Development of a subset of ICNP Nursing Diagnoses for the promotion of self-care in people with diabetes mellitus: a multi-center observational study.

INTRODUCTION: Self-care is a key for people with diabetes mellitus (DM) to avoid severe complications and to maintain quality of life. Person-centered and accurate nursing care plans can help nurses to deliver effective self-care promotion interventions. Few studies focused on nursing diagnoses that are specific for diabetes self-care education, and none of them used the International Classification for Nursing Practice (ICNP). International Catalogues of ICNP nursing diagnoses are missing in this field. AIMS: To identify the ICNP nursing diagnoses that are useful to promote self-care in people with DM; to describe the prevalence of ICNP nursing diagnoses in self-care of people with DM. METHODS: A subset of 55 ICNP nursing diagnoses was developed based on the Middle Range Theory of Self-care of Chronic Illness, and most recent diabetes clinical guidelines. Then, the subset was tested through a multicenter cross-sectional design involving a consecutive sample of 170 adults with confirmed diagnosis of Type 1 or Type 2 DM. Data were collected by medical records, physical examinations and semi-structured interviews. RESULTS: 1343 nursing diagnoses were identified, with an average of 8 nursing diagnoses per patient. The 100% of the nursing diagnoses were described using the pre-developed subset. Overall, the five prevalent nursing diagnoses were: Body weight problem (56.4%), Non adherence to immunization regime (53.5%), Conflicting attitude toward dietary regime (41.7%), Impaired weight monitoring (39.4%), and Lack of knowledge about blood glucose diagnostic test result (32.3%). Nursing diagnoses by self-care maintenance, monitoring and management were also described. CONCLUSIONS: A huge amount of nursing diagnoses was identified suggesting the need of intensive education. Clinicians and administrators can use this subset to improve the accuracy of the documentation of diabetes care. In Public Health, the subset can be used to assess the cost-effectiveness of diabetes healthcare services. Future research is needed to assess the effectiveness of this subset in settings that are different from the one where it was developed. Finally, this subset could be a starting point to develop and International ICNP Catalogue for diabetes care.

Ultrasound transmission gel as a bolus device for skin irradiation of irregular surfaces: technical note.

PURPOSE: This paper describes an uncommon radiation treatment of the external ear, with ultrasound (US) transmission gel used as bolus device to compensate for the irregularity of the target surface. MATERIALS AND METHODS: Postoperative radiotherapy for cutaneous carcinoma was performed with a single high-energy electron beam directed over the ear auricle. Due to the irregular surface of the target, a "missing tissue" compensator was employed. Daily, after patient positioning, the concha was filled and flattened with US gel, and a dose of 54 Gy in 27 fractions was delivered. RESULTS: Water equivalence of the gel was verified by comparing the gel's computed tomography (CT) number [Hounsfield units (HU)] and density with the corresponding values for water and another commercial bolus device. Whereas ultrasound gel and water had comparable values (HU: 0; density 1 g/cm(3) for both), the corresponding values for the commercial device were slightly higher (HU: 80; density 1.02 g/cm(3)). CONCLUSIONS: Ultrasound gel proved to be an easy, fast and cheap compensating tool. Its water equivalence allows it to be used as an alternative to water, though easier to position and with lower risk of displacement. Thus, it is recommendable as a practical tool for most irregular sites. Further investigations are warranted to validate this solution in more complex irradiation techniques.

Efficacy of bioactive compounds and their association with different cowpea cultivars against their major stored pest.

BACKGROUND: Stored grain insects are controlled with fumigant insecticides which can select resistant insect populations and cause environmental and applicator contamination. Thus, resistant cultivars and chemical constituents of essential oils are an alternative to the almost exclusive use of these insecticides. The effects of the combination of cowpea cultivars Vigna unguiculata (L.) Walp. with chemical constituents of essential oils against Callosobruchus maculatus were determined. Four cowpea cultivars: BRS Tracuateua, BR 17 Gurgueia, Epace 10 and Sempre Verde (insect rearing) untreated were used in the experiments and combined with chemical constituents of essential oil: eugenol, geraniol and trans-anethole. The biological parameters observed were: total egg number and eggs per grain, egg viability (%), insects emerged and insects per grain, immature stage viability (%), instantaneous rate of growth (ri), insect dry weight (mg), grain weight loss (%) and egg-adult period. RESULTS: When comparing all biological parameters, the cultivars BRS Tracuateua and BR 17 Gurgueia were harmful to C. maculatus. In the toxicity tests, the results showed that LC30 and LC50 of the chemical constituents ranged from 54.77 to 103.48 ppm and 60.99 to 125.18 ppm, respectively. In most of the biological parameters, LC50 had adverse effects significantly higher than LC30 and BR 17 Gurgueia treated were harmful to C. maculatus. CONCLUSIONS: Overall, the findings showed that BR 17 Gurgueia combined with eugenol and geraniol more significantly affected the biological parameters of C. maculatus than when associated with trans-anethole, reducing egg number, insects emerged and egg viability. © 2020 Society of Chemical Industry.

Astronomy and Solar Physics: X-ray Gas Scintillation Spectrometer Experiment.

The payload complement on Spacelab 1 included a spectrometer for observations of the brighter cosmic x-ray sources. The primary scientific objective was to study the detailed spectral features of cosmic x-ray sources and their associated temporal variations over a wide energy range from about 2 to 80 kiloelectron volts. The instrument, based on the gas scintillation proportional counter, had a geometrical area of some 180 square centimeters with an energy resolution of about 9 percent at 7 kiloelectron volts. The results presented here show new results from two galactic binary x-ray sources, Cygnus X-3 and Centaurus X-3, and from the Perseus cluster of galaxies. The excellent energy resolution of the instrument permits line features to be identified in these sources with unprecedented quality.

Signal transduction: response regulators on and off.

High resolution structures of the active phosphorylated forms of two-component response regulators have recently been reported. The results provide a basis for understanding how metabolic energy is coupled to signal transduction in cellular regulatory networks.

Promoter-specific involvement of the FixJ receiver domain in transcriptional activation.

The "two-component" FixLJ system activates nitrogen fixation genes via nifA and fixK in Sinorhizobium meliloti. Like other response regulators, the FixJ protein can be decomposed into an N-terminal phosphorylatable "receiver" domain FixJN and a C-terminal transcriptional activator domain FixJC. The FixJN receiver domain was known to regulate activity of FixJC negatively at the nifA promoter. Here we show a different situation at the fixK promoter where FixJN also contributes positively to transcriptional activation. This promoter-specific effect was mapped by alanine-scanning mutagenesis to the beta2 strand of the receiver domain. This interaction with FixJN is required for the recruitment of RNA polymerase at the fixK promoter by phosphorylated FixJ. Altogether the FixJ receiver domain appears to carry at least four functions, some of which can be separated by mutation: (1) autophosphorylation; (2) inhibition of FixJC; (3) dimerization; (4) transcriptional activation at pfixK. This example illustrates the formidable functional plasticity of receiver domains.

A receptor scaffold mediates stimulus-response coupling in bacterial chemotaxis.

The mechanism of stimulus-response coupling in bacterial chemotaxis has emerged as a paradigm for understanding general features of intracellular signal transduction both in bacterial and eukaryotic cells. Until recently it was thought that the mechanism involved reversible stochastic interactions between dimeric receptors freely diffusing in the cytoplasmic membrane and several soluble signal transduction proteins within the cytoplasm. Recent results have shown that this view is an oversimplification. The receptors and most of the signal transduction proteins are organized together in a higher ordered structure at one pole of the bacterial cell. The scaffolding network within this structure appears to be composed of C-terminal alpha-helical extensions of the membrane chemoreceptor proteins held together in a lattice by tandem SH3-like domains. Results suggest that stimuli are detected through the perturbations they induce in scaffolding architecture.

Kinetics of CheY phosphorylation by small molecule phosphodonors.

The chemotaxis response regulator CheY can acquire phosphoryl groups either from its associated autophosphorylating protein kinase, CheA, or from small phosphodonor molecules such as acetyl phosphate. We report a stopped-flow kinetic analysis of CheY phosphorylation by acetyl phosphate. The results show that CheY has a very low affinity for this phosphodonor (K(s)&z.Gt;0.1 M), consistent with the conclusion that, whereas CheY provides catalytic functions for the phosphotransfer reaction, the CheA kinase may act simply to increase the effective phosphodonor concentration at the CheY active site.

Orthodontic treatment in periodontally compromised patients: 12-year report.

This work describes the therapeutic protocol of combined orthodontic-periodontal treatment and evaluates the effectiveness of surgical and nonsurgical periodontal therapy in the maintenance of a healthy periodontal status after the orthodontic treatment. Surgical periodontal treatment was performed in 267 patients affected by severe periodontal disease, and 128 patients had nonsurgical treatment. For each patient the mean value of probing depth (mPPD) and the rate of positive bleeding on probing (%BoP) of the teeth involved in the orthodontic movement were registered before the start of the periodontal treatment, at the end of the orthodontic treatment, and 2, 4, 6, 10, and 12 years after the end of the orthodontic treatment. Comparison between pretreatment and posttreatment values and between pretreatment and follow-up values showed a decrease in mPPD and %BoP that was of statistical significance. The difference between posttreatment and follow-up values was not statistically significant. These results suggest that orthodontic treatment is no longer a contraindication in the therapy of severe adult periodontitis. In these cases orthodontics improve the possibilities of saving and restoring a deteriorated dentition.

Resin-bonded fixed partial dentures and splints in periodontally compromised patients: a 10-year follow-up.

In the present study, 139 periodontally compromised patients received a complete periodontal treatment; in 104 cases this was followed by orthodontic treatment. At the end of the entire therapy, a total of 150 Maryland restorations (69 resin-bonded fixed partial dentures and 81 resin-bonded splints) was placed and then followed for a period of up to 10 years (mean 6.7 y). Thirteen fixed partial dentures and 16 splints failed during the observation period; the 10-year cumulative survival rate from lifetable analysis was 76.2% (70.6% for fixed partial dentures and 80.7% for splints).

[Mixed tumor of an ectopic salivary gland. Presentation of a case]. / Tumore misto a carico di ghiandola salivare ectopica. Presentazione di un caso.

A case of mixed tumour in an island of ectopic salivary glandular tissue at the right nostril and surrounding labial skin is reported. An anatomopathological classification of salivary neoplasias is provided and the histological picture of mixed tumours described. Stress is laid on the rarity of the finding. An extensive tissue area was removed because the neoplasia was a recurrence of a previous intervention (done by others) not followed up by histological examination.

[A case of massive hemoperitoneum caused by spontaneous detachment of epiploic appendices]. / Su un caso di imponente emoperitoneo da distacco spontaneo di appendice epiploica.

An unusual case of spontaneous detachment of the sigmoid epiploic appendix is described. The most frequently reported pathologies of these formations are reviewed. The discussion stresses the unusual clinical picture which determined the diagnostic error. Some hypotheses are also formulated on the aetiopathogenesis of ischaemia of epiploic appendices.

[Non-appendicular primary pathology of the large intestine as a cause of emergency surgery. Clinico-statistical evaluation of its incidence in a provincial hospital]. / La patologia primitiva del grosso intestino, non appendicolare, quale causa di intervento in emergenza. Valutazione clinico statistica dell'incidenza in un ospedale provinciale.

Reference is made to the relevant literature in a description of cases of non-appendicular primary diseases of the large intestine necessitating emergency surgery at the Tradate District Hospital over the last five years. Emphasis is placed on the wide aetiological variety of these cases, their different clinical pictures, the types of operation performed, the possible complications, and the causes of death prior to discharge.

[Treatment of acute cholecystitis. Clinico-statistical findings]. / Trattamento delle colecistiti acute. Rilievi clinico-statistici.

A series of 354 patients suffering from gall bladder and/or bile way conditions and who had undergone operation in the acute phase has been reviewed. The usefulness of early operation over more wait-and-see tactics is confirmed. Shortening of mean hospitalization is particularly significant. The difference in hospital mortality is insignificant. The only complication reported is the higher frequency of suppurative accidents in the surgical wound.

[Bezoar of the stomach. Clinical case report]. / A proposito del bezoario dello stomaco. Contributo clinico.

A clinical case of bezoar of the stomach accompanied by peptic and gastric ulcer is presented. The different types of bezoar and the reasons for their formation are described, and the clinical, laparotomic and anatomopathological picture is illustrated.

[Case of familial hypodontia]. / A proposito di un caso di ipodontia familiare.

A brief account of abnormalities arising from absent teeth is followed by the description of three cases of hypodontia in the same family. The mother lacked 12 teeth, her first daughter (age 14 yr) lacked 20 permanent teeth (oligoblastodontia), and her 12-yr-old son lacked 14 permanent teeth (ateleblastodontia).

[Follow-up of 5 cases of mandibular adamantinoma treated by osteotomy and mixed grafts]. / Controllo a distanza su 5 casi di adamantinoma mandibolar trattati con osteotomia ed innesti misti.

The examination after fifteen years of five cases of mandibular adamantinoma treated with an operation performed in two stages (graft of metallic prosthesis and osseous autograft) has confirmed the success of this surgical method. In particular from the clinical and radiological examination it turns out that the essential requisites for a therapeutical success have been respected: the anatomical restoration and the aesthetical and function rehabilitation.

[Mechanical staplers in our surgical practice]. / Le suturatrici meccaniche nella nostra practica chirurgica.

On the basis of our experience from 1981 to 1989, advantages of staplers in digestive surgery are reported. Complications such as bleeding and stenosis are not clinically important, however, in most cases, they can be avoided if the instruments are properly used.