[A case of atrial myxoma with connectivitis-like onset]. / Un caso di mixoma atriale ad esordio similconnettivitico.

A case of cardiac myxoma is reported. This tumor, although histologically benign, may be potentially lethal if an early diagnosis and an adequate surgical treatment is not performed. In an early stage, the disease may be asymptomatic or a large array of aspecific symptoms may be present. In this case, an initial diagnosis of polymyositis was made. This paraneoplastic syndrome is frequently associated with tumors, and should trigger a full evaluation for cancer.

Dentine permeability and bond quality as affected by new bonding systems.

OBJECTIVES AND METHODS: The relationship between dentine bonding and the condition of dentine for four dentine bonding systems (All Bond 2, Clearfil Liner Bond, Scotchbond MP and XR Bond) has been examined. Different dentine conditions were evaluated and correlated with adhesion values. Dentine permeability was calculated using a hydraulic pressure apparatus working under physiological pulpal pressure (6.9 kPa), while remaining dentine thickness (RDT) was measured using pincer calipers. Scanning electron microscopic (SEM) examinations were effected to analyse dentine morphology. These evaluations were considered as an index of the condition of dentine. Shear bond strength tests were used to evaluate adhesion. Dentine samples after the bonding systems application were stored for 24 h under pulpal pressure before bond strength was tested. RESULTS: Scanning electron microscopy examinations indicated that the application of bonding system conditioners caused the removal of smear layer, the demineralization of dentine and the formation of a layer of collapsed collagen fibrils in the intertubular and peritubular dentine. Primers were able to infiltrate the collagen fibrils. A layer of resin infiltrated/reinforced dentine (the so-called 'hybrid layer') was observed for All Bond 2, Clearfil Linear Bond and Schotchbond MP. CONCLUSIONS: Significant correlations were observed only for XR Bond, which proved very sensitive to RDT and dentine permeability despite the presence of smear layer. The other three materials did not show any correlation with dentine conditions. By contrast they showed the highest bond values.

Clinical evaluation of oscillating positive expiratory pressure for enhancing expectoration in diseases other than cystic fibrosis.

The benefit of chest physiotherapy in patients with cystic fibrosis has been well documented. However, the benefit of similar rehabilitation in patients with large amounts of sputum who have diagnoses other than cystic fibrosis has not been clearly demonstrated. The aim of this study was to evaluate the acute effectiveness of a device advised for home chest physiotherapy in comparison to postural drainage combined with chest percussion in removing secretions in patients with high sputum production due to diseases other than cystic fibrosis. Fourteen in-patients, known to spontaneously produce more than 25 mL sputum.day-1, underwent two sessions each of two treatment modalities in random order. Treatment A consisted of postural drainage and manual chest percussion. Treatment B included breathing through a commercial device claimed to combine oscillating positive expiratory pressure with oscillations of the airflow. Expiratory flows and oxygen saturation were monitored and recorded throughout the study. The amount of sputum produced in the 30 min preceding, during, and in the 60 min after completing each treatment session was recorded, together with the sensation of "chest unpleasantness due to secretions" as assessed by means of a modified visual analogue scale. The mean time that the patients tolerated treatment was not different for A and B (18.7 +/- 5 and 19.3 +/- 5 min, respectively). Sputum significantly increased during both treatment periods and in the same amount for the two modalities (2.9 +/- 2.9 to 10.9 +/- 7.1 and 2.8 +/- 3.1 to 10.1 +/- 10.8 mL for A and B, respectively). Visual analogue scale score significantly decreased at the end of each treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Rectal administration of sodium valproate in children.

A study of VPA based on a comparison of mean plasma levels, plasma peak latency times and plasma half-lives after rectal and oral administration was conducted in 9 children between 6 months and 10 years of age suffering from various forms of epileptic seizure, before they received chronic VPA treatment. Each child received an oral dose of 20 mg/kg and after two days a rectal dose of 20 mg/kg and the mean plasma concentrations were determined at intervals for both modes of administration. An identical plasma concentration for both after 24 h showed that the quantity of drug absorbed was the same. The mean half-life varied according to age: 11 +/- 2 h for children over 3 years of age and 9 +/- 1 h for those under 3. The results of the study, in line with the few other available published data, thus confirm the validity of rectal VPA administration.