

Sixty-four elderly outpatients diagnosed according to the criteria of DSM-III as having affective disorders were submitted to follow-up study for 6-24 months (mean 15 months). Twenty patients (31%) were in good health throughout follow-up, fourty-four patients (69%) remained more or less chronically ill. The prognosis was better in patients diagnosed as having "adjustment disorder with depressed mood" and "dysthymic disorder"; when onset was late, and when there were no signs of organic brain C.N.S. damage.

Inhibitory effect of imipramine on epinephrine-dependent platelet aggregation: "in vitro" studies on platelets from healthy and depressed people.

Inhibitory effect of imipramine on platelet aggregation in healthy and depressed people was studied. A different sensitivity was observed between healthy and depressed people. Two groups (D I and D II) were identified among depressed patients on the basis of sensitivity to imipramine effect. ID50 was calculated for healthy subjects (59.5 +/- 22 microM) and depressed patients (D I: 20 +/- 7 microM - D II: 117 +/- 49).

Depressive equivalents: a clarification using the Rorschach test.

The authors present a study on 20 patients of uncertain diagnostic placement admitted to a neurological department. The patients are characterized by an atypical clinical neurological symptomatology and the absence of organic pathology. Through psychiatric examination and the Rorschach tests, which show some characteristics and constant aspects, the authors arrive at the diagnosis of depressive equivalents. It is emphasized that the Rorschach test offers a useful contribution to the often difficult diagnosis of these clinical pictures.