Development of a scoring system to assess disability in an Italian elderly population. Evaluation of a disability questionnaire

Patients with idiopathic and symptomatic restless legs syndrome (RLS) suffer from "dyskinesia while awake" or "daytime myoclonus" when at rest preceded by sensory symptoms. In order to characterise the RLS either as reflex movement or as voluntary movement we measured movement-related cortical potentials in 5 idiopathic and 8 uraemic RLS patients. Movements from both legs were polygraphically recorded concomitantly with cortical activity 2000 msec before to 500 msec after onset of EMG activity. These data were compared with a voluntary simulation of each patient's movement pattern and with 5 age-matched controls performing dorsiflexion of the right, left and both feet. Cortical activity preceding daytime myoclonus was absent in RLS patients whereas self-initiated leg movements in patients elicited onset times (1180-1380 msec) and amplitudes of Bereitschaftspotential (readiness potential) not significantly different from readiness potentials in control subjects (P > 0.05). Lack of movement-related potentials in myoclonus and/or dyskinesias during daytime in RLS patients is compatible with an involuntary mechanism of induction and points towards a subcortical or spinal origin of RLS.     

Congenital diseases of the equine head

Many questions concerning heritability arise when a veterinarian is asked to supervise and treat disease of congenital origin. Genetic counseling, ethics, and legality are often confronted in discussions between animal health professionals and laymen in animal industry. Guidelines have been offered as in the 1984 statement of the Judicial Council of the American Veterinary Medical Association: "Performance of surgical procedures in all species for the purpose of concealing genetic defects in animals to be shown, raced, bred, or sold as breeding animals is unethical. However, should the health or welfare of the individual patient require correction of such genetic defects, it is recommended that the patient be rendered incapable of reproduction." The Australian Veterinary Law, Ethics, Etiquette and Convention declares it fraud to alter a defect for sale purposes and unethical for a veterinarian to perform such treatments. It is permissible to correct defects causing discomfort or inconvenience, but the veterinarian is required to advise appropriate breeding counseling. Genetic counseling has progressed significantly in human medicine. This has been supported by better diagnostic methods for genetic disorders, greater acceptance of preventive measures, and extended screening programs to identify carriers of specific abnormal genes or chromosomal aberrations. Congenital diseases in veterinary medicine are constantly under investigation. The veterinary practitioner must continue to operate with an appreciation of the incomplete understanding of most of these abnormalities and act in accordance with personal ethical judgment and the guidance of the American Veterinary Medical Association when treating the affected individual animal patient.     

Alliance for destiny: education and practice

As the whole context of nursing continues to change radically in the face of unmet societal needs, nothing short of total revolution will suffice. Nurses must take control of nursing practice and be critical of the nation's inadequate "sick-care" system in order to effect sweeping changes in the scope, availability and efficacy of healthcare in the U.S. To do this requires an acknowledgment that true nursing education cannot exist without nursing practice. The transformation of curriculum must center on caring, which characterizes what nurses really do in a medically dominated system focused exclusively on curing.     

Ulcerative systematized porokeratosis (Mibelli)

An unusual clinical variant of porokeratosis (Mibelli's disease) appeared in a patient soon after birth; the lesions were widely distributed mostly on the right half of the body. Spontaneous recurrent ulcerations occurred over certain sites. The right foot was grossly deformed as a result of atrophic scarring after ulcerations. Biopsy specimens of the classical lesion showed cornoid lamella. It is suggested that the term "ulcerative systematized porokeratosis" be used to describe this clinical variant of porokeratosis.     

Percutaneous radiologic drainage of pancreatic abscesses

OBJECTIVE: The purpose of our study was to review and report the patient selection, techniques, and results of percutaneous drainage of pancreatic abscesses by retrospective review. MATERIALS AND METHODS: Fifty-nine patients (46 men and 13 women) with a mean age of 44 years old had 80 pancreatic abscesses that were drained percutaneously under radiologic guidance (CT, n = 77; sonography, n = 2; and fluoroscopy, n = 1). Abscesses had a wide spectrum of causes, with alcoholic pancreatitis being most common, trauma second most common, and gallstones third. Ten patients had undergone surgery for pancreatic necrosis or abscess. Patients with pancreatic pseudocysts, necrosis, or acute fluid collections were excluded from this study. RESULTS: Of the 59 patients, 51 (86%) were cured with percutaneous drainage and antibiotic therapy. Of the patients who were not cured with percutaneous drainage, seven required surgery and one underwent repeat percutaneous drainage. In the 59 patients, complications included non-life-threatening bleeding in three patients. Ten of 59 patients (17%) had fistulas that spontaneously formed into the gastrointestinal tract. The duration of catheterization ranged from 4 to 119 days, with a mean duration of 33 days. The rate of mortality at 30 days after completion of percutaneous drainage was 8% (5 of 59). CONCLUSION: Percutaneous drainage was an effective therapy for this defined group of patients with pancreatic abscesses. Factors leading to the relatively high success rate described in this study likely included selection of patients; catheters of adequate size, number, and location; careful follow-up with appropriate catheter manipulations; and an integrated, cooperative approach whereby surgeons were willing to permit drainage to effect its benefits, rather than operating prematurely.     

Enapotamab Vedotin,an AXL-Specific Antibody-Drug Conjugate,Demonstrates Antitumor Efficacy in Patient-Derived Xenograft Models of Soft Tissue Sarcoma

Doxorubicin (doxo) remains the standard of care for patients with advanced soft tissue sarcoma (STS), even though response rates to doxo are only around 14% to 18%. We evaluated enapotamab vedotin (EnaV), an AXL-specific antibody-drug conjugate (ADC), in a panel of STS patient-derived xenografts (PDX). Eight models representing multiple STS subtypes were selected from our STS PDX platform (n = 45) by AXL immunostaining on archived passages. Models were expanded by unilateral transplantation of tumor tissue into the left flank of 20 NMRI nu/nu mice. Once tumors were established, mice were randomized into an EnaV treatment group, or a group treated with isotype control ADC. Treatment efficacy was assessed by tumor volume evaluation, survival analysis, and histological evaluation of tumors, and associated with AXL expression. EnaV demonstrated significant tumor growth delay, regression, and/or prolonged survival compared to isotype control ADC in 5/8 STS PDX models investigated. Experimental passages of responding models were all found positive for AXL at varying levels, but no linear relationship could be identified between the level of expression and level of response to EnaV. One model was found negative for AXL on experimental passage and did not respond to EnaV. This study provides a preclinical rationale for the evaluation of AXL-targeting ADCs in the treatment of AXL-expressing sarcomas.     

Estimation of the effects of an intensive solar intervention in the historical centre of jaén (Spain)

This paper is directed at evaluating the theoretical potential of an intensive solar intervention in the historical centre of the city of Jaén (Spain). Using the outputs of a solar intervention proposal comprising biomass, photovoltaics and solar thermal domestic hot water (DHW) over a 50-building sample (in which those suitable for solar measures have been selected by evaluating each one over a collection of parameters), energy savings, environmental benefits and economic aspects of the envisaged actions are extrapolated over the entire historical centre. A saving of about 70% of conventional source energy annual consumption and a decrease of some 70% and 73% of CO₂ and SO_x annual releases, respectively, could be reached with respect to the present situation. Besides, an amount of conventionally generated electricity equivalent to the yearly photovoltaic-generated electricity would require 131500 m³ of water a year, which is a rather significant feature for a dry climate like that of the city. the unitary cost of energy in the new scenario would be 60.7 pta kWh-¹ for photovoltaics, 329.9 pta m-³ for DHW using solar thermal installations and 4.6 Pta kWh-¹ for biomass heating (1 US$ = 132.7 pta; 1 ECU = 160.9 pta).     

Biochemical changes during the preservation stage of ripe olive processing

The influences of initial sodium chloride (6% and 0% w/v in tap water) and acetic acid concentrations (0.3%, and 0.6% v/v), use of starter culture, and aerobic versus anaerobic conditions on the biochemical changes that take place throughout the preservation stage of ripe olive processing were investigated. Glucose, fructose and sucrose were completely consumed during preservation. Mannitol and malic acid were metabolized only in the presence of lactic acid bacteria or oxidative yeast (aerobic treatment). The main metabolites produced were lactic and acetic acid in aerobic or anaerobic treatments inoculated with Lactobacillus plantarum. Methanol and ethanol were present in all the brines although in a lower concentration when conditions were aerobic. Thus, induced lactic fermentation led to the most efficient utilization of carbohydrates and yielded the most suitable physicochemical characteristics for ripe olive preservation.     

The use of joint coordinates to monitor patients in a movement-based interaction system

Universal Access in the Information Society - Movement-based interaction has brought about new possibilities in healthcare environments. Concretely, rehabilitation therapies represent an adequate...