Considerazioni in merito all’uso dei test mentali nella quantificazione del danno biologico di natura psichica

Gli autori, pur rimarcando la centralità del colloquio strutturato e dell’esame delle condizioni mentali per la valutazione del danno biologico di natura psichica, sottolineano altresì l’importanza, all’interno di un corretto esame psicodiagnostico, dei test mentali quale utile supporto per la quantificazione del danno stesso, a condizione di conoscerne peculiarità e limiti

Left ventricular midwall mechanics at 24 weeks' gestation in high-risk normotensive pregnant women: Relationship to placenta-related complications of pregnancy

Most studies during pregnancy have assessed maternal left ventricular (LV) function by load-dependent indices, assessing only chamber function. The aim of this study was to assess afterload-adjusted LV myocardial and chamber systolic function at 24 weeks' gestation and 6 months postpartum in high-risk normotensive pregnant women

An overview of bottom trawl selectivity in the Mediterranean Sea

In the Mediterranean Sea, where bottom trawling for demersal species is the most important fishery in terms of landings, around 75% of the assessed fish stocks are overfished. Its status as one of the world’s most heavily exploited seas and the one subject to the highest trawling pressure has become a global concern. An extensive overview of bottom trawl selectivity studies was performed to assess the sustainability of this fishery in the Mediterranean. The selectivity parameters were collected from 93 peer-reviewed publications from 10 countries, totalling 742 records and 65 species. Our review highlighted that i) the catch of the bottom trawls commonly employed in the Mediterranean, although they comply with current codend mesh regulations, still includes immature individuals of 64-68% of the species investigated, and individuals under the minimum conservation reference size (MCRS) of 78% of the species investigated, and that ii) the MCRS set for 59% of the species analysed is well below their length at first maturity and is therefore ecologically inadequate. Although square-mesh codends are slightly more selective, the models developed herein demonstrate that improving size and species selectivity would require considerably larger meshes, which may significantly reduce profitability. The urgent need to mitigate the biological impacts of bottom trawling in the Mediterranean should be addressed by promoting the adoption of more ecologically sustainable fishing gears through the introduction of more selective meshes or of gear modifications

An overview of bottom trawl selectivity in the Mediterranean Sea

In the Mediterranean Sea, where bottom trawling for demersal species is the most important fishery in terms of landings, around 75% of the assessed fish stocks are overfished. Its status as one of the world's most heavily exploited seas and the one subject to the highest trawling pressure has become a global concern. An extensive review of bottom trawl selectivity studies was performed to assess the sustainability of this fishery in the Mediterranean; the selectivity parameters were collected from 93 peer-reviewed publications of 10 countries, totalling 742 records and 65 species. The review highlighted that i) the catch of bottom trawls commonly employed in the Mediterranean, even complying with current regulations on codend meshes, still includes immature individuals for 64-68% of the species investigated, and individuals under the minimum conservation reference size (MCRS) for 78% of the species investigated, and that ii) the MCRS set for 59% of the species analyzed is well below their length at first maturity, and is therefore ecologically inadequate. Although square-mesh codends are slightly more selective, the models developed herein demonstrate that improving size and species selectivity would require considerably larger meshes, which may significantly reduce profitability. The urgent need to reduce the biological impacts of bottom trawling in the Mediterranean should be addressed by promoting the adoption of more ecologically sustainable fishing gears through the introduction of more selective meshes or gear modifications

Optimal treatment duration of glyceryl trinitrate for chronic anal fissure: results of a prospective randomized multicenter trial

Background: Chronic anal fissure (CAF) is a painful condition that is unlikely to resolve with conventional conservative management. Previous studies have reported that topical treatment of CAF with glyceryl trinitrate (GTN) reduces pain and promotes healing, but optimal treatment duration is unknown. Methods: To assess the effect of different treatment durations on CAF, we designed a prospective randomized trial comparing 40 versus 80 days with twice daily topical 0.4% GTN treatment (Rectogesic®, Prostrakan Group). Chronicity was defined by the presence of both morphological (fibrosis, skin tag, exposed sphincter, hypertrophied anal papilla) and time criteria (symptoms present for more than 2 months or pain of less duration but similar episodes in the past). A gravity score (1 = no visible sphincter; 2 = visible sphincter; 3 = visible sphincter and fibrosis) was used at baseline. Fissure healing, the primary endpoint of the study, maximum pain at defecation measured with VAS and maximum anal resting pressure were assessed at baseline and at 14, 28, 40 and 80 days. Data was gathered at the end of the assigned treatment. Results: Of 188 patients with chronic fissure, 96 were randomized to the 40-day group and 92 to the 80-day group. Patients were well matched for sex, age, VAS and fissure score. There were 34 (19%) patients who did not complete treatment, 18 (10%) because of side effects. Of 154 patients who completed treatment, 90 (58%) had their fissures healed and 105 (68%) were pain free. There was no difference in healing or symptoms between the 40- and the 80-day group. There was no predictor of fissure healing. A low fissure gravity score correlated with increased resolution of pain (P < 0.05) and improvement of VAS score (P < 0.05) on both univariate and multivariate analysis. A lower baseline resting pressure was associated with better pain resolution on univariate analysis (P < 0.01). VAS at defecation and fissure healing significantly improved until 40 days (P < 0.001), while the difference between 40 and 80 days was not significant. Conclusion: We found no benefits in treating CAF with topical GTN for 80 days compared to 40 days. Fissure healing and VAS improvement continue until 6 weeks of treatment but are unlikely thereafter. © 2010 Springer-Verlag