Complications after Laparoscopic Appendectomy for Complicated Appendicitis

Background. Laparoscopic appendectomy is established method in the treatment of complicated appendicitis. Certain advantages of the technique do not fulfill the expectations for its superiority over the open appendectomy as when it is used for uncomplicated appendicitis. This is generally caused because of the high variety of postoperative complications reported in different series for complicated appendicitis. Material and methods. This prospective interventional clinical study analyzes 61 patients operated with laparoscopic and open appendectomy due to complicated appendicitis, with an end point of comparing the intra and postoperative complications in both groups. Results. Conversion in open appendectomy was forced in one patient (1.63%). The operative time was significantly shorter in the laparoscopic group (p = 0.048). Wound infection was significantly predominant in the open group (p = 0.045). Postoperative intraabdominal abscess occurred in one patient in the laparoscopic group (p = 0.52). The overall morbidity was 26.2% (7 patients in the laparoscopic, and 9 in the open group; p = 0.59). Length of stay was significantly shorter in the laparoscopic group (p = 0.00001). Conclusion. Certain significant advantages of the laparoscopic appendectomy as low incidence of wound infection, short hospitalization, less postoperative pain and faster socialization makes the laparoscopy up to date method in the treatment of complicated appendicitis

Regulatory Problems in Very Preterm and Full-Term Infants Over the First 18 Months

Objective: This study is an investigation of differences in regulatory problems (RPs; crying, sleeping, feeding) expressed by infants born very preterm (VP; <32 wk gestation) or with very low birth weight (VLBW; <1500 g) and infants born at full term (FT) during the first 18 months of life. It investigates the prevalence of single and multiple RPs, their persistence and how early in infancy RPs still found at 18 months of age can be predicted. Method: This prospective longitudinal study of 73 VP/VLBW and 105 FT infants utilized a standard interview of mothers to assess regulatory problems among the infants at term, 3, 6, and 18 months of age. Results: Few differences were found between VP/VLBW and FT infants in the first 6 months. At 18 months, VP/VLBW infants had more single sleeping (RR = 2.2, CI = 1.3–3.7), feeding (RR = 1.4, CI = 1.03–1.8), and multiple RPs (RR = 1.7, CI = 1.02–2.8) than FT infants. In VP/VLBW infants, RPs as early as 3 months and in FT infants RPs as early as 6 months predicted RPs at 18 months. Those infants who had persistent RPs in the first 6 months of life were more likely to still have RPs at 18 months. Conclusion: VP/VLBW children are at slightly increased risk for RPs at term and in the second year of life. Clinicians should be aware that RPs that persist across the first 6 months point to increased risk of continuing RPs into toddlerhood in both VP/VLBW and FT infants

Application and validation of the Feeding Infants: Behaviour and Facial Expression Coding System (FIBFECS) to assess liking and wanting in infants at the time of complementary feeding

Introduction: The aim of this study was to validate a novel tool developed to measure liking and wanting in infants during the weaning period. The Feeding Infants: Behaviour and Facial Expression Coding System (FIBFECS; Hetherington et al., in press) is an evidence based video coding tool, consisting of 13 items. There are 6 measures of avoidance/approach behaviours (turns head away, arches back, pushes spoon away, crying/fussy, leaning forward and rate of acceptance) to assess wanting and 7 facial expressions (brow lowered, inner brow raised, squinting, nose wrinkling, lip corners down, upper lip raised and gaping) to assess liking. Lower scores on the total scale indicated greater wanting and/or liking. The tool was applied to a recent randomized control trial (Hetherington et al., 2015). Method: 36 mother-infant dyads took part in the study and were randomised to the intervention or the control group. Infants were filmed on two occasions whilst eating a generally liked vegetable (carrots) and less preferred vegetable (green bean). 72 video extracts were coded by 4 trained researchers with adequate certification scores, each video was coded by at least two coders. Items and scales were tested for discrimination ((1) intervention vs control; (2) liked vs disliked vegetable) and construct validity (correlation with intake and liking assessed by mother and researcher). Results: Very good discrimination (p < 0.001) was obtained for carrots vs green bean for the total score and total negative facial expressions and rejection behaviours (p=0.003). Discrimination for the intervention vs control groups was only obtained for the total rejections and the rate of acceptance (p < 05). The FIBFECS subscales had good construct validity as these were significantly correlated with intake and liking ratings (p < 0.01). Items such as crying/fussy and leaning forward were removed from the scale as well as inner brow raised, squinting and lip corners down, as these do not correlate with other variables. Their removal did not affect the integrity of the scale. The rate of acceptance parameter was found to have potential as a short method to measure wanting in infants. Conclusion: The present study has demonstrated that the FIBFECS can be used to identify liking and wanting independent of subjective ratings from mothers and researchers, therefore, this tool can be used widely in the study of infant responses to novel foods at the time of weaning. There is potential to develop the tool for infants beyond the period of complementary feeding and to assist in identifying fussy eating in the early stages of development

A step-by-step introduction to vegetables at the beginning of complementary feeding. The effects of early and repeated exposure

Breastfeeding (BF) is associated with willingness to accept vegetables. This may be due to the variety of flavours delivered via breast milk. Some mothers add vegetables to milk during complementary feeding (CF) to enhance acceptance. The present study tested a step-by-step exposure to vegetables in milk then rice during CF, on intake and liking of vegetables. Just before CF, enrolled mothers were randomised to an intervention (IG, n = 18; 6 BF) or control group (CG, n = 18; 6 BF). IG infants received 12 daily exposures to vegetable puree added to milk (days 1-12), then 12 × 2 daily exposures to vegetable puree added to rice at home (days 13-24). Plain milk and rice were given to CG. Then both received 11 daily exposures to vegetable puree. Intake was weighed and liking rated on days 25-26 and 33-35 after the start of CF in the laboratory, supplemented by the same data recorded at home. Vegetables were rotated daily (carrots, green beans, spinach, broccoli). Intake, liking and pace of eating were greater for IG than CG infants. Intake and liking of carrots were greater than green beans. However, at 6m then 18m follow up, vegetable (carrot > green beans) but not group differences were observed. Mothers reported appreciation of the structure and guidance of this systematic approach. Early exposure to vegetables in a step-by-step method could be included in CF guidelines and longer term benefits assessed by extending the exposure period

Italian guidelines for primary headaches: 2012 revised version

The first edition of the Italian diagnostic and therapeutic guidelines for primary headaches in adults was published in J Headache Pain 2(Suppl. 1):105–190 (2001). Ten years later, the guideline committee of the Italian Society for the Study of Headaches (SISC) decided it was time to update therapeutic guidelines. A literature search was carried out on Medline database, and all articles on primary headache treatments in English, German, French and Italian published from February 2001 to December 2011 were taken into account. Only randomized controlled trials (RCT) and meta-analyses were analysed for each drug. If RCT were lacking, open studies and case series were also examined. According to the previous edition, four levels of recommendation were defined on the basis of levels of evidence, scientific strength of evidence and clinical effectiveness. Recommendations for symptomatic and prophylactic treatment of migraine and cluster headache were therefore revised with respect to previous 2001 guidelines and a section was dedicated to non-pharmacological treatment. This article reports a summary of the revised version published in extenso in an Italian version

From Francophonie to World Literature in French

In 2007 the French newspaper Le Monde published a manifesto titled “Toward a ‘World Literature’ in French,” signed by forty-four writers, many from France’s former colonies. Proclaiming that the francophone label encompassed people who had little in common besides the fact that they all spoke French, the manifesto’s proponents, the so-called francophone writers themselves, sought to energize a battle cry against the discriminatory effects and prescriptive claims of francophonie. In one of the first books to study the movement away from the term “francophone” to “world literature in French,” Thérèse Migraine-George engages a literary analysis of contemporary works in exploring the tensions and theoretical debates surrounding world literature in French. She focuses on works by a diverse group of contemporary French-speaking writers who straddle continents—Nina Bouraoui, Hélène Cixous, Maryse Condé, Marie NDiaye, Tierno Monénembo, and Lyonel Trouillot. What these writers have in common beyond their use of French is their resistance to the centralizing power of a language, their rejection of exclusive definitions, and their claim for creative autonomy

Caracterisation chimique et diversite antigenique de polysaccharides de surface chez des souches virulentes de S. aureus d'origine animale

SIGLEINIST T 75968 / INIST-CNRS - Institut de l'Information Scientifique et TechniqueFRFranc