Criptorchidectomia con tecnica classica nel cavallo: studio retrospettivo di 67 casi

Il criptorchidismo, o mancata discesa di uno o entrambi i testicoli nello scroto, è un difetto di sviluppo di comune riscontro nel cavallo; può essere classificato, in funzione della localizzazione degli organi ritenuti, in inguinale o addominale, completo o incompleto. La valutazione di un soggetto criptorchide prevede un accurato esame clinico, completo di palpazione, ispezione rettale ed eventualmente esame ecografico; in soggetti con anamnesi dubbia o sconosciuta e comportamento da maschio intero è necessaria la titolazione dei livelli plasmatici di testosterone e o estrogeni per identificare la presenza di tessuto testicolare. La castrazione di soggetti criptorchidi viene eseguita attraverso tecniche chirurgiche convenzionali o con tecnica laparoscopica. In questo studio retrospettivo sono stati valutati i dati di 67 soggetti sottoposti a criptorchidectomia utilizzando un approccio inguinale mininvasivo. Sono stati valutati la distribuzione di razza, età, localizzazione del testicolo ritenuto, tecnica e durata dell'intervento chirurgico, durata delle terapie perioperatorie, durata dell'ospedalizzazione, eventuali complicazioni. Dei 67 soggetti, 31 erano Quarter Horse 18 mezzosangue, 18 altre razze; l'età era compresa fra 18 mesi e 5 anni. 62 soggetti erano criptorchidi monolaterali e 5 bilaterali. In 38 casi il testicolo ritenuto era a sinistra, in 34 a destra. 31 testicoli erano inguinali, 26 addominali completi, 15 addominali incompleti. Tutti i testicoli ritenuti sono stati trovati ed asportati. In 8 casi è stato necessario ricorrere ad un approccio più invasivo. La durata dell'anestesia generale variava tra 60 e 130 min. L'ospedalizzazione variava tra 1 giorno e 5 giorni. Non si sono verificate complicazioni perioperatorie. In questa serie, la criptorchidectomia tradizionale con approccio inguinale si è rivelata una tecnica efficace e con morbidità e mortalità perioperatoria molto bassa. Cryptorchidism, or failure of one or both testes to descend into the scrotum, is a common developmental defect in horses. The undescended testis can be classified according to the location of the retained organs, inguinal or abdominal, complete or incomplete. The evaluation of a cryptorchid horse consists of a thorough clinical examination, including physical exam, rectal palpation and possibly ultrasonography; in subjects with a questionable history and stallion-like behaviour, plasmatic levels of testosterone or estrogen in order to identify testicular tissue. Cryptorchidectomy is performed with conventional surgical techniques or with laparoscopic techniques. In the present retrospective study, data of 67 individuals that underwent cryptorchidectomy by means of a non invasive traditional inguinal approach were reviewed. The distribution of breed, age, localization of the undescended testis, technique and duration of the surgery, duration of perioperative treatment, duration of hospitalization and complications were evaluated. There were 31 Quarter Horses, 18 Warmbloods, 18 various breeds. Age range was 18 months - 5 years. 62 individuals were unilateral cryptorchids and 5 bilateral. The left testis was retained in 38 cases, the right testis in 34 cases. 31 testes were inguinal, 26 complete abdominal, 15 incomplete abdominal. All undescended testes were found and removed. In 8 cases, it was necessary to use a more invasive approach . The duration of general anesthesia ranged between 60 and 130 min. Hospitalization ranged between 1 and 5 days. There were no perioperative complications. In this series, traditional cryptorchidectomy with inguinal approach proved to be an effective technique with very low perioperative morbidity and mortality

Corrigendum to a new neurocognitive interpretation of shoulder position sense during reaching:unexpected competence in the measurement of extracorporeal space

[This corrects the article DOI: 10.1155/2016/9065495.

A new neurocognitive interpretation of shoulder position sense during reaching: unexpected competence in the measurement of extracorporeal space

Background.The position sense of the shoulder joint is important during reaching. Objective. To examine the existence of additional competence of the shoulder with regard to the ability to measure extracorporeal space, through a novel approach, using the shoulder proprioceptive rehabilitation tool (SPRT), during reaching. Design. Observational case-control study. Methods. We examined 50 subjects: 25 healthy and 25 with impingement syndrome with a mean age [years] of 64.52 +/− 6.98 and 68.36 +/− 6.54, respectively. Two parameters were evaluated using the SPRT: the integration of visual information and the proprioceptive afferents of the shoulder (Test 1) and the discriminative proprioceptive capacity of the shoulder, with the subject blindfolded (Test 2). These tasks assessed the spatial error (in centimeters) by the shoulder joint in reaching movements on the sagittal plane. Results. The shoulder had proprioceptive features that allowed it to memorize a reaching position and reproduce it (error of 1.22 cm to 1.55 cm in healthy subjects). This ability was lower in the impingement group, with a statistically significant difference compared to the healthy group ( < 0.05 by Mann–Whitney test). Conclusions. The shoulder has specific expertise in the measurement of the extracorporeal space during reaching movements that gradually decreases in impingement syndrome

Abacavir and cardiovascular risk in HIV-infected patients: does T-lymphocyte hyperactivation exert a pathogenic role?

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Orbiting frames and satellite attitudes in relativistic astrometry

Space-born measuring devices require an accurate determination of the satellite rest frame. This frame consists of a clock and a triad of orthonormal axes which provide a local Cartesian reference system. The aim of this paper is to find the mathematical representation of this triad in two cases which may correspond to actual satellite attitudes. First we construct a Fermi frame which can be operationally fixed by a set of three mutually orthogonal gyroscopes, then we find a frame which corresponds to the expected attitude of the satellite GAIA which was ESA approved to fly not later than 2012. In the latter case, we were able to find an analytical solution accurate to (v/c)3. In order to exploit this solution in the treatment of GAIA's astrometrical observations, we illustrate all the steps needed to deduce the components of this triad of vectors

Reasons why HIV-positive women do not want to have a child: the questionnaire-based DIDI study

Given that the majority of HIV‐positive women are of reproductive age, it is necessary to understand the interaction between HIV and family planning, especially as antiretroviral medications allow to live longer, healthier lives. Aim of this analysis form the DIDI study was to assess prevalence of motherhood desire in current years and to identify variables associated pregnancy decision‐making in HIV‐infected women. DIDI is an Italian, 16‐center, questionnaire‐based survey performed in 585 HIV‐positive women between Nov. 2010 and Feb. 2011. The items covered in the self‐administered questionnaire included: socio‐demographic characteristics, sexual and gynecological health, motherhood desire, strategies adopted to become pregnant, reasons for not wanting a child, partnership, HIV disclosure, physical and mental health, ART adherence, drug use. For the present analysis only women aged<45 years and engaged in a partnership were included. Absence of motherhood desire was defined by a negative answer at the question whether the women at present would like to have a child. 178 women were included: mean age 39 (IQR, 33–42), HIV transmission heterosexual 75%, IVDU 11%, heterosexual/IVDU 2.5%, not known 7.5%; mean CD4 and HIV‐RNA were 552/mmc (+252) and 3.85 c/ml (+4.7), respectively. Absence of motherhood desire was found in 61% of women; 50% of women declared that HIV negatively affected motherhood desire, and 22% declared a decrease in desire after start of ART. The probability of vertical transmission was estimated higher than 50% by 19% of women, even when adopting all preventive measures. Not wanting a child was associated with: fear of vertical transmission (p<0.001), fear of not being able to raise the child (p<0.001), decline in motherhood desire after HIV (p=0.007), unstable partnership (p=0.02). At multivariable analysis, variables found to be significantly associated with negative pregnancy decision‐making were: fear of vertical transmission (AOR 3.75; 95%CI 1.18–11.89), economic restrictions (AOR 0.28; 95% CI 0.10–0.76 In conclusion, absent motherhood desire in HIV‐positive women with child‐bearing potential is frequent and essential information on vertical HIV transmission is lacking. HIV‐positive women of childbearing age may benefit from counseling interventions sensitive to factors that influence infected women's pregnancy decisions

Current models of care for the management of HIV patients with comorbidities in England: a survey

Introduction: The number of people aged ]50 living with HIV in the UK is rapidly increasing. Effective treatment means HIV is usually well controlled; however, there has been an increase in individuals experiencing comorbid conditions associated with ‘‘normal’’ ageing. This aim of this study was to find out what models of care are currently in place for the management of patients with comorbidities. Materials and methods: A link to an online questionnaire was sent via the British HIV Association (BHIVA) Audit Committee to one HIV clinician in each HIV unit in England. Results: Forty-four units responded. Only 11 units (25%) provided specialized clinics for the management of comorbidities. These included: 1) Specialist clinics for the management of a non-infectious comorbidity (any age) e.g. a liver or renal clinic (n10). These clinics utilized in-person appointments (n3), or a combination of virtual and in-person appointments (n7). They were managed by an HIV clinician and non-HIV clinician together (n8), HIV clinician with an interest in the specialist area (n4) or specialist with an interest in HIV (n4). 2) Services for HIV patients with multiple comorbidities (any age) (n2). 3) Dedicated clinics for older people (n5) with eligibility determined by age (]50 years) or the presence of a comorbidity. Additionally, two HIV units employed a GP on site and two had set up a locally enhanced service providing enhanced primary care for HIV-positive patients. Six HIV units ran nurse-led clinics for patients with comorbid conditions. Co-ordination of care for patients with comorbid conditions was conducted by an HIV specialist doctor (n27), the patient’s GP (n18), HIV specialist nurse (n11) or the patient themselves (n9). Eleven clinics reported using case management for patients with multiple comorbid conditions. Self-management support (e.g. nurse-led or as part of an expert patient programme) for patients with comorbid conditions was provided at 18 HIV units. Conclusions: Only a quarter of the clinics surveyed had set up clinics for the management of comorbidities in people living with HIV. While a variety of different approaches were used, services were usually focused on the management of one comorbidity, and few provided services for multiple comorbidities. This is an increasing priority in the context of an ageing population. P162 Th

One-pill once-a-day HAART: a simplification strategy that improves adherence and quality of life of HIV-infected subjects

OBJECTIVE: The aim of the ADONE (ADherence to ONE pill) study was to verify the effect of a reduced number of pills on adherence and quality of life (QoL) in HIV-infected patients on highly active antiretroviral therapy (HAART). DESIGN: Prospective, multicenter, study. METHODS: Patients chronically treated with emtricitabine (FTC) + tenofovir (TDF) + efavirenz (EFV) or lamivudine (3TC) +TDF +EFV and with a HIV-RNA < 50 copies/mL were switched to the single-pill fixed-dose regimen (FDR) of FTC +TDF +EFV. Data were collected with SF-36 using visual analog scales. Results of the final (6 months) primary as-treated analysis are reported. RESULTS: 212 patients (77.4% males) of mean age 45.8 years were enrolled; 202 completed the study. One month post switch to FDR the adherence rate increased significantly to 96.1% from a baseline value of 93.8% (P < 0.01). The increase was steadily maintained throughout the study (96.2% at 6 months). QoL improved over time from 68.8% to 72.7% (P = 0.042) as well, and was significantly associated with the perception of health status, presence of adverse events (AEs) and number of reported AEs (P < 0.0001). QoL significantly influenced adherence (P < 0.0001). During FDR use the mean CD4 count increased from 556 to 605 cells/muL (P < 0.0001). At the end of follow-up 98% of patients maintained HIV-RNA level < 50 copies/mL and 100% <400 copies/mL. Four patients stopped therapy because they were lost to follow-up and 6 because of AEs (insomnia/nervousness 4, allergy 1, difficulties swallowing pills 1). CONCLUSION: By substituting a one-pill once-a-day HAART, we observed an improvement of both adherence and QoL while maintaining high virologic and immunologic efficacy. HAART simplicity is an added value that favors adherence and may improve long-term success

Evaluation of quantitative fFn test in predicting the risk of preterm birth

To evaluate diagnostic accuracy of quantitative fetal fibronectin (qfFN) test in predicting preterm birth (PTB) risk &lt;34 weeks' gestation or within 14 days from testing. We explored the predictive potential of the test in five-predefined PTB risk categories based on predefined qfFN thresholds (&lt;10, 10-49, 50-199, 200-499 and ≥500 ng/mL)