Parental narratives of quality of life in children with leukemia as associated with the placement of a central venous catheter

Thirty mothers of children with leukemia were interviewed about the child's and family's daily routines using a version of the Ecocultural Family Interview. Parental narratives were analyzed qualitatively and quantitatively. Four broad dimensions, encompassing 23 subthemes, were identified: child coping ( = 0.88), child quality of life ( = 0.72), parental coping ( = 0.72), and parental trust in the medical care ( = 0.73). Two objective variables were drawn from the medical charts (time from the diagnosis, time from central venous catheter [CVC] placement). Regression analyses showed that the number of days from the CVC placement (β = 0.46) and child coping (β = 0.44) significantly predicted children's quality of life, which in turn predicted parental trust in the medical care (β = 0.31). The methodological implications of our narrative approach are discussed.     

Robotic radical parametrectomy in cervical cancer

Radical parametrectomy is indicated in cases of undiagnosed early-stage invasive cervical carcinoma discovered after simple hysterectomy performed for a presumed benign disease process. This radical surgical procedure is rarely performed for benign disease; however, there are some benign conditions such as endometriosis or ovarian remnant syndrome which may require wide excision, including parametria. Traditionally, radical parametrectomy has been performed via laparotomy; however, a minimally invasive approach via laparoscopy has been reported to be feasible and safe. Here we describe the robotic surgical approach to radical parametrectomy.     

The use of Well-Being Therapy in childhood: clinical cases

Anxiety, mood and somatoform disorders are among the most prevalent forms of psychological suffering during childhood and adolescence. If untreated, these problems can be predictors of more severe disorders in adulthood. New trends in clinical psychology suggest the relevance of focusing on child's competencies and developing optimal functioning in youth. A specific psychotherapeutic strategy for enhancing well-being (Well-Being Therapy; WBT) has been developed for adult patients and it was found to be effective in determining remission from affective symptoms, in improving psychological well-being and in preventing relapses. In this article we describe a modified form of WBT which has been applied for the first time to children suffering from emotional and behavioral disorders in order to test its feasibility and potential effects in reducing symptoms and in improving new skills. Four cases particularly interesting by a clinical point of view are reported. This new therapeutic approach, based on the promotion of psychological well-being seems to be a very promising intervention: children improved at post treatment and during 1 year follow-up, both in symptomatology and in social skills. The promotion of psychological well-being and optimal functioning is an innovative and relevant ingredient and could play an important role in the treatment of somatic and psychosocial symptoms in paediatric settings.     

Gene expression and mRNA editing of serotonin receptor 2C in brains of HPRT gene knock-out mice,an animal model of Lesch-Nyhan disease

Lesch-Nyhan disease (LND), a genetic disorder associated with motor and psychiatric disturbance and self-injurious behaviour (SIB) is caused by a complete deficiency of hypoxanthine-guanine phosphoribosyltransferase (HPRT). The connection between enzyme deficiency and neurological involvement is still unclear. Evidence exists for a role of basal ganglia dysfunction with decreased dopamine and excess serotonin striatal content. In this study, we investigate the role of serotonin receptor 2C (HTR2C) in the brains of HPRT gene knock-out mice, a model of LND. HTR2C expression is analyzed by real-time polymerase chain reaction (PCR) using SYBR-green detection methods. The percentage of edited HTR2C mRNA was determined by direct sequencing of amplification products of the region containing the editing sites. We found a 55% increase in the expression of HTR2C gene but no significant difference in mRNA editing levels between knock-out and control mice. The above alteration found in HPRT-deficient mice is similar to those found in other animal models used to study aggressive and self-injurious behaviour.     

LARS versus hamstring tendon autograft in anterior cruciate ligament reconstruction: a single-centre,single surgeon retrospective study with 8 years of follow-up

European Journal of Orthopaedic Surgery & Traumatology - The choice of graft type in the anterior cruciate ligament (ACL) reconstruction remains a subject of controversy. The aim of this study...     

Multidisciplinary approach in the management of advanced ovarian cancer patients: A personalized approach. Results from a specialized ovarian cancer unit

Objective

The aim of the present study was to evaluate the impact of a multidisciplinary approach in patients' selection with advanced ovarian cancer (AOC) for different therapeutic strategies.

Hyperbaric oxygen therapy as an adjuvant treatment for pyoderma gangrenosum

Pyoderma Gangrenosum is a rare neutrophilic dermatosis of skin and subcutaneous tissue characterized by a painful and progressive necrotizing process. The management of pyoderma gangrenosum often requires systemic drug therapy, such as corticosteroids, sulfones or immunosuppressants, either alone or in combination. Several reports in the literature document the successful treatment of pyoderma gangrenosum with hyperbaric oxygen therapy. In our case, hyperbaric oxygen therapy associated with corticoids and immunosuppressants promoted healing of large and very painful lesions in an adolescent girl with an excellent outcome, including rapid wound closure and decreased discomfort.