Usefulness of ultrasonography and color Doppler sonography in the diagnosis of major salivary gland diseases

The algorithm for imaging of the salivary glands depends on the clinical scenario with which the patient presents to the clinician. Ultrasound has been increasingly used in recent years and thanks to high performance, easy to use apparatus, it can now be used for exploration of the salivary glands. This non invasive, painless and relatively inexpensive examination provides rapid visualisation of the salivary glands and is a useful adjunct to computed tomography and magnetic risonance imaging examination, particularly in tumour pathology. In recent years, publications have highlighted the potential uselfulness of salivary gland ultrasonography as a simple and non-invasive adjunctive test for the detection of gland involvement in Sjögren's syndrome (SS). SS is a chronic inflammatory disease of the salivary glands characterised by focal lymphocytic infiltrates that cause progressive destruction of the acinar structures. The findings of a previous study lead us to believe, in agreement with other examiners, that semiquantitative assessment of ultrasonographic images of the salivary glands is a sensitive and very useful means of evaluating salivary involvement in SS. Color Doppler sonography is a recently introduced method which makes it possible to evaluate intra- and perilesional vascularization and to perform a hemodynamic study of the area being explored. The color Doppler sonography can provide a useful adjunct to conventional ultrasound, increasing diagnostic accuracy in submandibular- parotid masses and to analyze physiologic changes that occur during salivary stimulation in normal subjects and the flow alterations that occur in diseased glands of SS patients. This article reviews the normal ultrasound anatomy of the salivary glands along with lithiasic, inflammatory, tumoral, and autoimmune disease such as SS

Community-Based Homestay Service: A Proposed Livelihood Project for the Dumagats

The study is founded on a sustainable eco-tourism built on indigenous peoples’ economic empowerment without compromising their cultural heritage. The main objective of the study was to assess the economic viability of the community-based homestay service as a livelihood project to help improve the quality of life of the Dumagats who are native residents of Daraitan. The main service of the project is to provide accommodation and campsite for tourists who usually go for trekking at Mt. Daraitan. The descriptive survey method was employed in this study. Validated survey questionnaires were given out to 430 local and foreign tourists who visited the nature reserve. Data were tabulated and analyzed using the descriptive statistics and financial ratios; such as liquidity ratios, test of return on sales, gross profit ratio, and return on capital. The financial assessment of the homestay service yielded an average of 21.7% return on sales; 83.47% gross profit ratio, and 79.37% return on capital. A portion of the profit will be appropriated for charitable purposes. Mt. Daraitan is one of the to-go-to spots in the Philippines, where nature still can be seen at its most pristine state. Results of financial estimates showed that the economic viability of the project, through development, preservation of the natural architecture of the park, and a livelihood program for the natives that inhabit the area, are very strong reasons to push through with the proposal

BESPRECHUNGEN COMPTES RENDUS - REVIEWS

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/72613/1/j.1467-6435.1957.tb00243.x.pd

Surgical site infection after caesarean section. Space for post-discharge surveillance improvements and reliable comparisons

Surgical site infections (SSI) after caesarean section (CS) represent a substantial health system concern. Surveying SSI has been associated with a reduction in SSI incidence. We report the findings of three (2008, 2011 and 2013) regional active SSI surveillances after CS in community hospital of the Latium region determining the incidence of SSI. Each CS was surveyed for SSI occurrence by trained staff up to 30 post-operative days, and association of SSI with relevant characteristics was assessed using binomial logistic regression. A total of 3,685 CS were included in the study. A complete 30 day post-operation follow-up was achieved in over 94% of procedures. Overall 145 SSI were observed (3.9% cumulative incidence) of which 131 (90.3%) were superficial and 14 (9.7%) complex (deep or organ/space) SSI; overall 129 SSI (of which 89.9% superficial) were diagnosed post-discharge. Only higher NNIS score was significantly associated with SSI occurrence in the regression analysis. Our work provides the first regional data on CS-associated SSI incidence, highlighting the need for a post-discharge surveillance which should assure 30 days post-operation to not miss data on complex SSI, as well as being less labour intensive

Homocysteine metabolism in children and adolescents with epidermolysis bullosa

Background: Epidermolysis bullosa (EB) belongs to a family of rare heterogeneous, genetic disorders characterized by blistering of the skin and mucous membranes in response to minor mechanical trauma. The involvement of the oral mucosa and oesophagus stenosis is suggested to be responsible for severe nutritional deficiencies, but few studies have till now considered this aspect. This observational study aimed to evaluate homocysteine status in children and adolescents with EB by assessing total plasma homocysteine (tHcy) and metabolically related vitamins (B6, B12, folate) concentrations. Methods: Twenty EB patients (12 M; age range 0.5-19 years) were evaluated for: plasma tHcy, serum B12 and holotranscobalamin (HoloTC, the active fraction of B12), serum and erythrocyte folate (s-F and Ery-F, respectively), plasma B6 and serum high sensitive C-reactive-protein (hsCRP) levels. Clinical severity was also evaluated through the Birmingham Epidermolysis Bullosa Severity (BEBS) score. A sex and age well-matched population was also enrolled. Results: EB patients showed tHcy levels higher (p = 0.04) and B6 levels lower (p = 0.03) than controls. B12, HoloTC, s-F and ery-F concentrations did not differ between patients and controls. Multiple linear regression analysis showed that tHcy levels were independent of the metabolically related vitamins levels. In addition, serum hsCRP levels were higher in EB patients than in controls (p = 0.003) and correlated negatively with B6 concentrations (r = -0.6; p = 0.009). BEBS score correlated negatively with HoloTC (p = 0.022) and B6 (p = 0.005) levels and positively with age (p = 0.031) and hsCRP levels (p < 0.001). Conclusions: The assessment of tHcy and metabolically related vitamin levels describes an important aspect of EB patients' nutritional status which can result essential for their long term care. Monitoring B6 levels in EB patients could be particularly important in order to prevent several complications associated with B6 deficiency and to avoid a B6 excess which sustains an inflammatory condition

Intervención Social y Procesos Sociales: un estudio sobre la territorialidad, desterritorialidad y politicidad en la ciudad de Paraná

La investigación indagó los procesos sociales como expresión del movimiento tensional entre intervención social, espacios y formatos organizativos y politicidades que se despliegan con relación a la territorialidad. El trabajo exploratorio descriptivo, abordó el objeto cualitativamente, intentando captar la perspectiva de los actores observando cómo y bajo qué circunstancias producen, reproducen,&nbsp;recrean y/o transforman prácticas sociales, preguntándonos acerca de la incidencia&nbsp;de la intervención social en cada momento sobre las organizaciones sociales y en ese plano poder reconocer la politicidad que las mismas expresan. Nos planteamos como supuesto, que nos encontramos frente organizaciones sociales que responden a diferentes lógicas inscriptas en matrices divergentes que, no obstante, coexisten; lógicas en las que la intervención social de cada momento ha contribuido, sea como objetivo o como consecuencias no deseadas. En los resultados pudimos identificar modalidades que se expresan a través de rasgos que las caracterizan, encontrándonos con una territorialización desde una matriz asistencial en el Club de Abuelas de Barrio Belgrano, una construcción de la territorialidad a partir de la militancia partidaria en el Club Banfield, una territorialización de la noción de derechos en el Complejo Comunitario de Barrio Mitre, y una politización con rasgos tecnofilantrópicos en el Merendero Copa de Leche y Ropero Solidario

Immediate thoracotomy for penetrating injuries: Ten years' experience at a Dutch level I trauma center

Background: An emergency department thoracotomy (EDT) or an emergency thoracotomy (ET) in the operating theater are both beneficial in selected patients following thoracic penetrating injuries. Since outcome-descriptive European studies are lacking, the aim of this retrospective study was to evaluate ten years of experience at a Dutch level I trauma center. Method: Data on patients who underwent an immediate thoracotomy after sustaining a penetrating thoracic injury between October 2000 and January 2011 were collected from the trauma registry and hospital files. Descriptive and univariate analyses were performed. Results: Among 56 patients, 12 underwent an EDT and 44 an ET. Forty-six patients sustained one or multiple stab wounds, versus ten with one or multiple gunshot wounds. Patients who had undergone an EDT had a lower GCS (p < 0. 001), lower pre-hospital RTS and hospital triage RTS (p < 0. 001 and p = 0. 009, respectively), and a lower SBP (p = 0. 038). A witnessed loss of signs of life generally occurred in EDT patients and was accompanied by 100 % mortality. Survival following EDT was 25 %, which was significantly lower than in the ET group (75 %; p = 0. 002). Survivors had lower ISS (p = 0. 011), lower rates of pre-hospital (p = 0. 031) and hospital (p = 0. 003) hemodynamic instability, and a lower prevalence of concomitant abdominal injury (p = 0. 002). Conclusion: The overall survival rate in our study was 64 %. The outcome of immediate thoracotomy performed in this level I trauma center was similar to those obtained in high-incidence regions like the US and South Africa. This suggests that trauma units where immediate thoracotomies are not part of the daily routine can achieve similar results, if properly trained

Non solo entrate: il percorso della conoscenza attraverso i conti terzi delle Universit\ue0 di trieste e Udine

This paper focuses on the contract research (contratto in conto terzi), a frequent observed type of linkage between university and business but largely neglected in economic studies. The goal of the is twofold: i) to identify the characteristics of this specific \u201cchannel\u201d of knowledge transfer (exchange); ii) to specify these relations in terms of network links between universities and external partners. In this paper we study the interactions established in terms of contract research, by the Departments of Universities of the Friuli Venezia Giulia, a northern-east Italian region. Applying Social Network Analysis to data drawn from the administrative databases of two regional Universities, significant interactions between the University Departments and the outside world are shown. Particular attention is paid to the relationships activated with firms, grouped by sector and location, in order to stress the importance of geographical proximity in facilitating university-business relationships. The results support the existence of different knowledge exchange patterns between the two Universities, strongly influenced by the relational behavior and the scientific specialization of the most \u201ccentral\u201d Departments