Rehabilitation Counselor Education and the New Code of Ethics

The purpose of this article is to discuss recent changes in the Commission on Rehabilitation Counselor Certification Code of Professional Ethics for Rehabilitation Counselors , effective January 1, 2010, that are most relevant to rehabilitation counselor educators. The authors provide a brief overview of these key changes along with implications for ethical practice in rehabilitation counselor education

An overview and update on soft tissue lesions of the head and neck

Soft tissue lesions of the head and neck encompass a broad range of pathological entities associated with different prognoses and requiring different treatments. All pathologists will encounter a wide range of soft tissue tumours in whatever specialist area they practice. Getting the diagnosis ‘right the first time’ is critical for patients to be offered optimal treatment. Molecular testing can help reach the correct diagnoses and this arena is developing fast. However, pathologists should not rely unquestioningly on special tests, whether it is immunohistochemistry or whole genome sequencing as no test is entirely specific or sensitive. Pathologists should provide a diagnosis in the context of all tests including the histology along with medical imaging and the patient's symptoms, signs and family history. This article reviews key clinical, pathological and histologic features of tumours most commonly presenting in the head and neck region, including those most recently described

An overview and update on bone lesion in craniofacial bones

Pathologists infrequently see cases of bone tumours, which are rare entities, and their diagnosis is challenging. To achieve the correct diagnosis and for patients to be offered optimal treatment, it is critical that a multidisciplinary specialised team is involved. The last decade has seen exceptional advances in the molecular classification of bone tumours, which have not only made reaching diagnoses easier, but also makes the subspeciality an exciting area of research. Bone tumours are classified based on their histological features, irrespective of the anatomical site in which the tumour presents; however, not every tumour fits nicely into these categories as some share features. Bone tumours must be diagnosed in the context of the radiology, patient's symptoms, signs and family history. This article reviews key clinical, histologic features of bone tumours and highlights the recent advances made in understanding the pathology of bone lesions in the head and neck region

Low-frequency internal friction in silica glass

Precise low-frequency internal friction measurements on vitreous silica, taken over a wide temperature (4 K160 K the loss angle develops a distinct step-like structure followed by a plateau, both independent of ν, thus signalling the onset of a competing relaxation mechanism with much higher an activation energy.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/58117/2/epl_80_5_50008.pd

Comparison of the intestinal microbiome of italian patients with multiple sclerosis and their household relatives

Multiple sclerosis (MS) is a chronic immune-mediated disease of the central nervous system, caused by a combination of genetic and environmental factors. In recent years, a role in MS pathogenesis was assigned to the gut microbiota. However, different signatures of gut dysbiosis have been shown to depend on environmental factors, like diet and lifestyle. In this study, we compared the gut microbiome in MS patients and their household healthy relatives sharing lifestyle and environmental factors. Faecal metagenomic DNA was extracted and the V3-V4 regions of the conserved bacterial 16S ribosomal RNA gene were amplified and sequenced. While overall bacterial communities were similar, specific families differed between healthy and MS subjects. We observed an increase in Ruminococcaceae, Christensenellaceae, Desulfovibrionaceae, Clostridiales, and Family XIII in MS patients, while Bacteroidaceae, Tannerellaceae, Veillonellaceae, and Burkholderiaceae were more abundant in healthy controls. In addition, principle coordinate analysis showed that the gut microbiome of all MS patients formed a cluster being less diverse than the household relatives and that gut microbiota of MS patients with EDSS 4.5-7 formed a distinct cluster in respect to their controls. Overall, our study is consistent with the hypothesis that MS patients have gut microbial dysbiosis and evidenced the importance of environmental factors in shaping the gut microbiome

[OP.2D.05] RELATIONSHIP OF OXIDATIVE STRESS WITH CARDIAC HYPERTROPHY IN HYPERTENSIVE PATIENTS

OBJECTIVE: Left ventricular hypertrophy is common in hypertensive patients. In these subjects increased oxidative stress has been observed. Our aim was to evaluate the association of biomarkers of both oxidative stress and inflammation with markers of cardiovascular damage in a large group of hypertensives with different stages of renal function. DESIGN AND METHOD: In 517 hypertensives we analyzed left ventricular mass indexed for body surface area, and we assayed plasma levels of 8-isoprostaglandin F2alpha and high sensitivity C reactive protein. RESULTS: Multivariate analysis carried out considering left ventricular mass as dependent variable, and including 8-isoprostaglandin F2alpha, high sensitivity C reactive protein, age, sex, body mass index, estimated glomerular filtration rate, serum glucose, (log)triglycerides, hemoglobin, pulse pressure or systolic blood pressure, mean or diastolic blood pressure, and antihypertensive treatment showed that in hypertensives plasma levels of 8-isoprostaglandin F2alpha were correlated with left ventricular mass (beta=0.269, p\u200a<\u200a0.0001).The bivariate relationship of left ventricular mass with 8-isoprostaglandin F2alpha in hypertensives with estimated glomerular filtration rate higher and lower than 60\u200aml/min/1.73m2 was also calculated separately, demonstrating no significant differences in both correlations coefficients and slopes of the regression lines (r\u200a=\u200a0.254, p\u200a<\u200a0.001 and r\u200a=\u200a0.226, p\u200a<\u200a0.002; respectively).In the overall group, receiver operating characteristic curves showed that 8-isoprostaglandin F2alpha and high sensitivity C reactive protein were predictors of left ventricular hypertrophy, p\u200a<\u200a0.0001. CONCLUSIONS: To the best of our knowledge, this is the first demonstration that in hypertensives oxidative stress is correlated to left ventricular hypertrophy independently of other confounding factors. Oxidative stress might participate in the development of hypertensive cardiac hypertrophy

Utility of noninvasive methods for the characterization of nonalcoholic liver steatosis in the family practice. The "VARES" Italian multicenter study.

The diagnostic utilities of ultrasonography (US), fatty liver index (FLI) and an algorithm of nine serum markers (Fibromax) were evaluated in family practice to noninvasively characterize patients with nonalcoholic fatty liver disease (NAFLD). A multicenter study was conducted by enrolling 259 consecutively observed patients (age 51 ± 10 years) with clinical and ultrasonographic features of NAFLD . Patients had mild (16.2%), moderate (69.9%), or severe (13.9%) liver steatosis and 60.2% had hypertransaminasemia. The percent of patients with overweight, obesity, diabetes, hypertension, and dyslipidemia were 42.7%, 46.5% (4.2% severe obesity), 24.7%, 40.9%, and 56.4% , respectively. Lean patients (10.8%) had normal transaminases in two/ thirds of the cases. A multivariate logistic regression (including age > 50 yrs, BMI > 30 kg/m 2 , HOMA > 3, and hypertransaminasemia) identified 12.3% of patients at risk for steatohepatitis. With a sensitivity of 50% and specificity of 94.7%, Fibromax identified 34 patients (13.1%) with likely advanced fibrosis and found that over 28% of patients with moderate (ultrasonographic) steatosis were likely to be carrying severe steatosis. Steatotest score was significantly associated with BMI, waist circumference, ALT, triglycerides, and FLI. Fibrotest correlated only with ALT. FLI identified 73.4% of patients as likely to be carrying a fatty liver. In conclusion, NAFLD should be systematically searched and characterized in all patients with metabolic disturbances and cardiovascular risk. Asymptomatic subjects at risk also should be screened for NAFLD. Fibromax is a promising noninvasive diagnostic tool in family medicine for identifying patients at risk for NAFLD who require targeted follow-up

Post-acute COVID-19 neurological syndrome: A new medical challenge

In December 2019, in Wuhan (China), a highly pathogenic coronavirus, named SARS-CoV-2, dramatically emerged. This new virus, which causes severe pneumonia, is rapidly spreading around the world, hence it provoked the COVID-19 pandemic. This emergency launched by SARS-CoV-2 also had, and still has, devastating socio-economic aspects. Assessing the impact of COVID-19 on vulnerable groups of people is crucial for the adaptation of governments’ responses. Growing scientific evidence suggests that it is essential to keep the attention on people after acute SARS-CoV-2 infection; indeed, some clinical manifestations are frequently present even after recovery. There is consensus on the need to define which symptoms persist after the infection and which disabilities may arise after COVID-19. Recent reviews, case reports, and original contributions suggest that various organs may be affected, and neurological symptoms are present in about one third of patients with COVID-19. Neurological complications after severe COVID-19 infection might include delirium, brain inflammation, stroke, and nerve damage. In the recent pandemic, neurologists and neurobiologists have a chance to study key features of infection neurology. Furthermore, the psychological impact of the pandemic should not be underestimated, although there is currently no definition for this condition