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Background: Patient diaries are a supportive intervention aiding intensive care unit (ICU) survivors and their families post‐critical illness. Despite their growing acceptance, ICU diary usage varies across settings. Aim: This study explored themes in nurse‐written ICU diaries and their impact on nursing work and communication. Study Design: This qualitative study employed an interpretative narrative methodology to explore the experiences of ICU nurses. The narrative approach enabled the synthesis of diverse events and impressions into coherent stories, facilitating a deeper understanding of participants' perspectives. Data collection involved thematic analysis of diaries following Braun and Clarke's methodology. The analysis included familiarization, coding, theme identification and validation by the research team. The findings were reviewed by participants and translated into English using the WHO's cultural adaptation guidelines, ensuring reliability and credibility in the study's outcomes. Results: The sample consisted of 28 ICU nurses, each with professional experience ranging from 1 to 23 years. The hospitalized subjects for whom our sample wrote the diary consist of 13 participants aged 23–79 years. Two main themes emerged from the analysis: (1) simplifying the intensive care situation with specific minimization strategies and (2) attention to nonverbal communication. Conclusions: This study highlights the role of nurse‐written ICU diaries in making the ICU environment more understandable and less intimidating for patients. Nurse‐written ICU diaries contribute to improved communication and emotional support within the ICU environment. Further research is needed to explore these effects more fully and to assess the broader implications of ICU diaries on patient outcomes. Relevance to Clinical Practice: Nurse‐written intensive care unit (ICU) diaries have a significant impact on both patient care and nursing practice in ICUs. ICU diaries serve as a crucial tool for enhancing communication, emotional support and empathetic care within these high‐stress environments. By simplifying complex medical information and focusing on nonverbal communication, nurses can make the ICU experience more comprehensible and less intimidating for patients. This approach reduces patient anxiety and psychological stress while fostering a stronger nurse–patient relationship, ultimately improving care quality. [ABSTRACT FROM AUTHOR]

Avoidant/Restrictive Food Intake Disorder (ARFID) and food neophobia present significant challenges in pediatric healthcare, particularly among children with food allergies (FAs). These eating disorders, characterized by the persistent avoidance or restriction of food, can lead to severe nutritional deficiencies and psychosocial impairments. The presence of FAs further complicates these eating behaviors, as the fear of allergic reactions exacerbates avoidance and restrictive patterns. This comprehensive review synthesizes current knowledge on ARFID and food neophobia, focusing on their definitions, characteristics, and the unique challenges they present in the context of FAs. The review explores the critical role of healthcare professionals, especially nurses, in integrating psychological and clinical care to improve outcomes for affected children. A multidisciplinary approach, including Cognitive Behavioral Therapy (CBT) and Family-Based Therapy (FBT), is emphasized as essential in addressing the complex needs of these patients. The review also highlights the need for standardized treatment protocols and further research on the long-term outcomes of these disorders, aiming to enhance therapeutic strategies and family support systems. Effective management of ARFID and food neophobia in the context of FAs requires a holistic and integrated approach to mitigate the profound impacts on a child's growth, development, and overall well-being. [ABSTRACT FROM AUTHOR]

Aims and Objectives: This review aims to analyze the effectiveness of motivational interviewing (MI) in enhancing therapeutic adherence and compliance in adult patients with inflammatory bowel disease (IBD), especially considering the disruptions caused by the COVID-19 pandemic. Background: IBD, which includes conditions such as ulcerative colitis and Crohn's disease, affects over 10 million people globally. It significantly impacts both physical and psychological well-being, leading to challenges in therapeutic adherence. Only 25–47% of patients with IBD adequately follow prescribed treatments. Design and Methods: An integrative methodology that combines qualitative and quantitative research was utilized, following a 7-step framework. This framework encompasses identifying the research question, devising a search strategy, performing a critical appraisal, summarizing findings, extracting data, conducting an analysis, and drawing conclusions. Results: Poor adherence to therapy among patients with IBD can exacerbate disease progression and result in complications. MI has been identified as a promising approach to improving both adherence and treatment outcomes. Studies, including those predating the COVID-19 pandemic, have demonstrated MI's effectiveness in enhancing adherence among patients with IBD. Conclusions: MI shows promise in enhancing adherence among adult patients with IBD. Although initial results are promising, additional research is needed to thoroughly understand its effectiveness across various clinical contexts. Relevance to Clinical Practice: The findings underscore the potential of MI as an integral component of IBD treatment strategies, suggesting that its implementation could enhance patient–provider interactions and lead to better overall health outcomes. [ABSTRACT FROM AUTHOR]

Background: Acute respiratory distress syndrome (ARDS) presents a significant challenge in critical care settings, characterized by compromised gas exchange, necessitating in the most severe cases interventions such as veno-venous extracorporeal membrane oxygenation (vv-ECMO) when conventional therapies fail. Critically ill ARDS patients on vv-ECMO may experience several complications. Limited data exist comparing complication rates between COVID-19 and non-COVID-19 ARDS patients undergoing vv-ECMO. This retrospective observational study aimed to assess and compare complications in these patient cohorts. Methods: We retrospectively analyzed the medical records of all patients receiving vv-ECMO for ARDS between March 2020 and March 2022. We recorded the baseline characteristics, the disease course and complication (barotrauma, bleeding, thrombosis) before and after ECMO cannulation, and clinical outcomes (mechanical ventilation and ECMO duration, intensive care unit, and hospital lengths of stay and mortalities). Data were compared between COVID-19 and non-COVID-19 patients. In addition, we compared survived and deceased patients. Results: Sixty-four patients were included. COVID-19 patients (n = 25) showed higher rates of pneumothorax (28% vs. 8%, p = 0.039) with subcutaneous emphysema (24% vs. 5%, p = 0.048) and longer non-invasive ventilation duration before vv-ECMO cannulation (2 [1; 4] vs. 0 [0; 1] days, p = <0.001), compared to non-COVID-19 patients (n = 39). However, complication rates and clinical outcomes post-vv-ECMO were similar between groups. Survival analysis revealed no significant differences in pre-vv-ECMO complications, but non-surviving patients had a trend toward higher complication rates and more pleural effusions post-vv-ECMO. Conclusions: COVID-19 patients on vv-ECMO exhibit higher pneumothorax rates with subcutaneous emphysema pre-cannulation; post-cannulation complications are comparable to non-COVID-19 patients. [ABSTRACT FROM AUTHOR]

Background and Aim: Obtaining, positioning and managing intravenous access is complex but common procedure in nursing care practice. Learning the right knowledge and skills during basic nurse education is an essential goal. The use of simulators allows for a better acquisition of skills, guaranteeing safety for patients and nursing students. However, the literature is still lacking on the use of simulation for intravenous cannulation procedures and device management, presenting few conflicting results. The aim of this study was to examine the effect of simulator-based learning on vascular access management in a population of nursing students., Methods: Using comparative observational study design we evaluated the effect of simulator learning on vascular access management in a nursing student population., Results: The differences between the scores at t1 between the groups of students are significant for obtaining vascular access with relative management of the device and intravenous therapy (t = 3.062, p = 0.001), while at t0, albeit with strong differences in scores means (t = 0.061, p = 0.871) are not statistically significant. Early use of the simulator is also fundamental over time (t = 5.362, p = 0.001). Furthermore, the satisfaction noted by the students during the clinical simulations improves with the increase in the number of the same, as it can influence the single performance., Conclusions: Nursing training based on the use of simulators favors a better acquisition of skills compared to traditional didactic.

Numerous fasciotomy techniques have been proposed for the treatment of chronic exertional anterior compartment syndrome. In this work we evaluate the efficacy of a personal surgical technique whereby the fasciotomy is performed through a small cutaneous incision using endo mini-shears. From 2004 to 2006 19 patients, all professional skaters, were submitted to bilateral fasciotomy (38 legs). No complications were observed. Only two patients used pain-killers. In the follow-up (12 months), resumption of competitive activity was achieved by the fourth week in 63.2% of cases (12 patients), by the fifth week in 26.3% (5 patients), and by the sixth week in 10.5% (2 patients). All patients achieved sporting performance comparable to that present before the onset of symptoms. There were no recurrences. This technique is relatively simple to perform, is easily repeatable, does not require a long learning curve, is practically complication-free, and is characterised by a virtually painless postoperative course.

Local transanal excision as primary treatment of rectal and anal canal adenomas in selected patients is supported by the recent literature. Sixteen patients with low rectal or anal canal neoplastic polyps underwent transanal resection. Postoperatively, 5 patients (31.25%) had complications, consisting in 2 cases of bleeding (12.5%) and 3 of urine retention (18.75%). Histologically, 2 were tubular adenomas without atypia (12.5%), 3 were tubulo-villous adenomas with moderate atypia (18.75%), 8 were tubulo-villous adenomas (50%) with severe atypia, 2 were tubulo-villous adenomas with locally invasive foci of adenocarcinoma (12.5%), and 1 case was a pT1 cloacogenic carcinoma (6.25%). The mean follow-up was 21.7 months (range: 12-36 months). One patient had a double recurrence at 8 months and after a further 6 months. After the third surgical operation the patient had no further recurrence. The outcomes were similar to those reported in the recent literature, showing that the procedure, when correctly performed, is simple and effective, with a good risk/benefit ratio.

Desmoid tumour of the breast is a rare lesion. Only 9 cases in which the origin of the tumour was linked to a breast implant had been published up to 2004. We report a case of aggressive fibromatosis which developed on the thoracic wall two years after implantation of a mammary prosthesis. This tumour was locally aggressive. Radical surgery is the treatment of choice and in this case required a wide surgical resection, including removal of the chest wall, to gain control. The application of adjuvant radiation therapy is controversial.

This is a retrospective analysis of the results obtained with surgical treatment consisting in left lateral partial subcutaneous sphincterotomy for anal fissure. Fifty patients observed from January 2002 to June 2005 in our Coloproctology outpatients' department were recruited. Five patients (10%) did not undergo an operation and all 5 presented an acute anal fissure. Their treatment was conservative consisting in fibre ingestion, use of stool softeners, ointments, anti-inflammatory agents after opening the bowel, and a corticosteroid ointment. Forty-five patients (90%) were operated on. Twelve of these (26%) were operated on for an acute anal fissure after early failure of conservative therapy and demanded immediate surgical therapy; 14 (31%) of those operated on for acute anal fissure underwent a surgical procedure after at least a month of conservative treatment. The remaining 19 patients (42%) presented chronic anal fissures, with symptoms lasting more than 1 month and with sentinel haemorrhage, a hypertrophied anal papilla, and hardening of the edge of the fissures. Forty of the patients operated on (88%) presented a posterior anal fissure, 3 patients (6.5%) an anterior anal fissure and 2 patients (4.5%) synchronous anterior and posterior anal fissures. The surgical procedure carried out on all patients undergoing operation was a partial left lateral subcutaneous internal sphincterotomy using the closed technique according to Notoras under general anaesthesia. Follow-up was carried out 15 days and 2, 3 and 6 months postoperatively. The results were considered very good in 89% of the cases, while 5 patients (11%) complained of pain after opening the bowels, albeit of acceptable intensity and such as not to require another operation or significant pharmacological treatment. No complications were observed. The conclusion after the analysis of our experience is in agreement with the 8th recommendation, class I, recommendation grade A of the "The Standards Practice Task Force of the American Society of Colon and Rectal Surgeons" stating that "surgery may be appropriately offered without a trial of pharmacologic treatment after failure of conservative therapy" and that "in our experience can be proposed in those cases of acute anal fissure". In our experience, the 89% success rate and substantial patient satisfaction make this procedure more appropriate than medical treatment and alternative surgical treatments.