Humans ; Infant ; Infant Nutritional Physiological Phenomena ; Weaning

Aids are only one of the instruments with which the disabled person can often reach a good level of autonomy,he can improve his conditions of life and prevent the aggravating of his situation.Aids serve also to facilitate care on the part of the family.The rights confirmed by Law 104 can also be achieved through the use of aids.The Italian state has planned a system of care with regards to aids so that some of them can be purchased with different tax concessions but essential aids,those necessary for the reaching of autonomy goals and prevention defined by an individual rehabilitative project,are supplied free of charge.In Italy essential aids are part therefore of a rehabilitation plan that is identified for each person with disabilities by a team made up of different professionals.

The Italian care situation with regards to prostheses and aids is satisfying.The norm which establishes the ways in which aids can be supplied to disabled people goes back to 1999 and,even though it is based on correct principles and even though it has produced positive effects in the improvement of the life of disabled people,it must be updated in the light of the more recent technological and scientific innovations and of the new information instruments such as the diffusion of information and communication systems.

AIM: To assess whether the new microincision cataract surgery (MICS) induces less endothelium damages than the standard coaxial phacoemulsification.METHODS: Two hundred consecutive patients affected by age-related cataract were randomly assigned to undergo phacoemulsification using either standard coaxial phaco (SCP) or MICS. Central cornea and 12 o'clock endothelial cell count,cell size variation coefficient, percentage of hexagonality and central cornea thickness were measured before and up to one year after surgery.RESULTS: One hundred and seventy-three patients completed the trial. At the one-year follow-up visit, the loss of endothelium cells was 6.5204% in the MICS group and 8.726% in the SCP group (P＜0.00005). There was no significant differences between the two groups in terms of coefficient of variation in cell size, percentage of hexagonal cells,corneal thickness the day after surgery and variation of endothelial cell density measured both at the incision site and at the central cornea. In patients with hard cataracts, the increase in endothelial cell density loss was higher independently of the procedure.CONCLUSION: MICS induced a significant lower endothelial cell density loss than SCP.

No abstract available.

The most important reference in Italian legislation concerning interventions in favour of people with disabilities came about with Law 104 from February 5th 1992 in which the most important fights for disabled people were established.This law led to a new vision,the person with disabilities is no longer seen only a subject needing help but as a person who has the right to live his life in the best possible way that his condition allows him to and thus,it is society's duty and that of the Government,to do everything possible to remove invalidating causes,to promote a disabled person's autonomy and to realise his best social integration possible.To implement what is foreseen by this law it was necessary to activate different important interventions,two of which are very significant:the realisation of Guidelines from the Ministry of Health on rehabilitation activities in which the aims are defined on how rehabilitation should be implemented and how it should be organised on a national level and at a community level.Law 68 from March 12th 1999 decreed the full rights of people with disability to be integrated into the workplace.In the article we will also report some significant data concerning the results of the applications of the law.

No abstract available.
Venous Insufficiency*

Varicocele repair is mainly indicated in young adult patients with clinical palpable varicocele and abnormal semen parameters. Varicocele treatment is associated with a significant improvement in sperm concentration, motility, morphology, and pregnancy rate. Antegrade scrotal sclerotherapy (ASS) represented one of the main alternatives to the traditional inguinal or suprainguinal surgical ligation. This article reviews the use of ASS for varicocele treatment. We provide a brief overview of the history of the procedure and present our methods used in ASS. In addition, we review complication and success of ASS, including our own retrospective data of treating 674 patients over the last 17 years. Herein, we analyzed step by step the ASS technique and described our results with an original modified technique with a long follow-up. Between December 1997 and December 2014, we performed 674 ASS. Mean operative time was 14 min (range 9 to 50 min). No significant intraoperative complications were reported. Within 90 days from the procedure, postoperative complications were recorded in overall 49 (7.2%) patients. No major complications were recorded. A persistent/recurrent varicocele was detected in 40 (5.9%) cases. In 32/40 (80%) cases, patients showed preoperative grade III varicoceles. In patients with a low sperm number before surgery, sperm count improved from 13 × 10 6 to 21 × 10 6 ml-1 (P < 0.001). The median value of the percentage of progressive motile forms at 1 h improved from 25% to 45% (P < 0.001). Percentage of normal forms increased from 17% before surgery to 35% 1 year after the procedure (P < 0.001). In the subgroup of the 168 infertile patients, 52 (31%) fathered offspring at a 12-month-minimum follow-up. Therefore, ASS is an effective minimal invasive treatment for varicocele with low recurrence/persistence rate.

Major depressive disorders are ranked as the single largest contributor to non-fatal health loss and biomarkers could largely improve our routine clinical activity by predicting disease course and guiding treatment. However there is still a dearth of valid biomarkers in the field of psychiatry. The initial assumption that a single biomarker can capture the myriad of complex processes proved to be naive. The purpose of this paper is to critically review the field and to illustrate the possible practical application for routine clinical care. Biomarkers derived from DNA analysis are the ones that have received the most attention. Other potential candidates include circulating transcription products, proteins, and inflammatory markers. DNA polygenic risk scores proved to be useful in other fields of medicine and preliminary results suggest that they could be useful both as risk and diagnostic biomarkers also in depression and for the choice of treatment. A number of other possible fluid biomarkers are currently under investigation for diagnosis, outcome prediction, staging, and stratification of interventions, however research is still needed before they can be used for routine clinical care. When available, clinicians may be able to receive a lab report with detailed information about disease risk, outcome prediction, and specific indications about preferred treatments.

Anhedonia is a core symptom of depression and of several psychiatric disorders. Anhedonia has however expanded from its original definition to encompass a spectrum of reward processing deficits that received much interest in the last decades. It is a relevant risk factor for possible suicidal behaviors, and that it may operate as an independent risk factor for suicidality apart from the episode severity. Anhedonia has also been linked to inflammation with a possible reciprocal deleterious effect on depression. Its neurophysiological bases mainly include alterations in striatal and prefrontal areas, with dopamine being the most involved neurotransmitter. Anhedonia is thought to have a significant genetic component and polygenic risk scores are a possible tool for predicting an individual’s risk for developing anhedonia.Traditional antidepressants, such as selective serotonin reuptake inhibitors, showed a limited benefit on anhedonia, also considering their potential pro-anhedonic effect in some subjects. Other treatments may be more effective in treating anhedonia, such as agomelatine, vortioxetine, ketamine and transcranial magnetic stimulation. Psychotherapy is also widely supported, with cognitive-behavioral therapy and behavioral activation both showing benefit. In conclusion, a large body of evidence suggests that anhedonia is, at least partially, independent from depression, therefore it needs careful assessment and targeted treatment.