Improving employees' views about persons with mental disorders as potential workmates: A 2-year partially controlled study.

For many persons with mental disorders (MDs), having a job is a main life goal and a recovery sign. The possibility for these persons to enter the job market is limited by stigma. This study explored whether the participation of people with MDs in a job-training course would positively influence employees' opinions about workmates with these disorders. The job-training course was run by company trainers in a megastore 3 times over a 2-year period for a total of 18 participants with MDs. In the training store, employees' views regarding persons with MDs were assessed at pre- and postintervention with the use of matched questionnaires. At postintervention, views among the training store's employees were also compared with those of employees from other stores (controls). Compared with paired preintervention assessment, at postintervention, the training store's employees were more optimistic about recovery; more skeptical about unpredictability, dangerousness, and social distance from persons with MDs; more skeptical about difficulties of these persons in that workplace; more willing to have workmates with MDs; and more confident in the acceptance of workers with MDs by colleagues. Compared with controls, at postintervention, the training store's employees had higher levels of acceptance and lower perception of dangerousness and unpredictability, were more confident in the capacities of persons with MDs to acquire organizational skills and in their acceptance by colleagues, and were surer that having coworkers with MDs would improve the company public image. Providing job-training courses to persons with MDs could be helpful to reduce stigma against such persons in ordinary work contexts. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Hypercondylia: problems in diagnosis and therapeutic indications.

Condylar hyperplasia is a rare disease that alters the anatomy of one of the two condylus of the mandible as a consequence of the abnormal growth of the interested condylus and results in facial asymmetry and functional problems at puberty. Both sexes are affected. Two cases were analyzed, including an active and an inactive nucleus. Histopathologically, two types are distinguished: active and inactive hypercondylia. Diagnosis is usually achieved through clinical and radiographic approach and is utterly important to distinguish the consequent therapeutic approach. Thanks to the development of new diagnostic techniques, it is possible to quantify in advance the risk of skeletal relapse in case of hyperactive nucleus. This study points out the need to identify the type of hyperplasty to treat as active or inactive. Surgery should be based on scintigraphy results to evaluate active center of ossification. Clinical manifestations depend on the date of onset of this pathology and the speed of growth of the anomaly. We underline the importance of a precise diagnosis, clinical and instrumental, to plan the correct treatment achieved through a correct anamnesis, a standardized diagnostic protocol, supported by the indispensable scintigraphy.

Reconstruction of the nasal valve.

The authors present their experience with reconstructive nasal valve surgery, evaluating the effects related to the use of a composite graft, which is a graft made of skin and cartilage, or mucosa and cartilage, and to the transposition of mucocartilaginous flaps. A sample of 15 patients (12 women and three men) selected among 452 cases treated with functional and aesthetic rhinoplasty at the Department of Plastic and Reconstructive Surgery of the "Tor Vergata" University of Rome was analyzed. Patients were between 25 and 50 years of age, with a mean age of 40 years, and were treated with secondary rhinoplasty for valvular stenosis. Of these patients, 12 had functional problems of the internal and external nasal valve, and three had internal valve stenosis. In our sample of 15 patients, respiratory symptoms improved at short- and long-term follow up. In all cases, a good aesthetic result was obtained. The patients were not satisfied with the aesthetic result in only three cases as a result of enlargement or asymmetry of the external valvular area. In 11 cases, an "open tip" rhinoplasty was performed with a retroauricular skin-cartilage composite graft to correct internal-external valvular stenosis. In all the cases of internal valvular stenosis (three patients) and in one case of internal-external valvular stenosis, a transposition of mucocartilaginous flaps with a section of the mucosa of the upper lateral cartilage was performed.

Orbital reconstruction: bone-anchored implants.

The authors present their experience on reconstruction by extraoral bone-anchored implants technique, showing two patients from a total of 13, treated for orbital reconstruction. They were selected from 66 patients treated for reconstruction of orbit, ear and nose using this technique by the staff of the Department of Plastic and Reconstructive Surgery of the University of Tor Vergata, Rome, Italy. They underwent orbital emptying due to cancer pathology. Surgical technique is described in detail; its final purpose being positioning of titanium fixtures on the orbital borders, necessary to anchor the silicone epithesis. The advantages and potential limits of this technique are exposed, exposing the important role of patient's compliance. The importance of preliminary study on the patients is also emphasized and includes clinical evaluation and instrumental examination for surgical planning, completed by a photographic study in the three standard projections.Satisfactory aesthetic results were obtained by the use of this technique and the authors believe it may represent a valid option; complementary to more traditional ones, but is a first choice in patients who cannot endure major surgery or in case of failure of traditional techniques.

Evaluation of pretransplant immunologic status in kidney-transplant recipients by panel reactive antibody and soluble CD30 determinations.

OBJECTIVES: To retrospectively compare the accuracy of pretransplant panel of reactivity antibodies (PRA) and serum level of soluble CD30 (sCD30) in predicting early (<6 months) acute rejection (AR) in living-donor and deceased-donor kidney-transplant (KT) patients. METHODS: Pretransplant sera of 24 KT recipients were retrospectively tested for sCD30 and compared with PRA. Inclusion criteria were de novo graft patients on calcineurin-inhibitor-based immunosuppression, minimum follow-up of 1 year, alive with a functioning graft, and stable renal function over the last 12 months. Objective measures were incidence of biopsy-proven AR (BPAR) within 6 months of KT and sCD30 and PRA diagnostic indexes. The relative risk (RR) of BPAR for each test was also obtained. RESULTS: Fourteen (58.3%) patients presented at least one episode of BPAR within 6 months of KT. All rejection episodes were responsive to steroid treatment. PRA was positive in six (25%) patients, and four (66.7%) of them presented at least one episode of BPAR. sCD30 tested positive in nine (37.5%) patients, and all these later presented at least one episode of BPAR. sCD30 and PRA diagnostic indexes in predicting early (< 6months) BPAR were sensitivity 64.2% versus 28.5%; specificity 100% versus 80%; accuracy 79.1% versus 50%; positive predictive value 100% versus 66.6%; and negative predictive value 66.6% versus 44.4%. The RR of early AR was 1.4 in PRA-positive patients and extremely higher in the sCD30-positive group. CONCLUSIONS: Pretransplant sCD30 is a more accurate predictor of AR when compared with PRA. These results support its use in the pretransplant work-up of kidney-graft recipients.

Evaluation of pretransplant immunologic status in kidney-transplant recipients by panel reactive antibody and soluble CD30 determinations.

OBJECTIVES: To retrospectively compare the accuracy of pretransplant panel of reactivity antibodies (PRA) and serum level of soluble CD30 (sCD30) in predicting early (< 6 months) acute rejection (AR) in living-donor and deceased-donor kidney-transplant (KT) patients. METHODS: Pretransplant sera of 24 KT recipients were retrospectively tested for sCD30 and compared with PRA. Inclusion criteria were de novo graft patients on calcineurin-inhibitor-based immunosuppression, minimum follow-up of 1 year, alive with a functioning graft, and stable renal function over the last 12 months. Objective measures were incidence of biopsy-proven AR (BPAR) within 6 months of KT and sCD30 and PRA diagnostic indexes. The relative risk (RR) of BPAR for each test was also obtained. RESULTS: Fourteen (58.3%) patients presented at least one episode of BPAR within 6 months of KT. All rejection episodes were responsive to steroid treatment. PRA was positive in six (25%) patients, and four (66.7%) of them presented at least one episode of BPAR. sCD30 tested positive in nine (37.5%) patients, and all these later presented at least one episode of BPAR. sCD30 and PRA diagnostic indexes in predicting early (< 6 months) BPAR were sensitivity 64.2% versus 28.5%; specificity 100% versus 80%; accuracy 79.1% versus 50%; positive predictive value 100% versus 66.6%; and negative predictive value 66.6% versus 44.4%. The RR of early AR was 1.4 in PRA-positive patients and extremely higher in the sCD30-positive group. CONCLUSIONS: Pretransplant sCD30 is a more accurate predictor of AR when compared with PRA. These results support its use in the pretransplant work-up of kidney-graft recipients.