Search

Résumé Introduction L’expérience de l’hospitalisation, avec une succession de routines non familières, peut être extrêmement stressante pour l’enfant et ses parents. Plusieurs études ont démontré que les enfants préparés à une chirurgie récupéraient plus rapidement et avaient moins de problèmes émotionnels que ceux n’ayant pas été préparés. Nous avons voulu évaluer de quelle manière une préparation à domicile améliorait le séjour postopératoire des enfants hospitalisés en orthopédie. Patients et méthode Il s’agit d’une étude expérimentale cas contrôle. La première année, les patients ont constitué le groupe témoin. La deuxième année les enfants inclus ont reçu une préparation psychologique à domicile. Nous avons investigué l’impact de cette préparation sur la douleur ressentie, le stress de l’enfant et la durée d’hospitalisation. Résultats Vingt et un enfants ont été inclus la première année, 10 la deuxième. L’âge médian est de 12,6 ans (4,7–15,8). Le score médian de douleur maximale est de 6,0 dans le groupe préparé contre 7,0 dans le groupe témoin ( p = 0,359). Le stress de l’enfant au moment de partir au bloc opératoire est de 2,0 pour le groupe témoin contre 1,0 pour le groupe « préparé » ( p = 0,238). La médiane du nombre de jours d’hospitalisation prévus est de 5,5 jours dans le groupe témoin et de 8,5 pour le groupe préparé, celle des jours d’hospitalisation effectifs est respectivement de 4,9 vs 8,0. Conclusion Une préparation psychologique à domicile permet de réduire le stress de l’enfant et le score de douleur ressentie. D’autres études sont requises pour confirmer ces tendances. Summary Background Undergoing surgery with its unfamiliar routines, medical equipments, sounds and odours is a stressful experience for children as well as for the family. Several studies showed that prepared children recovered faster and were less emotionally impacted than those who were not prepared. For this study, we evaluated how a home-based psychological preparation improved postoperative stay of children undergoing orthopaedic surgery. Patients and methods For this experimental case-control study, the first year consisted in collecting control data. During the second year, every child enrolled received a standardized home-based preparation. Pain, child's anxiety before surgery and hospital stay duration were assessed. Results Twenty-one children were included in the control group, 10 in the intervention group. Median age is 12.6 years (4.7–15.8). Median maximum pain score during postoperative stay is 6.0 for the intervention group vs 7.0 for the control group ( P = 0.359). Mean anxiety score at the moment of entering surgery room is 2.0 for the control group vs 1.0 for the intervention group ( P = 0.238). Scheduled hospital stay is 5.5 in the control group vs 8.5 in the intervention group and effective hospital stay is 4.9 vs 8.0 respectively. Conclusion Home-based preparation enables to reduce child's anxiety and pain. Other studies are needed to confirm these trends. [ABSTRACT FROM AUTHOR]

Abstract: A research program addressed to evaluate the magnesium hydride storage scaling up effects is being developed by CESI RICERCA, Milano, and the Hydrogen Group of Padova University. A storage device containing 500g of magnesium hydride powder (manufactured by Venezia Tecnologie S.p.A. using high-energy ball milling) has been designed and tested in different operating conditions. A number of absorption and desorption cycles at different temperatures and pressures has been carried out in order to see if the results are comparable with laboratory data obtained on small amounts (fractions of grams) of powder samples. A sensible performance degradation that reduced the overall storage capacity of about 50% has been noticed after 20 cycles, presumably due to local powder heating, fragmentation and subsequent compaction. Further tests on a smaller tank equipped also with a porous baffle gave useful indications for the design of an improved large hydrogen reservoir. [Copyright &y& Elsevier]

This article discusses a new technique called Modified Per-Oral Endoscopic Septo-Miotomy (m-POESM) for the management of Zenker Diverticulum (ZD). The study followed eight patients who underwent the m-POESM procedure and found that it was successful in achieving clinical success in all cases. The technique involves a direct incision of the septum with a Hook Knife and a cricopharyngeal myotomy. The study concludes that m-POESM is a simple and effective technique with a favorable safety rate for ZD management, but further validation is needed through larger cohort studies. [Extracted from the article]

This article discusses the use of a new device called the VACStent for the treatment of post-esophagectomy leaks. The VACStent is a fully covered stent that combines the benefits of both endoscopic vacuum therapy (EVT) and covered self-expandable metal stents (c-SEMS). The article presents the results of a study conducted on three patients who were treated with the VACStent, showing that it was a safe and effective technique for treating leaks. However, larger studies are needed to further evaluate the role of the VACStent in managing these types of leaks. [Extracted from the article]

This article discusses the endoscopic management of delayed gastric emptying (DGE) after esophagectomy, a complication that affects 15-39% of patients and can lead to short and long-term complications and a poor quality of life. The main endoscopic procedures for treating DGE are intra-pyloric injection of botulinum toxin (BT), pyloric pneumatic dilation (PD), and a combination of both techniques (BTPD). The study analyzed data from patients who underwent these procedures and found that BT had a higher rate of clinical failure compared to PD and BTPD. The BTPD group had a shorter time to refeeding compared to the other groups. Further studies are needed to validate these findings. [Extracted from the article]

The hypothesis of a neurodevelopmental dysfunction being involved in the etiology of schizophrenia is suggested by the observation of morphological alterations in the brains of schizophrenia patients. These alterations may be caused by defects in neural cell differentiation or migration, which could lead to disrupted neuronal circuitry and to the schizophrenia symptomatology. The neural cell adhesion molecule (NCAM) plays a major role in cell migration and axon outgrowth, and is involved in synaptic plasticity mechanisms implicated in adult cognitive functions. Altered levels of the NCAM polysialylated form, PSA-NCAM, in the brain of schizophrenia patients have been reported, and are supportive of a role for this molecule in the disorder. To investigate the possible involvement of the NCAM gene in schizophrenia, we conducted a comprehensive genetic study, which included linkage analysis and an association study employing the Haplotype Relative Risk (HRR) design in nuclear families. Our results indicate that structural alterations in the NCAM gene are unlikely to play a major role in schizophrenia, although a function for the NCAM molecule in the etiology of the disease remains an intriguing hypothesis. [ABSTRACT FROM AUTHOR]

Objective: Narcolepsy is a lifelong disease, manifesting with excessive daytime sleepiness and cataplexy, arising between childhood and young adulthood. The diagnosis is typically made after a long delay that burdens the disease severity. The aim of the project, promoted by the "Associazione Italiana Narcolettici e Ipersonni" is to develop Red Flags to detect symptoms for early referral, targeting non-sleep medicine specialists, general practitioners, and pediatricians.Materials and Methods: A multidisciplinary panel, including patients, public institutions, and representatives of national scientific societies of specialties possibly involved in the diagnostic process of suspected narcolepsy, was convened. The project was accomplished in three phases. Phase 1: Sleep experts shaped clinical pictures of narcolepsy in pediatric and adult patients. On the basis of these pictures, Red Flags were drafted. Phase 2: Representatives of the scientific societies and patients filled in a form to identify barriers to the diagnosis of narcolepsy. Phase 3: The panel produced suggestions for the implementation of Red Flags.Results: Red Flags were produced representing three clinical pictures of narcolepsy in pediatric patients ((1) usual sleep symptoms, (2) unusual sleep symptoms, (3) endocrinological signs) and two in adult patients ((1) usual sleep symptoms, (2) unusual sleep symptoms). Inadequate knowledge of symptoms at onset by medical doctors turned out to be the main reported barrier to diagnosis.Conclusions: This report will hopefully enhance knowledge and awareness of narcolepsy among non-specialists in sleep medicine in order to reduce the diagnostic delay that burdens patients in Italy. Similar initiatives could be promoted across Europe. [ABSTRACT FROM AUTHOR]

Molecular Psychiatry (2002) 8, 146-147. doi:10.1038/sj.mp.4001221 [ABSTRACT FROM AUTHOR]

This study was performed to evaluate the incidence, risk factors, and outcome of cytomegalovirus (CMV) infection in autologous stem cell transplantation (ASCT), with the aim of performing preemptive therapy in patients with antigenemia. Starting from 2001, 171 consecutive ASCTs were performed in 136 patients; 102 of these patients were seropositive for CMV at the onset of hematological disease. In all these patients, a CMV pp65 antigenemia assay was determined weekly, starting from the day when the absolute neutrophil count went above 500/μL, and until day 60 after ASCT; subsequently, antigenemia was determined only when a CMV infection was suspected. Among the 136 transplanted patients, 40 (29.4%) presented a positive antigenemia; all of them were seropositive for CMV before ASCT; and no cases of primary infection were seen. The incidence of CMV infection in the seropositive population was 40/102 (39.3%); 6 patients (5 with multiple myeloma and 1 with non-Hodgkin's lymphoma) who received 2 ASCTs developed CMV infections after both transplantations, so that positive antigenemia developed after 46/171 (26.9%) transplantations. First positive antigenemia presented a median of 32 days (range 7–57) after stem cell reinfusion. The median antigenemia level at the first appearance was 2/200,000 (range 1–1000). No significant prognostic factors could be shown. Enteritis was present in 5 patients; 2 of them also had fever, and 1 of them also had thrombocytopenia. In 5 patients fever without any other clinical signs or symptoms was present; 30 patients were asymptomatic. Fourteen patients were treated with anti-CMV drugs. CMV reactivation was successfully treated in all patients, and no patient died from CMV disease. [ABSTRACT FROM AUTHOR]

Examines the effect of drinking water on the fattening period of veal calves. Diet composition; Physical evaluation of calves; Components of the milk replacer.

Evaluates the effects of the addition of two roughage sources to the milk replacer diet of veal calves, in order to reduce stress and improve animal welfare. Examination of the level of chronic stress; Behavioral observations; Discussion on the hematological values.

Part I. Compares the provision of two different fibrous feeds, dried beet pulp and wheat straw, in addition to a liquid diet, and evaluated their effects on calves' growth performance, forestomach development and carcass and meat quality. Information on the daily gain, feed intake, cleanliness and health status of the calves; Evaluation of slaughter measurements and meat quality; Concerns on the use of solid feeds.

The aim of this work was to evaluate the possibility of introducing in Italy a system for assessing animal welfare at farm level. For this purpose a questionnaire on the environmental characteristics of dairy farms and the reactions of cattle was prepared and submitted to 220 dairy farms. The data were obtained from interviews with farmers and from veterinarians' direct observations of the animals' reactions and farm structures. Preliminary data show that on the majority of the farms the animals were calm in the presence of the stockman and had no negative reactions relating to the presence of unfamiliar man. However, it is interesting to note the rapid turnover of milking personnel in 66% of the farms. Regarding abnormal behaviour, intersuckling in cows was detected on less than 20% of farms. This study, the first done at dairy farm level in Italy, is a first step towards finding a tool for veterinarians and farmers to assess dairy cow welfare. [ABSTRACT FROM AUTHOR]

Background: The purpose of this study was to evaluate the usefulness of intraoperative ultrasonography (IOUS), a new method of imaging the biliary tree and related structures, during laparoscopic cholecystectomy.Method: An IOUS probe (Aloka, Tokyo, Japan) with a 7.5-MHz linear-array transducer was used during cholecystectomy in 124 patients with symptomatic cholelithiasis (45 men, 79 women; mean age, 48 +/- 14 years).Results: The examination of the common bile duct (CBD) was excellent in 117 patients but unsatisfactory in 7 cases (5.6%) at the level of the head of the pancreas. In 5 patients, IOUS showed unsuspected choledocholithiasis: a subsequent intraoperational cholangiogram confirmed this. In five cases IOUS was able to help the surgeon to localize a Calot area obscured by inflammation. Postoperatively, one patient had an injury of the cystic duct stump: a nasobiliary tube resolved the bile leakage after 7 days. Another patient was submitted to postoperative endoscopic retrograde cholangiopancreatography (ERCP) for a choledocholithiasis recognized by a trans-cystic-tube cholangiography: the stone was suspected but not demonstrated either by laparoscopic IOUS or by intraoperative cholangiography. During the follow-up period, one patient had an episode of acute pancreatitis. ERCP showed a small stone wedged in the sphincter of Oddi.Conclusions: IOUS may be a real alternative to cholangiography during laparoscopic cholecystectomy since it is safer and offers a complete examination of the biliary tree. It has some disadvantages which can solved by additional experience. [ABSTRACT FROM AUTHOR]

We studied tyrosine hydroxylase (TH) gene variants in mood disorders using linkage disequilibrium techniques. One hundred and forty-five inpatients affected by bipolar (n = 88) and unipolar (n = 57) disorders, and 84 healthy controls, were typed for TH variants using polymerase chain reaction (PCR) amplification. TH was associated with mood disorder, with all affected subjects presenting an excess of TH[sup *]2 allele (χ² = 8.30, d.f. = 1; P = 0.004) and lack of the TH[sup *]1 allele (χ² = 6.90, d.f. = 1, P = 0.009). Linkage disequilibrium analyses confirmed the association. Our results suggest a moderate linkage disequilibrium of TH variants with mood disorders. [ABSTRACT FROM AUTHOR]