Symptoms of attention-deficit hyperactivity disorder in an Italian school sample: findings of a pilot study

OBJECTIVE: The objective of this study was to complete a teacher questionnaire on a sample of children (N = 232) in nine fourth grade classes in schools in two regions of central Italy to assess the frequency of occurrence of symptoms of attention-deficit hyperactivity disorder (ADHD) and the rates of probable cases in the sample. METHOD: Each ADHD symptom was rated by the teacher as either absent (0), sometimes present (1) or frequently present (2). RESULTS: Of the children 3.9% had eight or more DSM-III-R Criterion A symptoms of ADHD scored at a "frequent" level (score of 2) and were considered to be "likely cases" of ADHD; an additional 6.9% did not meet this threshold but had a total score of 16 or more on the scale and were considered to be "possible cases." CONCLUSIONS: The findings suggest the need for more systematic epidemiological investigations to evaluate the true prevalence of the syndrome and its risk factors in the Italian population.     

Y-chromosome STR haplotypes in an Italian population sample

A series of cloning vectors with conditional, temperature-sensitive replication that are selectable with ampicillin, chloramphenicol, and kanamycin has been constructed. These vectors are derivatives of a pSC101 mutant that can replicate only at low temperatures. The cloning vectors carry a number of unique restriction sites and provide for screening of recombinant plasmids by alpha complementation. These vectors have proven useful for a variety of applications where conditional replication of a recombinant plasmid is desired.     

Pediatric risk of mortality: an assessment of its performance in a sample of 26 Italian intensive care units

OBJECTIVE: To assess the validity of the Pediatric Risk of Mortality (PRISM) scoring system in accurately predicting the probability of mortality in an Italian intensive care unit (ICU) sample. DESIGN: Prospective, observational, multicenter study. SETTING: Twenty-six Italian ICUs classified into two groups: a) ICUs specifically dedicated to treating pediatric patients; and b) adult ICUs treating children on a regular basis. PATIENTS: Consecutive patients (n = 1,533) <15 yrs of age admitted during 1 yr. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: To assess the performance of the PRISM scoring system, the discrimination and calibration measures were adopted both in the whole population and in 12 preselected subgroups. A good discrimination capability of the scoring system was observed for both the whole population and subgroups (areas under the receiver operating characteristic curves were never <0.82). On the other hand, we documented an unsatisfactory calibration capability in the whole population and in most subgroups (p values of the Hosmer-Lemeshow goodness-of-fit test were <.001 in all but two subgroups). CONCLUSIONS: The analyses suggest that the unsatisfactory calibration of PRISM can be attributed to various reasons. Among those reasons, a poor performance of the system, as well as its sensitivity to factors not connected to clinical ICU performance, seem particularly important. A special caution is needed in adopting a severity of illness scoring system to assess quality of care, particularly in contexts different from the one in which the instrument was originally developed.     

Thromboembolic events in beta thalassemia major: an Italian multicenter study

Oxidation of cholesterol (1a) or pregnenolone (1b) with pyridinium dichromate (PDC) in dimethylformamide (DMF) or in dichloromethane (DCM) and pyridinium chlorochromate (PCC) in DCM provided cholest-4-en-3,6-dione (2a) or pregn-4-en-3,6,20-trione (2b). TLC monitoration of the reactions implied that cholest-5-en-3-one (3a) or pregn-5-en-3,20-dione (3b) and cholest-4-en-3-one (4a) or pregn-4-en-3,20-dione (4b) might be intermediates. Individual oxidation of 3a or 3b with PDC and PCC could give 2a or 2b, but 4a or 4b remained unchanged. Further investigation indicated that 4a or 4b was an isomerization product of 3a or 3b on silica gel TLC plate rather than really existence in the reaction mixture. These results shown steroidal 5-en-3-ones were intermediates of the transformation of steroidal 5-en-3 beta-ols to steroidal 4-en-3,6-diones oxidized by PDC and PCC.     

The DRPLA CAG repeats in an Italian population sample: evaluation of the polymorphism for forensic applications

The DRPLA CAG repeats polymorphism has been studied in an Italian population sample. PCR amplification, manual PAGE and silver staining were employed. A total of 16 different alleles, spanning the range from 5 to 21 CAG triplettes, was observed. The heterozygosity was 0.81 and no significant deviation from Hardy-Weinberg equilibrium was found 81 meioses from parentage testing were also analyzed and a Mendelian pattern of inheritance was observed in all cases. In addition, we could successfully type DRPLA locus in some forensic specimens, 1 ng of DNA allowing clear definition of alleles. The authors conclude that the DRPLA CAG repeats analysis may be useful for forensic applications.     

Preliminary results of a nutritional survey in a sample of 35,000 Italian schoolchildren

An investigation of the nutrient intake of a large-scale sample (n = 35,072), drawn from the Italian school-age population (7-10 years) was carried out in a nationwide survey of nutritional patterns. Friuli, the Piedmont, Latium and Sicily regions were selected as representative of the nation's north-south and east-west socio-economic divisions. A food frequency questionnaire was used to assess nutritional intake. Traditional methods of 24-h dietary recall and a weighted food diary were used in subsamples to assess the validity of the food frequency questionnaire. Our data suggest that the average diet of Italian schoolchildren is rich in protein (especially animal proteins) and lipids (prevalently saturated fatty acids), but that carbohydrate and fibre intakes remain generally low. The relatively low calcium intake among girls and a widespread, more than adequate iron intake are also noteworthy. The food and nutrient intakes assessed suggest a dietary pattern with several positive points, but also reveal potential hazards for a wider population spectrum. The type of large-scale nutritional monitoring with a multi-method approach can be used in Italy and elsewhere to describe the dietary trends of a school-age population.     

Repeat abortion: a comparative study

In a study of 404 women (simple random sample) 20-29 years of age, 201 women (group A) applying for abortion and 203 women (group B) continuing their pregnancies were given a questionnaire and were also interviewed. The aim of the study was to describe women applying for repeat abortion and to compare them with women having their first abortion and with women continuing their pregnancies. Variables measured were socio-economic, psychological and social problems, relationship with the partner, earlier pregnancies, how the present pregnancy was experienced and decision-making. For presentation of the results, the data have been divided into four subgroups: pregnant women applying for their first abortion (A1, n = 137), women applying for repeat abortion (A2, n = 64), women continuing their pregnancies who have never applied for abortion (B1, n = 142), and women continuing their pregnancies who had previously applied for one or more abortions (B2, n = 58). Women who had had previous abortion/abortions had experienced more psychological problems during their lifetime than the other groups studied. They had more contact with the social welfare service and evaluated their relationship with the partner as less harmonious than women having a first abortion, also in comparison with women continuing their pregnancies with no earlier applications for abortion. Women who have had previous abortion/abortions seem to have a need for special attention. This involves not only being provided with efficient and acceptable contraception, but also with social and psychological support based on the experiences of the women.     

Teenage primigravidae: a comparative study

A review of history sheets of obstetric cases recorded in a district hospital in 1992 was done to compare the obstetric outcome in 200 teenage first pregnancies (Study group) with that in Control group i.e. 20 years to 29 years. It revealed that incidence of complications of pregnancy like anaemia, pregnancy induced hypertension (PIH) and preterm labour were significantly higher among teenage mothers. The normal mode of delivery was commoner in teenagers (82.5%) in comparison to control group (76.5%), probably because of higher number of low birth weight babies. The fetal outcome was significantly worse in teenage mothers with high incidence of perinatal mortality (8%) and low birth weight babies (35%). There was not a single newborn with birthweight above 3500 gms, in teenage group, whereas, control group had 5 babies (2.5%) in the category.     

Mitochondrial DNA polymorphisms: a study of 50 French Caucasian individuals and application to forensic casework

The analysis of mitochondrial DNA polymorphisms has proved to be efficient on highly degraded samples or samples having little or no genomic DNA such as hair shafts. In order to use this very sensitive method, the authors first established a database by analysing the mitochondrial DNA polymorphism in 50 French white Caucasian individuals, applied the analysis to different types of samples that can be found in forensic investigations and finally performed this method on two forensic cases involving the discovery of highly putrefied unidentified remains.     

Polymorphism and sequence variations of the HumCD4 pentameric microsatellite in an Italian population sample

A sample of 265 subjects from central Italy was analyzed at the HumCD4 locus by polymerase-chain-reaction (PCR). Phenotypes were identified by comparison with a sequenced ladder, after high-resolution horizontal polyacrylamide gel electrophoresis (PAGE) followed by silver staining. A set of representative alleles was sequenced by Taq-cycle-sequencing with dye terminator labeling and capillary gel electrophoresis strategies. Eight common alleles--5, 6, 7, 8, 9, 10, 11, 12--and a rare larger 14, never before described in Caucasians, were found. Allele and genotype frequencies were similar to those described in former studies on Caucasians, with a prevalency of alleles number 5, 6, 10. Sequence analysis showed that the polymorphism is due to a pentameric TTTTC basic motif, tandemly repeated, and that from allele number 10 onwards the fourth repeat presents a T to C translation (CTTTC). Instead, allele number 9 may exist in two forms, because 75% of alleles examined in this study presented the CTTTC motif at the fourth position, while the remaining 25% had the basic repeat structure.     

Study of 15 protein polymorphisms in a sample of the Turkish population

Anatolia, because of its geographic position and its use as an area of settlement, was also a land of transit that accommodated a succession of populations. The last important invasion occurred in the Middle Ages with the arrival of the Turks, an Altaic-speaking nomadic population descended from the Oguz tribes and originating in Mongolia. Although the Turks imposed their culture, their genetic contribution seems to have been modest. To validate this hypothesis, we studied the genetic structure of the Turkish population by examining 15 genetic markers in a sample of 93 subjects. The allele frequencies observed were HP*1 = 0.240; GLO1*1 = 0.344, ESD*2 = 0.134, GC*1S = 0.613, GC*1F = 0.129, PGM1*2S = 0.322, PGM1*2F = 0.041, PGM1*1F = 0.027, F13B*1 = 0.762, F13B*2 = 0.101, ORM1*S = 0.327, AHSG*2 = 0.181, C6*B = 0.239, C7*1 = 0.983, APOC2*1 = 1.0, APOE*3 = 0.868, APOE*2 = 0.063, BF*F = 0.258, BF*S07 = 0.017, BF*SQ0 = 0.011, C4A*Q0 = 0.145, C4A*2 = 0.070, C4A*5 = 0.012, C4A*6 = 0.023, C4B*Q0 = 0.101, C4B*2 = 0.048, C4B*3 = 0.005, and C4B*11 = 0.005. The present Turkish population was compared to other European, Middle Eastern, and North African populations by means of correspondence analysis. Turks cluster with Turkomans, who share the ancient Turks' derivation from the Oguz tribe. Moreover, Turks clearly belong to European groups and resemble the populations of neighboring countries. Therefore the present data support the hypothesis that the ancient Turkish tribes, who started to enter Anatolia 1000 years ago, contributed little to the gene pool of the preexisting Anatolian populations. Alternatively, if the genetic structure of the invading Turks resembled that of the ancient Anatolians, it will be impossible to find traces of their admixture with the autochthonous inhabitants of Anatolia. However, further analysis of other samples from Turkey and from populations living in the homelands of the Turkish tribes, namely, the eastern area of the Caspian Sea and Mongolia, is needed.     

Urea kinetic modeling: an in vitro and in vivo comparative study

The urea kinetic model (UK) and the direct dialysis quantification method based on dialysate collection (DDQ) were used to determine the urea distribution volume (V) identified with the total body water and the urea generation rate (G) for different dialysis times, both in vivo during short hemodialysis (N = 20) and in vitro using an experimental single-pool urea system (N = 10). Both UK and DDQ allowed a satisfactory in vitro estimation of V and G for all dialysis times. On the other hand in vivo V and G estimations by both methods showed an increase of more than 50% between the determinations performed after 30 minutes of dialysis and at the end of dialysis. Our theoretical analysis shows that the in vivo changes of V are compatible with those expected for a two-compartment system in which one compartment is cleared faster than the other. Furthermore, given that urea is allowed to equilibrate in the body at the end of dialysis, DDQ permits an accurate estimate of V, G and PCR even for short hemodialysis, which UK does not.     

Accidents to patients in hospital: a comparative study

A comparative study of 50 reported accident patients (cases) and 50 non-accident patients (controls) was carried out in 10 wards in a large, acute hospital, using primary and secondary data from patients, nurses and records. Folstein's Mini-Mental State test was used to measure the mental status of patients. The mental status of the controls was significantly better than that of the cases. Nurses' responses indicated that significantly more accident patients were incontinent of urine than non-accident patients. There were also indications from patients of three additional unreported accidents. Further study was needed to estimate, more closely, the frequency of unreported patient accidents. This is the second paper in a series of three. The first appeared in Nursing Times on August 17, and the final one will be published on September 28, along with implications for practice and recommendations.     

Gallstones and diabetes: a case-control study in a free-living population sample

Data on the association between cholelithiasis and diabetes often are controversial and are mostly based on autopsies or on hospital series. Therefore, we designed a case-control study to determine the prevalence of diabetes mellitus in a group of subjects with gallstones or having undergone cholecystectomy (cases) and compared these with a control group of subjects without gallstones, selected during an epidemiological study performed on a free-living population sample. The subjects were matched for sex, age, and body mass index. We enlisted 336 cases and 336 controls, aged 30 to 69 years. All subjects with fasting glycemic levels of < 140 mg/dL and without a documented history of diabetes were submitted to a simplified oral glucose tolerance test (OGTT). All subjects who underwent OGTT were classified according to the National Diabetes Data Group (NDDG) criteria. The prevalence of diabetes in the subjects affected by gallstone disease was significantly higher than that in controls (11.6% vs. 4.8%; odds ratio [OR], 2.55; 95% confidence interval [CI], 1.39-4.67). Diabetes was more frequent in subjects with gallstone disease than in the control group, even according to sex (18.3% vs. 9.9% for men: OR, 2.03; 95% CI, 0.99-4.2; 9.3% vs. 2.6% for women: OR, 3.85; 95% CI, 1.4-10.6). We conclude that an altered glucose metabolism may increase the risk of developing cholelithiasis in certain subjects.     

Microlaparoscopy: a comparative study of diagnostic accuracy

OBJECTIVE: To investigate the diagnostic accuracy of microlaparoscopy in comparison to laparoscopy with a standard 10-mm laparoscope. DESIGN: Prospective evaluation by two independent observers. SETTING: Academic Medical Center. PATIENT(S): Ten patients scheduled to undergo diagnostic laparoscopy for the indications of infertility and/or chronic pelvic pain. INTERVENTION(S): Two surgeons were present for each operation. Diagnostic laparoscopy was performed using the Microlap 2-mm laparoscope (Imagyn Medical Inc., Lagun Niguel, CA). Standard diagnostic laparoscopy was then performed using a 10-mm laparoscope. After each procedure, each surgeon reported his or her observations in a confidential manner to a third person to record. MAIN OUTCOME MEASURE(S): Endometriosis and adnexal adhesions were staged. Observations made with the microlaparoscope were compared with those obtained with a standard 10-mm laparoscope for each surgeon. The observations of both surgeons were also compared with each other's to evaluate interobserver differences. RESULT(S): Operative findings reported by each individual surgeon using the microlaparoscope correlated with the operative findings reported using the larger laparoscope. Scores for both endometriosis and adnexal adhesions did not differ in any significant way. Endometriosis scores differed by no more than 6 points, and adhesion scores differed by no more than 2 points, with no subsequent change in severity classification for either finding. Furthermore, when comparing the additional operative findings of the two surgeons, no difference was noted when using either the microlaparoscope or a standard 10-mm laparoscope. CONCLUSION(S): The diagnostic accuracy achieved with microlaparoscopy is comparable to that achieved with standard 10-mm laparoscopy.     

HIV-associated brain pathology: a comparative international study

OBJECTIVES: This study examined the use of aides in occupational therapy practice, the supervision and training of aides, and practitioners' attitudes toward the use of aides. METHOD: A questionnaire was mailed to a systematically selected sample of 510 occupational therapists and occupational therapy assistants. The response rate was 74%. RESULTS: The use of occupational therapy aides is prevalent in a variety of settings. Forty percent of respondents reported that they currently work with aides, whereas 23% reported that they have never worked with aides. Occupational therapy aides perform a variety of tasks and receive various levels and amounts of supervision and training. Of those respondents who delegated specific skilled tasks to aides, 76% reported daily contact for purposes of supervision and training. Nineteen percent who currently work or have worked with aides reported being in a situation where an ethical issue arose related to aide use. CONCLUSION: On the basis of the data, it is suggested that occupational therapy practitioners would benefit from taking a proactive role in determining how aides can be used to maximize service delivery while maintaining quality services. There also appear to be ethical concerns related to appropriate delegation of tasks to aides and to their supervision and training.     

Converting an idea into a worldwide business commercializing smelting technology

Pyrometallurgy is an ancient art which has defined significant stages of human development. Today, new opportunities for improvements in the economic, environmental, and workplace costs of metal production continue to provide challenges for the profession and industry. Top-submerged lancing technology for the high-temperature processing of a range of metals and wastes is an example that has been taken up by many companies around the world. The furnace system now marketed under the names of Ausmelt and Isasmelt was, in the early stage of its 33 years of development, known as Sirosmelt. The voyage from the original idea through theoretical, laboratory, pilot plant, and commercial developments to establishment of a worldwide business has been both stimulating and rewarding. The Extraction and Processing Lecturer Award honors an outstanding scientific leader in the field of nonferrous extractive metallurgy with an invitation to present a comprehensive lecture at the TMS Annual Meeting. John Floyd is Deputy Chair, Ausmelt Limited, Australia. He earned his B.Sc. and M.Sc. from the University of Melbourne, Ph.D. from London University, and DIC from Imperial College. Dr. Floyd has authored or co-authored more than 70 published technical articles and has invented or co-invented 15 patented process or equipment inventions in the extractive metallurgy and high-temperature processing plant areas.     

Characterizing cavities in model inclusion molecules: a comparative study

We have selected fullerene-60 and -70 cavities as model systems in order to test several methods for characterizing inclusion molecules. The methods are based on different technical foundations such as a square and triangular tessellation of the molecule taken as a unitary sphere, spherical tessellation of the molecular surface, numerical integration of the atomic volumes and surfaces, triangular tessellation of the molecular surface, and a cubic lattice approach to a molecular space. Accurate measures of the molecular volume and surface area have been performed with the pseudo-random Monte Carlo (MCVS) and uniform Monte Carlo (UMCVS) methods. These calculations serve as a reference for the rest of the methods. The SURMO2 and MS methods have not recognized the cavities and may not be convenient for intercalation compounds. The programs that have detected the cavities never exceed 5% deviation relative to the reference values for molecular volume and surface area. The GEPOL algorithm, alone or combined with TOPO, shows results in good agreement with those of the UMCVS reference. The uniform random number generator provides the fastest convergence for UMCVS and a correct estimate of the standard deviations. The effect of the internal cavity on the accessible surfaces has been calculated.     

Effect of different immunosuppressive agents on acute pancreatitis: a comparative study in an improved animal model

BACKGROUND: Immunosuppressive drugs have been associated with the development and progression of acute pancreatitis after organ transplantation. Consequently, a reduction or a change in immunosuppressive therapy has been recommended once posttransplantation pancreatitis has been suspected. However, it is not known which of the available immunosuppressive agents is most harmful to the pancreas and which may be used safely in this situation. The objective of this study was to investigate the effect of different immunosuppressive drugs in various dosages on intrapancreatic protease activation, acinar cell necrosis, and mortality in an improved model of acute necrotizing pancreatitis in the rat. The rat model of acute necrotizing pancreatitis, like posttransplantation pancreatitis, is characterized by ischemia and microcirculatory disorders. METHOD: Acute pancreatitis was induced in rats by using a combination of low-dose controlled intraductal glycodeoxycholic acid superimposed on intravenous cerulein hyperstimulation. Six hours thereafter, animals were randomized to intravenous therapy with 2, 10, or 50 mg/kg/day prednisolone (PRED); 3, 15, or 60 mg/kg/day cyclosporine A (CsA); 10 mg/kg/day azathioprine (AZA); 0.6 mg/kg/day orthoclone OKT3 (OKT3); or saline. After 36 hr, surviving animals were killed to determine acinar cell necrosis and trypsinogen activation peptides levels (TAP) in blood and ascites. RESULTS: Compared with saline-treated control rats, animals treated with 60 mg/kg/day CsA developed significantly more acinar cell necrosis and had increased amounts of TAP in ascites. Likewise, there was more extensive acinar cell necrosis in animals subjected to AZA therapy. However, this was not associated with incremental TAP. Animals treated with 3 or 15 mg/kg/day CsA, OKT3, or PRED showed no significant changes in these target parameters. Animals given 10 or 50 mg/kg/day PRED even had decreased hematocrit values and produced significantly less ascites than animals in the other groups. CONCLUSION: The present results suggest that AZA and high doses of CsA aggravate acute pancreatitis and should, therefore, be avoided once posttransplantation pancreatitis has been suspected, whereas lower doses of CsA, OKT3, and PRED may be used safely. PRED can even be used at higher doses as may be required when graft rejection is suspected.