Chevrel technique for midline incisional hernia: still an effective procedure.

BACKGROUND: Prosthesis use in the treatment of incisional abdominal hernia is today an accepted concept worldwide. However, there is no agreement as to the most appropriate site of prosthesis insertion. The aim of this report was to analyse the operative steps of the premuscolo-aponeurotic repair and to present the results of our experience. METHODS: Between May 1996 and December 2006, 64 patients (52 women and 12 men, mean age 64 years) underwent a Chevrel repair for midline incisional hernia. They represented 52% of plasties performed for incisional hernia. Patients were subdivided according with Chevrel and Rath classification. Nineteen were operated on in emergency and 45 electively. Associated diseases, mainly cardiopathy, obesity, chronic pulmonary disease and diabetes, were recorded in 83% of the patients. Cholecystectomy and wide dermolipectomy were the more frequent procedures associated with plasty. Prosthetic material was polypropylene (53%), polyester (42%) and polypropylene + polyglactin 910 (5%). RESULTS: The mortality rate was 1.6%. Postoperative complications were exclusively parietal in 17 patients (26.5%), i.e. seroma, skin necrosis and superficial wound infection. No deep infection or intra-abdominal complications were observed. Mean postoperative hospital stay was 10 days, closely related to being elderly, associated operations and emergency admission. Two recurrences were registered, and chronic abdominal pain or late infections were not observed. CONCLUSIONS: Our experience shows that the Chevrel technique is a safe and effective procedure, easy to perform and reliable even in cases of septic risk.

In vitro interaction between ochratoxin A and different strains of Saccharomyces cerevisiae and Kloeckera apiculata.

The interaction of ochratoxin A (OTA) and 20 yeast strains of Saccharomyces cerevisiae and Kloeckera apiculata during alcoholic fermentation was studied. Levels of OTA were determined in the fermentation liquid and in the yeast cells solid using a high-performance liquid chromatography system with a fluorescence detector. Yeast cells do not adsorb OTA, and for all yeasts, OTA levels did not affect the alcoholic fermentation. Some yeast strains reduced levels of OTA, whereas other strains did not show any effect demonstrating that OTA level reduction is not a genus species characteristic but a strain trait.

Sex differences in the outcome of juvenile social isolation on HPA axis function in rats.

Women are more likely than men to suffer from anxiety disorders and major depression. These disorders share hyperresponsiveness to stress as an etiological factor. Thus, sex differences in brain arousal systems and their regulation by chronic stress may account for the increased vulnerability to these disorders in women. Social isolation is a model of early life stress that results in neurobiological alterations leading to increased anxiety-like and depressive-like behaviors. Here we investigated the sex difference in the effects of post-weaning social isolation on acute stress sensitivity and behavior in rats. In both sexes, social isolation at weaning reduced basal levels of the neuroactive steroid allopregnanolone in the brain and of corticosterone in plasma. Moreover, acute stress increased plasma corticosterone levels in both group-housed and socially isolated male and female rats; however this effect was greater in male than female rats subjected to social isolation. Intriguingly, group-housed female rats showed no change in plasma and brain levels of allopregnanolone after acute foot-shock stress. The absence of stress-induced effects on allopregnanolone synthesis might be due to the physiologically higher levels of this hormone in females vs. males. Accordingly, increasing allopregnanolone levels in male rats blunted the response to foot-shock stress in these animals. Socially isolated male, but not female, rats also display depressive-like behavior and increased hippocampal brain-derived neurotrophic factor (BDNF). The ovarian steroids could "buffer" the effect of this adverse experience in females on these parameters. Finally, the dexamethasone (DEX) suppression test indicated that the chronic stress associated with social isolation impairs feedback inhibition in both sexes in which an increase in the abundance of glucocorticoid receptors (GRs) in the hippocampus was found. Altogether, these results demonstrate that social isolation affects neuroendocrine reactivity to stress, plasticity and emotionality in a sexually dimorphic manner.

Perinatal alterations of thyroid hormones and behaviour in adult rats.

Several studies have shown the relevance of the neuroendocrinological system in the development and function of the nervous system. In order to observe the influence of thyroid hormones during development on the behaviour of adult rats we induced dysthyroid states during the perinatal period. Results indicate that some behaviours are more susceptible to the action of thyroid hormones than others. We observed that the thyroid hormone deficiency causes an increase of activity in animals in spite of a large period of rehabilitation. Thyroxine-treated rats showed an anxiogenic behavioural pattern in the elevated plus-maze, while animals rehabilitated from perinatal deficit of thyroid hormones showed an anxiolitic pattern. These findings suggest that an excess of thyroid hormones has less effect on behaviour than a deficiency of these hormones.

Is prolactin related to activity and emotional reactivity in rats?

Recent studies have shown different relationships between hormones and personality in humans, including a relationship between prolactin levels and impulsivity. The aim of the present work was to study the relationships between basal levels of prolactin and some measures of activity and emotional reactivity in rats. One of the most consistent results showed a negative correlation between basal prolactin levels and activity. This finding is in line with the serotonergic theories of impulsive behavior and with the effects of dopamine upon activity.

[Wiedemann-Beckwith syndrome in childhood]. / Contributo alla conoscenza della sindrome di Wiedemann-Beckwith in età evolutiva.

A follow up examination was carried out in a 10 year old child who had been diagnosed as having Wiedemann-Beckwith syndrome soon after birth. Macrosomy was seen to persist and body asymmetry and some dysmorphic aspects had become more pronounced over the years. The presence of moderate mental deficiency had led to difficulty in social relationships. In the prepuberty phase, the reappearance of hypoglycemia crises, which were also noted in the neonatal age, was of particular interest.

[Syndactylia associated with multiple malformation syndromes. Observation of a new symptomatologic complex in 3 brothers]. / In tema di sindattilia associata a sindromi plurimalformative. Osservazione di un nuovo complesso sintomatologico in tre fratelli.

Hand and feet malformations are often part of complex malformation associations. The present paper reports on a family whose three sibs (two males and one female) are affected with symmetric soft tissue syndactyly involving both fingers and toes, fifth finger clinodactyly, a pattern of dysmorphism including down slanting palpebral fissures, long flat nasal saddle, out turned nostril openings ("Greek warrior helmet"-like profile), dysplastic teeth, and, in addition, severe growth retardation, microcephaly, severe mental deficiency with immaturity of cerebral activity of EEG, hypergonadotropic hypogonadism and some skeletal anomalies. All cases show large secondary constriction in one of the chromosome 1 pair (1qh+).

[Cytogenetic and clinical aspects of Prader-Willi syndrome]. / Contributo alla conoscenza degli aspetti citogenetici e clinici della sindrome di Prader-Willi.

Two male nonconsanguineous cases (aged 4 years) of Prader-Willi syndrome are clinically and cytologically studied. Both had obesity, marked hypogonadism, reduced head circumference, psychomotor impairment, hypotonia, tooth decay, small hands and feet, immature EEG. Case 1 showed a "de novo" translocation 7;15 and case 2 showed a normal karyotype. According to various authors, many cases of Prader-Willi syndrome show the presence of a translocation of chromosome 15 onto an autosome or X chromosome. This is the first observation of chromosome 7 involvement in this translocation.

Maternal separation attenuates the effect of adolescent social isolation on HPA axis responsiveness in adult rats.

Adverse early life experiences that occur during childhood and adolescence can have negative impacts on behavior later in life. The main goal of our work was to assess how the association between stressful experiences during neonatal and adolescent periods may influence stress responsiveness and brain plasticity in adult rats. Stressful experiences included maternal separation and social isolation at weaning. Three hours of separation from the pups (3-14 PND) significantly increased frequencies of maternal arched-back nursing and licking-grooming across the first two weeks postpartum. Separation also induced a long-lasting increase in dams blood levels of corticosterone. Maternal separation did not modify brain and plasma allopregnanolone and corticosterone levels in adult offspring, but they demonstrate partial recovery from the reduction induced by social isolation during adolescence. Moreover, the enhancement of corticosterone and allopregnanolone levels induced by foot shock stress in socially isolated animals that were subjected to maternal separation was markedly reduced with respect to that observed in animals that were just socially isolated. All experimental groups showed a significant reduction of BDNF and Arc protein expression in the hippocampus. However, the reduction of BDNF observed in animals that were maternally separated and subjected to social isolation was less significantly pronounced than in animals that were just socially isolated. The results sustained the mismatch hypothesis stating that aversive experiences early in life trigger adaptive processes, thereby rendering an individual to be better adapted to aversive challenges later in life.

Incidence and risk factors for trocar site hernia following laparoscopic cholecystectomy: a long-term follow-up study.

BACKGROUND: The aim of this retrospective study was to assess the incidence of trocar site hernias (TSH) following laparoscopic cholecystectomy (LC) through a long-term follow-up and to elucidate the significance of several technical and patient-related factors. METHODS: A total of 313 patients submitted to LC between 2000 and 2004 were included in our study. The pneumoperitoneum was always performed by means of Hasson's technique at the umbilical site and the operative trocars were positioned using either the American technique or the French technique. Closure of the fascial defect was performed only at the umbilical site. The effects of several variables, including age, gender, size of gallstones, co-existing umbilical hernia, complexity of operation, diabetes, obesity, malnutrition, smoking, and heavy manual work on the development of TSH were assessed by univariate and multivariate models. RESULTS: Thirteen cases of TSH (4.1 %) were detected over a mean follow-up period of 89.8 months (range: 60-128). Of these, 11 (84.6 %) developed at the umbilicus and 2 at the 10 mm subxiphoid site (15.4 %). At univariate and multivariate analysis, gallstones ≥ 2 cm (p = 0.030; OR = 9.95, p = 0.01) and obesity (p = 0.002; OR = 22.93, p < 0.01) were found to increase the likelihood of TSH development. CONCLUSIONS: After long-term follow-up, the incidence of TSH following LC was higher than expected. The insertion of large trocars at the umbilical site plays a key role in the development of TSH. Other conditions such as obesity and large gallstones can be additional risk factors since the umbilical defect must often be widened in these cases.

Tumor edematoso de Pott, ¿una entidad olvidada? / Pott’s puffy tumour: a forgotten condition?

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Age effects on the social interaction test in early adulthood male rats.

The effects of age on active and passive social interaction were studied in Wistar rats using the social interaction test (S.I.T.). Individual behaviors such as ambulation, rearing, and defecation were also studied. Despite the widespread use of the S.I.T. in anxiety research, the effects of age on the S.I.T. have not been studied thoroughly. Male Wistar rats of 75, 135, and 180 days old were used. Our results showed age effects on active social contact, passive social contact, ambulation, rearing, and defecation. At 135 days old, animals presented the lowest scores on active social behavior and the highest scores on defecation. Moreover, exploratory behavior measured by ambulation and rearing decreased with age. These results suggest that age could be a relevant variable in the social interaction test.

[Hormones and aggression]. / Hormonas y agresión.

This work is a review about psychoendocrinologic aspects of aggressive behavior. We have considered two approaches, the classical view focused on hormonal influences in the regulation of aggression and the most recent view which accounts for the influences of aggressive behavior and social status on hormonal secretion. In this review we differentiate the organizational from the activational effects. The main conclusions are referred to the gonadal steroids effects both organization and activation of the neural subtract of aggression. Among them it seems that aromatizable androgens have the most important effects. On the other hand, the testosterone would be predictive for dominant social status, the corticosterone would be for submission and finally, the ACTH would be predictive for the aggressive behavior but not for submission. In addition to that the literature point that the defeat experience is the main factor in submission. Referred to the effects of behavior on hormonal secretions, all the studies point out that social interaction elicits sympathetic-medullar and gonadal activation in the dominant animals and cortico-adrenal activation in the submissive ones.

Three cases of ring chromosome 2, one derived from a paternal 2/6 translocation.

Two cases of primary ring chromosome 2 and one case of a ring secondary to a paternal 2/6 translocation are described and compared with a fourth case of ring 2 from the literature. The breakpoints in two cases are identical and the same as the breakpoint on chromosome 2 in the composite 2/6 ring. The three primary rings have a number of symptoms in common, but other cases are needed to identify a possible deletion syndrome. The levels of the enzyme MDH-1 were within the normal range in Cases 1 and 2. Thus we localised the locus for MDH-1 to segment 2p23 leads to p25; this had previously been localised to segment p23 leads to pter.

Trisomy 16q21 = to qter.

A case of trisomy 16q secondary to a paternal 16/18 translocation is described. A comparison of this case with the few other cases of trisomy 16q described in the literature indicates that trisomy for the long arm of chromosome 16 results in a severely affected phenotype and early death. Conversely, patient with trisomy 16p do not have gross abnormalities. We postulate that the prenatal lethality of full trisomy 16 is mainly due to the trisomy for the long arm.

[Domestic humidifiers. What do we know about them?]. / Humidificadores domésticos: 'qué se sabe de ellos?

Popular opinion assumes that environmental humidity relieves the clinical symptoms of respiratory tract diseases. Various types of home humidifiers are available on the market. Parents buy them in the belief that they will improve their children's well-being but are usually unaware of whether these devices provide a real benefit. Pediatricians should bear the main responsibility in the task of informing and guiding families in the use of home humidifiers but general lack of knowledge on the subject and the scarcity of published data make this task difficult. The aim of this review is to increase general knowledge of home humidifiers. We describe what they are, their main types, their basic functioning, advantages and disadvantages and the importance of suitable maintenance. We define what environmental humidity means, how it can change according to temperature and how it can influence human health. Finally, we suggest that optimal relative humidity is approximately 40-60 % and that it should be measured before using a home humidifier.

Copper(II)-selective membrane electrodes based on some recently synthesized mixed aza-thioether crowns containing a 1,10-phenanthroline sub-unit.

Three different mixed aza-thioether crowns containing a 1,10-phenanthroline sub-unit were investigated to characterize their abilities as copper(II) ion carriers in PVC-membrane electrodes. The electrode based on L1 exhibited a Nernstian response for Cu(2+) ions over a wide concentration range (2x10(-1) to 1x10(-5) M) with a limit of detection of 8.0x10(-6) M (0.5 p.p.m.). The response time of sensor is 15 s, and the membrane can be used for more than 3 months without observing any deviation. The electrode revealed comparatively good selectivities with respect to many alkali, alkaline earth, transition and heavy metal ions, and could be used in a pH range of 2.5-5.5. It was applied to the direct determination and potentiometric titration of the copper(II) ion.