Acta Biomedica de l''Ateneo Parmense最新文献

Wunderlich syndrome (WS) or spontaneous renal haemorrhage is a rare and life-threatening condition often leading to haemorrhagic shock. WS is characterized by an acute onset of non-traumatic subcapsular and perirenal haematoma formation due to several causes, including neoplasms, cystic rupture, vasculitis, coagulopathies, and infections. The classical presentation includes acute flank or abdominal pain, a palpable flank mass and hypovolemic shock (Lenk's triad). Nausea, vomiting, fever, and haematuria can also be present. Computed tomography angiography is mandatory to localize the source of haemorrhage. Super-selective embolization can be performed to stop bleeding, while surgery is reserved to haemodynamic unstable patients and neoplastic cases. We describe a case of WS in a 79-year-old male patient, who rapidly developed hypovolemic shock requiring urgent nephrectomy.

Background and aim: Vitamin A toxicity is uncommon, but when it occurs can be serious and even fatal. A case vitamin A intoxication with high levels in liver tests, thrombocytopenia and appearance virosis. Laboratory testing is one of the most widely used diagnostic interventions supporting medical decisions of this phenomenon are necessary.

Case report: Here, we report a case vitamin A intoxication with high levels in liver tests, thrombocytopenia and appearance virosis. The patient showed several clinical signs abdominal pain, including mild anemia and thrombocytopenia.

Conclusions: We believe that Laboratory testing is one of the most widely used diagnostic interventions supporting medical decisions, and further investigations regarding the etiology and prevalence of this phenomenon are necessary. (www.actabiomedica.it).

Background and aim: Sepsis is a potentially fatal condition which strikes 1.2 million children worldwide per year. New biomarkers have been proposed in the assessment of the risk of sepsis progression and in the identification of patients with the worst outcome. This review aims to assess the diagnostic value of presepsin, a promising new biomarker, in pediatric sepsis, with particular attention to its usefulness in emergency department.

Methods: We performed a literature search of the last 10 years to find presepsin related studies and reports concerning pediatric population aged from 0 months to 18 years. We mainly focused on randomized placebo-control studies, followed by case-control studies, observational (both retrospective or prospective), and finally systematic reviews and meta-analysis. The article selection process was carried out independently by three reviewers.   Results: A total of 60 records were identified in literature, 49 were excluded according to the exclusion criteria. The highest presepsin sensitivity value was 100%, with a high cut-off (800.5 pg/mL). The highest sensitivity-specificity ratio was 94% vs 100%, with a similar considered presepsin cut-off (855 ng/L). As regards the presepsin cut-offs reported in the various studies, several authors agree on a critical threshold of about 650 ng/L to guarantee a sensitivity> 90%. The analyzed studies show a wide variability for patients' age and presepsin risk cut-offs.   Conclusions: Presepsin seems to be a new useful marker for early diagnosis of sepsis, even in a pediatric emergency setting. Being a new marker of sepsis, more studies are required to better understand its potential.

Background and aim: Sacral fractures with concomitant unstable pelvic ring injuries are severe conditions which occur in patients involved in high-energy trauma. When operative treatment is required, high surgical experience on the field is mandatory, especially in a sub-polpulation of obese patients which have increased risk of complications. The aim of this multicentric retroscpective study was to describe and analyze clinical and radiological outcomes of sacral vertical fractures in obese patients with a minimum of 2 years follow-up.   Methods: A total of 121 pelvic fractures admitted to Emergency Departments of three II level trauma centres from April 2015 to April 2021 were retrospectively reviewed. Demographics, injury mechanism, surgical data and complications were collected. The quality of life and the pelvic function were respectively measured by SF-12 questionnaires, Denis Work Scale and Majeed Score. The inter-rater agreement between the clinical scores and the Denis Work Scale was assessed.   Results: A total of 19 patients were included in the study. The average follow up was 41.16 months. The average BMI was 38.63 and the mean abdominal circumference was 128.10 cm. The average Majeed and SF-12 scores were respectively 66.47 and 74.32. Five patients were able to return to their previous employment. The post traumatic life's quality and related dysfunctions are influenced by the high BMI.   Conclusions: Faster recovery and early weight-bearing should be persued in order to minimize complications, expecially in obese patients. In these sample of patients, "triangular osteosynthesis" was the best treatment choice for sacral vertical fractures.

Aim: This study aims to systematically review the current literature on published studies with data on the clinical significance of endometrial thickness on ultrasound for live birth rates after IVF or intracytoplasmic sperm injection (ICSI).

Methods: An extensive systematic review of PubMed, Web of Science, ScienceDirect, Google Scholar, and Open Gray databases, and following hand-search of the reference list of the included studies was performed.

Results: We found 20 eligible studies that evaluated 20 546 patients for endometrial thickness, presented risk factors for decreased endometrial receptivity, and IVF outcomes with fresh and frozen embryo transfer (FET) cycles. The mean age of the patients ranged from 28.86 to 41.03 years. Reported endometrial thickness ranged from <4 mm to >15 mm. The clinical pregnancy rate varied from 9,09% to 61,49% in fresh embryo transfer cycles and from 13,3% to 79,31% in FET cycles. Overall, LBR varied between 4,80% and 48,99% in fresh embryo cycles and between 6.06% and 39,19% in FET cycles.

Limitations: Only English-language studies were included; most studies were from the China region; retrospective study design used in most studies; different ET thresholds, which in turn could significantly alter the correlation with pregnancy outcomes; different IVF procedure protocols in fresh or FET cycles.

Conclusions: IVF outcomes in patients with impaired endometrial receptivity do not depend only on the condition of the endometrium. Risk factors and endometrial thickness significantly affect LBR in fresh and FET cycles.

Background and aim: This paper explores the relationship between Online Social Network (OSNs) abuse, Emotional Intelligence (EI), and distress due to COVID-19 confinement among adolescents.

Methods: A sample of 226 students from North Italy aged between 16 and 18 years completed from March to June 2020 the Bergen Social Media Scale (BSMAS), Trait Emotional Intelligence Questionnaire-Short Form (TEIQue-SF) and Depression, Anxiety and Stress Scale (DASS-21).

Results: Females scored higher in social network use as compared to males [t (225) = 46.56, p = <.05]. The prevalence of symptoms of distress was also higher in females. Conversely, males scored significantly higher on total EI as compared to their counterparts [t (178) = 4.1544, p = <.003] indicating that high EI contributes towards better self-perception of psychological wellbeing. On the contrary, having high stress levels and low EI levels seems to predict the possibility to experience in a social network addiction.

Conclusions: Our findings suggested EI as a protective factor for OSNs' addiction. Results support the need of implementing programs aimed at adopting an appropriate approach to the digital world and particularly addressed towards the growth of EI to reduce dysfunctional behaviors in adolescence. (www.actabiomedica.it).

Background and aim: Fatigue describes a wholeness feeling of tiredness or lack of energy. To assess which sampling nurses relating characteristics could influence the fatigue condition among nurses.

Methods: From May 2020 to September 2021 a cross sectional, multicenter study was conducted among Italian nursing professional orders. An on-line ad hoc questionnaire was spread including sampling characteristics both on socio-demographic and nursing-relating work characteristics.

Results: Significant associations were reported between item no.1 and gender (p<0.001) and BMI conditions (p=0.013), as most of the female participants (47%) affirmed to often feel themselves tired when they wake up, despite most of participants were at normal weight (32%). Item no.2 was significantly associated with gender (p=0.009), job role (p=0.039) and shift (p=0.030), as most of females never (31%) or often (31%) were not concentrated in their working tasks and, most of them were registered nurses (never: 41% and often: 35%), despite they were employed also during the night shift (never: 28%; often: 22%). Most of females (p=<0.001) were never slow in their reactions (42%), and they were young nurses (p=0.023). 44% of females declared to make an effort to express clearly themselves (p=0.031). Females reported significant high frequencies (p=0.016) in constant excitant substance assumption, such as caffeine (30%) and high significant percentage of females (p=0.047; 41%) reported the need to sleep during the day.

Conclusions: The fatigue will have a strong impact on the quality of life of nursing professionals, compromising their functional abilities, social relationships and their work and family roles.

Background and aim: The benefits of minimally invasive surgical techniques in total hip arthroplasty (THA) are well known, but concerns about applying SuperPATH in patients with secondary OA of acetabular dysplasia do not have been reported. We aim to evaluate whether SuperPATH is applicable to secondary OA, furthermore, to quantify the recovery of lower extremity function.

Methods: 30 patients with secondary OA admitted for THA applying SuperPATH were investigated. Clinical Japanese Orthopaedic Association (JOA) Score and radiographical evaluation were performed. Following was examined pre- and early post-operatively; pain level, blood tests, TUG and 10-M walking time for lower limb recovery.

Results: Preoperative radiographic measurements revealed an average Sharp angle of 46.2 ± 2.8 degrees and CE angle of 19.4 ± 7.3 degrees. 29 THAs had Crowe Type I and 1 THA had Crowe Type II. JOA score improved from 48.8 preoperatively to 91.5 at 2 months postoperatively. The perioperative pain assessment (VAS) averaged 7.0±1.5 preoperatively, 4.6±2.6 on the first postoperative day, then decreased gradually to 1.2±1.4 at 2 weeks. Blood data showed that creatine kinase, myoglobin, and CRP were significantly elevated on the day after surgery, but they normalized at 2 weeks postoperatively. Both TUG and 10M walking time showed slightly higher values at 1 week postoperatively compared to preoperatively but recovered to the same level as preoperatively at 2 weeks after surgery.

Conclusions: Our data suggests that SuperPATH approach to THA for dysplastic OA was applicable to mildly dysplastic OA and achieved an early recovery of lower limb function.

Symptomatic avascular necrosis (AVN) imposes a higher risk for acute care consumption in adults living with SCD. Symptomatic AVN, have higher rates of visits to the emergency department, higher rates of admissions, and longer lengths of stay in hospitals. Properly timed diagnosis and early interventions can reduce morbidity and enhance the quality of life in these patients. Vaso-occlusion secondary to sickling leads to osteonecrosis of the joint/bone (AVN, dactylitis) and invites infection (osteomyelitis and septic arthritis). Understanding and awareness of the imaging features related to this major morbidity complication are essential for early diagnosis and prompt management. In about half of the patients with SCD, AVN can lead to chronic pain, particularly in the head of the femur and humerus. Humeral and femoral head AVN tend to be linked with each other.  Vertebral bone compression and collapse secondary to AVN have also been reported.  The diagnosis of AVN must be accurate, as the condition is complex requiring specific treatment according to the grade of bone and joint involvement. There are several classifications or staging systems used for grading bone and joint involvement. Knowledge of the image patterns and grade of affection in different joints and bones and the degree of progression of AVN lesions can markedly improve management decisions on AVN-specific surgical versus non-surgical interventions and improve patient outcomes. The aim of this report is to summarize the different imaging techniques and their role in the proper/early diagnosis and follow up of patients with AVN with detailed examples of the common sites involved.

Background and aim: Lack of trunk control following spinal cord injury implicates a worse quality of life and a higher dependence on caregivers; literature proposes several evaluation scales, but studies show poor methodological quality. This study aimed to translate and explore the significance of the Italian version of the FIST-SCI scale for chronic spinal cord injury patients.

Methods: A longitudinal cohort study was conducted at Fiorenzuola D'Arda Hospital. After a forward/backward translation of the FIST-SCI scale in Italian content and face translational validity, intervalutator reliability was assessed. Patients were recruited by historical tracking of patients who received acute rehabilitation care at the Villanova D'Arda Spinal Unit. Two researchers administered the FIST-SCI scale to the same patients at the follow-up.

Results: Ten patients took part in the study; results showed that higher inter-rater correlation coefficient (Pearson's R= 0.89, p= 0.01 Intra-class correlation coefficient= 0.94, p=0.000). Content validity was also excellent (Scale Content Validity Index = 0.91); some experts suggested future scale developments.

Discussion: Italian FIST-SCI scale for assessing trunk control in chronic spinal patients appears to be an excellent assessment tool concerning intervalutator reliability. Content validity further confirms the validity of the instrument.