Acute myocarditis as a revealing clue of complete Kawasaki disease.

Not available.

[Cochrane EPOC group: closing the gap between quality assurance and organization of care research and front line professionals]. / Cochrane EPOC group: chiudere il gap tra ricerca sul miglioramento della qualità dei servizi sanitari e professionisti sul campo.

Keeping physicians informed on an ongoing basis is a new challenge for continuing medical education and quality assurance. In Italy over the last 5 years interest in evidence based literature is growing. This is demonstrated by the launch of an Italian edition of Clinical Evidence and by the growing number of guidelines and systematic reviews produced by Italian authors and institutions. However, there is some uncertainty concerning the familiarity of Italian policy makers and public health physicians with the evidence-based resources, including also how to access them. This article attempts to close this gap, by describing the activities of the Cochrane Collaboration and, within it, of the Cochrane Effective Practice and Organisation of Care Group (EPOC), both aim to prepare and maintaining SR of health care interventions. Specifically, the EPOC group develops systematic reviews of professional, financial, organisational and regulatory interventions that are designed to improve professional practice and the delivery of effective health services. EPOC has 31 reviews and 24 protocols published in Issue 4, 2004 of the Cochrane Library and has developed standard methods to assist people, such as quality criteria for study design specific to health services research. The EPOC specialized register contains details of over 2200 studies that fall within the group's scope. Systematic reviews provide a valuable and efficient source of information for policy makers and health care professionals aimed at implementing effective and efficient strategies to encourage medical behavioural change and deliver of high quality services.

[Risk assessment for eating disorders in a high school: a study based on the Eating Attitudes Test 26]. / Analisi del rischio per i disturbi del comportamento alimentare in una scuola media superiore: una ricerca basata sull'Eating Attitudes Test 26.

AIM: Disordered eating behaviours can lead to clinically evident and serious eating disorders (ED). Aim of this paper is to determine their extent among adolescents and to evaluate the associated characteristics. METHODS: All students of a high school (age 14-18) have been asked to fill up the Eating Attitudes Test (EAT-26) anonymously. EAT-26 is a self-reported questionnaire identifying subjects at risk for ED. This questionnaire included also an integrative section, aimed at investigating some ED-related variables (family composition, diet among relatives, social relationships, spare time activities, self-esteem). Collected data have been analyzed using EpiInfo6. RESULTS: The study involved all the 902 students of the school; 833 questionnaires have been distributed and 701 were collected (89.4% from girls, 10.3% from boys). The percentage of EAT-26 positive boys (i.e. scoring = or > 20) is 3%, while for girls is 13.7%. A positive test significantly correlates with low self-esteem (OR = 46.67, CI = 13.16-182.04), contentious relationships with the mother (OR = 2.20, CI = 1.12-4.29) and the father (OR=2.45, CI=1.24-4.80). No significant correlation has been found for being an only child, living in a single-parent family having limited/not having social relationships, having unsatisfactory social relationships, spending spare time mostly alone, watching TV more than 2 h per day. CONCLUSION: Our data suggest an increasing diffusion in the risk for ED among adolescents. Personal characteristics and behaviours related to this risk are good start points to program projects focusing on primary and secondary prevention of ED in high schools.

[Child sexual abuse primary prevention: outcome evaluation of a health education project implemented in Milan's elementary schools]. / Prevenzione primaria dell'abuso sessuale all'infanzia. Valutazione di efficacia di un progetto di educazione alla salute realizzato nelle scuole elementari di Milano.

The study we present is aimed at evaluating the efficacy of a child sexual abuse prevention program that involved children attending 4th and 5th grade in Milan's (Italy) elementary schools. The project involved 53 classes (10 of 4th, 43 of 5th grade) during school year 2000-2001. Children filled a questionnaire before the beginning of the project and two months after the end; the questionnaire evaluates children's perception of risk and their self-efficacy skills in adopting protective strategies when involved in at risk situations. Final analysis has involved 674 children, 51.8% girls, 48.2% boys; 19.6% of children attended 4th grade, 80.4% 5th grade. Percentage of children that recognize the potential danger in the suggested at-risk situation is higher in post-test then in pre-test (87.9% vs 73.2%) and the number of them that does not adopt any self-defence strategy decreases (from 35.3% to 21.0%). The project increased the number of children that know body puberal changes (from 16.0% to 32.8%). According to these results it is evident that the program increased children's capacity to recognize and use self defence strategies in at risk situations. These results call for a potential extention and replication of this health education program.

Experiencia preliminar con clavo expansible en fracturas de húmero / Preliminary experience with expandable nail in humerus fracture

El propósito de nuestro trabajo fue evaluar en forma prospectiva la experiencia clínica con las primeras siete Fracturas Diafisarias del húmero, el sexo predominate fue el masculino (6:1), con una edad promedio de 37.7 años (Rango entre 19 y 48 años). De ellas, dos con tercer fragmentos en el ala mariposa más del 50 por ciento, tres del trazo oblicuo corto y dos de trazo transverso. No se presentó ninguna complicación durante la cirugía y hospitalización, la inserción del clavo fue fácil, rápida y con buena fijación inmediata. En seis de los siete casos al día siguiente , en el post-operatorio inmediato, se inicio la rehabilitación en sala con ejercicios isométricos e isotónicos, al segundo día se indicaron movimientos pendulares, contraindicando los de rotación con resistencia externa ó interna. En uno de los casos del clavo en el post operatorio perdió la expansión por lo que ameritó manejo con inmovilizador universal para hombro, contraindicando los movimientos y evidenciando una osificación por aposición. Se concluye que es un sistema mínimamente invasivo que amerita el uso de intensificador de imágenes, elimina el sistema de bloqueo proximal y distal, y no requiere el fresado del canal medular, reduciendo el tiempo quirúrgico y de hospitalización, con una evolución rápida y satisfactoria del paciente

Factores de riesgo y baja masa ósea en la ciudad de Mérida / Risk factors and low bone mass in the city of Mérida

El propósito de nuestro trabajo fue determinar la presencia de factores de riesgo de osteoporosis y la disminución de la masa ósea, en mujeres mayores de 49 años en la ciudad de Mérida. Se tomaron ciento sesenta y tres (163) fichas de mujeres mayores de 49 años que viven en esta ciudad, de las cuales 39 de ellas se realizaron estudios de densitometría ósea, a este grupo se le determinaron los factores de riesgo y se analizaron estadísticamente. Al realizar análisis entre factores de riesgo y disminución de la masa ósea, ninguno de ellos representó tener significancia estadística. Dentro de los factores estudiados, la lactancia, el sedentarismo y la intolerancia a los lácteos, son los de mayor peso relativo pero no estadísticamente significativo