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Authors from Rome evaluated parental preference for treatment in children with grade III VUR. Parents were provided with detailed information about the three treatment options: antibiotic treatment, open surgery, endoscopic treatment. Most parents chose endoscopic management; with this in mind, the authors proposed a new treatment algorithm for VUR. OBJECTIVE To assess parental preference (acknowledged in treatment guidelines as important when choosing therapy) about treatments for vesico-ureteric reflux (VUR, commonly associated with urinary tract infection and which can cause long-term renal damage if left untreated), as at present there is no definitive treatment for VUR of moderate severity (grade III). SUBJECTS AND METHODS The parents of 100 children with grade III reflux (38 boys and 62 girls, mean age 4 years, range 1–15) were provided with detailed information about the three treatment options available for treating VUR (antibiotic prophylaxis, open surgery and endoscopic treatment), including the mode of action, cure rate and possible complications, and the practical advantages and disadvantages. They were then presented with a questionnaire asking them to choose their preferred treatment. RESULTS Most parents preferred endoscopic treatment (80%), rather than antibiotic prophylaxis (5%) or open surgery (2%); 13% could not decide among the three options and endoscopic treatment was recommended. CONCLUSION Given the strong preference for endoscopic treatment we propose a new algorithm for treating VUR; endoscopic treatment would be considered as the first option for persistent VUR, except in severe cases where open surgery would still be recommended. [ABSTRACT FROM AUTHOR]

From 1982 to 1990, 222 children (mean age 2.5 years, range 1-11 years) were admitted to Bambino Gesu' Children's Hospital for suspected caustic ingestion. In 126 cases (56.7%) esophageal injuries were evidenced on endoscopy, which was always performed within 24 h of the injestion. Eighteen children (8.1%) developed an esophageal stricture; 4 of these were treated surgically and the remaining 14 were included in two different protocols of conservative treatment: up to 1987, 7 patients (group 1) underwent periodic esophageal dilatations; from 1988 to 1990, 7 (group 2) were treated by esophageal stenting. In group 1, a mean of 25.1 ± 17.8 months and 19.3 ± 15.8 dilatations were necessary for the stenosis to heal completely. In group 2, disappearance of the stricture was achieved within 12.8 ± 9 months with a mean of 9.4 ± 11 dilatations. Esophageal stenting appeared to reduce by half both the duration of treatment and the number of dilatations required to obtain complete healing of corrosive stenoses. Moreover, the scars softened after stent placement, allowing safer dilatation of recurrent strictures. [ABSTRACT FROM AUTHOR]

From January 1976 to October 1986, 107 cases of esophageal atresia (EA) were admitted to the Neonatal Surgical Unit of the Bambino Gesú Hospital of Rome; 86% of the children had a type III EA. Associated anomalies were present in 47%; they were multiple in 18%. Cardiological malformations were the most frequent followed by digestive, skeletal, urological, and chromosomal aberrations. Surgical treatment was attempted in all children except 3, who died before surgical correction, in an effort to perform an end-to-end anastomosis in a single layer through a transpleural approach. According to the results, children were divided into two groups of 50 patients each: group 1 (1976-1981); and group 2 (1981-1986). Anastomosis was possible in 69% of children (68.7% in group 1, 69.3% in group 2). After 1983, gastrostomy fell into gradual disrepute and a transanastomotic tube was used. Immediate complications were seen in 36.6% of cases; in no case did recurrence of the tracheoesophageal fistula occur. The overall mortality decreased from 50% (group 1) to 30% (group 2). In the two periods considered, the mortality according to Waterston's risk classes was 28.5% → 5,8% (class A), 42.1% → 11.7% (class B), 82.3% → 68.7% (class C). Of a total of 41 deaths, 47% were due to severe associated malformations: bronchopneumopathy or prematurity seemed to have less importance in establishing the prognosis. [ABSTRACT FROM AUTHOR]

Optical performance monitoring based on digital signal processing (DSP) of a polarisation diverse coherent receiver can allow the estimation of the differential group delay (DGD) of the link fibre. In this reported work, it was found that the DGD estimation can be affected by substantial errors, since the DSP can introduce or leave uncompensated any symbol-time delay between orthogonal polarisations and cannot discriminate the in-line DGD from any other link delay. These issues are investigated and a method is proposed to partially overcome the problems. [ABSTRACT FROM AUTHOR]

Feedback-based single-stage polarization-mode dispersion compensators can suffer from dynamical limitations. These can be prevented by modulating the polarization of the transmitted signal. A high-depth modulation can result in high jitter and partial eye closure. A low-depth modulation (dithering) effectively stabilizes the compensator while it does not introduce significant system penalty. [ABSTRACT FROM PUBLISHER]

An abstract of the article "Efficacy of complete morphological screening for chromosomal anomalies at the time of nuchal translucency measurement," by M. Bellotti and colleagues is presented.

An abstract of the article "Intrauterine evolution of fetal cardiac effects diagnosed between 11 and 14 weeks of gestation," by M. Autuori and presented.

An abstract of the article "Effect of training on feasibility of early morphology evaluation at 11-13+6 weeks of gestation" by M. Bellotti and colleagues is presented.

An abstract of the article "Fetal hemodynamic adaptations to maternal chronic low level carbon monoxide exposure," by M. Bellotti and colleagues is presented.

An abstract of the conference paper "Comparison between transabdominal ultrasound with high resolution probe versus MRI for fetal cerebral morphological evaluation," by A. Prada and colleagues is presented.

An abstract of the conference paper "Doppler evaluation in fetuses with right ventricular prevalence: A contribution to the diagnosis of coarctation of aorta," by M. Bellotti and colleagues is presented.

An abstract of the article "First trimester cardiac morphology and diagnosis of cardiac defects using high-definition blood flow imaging mode," by M. Bellotti and colleagues is presented.