Pharmacological cytoreduction and sliding skin graft (h-plasty) for bilateral lower-eyelid squamous cell carcinoma in a pony

Purpose. To describe the surgical approach to a bilateral lower eyelid squamous cell carcinoma (SCC) in a pony. Methods. A 9 year old mare, Connemara Pony, light hair, presented for a bilateral lower-eyelid infiltrating mass. No diagnostic test was performed and a bilateral SCC was suspected. The neoplasia invaded 50% of the length of the lower-eyelid in both eyes, including the medial cantus in the left one. Because of new promising approaches to SCC (Hyperthermia, Brachytherapy, Photodynamic therapy) as well as most immunotherapy and chemotherapy molecules were not available, palpebral surgery was considered. Due to the size of the lesions, a pre-surgical cytoreduction was performed by using Piroxicam 0,3mg/kg/24 hours PO associated to local application of Imiquimod cream 3 times a week for 3 weeks. Slight reduction of the lateral portion of the mass was noted in both eyes, and surgical approach with H sliding skin graft was performed under general anesthesia. Lower lacrimal punctum in left eye was sacrificed, but the canaliculus was cannulated for one month. Tobramycin ointment was given topically after surgery q 6 h OU until healing occurred and systemic antibiotics and non-steroidal antiinflammatory (Flunixin M.) were administered for 7 days. cells. Results. Hystopathology confirmed the diagnosis of bilateral SCC infiltrating lower eyelid and the surgical margins appeared free from neoplastic cells. A normal palpebral function was maintained bilaterally; no recurrence was noticed 2 years after surgery. Conclusions. Whenever a new approach to palpebral SCC is not available, cytoreduction associated to surgery can be considere

Use of four-layer porcine small intestinal submucosa alone as a scaffold for the treatment of deep corneal defects in dogs and cats: Preliminary results

Background: To describe the efficacy of four-layer porcine small intestinal submucosa (Vetrix BioSIS plus+) as single scaffold for the treatment of deep corneal lesions in dogs and cats. Methods: 10 dogs and 3 cats with deep or full thickness corneal defects were treated surgically with BioSIS plus graft. Corneal transparency scores and vision were evaluated. Results: Lesions in dogs were four perforations, three descemetoceles, two limbal melanocytomas and one deep corneal ulcer. In cats, there were one limbal melanocytoma and two perforations. The average length of the follow-up was 86 days. In all, 12 out of 13 eyes treated were visual at last recheck (92.3 per cent). The scars were mild eight cases (66.7 per cent), but denser in four cases (33.4 per cent). Complication were partial collagenolysis in three cases (25 per cent), which resolved with medical therapy, mild corneal pigmentation in one case (8.4 per cent) and anterior synechia in one case (8.4 per cent). One case experienced severe collagenolysis and was enucleated 21 days postoperatively. Conclusions: Four-layer porcine SIS graft was successfully used for surgical treatment of deep corneal lesions in selected corneal diseases in a small series of dogs and cats, with good results in terms of mechanic support and corneal transparency

La conversazione durante la lettura congiunta con bambini con DSL e sviluppo tipico: l\u2019effetto del genere del libro sulla produzione linguistica

Introduzione: Nella letteratura sulla lettura congiunta come contesto privilegiato di acquisizione del linguaggio, pochi studi hanno esplorato l\u2019impatto di fattori situazionali, quali il genere del libro che costituisce il focus d\u2019attenzione. Al riguardo, l\u2019evidenza che il libro descrittivo, rispetto al libro narrativo, sollecita pi\uf9 interazione e produzione di enunciati extra-testuali e strategie supportive (Anderson et al., 2004; Hammett Price et al., 2009), appare oggi controversa (Nyhout & O'Neill, 2013). Inoltre, le evidenze empiriche dell\u2019impatto sul linguaggio del bambino durante l\u2019interazione sono scarse e limitate a b. con sviluppo tipico (ST). Il nostro studio ha esaminato la produzione linguistica di madri e bambini con DSL e ST durante la lettura congiunta di un libro descrittivo e di un libro narrativo, in relazione a: quantit\ue0 di enunciati prodotti, funzioni e strategie di supporto all\u2019apprendimento linguistico, variet\ue0 lessicale e complessit\ue0 morfosintattica. Metodo: 45 diadi madre-bambino d\u2019et\ue0 prescolare \u201215 b. con DSL espressivo e 15+15 b. con ST appaiati per et\ue0 cronologica(CRO) e linguistica(LIN)\u2012 sono state videoregistrate in 2 sessioni di lettura congiunta di un libro di immagini descrittivo vs. narrativo. Gli enunciati prodotti da madri e bambini sono stati analizzati per funzioni comunicative, strategie di supporto materno e caratteristiche linguistiche (n. types, tokens, LME, proporz. categ. grammaticali). ANCOVAs a disegno misto 2(genere libro) x 3(gruppo) sono state condotte controllando anni scolarizz. materna. Risultati: La lettura congiunta del libro descrittivo, rispetto a quella del libro narrativo, ha sollecitato conversazioni pi\uf9 lunghe nei gruppi DSL e CRO (p=.001, \u3b7p2=.31), pi\uf9 enunciati prodotti da madri (p=.004) e b. (p=.033) con ST, e pi\uf9 Riparazioni materne (p=.047) e Risposte Minime Adeguate dei b. (p=.031) nel gruppo DSL. Diversamente, la lettura del libro narrativo ha sollecitato pi\uf9 Espansioni materne degli enunciati dei b. (p=.008), e maggiore complessit\ue0 morfosintattica del linguaggio di madri e b.: maggiore LME materna nei gruppi con ST (p<.001, \u3b7p2=.46) e maggiori proporz. di verbi prodotti dalle madri (p<.001), e verbi e funtori prodotti dai b. in tutti i gruppi (p=.023 e p=.003). Conclusioni: Questi risultati indicano che i due generi di libri considerati tendono a promuovere comportamenti e abilit\ue0 linguistiche diverse, e suggeriscono un utilizzo complementare di libri descrittivi e narrativi con b. con DSL

Communication dynamics between mothers and their children with cochlear implants: Effects of maternal support for language production

This study examined (a) the functions and modalities of maternal and child communication during interaction between mothers and children with cochlear implants (CIs), comparing them with mothers and normally hearing (NH) children, and (b) the effectiveness of maternal support strategies in eliciting adequate answers in children with CI. Twenty preschoolers with CIs (M = 40 months) and 40 NH children \u2012 20 matched by chronological age (CANH, M = 40 months) and 20 matched by hearing age (HANH, M = 25 months) \u2012 were videotaped during shared book reading and toy play with their mothers. Child and maternal utterances were coded for communicative functions and modalities (vocal, gestural, bimodal), including gesture types; maternal repairs were examined for type of support provided, and child answers for adequacy. Mothers in the CI group and in the CANH group displayed higher proportions of Informative Repairs than mothers of HANH children. However, unlike the mothers of NH children, mothers of children with CIs used bimodal utterances significantly more than vocal utterances. Sequential analysis revealed that maternal Informative Repairs elicited the production of Adequate Answers in both children with CIs and CANH. Interestingly, in the CI group this association was found only when Informative Repairs were accompanied by gestures. These findings offer suggestions for intervention programs focused on parent-child conversation

Communication dynamics between mothers and children with cochlear implants: Effects of maternal vocal and gestural support for language production

Cochlear implantation (CI) at an early age is associated with improvements in language comprehension and production; nevertheless, there is wide variability in language outcomes of children with CI (Szagun, & Schramm, 2016), even after accounting for age of implantation and duration of implant use. Individual differences are explained partially by the contribution of family environment and parental linguistic input and support during interaction with these children (Cruz, Quittner, Marker, & DesJardin, 2013; Holt, Beer, Kronenberg, Pisoni, & Lalonde, 2012); however, no study has assessed modalities and impact of parental support for language production of children with CI in the real-time of parent-child interaction. This study contributes to this research field by examining (a) modalities and functions of maternal and child communication during interaction between mothers and children with CI, compared with mothers and normally hearing (NH) children, and (b) effects of maternal vocal and/or gestural supportive utterances (repairs) in eliciting conversational responsiveness and adequate answers in children with CI. Participants were 15 preschoolers with CI (M = 39 months) and 30 NH children: 15 matched by chronological-age (CANH, M = 38 months), and 15 matched by hearing-age (i.e., with children whose chronological age corresponded to the duration of CI activation; HANH, M = 26 months), and their mothers. Each child-mother dyad was videotaped during shared book reading and toy play. All interactive sessions were entirely transcribed using the Child Language Data Exchange System (CHILDES). Child and maternal utterances were coded for modality (Unimodal Spoken, Bimodal (speech+gesture), Unimodal Gestural), gesture type (Deictic, Representational, Conventional), communicative functions (Assertion, Question, Repair, Regulation, and Reading for maternal utterances; Initiative, Request, and Answer for child utterances); child answers were examined according to linguistic and content adequacy (as Absent, Inadequate, Minimally Adequate, or Fully Adequate); maternal repairs were examined according to the type of provided support (as Informative Repair, Non-Informative Repair, or Expansion) and the presence of gesture accompanying speech. Results showed interesting differences among the three groups with respect to maternal communication and to dyadic communication dynamics. Specifically, during shared book reading mothers in the CI and CANH groups displayed higher proportions of Informative Repairs than mothers of HANH children (F(2,41)=5.33, p=.009 ; MCI-MHANH=6.18, p=.016; MCANH-MHANH= 6.33, p=.002). However, unlike the mothers in both groups of NH children, mothers of children with CI used Bimodal utterances (MCI =62.44, SD =19.31) significantly more than Unimodal Spoken utterances (MCI=37.56, SD=19.31) during interaction with their children (CI t(14)=2.50, p=.026), and in higher proportions than mothers of HANH children (F(2,41)=4.15, p=.023; MCI-MHANH=17.09, p=.008). Sequential analysis (GSEQ; Bakeman & Quera, 2011) between maternal utterances and child utterances in both interactive contexts revealed that maternal Informative Repairs elicited the production of Adequate Answers in both children with CI and CANH regardless of the context. Interestingly, in the CI group this association was found only when Informative Repairs were accompanied by gestures. These findings suggest that children with CI are more sensitive to gestural cues than NH children, and offer suggestions for intervention programs focused on parent-child conversation

Il dialogo intergenerazionale come prassi educativa. Il Centro Infanzia Girotondo delle Et\ue0

Il testo presenta la progettazione intergenerazionale attuata nel Centro Infanzia Girotondo delle Et\ue0 nel Centro Infanzia di Santa Maria di Feletto: nascita, sviluppo, evoluzione, valutazione. Il progetto coinvolge da circa 20 anni il territorio circostante e il Centro Residenziale per anziani. Il testo contine anche delle riflessioni di carattere pedagogico, sociologico, psicologio e filosofico di alcuni docenti universitari, che danno un fondamento terico a tale progettazione

Identification of de novo mutations and rare variants in hypoplastic left heart syndrome.

Hypoplastic left heart syndrome (HLHS) is one of the most severe congenital heart malformations, characterized by underdevelopment of the structures in the left heartaorta complex. The majority of cases are sporadic. Although multiple genetic loci have been tentatively implicated in HLHS, no gene or pathway seems to be specifically associated with the disease. To elucidate the genetic basis of HLHS, we analyzed 53 well-characterized patients with isolated HLHS using an integrated genomic approach that combined DNA sequencing of five candidate genes (NKX2-5, NOTCH1, HAND1, FOXC2 and FOXL1) and genome-wide screening by high-resolution array comparative genomic hybridization. In 30 patients, we identified two novel de novo mutations in NOTCH1, 23 rare patients inherited gene variants in NOTCH1, FOXC2 and FOXL1, and 33 rare patients mostly inherited copy-number variants. Some of the identified variations coexisted in the same patient. The biological significance of such rare variations is unknown, but our findings strengthen the role of NOTCH pathway in cardiac valve development, indicating that HLHS is, at least in part, a valve disease. This is the first report of de novo mutations associated with isolated HLHS. Moreover, the coexistence of multiple rare variants suggests in some cases a cumulative effect, as shown for other complex disease

Body temperature at nursery admission in a cohort of healthy newborn infants: Results from an observational cross-sectional study

Background: Exposure to hypothermia is somehow unavoidable when a baby comes to life. This is the reason why any possible effort should be made by every caregiver involved during birth, from labour to transfer into the maternity ward, to reduce it. Hypothermia has widely shown to be related to several neonatal problems, and the risks are more relevant when the babies are born prematurely. Method: An observational study was conducted in April 2016 to assess the current practises to avoid hypothermia at birth in 20 Italian neonatal units. Each unit introduced local improvements in clinical practice and the same observational study was repeated 1 year later. Results: A total of 4722 babies were analysed. An overall increase in adherence to local and international recommendations emerged from our study. Significant differences between 2016 and 2017 were found in regard to neonatal temperature at nursery entry (36.3 \ub0C vs 36.5 \ub0C, respectively, p &lt; 0.0001), delayed cord clamping practice &gt; 60\u2033 (48.1% vs 68.1%, respectively, p &lt; 0.0001) and skin-to-skin practice &gt; 60\u2032 (56.3% vs 60.9, respectively, p = 0.03). Statistical correlations with the risk of hypothermia were found for delivery room (OR 0.88 (CI 95%0.83-0.94), p &lt; 0.0001) and maternal temperature (OR 0.57 (CI 95% 0.48-0.67), p &lt; 0.0001). Conclusion: Periodical assessment of the delivery room practice has shown to be effective in improving adherence to the international recommendations. Relationship between neonatal hypothermia and several other variables including the delivery room and mother temperature underlines how neonatal thermoregulation starts immediately after birth. Hence, a multi-disciplinary approach is needed to provide the optimal environment for a safe birth