In this article we have reviewed the main risk factors for this disease in particular: sun exposure, the use of tanning beds or sunlamps and skin phototype.
We also mention the importance of primary prevention in subjects at risk to reduce the onset of cutaneous melanoma.
Phalloplasty procedures for most men requiring penile augmentation surgery are cos-metic procedures; generally the patients have a normal-sized and fully functional penis but they think that their penis is too small. There are not well defined indications for penile enhancement surgery and, except for the treatment of "micropenis", there are not established guidelines and the outcome measures for success are still unclear. All penile enhancement techniques often do not reach the expected result and the grade of pa-tient’s satisfaction is frequently poor. Phalloplasty procedures for psychological dys-morfism are not approved by any scientific society and the majority of these procedures are performed in private settings. The ethical and medicolegal problems resulting from a penis enhancement can be various and numerous, but few of them are reported in litera-ture. After phalloplasty an attribution of professional responsibility and request of reim-bursement is not rare. In this contribution the authors summarize a panorama of several urological and medico-legal aspects related to phalloplasty procedures.
In the past few years, contributions of molecular biology assays to the investigation of sudden juvenile death have permitted to clarify some of the pathogenetic aspects of sud-den arrhythmic death, opening the way to preventive action on victims’ relatives.
We reviewed literature on the genetics of sudden juvenile death, and on molecular biol-ogy assays performed on autoptic samples.
Biological investigation permits the detection of genetic mutations underlying the suscep-tibility to sudden cardiac death of individuals with rare inherited forms of arrhythmia (Long QT Syndrome, Brugada Syndrome, Lev’s disease etc.) through the analysis of criti-cal sequences codifying for ion channel subunits (HERG, KvLQT1, MinK, Mirp1, SCN5A, KCNQ1, KCNH2, KCNE1, KCNE2).
The main objective of post-mortem investigation in sudden juvenile death is the detection of treatable monogenic inherited disorders, in order to prevent further deaths among the relatives of the deceased patient.
In this paper, the authors seek to outline the medico-legal aspects of the nursing folder and the requirement for precision in its compilation in terms of content, requirements, management and filing.
This article also discusses the importance of the introduction of the nursing folder and emphasizes its status as a public document. The passing of Law n. 42/1999 was funda-mental in empowering the nursing profession and marking the passage from "auxiliary health care profession" to "health care profession".
We analyzed the effects of working activity and working shifts on the circadian rhythmic-ity and circadian phase relations of serum cortisol level, white blood cell count, resting heart rate and systolic/diastolic blood pressure in a group of Italian fishermen.
We observed a shift-induced displacement of cortisol secretion and a change in leukocyte count. Moreover, systolic/diastolic blood pressure and resting heart rate were markedly influenced by the night shift, whereas no appreciable changes were observed after the morning and afternoon shifts, compared to pre-working values. These data suggest that the human circadian system is greatly influenced by shift work, and that serum cortisol level, leukocyte count, systolic and diastolic blood pressure as well as resting heart rate are sensitive indicators of the biological responses to a stress workload in shift workers, especially after a night shift.
Post-traumatic stress disorder (PTSD) is an anxiety disorder that results from exposure to a traumatic event, and is characterized by hypermnesia of the traumatic event with fre-quent re-experiencing of the tragic occurrence, hyperarousal, and avoidance behaviour. Depression, anxiety, sleep dysfunction and substance abuse are also commonly reported. PTSD is highly prevalent both in the general population and in certain occupations that are particularly exposed to life-threatening situations, physically and psychological de-manding activities, and physical assault, such as rescue workers, firefighters and para-medics. Recent advances in the comprehension of the epidemiology, physiopathology and clinical presentation of PTSD could push toward increased identification of this com-mon psychiatric disorder with significant reflections on the chances of successful treat-ment.
The allegation by a child victim of sexual abuse is, in many cases, the most important evidence of wrongdoing, especially in absence of medical or physical evidence or confes-sions of guilt. The Rorschach inkblot test is a projective personality assessment technique used to evaluate child witnesses.
We report a case of three girls allegedly abused by the father, in which the psychometric evaluation with the Rorschach test did not give credibility to the testimony of the chil-dren. When interrogating a minor, it is very difficult to distinguish between a true and a lie. Indeed, many different elements can affect the dialogue, such as the child’s age, the events being discussed, interrogation environment, factors linked to the interviewer, etc. Therefore, it is possible errors of evaluation, misunderstandings or confusion happen fre-quently.
The aim of this case report is to highlight that employment of methodologies and criteria recognised by the scientific community could simplify the acquisition and assessment of information from a minor.
Achilles tendon rupture is currently one of the most frequent injuries in athletes. Such rupture may be caused by a sudden dorsiflexion of the ankle, pushing off with the weight bearing forefoot while extending the knee or violent dorsiflexion of a plantar flexed foot. The treatment goal consists of restoring the normal tendon length and tension, as well as the function and strength of the gastrocnemius-soleus complex. The biological repair process can be enhanced in all stages of recovery with the use of PRP (Platelet Rich Plasma) without any side effects.
Attention Deficit Hyperactivity Disorder (ADHD) is characterised by low levels of internal-izing symptoms and self-efficacy which causes low self-esteem, while externalizing be-haviours appear to be related to high levels of stress in the parents.
The purpose of this research is to analyze the impact of ADHD on self-esteem and paren-tal stress. A multidimensional assessment of self-esteem was performed using the MSCS (Multidimensional Self-Concept Scale) in a group of 12 male patients with ADHD (age range 9-11 years). Parental stress was investigated using the Parenting Stress Index (PSI). These results were compared with a group of 12 healthy children (age 9-11 years), with both parametric statistics and correlation statistics.
The comparison between ADHD children and control subjects, performed by a calculation to rank with the Mann-Whitney, showed a high significance in two dimensional compo-nents of self-esteem: social relationships (Z -2.028 p 0.045) and academic success (Z -2.166 p 0.028). The total self-esteem score differed significantly between the two groups (Z -2.227 p 0.024). Parental stress increaseed with the level of the child‟s oppositional symptoms (p 0.790) but it did not correlate with the other scores (cognitive problems / inattention p 0.381); hyperactivity p 0.414; ADHD index p 0.324). The present study shows that self-esteem is impaired among children with ADHD.
A Salt Harris Fracture is a fracture involving the epiphyseal plate or growth plate of a bone. It is a common injury found in children; occurring in 15% of childhood long bone fractures. Injuries of the ankle joint are common. In our case report, we describe the case of a thirteen-year-old patient under our treatment at the Orthopaedic emergency depart-ment of Val D’Elsa Hospital (in Campostaggia Poggibonsi, Siena), who presented with a bimalleolar Salter Harris III fracture after a sport trauma. We reduced the bimalleolar Salter Harris III with percutaneous K-wires instead of an open access and two screws (one on the top and another on the bottom of the epiphyseal plate of distal tibia). We per-formed it according to a revision of scientific literature. The result was a satisfactory re-duction of the bimalleolar Salter Harris III.
KNOWLEDGE, ATTITUDES AND BEHAVIORS REGARDING INFLUENZA VACCINATION AMONG HYGIENE AND PREVENTIVE MEDICINE RESIDENTS IN CALABRIA AND SICILY.Written by Claudio Costantino et al.
Vaccinating health care workers is considered to be one of the most important steps in preventing the transmission of the influenza virus to vulnerable patients. Public Health physicians are the main promoters and executors of influenza vaccination campaigns for both healthcare workers and the general population.
The objective of the present survey was to analyze the knowledge, attitudes and practices regarding influenza vaccination among Hygiene and Preventive Medicine Residents.
64% of the participants had not been vaccinated against the influenza virus in the past 5 years, and 29% had been vaccinated only occasionally , with only 7.2% of the study popu-lation having been vaccinated every year. 20.3% of those surveyed were vaccinated in the 2010/2011 season. The best strategy to increase vaccination rates among health care workers according to the study participants was the participation of future public health operators to multidisciplinary training (34.8%)
the main factors associated with influenza vaccination compliance were having been vaccinated in the previous season for 2011/2012 (OR [95%]: 41.14 [7.56 - 223.87]) and having received the vaccination always or occasionally during the previous 5 years for both 2010/2011 (p-value <0.0001) and 2011/2012 (p-value <0.0001).
The findings of this study suggest that future public health physicians with a history of refusing influenza vaccination in previous years usually tend to maintain their beliefs over time. Changing this trend among Hygiene and Preventive Medicine residents is the real challenge for the future, and it can be achieved through organization of multidisciplinary training, improvement of university education and increasing the involvement of Hygiene and Preventive Medicine residents in influenza vaccination campaigns both for the gen-eral population and health care workers.
The patient was diagnosed with right foot cutaneous melanoma in February 2004.
In October the patient became metastatic and he underwent three different lines of tradi-tional chemotherapy (Fotemustine, Dacarbazin and Carboplatin with Thalidomide) but each time a progression of the disease was noted. Consequently, the patient was enrolled in Protocol CA180008 and treated with ipilimumab 10mg/Kg every 3 weeks for 4 cycles.
Ipilimumab has been established as a drug able to induce long-lasting responses, and has been approved for patients with metastatic melanoma in first- and second-line treatment by the FDA and in second-line treatment by the EMA.