Being adults with cerebral palsy: results of a multicenter Italian study on quality of life and participation

Cerebral palsy (CP) is still the most common cause of disability developing in infancy. How such a complex disorder affects adult life raises important questions on the critical issues to consider and the most appropriate care pathway right from early childhood. We conducted a multicenter study on a sample of 109 individuals with CP followed up from infancy and recalled for an assessment at ages ranging between 18 and 50 years (mean age 26 years). Semi-structured interviews and specific questionnaires (SF36, LIFE-H and Hollingshead Index) were conducted to assess general psychological state, quality of life, and socio-economic conditions. Our findings showed a globally positive perception of quality of life, albeit with lower scores for physical than for mental health. Our cases generally showed good scores on participation scales, though those with more severe forms scored lower on parameters such as mobility, autonomy, and self-care. These findings were investigated in more depth in interviews, in which our participants painted a picture showing that gradual improvements have been made in several aspects over the years, in the academic attainment and employment, for instance. On the downside, our sample reported persistent limitations on autonomy in daily life. As for the more profound psychological domain, there was evidence of suffering due to isolation and relational difficulties in most cases that had not emerged from the questionnaires. Our data have possible implications for the management of CP during childhood, suggesting the need to avoid an exclusive focus on motor function goals, and to promote strategies to facilitate communication, participation, autonomy, and social relations

Metachronous Paget’s disease of the breast: case report

Paget breast disease is a kind of intraductal carcinoma that through an intracanalicular diffusion invades the basal epidermical layer,reaching the areola and nipple, producing a typical erythematous desquamative eczematous-like lesion. This neoplasia can remain undetected for a long time and inadequately treated as a dermatological affection. Synchronous or metachronous lesions are very uncommon. Surgical choice is conditioned by the presence of a tumor below the epidermical lesion, by its dimensions, and by the possible lymph node involvement. Surgical therapy can be radical or conservative. From our experience we think that lesion biopsy is always necessary to formulate a correct diagnosis and to schedule an appropriate therapeutic approach. In our case, a biopsy was performed first, then on the basis of the frozen section analysis a radical mastectomy with axillary third level lymph nodes dissection, because of the large dimensions of thelesion and the previous history of a methachronous lesio

Biodegradable compounds: Rheological, mechanical and thermal properties

Recently great attention from industry has been focused on biodegradable polyesters derived from renewable resources. In particular, PLA has attracted great interest due to its high strength and high modulus and a good biocompatibility, however its brittleness and low heat distortion temperature (HDT) restrict its wide application. On the other hand, Poly(butylene succinate) (PBS) is a biodegradable polymer with a low tensile modulus but characterized by a high flexibility, excellent impact strength, good thermal and chemical resistance. In this work the two aliphatic biodegradable polyesters PBS and PLA were selected with the aim to obtain a biodegradable material for the industry of plastic cups and plates. PBS was also blended with a thermoplastic starch. Talc was also added to the compounds because of its low cost and its effectiveness in increasing the modulus and the HDT of polymers. The compounds were obtained by melt compounding in a single screw extruder and the rheological, mechanical and thermal properties were investigated. The properties of the two compounds were compared and it was found that the values of the tensile modulus and elongation at break measured for the PBS/PLA/Talc compound make it interesting for the production of disposable plates and cups. In terms of thermal resistance the compounds have HDTs high enough to contain hot food or beverages. The PLA/PBS/Talc compound can be, then, considered as biodegradable substitute for polystyrene for the production of disposable plates and cups for hot food and beverages

Shape Memory behavior of Functionalised Poly(e-caprolactone) Crosslinked by Hexamethylene-Diisocyanate

In this study, the shape memory behaviour of poly(ε-caprolactone) (PCL) with different crosslinking degrees was investigated. PCL was first functionalised with maleic anhydride (MA) and glycidyl methacrylate (GMA), and successively chemically crosslinked by hexamethylene diisocianate (HMDI). The crosslinking reaction was studied through with a rotational stress rheometer, while the shape memory behaviour was analyzed with cyclic thermomechanical experiments and optical microscopy. The results show that the new materials exhibit good shape memory behaviour and good stability of the shape recovery under consecutive cycles in the range 55 - 70°C, can reach high level of stretching, and are furthermore characterised by high recovery speed. These results are promising for potential practical applications, as biomaterials for embolic devices in minimally invasive surgery

Edible blend films of pectin and poly(ethylene glycol): Preparation and physico-chemical evaluation

The aim of this study was the development of novel polysaccharide based films intended to be used as edible food packaging material. The films were prepared by solution casting method using highly methoxylated pectin (PEC) and poly(ethylene glycol) (PEG) of various molecular weights (400, 600 and 1000 gmol(-1)) in different ratios (5:1, 3:1 and 1:1). The film formation was supported by hydrogen bonding between PEC and PEG, which was evidenced by means of ATR-FTIR and NMR analysis. TGA revealed that generally PEG behaves like a pro-degrading agent for pectin, except in the case of PEC/PEG film with a ratio of 1:1. Furthermore, DSC thermograms indicated that PEG1000 exists as a separate phase in the pectin matrix while the formulations with PEG400 and PEG600 showed mainly amorphous morphology. The addition of PEG enhanced the plasticization of PEC films, as evidenced by progressive decreasing of the glass transition temperature values (T-g). The tensile test measurements showed that increasing concentration of PEG produced weaker and more flexibile films. Due to the increased molecular mobility, the pectin phase became more permeable to water vapor as the PEG concentration increased. The obtained results showed that the combination of both polymers resulted in interesting bio -inspired edible films with the potential to compete with commercially used synthetic package materials