Effects of Additional Pleurodesis with Dextrose and Talc-Dextrose Solution after Video Assisted Thoracoscopic Procedures for Primary Spontaneous Pneumothorax

Recurrence after thoracoscopic surgery for primary spontaneous pneumothorax is a lingering problem, and many intraoperative methods to induce pleural symphysis have been introduced. We analyzed the effects of chemical pleurodesis during thoracoscopic procedures. Between August 2003 and July 2005, 141 patients among indicated surgical treatment for primary spontaneous pneumothorax in two hospitals of our institution allowed this prospective study. The patients were randomly assigned to 3 groups: thoracoscopic procedure only (group A, n=50), thoracoscopic procedure and pleurodesis with dextrose solution (group B, n=49), and thoracoscopic procedure and pleurodesis with talc-dextrose mixed solution (group C, n=42). There was no significant difference in demographic data among the three groups. The two groups that underwent intraoperative pleurodesis had significantly longer postoperative hospital stays (A/B/C: 2.50±1.85/4.49±2.10/6.00±2.58 days; p=0.001) and a higher incidence of postoperative fever (A/B/C: 10.0/22.45/52.38%; χ2=21.598, p=0.00). No significant differences were found for recurrence rates or the number of postoperative days until chest tube removal. Therefore, the results of our study indicate that intraoperative chemical pleurodesis gives no additional advantage to surgery alone in deterring recurrence for patients with primary spontaneous pneumothorax. Thus, the use of such scarifying agents in the operating room must be reconsidered

Lo studio della personalità in una prospettiva longitudinale: Misura e relazioni con intelligenza, profitto scolastico e indicatori di buono/cattivo adattamento

This study evaluates the relationship between the dimensions of personality, intelligence and indicators of adjustment. The research is part of a longitudinal study devoted to the identification of risk factors and protective factors for the wellbeing of adolescents. In particular, the work is divided into three different studies. First is dedicated to the validation of two alternative forms of Big Five Questionnaire for Children, in particular a reduced form of 30 items and an application of the technique of Peer Nomination to the Five Factor Model. Second study evaluated the development of personality traits during the age considered, using the methodology of Growth Curve Analysis. Finally, the third part deals with the predictive value of intelligence and personality variables in relation to indicators of adaptation and with the relationships among the variables. Were considered for personality the Big Five dimensions and self-efficacy beliefs, rather to measure the adaptation were used academic achievement and test scores of Achenbach’s Youth Self-Report. In general results confirm the validity of the new scales, which can be particularly useful in the study of children and adolescents due to their characteristics of brevity and capacity to capture aspects that more objective scales can’t take.Development paths of the big five agree with scientific research although sometimes our subjects have anticipated changes expected. Correlations and regressions analysis also provide the expected results, but also bring some interesting informationLo scopo di questo lavoro è investigare la struttura e l’andamento dei tratti di personalità dei ragazzi nella delicata fase preadolescenziale e le loro relazioni con altre variabili importanti per la previsione di fenomeni quali il profitto scolastico e l’insorgenza di problemi di comportamento. I tre studi presentati riguardano la validazione di due versioni alternative del Big Five Questionnaire for Children, BFQ-C (Barbaranelli, Caprara e Rabasca, 1998), una ridotta ed una di eterovalutazione, l’analisi dell’andamento dei tratti di personalità nel periodo tra gli 11 ed i 15 anni e la valutazione dell’impatto della personalità, dell’intelligenza e di alcune misure dell’autoefficacia su domini comportamentali rilevanti quali la performance scolastica e la presenza di comportamenti esternalizzanti ed internalizzanti nei ragazz

Correcting Reflux Laparoscopically

Most operations in the abdominal cavity and chest can be performed using minimally invasive techniques. As yet it has not been determined which laparoscopic procedures are preferable to the same operations done through conventional laparotomy. However, most surgeons who have completed the learning curves of these procedures believe that most minimally invasive techniques will be scientifically recognized soon. The evolution, validation and justification of advanced laparoscopic surgical methods seem inevitable. Most believe that the trend towards procedures that minimize or eliminate the trauma of surgery while adhering to accepted surgical principles is irreversible. The functional results of laparoscopic antireflux surgery in the seven years since its inception have been virtually identical to the success curves generated with open fundoplication in past years. Furthermore, overall patient outcomes with laparoscopic procedures have been superior to outcomes with the traditional approach. Success is determined by patient selection and operative technique. Patient evaluation should include esophagogastroduodenoscopy, barium swallow, 24 h pH study and esophageal motility study. Gastric emptying also should be evaluated. Patients who have abnormal propulsion in the esophagus should not receive a complete fundoplication (Nissen) because it adds a factor of obstruction. Dor or Toupet procedures are adequate alternatives. Prokinetic agents, dilation or pyloroplasty are used for pyloric obstruction ranging from little to more severe. Correcting reflux laparoscopically is more difficult in patients with obesity, peptic strictures, paraesophageal hernias, short esophagus, or a history of previous upper abdominal or antireflux surgery

Association of TPH2 and dopamine receptor gene polymorphisms with obsessive-compulsive symptoms and perfectionism in healthy subjects

Obsessive–compulsive disorder (OCD) has a multifactorial genetic basis, resulting from the action of several genes and environmental factors. To extend information on the genetics of this disorder, we examined an Italian population sample composed of 72 healthy graduate or undergraduate students of Sapienza University of Rome for association of OC symptoms, perfectionism, and personality traits, with known polymorphisms of tryptophan hydroxylase 2 (TPH2), serotonin transporter (5-HTT) and receptor 5-HT2A, dopamine receptors DRD2, DRD3 and DRD4. Results obtained may contribute to pinpoint TPH2, DRD2 and DRD3 as vulnerability factors in specific behavioral/psychopathological dimensions and represent a further step in the definition of phenotypic OC/perfectionistic behaviors of genetic relevance, ready to be further investigated in other populations

Association of state and trait anxiety to semen quality of in vitro fertilization patients: A controlled study

Objective: To investigate the relationship between semen quality and state/trait anxiety in patients enrolled in an in vitro fertilization (IVF) program and in control subjects. Design: Cross-sectional study. Setting: Centre for Reproductive Medicine and Biology, European Hospital, Rome. Patient(s): Ninety-four first-Attempt IVF patients and 85 age-matched, random subjects recruited in the period July 2006 through March 2008. Intervention(s): None. Main Outcome Measure(s): Behavioral features of stress, including state and trait anxiety, self-perceived impact of physical disturbance on everyday activities, ethanol consumption, cigarette smoking, and semen parameters such as semen volume, sperm concentration, total count, motility, morphology, and DNA fragmentation. Result(s): Increased levels of both state and trait anxiety were associated with lower semen volume, sperm concentration and count, reduced sperm motility, and increased sperm DNA fragmentation of IVF patients, thus influencing seminal parameters at the macroscopic and cellular/subcellular levels. Similar results were obtained in the controls. Conclusion(s): Our data confirm previous observations with state anxiety and show that trait anxiety also is negatively associated with male fertility. © 2013 American Society for Reproductive Medicine