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We conducted a retrospective analysis of cases of SUID referred to the SIDS-ALTE Center of the Liguria Region (Italy) from 2010 to 2018. In all cases, the death scene was inspected and a multidisciplinary post-mortem evaluation was conducted. Our aim was to analyze the epidemiological data and etiological distribution. We examined 15 cases initially classified as sudden infant death. In all cases, the death was initially unexplained. Seven cases involved males and eight involved females. Their mean age was 67,47 days; the youngest victim was 2 days old, while the oldest was 8.5 months (253 days). In 7 cases, the post-mortem analysis showed an infection of lung. In 4 cases, the prone position of the infant during sleep was identified as a risk factor. In only one case did the cause of death remain unexplained and it was classified as sudden infant death syndrome II according to San Diego classification. In the forensic approach to cases of SUID, it is always important to conduct a thorough multidisciplinary investigation. In order to avoid procedural errors that might compromise the post- mortem investigation, it is necessary to consider the medical and social history of both mother and child, in addition to the circumstances of the death. Moreover, a complete pediatric post-mortem examination and multidisciplinary discussion are required in order to identify potentially important causative or contributory factors.BACKGROUND There has been a paucity of data about the therapeutic efficacy of bronchoalveolar lavage (BAL) for pediatric refractory Mycoplasma pneumonia pneumonia (RMPP) complicated with atelectasis. This study aims to evaluate the clinical effectiveness and safety of BAL in pediatric RMPP inpatients complicated with atelectasis. METHODS Totally 225 children diagnosed as having RMPP with radiological proven irreversible atelectasis completed this study. According to whether they received BAL treatment, they were divided into BAL-intervention group (n=125) and the control group (n=100). Clinical, laboratory and radiological effects were compared between these two groups. Bronchoscopic imaging features were also comprehensively investigated. RESULTS Compared with control group, the febrile days after enrollment was significantly shorter in BAL-intervention group (3.0±1.6 d) compared with that in control group (4.1±1.7 d) (P less then 0.01). The duration of coughing was 3.1±1.7 d in BAL-intervention group and 4.6±1.8 days in the control group (P less then 0.01). The duration of abnormal lung auscultation was 3.8±1.8 d in intervention group and 5.8±1.6 d in the control group (P less then 0.01). The length of hospital stays was 5.8±1.6 days and 7.8±1.9 days (P less then 0.01), respectively. We also found that WBC count (P less then 0.01) and CRP value (P less then 0.01) recovered more quickly in BAL-intervention group compared with that in the control group. Seven days after admission, 85.6% of patients in BAL-intervention group showed atelectasis resolution versus 39.0% in control group (P less then 0.01), and for pleural effusion disappearance 78.4% versus 43.0% (P less then 0.01). CONCLUSIONS Our data suggested that BAL intervention combined with regular drug usage and prednisolone is a better treatment for RMPP children complicated with atelectasis than conventional drug therapy alone.BACKGROUND The literature reports a significant association between sleep disorders and learning disabilities. Nevertheless, not all children with learning disorders have sleep alterations, and which sleep characteristics are associated with which learning difficulty is still unknown. The study aimed at acquiring new information on the relation between sleep disturbances or habits and the learning profiles of children with Specific Learning Disorder (SLD). METHODS The Sleep Disturbance Scale for Children (SDSC) and an actigraph (the FitBit-Flex, FB-F) were used in 26 and 16 SLD children respectively; all children were also assessed for learning skills. RESULTS Although parents' reports at the SDSC did not differentiate SLD from typical readers, the awakening, respiratory and arousal disturbances at the SDSC correlated with sleep duration at the FB-F. Sleep alterations at the FB-F actigraph characterize SLD with literacy difficulties children with reading decoding difficulties showed shorter minimum amount of sleep than typical children, and severe SLDs showed shorter maximum sleep duration and a higher number of awakenings in comparison to SLDs with mild learning deficits. CONCLUSIONS Mild alterations in the amount, duration and quality of sleep may characterize children with learning disorders and actigraphy proves to be a useful tool in starting the individual monitoring of sleep in these populations.Transthoracic and transesophageal echocardiographic examinations may be required in COVID-19 patients, resulting in direct contact with the patient and a risk of infection transmission from patients to personnel. Therefore, we recommend to perform problem-oriented, time-limited transthoracic studies. Whenever possible studies should be analyzed off-line outside isolation zones. Transesophageal echocardiography is considered an aerosol-generating procedure and should be performed only in lifesaving indications. Personnel should use appropriate personal protection equipment in the immediate vicinity of the patients, according to the relevant guidelines. Polish version of this document can be found in the "Supplementary data" tab.We hereby report a puzzling case of multiple sclerosis (MS) relapse presenting as Takotsubo syndrome (TTS). selleckchem Female, 42-years old, who presented herself to the Emergency Room of University Hospital "ASST Spedali Civili" of Brescia, Italy, for a severe headache and a non-ST-segment elevation acute coronary syndrome. Coronary angiogram showed no signs of coronary atherosclerosis. Upon further neurological evaluation, a diagnosis of MS relapse, related to TTS, was made, and treatment was started accordingly. The patient was discharged after 12 days after the admission, free of symptoms, and without signs of neurological and cardiological active disease. A hallmark of TTS is its association with a preceding stressful event. It may also be connected to a wide variety of diseases, including neurological ones, such as stroke, intracranial bleeding, head trauma, migraine, and seizures. However, up to our knowledge, only few cases of MS-induced TTS were previously described. Whether it is plausible to consider TTS as an uncommon extra-neurological manifestation of MS is still debated, however all the evidence points in that direction, considering the central role of catecholamines in TTS pathogenesis.
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