Prevalencia de alteraciones del neurodesarrollo motriz en niños prematuros sin diagnóstico de parálisis cerebral / Prevalence of neurodevelopmental motor disorders in pre-term children without a diagnosis of cerebral palsy

Antecedentes y objetivo: Las alteraciones del neurodesarrollo motriz pueden ir asociadas a la prematuridad extrema. El objetivo del estudio consiste en determinar la prevalencia de alteraciones del neurodesarrollo motriz en prematuros extremos o muy prematuros, sin diagnóstico de parálisis cerebral. Material y métodos: Participaron 23 pacientes, un 69% niños, de 68,26 ± 6 meses de edad (40-86), de los cuales 10 eran prematuros extremos (con edad gestacional < 28 semanas y peso < 1.500g al nacer) y 13 muy prematuros (≥ 28 y < 32 semanas de edad gestacional, de los cuales 8 tenían un peso < 1.500 g al nacer), todos ellos sin parálisis cerebral. Se aplicó el test de desarrollo psicomotor de Picq-Vayer y la prueba neuropsicológica Beere-Buktenica de integración visomotriz. Resultados: El 69,57% de los pacientes presentó retraso del desarrollo psicomotor leve. Los indicadores globales de la prueba de integración visomotriz mostraron que el 86,9% presentaba disminución de la edad de desarrollo. El bajo peso al nacer explicaba el 15% de la varianza en edad psicomotora (R2ajustado = 0,15; ß = 0,44; p = 0,041) y el 31% de la integración visomotriz (R2ajustado = 0,31; ß = 0,59; p = 0,004). Conclusión: El estudio contribuye a aportar pruebas relativas a la incidencia de factores asociados a la prematuridad, especialmente el bajo peso al nacer, en el neurodesarrollo motriz. Los datos apoyan la presencia significativa de alteraciones neuromotrices de carácter leve en pacientes prematuros extremos y muy prematuros, sin que exista un diagnóstico de parálisis cerebral asociado, lo que podría generar problemas a largo plazo en estos pacientes

Background and objective: Motor neurodevelopment disorders may be associated with extreme prematurity. This study aims to determine the prevalence of motor neurodevelopmental disorders of extremely pre-term or very pre-term children without a diagnosis of cerebral palsy. Material and methods: The study included 23 patients, 69% boys, age: 68.26±6 months (40-86), of which 10 were extremely preterm, with gestational age < 28 weeks and birth weight < 1500g, and 13 very preterm (≥28 and <32 weeks of gestational age), of which 8 had a birth weight < 1500g, all of them without cerebral palsy. The psychomotor development test of Picq-Vayer and the Beere-Buktenica neuropsychological test of visual-motor integration were applied. Results: A large majority (69.57%) of patients have slight psychomotor development retardation. Global indicators for the visual-motor integration test show that 86.9% had a decrease in the developmental age. Low birth weight explained 15% of the variance in psychomotor age (R2adjusted = .15, ß = .44, P = .041) and 31% of visual-motor integration (R2adjusted = .31, ß = .59, P = .004). Conclusion: The presented study contributes to provide evidence regarding the incidence of factors associated with prematurity, especially low birth weight, in motor neurodevelopment. The data support the significant presence of mild neuromotor disorders in extremely preterm and very preterm patients without an associated diagnosis of cerebral palsy, which could generate long-term problems in these patients

Beam steering by liquid crystal elastomer fibres.

The problem of utilizing a laser beam as an information vehicle and dividing it into different channels is an open problem in the telecommunication field. The switching of a signal into different ports has been demonstrated, to date, by employing complex devices and mechanisms such as the electro optic effect, microelectromechanical system (MEMS) mirrors, or liquid crystal-based spatial light modulators (SLMs). We present here a simple device, namely a mirror held by a liquid crystal elastomer (LCE) fibre, as an optically and remotely driven beam steerer. In fact, a considered signal (laser beam) can be addressed in every in-plane direction by controlling the fibre and mirror rotation, i.e., the deflected probe beam angle. Such movement is possible due to the preparation of LCE fibres able to rotate and contract under a selective light stimulus. By adjusting the irradiation stimulus power, elastic fibres are able to rotate with a specific angle, performing more than one complete revolution around their axis. The described movement is perfectly reversible as soon as the stimulus is removed.

Influence of block copolymer feature size on reactive ion etching pattern transfer into silicon.

A successful realisation of sub-20 nm features on silicon (Si) is becoming the focus of many technological studies, strongly influencing the future performance of modern integrated circuits. Although reactive ion etching (RIE), at both micrometric and nanometric scale has already been the target of many studies, a better understanding of the different mechanisms involved at sub-20 nm size etching is still required. In this work, we investigated the influence of the feature size on the etch rate of Si, performed by a cryogenic RIE process through cylinder-forming polystyrene-block-polymethylmethacrylate (PS-b-PMMA) diblock copolymer (DBC) masks with diameter ranging between 19-13 nm. A sensible decrease of the etch depth and etch rate was observed in the mask with the smallest feature size. For all the DBCs under investigation, we determined the process window useful for the correct transfer of the nanometric cylindrical pattern into a Si substrate. A structural and physicochemical investigation of the resulting nanostructured Si is reported in order to delineate the influence of various RIE pattern effects. Feature-size-dependent etch, or RIE-lag, is proved to significantly affect the obtained results.

Active surveillance for asymptomatic carriers of carbapenemase-producing Klebsiella pneumoniae in a hospital setting.

The spread of carbapenemase-producing Klebsiella pneumoniae (CPKP) is a challenging public health threat. Early identification and isolation of infected patients and carriers are key measures of control. This study describes a CPKP screening strategy in a tertiary Italian hospital. During the five-month study period, 1687 patients were screened by rectal swabs. Of these, 65 (3.9%) tested positive for CPKP; 5.1% of case contacts tested positive. Screening case contacts appears to be the essential surveillance component for detecting asymptomatic carriers of CPKP. The added value of selective CPKP screening on hospital admission depends on the frequency of carriers among incoming patients.

Carpal tunnel syndrome in hemodialyzed patients.

A total of 18 hemodialyzed patients submitted to surgery for the treatment of carpal tunnel syndrome are examined. In all of the cases pre- and postoperative EMG and biopsy were performed. Six months after surgery all of the patients showed improved pain symptoms, in 66% there was good recovery of sensitivity and of the function of the hand: these results were confirmed by EMG monitoring. In all of the biopsies amyloid deposits, particularly diffused in the tendinous and nervous sheaths, were observed. At 2-year follow-up 75% of the patients showed recurrence of pain symptoms. Thus, surgery does not seem to definitively resolve symptoms.

[A case of oxalosis with heart and lung involvement]. / Un caso di ossalosi con interessamento cardiaco e polmonare.

We report the case of a 37-year-old woman with oxalosis, and cardiopulmonary involvement. Two-dimensional and Doppler echocardiography disclosed intracardiac calcifications compatible with deposition of calcium oxalate, and severe chronic pulmonary hypertension. Endomyocardial biopsy showed interstitial deposition of calcium oxalate. The absence of severe cardiac disease strengthened a deposition of calcium oxalate even in the arteries of the lungs, with secondary chronic pulmonary hypertension.

Ten years experience with plasma exchange in renal transplantation.

Plasma exchange has been used in our renal transplantation programme for over ten years to treat 86 patients divided into four groups. Five patients had preformed cytotoxic antibodies before transplantation (group A); 13 sensitized patients (greater than 60% PRA) underwent prophylactic plasma exchange in the immediate post-operative period (group B); 62 patients were treated for acute vascular rejection (group C); six patients had chronic graft rejection (group D). Plasma exchange is a valid tool for the treatment of acute vascular rejection, provided that it is started before irreversible graft damage occurs: 75% rejection crises were reversed by plasma exchange and the actuarial graft survival from the rejection episode was 75% at one year, 66% at two and 50% at five years. Serum creatinine before treatment and glomerular thrombosis at graft biopsy correlated with the response to plasma exchange. In sensitized patients and in those with chronic rejection the results were disappointing and suggest that in these clinical conditions plasma exchange should be used only in selected cases.

Prevention of chronic glomerular uremia in steroid resistant glomerulonephritis. A clinical trial with a new antithrombotic agent.

To investigate the possibility of slowing down disease progression 27 patients with primary glomerular diseases unresponsive to steroids and cytotoxic drugs were treated with Defibrotide. This drug is a single stranded DNA fraction which has profibrinolytic and deaggregating properties and can promote the generation and release of prostacyclin from vascular tissue. Before treatment all patients showed proteinuria in excess of 1 g/day and 16 had a nephrotic syndrome (59%); 10 patients had serum creatinine above 1.6 mg/dl (37%) and 6 were hypertensive. After therapy a significant decrease in daily proteinuria was observed, although the reduction exceeded 50% of pre-treatment values in only 16 patients (59%). A progressive decrease in serum creatinine occurred in patients with abnormal renal function; serial measurement of renal plasma flow showed a progressive improvement with an average increase of 6 and 12%, after 1 and 3 months of treatment, respectively. These observations confirm the view that drugs improving endothelial function and renal hemodynamics can be of value in the treatment of chronic glomerular diseases and can contribute to the maintenance of renal function.

Glomerulonephritis in renal transplantation.

Recurrent glomerulonephritis and de novo glomerulonephritis may develop in the graft after renal transplantation. Among 59 patients with a pathological diagnosis of glomerulonephritis as original renal disease, 12 (20.3%) showed recurrence of the original lesions in the graft. Two patients with hereditary nephritis developed anti-GBM disease (one patients in two grafts). The disease rapidly progressed to graft loss. A de novo membranous nephropathy was diagnosed in four patients whose original renal disease was not a glomerulonephritis. One patient had been treated with antilymphocyte globulin, another with captopril.