Clinical assessment instruments validated for nursing practice in the Italian context: a systematic review of the literature

Aims. With the aim to identify the instruments validated for Italian nursing practice, a systematic review of the literature was undertaken.Results. A total of 101 instruments emerged. The majority (89; 88.1%) were developed in other countries; the remaining (14; 13.9%) were developed and validated in the Ital-ian context. The instruments were developed to measure patient’s problems (63/101; 62.4%), outcomes (27/101; 26.7%), risks (4/101; 4%) and others issues (7/101; 6.9%). The majority of participants involved in the validation processes were younger adults (49; 48.5%), older adults (40; 39.5%), children (4; 4%), adolescents (3; 3%), and children/adolescents (1; 1%). The instruments were structured primarily in the form of questionnaires (61; 60.4%), as a grid for direct observation (27; 26.7%) or in other forms (12; 11.9%). Among the 101 instruments emerged, there were 1 to 7 validation measures documented with on average 3.2 (95% CI 2.86-3.54) for each instrument.Conclusions. Developing validation studies giving priority to those instruments widely adopted in the clinical nursing practice is recommended.  

Congenital myopathies: Clinical phenotypes and new diagnostic tools

Congenital myopathies are a group of genetic muscle disorders characterized clinically by hypotonia and weakness, usually from birth, and a static or slowly progressive clinical course. Historically, congenital myopathies have been classified on the basis of major morphological features seen on muscle biopsy. However, different genes have now been identified as associated with the various phenotypic and histological expressions of these disorders, and in recent years, because of their unexpectedly wide genetic and clinical heterogeneity, next-generation sequencing has increasingly been used for their diagnosis. We reviewed clinical and genetic forms of congenital myopathy and defined possible strategies to improve cost-effectiveness in histological and imaging diagnosis

Coronary plaque quantification and composition in asymptomatic patients with type II diabetes mellitus

Objective The aim of this study was to characterize the extent and morphology of coronary lesions in asymptomatic patients with type II diabetes mellitus. Methods We enrolled 102 asymptomatic patients with type II diabetes mellitus and 97 patients without diabetes as controls. All individuals had no history of ischemic heart disease. They underwent multidetector computed tomography (MDCT). Plaque density and plaque volume were calculated using specific software on axial images. Arterial remodeling was evaluated with semiquantitative assessment on image reconstructions. Results MDCT angiography revealed the presence of 124 coronary plaques in 46 patients with type II diabetes mellitus and 59 plaques in 21 controls (P<0.01). Diabetic patients had a significantly higher proportion of lesions with impaired adaptive remodeling (56.5 versus 35.6%, P<0.01), as compared with nondiabetic individuals. The volume of fibrofatty component was 0.1 cm(3) (0.01-0.72) in diabetic patients and 0.08 cm(3) (0.01-0.33) in controls (P = 0.14). The calcium volume was 0.082 cm(3) (0-0.558) in diabetic patients and 0.12 cm(3) (0-0.669) in controls (P = 0.21). Plaques with fibrofatty components had a significantly higher density in the diabetic cohort (58.76 +/- 9.55 Hounsfield Units), as compared with the control group (47.31 +/- 5.42 Hounsfield Units, P<0.001). Plaque density correlated with the duration of type II diabetes mellitus (r = 0.37, P = 0.044), but was independent of age, sex, hypertension and metabolic profile. In the control group, plaque density was independent of any covariate. Conclusion Coronary plaques in type II diabetes mellitus show a tendency to develop impaired adaptive remodeling and to have a higher tissue density

Copper(ii) binding to flexible triethanolamine-core PAMAM dendrimers: a combined experimental/in silico approach

The structure of copper( II ) complexes formed with triethanolamine (TEA) core poly(amidoamine) (PAMAM) dendrimers from generation 0 (G0) to 4 (G4) were investigated by the electron paramagnetic resonance (EPR) technique and molecular simulations. Di\ufb00erent square planar coordination modes were detected as a function of copper( II ) concentration, whose dynamic evolution relates to the high structural flexibility peculiar to this dendrimer family. Modulated by generation and solvation e\ufb00ects, copper( II ) complexation begins at the dendrimer core and progresses to the dendrimer periphery. Differently from the ethylenediamine (EDA) core PAMAM dendrimers, the copper complexes involving the TEA core showed high mobility and saturation of the internal sites above the 1 : 1 molar ratio between the dendrimers and the ions. Therefore, by combining EPR and molecular simulations for the first time, ultimately we obtained unique information on structure, dynamics and copper interacting ability of these dendrimers which could be successfully exploited in biomedical applications

An update of the long-term trend of aerosol optical depth in the polar regions using POLAR-AOD measurements performed during the International Polar Year

An updated set of time series of derived aerosol optical depth (AOD) and Ångström’s exponent a from a number of Arctic and Antarctic stations was analyzed to determine the long-term variations of these two parameters. The Arctic measurements were performed at Ny-Ålesund (1991e2010), Barrow (1977e2010) and some Siberian sites (1981e1991). The data were integrated with Level 2.0 AERONET sun-photometer measurements recorded at Hornsund, Svalbard, and Barrow for recent years, and at Tiksi for the summer 2010. The Antarctic data-set comprises sun-photometer measurements performed at Mirny (1982e2009), Neumayer (1991e2004), and Terra Nova Bay (1987e2005), and at South Pole (1977e2010). Analyses of daily mean AOD were made in the Arctic by (i) adjusting values to eliminate volcanic effects due to the El Chichón, Pinatubo, Kasatochi and Sarychev eruptions, and (ii) selecting the summer background aerosol data from those affected by forest fire smoke. Nearly null values of the long-term variation of summer background AOD were obtained at Ny-Ålesund (1991e2010) and at Barrow (1977e2010). No evidence of important variations in AOD was found when comparing the monthly mean values of AOD measured at Tiksi in summer 2010 with those derived from multi-filter actinometer measurements performed in the late 1980s at some Siberian sites. The long-term variations of seasonal mean AOD for Arctic Haze (AH) conditions and AH episode seasonal frequency were also evaluated, finding that these parameters underwent large fluctuations over the 35-year period at Ny-Ålesund and Barrow, without presenting well- defined long-term variations. A characterization of chemical composition, complex refractive index and single scattering albedo of ground-level aerosol polydispersions in summer and winterespring is also presented, based on results mainly found in the literature. The long-term variation in Antarctic AOD was estimated to be stable, within `0.10% per year, at the three coastal sites, and nearly null at South Pole, where a weak increase was only recently observed, associated with an appreciable decrease in a, plausibly due to the formation of thin stratospheric layers of ageing volcanic particles. The main characteristics of chemical composition, complex refractive index and single scattering albedo of Antarctic aerosols are also presented for coastal particles sampled at Neumayer and Terra Nova Bay, and continental particles at South Pole

Utility of stress perfusion-cardiac magnetic resonance in follow-up of patients undergoing percutaneous coronary interventions of the left main coronary artery

To assess the accuracy of cardiac magnetic resonance (CMR) for the diagnosis of angiographic stenosis after percutaneous coronary intervention (PCI) of left main coronary artery (LMCA). Patients undergone in the last year PCI of unprotected LMCA and scheduled for conventional X-ray coronary angiography (CXA) were evaluated with stress perfusion CMR within 2 weeks before CXA. Main contraindications to CMR were exclusion criteria. Stress perfusion CMR was performed to follow a bolus of contrast Gadobutrol after 3 min of adenosine infusion. Between the 50 patients enrolled, only 1 did not finish the CMR protocol and 49 patients with median age 71 (65\u201375) years (38 male, 11 female) were analyzed. Between 784 coronary angiographic segments evaluated we found 75 stenosis or occlusions (prevalence 9.5%), but only 13 stenosis or occlusions in proximal segments (prevalence 6.6%). Patients with coronary stenosis (n = 12, 24%) showed a significantly (p = 0.002) higher prevalence of diabetes (7 of 12, 58%). At CMR examination, late gadolinium enhancement was present in 25 (51%), reversible perfusion defects in 12 (24%), and fixed perfusion defects in 6 subjects (12%). The only patient with LMCA restenosis resulted positive at perfusion CMR. The accuracy of stress perfusion CMR in diagnosis of coronary stenosis was higher when the analysis was performed only in proximal coronary arteries (95%, CI 86\u201399) compared to overall vessels (84%, CI 70\u201392). Stress perfusion CMR could strongly reduce the need for elective CXA in follow up of LMCA PCI and should be validated in further multicenter prospective studies