Appendiceal abscess in a giant left-sided inguinoscrotal hernia: a rare case of Amyand hernia

The hernia of Amyand is an inguinal hernia containing the appendix in the sac. It is a rare pathology often diagnosed only intra-operatively. We report a case even more rare of a giant left-sided inguinoscrotal Amyand hernia with appendiceal abscess without clinical findings of incarceration/strangulation, occlusion, perforation, or acute scrotum and with the presence in the sac of the caecum and other anatomical structures (last ileal loops, bladder and omentum). The 68-years-old man patient successfully underwent surgical treatment only through the hernia sac (meshless repair according to Postempski technique)

PERCUTANEOUS TIBIAL NERVE STIMULATION FOR TREATMENT OF ANAL INCONTINENCE

Faecal incontinence (FI) is a not common symptom in the general population (0.4–2.2% in population-based studies), which 342 Tech Coloproctol (2009) 13:341–368 123 affects predominantly the elderly people, with a female prevalence. FI has a notable public health impact. It is psychologically and physically debilitating and can lead the patient to isolation and progressive loss of all social activities. Patient selection is decisive to opt for an effective intervention. A conservative approach is required to treat mild to moderate FI; it is based on nutritional, medical and rehabilitative therapy, with a success rate of5%. In no-responsive cases, other several different semi-conservative procedures, such as bulking agents, injection or sacral neuromodulator implant can be proposed prior to resorting to surgery. One of the least invasive forms of neuromodulation is the tibial nerve percutaneous stimulation (PTNS), currently used for a wide variety of urologic conditions.PTNS seems to be a safe and effective therapeutic option and it could represent a valid approach to mild to moderate FI. Tolerableness, affordability and mininvasivity of this simple procedure compel to further studie

Detection of stiff nanoparticles within cellular structures by contact resonance atomic force microscopy subsurface nanomechanical imaging

Detecting stiff nanoparticles buried in soft biological matrices by atomic force microscopy (AFM) based techniques represents a new frontier in the field of scanning probe microscopies, originally developed as surface characterization methods. Here we report the detection of stiff (magnetic) nanoparticles (NPs) internalized in cells by using contact resonance AFM (CR-AFM) employed as a potentially non-destructive subsurface characterization tool. Magnetite (Fe3O4) NPs were internalized in microglial cells from cerebral cortices of mouse embryos of 18 days by phagocytosis. Nanomechanical imaging of cells was performed by detecting the contact resonance frequencies (CRFs) of an AFM cantilever held in contact with the sample. Agglomerates of NPs internalized in cells were visualized on the basis of the local increase in the contact stiffness with respect to the surrounding biological matrix. A second AFM-based technique for nanomechanical imaging, i.e., HarmoniX™, as well as magnetic force microscopy and light microscopy were used to confirm the CR-AFM results. Thus, CR-AFM was emonstrated as a promising technique for subsurface imaging of nanomaterials in biological samples

Il concetto di Health Literacy e la sua importanza per la professione infermieristica

Introduzione: La salute degli individui e della popolazione dipende da una serie di variabili tra cui decisioni sociali, ambientali, economiche e culturali che mettono in connessione l’individuo con la società. Per poter decidere, le persone devono possedere un insieme di competenze che determinano la capacità e la motivazione di accedere ed utilizzare le conoscenze necessarie ad effettuare scelte consapevoli. Scopo: Scopo del presente lavoro è di sintetizzare e valorizzare l’importanza del concetto di Health Literacy (HL) e definire la sua importanza per la professione infermieristica, attraverso una revisione narrativa della letteratura con: analisi e focalizzazione delle diverse definizioni di HL presenti in letteratura ed elaborazione di un modello multidimensionale di HL; valutazione, attraverso revisione della letteratura, della correlazione esistente tra la professione infermieristica e l’ Health Literacy. Metodo: La revisione narrativa è stata condotta attraverso le banche dati PUBMED e CINAHL, utilizzando il termine “Health Literacy” e termini relativi associato al termine Nursing e termini relativi su studi pubblicati nel periodo 2010-2015 in lingua italiano ed inglese. Risultati: Le due direttrici di questo studio ci consentono di affermare che il concetto è variamente e largamente esaminato; allo stesso tempo l’attenzione da parte degli infermieri verso l’health literacy è ridotta, sia per non piena comprensione degli esiti sulla salute dei singoli sia per la carenza di valutazione. Dallo studio delle 28 definizioni è emerso come i concetti espressi dagli Autori siano ricorrenti e orientati su poche abilità e competenze individuali applicate al contesto sanitario (lettura, scrittura, comprensione, ascolto, etc.). Conclusioni: La presenza di tante descrizioni in letteratura, legate all’aspetto multidimensionale dell’HL rende complesso racchiudere così tanti concetti in un unicum. L’HL è legata a troppe variabili sociali, individuali ed ambientali in continua evoluzione sia arduo arrivare ad una definizione statica di HL da poter essere applicata ad ogni contesto. Allo stesso tempo diventa sempre più cogente che moduli formativi relativi all’Health Literacy vengano stabilmente integrati nella formazione sanitaria ed allo stesso tempo è necessario uno sforzo da parte dei professionisti e dei decisori per fornire risorse e strumenti alla popolazione per una migliore comprensione del sistema sanitarioIntroduction: Individuals and population’s health is influenced by environmental, social economical and cultural aspects which in turn connect individuals to society. In order to decide autonomously, independently and consciously individuals should have several competences. Aim: The aim of this study is to identify, analyse and emphasise health literacy concept relevance per se,its relationship with nursing through a narrative revision focused on: Health literacy definition recognition and analysis; Evaluation of connection between nursing and health literacy. Method: A narrative review was carried out through PUBMED and CINHAL, using ‘health literacy’ and nursing related terms, in English or Italian between 2010 and 2015. Result: Results show that ‘health literacy’ is fully appraised, while attention paid by nurses on the topic is poor due both to a lack of awareness of its relevance on individuals’ health and of appraisal. Twenty-height definition emerged from the revision; concepts expressed by scholars are mainly focused on very few individuals’ abilities and competences applied to the health context (reading, writing, calculation, comprehension , listening and so on). Conclusion: According to the results it is difficult to define ‘health literacy’ due to its multidimensional nature. Notwithstanding the above an attempt to develop a unique new definition of health literacy has been carried out although its multidimensional nature and its strong connection to several variables constantly under development. Nevertheless it is imperative that educational modules would be developed and stably integrated in health care education, at the same time a strong effort is due from professional and policy makers to provide population of the necessary tools in order to improve their health

Polymer Encapsulated Liposomes for Oral Co-Delivery of Curcumin and Hydroxytyrosol

Curcumin (Cur) is a hydrophobic polyphenol from the rhizome of Curcuma spp., while hydroxytyrosol (HT) is a water-soluble polyphenol from Olea europaea. Both show outstanding antioxidant properties but suffer from scarce bioavailability and low stability in biological fluids. In this work, the co-encapsulation of Cur and HT into liposomes was realized, and the liposomal formulation was improved using polymers to increase their survival in the gastrointestinal tract. Liposomes with different compositions were formulated: Type 1, composed of phospholipids and cholesterol; Type 2, also with a PEG coating; and Type 3 providing an additional shell of Eudragit® S100, a gastro-resistant polymer. Samples were characterized in terms of size, morphology, ζ-potential, encapsulation efficiency, and loading capacity. All samples were subjected to a simulated in vitro digestion and their stability was investigated. The Eudragit®S100 coating demonstrated prevention of early releases of HT in the mouth and gastric phases, while the PEG shell reduced bile salts and pancreatin effects during the intestinal digestion. In vitro antioxidant activity showed a cumulative effect for Cur and HT loaded in vesicles. Finally, liposomes with HT concentrations up to 40 μM and Cur up to 4.7 μM, alone or in combination, did not show cytotoxicity against Caco-2 cells

Spatial and temporal expressions of prune reveal a role in Muller gliogenesis during Xenopus retinal development

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Manejo anestésico em gestante com dissecção aguda de aorta tipo Stanford A: Anesthetic management in pregnant women with Stanford A type acute aorta dissection

A dissecção aguda de aorta é um evento raro durante a gestação, apresentando-se de forma potencialmente catastrófica, necessitando de adequado manejo anestésico. O presente caso trata de uma mulher de 30 anos, 35 semanas e 6 dias de gestação, com história de doença hipertensiva específica da gravidez (DHEG) e quadro de precordialgia de forte intensidade. Foi diagnosticada com dissecção de aorta tipo A de Stanford, sendo realizada cesárea de emergência e posterior correção cirúrgica da dissecção da aorta com anestesia geral, sem intercorrências. O manejo anestésico disponível na literatura ainda é escasso, sendo de fundamental importância o controle pressórico e hemodinâmico. Há relatos de desfechos vantajosos sobre diferentes anestesias, não existindo consenso. É importante que os anestesiologistas conheçam as possíveis dificuldades a serem encontradas para melhor manejo dos pacientes

Combined effect of obesity and diabetes on early breast cancer outcome: A prospective observational study

Background: Previous studies suggested that obesity and diabetes were correlated with breast cancer outcome. The aim of the present study was to investigate the prognostic effect of obesity and diabetes on the outcome of early breast cancer patients. Materials and Methods: Overall, 841 early breast cancer patients were prospectively enrolled between January 2009 and December 2013. Study population was divided into four groups: (1) patients without obesity or diabetes; (2) patients with only diabetes; (3) patients with only obesity; and (4) patients with both diabetes and obesity. Categorical variables were analyzed by the chi-square test and survival data by the log-rank test. Results: At diagnosis, obese and diabetic patients were more likely to be older (p < 0.0001) and post-menopausal (p < 0.0001) and to have a tumor larger than 2 cm (p < 0.0001) than patients in groups 1–3. At univariate analyses, obese and diabetic patients had a worse disease-free survival (p = 0.01) and overall survival (p = 0.001) than did patients without obesity and diabetes. At multivariate analyses, the co-presence of obesity and diabetes was an independent prognostic factor for diseasefree survival (hazard ratio=2.62, 95% CI 1.23–5.60) but not for overall survival. Conclusions: At diagnosis, patients with obesity and diabetes were older, had larger tumors and a worse outcome compared to patients without obesity or diabetes. These data suggest that metabolic health influences the prognosis of patients affected by early breast cance

Practice of the intensive nurse in the treatment of pressure ulcers

Objetivo: analisar a atua&ccedil;&atilde;o dos enfermeiros de unidade de terapia intensiva no tratamento das &uacute;lceras por press&atilde;o. M&eacute;todos: estudo descritivo desenvolvido com 13 enfermeiros da unidade de terapia intensiva de um Hospital Universit&aacute;rio no nordeste do Brasil. Um question&aacute;rio foi aplicado em junho e julho de 2011 e submetido &agrave; an&aacute;lise de conte&uacute;do tem&aacute;tica. O estudo aprovado pelo Comit&ecirc; de &Eacute;tica da Universidade Federal do Rio Grande do Norte (Protocolo 047/2011) e Certificado de Apresenta&ccedil;&atilde;o para Aprecia&ccedil;&atilde;o &Eacute;tica 0240.0.051.000.&nbsp; Resultados: os enfermeiros mencionaram como atua&ccedil;&atilde;o a avalia&ccedil;&atilde;o inicial; a escolha da cobertura, conforme avalia&ccedil;&atilde;o individual; e a realiza&ccedil;&atilde;o de desbridamento mec&acirc;nico. Conclus&atilde;o: a atua&ccedil;&atilde;o dos enfermeiros do estudo &eacute; restrita e n&atilde;o segue uma padroniza&ccedil;&atilde;o dos cuidados. &nbsp;Descritores: &Uacute;lcera por Press&atilde;o; Assist&ecirc;ncia de Enfermagem; Unidade de Terapia Intensiva