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We assessed knowledge about Alzheimer’s disease (AD) in a sample of Italian general practitioners (GPs). We first carried out a propedeutic study to verify the ability of an Italian version of the University of Alabama at Birmingham’s AD Knowledge Test for Health Professionals to distinguish between 20 AD specialists and 20 non-specialists and to gain reference values. We then administered the test, together with a short questionnaire, to 139 GPs attending an educational programme in November 2000. The cut-off score for discriminating specialists from non-specialists was ≥9. Among the 95 GPs who performed the AD Knowledge Test (68.3% response rate), 21% had a total score ≥9. Our findings suggest that particular focus should be given to dementia in continuing medical education (CME) programmes for GPs. [ABSTRACT FROM AUTHOR]

Pressure sores are very common complications following spinal cord injuries and other neurological problems. We present out 15 years' experience in treating pressure sores with myocutaneous flaps. Each anatomical site is considered, divided into those in which cover was successful and those with recurrences. Over the past 8 years careful preoperative planning has been used and specific flaps for each anatomical area. Our home care system is organized to cover both domestic and medical problems. Treatment is determined after examining the wound (anatomical site, staging, infection) and underlying medical, nutritional, and neurological problems. The first choice for ischial ulcers is the VY advancement hamstring myocutaneous flap, sacral ulcers a VY myocutaneous advancement flap of gluteus maximus muscle, and for trochanteric ulcers the myocutaneous rotation flap of tensor fascia lata muscle. Using this protocol the treatment outcome of sacral and ischial ulcers has been encouraging, but in trochanteric ulcers the results have been less satisfactory. This experience supports the use of these flaps in the treatment of pressure sores in para and tetraplegic patients. [ABSTRACT FROM AUTHOR]

The "three flap mammaplasty" is a technique for breast reduction that has been used since 1992. It can be applied to breasts with any degree of ptosis and of any size. The same surgeon performs each surgical step on both breasts, which are held in traction by a special sterile device. The excision is mainly from the lower quadrants. The residual breast parenchyma consists of a large upper flap, to which the nipple–areola complex (NAC) is connected by a dermoglandular bridge, and of two smaller flaps (medial and lateral). The upper parts of these flaps are de-epithelialized and turned inwards to form a dermal septum that supports the large upper flap. This septum also contains a continuous nonabsorbent suture that connects the lower margin of the NAC to the gland center; thus preventing recurrence of ptosis. The scars are vertical or, in more severe cases, an inverted T with a short horizontal arm. [ABSTRACT FROM AUTHOR]

The usual approach for patients with advanced hypopharyngeal cancer is a multimodal treatment with surgical resection and radiation therapy. A circular pharyngolaryngoesophagectomy is mandatory in cases with advanced disease, even if it extends above the upper esophageal sphincter, followed by an immediate reconstruction. A microsurgical reconstructive technique is advised, based on Kawahara’s technique, using an ileocolic free flap as a single stage procedure for voice and swallowing rehabilitation. A total of four patients with advanced squamous cell carcinoma of the oropharynx was submitted to surgery. After pharyngolaryngoesophagectomy, the ileocolic complex was transposed and revascularized in the cervical field; the digestive tract restoration was performed with the cecum and ascending colon, while the last ileal loop was anastomosed to the cervical trachea. The continence mechanism of the ileocecal valve was used to protect the airways from inhalation of food and saliva and to obtain a monotonic phonation. A tracheal stoma was maintained to permit satisfactory breathing. All patients underwent this procedure successfully, with recovery of swallowing function and vocal performance within a short time, varying from 18 to 38 days. [ABSTRACT FROM AUTHOR]

The effects of scar retraction, following burns of the neck, on cervical movement, physiognomy and growth of facial bones are noted. The early classification of retracting scars in an attempt to facilitate the choice of surgery and the various methods used to try to prevent hypertrophic scarring and maintain neck extension are mentioned. The requirements for an efficient skin covering following excision of the neck scars are listed. The advantages and disadvantages of the various tube pedicle flaps taken from the chest and abdomen and the grafts obtained with the Padgett dermatome are compared with the advantages of the shoulder flaps from the point of view of the quality of the skin transferred, the donor area scarring as well as the early mobilisation of the cervical spine. A brief reference is made to the technique and four cases demonstrate the results obtained with the use of shoulder flaps in the treatment of retracting scars of the neck. [ABSTRACT FROM AUTHOR]

The paper describes the nipple-areolar complex (NAC) transposition technique utilized in a case of breast reconstruction after subcutaneous mastectomy. This technique is based upon the use of a medial dermal pedicle flap able to preserve NAC sensation and trophism. This flap was used to correct breast asymmetry due to NAC displacement following scar retraction. [ABSTRACT FROM AUTHOR]