326,806 research outputs found

    Ambulatory assisted living fallers at greatest risk for head injury

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    OBJECTIVES: To determine the relationship between head injuries sustained during each fall with various known high risk health and demographic factors predictive of falls. DESIGN: Prospective cohort study conducted over 1 year SETTING: Assisted living and skilled nursing units of a Continuing Care Retirement Community located in the northeastern United States. PARTICIPANTS: Sixty nine OAs who fell. MEASUREMENTS: Age, gender, diagnosis, high risk medication, functional, cognitive, ambulation/elimination status, mode of locomotion, fall related symptoms and the position of the fall, were analyzed using General Estimating Equations among elderly fallers with and without head injury. RESULTS: A total of 173 falls (average of 2.9 times) were observed for 62 patients who had complete injury data. Injuries were recorded in 40.5% of falls, with 41.4% being head injuries. Head injuries were more likely to be hematomas than lacerations (66.7% vs. 14.7%) and among assisted living residents (p=0.04). Head injured patients were more likely to be walking at the time of the fall (69% vs. 36.1%) and less likely to have bowel incontinence (3.5% vs. 28.5%; p=0.04). None of the high risk diagnosis or medications associated with falls risk increased risk for head injury. CONCLUSION: Those at greatest risk for head injury were ambulatory assisted living residents. None of the known clinical conditions predictive of risk to fall were predictive of head injury. For head injury prevention to be successful we need a closer examination of resident’s mobility, shoe-wear, health behavior with respect to ability to use assistive devices, and floor surface landing area. Future health policy implications include measures to ensure standard of care practices for head injured patients are in place.This is the peer reviewed version of the following article: Gray-Miceli, D. L., Ratcliffe, S. J. and Thomasson, A. (2013), Ambulatory Assisted Living Fallers at Greatest Risk for Head Injury. Journal of the American Geriatrics Society, 61: 1817–1819, which has been published in final form at https://dx.doi.org/10.1111/jgs.12467. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.Peer reviewe

    S. Miceli, Il Demiurgo trasgressivo

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    Severi Carlo. S. Miceli, Il Demiurgo trasgressivo. In: L'Homme, 1987, tome 27 n°103. p. 131

    Ondansetron for food protein-induced enterocolitis syndrome

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    Recently, a study on 5 patients [Holbrook et al.: J Allergy Clin Immunol 2013;132:1219-1220] documented the efficacy of the intravenous administration of ondansetron in children with acute symptoms due to food protein-induced enterocolitis syndrome (FPIES). We report on the experience at our institution using ondansetron during oral food challenge (OFC) in 5 children affected by FPIES. In all 5 cases, the use of intramuscular ondansetron led to a complete and rapid resolution of symptoms within 15 min. Intramuscular administration, without the need for intravenous access for an infusion or steroid administration, enables this therapy to be easily performed, even at home (i.e. out of a hospital setting). A home treatment with ondansetron cannot be considered as an alternative to a medical examination with eventual treatment in hospital, which is advised after any acute episode of FPIES. We consider ondansetron to be very useful in the management of acute FPIES. Further study is required to confirm its efficacy. © 2014 S. Karger AG, Basel

    Sull'attualità del dispositivo della razza.

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    The article proposes a re-reading of W.E.B. Du Bois' The Souls of the Black Folk, focusing on his conceptual contribution to the sociological analysis of the category of “race”. After a brief outline of the intellectual history of this scholar, who for a long time has not been adequately recognised as one of the founders of American sociology, a brief overview of the text under review is offered. It highlights the innovative elements through which Du Bois was able to narrate and analyse the process of transition from slavery to the emancipation of the African American people. The two main analytical concepts developed in the volume are the colour line and double consciousness, to which this contribution pays particular attention to highlight their ability to focus on the processes of social construction of race, in both structural and subjective terms. Finally, we dwell on the relevance of Duboisian thought and the effectiveness of his interpretative perspective to read in a complex and transversal way various phenomena that cross contemporary societies, and specifically Italy, where the social category of race is not always sufficiently taken into consideration

    Chronic food protein-induced enterocolitis syndrome caused by cow's milk proteins passed through breast milk

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    We describe 2 cases of food protein-induced enterocolitis syndrome (FPIES) caused by cow's milk (CM) passed through breast milk. The onset in both cases was characterized by chronic symptoms (regurgitation, colic, diarrhea, failure to thrive); in one patient, two acute episodes due to the direct consumption of CM formula by the infant were also reported. The diagnosis of FPIES through breast milk can be easily overlooked, especially in milder cases. We also discuss some important issues concerning the general management of the disease. In conclusion, (1) the diagnosis of chronic FPIES should be taken into account even in exclusively breast-fed infants who present suggestive symptoms such as persistent regurgitation, small amounts of vomiting, lethargy, failure to thrive, dehydration, diarrhea (sometimes bloody) and abdominal distention. A 2-week maternal elimination diet should be considered even in apparently mild cases. (2) CM seems to be the most frequently reported culprit food. (3) In those cases in which acute FPIES is elicited by the direct consumption of the culprit food in breast-fed infants, maternal diet may be unrestricted

    Specific oral tolerance induction with raw hen's egg in children with very severe egg allergy: A randomized controlled trial

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    To cite this article: Dello Iacono I, Tripodi S, Calvani M, Panetta V, Verga MC, Miceli Sopo S. Specific oral tolerance induction with raw hen's egg in children with very severe egg allergy: A randomized controlled trial. Pediatr Allergy Immunol 2012: 00. ABSTRACT: Background: Treatment of severe egg allergy is avoidance of hen's egg (HE) and carrying self-injectable epinephrine. Specific oral tolerance induction (SOTI) seems a promising alternative treatment. However, some aspects of SOTI are still considered experimental. Methods: We evaluated the efficacy and safety of an original 6-month SOTI protocol in children with very severe HE allergy using raw HE emulsion. Twenty children (age range: 5-11 yr) were randomized equally into a SOTI treatment group and a control group. The treatment group started SOTI and underwent a second challenge 6 months later. Control children were kept on an egg-free diet for 6 months and then underwent a second challenge. Results: After 6 months, 9/10 children of the SOTI group (90%) achieved partial tolerance (at least 10 ml, but <40 ml of raw HE emulsion, in a single dose) and 1 (10%) was able to tolerate only 5 ml (no tolerance). After 6 months, nine control children tested positive to the second challenge at a dose ≤0.9 ml of raw HE emulsion, and one reacted to 1.8 ml (SOTI vs. control group p < 0.0001). All children in the SOTI group had side effects, but no child had a grade 5 reaction according to the Sampson grading. Conclusion: Six months of SOTI with raw HE emulsion resulted in partial tolerance, with regular intake, in a significant percentage of children with severe egg allergy

    Excavations in San Miceli, Sicily

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    In 2014, Andrews University began excavating San Miceli in Sicily in order to offer its students the opportunity to excavate in a site of a different period, Early Christianity. The site had been explored in the late 1800’s. However, many questions were left unanswered and the dating of the finds was questionable due to lack of correct stratigraphy. Thus, the Andrews team has excavated in San Miceli for the last 4 years. This work has rendered additional information for the historical reconstruction of the site and its connections to the surrounding towns. Three fields were opened, A, B, and C. A large building was found in field A; tombs and a baptistery were found in field B; and in field C five rooms were dug and showed a large amount of pottery

    Constipation and cow's milk allergy: A review of the literature

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    The causal association between cow's milk allergy (CMA) and constipation is not well established. Some guidelines describe constipation as a possible symptom of CMA, while others do not mention it. We conducted a literature review and found 10 prospective clinical trials. In all of them, an oral food challenge was performed, and 2 of them were randomized. These studies reported that a cow's milk (CM) protein-free diet has a beneficial effect on constipation, with a rate of successful outcomes ranging from 28 to 78%. The hypothetic pathogenic mechanism lies in increased anal pressure at rest, probably caused by allergic inflammation of the internal sphincter area due to mucosal eosinophil and mast cell infiltration. Eighty percent of patients reach tolerance within 1 year after the diagnosis of CMA-related constipation. We believe that a CM-free diet for 2-4 weeks should be proposed for children with chronic functional constipation, even if it is not severe or resistant to laxatives. © 2014 S. Karger AG, Basel
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