Berntsenjosephsen1606

In Multiple Sclerosis (MS) spasticity worsen patient's quality of life. Selleck FHD-609 Botulinum NeuroToxin TypeA (BoNT-A) is extensively used in focal spasticity, frequently combined with physical therapies. Radial extracorporeal shock waves (rESW) were already used in association with BoNT-A. Considering that loss of efficacy and adverse events are determinants of BoNT-A treatment interruption, this study aimed to evaluate the possibility to prolong BoNT-A's effect by using rESW in MS focal spasticity.

Sixteen MS patients with spasticity of triceps surae muscles were first subjected to BoNT-A therapy and, four months later, to 4 sections of rESWT. Patients were evaluated before, 30, 90 days after the end of the treatments, by using Modified Ashworth Scale (MAS), Modified Tardieu Scale (MTS) and kinematic analysis of passive and active ankle ROM. Results BoNT-A determined a significant reduction of spasticity evaluated by MAS with a reduction of positive effects after 4months (p<0.05); MTS highlighted the efficacy asticity evaluated by MAS with a reduction of positive effects after 4months (p less then 0.05); MTS highlighted the efficacy only 90 days after injection (p less then 0.05). rESWT decreased MAS values at the end and 30 days later the treatment (p less then 0.01); MTS values showed instead a prolonged effect (p less then 0.01). BoNT-A determined a gain of passive and active ankle ROM, persisting along with treatment and peaking the maximum value after rESWT (p less then 0.05). Conclusions rESWT can prolong BoNT-A effect inducing significant reduction of spasticity and improvement in passive and active ankle ROM in MS patients. The use of rESWT following BoNT-A injection is useful to avoid some limitations and to prolong the therapeutic effects of BoNT-A therapy.

Considerable differences in terms of prognosis exist between the right-sided (RCC) and the left-sided colon cancer (LCC).Aim of the work In this study, we evaluated prognostic implications of primary tumor location (PTL) among patients who underwent curative-intent hepatectomy for synchronous (SM) and metachronous (MM) colorectal liver metastases (CRLM).

The study population included all consecutive patients affected by CRLM scheduled for first liver resection at three Italian oncological centers.

A total of 204 patients who underwent CRLM resection were included, 50% with RCC. Synchronous lesions were prevalent (n=133, 65%). Median OS was respectively 40.3 months for SM-RCC, 53.5 months for SM-LCC, 64.5 months for MM-RCC and 81.6 months for MM-LCC. Patients with MM-LCC showed an OS better than patients with SM-RCC (p=0.008) and SM-LCC (p=0.002).PTL had no influence on RFS. RCC group had less recurrences (75% vs 86.5%), though further surgery with curative-intent was possible more in LCC group (29.3% vs 32.5%). Cox proportional hazards model analysis showed that age and the presence of SM vs MM was associated with a significantly higher hazard ratio (HR) for death (HR=1.024; 95%CI=1.005-1.043; p=0.011 and HR=2.010; 95%CI=1.328-3.043; p=0.001, respectively).

We confirmed that patients with CRLM and right-sided primary colon cancer experience worse survival after hepatic resection. The timing of metastasis has been revealed as important prognostic factor.

We confirmed that patients with CRLM and right-sided primary colon cancer experience worse survival after hepatic resection. The timing of metastasis has been revealed as important prognostic factor.

The present study aims to investigate the number of surgical procedures performed by Italian residents and their confidence to carry out different surgeries in obstetrics and gynecology.

The present study is a national survey including all Italian gynecology and obstetrics senior residents. A questionnaire including 25 questions was provided. The free Google Forms site was used to create the survey. The study was conducted from April to October 2019. The survey started from the University Hospital of Parma, a tertiary hospital, and was sent to all the Italian post-graduation medical school in gynecology and obstetrics. An e-mail was sent to all representative residents in gynecology and obstetrics in Italy, then forwarded to all the senior residents.

Of the 555 residents enrolled, 100 joined the survey (18.2%). The analysis of the different procedures performed by residents has shown that 53%, 57%, and 77% of the residents had never performed a laparotomic, laparoscopic, and vaginal hysterectomy, respectively. The analysis of cesarean section skills has shown that 1% of residents had never performed any simple cesarean section, and 6% of residents had never performed any complex cesarean section. Fifty-two doctors in training had never performed an operative vaginal delivery. Seventy-three and ninety-three residents performed more than thirty uterine curettages and sutures of 1st or 2nd degree tears, respectively.

In Italy, senior residents are generally confident with the low-complexity procedures and also with complex cesarean sections. The number of Italian residents confident to perform a hysterectomy is poor.

In Italy, senior residents are generally confident with the low-complexity procedures and also with complex cesarean sections. The number of Italian residents confident to perform a hysterectomy is poor.

Congenital malformations such as oesophageal atresia (OA) and tracheoesophageal fistula (TOF), congenital pulmonary airway malformations (CPAMs), congenital diaphragmatic hernia (CDH) and vascular rings (VRs) can affect lung development and respiratory function. This observational study describes our multidisciplinary approach and respiratory follow-up of children with such congenital malformations.

Clinical data of children followed at the Pediatric Respiratory Unit of Parma University Hospital (Italy) between January 2015 and January 2020 were collected. Results. Twenty-three patients with congenital malformation affecting lung development were identified. Almost half of our patients were diagnosed with fetal ultrasound. Children attended the clinic at a mean age of 3 (3.7) years and follow-up visits were scheduled every 6 months average. More than half of our patients were hospitalized for lower respiratory tract infections. Six out of 9 children able to perform spirometry showed anomalies in lung function.