An unavoidable reciprocal influence characterizes the mother-child dyad. Within this relationship, the presence of depression, somatization, hostility, paranoid ideation, and interpersonal sensitivity symptoms at a subclinical level and their possible input on infant motor competences has not been yet considered. Bearing in mind that motor abilities represent not only an indicator of the infant's health-status, but also the principal field to infer his/her needs, feelings and intentions, in this study the quality of infants' movements were assessed and analyzed in relationship with the maternal attitudes. The aim of this research was to investigate if/how maternal symptomatology may pilot infant's motor development during his/her first year of life by observing the characteristics of motor development in infants aged 0–11 months. Participants included 123 mothers and their infants (0–11 months-old). Mothers' symptomatology was screened with the Symptom Checklist-90-Revised (SCL-90-R), while infants were tested with the Peabody Developmental Motor Scale-Second Edition. All dyads belonged to a non-clinical population, however, on the basis of SCL-90-R scores, the mothers' sample was divided into two groups: normative and subclinical. Descriptive, t-test, correlational analysis between PDMS-2 scores and SCL-90-R results are reported, as well as regression models results. Both positive and negative correlations were found between maternal perceived symptomatology, Somatization (SOM), Interpersonal Sensitivity (IS), Depression (DEP), Hostility (HOS), and Paranoid Ideation (PAR) and infants' motor abilities. These results were further verified by applying regression models to predict the infant's motor outcomes on the basis of babies' age and maternal status. The presence of positive symptoms in the SCL-90-R questionnaire (subclinical group) predicted good visual-motor integration and stationary competences in the babies. In particular, depressive and hostility feelings in mothers seemed to induce an infant motor behavior characterized by a major control of the environmental space. When mothers perceived a higher level of hostility and somatization, their babies showed difficulties in sharing action space, such as required in the development of stationary positions and grasping abilities. In a completely different way, when infants can rely on a mother with low-perceived symptoms (normative group) his/her motor performances develop with a higher degree of freedom/independence. These findings suggest, for the first time, that even in a non-clinical sample, mother's perceived-symptoms can produce important consequences not in infant motor development as a whole, but in some specific areas, contributing to shape the infant's motor ability and his/her capability to act in the world.
Introduction: Over the last decades, the number of elderly patients on dialysis has rapidly grown on account of increased life expectancy, improved care and reduced mortality rate. Therefore, cooperation between geriatricians and nephrologists has become mandatory for co-managing kidney disease in these patients. Based on renewed interest in home hemodialysis (HHD), elderly patients may benefit from not being transported from their home for therapy. Methods: Here, we report our experience with HHD involving three elderly patients who were followed-up over a 15-months period in a nursing home. Findings: Our experience demonstrates that hospitalization abruptly dropped from 40 days to zero days, the need for erythropoietin stimulating agents (ESAs) diminished, transportation-related costs for home treatments decreased, and quality of life (QoL) improved. This was confirmed by a questionnaire administered to our patients at the start and again after 6 months of HHD which evaluated the Physical Health Component Score (PCS) and the Mental Health Component Score (MCS). Discussion: Home hemodialysis may represent an important way to improve social, mental, and physical recovery, while also eliminating the cost of transportation and the discomfort of abandoning their "homes" and daily habits. Home hemodialysis is an effective alternative to incenter HD or peritoneal dialysis (PD) that should be offered to elderly patients when a home caregiver is not available, nonetheless, nursing assistance is required. Moreover, HHD allows patients to stay at home, thereby avoiding several weekly trips to the dialysis center, and may be useful in reducing infections, especially in times of the COVID-19 pandemic, as demonstrated by our experience.
Predicting complications in intensive care units (ICUs) is an important step in the care of critically ill patients. Intensive care specialists have developed numerous prognostication tools for patients admitted to the ICU; however, although useful, many of these tools are not applicable in a clinical setting, and multiple severity-of-illness scores often underestimate hospital mortality in several conditions (1, 2 ).Many acute pathologic states, such as burns, trauma, bleeding, and sepsis, are associated with the induction of a "systemic inflammatory response", which is characterized by the release of pro-inflammatory mediators and the activation of different types of cellular elements (3-6 ). This response primarily involves endothelial cells and leukocytes (7)(8)(9). It is possible to use renal function as an early marker for systemic illness because kidney involvement is a recognized complication of several systemic diseases. Acute renal failure (ARF), usually attributable to intrarenal hemodynamic changes, often complicates the clinical course of critically ill patients (10 -12 ). Microalbuminuria has been proposed as a marker of capillary leak severity in the ICU (13,14 ). It has previously been demonstrated that urinary albumin degrades into multiple fragments in meningococcal sepsis and that the quantity of degraded albumin is associated with severity (15 ).Since April 2003, we have analyzed untimed urine samples from critically ill patients with ARF in ICUs: dipstick test and urine sediment analysis were performed on all samples, and none showed massive leukocyturia. The proteinuria is typed by quantitative (nephelometry) (16, 17 ) and qualitative (immunofixation) (18 ) immunologic techniques and by sodium dodecyl sulfate-agarose gel electrophoresis (SDS-AGE) (19 ), with retinol-binding protein (21 kDa) and ␣ 1 -microglobulin (31 kDa) considered as markers of tubular damage; albumin (67 kDa), transferrin (80 kDa), and IgG (150 kDa) as markers of glomerular injury; and ␣ 2 -macroglobulin (725 kDa) as a marker of postrenal proteinuria. In addition, we measure total urinary proteins by the biuret (20 ) and pyrogallol red assays. All samples were stored at 4°C after centrifugation (400g for 5 min) and were analyzed within 3-24 h. Storage in a refrigerator (4°C) did not change the results.Here we report on 10 cases (9 males and 1 female; age range, 40 -79 years; 18.1% of all screened patients) with ARF in whom we found evidence of urinary protein degradation. All patients had a prerenal cause of ARF; only one patient was not oliguric and did not need renal replacement therapy. Five patients died, and five had renal function recovery.SDS-AGE performed at the time of the nephrologic visit and diagnosis revealed a smeared band of proteins and protein fragments, covering the molecular mass range between 10 and 300 kDa, and an absence of the typical bands for the single proteins.The SDS-AGE migration patterns of one of these patients on 3 consecutive days are shown in Fig. 1; after 24 and 48 h, the bands for albu...
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