New Data on Native and Alien Vascular Flora of Sicily (Italy): New Findings and Updates.

In this paper, based on fieldwork and herbaria surveys, new data concerning the presence of 32 native and alien vascular species for Sicily (Italy) are provided. Among the native species, the occurrence of the following is reported for the first time or confirmed after many decades of non-observation: , , subsp. , , , and .

Design and implementation of a low-cost birth simulator.

During spontaneous and operative deliveries it is important to correctly estimate the position and orientation of the fetus in the birth canal. In fact, incorrect evaluations can lead to errors in ventouse extraction, forceps application, and increased use of cesarean section. In this scenario, simulation is an appropriate tool for training and evaluating the abilities of gynecologists and midwives, because it allows student to practice both common situations and unlikely or risky events.

Adaptation of non-technical skills behavioural markers for delivery room simulation.

Background: Simulation in healthcare has proved to be a useful method in improving skills and increasing the safety of clinical operations. The debriefing session, after the simulated scenario, is the core of the simulation, since it allows participants to integrate the experience with the theoretical frameworks and the procedural guidelines. There is consistent evidence for the relevance of non-technical skills (NTS) for the safe and efficient accomplishment of operations.

How to maintain equity and objectivity in assessing the communication skills in a large group of student nurses during a long examination session, using the Objective Structured Clinical Examination (OSCE).

Background: While development, testing, and innovation of the Objective Structured Clinical Examination (OSCE) are common in the international literature, studies from the United States of America (USA), Australia, and the United Kingdom (UK) predominate. There is little known about OSCE use in European countries, such as Italy, where other than cost analysis, there is little reporting of OSCE use or validation.

Objectives: This paper reports on one Italian initiative, which evaluated the equity and objectivity of the OSCE method of assessing communication skills.

The role of simulation in developing communication and gestural skills in medical students.

Background: International studies have shown that laboratory training, particularly through the application of the principles of simulation learning, is an effective means of developing the communication and gestural skills of healthcare professionals. At the Advanced Simulation Center of the University of Genoa we have therefore established the first clinical skill laboratory with medical school students and an interprofessional team of trainers, as the first step towards developing simulation training of both medical and nursing students at our University.The aim of this study was to assess student satisfaction with laboratory training in an Advanced Simulation Center.

Currarino syndrome with pelvic neuroendocrine tumor diagnosed by post-mortem genetic analysis of tissue specimens.

Currarino syndrome (CS) is an autosomal dominant disorder of embryonic development characterized by the triad of anorectal abnormalities, partial sacral agenesis, and presacral mass. Mutations of the HLXB9 gene have been identified in most CS cases, but a precise genotype-phenotype correlation has not been described so far. We report the clinical case of a 44-year-old Caucasian woman with malignant neuroendocrine transformation of a pre-sacrococcygeal mass combined with bicornuate uterus, dermoid cyst of the ovaries, and chronic constipation.

Tako-tsubo cardiomyopathy as initial presentation of pheocromocytoma. A clinical case.

Introduction: Tako-tsubo cardiomyopathy is a rapidly reversible form of acute heart failure triggered by stressful events that occur more frequently in postmenopausal women. A central role is supposed to be played by catecholamines and the association with pheocromocytoma is rare.

Case Presentation: We describe a patient admitted for abdominal pain and suffering of hypertension pharmacologically treated.

Pheochromocytoma during pregnancy treated by surgery. A case report and the review of the literature.

Introduction: Prenatal diagnosis of pheocromocytoma, although rare, is important as it allows a reduction in both maternal mortality and foetal loss. Pheocromocytoma operated on in the first trimester of pregnancy with survival of both patient and foetus is rare in literature. Our case was operated on with success after a correct and early diagnosis was obtained despite a chronic hypertension which existed long before pregnancy.

Anal metastasis from recurrent breast lobular carcinoma: a case report.

We report a case of isolated gastrointestinal metastasis from breast lobular carcinoma, which mimicked primary anal cancer. In July 2000, an 88-year-old woman presented with infiltrating lobular cancer (pT1/G2/N2). The patient received postoperative radiotherapy and hormonal therapy.

A model to prioritize access to elective surgery on the basis of clinical urgency and waiting time.

Background: Prioritization of waiting lists for elective surgery represents a major issue in public systems in view of the fact that patients often suffer from consequences of long waiting times. In addition, administrative and standardized data on waiting lists are generally lacking in Italy, where no detailed national reports are available. This is true although since 2002 the National Government has defined implicit Urgency-Related Groups (URGs) associated with Maximum Time Before Treatment (MTBT), similar to the Australian classification.

Neurinoma originating from the recurrent nerve: report of a case.

Schwannoma is an uncommon, peripheral nerve sheath tumor of the neck that can occur either as an isolated lesion or multiple lesions. Multiple schwannomas, as seen in neurofibromatosis, occur less frequently. The rare occurrence and poorly defined symptoms of these tumors often make their preoperative diagnosis difficult.

CD8+ CD28- T regulatory lymphocytes inhibiting T cell proliferative and cytotoxic functions infiltrate human cancers.

Tumor growth is allowed by its ability to escape immune system surveillance. An important role in determining tumor evasion from immune control might be played by tumor-infiltrating regulatory lymphocytes. This study was aimed at characterizing phenotype and function of CD8+ CD28- T regulatory cells infiltrating human cancer.

A three-phase approach for operating theatre schedules.

In this paper we develop a three-phase, hierarchical approach for the weekly scheduling of operating rooms. This approach has been implemented in one of the surgical departments of a public hospital located in Genova (Genoa), Italy. Our aim is to suggest an integrated way of facing surgical activity planning in order to improve overall operating theatre efficiency in terms of overtime and throughput as well as waiting list reduction, while improving department organization.

[Diagnostic, therapeutic and healtcare management protocols in thyroid surgery. I consensus conference (UEC club)].

The aim of the study was to draw up a management protocol in thyroid surgery promoted by the Italian Association of Endocrine Surgery Units (Club delle UEC), shared by the experts and applied by the operators in the sector. The management protocols already presented in February 2002 and drawn up by the first Author of the present publication on the occasion of the current review were examined by the I Consensus Conference called on the topic by the Italian Endocrine Surgery Units. The conference comprised two distinct sessions, the first on 18 June 2005 within the framework of the 4th National Congress of the Club delle UEC in Naples, and the second on 17 September 2005 within the framework of the 8th Multidisciplinary Scanno Prize Meeting.

DNA fragmentation and DNA repair synthesis induced in rat and human thyroid cells by four rat thyroid carcinogens.

Four chemicals that are known to induce in rats thyroid follicular-cell adenomas and carcinomas were assayed for their ability to induce DNA damage and DNA repair synthesis in primary cultures of human thyroid cells. Significant dose-dependent increases in the frequency of DNA single-strand breaks and alkali-labile sites, as measures by the Comet assay, were obtained after a 20-h exposure to the following subtoxic concentrations of the four test compounds: 2,4-diaminoanisole (DAA) from 0.10 to 1.