@article {10780, title = {First urinary tract infections in children: the role of the risk factors proposed by the Italian recommendations.}, journal = {Acta Paediatr}, volume = {108}, year = {2019}, month = {2019 Mar}, pages = {544-550}, abstract = {

AIM: In 2009, the Italian society for paediatric nephrology suggested the need for cystography, following a first febrile urinary tract infection (UTI), only in children at high risk for dilating vesicoureteral reflux or in the event of a second infection. The aim of this study was to evaluate the adequacy of the risk factors proposed by the Italian guidelines.

METHODS: Children aged 2-36~months, managed by 10 Italian hospitals between 2009 and 2013, with a first febrile UTI were retrospectively evaluated.

RESULTS: Four hundred and fourteen children were included: 51\% female, mean age eight months. Escherichia coli was responsible of 84\% UTIs. 269 children (65\%) presented at least one risk factor, thus were further investigated: 44\% had a reflux. The presence of a pathogen other than E.~coli significantly predicted high-grade reflux, both in the univariate (Odd Ratio 2.52, 95\% Confidence Interval 1.32-4.81, p~<~0.005) and multivariate analysis (OR 2.74, 95\% CI: 1.39-5.41, p: 0.003). 26/145 children (18\%) with no risk factors experienced a second UTI, which prompted the execution of cystography, showing a dilating reflux in 11.

CONCLUSION: Among the risk factors proposed by the Italian guidelines, only the presence of a pathogen other than E.~coli significantly predicted reflux. Cystography can be postponed in children with no risk factors.

}, issn = {1651-2227}, doi = {10.1111/apa.14506}, author = {Alberici, I and La Manna, A and Pennesi, M and Starc, M and Scozzola, F and Nicolini, G and Toffolo, A and Marra, G and Chimenz, R and Sica, F and Maringhini, S and Monasta, L and Montini, G} } @article {8046, title = {Brain sparing effect in growth-restricted fetuses is associated with decreased cardiac acceleration and deceleration capacities: a case-control study.}, journal = {BJOG}, year = {2015}, month = {2015 Sep 23}, abstract = {

OBJECTIVE: Phase rectified signal averaging (PRSA) is a new method of fetal heart rate variability (fHRV) analysis that quantifies the average acceleration (AC) and deceleration capacity (DC) of the heart. The aim of this study was to evaluate AC and DC of fHR [recorded by trans-abdominal fetal electrocardiogram (ta-fECG)] in relation to Doppler velocimetry characteristics of intrauterine growth restriction (IUGR).

DESIGN: Prospective case-control study.

SETTING: Single third referral centre.

POPULATION: IUGR (n = 66) between 25 and 40 gestational weeks and uncomplicated pregnancies (n = 79).

METHODS: In IUGR the nearest ta-fECG monitoring to delivery was used for PRSA analysis and Doppler velocimetry parameters obtained within 48 hours. AC and DC were computed at s = T = 9. The relation was evaluated between either AC or DC and Doppler velocimetry parameters adjusting for gestational age at monitoring, as well as the association between either AC or DC and IUGR with or without brain sparing.

RESULTS: In IUGRs there was a significant association between either AC and DC and middle cerebral artery pulsatility index (PI; P = 0.01; P = 0.005), but the same was not true for uterine or umbilical artery PI (P > 0.05). Both IUGR fetuses with and without brain sparing had lower AC and DC than controls, but this association was stronger for IUGRs with brain sparing.

CONCLUSIONS: Our study observed for the first time that AC and DC at PRSA analysis are associated with middle cerebral artery PI, but not with uterine or umbilical artery PI, and that there is a significant decrease of AC and DC in association with brain sparing in IUGR fetuses from 25 weeks of gestation to term.

TWEETABLE ABSTRACT: Brain sparing in IUGR fetuses is associated with decreased acceleration and deceleration capacities of the heart.

}, issn = {1471-0528}, doi = {10.1111/1471-0528.13607}, author = {Stampalija, T and Casati, D and Monasta, L and Sassi, R and Rivolta, M W and Muggiasca, M L and Bauer, A and Ferrazzi, E} } @article {3567, title = {HLA-G gene polymorphisms associated with susceptibility to rheumatoid arthritis disease and its severity in Brazilian patients.}, journal = {Tissue Antigens}, volume = {84}, year = {2014}, month = {2014 Sep}, pages = {308-15}, abstract = {

We analyzed the possible association between human leukocyte antigen-G (HLA-G) genetic variants, supposed to regulate HLA-G expression, and the susceptibility to develop rheumatoid arthritis (RA) as well as its clinical manifestations. The 5{\textquoteright}upstream regulatory region (5{\textquoteright}URR) and 3{\textquoteright}untranslated region (3{\textquoteright}UTR) regions of the HLA-G gene were screened in 127 RA patients and 128 controls: 10 5{\textquoteright}URR and 3 3{\textquoteright}UTR HLA-G polymorphisms as well as two haplotypes were associated with risk for RA development, while a polymorphism in the 5{\textquoteright}URR showed an association with the degree of disease activity. These findings, although the number of cases analyzed is limited and the P-values are modest, indicate a possible association between HLA-G gene polymorphisms and susceptibility to develop RA disease and its severity.

}, keywords = {3{\textquoteright} Untranslated Regions, 5{\textquoteright} Flanking Region, Aged, Arthritis, Rheumatoid, Brazil, Disease Progression, DNA Mutational Analysis, Female, Gene Frequency, Genetic Association Studies, Genetic Predisposition to Disease, Genotype, Haplotypes, HLA-G Antigens, Humans, Male, Middle Aged, Polymorphism, Single Nucleotide, Risk}, issn = {1399-0039}, doi = {10.1111/tan.12396}, author = {Catamo, E and Addobbati, C and Segat, L and Sotero Fragoso, T and Domingues Barbosa, A and Tavares Dantas, A and de Ata{\'\i}de Mariz, H and F da Rocha, L and Branco Pinto Duarte, A L and Monasta, L and Sandrin-Garcia, P and Crovella, S} } @article {1876, title = {First trimester maternal serum PIGF, free β-hCG, PAPP-A, PP-13, uterine artery Doppler and maternal history for the prediction of preeclampsia.}, journal = {Placenta}, volume = {33}, year = {2012}, month = {2012 Jun}, pages = {495-501}, abstract = {

OBJECTIVE: To evaluate the detection of pregnancy hypertensive disorders by integrating maternal history, serum biomarkers and uterine artery Doppler in the first trimester.

METHODS: We prospectively recruited 2118 women that underwent an 11-13 weeks aneuploidy screening. We gathered information on maternal history, uterine artery Doppler and serum biomarkers (PAPP-A, PlGF, PP-13 and free β-hCG). Models were developed for the prediction of overall preeclampsia (PE), early-onset PE, late-onset PE and gestational hypertension (GH). For each outcome, we performed a multivariate logistic regression starting from the saturated model: adopting a step-down procedure we excluded all factors not statistically significant (p > 0.05). Sensitivity models only for statistically significant parameters were calculated from the ROC curves for fixed false-positive rates (FPR).

RESULTS: Among 2118 women, 46 (2.17\%) developed GH and 25 (1.18\%) were diagnosed with PE, including 12 (0.57\%) early-onset PE and 13 (0.61\%) late-onset PE. For a fixed FPR of 10 and 5\%, serum PlGF, free β-hCG and chronic hypertension identified respectively 67 and 75\% of women who developed early-onset PE. In the model for the prediction of overall PE the combination of the uterine artery Doppler pulsatility index (UtA PI) with PlGF and chronic hypertension reached a sensitivity of 60\% for a 20\% of FPR.

CONCLUSION: An integration of maternal characteristics and first trimester maternal serum biomarkers (free β-hCG and PlGF) provided a possible screening for early-onset PE. In the overall PE model, UtA PI turned out to be statistically significant but did not improve the detection rate.

}, keywords = {Adult, Biological Markers, Chorionic Gonadotropin, beta Subunit, Human, Cohort Studies, Female, Galectins, Humans, Hypertension, Pregnancy-Induced, Pre-Eclampsia, Pregnancy, Pregnancy Complications, Pregnancy Proteins, Pregnancy Trimester, First, Pregnancy-Associated Plasma Protein-A, Prospective Studies, Ultrasonography, Prenatal, Uterine Artery, Uterus}, issn = {1532-3102}, doi = {10.1016/j.placenta.2012.03.003}, author = {Di Lorenzo, G and Ceccarello, M and Cecotti, V and Ronfani, L and Monasta, L and Vecchi Brumatti, L and Montico, M and D{\textquoteright}Ottavio, G} } @article {1676, title = {Interventions for the prevention of overweight and obesity in preschool children: a systematic review of randomized controlled trials.}, journal = {Obes Rev}, volume = {12}, year = {2011}, month = {2011 May}, pages = {e107-18}, abstract = {

The objective of this study was to analyse interventions for the prevention of overweight and obesity in children under 5 years of age. We carried out a systematic review focusing exclusively on randomized controlled trials (RCTs). Data sources include Medline, Cochrane Library, EMBASE, CINHAL, PsychInfo and Web of Science. Data were extracted from seventeen articles describing seven RCTs identified through electronic search, screening of references in systematic reviews, own files and contact with authors. RCTs were assessed with the Jadad scale. Four trials were carried out in preschool settings, one with an exclusive educational component, two with an exclusive physical activity component and one with both. Two trials were family-based, with education and counselling for parents and children. The remaining trial was carried out in maternity hospitals, with a training intervention on breastfeeding. None of the interventions had an effect in preventing overweight and obesity. The failure to show an effect may be due to the choice of outcomes, the quality of the RCTs, the suboptimal implementation of the interventions, the lack of focus on social and environmental determinants. More rigorous research is needed on interventions and on social and environmental factors that could impact on lifestyle.

}, keywords = {Child Nutrition Sciences, Child Nutritional Physiological Phenomena, Child, Preschool, Exercise, Female, Health Promotion, Humans, Life Style, Male, Obesity, Overweight, Randomized Controlled Trials as Topic}, issn = {1467-789X}, doi = {10.1111/j.1467-789X.2010.00774.x}, author = {Monasta, L and Batty, G D and Macaluso, A and Ronfani, L and Lutje, V and Bavcar, A and van Lenthe, F J and Brug, J and Cattaneo, A} }