Minerva medica最新文献

Background: The Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD™) questionnaire is a reliable indirect indicator of functional, health status and quality of life in children with severe Cerebral Palsy (CP), as well as the caregiving burden. The aim of the study is to validate the Italian translation of Caregiver Priorities and Child Health Index of Life with Disabilities (CPCHILD™) questionnaire and assess its reliability and validity.

Methods: A cross-sectional study was conducted. The study involved 60 caregivers of children with CP, classified according to the Gross Motor Function Classification System (GMFCS) levels I-V. There was a self-compilation of the CPCHILD™ by primary caregivers during the clinical visit and a re-administration of the questionnaire 2-3 weeks after the first to a defined sample (N.=30, GMFCS IV-V). The Italian version of CPCHILD™'s psychometric properties were evaluated through internal consistency, test-retest reliability, and validity analyses.

Results: The translated CPCHILD™ questionnaire showed excellent test-retest reliability (Intraclass Correlation Coefficient - ICC=0.97) across most sections, with significant construct validity, differentiating well between the various GMFCS levels. The internal consistency was robust (Cronbach's alpha=0.852) except for the health section. The face validity indicated high relevance of the questionnaire items to the caregivers, particularly in emotional well-being and social interaction.

Conclusions: The Italian version of CPCHILD™ questionnaire is a reliable and valid tool for assessing the quality of life in children with severe CP, offering insights into the care burden and health status impacts perceived by caregivers.

Venous thromboembolism (VTE) is a leading cause of maternal mortality. The risk of VTE in pregnant and postpartum women is ~ five times higher compared with non-pregnant women. There is a physiological tendency to a hypercoagulable state, from conception to the postpartum period. Several non-obstetric risk factors independently increase the risk of VTE. Since most signs and symptoms of VTE might mimic those of a normal pregnancy, a high index of suspicion is warranted to establish the diagnosis. D-dimer, ultrasonography and computed tomography pulmonary angiography are the primary tools for VTE diagnosis. Management mainly revolves around systemic anticoagulation with heparin. Advanced therapy options exist, but these can be considered for selected high-risk cases.

Background: In asymptomatic patients presenting with significant internal carotid artery (ICA) stenoses undergoing endovascular revascularization, a selective angiography before stenting (CAS) is required. Sometimes, angiographic findings could be discordant from non-invasive assessment and a tool able to evaluate functional relevance of the stenosis could be of value. We sought to evaluate the usefulness of quantitative flow ratio (QFR) as angiography-based tool for functional assessment of ICA stenoses.

Methods: We prospectively enrolled 50 asymptomatic patients undergoing CAS. Peak systolic velocity (PSV, cm/s) assessed at color Doppler echocardiography was used to identify significant stenoses (PSV >125 cm/s). At angiography, assessment of ICA stenosis was obtained visually (%DSVISUAL) and according NASCET criteria (%DSNASCET). Stenoses were considered significant if >60%. After exclusion of 20 vessels, QFR, area stenosis (AS, %) and minimal lumen area (MLA, mm²) were obtained in the remaining 80 vessels.

Results: At linear regression analysis, QFR significantly correlated with PSV (r²=0.52, P<0.001) as well as with %DSNASCET (r²=0.68, P<0.001) and %DSVISUAL (r²=0.71, P<0.001). Using PSV as reference, QFR showed good accuracy to predict functionally significant stenosis (AUC=0.98, P<0.001) with a cut-off value of 0.93. As compared with %DSNASCET and %DSVISUAL, QFR showed a significantly higher accuracy (61% vs. 73% vs. 94%, respectively; P<0.05), sensitivity (43% vs. 61% vs. 93%, respectively; P<0.05) and negative predictive value (46% vs. 51% vs. 85%, respectively; P<0.05) for detecting hemodynamically significant ICA stenoses.

Conclusions: This study suggest the potential benefit of adopting QFR for functional assessment of extracranial ICA stenoses. These data should be validated in larger studies.

Nearly 35 years after its initial publication in 1989, the Italian Society of Sports Cardiology and the Italian Federation of Sports Medicine (FMSI), in collaboration with other leading Italian Cardiological Scientific Associations (ANCE - National Association of Outpatient Cardiology, ANMCO - National Association of Inpatient Cardiology, SIC - Italian Society of Cardiology), proudly present the 2023 version of the Cardiological Guidelines for Competitive Sports Eligibility. This publication is an update of the previous guidelines, offering a comprehensive and detailed guide for the participation of athletes with heart disease in sports. This edition incorporates the latest advances in cardiology and sports medicine, providing current information and recommendations. It addresses various topics, including the details of the pre-participation screening in Italy and recommendations for sports eligibility and disqualification in competitive athletes with various heart conditions. This revised version of the Cardiological Guidelines for Competitive Sports Eligibility, recorded in the Italian Guidelines Registry of the Italian Minister of Health, stands as a crucial resource for sports medicine professionals, cardiologists, and healthcare providers, marked by its completeness, reliability, and scientific thoroughness. It is an indispensable tool for those involved in the care, management and eligibility process of competitive athletes with heart conditions.