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Background: Bronchopulmonary dysplasia (BPD) is a chronic lung condition of premature neonates, yet without an established pharmacological treatment. The BPD rabbit model exposed to 95% oxygen has been used in recent years for drug testing. However, the toxicity of the strong hyperoxic hit precludes a longer-term follow-up due to high mortality after the first week of life. This study aimed to extend the preterm rabbit model to postnatal day (PND) 14 to mimic the evolving phase of BPD and enable the investigation of therapeutic interventions at later and more relevant time points. Methods: Preterm rabbit pups delivered on the 28th day of gestation were either exposed to room air or different degrees of hyperoxia (50% and 70% O2) for 14 days. Single (immediately after birth) or double (at birth and at PND5) intratracheal lipopolysaccharide (LPS) administrations were also tested in combination with 50% O2. Age-matched rabbits delivered vaginally at term were used as controls. Survival, weight gain, lung function, pulmonary artery micro-ultrasound Doppler analysis, lung histology (alveolarization, lung injury score, and design-based stereology), and longitudinal micro-CT imaging were used to compare the outcomes at PND14. Results: Premature birth itself, without any other BPD hit, was associated with lung function deficits, delayed lung development, and cardiovascular abnormalities. The BPD-like lung phenotype was enhanced by 70% O2 but not by 50% O2 hyperoxia. Intratracheal LPS delivered immediately after birth was associated with significantly higher lung injury scores at PND14 and increased tissue damping, a marker of parenchymal air resistance. Conclusion: Several strategies are feasible to extend the preterm rabbit model of BPD to PND14. Preterm birth at the saccular phase itself, even in the absence of other postnatal BPD hits, was associated with lung function deficits, delayed lung development, and cardiovascular abnormalities compared with age-matched term rabbit pups. Enhanced BPD-like phenotypes can be further achieved by continued exposure to moderate hyperoxia (70% O2) and the intratracheal administration of LPS. [ABSTRACT FROM AUTHOR]

Variation of the isotopic abundance of selected nutrients and molecules has been used for pharmacological and kinetics studies under the premise that the administered molecule has a different isotopic enrichment from the isotopic background of the recipient subject. The aim of this study is to test the feasibility of assessing the contribution of exogenous surfactant phospholipids to the endogenous alveolar pool in vivo after exogenous surfactant replacement therapy in rabbits. The study consisted in measuring the consistency of 13C/12C ratio of disaturatedphosphatidylcholine palmitate (DSPC-PA) in 7 lots of poractant alfa, produced over a year, and among bronchoalveolar lavages of 20 rabbits fed with a standard chow. A pilot study was performed in a rabbit model of lavage-induced surfactant deficiency: 7 control rabbits and 4 treated with exogenous surfactant. The contribution of exogenous surfactant to the alveolar pool was assessed after intra-tracheal administration of 200 mg/kg of poractant alfa. The 13C content of DSPC-PA was measured by isotope ratio mass spectrometry. The mean DSPC-PA 13C/12C ratio of the 7 lots of poractant alfa was -18.8‰ with a SD of 0.1‰ (range: -18.9‰; -18.6‰). The mean 13C/12C ratio of surfactant DSPC recovered from the lung lavage of 20 rabbits was -28.8 ± 1.2‰ (range: -31.7‰; -25.7‰). The contribution of exogenous surfactant to the total alveolar surfactant could be calculated in the treated rabbits, and it ranged from 83.9% to 89.6%. This pilot study describes a novel method to measure the contribution of the exogenous surfactant to the alveolar pool. This method is based on the natural variation of 13C, and therefore it does not require the use of chemically synthetized tracers. This method could be useful in human research and especially in surfactant replacement studies in preterm infants. [ABSTRACT FROM AUTHOR]

Copyright of SCENARIO: Official Italian Journal of ANIARTI is the property of ANIARTI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of SCENARIO: Official Italian Journal of ANIARTI is the property of ANIARTI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of SCENARIO: Official Italian Journal of ANIARTI is the property of ANIARTI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of SCENARIO: Official Italian Journal of ANIARTI is the property of ANIARTI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of SCENARIO: Official Italian Journal of ANIARTI is the property of ANIARTI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Respiratory Distress Syndrome (RDS) is a prematurity-related breathing disorder caused by a quantitative deficiency of pulmonary surfactant. Surfactant replacement therapy is effective for RDS newborns, although treatment failure has been reported. The aim of this study is to trace exogenous surfactant by 13C variation and estimate the amount reaching the lungs at different doses of the drug.Methods: Forty-four surfactant-depleted rabbits were obtained by serial bronchoalveolar lavages (BALs), that were merged into a pool (BAL pool) for each animal. Rabbits were in nasal continuous positive airway pressure and treated with 0, 25, 50, 100 or 200 mg/kg of poractant alfa by InSurE. After 90 min, rabbits were depleted again and a new pool (BAL end experiment) was collected. Disaturated-phosphatidylcholine (DSPC) was measured by gas chromatography. DSPC-Palmitic acid (PA) 13C/12C was analyzed by isotope ratio mass spectrometry. One-way non-parametric ANOVA and post-hoc Dunn's multiple comparison were used to assess differences among experimental groups.Results: Based on DSPC-PA 13C/12C in BAL pool and BAL end experiment, the estimated amount of exogenous surfactant ranged from 61 to 87% in dose-dependent way (p < 0.0001) in animals treated with 25 up to 200 mg/kg. Surfactant administration stimulated endogenous surfactant secretion. The percentage of drug recovered from lungs did not depend on the administered dose and accounted for 31% [24-40] of dose.Conclusions: We reported a risk-free method to trace exogenous surfactant in vivo. It could be a valuable tool for assessing, alongside the physiological response, the delivery efficiency of surfactant administration techniques. [ABSTRACT FROM AUTHOR]

Introduction: The nature of nursing has prompted researchers nurses to use a large number of qualitative methodology research. The trend showed a substantial increase in its production between 1997 and 2000 to settle back down in the following years although until recently the qualitative methodology was considered a non-scientific research. The growing number of publications with qualitative design is paid concern to verify the rigor and credibility of studies using this method. The use of the quality assessment tools showed that the methodological precision of studies with a qualitative design has grown over time., Aim: Assessing, using the tool Critical Appraisal Skills Programme, the quality of qualitative studies published in the last five years by international nursing journals with higher impact factor., Method: We will search the qualitative articles published on the ten most influential nursing journals that will be submitted by two independent researchers at the Critical Appraisal Skills Programme tool in its original version., Expected Results: The results make it possible to observe whether the qualitative research produced in the field of nursing uses a rigorous methodology in the drafting of the report, assuming that the quality has grown in the past five years than in previous years., Conclusion: The study will help researchers assess which level reached nurses in the development of qualitative research.

Background: The pain in instituzionalized elderly people with cognitive impairment is common. This symptom is severely under-reported and under-treated within this population. Evaluation of pain intensity is an essential component of pain assessment. Self-report approach to pain assessment is generally regarded as the gold standard of pain measurement in people with mild and moderate cognitive decay. The literature demonstrated more different unidimensional self-report scales but the conclusions of the studies suggested often the utilization of different scales., Aim: The goal of this study was to compare three different unidimensional pain assessment scales to be used with 84 instituzionalized elderly people with an average Mini-Mental State Examination score of 18., Method: This was a descriptive cross-sectional study. The pain assessment was carried out by administering the three scales Faces Pain Scale (FPS), Numeric Rating Scale (NRS), Verbal Rating Scale (VRS)., Results: The results showed that the prevalence of pain was 60-70%. All three pain intensity scales had good reliability and validity (p=0.0001); The compilation time of Faces Pain Scale most above than the other two scales (p=0.0001)., Conclusion: The findings of this article support the implementation of these scales in operative protocols considering the compilation time and preferences of the patients.

Pain is one of the most frequent symptom in elderly people with dementia and despite of this, it is still under-acknowledged and under-treated. The best approach to pain assessment is to evaluate it with the most appropriate scale. While in the elderly suffering mild-moderate cognitive impairment, it's possible to use self-report scales, in the elderly with severe cognitive impairment the use of observational scales is recommended. The objective of this review is to analyze the various types of pain assessment tools used in patients with cognitive impairment. Literature review was carried out through consultation of the most important bio-medical databases: Medline (PubMed), KT+, Trip Database, Cinahl, Cochrane Library, Embase. The keywords used were: "pain measurement", "pain assessment", "dementia", "validation study", "aged". All keywords were linked using AND and OR boolean operators. Altogether 5 self-report scales and 17 observational scales were retrieved, 7 of which available in Italian validated versions. The review analyzes potential and limitations of each assessment tool, in order to assist the clinician to make the most appropriate choice when using it in health care contexts.

Focused Assessment with Sonography for Trauma (commonly abbreviated as FAST) is considered for patients with blunt abdominal trauma as the gold standard for accident assessment in site. This method is increasingly used even by not radiologists professionals, as well as by nurses who works in emergency settings. This systematic review is aimed at evaluating the effectiveness of ultrasound FAST performed by nurses in emergencies department. Seven databases of primary and secondary literature as well as three national journals relevant to the field were consulted. The review was conducted between March and August 2011 developing 9 search strings. Articles have been critically reviewed by two authors independently. No restriction on language or time of publication have been used. A total of 4767 documents were displayed, of those only 4 were considered to be reviewed. A total of 1035 FAST ultrasound performed by nurses were included. The results show that the use of ultrasound FAST performed by trained nurses is very effective, with a sensitivity of 84% (95% CI 72.1-92.2) and a specificity of 97.37% (95% CI 92.55-99.10) . Practice execution time was an average of 156 seconds (2.6 minutes), median time of 138 seconds (range = 76 to 357). Just one study specified the training course that nurses were required to attend. To sum up, FAST ultrasound performed by nurses have an important role in emergencies management as well as in triage setting as valid screening tool.

Scientific literature recommends nurses to use the Geriatric Depression Scale (GDS) in the assessment of symptoms of depression among elderly with no cognitive deficits. The first purpose of this observational study was to determine the prevalence of depressive symptoms and the related antidepressant therapy in a sample of institutionalized elderly people administering the 30 questions GDS (GDS 30). The second aim was to estimate the time to complete the test. The survey is a cross-sectional multicenter study. 115 cognitively intact elderly residents in 5 retirement houses in the province of Vicenza (Italy) were administered the 30 items GDS by nursing staff: 80 females with a median age of 83 years (Inter Quartile Range RIQ: 80-85) and 35 males with a median age of 79 years (RIQ: 73-85). The prevalence of depression was 46% (95% Confidence Interval: 37-55%). The difference in depression between males and females was not significant (p=0.646). The median of the total answering time was equal to 306 seconds (RIQ: 257-315). The answering time of the GDS in people taking antidepressants is higher with respect to those who do not take them. The GDS 30 is an useful tool for nurses to identify in a fairly short amount of time institutionalised individuals with no cognitive deficit and risk of depression.

Mistakes in providing medication are amongst main problems in National Health Service. The literature shows that drug's errors administration occur much more frequently in emergency departments than in other care settings. Main objective is to identify most commonly mistakes, recorded in nursing clinical practice, occurring during drugs administration. A secondary objective is to identify factors that may contribute to errors and possible preventive measures. A multicentre survey was conducted, administering an anonymous questionnaire to 206 nurses of 7 wards of 4 health services in Lombardia and Veneto region of Italy. The self-compiled questionnaire is composed by 15 questions. Informations were collected by a third-party nurse. Responders to test were 150 (72.8%). Main results show that 81 nurses (54%) administered a wrong drug dose, as well as 80 health care professional (53.3%) gave one or more drug at a different time from what was prescribed. It was also found a statistically significant association between improper performance of diagnostic tests and health care professionals age. Moreover, a strong linear association between medication error reporting and nurses was found. Educating nurses about accident reporting system to enhance patient safety culture is highly recommended. Our results could be used in programs aimed to promote medication error recognition and reduce or eliminate barriers to communication.

The cognitive impairment is the main obstacle for a nurse in the recognition of the patient's pain; moreover, the nurse needs valid scales which can be daily adopted during the phase of testing. Recently, a pain assessment scale for patients with cognitive impairment has been setted in Australia. Our aim is the validation of the Abbey scale in the Italian medical circle so as to allow the nurse to use it in the clinical practice. The original scale was validated in the Italian version and afterwards it was tested on 110 institutionalized elderly patients coming from three retirement houses of Vicenza, Italy. The results prove that the Italian version of Abbey scale is a valid tool, considering the content and reliability.

The management of pain in a elderly patients with advanced dementia is a very frequently problem in geriatric wards. The pain in patients with advanced dementia whose verbal fluency is declining is underestimated and poorly treated and this is mainly due to the lack of availability of proper tools able to recognise and to assess this disease symptom in those patients. During recent years major progress has taken place, and valid scales that allow for the assessment of the pain also in those kind of patients have been developed. The objective of this research is to verify the pertinence of the PAINAD and ABBEY scales throughout the assessment of pain in a 30 resident patients in care of a geriatric setting. The thirty elderly were average age 86 years (18 female and 12 male) with vascular dementia or late stage Alzheimer's disease, completely dependant on ADLs and with global aphasia. After 48 hours from the acceptance to hospital the pain has been identified. The pain assessment was carried out by administering the PAINAD (already validate in italian) and ABBEY scales by the nurse responsible for the patient and by a second nurse, for an amount of four surveys for each patients. Results show that both scales give equivalent results for the pain assessment (K=0.68), with concordance asset moderately good between the exams taken by the two nurses (Cohen K rate between 0.49 and 0.58). The PAINAD scale requires an administering time far lower than the ABBEY scale (p 0.001) and both can be used for the assessment of pain in those patients, also in the hospital.