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Optimal management and better outcome of pancreaticoduodenal injuries seem to be associated with shorter operative time, and with simple and fast damage control surgery (DCS), in contrast to definitive surgical procedures.

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This study set out to determine the relationship between splenic function (as assessed by the percentage of pitted red cells) and tuftsin activity, and to confirm the return of effective splenic function after splenectomy for trauma. Twenty-three patients (13 men) took part. Ten of mean age 48.5 (range 30-74) years had had the spleen removed for traumatic rupture and 13 of mean age 49.7 (range 23-66) years had undergone elective splenectomy. At the time of the study all patients had had the spleen removed a minimum of 1 year previously (mean 6.1 (range 1-15) years). Fifty healthy volunteers matched for sex and age were also studied. In each subject, residual splenic function was evaluated by counting the percentage of pitted red cells. Tuftsin activity was also determined. A highly significant negative correlation was found between pitted red cell percentage and tuftsin activity (rs = -0.80, P < 0.001). Compared with healthy controls (mean 21.6 (range 13-37) per cent), tuftsin activity was significantly reduced both in patients who had undergone splenectomy for trauma (mean 4.4 (range 0-9) per cent; P < 0.0001) and in those who had had elective splenectomy (mean 0; P < 0.0001). Tuftsin activity was significantly (P < 0.001) more depressed after elective than traumatic splenectomy. These data confirm a decrease in tuftsin activity following splenectomy and show that this deficit is significantly greater after elective than emergency removal. These observations confirm that residual splenic function is often present after traumatic splenectomy.

Urethral syndrome (urinary symptoms and pain without organic lesions) is a frequent female pathology but its aetiology is obscure and its treatment undetermined. A number of studies have highlighted emotional disturbances in these patients. To assess the efficacy of psychotherapy in the treatment of this syndrome, the authors studied 36 patients diagnosed with urethral syndrome. Of these, 13 were randomly selected for short‐term dynamic psychotherapy. The remaining 23 patients were treated with traditional urological therapies and used as the control group. After the medical diagnosis and during follow‐up at 6 months and 4 years, one psychological questionnaire (SQ) was administered together with a specially prepared clinical questionnaire. The urinary symptomatology and pain disappeared completely in over 70 per cent of the patients who had completed the psychotherapy. For the remaining patients, at the termination of the treatment the symptomatology had improved to the point that it was no longer a problem. These results proved stable in time and were associated with a general improvement in psychic status, particularly for the depression, anxiety and hostility levels. In the controls, on the other hand, no significant improvement was noted in the parameters examined.

Intra-abdominal packing was shown to be feasible, safe, and effective for patients with intra-abdominal nontraumatic massive hemorrhage, and the application of the principles of DCS may improve survival in cases of surgical hemorrhage with development of the lethal triad.

Stress is associated with dyadic adjustment during transition to parenthood, but little is known about mechanisms underlying this link, particularly during prenatal period. This dyadic study explored the mediating role of depressive symptoms in the relationship between perceived stress and dyadic adjustment in expectant couples. One hundred and fourteen couples at the third trimester of pregnancy completed self-reports of perceived stress, depression, and dyadic adjustment. Results indicated that both parents’ perceived stress was associated with their own lower relationship satisfaction directly and indirectly, through their own higher depressive symptoms. Mothers’ perceived stress was also linked to higher fathers’ depressive symptoms, and thus also to lower fathers’ relationship satisfaction. Both parents’ perceived stress was only directly associated with their own dyadic consensus, and their own and their partners’ affectional expression. Findings suggest that interventions aimed at reducing expectant parents’ perceived stress could protect against depressive symptoms and promote the couple’s adjustment during pregnancy.