Clinical Significance

Tumour  markers  are  biochemical  indicators  of  the  presence  of  a
tumour, which are selectively produced by the neoplastic tissue and
released into blood or in other body fluids. They are widely accepted
and applied to the management of patients with cancer since the
introduction  of  diagnostic  immunopathology.  Tumour  markers
include  oncofetal  antigens  (AFP),  glycoproteins  (CEA),  placental
proteins  (PLAP),  hormones  (ACTH  and  HCG),  enzymes  (PSA  and
PAP) and other molecular species. Monoclonal antibody technique is
the most commonly used method for identification of specific marker
in  tissue,  urine  or  blood  sample.  Assay  of  various  tumour  markers
can be used for population screening, tumour detection, diagnosis,
staging, prognosis, or follow up of malignant diseases.

Aim and objectives.  The purpose of this study was to investigate open system endotracheal suctioning (ETS) practices of critical care nurses. Specific objectives were to examine nurses’ practices prior to, during and post-ETS and to compare nurses’ ETS practices with current research recommendations.Background.  ETS is a potentially harmful procedure that, if performed inappropriately or incorrectly, might result in life-threatening complications for patients. The literature suggests that critical care nurses vary in their suctioning practices; however, the evidence is predominantly based on retrospective studies that fail to address how ETS is practiced on a daily basis.Design and method.  In March 2005, a structured observational study was conducted using a piloted 20-item observational schedule on two adult intensive-care units to determine how critical care nurses (n = 45) perform ETS in their daily practice and to establish whether the current best practice recommendations for ETS are being adhered to.Results.  The findings indicate that participants varied in their ETS practices; did not adhere to best practice suctioning recommendations; and consequently provided lower-quality ETS treatment than expected. Significant discrepancies were observed in the participants' respiratory assessment techniques, hyperoxygenation and infection control practices, patient reassurance and the level of negative pressure used to clear secretions.Conclusion.  The findings suggest that critical care nurses do not adhere to best practice recommendations when performing ETS. The results of this study offer an Irish/European perspective on critical care nurses’ daily suctioning practices.Relevance to clinical practice.  As a matter of urgency, institutional policies and guidelines, which are based on current best practice recommendations, need to be developed and/or reviewed and teaching interventions developed to improve nurses’ ETS practices, particularly in regard to auscultation skills, hyperoxygenation practices, suctioning pressures and infection control measures.

Background: Exposure to violence perpetrated on a mother by her intimate partner (IPV or intimate partner violence) has an impact on the psychosocial adjustment of her children. In addition, the violence suffered by mothers could affect parental competences. Methods: Through the Child Behavior Checklist (CBCL), this work analyzes the psychosocial adjustment in children between 6 and 17 years old who live with their mothers in shelters after having experienced IPV situations. It also explores the association between mothers’ parenting competences and children’s adjustment in shelters. Results: The evaluation shows a negative correlation between the quality of mothers’ care of their children during their stay in shelters and the rate of children’s behavioral problems, so that the better the parental competences of mothers, the lower the rate of behavioral problems presented by children. Conclusions: As a result of IPV, mother–child relationships can be affected. Children exposed to IP...

OBJECTIVE: The tendons of the extensor carpi radialis longus and brevis muscles are quite useful in tendon transfer, such as in correction of finger clawing and restoration of thumb opposition. Knowledge of additional radial wrist extensor muscle bellies with independent tendons is useful in the above-mentioned surgical procedures. METHODS: The skin, subcutaneous tissue, and antebrachial fascia of 48 (24 on the right side and 24 on left side) male upper limb forearms were dissected. The following aspects were then analyzed: (a) the presence of additional muscle bellies of radial wrist extensors, (b) the origin and insertion of the additional muscle, and (c) measurements of the muscle bellies and their tendons. RESULTS: Five out of 48 upper limbs (10.41%) had additional radial wrist extensors; this occurred in 3 out of 24 left upper limbs (12.5%) and 2 out of 24 right upper limbs (8.3%). In one of the right upper limbs, two additional muscles were found. The length and width of each additional muscle belly and its tendon ranged between 2 - 15cm by 0.35 - 6.4cm and 2.8 - 20.8cm by 0.2 0.5cm, respectively. The additional radial wrist extensor tendons in our study basically originated either from the extensor carpi radialis longus or brevis muscles and were inserted at the base of the 2nd or 3rd metacarpal bone. CONCLUSION: The present study will inform surgeons about the different varieties of additional radial wrist extensors and the frequency of their occurrence.

Il contributo di Agnoli e Furlan (questo numero) ha chiarito bene che le misure di significatività clinica o pratica possono essere definite solo entro il contesto a cui si riferiscono. Un conto ad esempio è riferirsi a percentuali di infarti evitati dove anche un 1% di differenza può avere un alto valore pratico con importanti ripercussioni sulle politiche sanitarie, altra cosa è parlare di una riduzione dell'1% degli errori di ortografia in prima elementare, dove al massimo si può parlare di modesto miglioramento. È chiaro quindi che i concetti di guarigione e miglioramento e ...

Over the last several years, research has increasingly focused on how to meaningfully characterize treatment outcome, with different terminologies emerging. In the psychotherapy and behavioral assessment research, clinical significance has emerged as the dominant term to describe the assessment of meaningful change due to treatment, whereas for certain psychiatric disorders remission is the term most commonly used to represent the posttreatment assessment of clinically meaningful change. In the treatment of major depressive disorder, these two constructs exhibit parallels in terms of methodology and conceptual themes, though the two lines of outcomes research using these terms have proceeded along largely isolated paths with little acknowledgment of their shared concerns. With a particular focus on the depression literature, this review summarizes the features, concepts, and debates common to both outcome constructs, and suggests future research on these methods that are used to define meaningful treatment outcome.