Psychopathology and traffic violations in subjects who have lost their driving license.

BACKGROUND: The persistence of risky behaviors while driving and traffic accidents despite campaigns to increase awareness suggest that there may be underlying causes that maintain proneness to traffic violations. The aim of the current study was to assess: a) the prevalence of psychopathology in a sample of people who have lost their driving license due to former traffic violations and b) the discriminatory capacity of each psychopathological disorder to differentiate among people with high and low proneness to perform risky behaviors while driving. METHODS: 383 participants in a course to recover their driving license after its loss due to previous traffic violations were included. The International Neuropsychiatric Interview (M.I.N.I.) according to DSM-IV was used to assess psychopathology. RESULTS: Between 67% and 76.2% of the participants had been affected by a lifetime psychopathological disorder until the moment of assessment. The most prevalent diagnoses were substance abuse including alcohol (52.5-62.7%), ADHD (19.7-28.5%), depression (7.9-14.4%) and anxiety (3.6-12.4%). Substance abuse and ADHD also showed the strongest set of associations with specific risk behaviors, but ADHD emerged as the most discriminant disorder to distinguish between those people at high and low risk of while driving. CONCLUSIONS: The results of the current study suggest that addressing psychopathology explicitly to prevent risky behaviors and recidivism while driving would provide benefits in this area.

Analysis of body condition indices reveals different ecotypes of the Antillean manatee.

Assessing the body condition of wild animals is necessary to monitor the health of the population and is critical to defining a framework for conservation actions. Body condition indices (BCIs) are a non-invasive and relatively simple means to assess the health of individual animals, useful for addressing a wide variety of ecological, behavioral, and management questions. The Antillean manatee (Trichechus manatus manatus) is an endangered subspecies of the West Indian manatee, facing a wide variety of threats from mostly human-related origins. Our objective was to define specific BCIs for the subspecies that, coupled with additional health, genetic and demographic information, can be valuable to guide management decisions. Biometric measurements of 380 wild Antillean manatees captured in seven different locations within their range of distribution were obtained. From this information, we developed three BCIs (BCI1 = UG/SL, BCI2 = W/SL3, BCI3 = W/(SL*UG2)). Linear models and two-way ANCOVA tests showed significant differences of the BCIs among sexes and locations. Although our three BCIs are suitable for Antillean manatees, BCI1 is more practical as it does not require information about weight, which can be a metric logistically difficult to collect under particular circumstances. BCI1 was significantly different among environments, revealing that the phenotypic plasticity of the subspecies have originated at least two ecotypes-coastal marine and riverine-of Antillean manatees.

Prevalence of home artificial nutrition in Italy in 2005: a survey by the Italian Society for Parenteral and Enteral Nutrition (SINPE).

AIM: To determine the prevalence (cases per million inhabitants) of home artificial nutrition (HAN), enteral (HEN) and parenteral (HPN), in Italy, grouped according to administrative regions, patient age and primary disease, and to analyze the impact both of the presence of an HAN regional regulation and of demographic characteristics. METHODS: In April 2005, the Regional Coordinators of the Italian Society for Parenteral and Enteral Nutrition (SINPE) recorded all the ongoing cases of HAN using a structured questionnaire and were asked to estimate the representativeness of the collected sample with respect to the total expected HAN. RESULTS: A total of 6955 cases of HAN (93.5% adults, 6.5% pediatric patients < or = 18 years) were recorded in 16 of the 20 Italian regions (80% of the Italian population; sample representativeness 78%). HAN prevalence 152.6 (83.9% HEN, 16.1% HPN); the HAN range among the regions was: prevalence 28.1-519.8; oncological disease 13.8-75.7%, neurological disease 15.5-79.9%, intestinal failure 1.3-14.0%. An HAN regulation was present in 11 regions. A positive association (P=0.012) was found between the number of years since the regulation was issued and the HAN prevalence, and also between the % neurological patients and the population density (P=0.130) and the % inhabitants > or = 75 years (P=0.040). CONCLUSIONS: The need for HAN regards a great number of patients throughout the country; there are substantial differences between the regions with respect to both the prevalence and the use of HAN in various disease categories. A specific regulation may favor the development of HAN.

[Natriuretic peptides in heart failure]. / Peptidi natriuretici come guida alla prognosi e terapia nello scompenso cardiaco.

The recent discovery of cardiac endocrine function, together with the development of accurate and feasible assay methods for cardiac natriuretic hormone evaluation, i.e. for B-type natriuretic peptide (BNP) and inactive peptide NT-proBNP have confirmed their pathophysiological and clinical significance for cardiovascular disease assessment. Concerning heart failure, their value is for diagnostic screening in selected/unselected populations, for differential diagnosis of dyspnea and for prognostic stratification, and as a guide for follow-up and treatment of patients. Recent Italian recommendations pointed out that BNP/NT-proBNP has a role in ruling-out the diagnosis of heart failure in patients with dubious signs/symptoms: plasma BNP/NT-proBNP concentrations help in the clinical evaluation of chronic heart failure patients when risk stratification is needed, whereas the routine BNP/NT-proBNP assay is still not recommended to guide therapeutic decision-making.

Restricted phosphorus and nitrogen intake to slow the progression of chronic renal failure: a controlled trial.

Twenty chronically azotemic patients (experimental group) with a mean creatinine clearance of 22.5 +/- 9.4 ml/min followed a diet supplying daily, per kilogram of body weight, 7.0 mg of phosphorus and 0.5 g of protein, mostly of high biological value, for 11.3 months. A group of 19 similar patients (control group) followed a diet supplying daily, per kilogram of body weight, 12 mg of phosphorus and 0.8 g of protein for a similar period of time. In the experimental group, the serum inorganic phosphorus, urea, and iPTH (both N-terminal and C-terminal fragments) decreased significantly. The creatinine clearance decreased by -0.59 +/- 0.7 ml/min per month prior to the commencement of the experimental diet and increased by a mean of 0.1 +/- 0.4 ml/min per month during the period of study. In the control group, the serum inorganic phosphorus increased, the serum urea and iPTH remained practically constant, and the mean creatinine clearance continued to decrease at a rate not significantly different from that prior to the onset of the study (-0.50 +/- 0.66 and -0.44 +/- 0.10 ml/min per month, respectively). The mechanisms by which the low-phosphorus, low-nitrogen diet slows the progression of renal failure are discussed, and the practical importance of prescribing the dietetic restriction early in the course of renal disease is stressed.

The decline of renal function slowed by very low phosphorus intake in chronic renal patients following a low nitrogen diet.

The rate of progression of renal failure has been evaluated in two homogenous groups of chronic renal patients with early insufficiency. In both groups the diet supplied the same amount of calories (approximately 35 Kcal/kg/day) and the protein intake was equally restricted (approximately, 0.6 g/kg/day); however, in Group 1 the phosphorus intake was lower (6.5 mg/kg/day) than in Group 2 (12 mg/kg/day). In both groups the rate of decline of creatinine clearance decreased when patients changed from a free mixed diet to the specially controlled diets, but in Group 1 (lower phosphorus intake) this change was much more marked than in Group 2. Elevated mean levels of serum phosphate and of urinary output of phosphate per unit of creatinine clearance, and elevated mean levels of serum iPTH were found in the patients of Group 2, whereas Group 1 patients had normal mean levels of serum phosphate and of iPTH, and the phosphaturia per unit of creatinine clearance was almost normal. The role of such abnormalities in urinary and serum phosphate, and of secondary hyperparathyroidism, on the progression of renal failure is discussed.

Helminths from a stranded manatee in the Dominican Republic.

Endangered West Indian manatees (Trichechus manatus) are known to be parasitized by a number of helminths and ectoparasites. Records of parasitic associations exist for Florida, Mexico, Guyana, Brazil, Cuba and recently for Puerto Rico. Parasites of manatees in other Caribbean areas have not been documented, particularly from Hispaniola. We report on the occurrence of a species of nematode and of two trematodes from a 238-cm male manatee from Portillo (19 degrees 20' N, 69 degrees 35' W), Las Terrenas, in the Dominican Republic. Three species of helminths were collected, including the opisthotrematid Cochleotrema cochleotrema, the ascarid Heterocheilus tunicatus, and the paramphistomid trematode Chiorchis fabaceus. The documentation of these helminths constitutes the first record of these parasites and host relationships for Hispaniola and the second for the northeastern Caribbean.

Metazoan parasites and other symbionts of cetaceans in the Caribbean.

The parasite fauna in cetaceans from Puerto Rico, the Virgin Islands, and the larger Caribbean region is poorly known. We provide the first records for parasite biodiversity among a diverse assemblage of cetaceans from the Caribbean Sea. Internal and external parasites and commensals were collected from stranded whales and dolphins salvaged in Puerto Rico, the United States and British Virgin Islands, Jamaica, and Venezuela between 1989 and 1997. A total of 47 individuals of 16 species of whales and dolphins (15 odontocetes and 1 mysticete) was examined. Overall, parasites and commensals were found in 34 (72.3%) animals, representing 13 species of odontocetes and 1 mysticete. Eighteen species of endoparasitic helminths were found, including 8 species of nematodes, 2 digeneans, 6 cestodes, and 2 acanthocephalans. Three species of whale-lice and 2 species of barnacles were also collected.

[Epidemiology of accidents related to sea-swimming in the Tuscany Region using a health-promotion strategy. Preliminary report]. / Epidemiologia degli incidenti correlati all'attività balneare nella Regione Toscana per una strategia di promozione della salute--nota preliminare.

In the summer season 1999 an integrated epidemiological surveillance system (involving mobile emergency medical services, first aid and tourist stations, hyperbaric medical centres, bathing attendants) of sea-bathing-related accidents was set up on the coasts of Tuscany, central Italy, aimed at health promotion and education. The pilot phase allowed to collect a first set of information on periods and time with highest incidence of events, type of assistance delivered, kind of accident (trauma or illness) and seriousness of the event as codified by emergency medical services. The pilot experience also pointed out the changes to detection tools needed in order to obtain more precise and comparable data. Such corrections, introduced during the summer season 2000, could contribute to the creation of a model with potential applications in other Italian and European coastal regions.

Percutaneous management of benign renal cysts.

Percutaneous emptying of benign renal cysts represents the adopted treatment for this kind of pathology. The introduction of pure ethilic alcohol (95 degrees) is usually associated with emptying because it determines the necrosis of the secreting epithelious with recurrences and little significant complications. This treatment is the less bloody solution that can be executed in surgery and for this reason it is proposed in the time as an alternative to surgery treatment of removal.

[Anesthesia with isoflurane in surgery of the anterior segment of the eye]. / Anestesia con isoflurano nella chirurgia del segmento anteriore dell'occhio.

The effects of isoflurane on intraocular pressure (IOP) were studied in 46 patients undergoing cataract surgery. The IOP was measured 30 minutes after premedication, 10 minutes after induction of anesthesia and 10 minutes after administration of isoflurane. Since a significant decrease of IOP was found to occur after the administration of volatile agent, and in account of absence of complications or side effects, the Authors conclude that isoflurane can be considered a suitable anesthetic agent in ophthalmic surgery.

Three years experience with a very low nitrogen diet supplemented with essential amino acids and keto-analogues in the treatment of chronic uraemia.

A low nitrogen, low phosphorus diet, supplemented with essential amino acids and keto-analogues, was administered to 48 chronic uraemics for a maximum of 36 months. In 10 cases renal function deteriorated and dialysis was started; eight patients changed to the dialytic therapy having difficulties in complying to the diet and three died for reasons not directly related to renal failure. The remaining twenty-seven patients are still on dietetic treatment and their renal function has not changed significantly. Their serum inorganic phosphorus and their circulating iPTH decreased significantly. Their subjective and objective conditions are satisfactory and no manifestation of protein malnutrition or other unwanted effects are detectable.

Phylogeography of the West Indian manatee (Trichechus manatus): how many populations and how many taxa?

To resolve the population genetic structure and phylogeography of the West Indian manatee (Trichechus manatus), mitochondrial (mt) DNA control region sequences were compared among eight locations across the western Atlantic region. Fifteen haplotypes were identified among 86 individuals from Florida, Puerto Rico, the Dominican Republic, Mexico, Columbia, Venezuela, Guyana and Brazil. Despite the manatee's ability to move thousands of kilometers along continental margins, strong population separations between most locations were demonstrated with significant haplotype frequency shifts. These findings are consistent with tagging studies which indicate that stretches of open water and unsuitable coastal habitats constitute substantial barriers to gene flow and colonization. Low levels of genetic diversity within Florida and Brazilian samples might be explained by recent colonization into high latitudes or bottleneck effects. Three distinctive mtDNA lineages were observed in an intraspecific phylogeny of T. manatus, corresponding approximately to: (i) Florida and the West Indies; (ii) the Gulf of Mexico to the Caribbean rivers of South America; and (iii) the northeast Atlantic coast of South America. These lineages, which are not concordant with previous subspecies designations, are separated by sequence divergence estimates of d = 0.04-0.07, approximately the same level of divergence observed between T. manatus and the Amazonian manatee (T. inunguis, n = 16). Three individuals from Guyana, identified as T. manatus, had mtDNA haplotypes which are affiliated with the endemic Amazon form T. inunguis. The three primary T. manatus lineages and the T. inunguis lineage may represent relatively deep phylogeographic partitions which have been bridged recently due to changes in habitat availability (after the Wisconsin glacial period, 10 000 B P), natural colonization, and human-mediated transplantation.