Microplastic ingestion by common terns (Sterna hirundo) and their prey during the non-breeding season.

Current evidence demonstrates the presence and persistence of microplastics in the marine food web. Seabirds are predators in marine ecosystems and are highly exposed to marine plastic debris through the food. The aim of this work was to examine the presence of microplastics in a long-distance migratory seabird, the Common tern (Sterna hirundo) (n = 10), and in their prey (n = 53) during the non-breeding season. The study was conducted in Punta Rasa, Bahía Samborombón, province of Buenos Aires, which is an important resting and feeding location for migratory seabirds and shorebirds in South America. Microplastics were found in all the birds examined. The occurrence of microplastics in the gastrointestinal tract (GIT) of Common terns (n = 82) was higher than in regurgitated prey (RP) (n = 28), which is likely reflecting trophic transfer process. Almost all microplastics found were fibers and only 3 were fragments. Microplastics were sorted by color; transparent, black and blue-colored fibers were the most abundant plastic types. Characterization of the polymer type by Fourier Transform Infrared Spectrometry (FTIR) revealed that cellulose ester plastics, polyethylene terephtalate, polyacrylonitrile and polypropylene were the most abundant types found in both the gastrointestinal tract and prey. Our results highlight the high levels of ingested microplastics in Common terns and in their prey, and reflect a concern in this important location for migratory seabirds.

Modifiable and non-modifiable risk factors affecting walking recovery after hip fracture.

UNLABELLED: Modifiable and non-modifiable predictors of mobility recovery were analyzed on a sample of 774 hip fracture patients according to pre-fracture abilities. Overall predictors were mostly non-modifiable factors related to frailty of patients with the exception of 25-hydroxyvitamin D concentration which significantly affected walking recovery, especially in patients with higher pre-fracture performance. INTRODUCTION: This study aims to investigate mobility changes after hip fracture with the aim of identifying modifiable and non-modifiable predictors of mobility recovery according to different pre-fracture abilities. METHODS: This is a prospective inception cohort study of consecutive older patients, admitted with a fragility hip fracture in three Hospitals of Emilia Romagna (Italy). A sample of 774 patients alive at the sixth month was divided into three groups according to pre-fracture ambulation ability (group 1: mobile outdoors; group 2: mobile indoors; and group 3: mobile with help). The relationship between baseline characteristics of patients and the odds of walking recovery was analyzed using multivariate regression analysis. RESULTS: Mortality differed significantly among the three groups and was the highest in patients needing help to walk. Among the survivors, only 50.3 % of patients recovered walking ability. In a multivariate analysis, independent risk factors were different among the three groups. In group 1, older age, comorbidities, the use of walking devices before fracture, and low albumin level acted as negative factors while male gender, a pre-fracture high functional status, and higher 25-hydroxyvitamin D levels increased the probability of full recovery. In group 2, only pre-fracture functional status and 25-hydroxyvitamin D concentration were related to the recovery of walking ability. Pre-fracture functional status was also the only significant predictor for patients in group 3. CONCLUSIONS: Several baseline characteristics of patients are related to the likelihood of recovering walking ability after hip fracture. The 25-hydroxyvitamin D level seems to be the only relevant modifiable factor even if the effectiveness of its supplementation has yet to be demonstrated.

[The video recording of medical visits for the study of physician-patient rapport in general medicine. An experimental experience in Italy]. / Videoregistrazione di visite mediche per lo studio del rapporto medico-paziente in Medicina Generale. Un'esperienza sperimentale in Italia.

The communication and relationship between doctors and patients has been given increased attention in recent years. There are many different methods by which to collect data on doctor-patient communication and relationship: of these, videorecording seems to have the most advantages. The objective of this article is to describe the method we used to make videorecorded consultations in General Medical Practice in Italy. In particular, the article addresses: 1) the technical feasibility of videorecording consultations; 2) a possible answer to the problem of informed consent both from doctors and from patients. At present, the archives collect 258 videotaped consultations of 14 General Practitioners: about three patients in four (75.9%) did consent to have their consultation recorded; a high range of videorecorded consultations (94.2%) does not present technical problems. In line with published surveys, these recording consultations are an increasingly important method of studying communication and doctor-patient relationship, and of teaching/learning these aspects of medical practice.

Effects of physical training on straightening-up processes in patients with Parkinson's disease.

PURPOSE: The aim of this study was to evaluate whether motor training could improve the straightening-up sequences in patients with Parkinson's disease and, consequently, could ease the capacity of the patients to change body's position. METHODS: Twenty out-patients with idiopathic Parkinson's disease (12 males, 8 females; mean age 72.9; H-Y, 1. 5-3) were enrolled in a rehabilitation programme which included exercises for the mobility of the trunk, of upper and lower limbs and of each segment of the spine, in order to improve the coordination of movement and to avoid postural disturbances. They received 1 hour of group treatment twice a week for a 5 week consecutive period. No changes were made in the pharmacological treatment received by each patient. The patients were evaluated at the beginning and at the end of the rehabilitation training. The statistical evaluation was made using the Wilcoxon test. RESULTS: Statistically significant differences were observed in all the motor parameters that were evaluated (supine to sitting and sitting to supine, supine rolling, standing from a chair). CONCLUSIONS: The observations demonstrate that physical training can be effective in improving motor performance related to changes in position which affects the simple daily activities of the patients.

Alterations of ballistic movements in epileptic patients with phenytoin intoxication.

We assessed the effects of phenytoin (PHT) overdosage on ballistic arm abduction movements in nine epileptic patients receiving long-term PHT treatment. During the overdosage period, all but one showed clinical abnormalities referable to impaired cerebellar function; one also had slowness of movement. Ballistic movements showed abnormalities in all of the patients although a great variability was present in the type and severity of abnormalities. In four patients, kinematic and EMG recordings differed least from the normal, in four they resembled those described in patients with cerebellar deficits, and in one those described in patients with Parkinson disease. The type and severity of clinical disturbances of voluntary motor control as well as alterations of ballistic movements were not related to specific PHT plasma concentrations. One month after the adjustment of PHT dosage, the patients who had clinical abnormalities completely recovered or markedly improved. Previously observed kinematic and EMG abnormalities completely disappeared or improved markedly.