Psychiatric and Psychosocial Predictors of Medical Outcome After Liver Transplantation: a Prospective, Single-Center Study

OBJECTIVE: Recognizing the potential impact of psychiatric and psychosocial factors on liver transplant patient outcomes is essential to apply special follow-up for more vulnerable patients. The aim of this article was to investigate the psychiatric and psychosocial factors predicted medical outcomes of liver transplanted patients. METHODS: We studied 150 consecutive transplant candidates, attending our outpatient transplantation clinic, including 84 who had been grafted 11 of whom died and 3 retransplanted. RESULTS: We observed that active coping was an important predictor of length of stay after liver transplantation. Neuroticism and social support were important predictors of mortality after liver transplantation. CONCLUSION: It may be useful to identify patients with low scores for active coping and for social support and high scores for neuroticism to design special modes of follow-up to improve their medical outcomes.

Karjanlannan typpi- ja fosforimäärät sekä niiden jakautuminen Satakunnassa ja Varsinais-Suomessa

Karjanlanta on arvokasta lannoitetta, jonka sisältämät ravinteet tulisi käyttää mahdollisimman tehokkaasti hyödyksi viljelykasvien ravinteina. Kotieläimet ovat jakaantuneet epätasaisesti sekä valtakunnallisesti, alueellisesti että paikallisesti. Varsinais-Suomeen ja Satakuntaan on syntynyt erityisesti sika- ja siipikarjatalouskeskittymiä. Tämän seurauksena eräillä alueilla syntyy enemmän lantaa kuin viljelykasvien ravinteiksi tarvitaan. Runsaan fosforilannoituksen seurauksena peltojen fosforipitoisuus on noussut paikoin niin korkeaksi, että lannan levitys ole enää mahdollista ympäristötuen ehtojen mukaan. Tällöin lantaa joudutaan kuljettamaan yhä kauempana oleville pelloille, mikä lisää kustannuksia. Tällaisissa tilanteissa lannan käsittely (esim. separointi) saattaa tulla tarpeelliseksi. Julkaisussa esitetään tilastoihin perustuvien laskelmien avulla, kuinka paljon kotieläimet tuottavat vuosittain Satakunnassa ja Varsinais-Suomessa lannan mukana typpeä ja fosforia sekä kuvataan ravinteiden alueellista ja paikallista jakaantumista. Raportti on toteutettu osana Tehoa maatalouden vesiensuojeluun (TEHO) -hanketta.

Manual sobre desarrollo del lenguaje. Segunda parte

Hemos elegido analizar, a través de la elaboración del texto: Manual para el Desarrollo del Lenguaje II, las estrategias metodológicas que se han venido empleando durante el desarrollo de la asignatura Desarrollo de la comunicación I.

Autistic spectrum disorders : practical strategies for teachers and other professionals.

El espectro autista, a veces también se conoce como trastorno generalizado del desarrollo, se caracteriza por presentar la persona déficit en la interacción social, la comunicación y en la restricción de actividades e intereses. Se han identificado seis áreas principales en las que los niños con este trastorno tienen más dificultad en las escuelas: comportamiento, aprendizaje y pensamiento, conversación, experiencias sensoriales y motoras, lenguaje y comunicación y habilidades sociales. Este manual ofrece ayuda a los adultos interesados en identificar, comprender la razón de esta conducta particular y da consejos prácticos para cambiar, moderar o administrar estas dificultades dentro de escuelas normales. Tiene recursos fotocopiables.

Role of catecholaminergic neurones of the caudal ventrolateral medulla in cardiovascular responses induced by acute changes in circulating volume in rats

Several findings suggest that catecholaminergic neurones in the caudal ventrolateral medulla (CVLM) contribute to body fluid homeostasis and cardiovascular regulation. The present study sought to determine the effects of lesions of these neurones on the cardiovascular responses induced by changes in circulating volume. All experiments were performed in male Wistar rats (320-360 g). Medullary catecholaminergic neurones were lesioned by microinjection of anti-dopamine beta-hydroxylase-saporin (6.3 ng in 60 nl; SAP rats, n = 14) into the CVLM, whereas sham rats received microinjections of free saporin (1.3 ng in 60 nl, n = 15). Two weeks later, rats were anaesthetized (urethane, 1.2 g kg(-1), I.V..), instrumented for measurement of mean arterial pressure (MAP), renal blood flow (RBF) and renal vascular conductance (RVC), and infused with hypertonic saline (HS; 3 M NaCl, 0.18 ml (100 g body weight)(-1), I.V.) or an isotonic solution (volume expansion, VE; 4% Ficoll, 1% of body weight, I.V.). In sham rats, HS induced sustained increases in RBF and RVC (155 +/- 7 and 145 +/- 6% of baseline, at 20 min after HS). In SAP rats, RBF responses to HS were blunted (125 +/- 6%) and RVC increases were abolished (108 +/- 5%) 20 min after HS. Isotonic solution increased RBF and RVC in sham rats (149 +/- 10 and 145 +/- 12% of baseline, respectively, at 20 min). These responses were reduced in SAP rats (131 +/- 6 and 126 +/- 5%, respectively, at 20 min). Pressor responses to HS were larger in SAP rats than in sham rats (17 +/- 5 versus 9 +/- 2 mmHg, at 20 min), whereas during VE these responses were similar in both groups (6 +/- 3 versus 4 +/- 6 mmHg, at 20 min). Immunohistochemical analysis indicates that microinjections of anti-D beta H-saporin produced extensive destruction within the A1/C1 cell groups in the CVLM. These results suggest that catecholaminergic neurones mediate the cardiovascular responses to VE or increases in plasma sodium levels.

Fatores que afetam a expressão de estro detectado por monitores de atividade e riscos de concepção em vacas leiteiras lactantes

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Does emergency vaccination make sense as a supporting element in control of foot-and-mouth disease in Switzerland

The outbreak of foot and mouth disease (FMD) in Great Britain in 2001 let to discussions and especially emergency vaccination was deemed as an alternative to the culling of vast numbers of healthy animals. The project emergency vaccination for FMD in Switzerland was conducted to compare the effectiveness of conventional control strategies during a FMD outbreak alone and with ring vaccination of 3 km and 10 km, respectively. The results of this project showed that emergency vaccination conducted at the beginning of an epidemic was not favorable compared to conventional disease control strategy in Switzerland. In case of an advanced FMD epidemic, a 10 km ring vaccination could support the disease control in a positive way. However, the goal of emergency vaccination to save animal live can hardly be achieved due to actual legal basis and the consequent restriction measures within vaccination zones which will lead to welfare culling.

Batch and continuous fermentation methods for the production of dextransucrase

The available literature concerning dextransucrase and dextran production and purification has been reviewed along with the reaction mechanisms of the enzyme. A discussion of basic fermentation theory is included, together with a brief description of bioreactor hydrodynamics and general biotechnology. The various fermenters used in this research work are described in detail, along with the various experimental techniques employed. The micro-organism Leuconostoc mesenteroides NRRL B512 (F) secretes dextransucrase in the presence of an inducer, sucrose, this being the only known inducer of the enzyme. Dextransucrase is a growth related product and a series of fed-batch fermentations have been carried out to extend the exponential growth phase of the organism. These experiments were carried out in a number of different sized vessels, ranging in size from 2.5 to 1,000 litres. Using a 16 litre vessel, dextransucrase activities in excess of 450 DSU/cm3 (21.67 U/cm3) have been obtained under non-aerated conditions. It has also been possible to achieve 442 DSU/cm3 (21.28 U/cm3) using the 1,000 litre vessel, although this has not been done consistently. A 1 litre and a 2.5 litre vessel were used for the continuous fermentations of dextransucrase. The 2.5 litre vessel was a very sophisticated MBR MiniBioreactor and was used for the majority of continuous fermentations carried out. An enzyme activity of approximately 108 DSU/cm3 (5.20 U/cm3) was achieved at a dilution rate of 0.50 h-1, which corresponds to the maximum growth rate of the cells under the process conditions. A number of continuous fermentations were operated for prolonged periods of time, with experimental run-times of up to 389 h being recorded without any incidence of contamination. The phenomenon of enzyme enhancement on hold-up of up to 100% was also noted during these fermentations, with dextransucrase of activity 89.7 DSU/cm3 (4.32 U/cm3) being boosted to 155.7 DSU/cm3 (7.50 U/cm3) following 24 hours of hold-up. These findings support the recommendation of a second reactor being placed in series with the existing vessel.

Separazioni conflittuali e minori

All’interno di separazioni altamente conflittuali, non è infrequente che si presentino situazioni in cui un figlio rifiuta, in maniera ingiustificata, un genitore. Esclusi i casi in cui sono presenti abusi, trascuratezza o condizioni reali di paura per cui il rifiuto è motivato, come mai un figlio può arrivare a rifiutare in maniera totale e permanente di incontrare un genitore? Può capitare che durante la separazione tra i coniugi siano presenti e persistano conflitti esasperanti, che in alcuni casi evolvono in dinamiche relazionali disfunzionali. Capita anche che a volte, all’interno di queste dinamiche, un genitore metta in atto una sorta di “alienazione” nei confronti dell’altro genitore, a cui corrisponde un rifiuto da parte del figlio del genitore cosiddetto “alienato”. Il minore, coinvolto in maniera attiva in queste dinamiche, si trova quindi in una condizione di rischio. Al di là del “dibattito” scientifico in merito alla definizione del fenomeno, ciò che risulta fondamentale è non disconoscerlo.

L'aggressività nelle prime relazioni sentimentali

Un fenomeno poco indagato in Italia, ma che ha catturato l’attenzione e anche la preoccupazione delle ricerche in diverse parti del mondo, sono i comportamenti aggressivi che possono avvenire nelle prime relazioni sentimentali, tra adolescenti. La ricerca si è concentrata principalmente sulla violenza nelle coppie adulte, sulla violenza domestica, trascurando quelle condotte aggressive che avvengono nelle prime relazioni intime, in quanto ritenute poco stabili e fugaci. Diverse ricerche dimostrano che non è così e che anzi, spesso gli adolescenti “investono” molto in queste prime esperienze. Tra i principali motivi che spingono gli studiosi ad indagare questo fenomeno, vi è la considerazione della gravità delle stime di prevalenza, le conseguenze per il benessere psico-fisico, ed il valore predittivo che tali comportamenti potrebbero assumere rispetto al fenomeno della violenza nelle coppie adulte.

Frammenti del sè: un caso clinico

Ad oggi, a fronte di un crescente interesse sociale, giuridico, medico e psicologico alle varie forme di abuso sessuale subite da minori e agli esiti a breve, medio e lungo termine che tali eventi possono esercitare sul benessere bio-psico-sociale dei sopravvissuti (Gulotta & Cutica, 2009), sembra, comunque, manifestarsi una insufficiente attenzione al tema del maltrattamento fisico (Di Blasio, 2000). Nel nostro contesto culturale gli episodi di aggressività fisica sono ancora facilmente rubricati nella categoria delle prassi genitoriali lecite, con un’implicita sottovalutazione dei rischi per la salute del bambino. Con questo non vogliamo sottendere che ogni singolo episodio di aggressività diretta del caregiver possa inserirsi tout court nella categoria dei maltrattamenti fisici; allo stesso tempo, riteniamo però necessario che, a livello sociale e sanitario, si presti attenzione ai possibili rischi per la salute della persona in caso di maltrattamenti fisici reiterati.