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We present a modified laparoscopic ventral mesh rectopexy procedure using biological mesh and bilateral anterior mesh fixation. The rectopexy is anterior with a minimal posterior mobilization. The rectum is symmetrically suspended to the sacral promontory through a mesorectal window. [ABSTRACT FROM AUTHOR]

The neurophysiological instrumental diagnostics is gaining increasingly an undisputed value, revealing an indispensable practice for both diagnostic and prognostic purposes. Many novelties in medicine have introduced an innovative model of Electronic Health, called E-Health. The purpose of this study is to verify that a new modular device, the BluNet®, is a device able to maximize patient comfort and to operate in a way effective but minimally invasive. The study was conducted on a sample of 10 neonates (5F), with gestational ages between the 27 + 6 and 41 weeks, and the recordings were done simultaneously with two devices: NeMus® (gold standard) and BluNet. We made a visual comparison with the reading software, we extracted and compared the frequency of polygraphic channels (ECG and abdominal breathing) and we made two Bland-Altman-Plots. We also conducted a spectral analysis of the traces. The signals’ studies showed that there aren’t substantial differences between the signals acquired through the two different methods. BluNet, thanks to its innovative features, is a valid tool for electroencephalographic evaluation and the prospects for future use are manifold: screening for early differential diagnosis, initial evaluation for possible hospitalization, ability to get tests at home. [ABSTRACT FROM AUTHOR]

Background: Laparoscopic ventral mesh rectopexy (LVR) is gaining wider acceptance as the preferred procedure to correct internal as well as external rectal prolapse associated with obstructed defaecation syndrome and/or faecal incontinence. Very few reports exist on the use of biologic mesh for LVR. The aim of our study was to report the complication and recurrence rate of our first 100 cases of LVR for symptomatic internal rectal prolapse and/or rectocele using a porcine dermal collagen mesh. Methods: Prospectively collected data on LVR for internal rectal prolapse were analysed. Surgical complications and functional results in terms of faecal incontinence (measured with the Faecal Incontinence Severity Index = FISI) and constipation (measured with the Wexner Constipation Score = WCS) at 3, 6 and 12 months were analysed. It was considered an improvement if FISI or WCS scores were reduced by at least 25 % and a cure if the FISI score decreased to <10 and the WCS decreased to <5. Results: Between April 2009 and April 2013, 100 consecutive female patients (mean age 63 years, range 24-88 years) underwent LVR. All patients had internal rectal prolapse (grade III [ n = 25] and grade IV [ n = 75] according to the Oxford classification) and rectocele. Mean operative time was 85 ± 40 min. Conversion rate to open technique was 1 %. There was no post-operative mortality. Overall 16 patients (16 %) experienced 18 complications, including rectal perforation ( n = 1), small bowel obstruction ( n = 2), urinary tract infection ( n = 8), subcutaneous emphysema ( n = 3), wound haematoma ( n = 2), long lasting sacral pain ( n = 1) and incisional hernia (1). Median post-operative length of stay was 2 days. Ninety-eight out of 100 patients completed follow-up. At the end of follow-up, the mean FISI score improved from 8.4 (±4.0 standard deviation (SD) p = 0.003) to 3.3 ± 2.3 SD ( p = 0.04). Incontinence improved in 37 out of 43 patients (86 %), and 31 patients (72 %) were cured. Similarly, the mean WCS score improved from 18.4 ± 11.6 SD to 5.4 ± 4.1 SD ( p = 0.04). Constipation improved in 82 out of 89 patients (92 %), and 70 patients (79 %) were cured. No worsening of continence status, constipation or sexual function was observed. Fourteen patients (14 %) experienced persistence or recurrence of prolapse. Conclusions: LVR using biologic mesh is a safe and effective procedure for improving symptoms of obstructed defaecation and faecal incontinence in patients with internal rectal prolapse associated with rectocele. [ABSTRACT FROM AUTHOR]

A response by M. Pensabene et al to a letter to the editor about their article on BRCA2 Splice site mutations in an Italian breast/ovarian cancer family is presented.

Background: Although most BRCA sequence variants are clearly deleterious and unequivocally pathogenetic, several are still classified as variants of unknown significance. Patients and methods: We followed families undergoing oncogenetic counseling from risk identification to risk definition by genetic testing and risk management. Results: We identified two germline mutations in the BRCA2 gene in a woman with breast and ovarian cancer. One sequence alteration was 859/G>A in exon 7 (V211I). The other second sequence alteration (IVS13-2A>T) affected the splicing site in intron 13. The latter alteration is not yet listed in the Breast Cancer Information Core database. RT–PCR resulted in transcription of a sequence lacking exon 7 and a subsequent anomalous stop codon in exon 9 thereby confirming altered messenger RNA (mRNA) maturation. Amplification of the mutation in intron 13 resulted in transcription of a sequence lacking exon 14 and an anomalous stop codon in exon 15 thereby confirming altered mRNA maturation. Both mutations led to a truncated BRCA2 protein in its carboxy-terminal region. Conclusion: The two BRCA2 mutations identified affect mRNA splicing fidelity and play a pathogenetic role in breast and ovarian cancer. [ABSTRACT FROM AUTHOR]

Studies the management of prurigo gestationis, a type of skin disease, in pregnant women. Oral administration of ion exchange resins; Increase of the transaminases and of the liver alkaline phosphatase; Duration of therapy.