Congenital adrenal hyperplasia. Role of dentist in early diagnosis

Congenital adrenal hyperplasia (CAH) is a genetic disorder characterized by an impairment of steroid synthesis due to an altered production of 21-hydroxylase enzyme. Corticoid hormones are involved in the development and functioning of many organs. The aim of the present study was to review the international literature to collect data regarding oral manifestations of CAH. A review of the literature describing oral features of patients affected by CAH was performed using electronic databases (PubMed and Scopus). The data about number of patients, form of CAH, and oral findings were extracted and analyzed. Seven studies were included in the final analysis. The principal findings reported regarded an advanced dental development observed in patients with CAH. One paper reported amelogenesis imperfecta and periodontal issues. The dentist could be the first specialist involved in the CAH syndrome diagnosis, identifying the characteristic features described above, especially for the classical simple virilizing and non-classical form

The Effect of Heart Rate on Jump-Shot Accuracy of Adolescent Basketball Players

Basketball is a team sport, where fundamental skills - fundamentals - are key determinants for success. Jump-shot (JS) is a basketball fundamental used frequently during game. It is interesting to spread light on the relationship between effort intensity and JS ability. Study aim was to investigate different heart rates (HRs) effect on JS accuracy (JS%) in 22 male youth (15.7 +/- 0.9 years) players. Experimental sessions consisted of 10 JSs from five spots 5 m from basket at three different HRs: rest (0HR) and after warm-up (50% [50HR] and 80% maximal HR [80HR]). Analysis of variance showed differences in JS% over sessions (42.27 +/- 14.78% at 0HR, 38.18 +/- 10.53% at 50HR, and 30.00 +/- 16.62% at 80HR; P = 0.018). Least significant difference test did not show any significant difference between 50HR and 0HR JS% (P = 0.343), while 80HR elicited significantly lower values with respect to both 0HR (P = 0.006) and 50HR (P = 0.049). Study provided practical indications on maintaining high JS%: preliminary warm-up (even if injury-protecting) does not improve JS%, because between 50HR and 0HR difference was not significant; and 80HR significantly decreases JS%. Therefore, to maximize JS scoring players have to rest as much as possible during game-play pauses, and coaches should manage timeouts and substitutions accordingly, especially during final minutes of close games

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 \ub1 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

Water stress, yield and oil characteristics of partial rootzone drying and deficit irrigated very-high density olive orchard (Olea europaea L. 'Arbequina')

Four irrigation treatments were applied in a commercial, very-high density (VHD) olive orchard in the area of the 'Alto Tavoliere' (Province of Foggia, Apulia, Italy). The treatments consisted of: T (100% water consumption by plants - 1 dripper line; control); D (50% water consumption - 1 dripper line); P (100% water consumption - 2 dripper lines with partial rootzone drying (PRD)); PD (50% water consumption - 2 dripper lines with PRD). Pre-dawn leaf water potential (Φpd), the diurnal pattern of stem water potential (Φstem) and stomatal conductance (gs) were measured as indicators of the stress level of treatments. Vegetative-productive balance were evaluated through shoot length and yield per plant in terms of fruit and oil production. All treatments have provided extra virgin olive oils that have been characterized in terms of fatty acid composition and phenolic fraction. Water stress indices and WUEs calculated for the compared irrigation treatments showed that olive trees tolerate substantial deficit of irrigation intakes even when grown with the veryhigh density system

“Complicanze dell’ernioplastica inguinale.”

It's shown by literature and confirmed by Author's experience that, on account of the excellent results, prosthetic repair of inguinal hernia is more effective than "conventional" (Bassini, Mc Vay, Shouldice). Between January 1993 and December 2000 were observed 875 patients with inguinal hernia (814 monolateral, 61 bilateral); all patients underwent a Lichtenstein repair both in the primary version and in its variations (internal ring plastic, trasversalis plicate, plug repair). The patients were discharged from hospital within 24 hours after surgery in 90% of cases. No important intraoperative complications were observed; the patients restarting work varied from 3 to 15 days after the discharging in relation to patient anxiety, onset of complications and to the type of work. The complications observed were: urine retention (1.6%), superficial haematoma (1.3%), superficial infection (1%), wound suppuration (0.5%), serous effusion (0.7%), postsurgery pain (2.1%), scrotal edema (1.7%), persistent inguinal neuralgia (0.6), local hypoesthesia (4.3%), ischemical orchitis (0.1%), recurrence (0.2%). In conclusion Authors assert that "tension free" repair allows optimal results both for the surgery point (easiness of the technique, repeatability, less invasivity, scanty incident of recurrences, low frequency of postoperative complications) and in economic terms, allowing an early mobilization of the patients. A further improvement would be obtained with more care in surgical and patient management, with more excellent results