Patients undergoing double J substitution with a pigtail suture stent report a significant decrease of stent-related symptoms. Results from a prospective multicenter longitudinal trial.

PURPOSE: To compare stent-related symptoms (SRS) in patients with double J (DJ) undergoing substitution with a pigtail suture stent (PSS) after ureteroscopy (URS), through the Ureteral Stent Symptom Questionnaire (USSQ). MATERIALS AND METHODS: Patients with DJ undergoing URS for stone treatment were enrolled in this prospective multicenter longitudinal study. The USSQ was submitted thrice: 2 weeks after DJ, 2 weeks after PSS and 4 weeks after PSS removal (baseline). PRIMARY ENDPOINT: to compare Urinary Symptom Index Score and the rate of patients with pain 2 weeks after DJ and PSS. Secondary endpoints: to compare other USSQ scores and single answers 2 weeks after DJ and PSS, and DJ and PSS USSQ scores with baseline. RESULTS: 93 patients were enrolled. 2 weeks Urinary Symptom Index Score (p < 0.001) and the percentage of patients complaining of pain (60.2% vs 88.2%, p < 0.001) were significantly in favour of PSS compared to DJ. 2 weeks scores were significantly improved with PSS compared to DJ: Pain Index (p < 0.001), VAS (p < 0.001), General Health Index (p < 0.001) and Work Performance Index (p < 0.001). All urinary symptoms were significantly decreased with PSS, including renal pain during micturition and pain interfering with life. Pain Index Score (p = 0.622) and VAS (p = 0.169) were comparable to baseline with PSS, while differed with DJ. CONCLUSIONS: Patients undergoing DJ substitution with PSS after URS report a significant decrease of SRS. Urologists may consider positioning PSS after URS in pre-stented patients to reduce the impact of SRS.

First COVID-19 sub-intensive respiratory unit in Europe: the Italian experience.

European SARS-CoV-2 pandemic epicenter was detected in Northern Italy, in a little Italian town of Lodi province, the Lodi Hospital was therefore rapidly saturated, and in particularly the departments of respiratory diseases and Intensive Care Unit had been largely involved. In this paper, we describe how the first Sub-intensive Respiratory Unit in Europe completely dedicated to COVID-19 patients was organized and managed in our hospital. From February 25th to April 30th 2020, 156 patients were admitted to our Respiratory Sub-intensive Unit. Among them, 100 were discharged, 28 dead and 28 transferred to ICU for intubation.

Executive function outcome in preterm adolescents.

Preterm birth (PT) and low birthweight (LBW) are risk factors for cognitive, academic, and behavioral difficulties. Executive functioning, which is an umbrella term encompassing higher-order problem-solving and goal-oriented abilities, may help to understand these impairments. This review article examines executive functioning in PT and LBW children, with a specific focus on adolescence and the functional consequences of executive dysfunction in this age group. We have focused on adolescence as it is a critical period for brain, cognitive and social-emotional development, and a period of increased autonomy, independence and reliance on executive functioning. While more longitudinal research is required, there is evidence demonstrating that the PT/LBW population is at increased risk for impairments across all executive domains. Emerging evidence also suggests that executive dysfunction may partly explain poorer academic and social-emotional competence in PT/LBW adolescents. In conclusion, PT/LBW adolescents exhibit poorer executive functioning, and close surveillance is recommended for high-risk individuals.