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Objective: Using an untargeted metabolomics approach we investigated the metabolome of children with type 1 diabetes (T1D) in comparison with healthy peers and explored the contribution of HbA1c and clinical features to the observed difference. Research Design and Methods:We enrolled children with T1D aged 6-15 years, attending the pediatric diabetes clinic of University of Padova (Italy). Healthy controls were enrolled on voluntary basis and matched for age, sex, pubertal status, body mass index (BMI). We performed a liquid chromatography and mass spectrometry analysis (LC-MS) on fasting urinary samples of the 2 groups.Results: A total of 56 patients with T1D aged (11.4 AE 2.2) years, and 30 healthy controls (10.7 AE 2.8) years were enrolled. We identified 59 urinary metabolites having a higher level in children with T1D, mainly represented by gluco-and mineralcorticoids, phenylalanine and tryptophan catabolites (kynurenine), small peptides, glycerophospholipids, fatty acids, and gut bacterial products. We did not find any association between HbA1c, pubertal status, disease duration, and metabolome profile within the case group.Conclusions: T1D profoundly disrupts the metabolome of pediatric patients. The excess of cortisol and aldosterone may contribute to the development of macrovascular complications in adulthood, while the increase of tryptophan derivates may have a role in neuronal damage associated to hyperglycemia. Determinants of such findings, other than HbA1c, should be explored. To date, the metabolome-based approach has demonstrated that, despite insulin treatment and a good glycemic control, in terms of In this study, we investigated a larger cohort by an untargeted metabolomics approach based on a different analytical platform (Ultra Performance Liquid Chromatography-Mass Spectrometry) able to detect thousand metabolites with 2 different polarity.The aim of this study was to investigate whether early metabolomic perturbations are detectable already in urinary metabolome of children with T1D when compared with healthy peers, in order to identify early markers of impaired metabolic pathways and generate novel hypothesis regarding the future complications described in adulthood.2 | METHODS | ParticipantsWe sequentially enrolled all pediatric patients with T1D admitted to | Sample preparationA 3 mL urine sample was collected from each subject enrolled and | Liquid chromatography and mass spectrometry analysis (LC-MS)The urine samples were analyzed with a Q-ToF Synapt G2high-resolution mass spectrometer interfaced with an Acquity Ultra Performance Liquid Chromatography (UPLC) (Waters Co., Milford, their ratio of mass on charge and retention time. A detailed description of the chromatographic analysis, and of the data pretreatment and processing is given in the Section 1 of Appendix S1, Supporting Information. | Statistical analysisMultivariate data analysis based on projection methods was applied to model the collected data. Specifically, exploratory data analysis was performed by Principal Componen...

The continuous evolution of biomedical instrumentation makes feasible, nowadays, the acquisition of a wide variety of physiological variables. This increase in the amount of data is creating the need for systems that integrate all this information. If we add the possibilities that systems for the production of rules offer, programmes that not only integrate these variables but that, with the adequate knowledge base, perform surveillance. follow up and selective monitoring tasks, in other words, intelligent monitoring systems, can be developed.

Doctors in intensive care units are at present obliged to supervise their patients' progress by means of a variety of apparatuses that measure and monitor relevant variables. These apparatuses comply with no joint standard, and there is no uniformity in the way in which information is presented or in the detection of danger levels. This situation is now additional ly unfortunate in that the expert systems currently being developed for medical monitoring and surveillance require input from systems for integrated monitoring of the patient's variables.In this comunication we present the design and implementation of an integrated system for monitoring haemodynamic I respiratory variables. The system has been devised initially with from mechanical respiratory assistance.

Flexible bronchoscopy (FOB) with bronchoalveolar lavage (BAL) is useful in children with recurrent pneumonia to discriminate among different aetiologies. Fever post-FOB and BAL has reported in these children but its origin is subject to debate. METHODS: We examined risk factors associated with fever in immunocompetent children with recurrent pneumonia undergoing FOB with BAL. Before the procedure all children performed routine blood tests, total and specific IgE dosages, Chest X-ray. All BAL specimens were tested for total and differential cell counts, interleukin (IL-8), eosinophil cationic protein (ECP), tumor necrosis factor (TNF), bacterial growth and respiratory viruses (reverse transcription-polymerase chain reaction). The cutoff for fever was 38°C in the 12 hours after the procedure.