The role of haptic feedback in video-Assisted thoracic surgery simulation training

technological advances on haptic devices, together with further studies focused on haptic feedback, be useful to develop efficient and effective training curricula and for establishing the value of simulators with haptic feedback in training and assessing thoracic surgical skills

Cervico-mediastinal schwannoma of the vagus nerve: resection with intraoperative nerve monitoring.

Schwannomas are usually benign, single, encapsulated, slow-growing tumours originating from cranial or spinal nerve sheaths. The vagus nerve involvement at the mediastinal inlet is very uncommon. For anatomical reasons, the resection of cervical and mediastinal schwannoma of the vagus nerve has a high risk of vocal fold paralysis. We describe the case of a 67-year-old female with a cervico-mediastinal schwannoma of the vagus nerve that we removed using the intraoperative neuromonitoring technique. The patient presented with mild hoarseness and complained of discomfort behind the jugular notch. Neck and chest computerized tomography described a 35 9 30 mm solid lesion behind the left clavi-sternal junction; preoperative fine needle aspiration cytology revealed schwannoma. Resection of the mass was performed with a cervical approach and the vagus nerve tumour was completely removed under continuous neuromonitoring (NIM-3 System), preserving the vagus and the recurrent laryngeal nerve function. Pathology on the resected mass documented A-type schwannoma with \u2018\u2018ancient schwannoma\u2019\u2019 areas. The intraoperative neurostimulation and neuromonitoring approach for the resection of vagus schwannoma are recommended because it may reduce the risk of injury to the vagus and to the recurrent laryngeal nerve

Nature reappraisers, benefits for the environment: A model linking cognitive reappraisal, the “being away” dimension of restorativeness and eco-friendly behavior

In the last decades, an increasingly prominent role has been given to the motivational factors that can promote pro-environmental behavior. In this contribution, we focus on the role of the individual’s ability to shape the emotions originating from nature in engaging in pro-environmental behavior. In particular, we expect that an emotion regulation strategy as cognitive reappraisal should positively predict pro-environmental behavior, through enhanced perceived restorativeness attributed to the natural environment in terms of the experience of “being away.” One-hundred and fifteen visitors to an urban park (Parco Nord Milano) filled out a questionnaire including measures of cognitive reappraisal, the experience of “being away,” and pro-environmental behaviour while in the park. Results confirmed that cognitive reappraisal was positively and significantly related to pro-environmental behavior. Importantly, the indirect effect of cognitive reappraisal on pro-environmental behavior through the experience of “being away” was significant. Findings suggest the importance of implementing interventions aimed at promoting the habitual use of cognitive reappraisal to enhance the experience of “being away” and, thus, sustain pro-environmental behavior

Cinema in the training of psychiatry residents: focus on helping relationships

Background: Medical schools are currently charged with a lack of education as far as empathic/relational skills and the meaning of being a health-care provider are concerned, thus leading to increased interest in medical humanities. Discussion. Medical humanities can offer an insight into human illness and in a broader outlook into human condition, understanding of one self, responsibility. An empathic relation to patients might be fostered by a matching approach to humanities and sciences, which should be considered as subjects of equal relevance, complementary to one another. Recently, movies have been used in medical - especially psychiatric - trainees education, but mainly within the limits of teaching a variety of disorders. A different approach dealing with the use of cinema in the training of psychiatry residents is proposed, based on Jung and Hillman's considerations about the relation between images and archetypes, archetypal experience and learning. Summary. Selected full-length movies or clips can offer a priceless opportunity to face with the meaning of being involved in a care-providing, helping profession

Bullous lung disease and neurofibromatosis type-1.

Lung interstitial diseases and bullae are described as possible complications of neurofibromatosis type-1 (NF-1), a genetic disorder inherited as a autosomal-dominant trait. We report the case of a 16-year-old male non-smoker with NF-1, who presented with pneumothorax caused by ruptured lung bullae. The case of this young patient, successfully treated by video-assisted thoracoscopic resection of bullae, supports the concept that pulmonary alterations may be part of the NF-1 syndrome, rather than as an unrelated complication

Prevalence of heavy smokers in the year 2000 in the province of Varese, Italy.

ABSTRACT: Prevalence of heavy smokers in the year 2000 in the Province of Varese, Italy. A. Imperatori, N. Rotolo, V. Conti, D. Di Natale, V. Tropeano, W. Mantovani. Background. Knowing the prevalence of heavy smokers (HS) by gender and age is a pre-requisite for bringing into effect public health measures against smoking-related diseases. Smoking prevalence data is available for the Italian Regions, however it is generally unknown for the Italian Provinces. Methods. In the year 2000 a survey of smoking prevalence was conducted by 47 general practitioners (GPs), by personal interview, in a large sample of the Varese Province population 45-74 years of age (28,034 subjects; 13,528 men, 14,506 women). Each surveyed subject was categorised either as ever HS (current/former smoker of at least 10 pack-years) or as non HS. The information on smoking habit collected by the GPs was anonymously pooled for analysis. Prevalence figures of smoking were tabulated by gender and by 5-year age-strata. Results. In the population 45-74 years of age the percentage of ever HS overall was 22.3% (34.4% of men; 11.0% of women). The prevalence of ever HS in both sexes combined progressively decreased with advancing age, from 23.6% (45-49 year stratum) to 19.5% (70-74 year stratum). Current HS were 24.5% of men and 9.5% of women. Conclusions. The year 2000 survey on smoking habit, showing 22.3% prevalence of ever HS in age range 45-74 years, is the first conducted in the Varese Province using a large population sample. The data on heavy cigarette smoking presented in this paper, stratified by gender and age, may be used to monitor changes in the smoking habit and in the incidence of smoking-related illnesses at the provincial level

Bullous lung disease and neurofibromatosis type-1

Lung interstitial diseases and bullae are described as possible complications of neurofibromatosis type-1 (NF-1), a genetic disorder inherited as a autosomal-dominant trait. We report the case of a 16-year-old male non-smoker with NF-1, who presented with pneumothorax caused by ruptured lung bullae. The case of this young patient, successfully treated by video-assisted thoracoscopic resection of bullae, supports the concept that pulmonary alterations may be part of the NF-1 syndrome, rather than as an unrelated complication

Self-selection effects in smokers attending lung cancer screening: a 9.5-year population-based cohort study in Varese, Italy.

BACKGROUND:: We hypothesize that mortality risk profile of participants and nonparticipants in nonrandomized lung cancer (LC) screening of smokers may be different. METHODS:: In 1997, a population-based cohort of 5815 smokers of Varese Province was invited to nonrandomized LC screening by annual chest x-ray examination for 4 years. LC risk factors and screening participation rate were recorded. Except for screening, the whole cohort received usual care. After 9.5-year observation, we compared mortality of participants versus nonparticipants by assessing age-standardized all-cause mortality rate ratio (MRR) and disease group-specific MRR with 95% confidence intervals (95% CI). RESULTS:: Self-selected screening participants were 21% of cohort. Participants were younger (p < 0.001), were more frequently current smokers (p = 0.019), had more pack-years of smoking (p < 0.0001), and had higher rate of LC family history (p < 0.0001) and of occupational LC risk (p < 0.0001) relative to nonparticipants. In logistic regression analysis familial LC, occupational risk and pack-years smoked were significant predictors of participation in screening and of developing LC. Participants displayed a healthy effect, as shown by all-cause MRR = 0.67 (95% CI, 0.53-0.84), all cancers except LC MRR = 0.61 (95% CI, 0.41-0.91), cardiovascular diseases MRR = 0.38 (95% CI, 0.22-0.63), and noncancer disease other than cardiovascular or respiratory MRR = 0.57 (95% CI, 0.34-0.92). The LC mortality (MRR = 1.40; 95% CI, 1.03-1.91) was higher in participants relative to nonparticipants (p = 0.031). CONCLUSION:: The selection effect in LC screening participants was dual: healthy effect and higher LC mortality. In assessing the overall effectiveness of LC screening on a population level, a higher LC mortality risk in participants should be considered