Comparing cortical auditory processing in children with typical and atypical benign epilepsy with centrotemporal spikes: Electrophysiologic evidence of the role of non-rapid eye movement sleep abnormalities
Filippini M.,IRCCS Institute of Neurological science |
Boni A.,IRCCS Institute of Neurological science |
Giannotta M.,IRCCS Institute of Neurological science |
Pini A.,IRCCS Institute of Neurological science |
And 5 more authors.
Objective The mismatch negativity (MMN) is an objective measure of central auditory discrimination. MMN alterations have been shown in children with language and/or developmental disorders. In benign focal epilepsies, neuropsychological disorders are often reported and linked to interictal epileptic discharges (IEDs) during non-rapid eye movement (NREM) sleep. There are few studies reporting MMN in children with benign epilepsy with centrotemporal spikes (BECTS) and sleep IEDs. Moreover, no MMN recording has yet been reported in atypical BECTS children with continuous spike-and-wave during sleep (CSWS). We retrospectively compared MMN in typical and atypical BECTS children, particularly addressing the impact of NREM sleep IEDs on auditory discrimination. Moreover, we attempted a neuropsychological characterization of patients. Methods The MMN was recorded in 9 normal controls and 23 patients (14 typical BECTS and 9 atypical BECTS) in an oddball paradigm with syllable stimuli. MMN, sleep electroencephalography (EEG) and neuropsychological evaluation were realized in the same testing session. Results Measurable MMN responses to speech stimuli were identified in both the control and patient groups. A significant difference between control and atypical BECTS children was found with respect to amplitude (p = 0.0061). Atypical BECTS also showed a lower MMN amplitude with respect to typical BECTS, but this difference did not reach statistical significance (p = 0.0545). Statistical comparisons between groups revealed no differences in latency. Among the neuropsychological variables, academic difficulties were significantly more prominent in the patients with atypical BECTS (p = 0.04). Significance CSWS EEG pattern affects auditory discrimination and may have a long-lasting impact on academic skills acquisition, whereas in typical BECTS children with a lower degree of IED NREM sleep, plastic brain reorganization or the preservation of participating networks may prevent such difficulty. Early electrophysiologic identification of auditory discrimination deficits in epileptic children could be used in early rehabilitation, thereby reducing the risk of developing neuropsychological disorders. © Wiley Periodicals, Inc. © 2015 International League Against Epilepsy. Source
Dallolio L.,University of Bologna |
Belletti M.,Local Health Authority of Bologna |
Agostini A.,U.S. Environmental Protection Agency |
Teggi M.,Local Health Authority of Bologna |
And 4 more authors.
In the three-year period 2010-2012, 80 public swimming facilities in the metropolitan area of Bologna (Emilia Romagna Region, Italy), including 144 pools (69 indoor, 75 outdoor), were monitored to assess the microbiological and chemical water quality, after about ten years of implementing the new Italian guidance which introduced the principles of internal safety plans in the surveillance of swimming pools. According to the Italian guidance, water samples were collected from supply water (370 samples), pool water (645), and recirculating water entering the pool (307). The samples of supply water always conformed to the microbiological limits for drinking water. The pool water did not conform to the Italian legal requirements in around 16% of indoor pools and 25% of outdoor pools. In 65% of non-compliant samples, only one parameter exceeded the required standards. The microorganisms of faecal origin were isolated very rarely (Enterococci in less than 2% of samples) and pH and residual chlorine showed good compliance in pool water, implying an efficient management of the internal control. The inlet water exceeded the required standards in about 36% and 50% of samples, respectively in indoor and outdoor pools. However, 83.6% of the corresponding samples of pool water met the required limits. The microbiological incongruities were prevalently due to high levels of total heterotrophic counts (THCs) and Pseudomonas aeruginosa, and were indicative of bacterial colonization of the filters. The sampling of inlet water can thus be indicated as a critical control point for checking the correct functioning of the filters. The non-conformity of samples led to pool closure only in 1.5% of cases. In the other cases, the operators were officially invited to perform the corrective measures previously established in the plan of risk assessment. On the whole, the approach based on internal safety plans produced satisfactory results in terms of pool water quality, demonstrating the effective working of the internal system of analysis and management of risks. © 2013 Elsevier B.V. Source
Pandolfi P.,Local Health Authority of Bologna |
Zanasi A.,Pneumology Unit |
Musti M.A.,Local Health Authority of Bologna |
Stivanello E.,Local Health Authority of Bologna |
And 7 more authors.
Background Socio-economic, cultural and environmental factors are becoming increasingly important determinants of chronic obstructive pulmonary disease (COPD). We conducted a study to investigate socio-demographic, lifestyle and clinical factors, and to assess their role as predictors of acute events (mortality or hospitalization for respiratory causes) in a group of COPD patients. Methods Subjects were recruited among outpatients who were undertaking respiratory function tests at the Pneumology Unit of the Sant'Orsola-Malpighi Hospital, Bologna. Patients were classified according to the GOLD Guidelines. Results 229 patients with COPD were included in the study, 44 with Mild, 68 Moderate, 52 Severe and 65 Very Severe COPD (GOLD stage). Significant differences among COPD stage, in terms of smoking status and fragility index, were detected. COPD stage significantly affected the values of all clinical tests (spirometry and ABG analysis). Kaplan-Meier estimates showed a significant difference between survival curves by COPD stage with lower event-free probability in very severe COPD stage. Significant risk factors for acute events were: underweight (HR = 4.08; 95% CI 1.01-16.54), having two or more comorbidities (HR = 4.71; 95% CI 2.52-8.83), belonging to moderate (HR = 3.50; 95% CI 1.01-12.18) or very severe COPD stage (HR = 8.23; 95% CI 2.35-28.85). Conclusions Our findings indicate that fragility is associated with COPD stage and that comorbidities and the low body mass index are predictors of mortality or hospitalization. Besides spirometric analyses, FeNO measure and comorbidities, body mass index could also be considered in the management and monitoring of COPD patients. Copyright: © 2015 Pandolfi et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Source