Caterina Lambiase

Relationship between chlorinated pools and bronchial asthma

In the last few years there has been many reports on the possible effects that swimming pool Chlorine should have on respiratory symptoms in kids. It is common knowledge that Chlorine, binding with derivatives of organic fluids (such as sweat and saliva) forms volatile compounds (as Chloramine) which are irritant for the respiratory tract. These remarks are on the basis of the work of since they noticed a correlation between the hours spent in a swimming pool and wheezing in kids. During our clinical activity, we have evaluated a group of 100 children affected by bronchial asthma or recurring wheezing, on an age range of 10–16 years and 6 months (average age 12.7), 58 males and 42 females. Comparing medical history, respiratory functionality and allergic sensitization with the number of hours spent in a swimming pool (cumulated pool attendance, CPA) data show that

Congenital heart diseases and cardiovascular abnormalities in 22q11.2 deletion syndrome: From well-established knowledge to new frontiers

Congenital heart diseases (CHDs) and cardiovascular abnormalities are one of the pillars of clinical diagnosis of 22q11.2 deletion syndrome (22q11.2DS) and still represent the main cause of mortality in the affected children. In the past 30 years, much progress has been made in describing the anatomical patterns of CHD, in improving their diagnosis, medical treatment, and surgical procedures for these conditions, as well as in understanding the underlying genetic and developmental mechanisms. However, further studies are still needed to better determine the true prevalence of CHDs in 22q11.2DS, including data from prenatal studies and on the adult population, to further clarify the genetic mechanisms behind the high variability of phenotypic expression of 22q11.2DS, and to fully understand the mechanism responsible for the increased postoperative morbidity and for the premature death of these patients. Moreover, the increased life expectancy of persons with 22q11.2DS allowed the expansion of the adult population that poses new challenges for clinicians such as acquired cardiovascular problems and complexity related to multisystemic comorbidity. In this review, we provide a comprehensive review of the existing literature about 22q11.2DS in order to summarize the knowledge gained in the past years of clinical experience and research, as well as to identify the remaining gaps in comprehension of this syndrome and the possible future research directions.

Effects of Exercise on Arrhythmia (and Viceversa): Lesson from the Greek Mythology

Exercise represents an important lifestyle factor in all human ages when felt in harmony with other psycho-physical and environmental variables that affect individual life (e. g. quality of interest, affections, environment, diet and food). Consequently, in addition to the training level, the amount, intensity and modality of exercise (ana-/aerobic, isometric/isotonic), need to be personalized, considering the underlying diseases, which may benefit from it or worsening.Greek mythology gives us good examples of the exercise concepts evolution.From Discus-thrower to Spear-carrier the idea of physical activity is more effectively expressed. The Myron Discobolus displays the enduring pattern of athletic energy translated into the dynamic force given by the exercise. In Doryphoros instead, the physical activity is oriented to the achievement of the required psyco-physical harmony, whos the concept is aimed of being expressed by the sculpture.As outlined below, even in the field of arrhythmia, scientific evidence as well as clinical experience, supports the same concept: physical activity may be important while safely managed and personalized.

Indoor pollution such as source of wheezing in children

Wheezing in children can be triggered by both allergic and non-allergic factors and the environmental pollution is widely recognized as an important non-allergic factor. Between 1992 and 2002 the Department of Edmonton inCanada carried out an extended study of 58,000 children and adults, aiming to establish the connection between atmospheric pollution and asthmatic symptoms in both children and the elderly. Indoor pollution is a serious problem in developing countries but its importance in industrialized countries should not be underestimated. Children spend a large part of their time inside the home, where concentrations of pollutants are higher than in the outside environment. In numerous case studies, closed environments have been identified as a source of pollutants such as central heating fuel, cooking gas, building materials, etc., while less emphasis has generally been placed on analyzing the effect of chemical home cleaning products. In November 2006 in the Emergency Unit of the ‘‘Sapienza’’ University of Rome Pediatric Department we conducted a study to analyze the effect of common domestic cleaning products. A questionnairewas given to the parents of 200 children visited in the Pediatric Emergency Unit. 100 had respiratory symptoms, and 100 had gastro-intestinal symptoms. Parents were asked to indicate use of various domestic hygienic products in the 2 days prior to the hospital visit. The list of products included insecticides, variations from the usual domestic cleaning product, head-lice shampoo and anti-parasitics for pets. Parents were also required to indicate the presence of smokers in the household. In the group with respiratory symptoms the diagnosis were: cough (15 cases), bronchiolitis (18 cases), croup (17 cases), asthma (51 cases), bronchopneumonia (8 cases), and epiglottitis (1 case). In the group with gastrointestinal symptoms the diagnosis were: abdominal pain (58 cases), vomiting (9 cases), gastro-enteritis (31 cases), and appendicitis (2 cases). Analysis of the questionnaire showed that 24 of the 100 children with respiratory symptoms and 4 of the 100 children with gastro-intestinal symptoms had been exposed to specific domestic hygienic products in the 2 days prior to visiting the Pediatric Emergency Unit (P< 0.0001, Fisher test). Smokers were present in the households of 32 of the childrenwith respiratory symptoms, and 25 of the children with gastro-intestinal symptoms (n.s.). The data confirm that acute respiratory symptoms in children can be related to use of common domestic cleaning products.