Etiology of chronic calcifying pancreatitis in Brazil: a report of 329 consecutive cases

Journal of Gastrointestinal Cancer - The authors observed 329 consecutive cases of chronic calcifying pancreatitis (CCP) from January 1963 to January 1986. Alcoholism was the etiological agent in...     

Observations on the management of childhood acute asthma in a large hospital.

OBJECTIVE: To study the documentation of assessment, the treatment and the follow-up arrangements for children admitted to hospital with acute asthma. DESIGN: A retrospective audit of case notes. SETTING: Tertiary level teaching hospital. MAIN OUTCOME MEASURES: A comparison with the asthma management plan issued by the Thoracic Society of Australia and New Zealand. RESULTS: We found poor documentation of assessment of asthma severity, low referral rates for asthma education, and inappropriate use of chest radiography. Bronchodilator therapy did not follow published guidelines. Good follow-up arrangements were achieved. CONCLUSIONS: The proportion of children with documentation of the assessment of acute asthma was unacceptably low.     

Plasma cell counts on human jejunal biopsy specimens examined by immunofluorescence and immunoperoxidase techniques: a comparative study.

Ten human jejunal biopsy specimens were examined by both immunofluorescence (IF) and immunoperoxidase (IP) methods to compare both plasma cell counts and the distribution of extracellular immunoglobulins. Each specimen was cut into at least two portions, one fixed in 5% formaldehyde in phosphate-buffered saline before being snap-frozen and sectioned on a cryostat for IF, the other being fixed in half-strength Zenker and embedded in paraffin wax by standard methods for IP. Plasma cell counts were comparable in the eight biopsy specimens for which they could be estimated, geometric mean values being IgA 22.9 (IF), 19.3 (IP) and IgM 9.5 (IF), 10.6 (IP). Two specimens showing subtotal villous atrophy had too much extracellular IgA for plasma cell counts to be feasible. For these the IF methods had the advantage that the extracellular immunoglobulin was more readily distinguishable from background staining.     

The presterilization microbial load on used medical devices and the effectiveness of hydrogen peroxide gas plasma against Bacillus subtilis spores.

OBJECTIVES: To determine the microbial load found on used critical medical devices (5 spinal anesthesia needles, 21 catheters, and 28 sheaths) prior to sterilization and to evaluate the effectiveness of hydrogen peroxide gas plasma against inoculated Bacillus subtilis var globigii (American Type Culture Collection 9372) spores. METHODS: Membrane filter and pour-plate methods were applied to estimate total microbial loads (aerobic and anaerobic, mesophilic and thermophilic, vegetative and spore forms). Spinal anesthesia needles (102 units) and sheath components (61 units) were inoculated with a suspension of B. subtilis spores. After drying, the devices were sterilized with hydrogen peroxide gas plasma. RESULTS: Higher counts of aerobic, mesophilic, and fungal organisms were recovered when the drying period was insufficient. Anaerobic spores were not found in any analyzed presterilization items. The hydrogen peroxide gas plasma effected a 5 to 7 log10-fold reduction in B. subtilis spore counts in well-dried needles and sheath components. CONCLUSIONS: The success of hydrogen peroxide gas plasma sterilization depends mostly on educating the staff to assure well-cleaned and dried reusable medical devices, allowing penetration of the hydrogen peroxide gas plasma into the critical points of the items and providing a reduction in organisms.     

Psychological well-being and metacognition in the fourth age: an explorative study in an Italian oldest old sample

Objectives: The research largely aimed at exploring the impact of marital status, cognitive efficiency, gender, physical health and sociocultural context on self-rated emotional competence, depression, memory and cognitive measures.Method: Ninety-four healthy adults aged 75–99 were recruited in the Sardinian province of Ogliastra, where a collectivistic culture prevails, and in northern Italy, which in turn is characterized by the prevalence of individualistic cultural traits. Participants were administered self-referent metacognitive efficiency, subjective wellness and depression measures.Results: Sardinian elders self-rated lower levels of depression and cognitive failures and had greater levels of emotional competence.Conclusions: Perceived psychological well-being, metacognitive efficiency and depression seem to be affected by sociocultural context.     

More to Blue Zones than long life: positive psychological characteristics

Blue Zones are defined as regions of exceptional longevity. Emerging evidence also indicates the presence of several positive psychological characteristics amongst older inhabitants. No synthesis of this information is currently available. The current article focuses on psychological characteristics of successful ageing, including perceived well-being and cognitive health. Relevant findings concerning the Sardinian Blue Zone are reviewed along with an evidence suggesting links to the distinctive sociocultural environment of this region. People aged 65+ living in the Sardinian Blue Zone have substantially lower levels of depressive symptomatology, higher levels of self-perceived well-being and better subjective and objective cognitive health relative to matched control samples. These differences are robust, reliable and persist throughout late adulthood. Important determinants of the positive traits include increased active engagement in community religious and leisure activities. Sparse evidence for other Blue Zones exists but reduced levels of depression may be a shared attribute. Older Blue Zone Sardinians possess positive psychological characteristics, which are associated with successful ageing and are known to promote longevity. Blue Zone populations appear to be a valuable, but overlooked, resource for the study of positive aspects of ageing.     

Self-reported influenza vaccination uptake in people with chronic diseases: data from Progressi delle Aziende Sanitarie per la Salute in Italia (PASSI)

BackgroundInfluenza is an important public health problem, with potential severe consequences among people with chronic diseases. The aim of this study was to obtain reliable measures of seasonal influenza vaccine uptake in this population, otherwise not available in Italy.MethodsProgressi delle Aziende Sanitarie per la Salute in Italia (PASSI) is a nationwide surveillance system of health-related behaviours and acceptance of preventive interventions (including influenza immunisation) offered by the Italian National Health Service. Data are collected with telephone interviews at local health unit level for supporting local activities. The survey sample is randomly selected from local health unit lists of adult residents. The trend of annual vaccine coverage since 2008 was estimated for people aged 18–64 years who reported having at least one chronic disease. To obtain a sufficient sample size in subgroups, we analysed the characteristics of vaccinated people in the 2010–13 cumulative dataset. Univariate, multivariate, and logistic regression analyses were undertaken.FindingsIn 2008–13, 13 659 individuals with at least one chronic disease were interviewed. Vaccination coverage fell significantly from 29·7% (95% CI 27·2–32·4) in 2007–08 to 19·9% (18·0–22·1) in 2012–13. During 2010–13, the overall proportion of vaccinated people with a chronic disease was 25·6% (24·5–26·7). Vaccine coverage of people with diabetes (34·3%, 31·7–36·9) or cardiovascular diseases (31·8%, 29·6–34·2) was greater than that of people affected by renal failure, respiratory diseases, tumours, or chronic liver diseases (26·5% [22·5–30·7], 24·9% [23·2–26·7], 22·2% [20·0–24·6], and 20·6% [17·5–24·6], respectively). Vaccination coverage increased with age (from 13·1% [11·0–15·5] in the 18–34 year age group to 33·4% [31·9–35·1] in people aged 50–64 years); it was higher among people with a low educational level than among those with a high educational level, higher in those having economic difficulties than in those with no economic difficulties, and higher among Italian citizens than among non-citizens.InterpretationIn the past few years, prevalence of influenza vaccination in Italian adults with at least one chronic disease was well below the Ministry of Health's goal (75% minimum) and showed a downward trend. A major reason of this evolution is probably the changing public perception of the benefits and risks of vaccines. PASSI is a source of useful data not otherwise available for public health intervention.FundingItalian Ministry of Health.