The psychosocial impact of assistive device scale: Italian validation in a cohort of nonambulant people with neuromotor disorders.

The importance of adaptive seating system on body structure and function is widely accepted, but its impact on psychosocial aspects needs more consideration by health professionals. This article describes the Italian validation of the Psychosocial Impact of Assistive Device Scale (IT-PIADS) for non-ambulant people with neuromotor disorders.Once agreement has been given by the original authors, the scale was translated and adapted to the Italian culture. The IT-PIADS was administered to different wheelchairs users with heterogeneous diagnosis. The internal consistency and test-retest reliability were examined. Its concurrent validity was evaluated with the Italian version of the WheelCon-M-SF.The IT-PIADS was administered to 87 subjects. Cronbach's α was 0.92 (p < 0.05), and the test-retest reliability (ICC) for competence, adaptability and self-esteem subscales were 0.96, 0.90, 0.93, respectively. The Pearson correlation coefficient of the IT-PIADS with the WheelCon-M-I-SF scores showed significant data for competence and adaptability subscales.Psychosocial perception on assistive devices can be reliably measure. The IT-PIADS showed good psychometric properties and it is possible to confirm its validity for clinical and research purposes. Nevertheless, before using this measure with greater confidence, further psychometric properties tests of the IT-PIADS are recommended.

Perioperative nutritional support or perioperative fasting? A narrative review.

Traditionally, overnight fasting before elective surgery has been Romathe routine in medical practice for risk reduction of pulmonary aspiration of gastric contents. Several original study and international societies recommend a 2h preoperative fast for clear fluids and a 6h fast for solids in most elective patients. We conducted a narrative review of the literature, searching electronic databases (Medline and CINAHL). We used PICO approach. The results of our review suggest that nutrition support in the perioperative period is very important to reduce length of hospital stay and reduced postoperative complication.

Blockade of K(ATP) channels reduces endothelial hyperpolarization and leukocyte recruitment upon reperfusion after hypoxia.

Ischemia/reperfusion injury in renal transplantation leads to slow or initial nonfunction, and predisposes to acute and chronic rejection. In fact, severe ischemia reperfusion injury can significantly reduce graft survival, even with modern immunosuppressive agents. One of the mechanisms by which ischemia/reperfusion causes injury is activation of endothelial cells resulting in inflammation. Although several therapies can be used to prevent leukocyte recruitment to ischemic vessels (e.g. antiadhesion molecule antibodies), there have been no clinical treatments reported that can prevent initial immediate neutrophil recruitment upon reperfusion. Using intravital microscopy, we describe abrogation of immediate neutrophil recruitment to ischemic microvessels by the K(ATP) antagonist glibenclamide (Glyburide). Further, we show that glibenclamide can reduce leukocyte recruitment in vitro under physiologic flow conditions. ATP-regulated potassium channels (K(ATP)) are important in the control of cell membrane polarization. Here we describe profound hyperpolarization of endothelial cells during hypoxia, and the reduction of this hyperpolarization using glibenclamide. These findings suggest that control of endothelial membrane potential during ischemia may be an important therapeutic tool in avoiding ischemia/reperfusion injury, and therefore, enhancing transplant long-term function.

[Central diabetes insipidus as a first manifestation of lung adenocarcinoma]. / Diabete insipido centrale come prima manifestazione di adenocarcinoma polmonare.

The pituitary gland and infundibulum can be involved in a variety of medical conditions, including infiltrative diseases, fungal infections, tuberculosis, primary and metastatic tumors. Metastases to the pituitary gland are absolutely rare, and they are generally secondary to pulmonary carcinoma in men and breast carcinoma in women. Pituitary metastases more commonly affect the posterior lobe and the infundibulum than the anterior lobe. The posterior lobe involvement may explain why patients with pituitary metastases frequently present with diabetes insipidus. We are presenting a case report of a 48-year-old male patient with sudden onset of polyuria and persistent thirst. Laboratory results revealed central diabetes insipidus. Computed tomography (CT) scan of the brain showed a mass located in the sella turcica and suprasellar region. CT scan of the chest showed a mass in the right superior lobe with mediastinal lymphadenopathy. Bronchoscopy and biopsy demonstrated a pulmonary adenocarcinoma. Thus, we made a diagnosis of lung cancer with local and pituitary metastases. The patient received radiotherapy on the pituitary gland and adjuvant chemotherapy. As a result the intrasellar and suprasellar mass decreased in size and urinary output accordingly decreased. In conclusion, in patients presenting with sudden onset of diabetes insipidus pituitary metastases should be taken in account in differential diagnosis.

Five-year follow-up results of instep plantar fasciotomy for chronic heel pain.

The results of a 5-year follow-up of patients who underwent surgical partial release of plantar fascia with plantar skin incision for treatment of chronic heel pain are presented. Evaluation included survey results from both a modified Mayo Scoring System and a list of specific questions developed by the authors. Thirty-three feet of 30 patients are evaluated. Thirty of the 33 feet studied achieved good or excellent results, scoring 80 or better on a 100-point scale. Ninety percent pain relief was achieved in 27 of the 33 feet studied (81.8%). A satisfaction rate of 90% or better was found with 30 of the 33 feet studied (90.9%). Long-lasting complications were described by five patients, including opposite foot pain, dorsal foot pain after extended activity, scar tissue discomfort, callus at scar area, and continued heel pain.

The medial instep plantar fasciotomy.

A review of the anatomy, etiology, and conservative and surgical treatments of plantar fasciitis are presented and a simple surgical technique is introduced. The medial instep plantar fasciotomy was performed by the authors on 50 feet previously untreated by surgery (41 patients). The follow-up results (average length of time to follow-up was 11.3 months) revealed that 82.6% of the patients experienced at least 90% pain relief and 97.8% experienced at least 80% pain relief. Overall, 91.3% of the patients related at least 80% satisfaction with the results of the surgery and all but one of the patients stated that they would recommend and/or have the procedure performed again if the need arose. Complications arising from the instep procedure were limited, and the most frequent complaint was scar formation. Stress was placed on exhausting conservative measures before attempting surgical correction, and the average patient utilized five different modalities of conservative treatment over an average period of 13 months. Postoperatively, patients were encouraged to continue, or begin using, orthotics/arch supports to avoid problems such as arch pain.

Metatarsal fractures. An overview.

Fractures of the metatarsals are a common condition seen by all health care specialists. They may be precipitated by direct or indirect trauma to the specific area of concern. This article is a review of the angiology of the metatarsal. It provides a workable classification of metatarsal fractures and provides an insight into their proper treatment.

Peroneus tertius myocele: a rare herniation of the lower extremity.

Peroneus tertius myocele has not been reported in the literature. A case report and long term follow-up is presented.

Practical approach to a rare deformity: macrodactyly.

Macrodactyly, the exact etiology of which is unknown, is a rare congenital deformity. Four basic surgical approaches to correction have been considered. When the first and second digits are involved, Dr. Figura believes that amputation should not be considered as these two digits are necessary for stability. He believes the worm advancement of Tsuge, which can be performed on any toe, to be the procedure of choice, both functionally and cosmetically. The metatarsophalangeal joint is not disturbed, the digit is not syndactylized into a bulbous mass, the nail is left intact, and the functions are preserved.