A Case of Isolated Left Ventricular Noncompaction with Basal ECG-Tracing Strongly Suggestive for Type-2 Brugada Syndrome

Isolated left ventricular noncompaction (ILVNC) is a cardiomyopathy caused by intrauterine arrest of compaction of the myocardial fibres and meshwork, an important process in myocardial development. ILVNC is clinically accompanied by depressed ventricular function, arrhythmias, and systemic embolization. We reported a case of ILVNC with basal ECG-tracing strongly suggestive for type-2 Brugada syndrome (BrS). Up to now, this is the first report investigating the association between ILVNC and this particular ECG pattern

Chemotherapy and palliative care near end-of life: Examining the appropriateness at a cancer institute for colorectal cancer patients

Background: Appropriate cessation of chemotherapy and timely referral of patients to hospice services are crucial for the quality of care near death. We investigated the quality of care in our Cancer Institute in very advanced metastatic colorectal cancer patients treated in real life. Patients and Methods: We performed a retrospective analysis of electronic medical data of patients with metastatic colorectal cancer who were candidates for chemotherapy during the study period (1 January 2007-30 June 2014) and died before 31 December 2014. Quality-of-cancer-care indicators were calculated for the overuse of chemotherapy and referral to hospice. Predictive factors of chemotherapy discontinuation and hospice referral in end-of life care were investigated using parametric and nonparametric methods. Results: Of the 365 patients who died before 31 December 2014, 26 (7.1%) received chemotherapy in the last 14 days of life and 36 (9.8%) started a new chemotherapy regimen in the last 30 days of life. Factors associated with the overuse of chemotherapy were being < 70 years of age for both indicators and not having received advanced chemotherapy treatments for the former indicator. The majority of patients (74.7%) had access to hospice services, of whom only a small percentage (7.2%) accessed them very near to death. Conclusions: According to the criteria used, our Institute provides a good quality of cancer care for dying colorectal cancer patients, measured by the use of chemotherapy and referral to hospice in their last days of life

Herlyn-werner-wunderlich syndrome: MRI findings, radiological guide (two cases and literature review), and differential diagnosis

<p>Abstract</p> <p>Background</p> <p>Herlyn-Werner-Wunderlich (HWW) syndrome is a very rare congenital anomaly of the urogenital tract involving Müllerian ducts and Wolffian structures, and it is characterized by the triad of didelphys uterus, obstructed hemivagina and ipsilateral renal agenesis. It generally occurs at puberty and exhibits non-specific and variable symptoms with acute or pelvic pain shortly following menarche, causing a delay in the diagnosis. Moreover, the diagnosis is complicated by the infrequency of this syndrome, because Müllerian duct anomalies (MDA) are infrequently encountered in a routine clinical setting.</p> <p>Cases presentation</p> <p>two cases of HWW syndrome in adolescents and a differential diagnosis for one case of a different MDA, and the impact of magnetic resonance (MR) imaging technology to achieve the correct diagnosis.</p> <p>Conclusions</p> <p>MR imaging is a very suitable diagnostic tool in order to perform the correct diagnosis of HWW syndrome.</p

Portomesenteric Venous System Gas after CT Colonography: A Case Report

Portomesenteric vein gas can occur owing to a variety of interraleted factors such as loss of mucosal integrity and intraluminal overpressure, and the most common and serious cause is bowel ischemia, which requires urgent laparotomy. Nevertheless, when portal venous gas is caused by nonischemic causes, surgery is not required and it can be treated conservatively. So, its features should be carefully evaluated at CT scan, together with clinical findings. The authors report a case of an old male with portomesenteric venous system gas after CT colonography, without evidence of pneumatosis intestinalis or colonic perforation. A CT scan without enema was required after 24 hours in absence of worsened patient conditions, revealing the disappearance of gas in mesenteric vein and in the portal venous system

Birth weight and coronary artery disease. The effect of gender and diabetes

<p>Background: The developmental origin theory of coronary heart disease proposes that undernutrition in utero permanently changes body functions and metabolism leading to an increased risk of coronary artery diseases (CAD) in adult life. Some studies support this theory but others suggest that birth weight (BW) is not a major risk factor for cardiovascular diseases. Gender differences concerning the association between BW and risk factors for CAD have been reported in some studies but not in others.</p> <p>In this paper we have analyzed the effect of gender and diabetes on the relationship between BW and CAD in the White population of Rome.</p> <p>Material and Methods: 226 subjects admitted to the Hospital for non fatal CAD from the White population of Rome were studied. 395 consecutive newborn infants studied in the same population in the years 1968-1972 were considered for comparison.</p> <p>Results: Among subjects with CAD, reliable information on BW was obtained in 127 subjects. The distribution of BW in CAD depends on gender (p=0.009). In females with CAD there is a tendency toward low BW, while in males with CAD there is a tendency toward high BW. These associations are very marked in non-diabetic subjects with CAD (p=.001), while no significant association is observed in diabetic subjects (p=0.557).</p> <p>Conclusion: Our data confirm the association between BW and CAD and suggest that the association depends on gender and is influenced by diabetes.</p

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 societí . Per poter decidere, le persone devono possedere un insieme di competenze che determinano la capacití  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 abilití  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 cosí¬ 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 sanitario.Parole Chiave: Health Literacy, servizio sanitario, infermieristica, competenze.The concept of Health Literacy and its importance for nursingIntroduction: 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. Keywords:"ˆ Health Literacy, health services, nursing, competence

I volti di Clio

La collana si rivolge a un pubblico diversificato e propone un'idea di storia contemporanea globale, intesa come impegno scientifico, critico e problematico