Burn care in relation to burn epidemiology in Italy.

AIM: Burn centres are 'hubs' of referral for large areas and should be organised in a network optimised for the needs of their area. Burn centres' organisation and activity in Italy are analysed with reference to burn epidemiology in the country. METHODS: A questionnaire was submitted to Italian burn centres concerning organisation, activity and epidemiology of burns treated in 2008. RESULTS: A total of 2067 patients were admitted to a burn centre in 2008; 50% of burns were due to flames (21% alcohol); and 25% of patients were <14 years old. Overall mortality was 5.3%. 144 beds in 15 burn centres were available (seven reserved for children; bed/inhabitants ratio, 1/414, .023). However, distribution is not uniform in the country. Bed rotation was 14.4 patients/bed, and hospital stay varied from 11.7 days for <20% total body surface area (TBSA) burns to >120 days for burns >70%. About half (57%) of patients admitted had less than 20% TBSA burns, 32% had 20-50% TBSA burns, 7% from 50% to 70% and 4% over 70% TBSA. A national network coordinating burn centre activity is lacking. CONCLUSIONS: Italy seems to have less availability of beds for burn care than other countries, and distribution and organisation of the network may be improved. The high prevalence of child burns should be noticed and this makes prevention campaigns advisable.

[Eole-Réseau LIENS: telephone based assistance and referral advice for primary care professionals confronted with mental health issues in their patients]. / Eole-Réseau LIENS: Service d'appui et d'orientation téléphonique pour les professionnels confrontés à des personnes souffrant de problèmes de santé mentale.

Eole-LIENS is an available telephone line for first-line professionnels facing, in their daily practice, patients or users in psychological trouble. This service proposes a dialogue with a third party allowing a support, a help to the handling of the situation, a finer orientation towards the institutions existing in the network.

Supervisory attentional system in nonamnesic alcoholic men.

BACKGROUND: Many studies have shown that recently detoxified alcoholic persons perform poorly on tasks thought to be sensitive to frontal lobe damage, supporting the hypothesis that the frontal lobes are highly vulnerable to chronic alcohol consumption. However, it appeared that most of the executive tasks used in these studies also involved nonexecutive components, and these tasks had been shown to be impaired as a result of nonfrontal lobe lesions. In this study, we examined further the "frontal lobe vulnerability" hypothesis using executive tasks, proved to be associated with frontal lobe functioning, that allowed us to distinguish the relative importance of executive and nonexecutive processes. METHOD: Thirty recently detoxified asymptomatic male alcoholic inpatients and 30 control subjects were tested for planning, inhibition, rule detection, and coordination of dual task, as well as the speed of processing and nonexecutive functions (such as short-term memory storage). RESULTS: Alcoholics performed worse than controls in almost all tasks assessing executive functions. However, they were not slower than the controls and showed normal results for nonexecutive functions. CONCLUSIONS: Chronic alcohol consumption seems to be associated with severe executive function deficits, which are still present after a protracted period of alcohol abstinence. These data support the idea that the cognitive deficits in recently detoxified sober alcoholic subjects are due, at least partly, to frontal lobe dysfunctioning.

Correlation between inhibition, working memory and delimited frontal area blood flow measure by 99mTc-Bicisate SPECT in alcohol-dependent patients.

Recently detoxified non-neurological alcoholic patients appear to be impaired in cognitive tasks measuring inhibitory processes as well as working memory (involving storage and manipulation of information). The aim of this study was to investigate in alcoholic participants the relationship between these two cognitive functions and regional cerebral blood flow (rCBF) studied at rest in regions of interest selected on the basis of recent PET studies which explored inhibitory and working memory in normal subjects. Twenty non-neurological alcoholic patients and 20 normal volunteers were selected for a neuropsychological exploration, including assessment of inhibition processes (by means of the Hayling test) and working memory (by means of the Alpha-span task). rCBF of alcoholics was also evaluated with a semi-quantitative method using a 99mTc-Bicisate single photon emission computed tomography (SPECT) procedure. Alcoholic patients performed worse than controls in the alphabetical condition of the Alpha-span task (involving manipulation and storage of information), and on the Hayling test. Significant correlation emerged between inhibition performance and both the bilateral inferior (left BA 47, r = -0.40; right BA 47, r = -0.599) and median frontal gyrus (left BA 10, r = -0.55; right BA 10, r = -0.59), but not with the region of reference (occipital/cerebellum, r = -0.13). Coordination of storage and manipulation was correlated with bilateral median frontal (left BA 10/46, r = -0.50; right BA 10/46, r = -0.45), but not with bilateral parietal area (left BA 7, r = -0.12, right BA 7, r = -0.18). These results suggest a relationship between inhibition and working memory deficits in alcoholic patients, and regional rCBF measured in frontal areas. Clinical implications of these data related to alcohol relapse are discussed.

An atypical neuropsychological profile of a Korsakoff syndrome patient throughout the follow-up.

The basis of amnesia in alcoholic Wernicke-Korsakoff syndrome (WKS) has been generally associated with diencephalic lesions and more specifically with lesions of the anterior thalamic nuclei. These brain structures are considered to be involved in encoding/consolidation processes of episodic memory. However, frontal lobe damage responsible for executive function deficits has also been documented. The present report details the nature and extent of amnesia in an alcoholic patients with WKS and which appears to be mainly due to frontal lobe (executive) deficits.