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A Friend is truly a treasure, in accordance with age and competence’s qualitative changes. The aim of this study was to con?rm the increase in friendship competence and its multifactorial nature in 3- up to 10-year-old children, and to verify gender differences, and parenting in?uences on the concept of friendship. A semi-structured interview was administered in a natural context to 3- to 10-year-old children (N?=?167; Mean?=?7.6 years; SD?=?2.16). According to Selman’s Model, the coding provides ?ve sub-categories: (1) friendship; (2) social perspective taking; (3) emotions understanding; (4) social interaction strategies; and (5) aggressiveness. Three parental style questionnaires were administered to parents. Results point up an increase in social skills according to age. The Friendship Interview turned out to be a reliable tool able to investigate how the concept of friendship is also structured in preschool children.  相似文献   
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Clinical and biological data were evaluated using Desu univariate analyses or Cox multivariate analyses in a series of 1,777 chronic lymphocytic leukemia (CLL) patients from an Italian Cooperative Group. In univariate analyses, age and sex of patients, presence of bone marrow (BM; greater than or equal to 50%), and peripheral blood (PB; greater than or equal to 60,000/microL) lymphocytosis, anemia (hemoglobin [Hb] less than 11 g/dL), thrombocytopenia (less than 100,000/microL), direct Coombs' test positivity, hepatomegaly, splenomegaly, and extent of lymph node involvement were shown to be of significant prognostic value. Multivariate analyses, through a stepwise procedure, showed that the most important prognostic variables are Hb, hepatomegaly, lymph node involvement, PB lymphocytosis, and age and sex of patients. Further covariates would produce an improvement having a nonsignificant P value. Based on the results of multivariate analyses, a four-step staging using the significant variables of the Cox model is proposed.  相似文献   
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Cognitive functions were investigated in 37 patients with myotonic dystrophy (MD) and correlated with clinical and neuroradiological variables. The whole cognitive performance was at a low-average level; in about 1/3 of the subjects, in fact, the scores at the neuropsychological tests were below the normal range. There was a consistent trend for patients with inheritance on maternal side to perform worse on Wechsler verbal score and to present cerebral atrophy. In 7 out of 12 subjects focal white matter lesions were found at nuclear magnetic resonance. The significance of these findings and its relation to cognitive performance are discussed.  相似文献   
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The prevalence of abnormal physical signs (e.g., bleeding, scars, or bruises) and genital infections, notably Chlamydia Trachomatis, Neisseria Gonorrhea, and Herpes Simplex Genitalis was studied in 219 female children with validated sexual abuse. They were compared to 113 nonabused female children. The average abused child was 8.3 years old, with 69% having been abused on multiple occasions. Most offenders were family members (65%) or a close family friend (22%). Stranger-perpetrated sexual assault, in the sample, was low (9.1%). Few children had severe vaginal tears, though 56% showed signs of subtle anatomical injury to their genitalia. No similar anatomical abnormalities were present in nonabused children. Among the sexually abused children and adolescents, 35% were colonized with a pathogen or a potential pathogen, compared to a prevalence rate of 18.5% in non-abused children. The proportion of abused children colonized with Ureaplasma Urealyticum and Mycoplasma Hominis was not significantly different from that found in nonabused children. At present, Neisseria gonorrhea and Chlamydia Trachomatis remain the only conclusive markers for sexual abuse. It is recommended that routine cultures of the pharyngeal, rectal, and vaginal areas be taken in all cases of suspected child sexual abuse, regardless of clinical findings.  相似文献   
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PDB is genetically heterogeneous. Mutations of the sequestosome1 gene have been reported in sporadic and familial forms of Paget's in patients of French Canadian and British descent. Mutational analyses in different ethnic groups are needed to accurately investigate hereditary diseases. We describe two novel mutations of sequestosome1 in 62 Italian sporadic patients, confirming the role of the encoded protein in this disorder. INTRODUCTION: Paget's disease of bone (PDB) is a relatively common disease of bone metabolism reported to affect up to 3% of whites over 55 years of age. The disorder is genetically heterogeneous, and at present, there is scientific evidence that at least eight different human chromosomal loci are correlated with its pathogenesis. Mutations of the sequestosome1 (SQSTM1) gene were identified as responsible for most of the sporadic and familial forms of Paget in patients of French Canadian and British descent. Such mutations were located at exon 7 and 8 levels, encoding for the ubiquitin protein-binding domain (UBA) and representing a mutational hot spot area. MATERIALS AND METHODS: To verify the involvement of this gene in Italian subjects affected by PDB, we performed mutational analysis in 62 sporadic PDB cases. RESULTS: We described three different mutations at exon 8 level: P392L, already described in the French Canadian population and families predominantly of British descendent, and two novel mutations consisting of the amino acid substitutions M404V and G425R. No significant differences in the clinical history of PDB have been observed in patients with SQSTM1 mutations in respect to those without. CONCLUSIONS: Even though our findings suggest a minor involvement of the SQSTM1 gene in the pathogenesis of sporadic Italian Paget's cases, the identification of different significant mutations within the SQSTM1 gene in unrelated, but clinically similar individuals, offers extremely convincing evidence for a causal relationship between this gene and PDB. Longitudinal studies are needed to assess the penetrance of genotype/phenotype correlations. Our findings confirm the evidence of a clustered mutation area at this level in this disorder.  相似文献   
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Between 1982 and 1988, 111 elderly women with breast cancer but without clinical involvement of the axillary lymph nodes underwent wide lumpectomy in a Day Hospital regimen at the National Cancer Institute of Milan. The patients ranged in age from 70 to 92 years (median, 79). An adjuvant treatment was carried out in all but 9 cases: tamoxifen only in 84 cases, tamoxifen plus radiotherapy in 6 cases, radiotherapy alone in 12 cases. The median duration of follow-up was 44 months (range, 30-109 months). Four patients (3.6%) were lost to follow-up. In the remaining 107 patients, 10 local-regional relapses (9.1%) and 7 distant metastases (6.5%) occurred. Six patients died from the disease, 14 from unrelated conditions. This retrospective study showed that selected elderly patients with breast cancers can be treated successfully under local anesthesia on an outpatient basis. The treatment guarantees local control of the disease, meets the favor of elderly women and consequently improves their quality of life.  相似文献   
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