[Rectosigmoid junction neoplasms: our experience].

The Authors report their experience with 25 patients operated for colorectal junction neoplasms from January 1998 to December 2002 in the Section of Oncological Surgery, at Perugia University. According to the international literature, the Authors maintain the absolute functional and anatomical individuality of this part of the large bowel, underlining the peculiarity of the sigmoidal junction neoplasms respect all the others colic sites regarding clinical manifestations, symptoms developing and biological behaviour. The characteristics seem also capable of changing the surgical choice as well as the prognosis of the disease.

Direct cost of medical management of epilepsy among adults in Italy: a prospective cost-of-illness study (EPICOS).

Purpose: To investigate the costs of epilepsy from a nationwide survey comparing adult patients included in different prognostic categories.

Methods: A 12-month prospective observational study was conducted in 15 epilepsy centers from Northern, Central, and Southern Italy. The study population included a random sample of individuals aged 18 years and older with newly diagnosed (ND) epilepsy, seizure remission (R), occasional seizures (OS), active non-drug-resistant (NDR) seizures, drug-resistant (DR) seizures, or surgical candidates (SC).

Determinants of erectile dysfunction risk in a large series of Italian men attending andrology clinics.

Objective: To assess determinants of ED in men who asked for a free of charge andrologic consultation during a week focused on andrologic prevention in Italy.

Methods: Men were invited to attend 178 participating andrology centers for a free of charge visit for counselling about urologic or andrologic conditions. Data were recorded with a simple questionnaire used by all centers.

Cardiac features of Emery-Dreifuss muscular dystrophy caused by lamin A/C gene mutations.

Aims: Retrospective studies have identified a mutation in the lamin A/C (LMNA) gene in patients selected on the basis of a phenotype characterized by dilated cardiomyopathy, atrioventricular conduction disturbances and sudden death. However, the features of cardiac abnormalities in patients with an initial diagnosis of Emery-Dreifuss muscular dystrophy (EDMD) are poorly known. Aim of the present study was to investigate the spectrum of cardiac disease in patients with an initial diagnosis of EDMD caused by a mutation in the LMNA gene.

Changes in motor cortex excitability in facioscapulohumeral muscular dystrophy.

Previous studies found that some patients with severe, early onset facioscapulohumeral muscular dystrophy (FSHD) present epilepsy and mental retardation. This suggests a functional involvement of central nervous system in severe FSHD. It is unknown whether minor functional changes of central nervous system are also present in less severe forms of FSHD.

Risk factors for lipodystrophy in the CISAI cohort.

Purpose: This study set out to describe the frequency of lipodystrophy, and identify its risk factors, in HIV-positive patients treated with HAART containing at least one protease inhibitor (PI). We analyzed the data collected in the CISAI study.

Methods: The CISAI is a multicenter cohort study that has enrolled 1480 patients.

Local health departments' mission to the uninsured.

It is often maintained that local health departments (LHDs) should not directly provide personal health services. However, our nationally representative sample revealed that most LHD directors (87%) believed LHDs must directly provide these services, primarily because they perceived a high level of unmet need among the uninsured. While only a minority believed LHDs should focus exclusively on the core functions, this proportion rose dramatically when we asked directors to assume that there were no uninsured people.

Tailored interventions to increase influenza vaccination in neighborhood health centers serving the disadvantaged.

Objectives: We designed and evaluated interventions to increase adult immunizations within inner-city health centers.

Methods: Interventions included reminders, standing orders, and walk-in "flu shot clinics." Patients were surveyed and records evaluated.

Treatment of asymptomatic bacterial vaginosis to prevent pre-term delivery: a randomised trial.

Objectives: To evaluate the efficacy of clindamycin vaginal cream 2% once daily for 7 days in prolonging pregnancy.

Study Design: Randomised clinical trial of 112 women between 14 and 25 weeks of gestation with diagnosis of asymptomatic bacterial vaginosis were enrolled in a multicenter randomised trial and assigned to active or no treatment. A total of 55 women were assigned to clindamycin and 57 to no treatment.

Current drug use as risk factor for erectile dysfunction: results from an Italian epidemiological study.

Several drugs have been associated with an increased risk of erectile dysfunction (ED). We analysed the role of pharmacological treatments on the risk of ED using data from a cross-sectional study on prevalence and risk factors for ED in the general population in Italy. A total of 2450 men aged more than 18 years were randomly identified by 143 general practioners (GP) among their registered patients and invited to a confidential interview by their GP.

Ultrasound tissue characterization detects preclinical myocardial structural changes in children affected by Duchenne muscular dystrophy.

Our goal was to identify early changes in myocardial physical properties in children with Duchenne muscular dystrophy (DMDch). Duchenne muscular dystrophy (DMD) is caused by the absence of dystrophin, which triggers complex molecular and biological events in skeletal and cardiac muscle tissues. Although about 30% of patients display overt signs of cardiomyopathy in the late stage of the disease, it is unknown whether changes in myocardial physical properties can be detected in the early (preclinical) stages of the disease.

Maternal and paternal smoking and pregnancy-induced hypertension.

Objective: Smoking has been suggested to reduce the risk of pregnancy-induced hypertension (PIH). We have analyzed the association between smoking and risk of PIH using data from a case-control study conducted in Italy.

Study Design: Cases were 215 women who gave birth on randomly selected days at a network of obstetric departments and with a diagnosis of PIH, i.

Managerial and professional beliefs influencing public health privatization: results of a national survey of local health department directors.

This article describes managerial and professional beliefs underlying decisions to privatize public health services. We drew a stratified, nationally representative sample of local health departments and interviewed 347 department directors by telephone. We used logistic regression to establish the independent effects of various beliefs on the decision to privatize.

Impact of cerebral protection devices on early outcome of carotid stenting.

Purpose: To evaluate the impact of cerebral protection devices on the procedural safety and outcome of carotid stent procedures.

Methods: From June 1997 to July 2001, 275 consecutive patients (208 men; mean age 71 +/- 7.4 years) underwent percutaneous angioplasty and/or stenting of the extracranial carotid artery.

Frequent low penetrance mutations in the Lamin A/C gene, causing Emery Dreifuss muscular dystrophy.

Emery Dreifuss muscular dystrophy is a genetically heterogeneous disorder characterized by the clinical triad of early onset contractures, progressive muscular wasting and weakness with humeroperoneal distribution and cardiac conduction defects. Mutations in the Lamin A/C (LMNA) gene are responsible for the autosomal dominant and the autosomal recessive forms. Familiar and sporadic patients carrying mutations in the LMNA gene show high variability in the clinical symptomatology and age of onset.

Pregnancy outcome after cabergoline treatment in early weeks of gestation.

We collected information on 61 pregnancies in 50 women treated with cabergoline. These pregnancies resulted in 12 (19.7%) early terminations (five induced abortions, six spontaneous abortions, one hydatidiform mole) and 49 (80.

Facioscapulohumeral muscular dystrophy presenting isolated monomelic lower limb atrophy. Report of two patients with and without 4q35 rearrangement.

Facioscapulohumeral muscular dystrophy has a distinctive regional distribution but variable clinical expression and may be markedly asymmetrical. We report two patients presenting weakness and wasting confined to a single lower limb. Creatine kinase was slightly increased, electromyogram and muscle biopsy were myopathic.

Rheological characterization of Poloxamer 407 lidocaine hydrochloride gels.

Thermal gelation of Poloxamer 407 lidocaine hydrochloride gels was characterized by rheological studies. Lidocaine, a local anesthetic used for treatment of acute and chronic pain, presents short duration action; thus a long-action single-dose injection would be of clinical importance. Poloxamer 407 gel can extend the release and the action of lidocaine.

[The use of surgical endo-prosthesis in the treatment of choledocolithiasis in the elderly. Personal experience].

Background: The usefulness of biliary endoprostheses in some selected elderly patients affected by hepato-choledocolithiasis is described.

Methods: In the Department of Surgery, University of Perugia, 119 elderly patients were surgically treated for choledocholithiasis from January 1999 to December 2000. In 44 selected cases#151;oldest patients with thinner hypovascularized ectasic choledochal wall#151; a permanent transpapillary polyurethane prosthesis was placed, after choledocolithotomy with or without sphinterotomy; sometimes prosthesis was placed under the duodenal mucosa.

The role of qualitative methods for investigating barriers to adult immunization.

In 1999, the Agency for Healthcare Research and Quality funded a study of barriers to immunization, which included a short-term qualitative data collection to assess the organizational and cultural features of selected primary care practices and to explore their impact on adult immunization rates. The authors describe the short-term qualitative data collection system and the contributions made by the qualitative study to the parent project. They address previously held concerns about qualitative research and provide a system that can be replicated or modified for use for projects designed to assess complex attitudes and behaviors that affect health outcomes.

The privatization of environmental health services: a national survey of practices and perspectives in local health departments.

Objectives: This article presents nationally representative data on environmental health (EH) services privatized by local public health departments, enforcement and assurance mechanisms for privatized services, and administrators' views about EH services that should not be privatized.

Methods: A national sample of 380 local public health departments, stratified by jurisdiction size, was drawn from a universe of 2,488 departments. Telephone interviews were conducted with 347 administrators of departments.