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Background: Kawasaki disease (KD) is a systemic vasculitis of medium arteries, particularly involving coronary arteries. Coronary artery lesions (CALs) is the most serious complication in the acute stage, potentially leading to ischemic cardiomyopathy, myocardial infarction and sudden death. Environmental factors and genetic background contribute to individual susceptibility to develop CALs. The aim of this study was to define the risk factors for CALs in an Italian cohort. Methods: Data of KD patients from 10 Italian sites were registered into a REDCap database where demographic and clinical data, laboratory findings and coronary status were recorded. KD was diagnosed according to AHA definition. We used multiple logistic regression analysis to identify independent risk factors for CALs. Results: A total of 517 patients were enrolled, mainly Caucasians (83.6%). Presentation was complete in 321 patients (62.8%) and IVIG responsiveness in 360 (70%). CALs developed in 136/517 (26.31%). Gender, age, ethnicity, clinical presentation, fever duration, non-coronary cardiac events, Hb, albumin and CRP were significantly different between patients with and without CALs, while seasonality was not. Male gender, age < 18 months, Asian ethnicity, incomplete presentation and fever > 10 days were independent risk factors for CALs. Conclusions: Age younger than 18 months, incomplete KD and longer fever duration are risk factors for CALs. Asian ethnicity also represents a risk factor in our Italian Cohort.

In this work, the effect of X-ray irradiation as a disinfection treatment in original ancient parchment samples, belonging to a discarded book cover of a 16th-century archival register, has been evaluated. Specifically, the bacterial and fungal species isolated from the book cover have been characterized and then irradiated with increasing doses of X-rays with the aim to evaluate the effectiveness of the antimicrobial protocol on the isolated microorganisms. The deterioration effects induced by the X-ray treatment as well as the natural aging on the collagen matrix of the parchment sample have been tested by employing several techniques, namely, Light Transmission Analysis, Fiber Optic Reflectance Spectroscopy, Attenuated Total Reflectance-Fourier Transformed Infrared spectroscopy, UV Resonant Raman spectroscopy and Atomic Force Microscopy. The results reveal that the irradiation treatment applied to our ancient parchment samples deteriorated by biological attack and other naturally occurring phenomena, possibly associated with inappropriate conservation conditions, does not seem to induce further damage factors even when large doses of irradiation are employed. The X-rays-based disinfection treatment effects are limited on the collagen support and this confirms the potential of this method in mass disinfection of library and archival materials.

The Ethiopian magic scrolls are traditional parchment artifacts used by the Christians of Ethiopia as protection against disease and demonic possessions. On the occasion of their restoration in the Accademia delle Belle Arti di Bologna (Italy); a preliminary characterization before the treatments has been performed on four Ethiopian scrolls belonging to the Archivio storico della provincia di Cristo Re dei Frati Minori dell’Emilia Romagna of Bologna (Italy). In order to plan an effective preservative restoration procedure and; at the same time; to investigate the manufacturing techniques; the text and the decorations on the magic scrolls were studied and characterized. A combined approach by imaging and compositional techniques was used: Infrared Reflectography (IRR) for the preliminary characterization of the graphic supports and the identification of the points to sample the chemical measurements; and the spectroscopic analyses to clarify the hypothesized investigations and confirm the chemical composition of the inks. In particular; Attenuated Total Reflectance-Fourier Transform Infrared (ATR-FTIR) spectroscopy has provided information relating to the molecular composition of inks and pigments; while a characterization of the constituent elements is obtained with the Ion Beam Analysis (IBA). The ink composition proved to be consistent with data generally documented in the literature and contributing to the expansion of knowledge on Ethiopian magic scrolls and their production.

Among the different forms of art, the puppet theatre constitutes a long-standing and often little-known tradition. The use of puppets as support for acting dates back to the Greek age, and it was mainly developed during the modern period. The reason for such a large diffusion was due to the possibility of using affordable materials, such as papier-mâché, for the puppets’ manufacture. In this paper, a method based on the combined use of pulsed thermography (PT) and mid-wave infrared reflectography (MIR) is, for the first time, proposed for the characterization of papier-mâché artworks. In particular, some puppets belonging to the collection of the Museo delle Civiltà in Rome and made by Olga Lampe Minelli, a 20th-century puppet master, were investigated in order to detect damaged areas, such as those affected by insect attacks, and, consequently, to specifically plan suitable restoration works. Finally, the investigations were also carried out after the restoration to evaluate the effectiveness of the adopted treatments.

On the occasion of the 700th centenary of the death of Dante Alighieri, medium wave infrared imaging analysis of illuminations of the XIV-century code of the Divina Commedia (MS. 1102), hosted in the Biblioteca Angelica in Rome, was performed and discussed. The investigation was carried out by means of thermographic and reflectographic techniques on illuminations where the iconographic representation appeared severely damaged. In particular, through the combined use of both techniques, it was possible to recover the images of the damaged parts of the pictorial layer of the illuminations and of their underdrawings, displaying details of the “lost guardians”, which was useful to reconstruct the conservative history of the precious manuscript.

Microorganisms often cause significant damage on historical objects. The archive or library materials as well as textile or leather artifacts suffer serious attacks that need appropriate care treatments. Several biocide processes have been implemented but often their application does not preserve the material of the good. The objective of this work is the disinfection through ionizing radiation of leather wallpaper from the museum building Palazzo Chigi in Ariccia (Rome, Italy). The controlled sterilization treatments were carried out using X-ray beams to eliminate the microorganisms present on the leather and maintaining unchanged the properties of the constituent material. Some fragments of decorated leather wallpaper, dating back to the 1700s, were irradiated with X-rays up to 5,000 Gy. The amount of microorganisms was evaluated by microbiological analysis before and after X-ray irradiation treatments to identify the dose that inhibits the bacterial load. It will be shown how the results obtained by the application of different chemical-physical techniques (Scanning Electron Microscopy, Fourier Transform Infrared spectroscopy and Light Transmission Analysis) have helped in the evaluation of the impact of the X-rays on leather chemical and physical integrity.

Abstract Background Unilateral absence of the pulmonary artery (UAPA) is a rare congenital malformation often associated with other cardiac anomalies; however it may occur as an isolated lesion. Isolated absence of the right pulmonary artery is twice more frequent than that of the left pulmonary artery. Patients with isolated UAPA are usually asymptomatic at birth; thereafter they may develop a progression of symptoms such as exercise intolerance, dyspnea, chest pain, hemoptysis and recurrent pulmonary infections. As patients may remain asymptomatic or have vague symptoms, the diagnosis of isolated UAPA can be difficult to make in infancy. Indeed, most cases described in literature are adults. Due to the rarity of neonatal presentation, there is no consensus regarding the treatment of this malformation. Case presentation Herein, the case of a two-day-old term female infant, born after uneventful pregnancy, who required a cardiological assessment for a light murmur, is reported; an echocardiogram demonstrated an isolated unilateral absence of the right pulmonary artery, confirmed by means of magnetic resonance imaging (MRI) performed 1 month after child’s birth. Besides this finding, MRI showed a slightly increased lumen and size of the main and left pulmonary arteries. The right lung was shown to be perfused by some systemic collateral arteries. In the absence of any other cardiovascular malformation, our patient did not need any treatment. As symptoms may occur later in life, a thorough clinical and cardiological follow up was immediately started. Three years later, she is still asymptomatic, showing adequate growth, without any sign of pulmonary hypertension. Conclusions Isolated UAPA is a very rare malformation with a diverse clinical presentation. To the best of our knowledge, this is the second case of neonatal presentation of UAPA reported in literature to date. We believe that our case report supports the opinion that a prompt cardiological evaluation is needed whenever a newborn shows signs and/or symptoms of cardiorespiratory concern. Any missed neonatal diagnosis of UAPA may contribute to the later age at presentation, with resultant higher risk of morbidity and mortality and greater therapeutical difficulties.

BACKGROUND:Kawasaki disease (KD) is a febrile systemic vasculitis of unknown etiology and the main cause of acquired heart disease among children in the developed world. To date, abdominal involvement at presentation is not recognized as a risk factor for a more severe form of the disease. OBJECTIVE:To evaluate whether presenting abdominal manifestations identify a group at major risk for Intravenous immunoglobulin (IVIG)-resistance and coronary lesions. METHODS:Retrospective study of KD patients diagnosed between 2000 and 2015 in 13 pediatric units in Italy. Patients were divided into 2 groups according to the presence or absence of abdominal manifestations at onset. We compared their demographic and clinical data, IVIG-responsiveness, coronary ectasia/aneurysms, laboratory findings from the acute and subacute phases. RESULTS:302 patients (181 boys) were enrolled: 106 patients with, and 196 patients without presenting abdominal features. Seasonality was different between the groups (p = 0.034). Patients with abdominal manifestations were younger (p = 0.006) and more frequently underwent delayed treatment (p = 0.014). In the acute phase, patients with abdominal presentation had higher platelet counts (PLT) (p = 0.042) and lower albuminemia (p = 0.009), while, in the subacute phase, they had higher white blood cell counts (WBC) and PLT (p = 0.002 and p < 0.005, respectively) and lower red blood cell counts (RBC) and hemoglobin (Hb) (p = 0.031 and p 0.009). Moreover, the above mentioned group was more likely to be IVIG-resistant (p < 0.005) and have coronary aneurysms (p = 0.007). In the multivariate analysis, presenting abdominal manifestations, age younger than 6 months, IVIG- resistance, delayed treatment and albumin concentration in the acute phase were independent risk factors for coronary aneurysms (respectively p

In this paper, an overview of the recent applications of pulsed infrared thermography is presented. Pulsed infrared thermography, which provides stratigraphic information by analyzing the heat diffusion process within the sample after a thermal perturbation, is applied to the investigation of different kinds of cultural heritage artefacts. In particular, it is used to analyze repairs, decorative elements, and casting faults on bronzes, to detect texts hidden or damaged in ancient books/documents, and to characterize paint decorations. Moreover, the integration of pulsed infrared thermography and three-dimensional shape recording methods is proposed in order to provide a three-dimensional representation of the thermographic results. Finally, it is shown how the obtained thermographic results may be crucial from the historical and artistic points of view for understanding the modus operandi of a specific artist and/or of a workshop and for reconstructing the manufacturing process of the analyzed artefacts.

In this study, the employment of the X-ray irradiation as bioremediation method to treat parchment has been deeply investigated. In particular, the effect of the irradiation doses on the structural stability of collagen, the main constituent of parchment, has been evaluated on a series of modern parchment samples by means of different opto-thermal and spectroscopic techniques in order to obtain the dose-dependent effect of irradiation on collagen. Moreover, the long-term behavior of the irradiated parchment has been considered by analyzing the same series of samples after being hygrothermally artificially aged. Characterizations by light transmission analysis, Fourier transform infrared spectroscopy and the ultraviolet–visible–near infrared (UV–Vis–NIR) reflectance one have been performed for the identification of the radio-induced effect on the parchment structure even in a dose range much wider than the need for sterilization. The obtained results have proved the safeness of the method in the short and long term confirming the applicability of this emerging procedure. [ABSTRACT FROM AUTHOR]

FUNDAMENTO: Na hipertensão arterial pulmonar (HAP) a qualidade de vida relacionada saúde (QVRS) tem sido investigada em curtos períodos de tempo (semanas), mas pouco se sabe sobre a perspectiva do paciente no médio e longo prazo. OBJETIVO: Analisar o estado de pacientes em terapias específicas de HAP durante um ano de observação, em termos de QVRS, e investigar se possíveis associações entre a capacidade de exercício (CE) e a QVRS persistem no médio prazo. MÉTODOS: Trinta e quatro pacientes em terapias para a HAP (bosentan e/ou sildenafil) foram selecionados (idade de 14 a 58 anos, mediana de 35,5 anos, classe funcional II ou III), e avaliados no momento basal, e 3, 6, 9 e 12 meses depois, usando o teste de caminhada de 6 minutos e questionário SF-36 de QVRS. RESULTADOS: A distância percorrida nos seis minutos não mudou durante o acompanhamento (387 - 432 metros, valores da mediana, p=0.2775), o mesmo para a classe funcional e saturação periférica de oxigênio. Os escores SF-36 também se mantiveram estáveis, com a saúde física sempre pior que a saúde mental. Das 40 possíveis associações entre a CE e QVRS, apenas 12 foram significativas (30%, p90%, mas sensível em BACKGROUND: In pulmonary arterial hypertension (PAH) health-related quality of life (HRQOL) has been investigated over the short-term (weeks) but little is known about patient's perspective over the medium and long term. OBJECTIVE: To analyze how patients on specific PAH therapies do over one year of observation in terms of HRQOL, and to investigate if possible associations between the exercise capacity (EC) and HRQOL persist over the medium term. METHODS: Thirty-four patients on PAH therapies (bosentan and/or sildenafil) were enrolled (age 14 to 58 years, median 35.5 years, functional class II or III), and evaluated at baseline, and 3, 6, 9 and 12 months subsequently using the six-minute walk test and the SF-36 HRQOL questionnaire. RESULTS: The six minute walked distance did not change over the follow-up (387-432 meters, median values, p=0.2775), the same for the functional class and peripheral oxygen saturation. The SF-36 scores also remained stable, with physical health always worse than mental health. Of 40 possible associations between EC and HRQOL, only 12 were significant (30%, p90% specific but

FUNDAMENTO: Os efeitos de longo prazo das drogas desenvolvidas para o controle da hipertensão arterial pulmonar (HAP) são pouco conhecidos, já que os estudos multicêntricos em geral têm duração de 12 a 16 semanas. OBJETIVO: Avaliar a evolução de dois anos, em pacientes com HAP submetidos à monoterapia com sildenafila (inibidor da fosfodiesterase-5), com respeito à capacidade funcional. MÉTODOS: Vinte e quatro pacientes (idade entre 8 e 54 anos) com HAP idiopática (HAPI, n = 9) ou associada a cardiopatias congênitas (HAP-CCg, n = 15) foram tratados com sildenafila por dois anos, com doses diárias que variaram de 60 a 225 mg (três tomadas), por via oral. A capacidade física foi avaliada pela distância caminhada no teste de 6 minutos (DC6M) e pelo grau de dispneia ao final da caminhada (escala de Borg), sendo também registrada a saturação periférica de oxigênio (SpO(2)6M, oximetria de pulso). RESULTADOS: Nos 18 pacientes que completaram dois anos de seguimento, houve incremento progressivo e sustentado na DC6M, tanto no grupo HAPI (de 239 ± 160 m para 471 ± 66 m, p = 0,0076) como no grupo HAP-CCg (de 361 ± 144 m para 445 ± 96m, p = 0,0031), com melhora da dispneia ao final da caminhada (p < 0,05 em ambos). Não houve decréscimo na SpO(2)6M nos grupos considerados; em particular, pacientes com HAP-CCg evoluíram de 77 ± 20% para 79 ± 16% (p = 0,5248). Houve 5 óbitos (três no grupo HAPI) e uma perda de seguimento no período. CONCLUSÃO: Em dois anos de seguimento, a sildenafila mostrou-se útil no controle da condição funcional de pacientes com HAP, com melhora significante nas duas etiologias consideradas.FUNDAMENTO: Los efectos a largo plazo de las drogas desarrolladas para el control de la hipertensión arterial pulmonar (HAP) son poco conocidos, ya que los estudios multicéntricos en general tienen una duración de 12 a 16 semanas. OBJETIVO: Evaluar la evolución a dos años, en pacientes con HAP sometidos a monoterapia con sildenafil (inhibidor de la fosfodiesterasa-5), con respecto a la capacidad funcional. MÉTODOS: Veinticuatro pacientes (edades entre 8 y 54 años) con HAP idiopática (HAPI, n = 9) o asociada a cardiopatías congénitas (HAP-CCg, n = 15) fueron tratados con sildenafil durante dos años, con dosis diarias que variaron de 60 a 225 mg (tres tomas), por vía oral. La capacidad física fue evaluada por la distancia caminada en el test de 6 minutos (DC6M) y por el grado de disnea al final de la caminata (escala de Borg), siendo también registrada la saturación periférica de oxígeno (SpO26M, oximetría de pulso). RESULTADOS: En los 18 pacientes que completaron dos años de seguimiento, hubo un incremento progresivo y sostenido en la DC6M, tanto en el grupo HAPI (de 239 ± 160 m a 471 ± 66 m, p = 0,0076) como en el grupo HAP-CCg (de 361 ± 144 m a 445 ± 96m, p = 0,0031), con mejora de la disnea al final de la caminata (p < 0,05 en ambos). No hubo disminución de la SpO26M en los grupos considerados; en particular, pacientes con HAP-CCg evolucionaron de 77 ± 20% a 79 ± 16% (p = 0,5248). Hubo 5 óbitos (tres en el grupo HAPI) y una pérdida de seguimiento en el período. CONCLUSIÓN: En dos años de seguimiento, el sildenafil demostró ser útil en el control de la condición funcional de pacientes con HAP, con mejora significativa en las dos etiologías consideradas.BACKGROUND: The long-term effects of drugs developed for the control of pulmonary arterial hypertension (PAH) are little known, since multicenter studies usually last 12 to 16 weeks. OBJECTIVE: To evaluate the two-year outcome of PAH patients receiving monotherapy with sildenafil (a phosphodiesterase-5 inhibitor), with regard to their functional capacity. METHODS: Twenty four patients (ages between 8 and 54 years) with idiopathic PAH (IPAH, n = 9) or congenital heart disease-associated PAH (CHD-PAH, n = 15) were treated with sildenafil for two years, with daily oral doses ranging from 60 to 225 mg (tid). Physical capacity was assessed by the distance walked in the 6-minute walk test (DW6M) and by the degree of dyspnea at the end of the walk (Borg scale); peripheral oxygen saturation was also recorded (SpO(2)6M, pulse oximetry). RESULTS: In the 18 patients who completed the two-year follow-up, there was a progressive and sustained increase in DW6M, both in the IPAH group (from 239 ± 160 m to 471 ± 66 m, p = 0.0076) and in the CHD-PAH group (from 361 ± 144 m to 445 ± 96m, p = 0.0031), with improvement of dyspnea at the end of the walk (p