Corrigendum: Protocol for a prospective multicenter longitudinal randomized controlled trial (CALIN) of sensory-tonic stimulation to foster parent child interactions and social cognition in very premature infants

[This corrects the article DOI: 10.3389/fped.2022.913396.].

[Crisis consultations in child and adolescent psychiatry in Reims: Cross-sectional study of the population of accompanied minors]

INTRODUCTION

The crisis consultation unit (CCU) of the child psychiatry department of the Reims University Hospital was created to respond to an increasing demand for rapid interventions with minors.

OBJECTIVE

The objective of this study is to observe the characteristics of the population received in this facility and to explore the links between the data, to hypothesize about its specificities.

METHOD

We conducted a cross-sectional study of data collected during telephone assessments between June 2016 and January 2018. A univariate analysis was performed using EpiInfo© software and the pvalue.io© statistical interface using R statistical software. A total of 263 telephone contacts were counted.

RESULTS

A greater activity of the service is found during the school period. The majority of minors did not have any psychiatric or psychological follow-up at the time of the call. Boys consulted earlier, preferably for externalized disorders. The youngest children are often referred to prevent symptoms following an acute stress.

CONCLUSION

Our study allowed us to draw up a sociodemographic profile and to show certain trends observed within the CCU of the child psychiatry department of the Reims University Hospital, in particular the multiplicity of reasons for consultation. At a time when the health crisis is impacting the mental health of the entire population and increasing the time required for treatment, this type of system is particularly relevant to the possible reorganization of the care offered by the CMP. The CCU would make it possible to report the most urgent situations, which would then benefit from specific care (hospitalization, medication, specific consultations).

Protocol for a prospective multicenter longitudinal randomized controlled trial (CALIN) of sensory-tonic stimulation to foster parent child interactions and social cognition in very premature infants

Introduction

Premature birth is associated with long-term somatic and neurological disorders, including cognitive, social and behavioral impairments. Moreover, the mothers of infants born preterm exhibit a higher prevalence of anxiety and depressive symptoms after birth. Early rehabilitation, developmental care, and parenting support have already been shown to have a positive impact on neurological outcome. However, no randomized controlled study has so far assessed the effects on parenting and long-term neurological outcomes of proprioceptive stimulation to trigger positive brain plasticity in very preterm babies. The CALIN project will therefore investigate the impact of sensory-tonic stimulation (STS) of extremely preterm infants by their parents on child parent interactions, infants' morphological and functional brain development and subsequent cognition (including social cognition), and parents' anxiety and depressive symptoms in the postpartum period.

Methods and analysis

Infants born between 25 and 32 weeks of gestation will be randomly assigned to the "STS + Kangaroo care" or "Kangaroo care" group. The primary endpoint, child and parent interactions, will be rated at 12 months corrected age using the Coding Interactive Behavior system. Secondary endpoints include: 1/functional and anatomical brain maturation sequentially assessed during neonatal hospitalization using electroencephalogram (EEG), amplitude-integrated EEG (aEEG), cranial ultrasound and MRI performed at term-corrected age, 2/social and cognitive outcomes assessed at 15 months, 2, 4 and 6 years, and 3/parents' anxiety and depressive symptoms assessed at 7 ± 1 weeks after birth, using dedicated questionnaires.

Ethics and dissemination

This study was approved by the French Ethics Committee for the Protection of Persons on 18 October 2021. It is registered with the French National Agency for the Safety of Medicines and Health Products (ANSM; no. 2020-A00382-37). The registry number on ClinicalTrials.gov is NCT04380051.

Prevalences and predictive factors of maternal trauma through 18 months after premature birth: A longitudinal, observational and descriptive study

Posttraumatic reactions are common among mothers of preterm infants and can have a negative influence on their quality of life and lead to interactional difficulties with their baby. Given the possible trajectories of posttraumatic reactions, we hypothesized that prevalences of postpartum posttraumatic reactions at given times underestimate the real amount of mothers experiencing these symptoms within 18 months following delivery. Additionally, we examined whether sociodemographic and clinical characteristics of dyads influence the expression of posttraumatic symptoms among these mothers. A sample of 100 dyads was included in this longitudinal study led by 3 french university hospitals. Preterm infants born before 32 weeks of gestation and their mothers were followed-up over 18 months and attended 5 visits assessing the infants’ health conditions and the mothers’ psychological state with validated scales. Fifty dyads were retained through the 18 months of the study. The period prevalence of posttraumatic reactions was calculated and a group comparison was conducted to determine their predictive factors. Thirty-six percent of the mothers currently suffered from posttraumatic symptoms 18 months after their preterm delivery. The 18 months period prevalence was 60.4% among all the mothers who participated until the end of the follow-up. There was a statistical link between posttraumatic symptoms and a shorter gestational age at delivery, C-section, and the mother’s psychological state of mind at every assessment time. Only a small proportion of mothers were receiving psychological support at 18 months. Preterm mothers are a population at risk of developing a long-lasting postpartum posttraumatic disorder, therefore immediate and delayed systematic screenings for posttraumatic symptoms are strongly recommended to guide at-risk mothers towards appropriate psychological support.

Impact of Executive Functions and Parental Anxiety on the Development of Social Cognition in Premature Children: A Cross-Sectional Case-Control Protocol

Background: Recent research has identified neuropsychological disorders, specifically executive function disorders, in premature children. Executive functions support goal-oriented mental activity and play a role in the development of social cognition. This underlies the social and emotional behavior of individuals. Parental anxiety is also an important environmental factor that can influence the psycho-emotional development of children. Objectives: The present protocol aims to compare the development of social cognition in school-age children born prematurely to that of school-age children born full-term, and to determine the impact of executive (dys)function and parental anxiety on such development. Methods/Design: In this cross-sectional protocol, 28 prematurely born children aged 7-10 years ("preterm") and 28 full-term born children aged 7-10 years ("control") will be included. The "preterm" and "control" groups will be matched for sex and age. The neuropsychological evaluation will include that of non-verbal intellectual efficiency (Raven's colored progressive matrices), verbal level (WISC-IV subtests), and executive functions (NEPSY II subtests and the opposite worlds of TEA-CH). The evaluation of social cognition will be conducted via tests of the theory of cognitive and affective mind. Several dimensions of the level of parental anxiety will be collected through the Spielberg Trait Anxiety Inventory Form Y, Beck Depression Inventory, Social Support Questionnaire-6, Parental Stress Index and, specifically for mothers, the Modified Perinatal Post-Traumatic Stress Disorder Questionnaire. Discussion: The results of this protocol will aid our understanding of the development of social cognition in premature children and to determine the factors that influence such development. This clinical research project, although following a fundamental approach, will have clinical implications because a more precise description of the development of social cognition in this school-age population will make it possible to better determine the cognitive targets of therapeutic actions and to search for predictive indices of the efficacy of practices. Trial Registration:https://clinicaltrials.gov/ct2/show/NCT03007095, identifier: NCT03007095.

Pregnancy denial and early infant development: a case-control observational prospective study

Background

The denial of pregnancy is the non-recognition of the state of the current pregnancy by a pregnant woman. It lasts for a few months or for the whole pregnancy, with generally few physical transformations. In this study, we will consider the denial of pregnancy as a late declaration of pregnancy (beyond 20 weeks of gestation) as well as a lack of objective perceptions of this pregnancy. The main objective of this study is to explore the relationship between pregnancy denial and the development of the infant (attachment pattern of the infant, early interactions of mother-infant dyads, and early development of the infant).

Methods

The design is a case-control prospective study, which will compare two groups of mother-infant dyads: a “case” group with maternal denials of pregnancy and a “control” group without denials of pregnancy. A total of 140 dyads (mother + infant) will be included in this study (70 cases and 70 controls) and followed for 18 months. The setting is a national recruitment setting with 10 centers distributed all over France. The follow-up of the “cases” and the “controls” will be identical and will occur over 5 visits. It will include measures of the infant attachment pattern, the quality of early mother-infant interaction and infant development.

Discussion

This study aims to examine the pathogenesis of pregnancy denial as well as its consequences on early infant development and early mother-infant interaction.

Trial registration

Clinical Trial Number: NCT02867579 on the date of 16 August 2016 (retrospectively registered).

Frequency and clinical impact of CDKN2A/ARF/CDKN2B gene deletions as assessed by in-depth genetic analyses in adult T cell acute lymphoblastic leukemia

Recurrent deletions of the CDKN2A/ARF/CDKN2B genes encoded at chromosome 9p21 have been described in both pediatric and adult acute lymphoblastic leukemia (ALL), but their prognostic value remains controversial, with limited data on adult T-ALL. Here, we investigated the presence of homozygous and heterozygous deletions of the CDKN2A/ARF and CDKN2B genes in 64 adult T-ALL patients enrolled in two consecutive trials from the Spanish PETHEMA group. Alterations in CDKN2A/ARF/CDKN2B were detected in 35/64 patients (55%). Most of them consisted of 9p21 losses involving homozygous deletions of the CDKNA/ARF gene (26/64), as confirmed by single nucleotide polymorphism (SNP) arrays and interphase fluorescence in situ hybridization (iFISH). Deletions involving the CDKN2A/ARF/CDKN2B locus correlated with a higher frequency of cortical T cell phenotype and a better clearance of minimal residual disease (MRD) after induction therapy. Moreover, the combination of an altered copy-number-value (CNV) involving the CDKN2A/ARF/CDKN2B gene locus and undetectable MRD (≤ 0.01%) values allowed the identification of a subset of T-ALL with better overall survival in the absence of hematopoietic stem cell transplantation.

PDD-NOS, psychotic features and executive function deficits in a boy with proximal 22q11.2 microduplication: Evolution of the psychiatric symptom profile from childhood to adolescence

22q11.2 microduplication (22q11.2DupS) is associated with a broad spectrum of phenotypes, including normality. Psychiatric disorders are described in 13% of these patients, including Attention Deficit and Hyperactivity Disorder (ADHD), Intellectual Deficiency (ID), and Autism Spectrum Disorder (ASD), but not schizophrenia. We report changes in the psychiatric symptom profile in the course of development of a young boy with a 22q11.2DupS syndrome, from early childhood to adolescence. The boy's psychiatric presentation was characterized by features of Pervasive Developmental Disorder (PDD), with ADHD in early childhood, a single psychotic episode in mid-infancy, and executive impairment in adolescence. We discuss the importance of an in-depth assessment of cognitive functions in children with22q11.2DupS throughout their development.

Ground penetrating radar: a case study for estimating root bulking rate in cassava (Manihot esculenta Crantz)

BACKGROUND

Understanding root traits is a necessary research front for selection of favorable genotypes or cultivation practices. Root and tuber crops having most of their economic potential stored below ground are favorable candidates for such studies. The ability to image and quantify subsurface root structure would allow breeders to classify root traits for rapid selection and allow agronomist the ability to derive effective cultivation practices. In spite of the huge role of Cassava (Manihot esculenta Crantz), for food security and industrial uses, little progress has been made in understanding the onset and rate of the root-bulking process and the factors that influence it. The objective of this research was to determine the capability of ground penetrating radar (GPR) to predict root-bulking rates through the detection of total root biomass during its growth cycle. Our research provides the first application of GPR for detecting below ground biomass in cassava.

RESULTS

Through an empirical study, linear regressions were derived to model cassava bulking rates. The linear equations derived suggest that GPR is a suitable measure of root biomass (r = .79). The regression analysis developed accounts for 63% of the variability in cassava biomass below ground. When modeling is performed at the variety level, it is evident that the variety models for SM 1219-9 and TMS 60444 outperform the HMC-1 variety model (r² = .77, .63 and .51 respectively).

CONCLUSIONS

Using current modeling methods, it is possible to predict below ground biomass and estimate root bulking rates for selection of early root bulking in cassava. Results of this approach suggested that the general model was over predicting at early growth stages but became more precise in later root development.

Cardiac risk stratification in elective non-cardiac surgery: role of NT-proBNP

AIM

The aim of the study was to investigate the utility of NT-proBNP measurement for the stratification of presurgical cardiac risk.

METHODS

Cardiac risk before elective non-cardiac surgery was evaluated in 82 consecutive patients. From each patient a venous blood sample was drawn to determinate NT-proBNP levels. Patients were followed up over three months in order to detect the occurrence of cardiac adverse events.

RESULTS

NT-proBNP was positively correlated (P<0.0001) with age, days of hospitalization (P=0.001) and ASA class (P=0.001). High surgical risk (P<0.0001), diabetes (P=0.004), dyslipidemia (P=0.006) and elevated levels of NT-proBNP (P<0.0001) were significantly correlated with events. Using a logistic regression analysis we found an independent association between pre-operative elevated NT-proBNP and postoperative cardiac events (OR 1.2, 95% CI 1.0-1.4, P=0.01).

CONCLUSION

Measuring NT-proBNP before non cardiac surgery in clinical practice could be useful to better stratify patients' risk.

Ongoing rubella outbreak in Bosnia and Herzegovina, March-July 2009--preliminary report

Between 24 March and 31 July 2009, 342 clinically diagnosed cases of rubella were notified in five municipalities in Republika Srpska, Bosnia and Herzegovina. Fourteen cases were laboratory-confirmed by positive IgG against rubella virus. Four virus isolates were obtained and identified as genotype 2B strains, with one isolate differing by a single mutation in the region of the E1 gene. This ongoing outbreak revealed gaps in the immunisation programme during the war in BiH (1992-1995) and highlights the need to revise legislation to permit immunisation of children above 14 years of age with measles, mumps, rubella (MMR) vaccine and to introduce supplemental immunisation activities.

[Home versus inpatient therapy for deep venous thrombosis. A cost-comparative analysis]

AIMS

To compare the home-care management of deep vein thromboses (DVT) by a Home Care Unit (HCU) respect to conventional inpatient treatment.

METHODS

Twenty-one patients with a doppler-ecography diagnosis of DVT were managed by the HCU during 2002. In 7 out 13 a concomitant diagnosis of pulmonary embolism (PE) was made by lung scan. Median age was 81 years, 52% were women and all, except one case, showed severe medical concomitant conditions. All patients received low-weight molecular heparin, followed by oral anticoagulants in 3 patients. No patients died and only one was hospitalized briefly due to a poor thrombosis-related pain control. Costs of this patient were added to those of HCU. A comparison was made between ambulatory and hospitalary costs for EP and DVT. Pharmacological treatment costs were calculated for a 10-days period.

RESULTS

The length of inhospital stay was 1 day for HCU vs. 8 days (DVT) and 13 days (EP). There was a estimated cost-saving of 1680 per patient.

CONCLUSIONS

The management of DVT in patients with serious conditions, can be accomplished safely and in a cost-saving manner by a Home Care Unit.

Long-term storage at -80 degrees C of hematopoietic progenitor cells with 5-percent dimethyl sulfoxide as the sole cryoprotectant

BACKGROUND

Hematopoietic progenitor cells (HPCs) can be cryopreserved and stored below -120 degrees C in liquid nitrogen or at -80 degrees C in mechanical freezers.

STUDY DESIGN AND METHODS

The feasibility of long-term storage of HPCs at -80 degrees C was investigated. The studies included a comparison of 5- and 10-percent dimethyl sulfoxide (DMSO) as cryoprotectant at various lengths of storage time. Mononuclear cell (MNC) recovery and viability and colony-forming unit-granulocyte-macrophage (CFU-GM) and burst-forming unit-erythroid (BFU-E) recovery assays were performed. The peripheral blood HPCs of 24 consecutive patients included in the program of autologous transplantation were studied.

RESULTS

The MNC viability decreased progressively with the length of time from cryopreservation, reaching 32 percent after 31 months of storage. The recovery rates of CFU-GM and BFU-E also decreased progressively with the duration of frozen storage, to 50 and 43.5 percent, respectively, after 12 months and to 0 percent (both) after 24 months. At 6 months of storage, MNC viability was 80 percent, and CFU-GM and BFU-E recovery was 63.5 and 80.5 percent, respectively. There were no differences between MNCs cryopreserved with 5- or 10-percent DMSO in terms of cell viability. There were no differences between CFU-GM recovery or BFU-E recovery from HPCs cryopreserved in 5- or 10-percent DMSO. Patients given HPCs stored in these conditions for periods ranging between 123 and 202 days showed a complete and rapid hematologic recovery.

CONCLUSION

HPCs can be cryopreserved at -80 degrees C with 5-percent DMSO and stored at -80 degrees C no longer than 6 months. A 5-percent DMSO concentration is comparable to a with 10-percent concentration in terms of recovery and MNC viability.

Ovulation induction with pulsatile GnRH in a patient with anovulation of hypothalamic origin and central diabetes insipidus

Patients with diabetes insipidus (DI) are at high risk for dehydration, hypernatremia and hemodynamic instability. Ovarian hyperstimulation syndrome (OHSS) likewise has negative effects on electrolyte balance. If ovulation induction is required in a patient with DI, there is thus a strong argument for avoiding techniques that increase the risk of OHSS. This paper reports the results of ovulation induction in a patient with anovulation of hypothalamic origin and central (vasopressin deficit) DI. Ovulation was induced with pulsatile gonadotropin-releasing hormone (GnRH), which induces single-ovule cycles and which does not increase the risk of OHSS. The patient successfully achieved pregnancy after seven ovulatory cycles.

Cefminox versus Cefoxitin in Hysterectomy Prophylaxis : Clinical Efficacy and Serum and Tissue Concentrations

This phase III, prospective, randomised, open, controlled clinical trial compared the efficacy of single-dose cefminox (2g) versus triple-dose cefoxitin (2g every 4 hours) as antibiotic prophylaxis in 112 women undergoing gynaecological surgery (vaginal or abdominal hysterectomy). Peak, intraoperative and trough serum concentrations were determined for both antibiotics, as well as their concentrations in myometrial tissue in a subset of patients from the study (22 patients from the cefminox group and 18 from the cefoxitin group). Clinical response was satisfactory in all women treated with cefminox (59 of 59) and in 52 of 53 patients treated with cefoxitin. Fever-related morbidity, hospital stay and adverse reactions were similar in both groups. Peak serum concentrations were 132.3 mg/L for cefminox and 82.2 mg/L for cefoxitin. 12-hour concentrations were 2.82 mg/L for cefminox and 2.17 mg/L for cefoxitin, and were higher than the respective minimum inhibitory concentrations (MICs) for pathogens commonly associated with this pathology. Uterine tissue concentrations were 24.5 and 41.6 mg/L for cefminox and cefoxitin, respectively, and also clearly exceeded MIC. It was shown that the use of a single preoperative dose of cefminox was similar in efficacy to 3 doses of cefoxitin administered every 4 hours, and that the serum and tissue concentrations attained provide adequate antibiotic coverage. In view of the general trend towards the use of a single dose for prophylaxis, cefminox offers a new alternative for antibiotic prophylaxis in gynaecological surgery.

Long-term administration of pulsatile gonadotropin-releasing hormone for exploration of pituitary functionality in amenorrheic patients

Differentiation between hypothalamic and pituitary amenorrhea is generally based on the luteinizing hormone-releasing hormone (LHRH) test (whether as a single dose, two consecutive doses, or pulsatile over 5-10 days), together with high-resolution imaging (computed tomography or magnetic resonance) of the sellar region. Long-term administration of gonadotropin-releasing hormone (GnRH) is generally used only for ovulation induction, and not for diagnostic purposes. Here, we report the results of long-term administration of GnRH to 19 women initially diagnosed as suffering from hypothalamic amenorrhea on the basis of LHRH testing and computed tomography imaging. During treatment, subjects received 20-micrograms pulses of GnRH every 90 min, subcutaneously from a portable infusion pump. Fourteen subjects responded (i.e. ovulated) during the first treatment cycle; one subject menstruated but did not ovulate during the first cycle, and the dropped out of the study; the remaining four subjects did not ovulate or menstruate despite at least three treatment cycles. Magnetic resonance imaging of the sellar region of these four subjects revealed pituitary lesions (partially empty sella in three cases, microadenoma in one case) which had not been detected by computed tomography. By contrast, no such abnormalities were detected in the nine responders who agreed to undergo magnetic resonance imaging. These findings suggest that long-term administration of GnRH is of value not only for ovulation induction but also for diagnostic purposes. Specifically, an initial diagnosis of hypothalamic amenorrhea is confirmed if there is a positive ovulation response after two GnRH treatment cycles; otherwise, pituitary amenorrhea should be suspected. Our results also suggest that magnetic resonance imaging is more effective than computed tomography for the detection of partially empty sella.

Analysis of compliance with oral contraception in Spain

OBJECTIVE

The study was designed to analyze factors related to compliance in oral hormonal contraception in Spain.

METHOD

A review study and a multicenter analysis of experience of compliance by 300 doctors, by means of a questionnaire and discussion about the determinants of contraceptive use.

RESULTS

Compliance is a major problem in Spain, being influenced mainly by side-effects, the general perception of the method and personal factors. The different factors involved in non-compliance in Spain were analyzed, with regard to the perspective of the professionals.

CONCLUSIONS

Strategies to improve compliance in Spain aim mainly at improving the general perception of the method and the accessibility of family planning centers. Factors associated with compliance are still not well known in our country. Better knowledge of the determinants of non-compliance in Spain is needed. For this purpose, another research group was formed to conduct a national study among women.

A simplified method for cryopreservation of hematopoietic stem cells with -80 degrees C mechanical freezer with dimethyl sulfoxide as the sole cryoprotectant

A simplified method for cryopreservation was developed with 10% dimethylsulfoxide (DMSO) as the sole cryoprotectant without rate-controlled freezing. This method produced high recovery rate for mononucleated cells (87%) and elevated trypan blue viability (90%). Autologous peripheral blood stem cells (PBSCs) and bone marrow cells with plasma and 10% DMSO were frozen and stored in a -80 degrees C mechanical freezer. Eleven patients with solid and hematological malignancies were transplanted with autologous bone marrow or PBSCs. The median number of infused mononuclear cells (MNC) and CD34+ cells were 3.63 x 10(8)/Kg and 4.80 x 10(6)/Kg, respectively. The median number of infused post-thawing CFU-GM was 20 x 10(4)/Kg. All patients showed a rapid and sustained engraftment. The mean times to reach a neutrophil count of 0.5 x 10(9)/L and a platelet count of 50 x 10(9)/L were 11 and 13 days, respectively. All patients are alive and 10 in unmaintained complete remission for 3-9 months after transplantation. These results show the efficacy of this simplified cryopreservation technique that will be useful for institutions without rate-controlled freezing facilities.

[Prophylaxis with ciprofloxacin in postchemotherapy neutropenia in acute myeloid leukemia]

BACKGROUND

Infection is the most frequent complication in patients with acute myeloid leukemia (AML) following chemotherapy. The new quinolones, among which ciprofloxacin may be found, seem to be effective in the prophylaxis of this complication.

METHODS

Fifty consecutive episodes of neutropenia were studied in patients with AML who received prophylaxis with ciprofloxacin and these were compared with a historic control group of another 50 consecutive episodes of neutropenia in AML patients who did not receive antibiotic prophylaxis. The difference with regard to the prevalence of infection and the characteristics of the same were studied.

RESULTS

Ciprofloxacin significantly decreased the number of febrile episodes following chemotherapy of induction or consolidation with respect to those who did not receive prophylaxis (68% versus 94%; p = 0.002). Likewise, the patients who received ciprofloxacin presented fewer bacteriologically documented infections (26% versus 50%; p = 0.023), bacteremias (10 versus 25, p = 0.03) and infections produced by Gram negative microorganisms (2 versus 13, p = 0.009). Ciprofloxacin led to disappearance of the infections produced by Pseudomonas aeruginosa. Delay in the development of infection was observed in patients who received ciprofloxacin (mean: 11 days, CI: 7-15 days) with respect to those who did not receive prophylaxis (mean: 6 days, CI: 4-6 days) (p = 0.0001).

CONCLUSIONS

Ciprofloxacin is an effective antibiotic in the prevention of infection in episodes of neutropenia after induction or consolidation chemotherapy in patients with acute myeloid leukemia. Not only does it decrease the number of febrile episodes, bacteriologically documented infections, bacteremias and infections produced by Gram negative microorganisms, but it also delays the appearance of the febrile episodes.

Progesterone challenge test for the assessment of endometrial pathology in asymptomatic menopausal women

The progesterone challenge test was correlated with endometrial pathology in 130 asymptomatic menopausal women without hormonal treatment. The sensitivity of the test for detection of endometrial proliferative activity was 76%, specificity 100%, positive predictive value 100% and negative predictive value 94.1%. A 10-day test provided better results than a 5-day test. The test seems useful for detection of those at high risk for endometrial cancer.

Rain and throughfall chemistry in a Norway spruce forest in the Western Prealps

From January 1987 to December 1989 precipitation was collected in an open field in a forested area of the Western Prealps. The site faces the intensely industrialized area of the Po Valley. In a Norway spruce plantation, next to the open field sampler, throughfall was collected from January 1987 to August 1989 for a period of 32 months. In the common sampling period median pH values of the open field precipitation and throughfall were 4.28 and 4.19 respectively. Open field precipitation has yearly deposition rates of acidity, Ca, S, and N of 0.81, 9.82, 24.83 and 32.81 kg/ha(-1) respectively. The throughfall showed significant increases in the deposition rates for Ca, Mg, K, N and S, due to abundant dry deposition and, probably, to nutrient leaching contributed by the canopies of the spruce. On the basis of available data, an initial approach to atmosphere-canopy interaction was made.

An application of multivariate analysis to acid rain data in Northern Italy to discriminate natural and man-made compounds

This paper presents the preliminary results of a study, the aim of which was to analyse the pluviometric and chemical rain data, recorded by a wet only network located in Northern Italy.More in detail, precipitations were collected on a weekly basis and chemical analysis was performed on pH, electric conductivity and Ca, Mg, Na, K, NH4, NO3, SO4, Cl concentrations.The Principal Components Analysis pointed out that the first three components are enough to explain more than 90% of the variability of the parameters. Moreover each component may have a different physical interpretation, that is the first one is mainly related to the precipitation amount, while the second to the man made and natural sources and the last one to the sea/soil contribution.

Pure squamous carcinoma of the breast. Report of a case diagnosed by aspiration cytology

A case of pure squamous carcinoma of the breast diagnosed by needle aspiration cytology is presented. The three conditions required for that diagnosis were fulfilled: (1) an absence of elements other than malignant epidermoid cells, (2) the independence of the lesion from adjacent dermal structures, and (3) the exclusion of other squamous carcinomas in the patient. Other well-documented cases of this entity are reviewed.

Primary repair of flexor tendons in the hand with early passive mobilization

Flexor tendon injuries in zones I-III in the hand were treated by meticulous suture of the tendons and peritendinous structures, followed by early passive mobilization of the injured fingers, the remaining fingers being kept extended by a plaster splint. This method was used in 51 cut tendons in 38 patients. The functional recovery approached normal in 72%, and only 8% were poor.

Malignant fibrous histiocytoma in a child's hand

A 3-year-old girl had a 4-month history of a tumor in her right hand. The tumor was located in the subcutaneous and soft tissues of the palm and the long, ring, and small fingers. Histologic studies showed a malignant fibrous histiocytoma that was confirmed by the ultrastructural study as having a fibroblastic and histiocytic origin. The long, ring, and small fingers were amputated. The postoperative course was normal, and 18 months later no recurrence or metastases were observed.