Learning disabilities: case study of the Piedmont Region in the years 2006-2007-2008.

AIM: The aim of the study is to analyse the comorbidity of learning disabilities (LD), its variation relating to the age of the children and to interpret the possible meaning of these data. METHODS: All patients in age of compulsory education (aged 5-16) diagnosed as LD in Piedmont, registered in the Regional Informative System NPI.net, in the years 2006-2007-2008, were considered. The cases were divided in two age ranges: from 5 to 11 years the first one, from 12 to 16 years the second one. The cases were further subdivided according to comorbidity with 5 diagnostic categories, identifying: Pure LD; 2) LD + psychiatric disorders; 3) LD + psycho-developmental risk; 4) LD + not psychiatric disease; 5) LD + borderline intellectual functioning and mental retardation. The average values computed for each group of comorbidity in the three years for the two age ranges were statistically compared. RESULTS: A major number of LD was observed in the age range 12-16; here LD is more often associated to psychiatric disorders and psycho-developmental risk. LD is more often pure from 5 to11 years. CONCLUSION: LD may be an inducing factor for psychiatric pathologies and situations of psychodevelopmental risk. However the major amount of LD in the age range 12-16 may be due to the rising of psycho-developmental risk factors and of social-environmental disadvantage; so these data may underline a form of "adolescence uneasiness", evident in school, in patients without major neurologic, psychiatric and cognitive disorders. The available data collection system facilitated this study.

The Piemonte Regional Allergy Network: a model of healthcare organization.

The Allergology Hospital Network and Regional Register for Severe Allergic Reactions (Regional Observatory) is the Piemonte Health Authority new challenge. It satisfied the need to promote and monitor the best practice among a variegated pool of specialists and to define both state of the art and evolution of efficiency and efficacy of standard working process. Harmonization in clinical daily activities and report of severe allergic reactions notified to Regional Observatory, had been gained by mean of a customized Information Technology (IT) solution. The overall target is to ensure a correct diagnostic treatment to patients with severe allergic reactions preventing possible future reactions. Statistics data as a whole, provide basilar epidemiological information to allocate both economical and human resources and to fulfill the rising of health diseases. Piemonte Allergology Medical Network with the Regional Register are an Italian unique and innovative project. It would represent a benchmark for other medical branches.

Changing patterns of cancer incidence in the early- and late-HAART periods: the Swiss HIV Cohort Study.

BACKGROUND: The advent of highly active antiretroviral therapy (HAART) in 1996 led to a decrease in the incidence of Kaposi's sarcoma (KS) and non-Hodgkin's lymphoma (NHL), but not of other cancers, among people with HIV or AIDS (PWHA). It also led to marked increases in their life expectancy. METHODS: We conducted a record-linkage study between the Swiss HIV Cohort Study and nine Swiss cantonal cancer registries. In total, 9429 PWHA provided 20,615, 17,690, and 15,410 person-years in the pre-, early-, and late-HAART periods, respectively. Standardised incidence ratios in PWHA vs the general population, as well as age-standardised, and age-specific incidence rates were computed for different periods. RESULTS: Incidence of KS and NHL decreased by several fold between the pre- and early-HAART periods, and additionally declined from the early- to the late-HAART period. Incidence of cancers of the anus, liver, non-melanomatous skin, and Hodgkin's lymphoma increased in the early- compared with the pre-HAART period, but not during the late-HAART period. The incidence of all non-AIDS-defining cancers (NADCs) combined was similar in all periods, and approximately double that in the general population. CONCLUSIONS: Increases in the incidence of selected NADCs after the introduction of HAART were largely accounted for by the ageing of PWHA.

[Deficiencies, disabilities and handicaps: taking responsibility for the young maladjusted child]. / Déficiences, incapacités et handicaps: prise en charge du jeune enfant inadapté.

A handicap should not be confused with deficiency or incapacity. It is the resulting difference between an individual's competencies and the situation which is proposed to, or imposed to, him. Whatever the type of deficiency a child may have, and the subsequent incapacity, it is important to discern for therapy, the positive aspects of his personality as soon as possible in order to develop his chances for success and avoid set backs. Structures such as the Medical and Social Early Action Center (CAMSP), which we created in 1976 at the Medical Center in Versailles, allow personalized care. More than progress in reference to an often illusory norm, it is the search for talents, aptitudes and, in function of this, the acquisition of knowledge, which should be the educator's concern. An excess of legislation may unfortunately lead to the standardization of the means and goals.