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Biomedical subjects

A Bulfoni

Publications and source records attributed to A Bulfoni.

At least 19 recordsLinked to original sources
PubMed1999

Use of medical resources and quality of life of patients with chronic heart failure: a prospective survey in a large Italian community hospital.

AIMS: To assess the prevalence, clinical characteristics, use of medical resources and quality of life in consecutive patients with chronic heart failure (CHF) hospitalized in a large community hospital during 3 months. METHODS AND RESULTS: The study group included 354 patients with CHF, admitted in the Departments of Internal Medicine (97%) and Cardiology. Median age was 78 years [72;85], 45% were males. CHF was the main diagnosis in 72%; 28% were in NYHA class III and 49% in class IV; 42% had atrial fibrillation. The median hospital stay was 8 days [5;14], in-hospital mortality 9% in those admitted for CHF and 19% in those admitted primarily for other diseases. Patients with CHF occupied 15% of the beds; 1330 ECGs, 389 chest X-rays, 112 echocardiograms and 10 coronary angiograms were performed. A quality of life questionnaire revealed that 82% had problems with mobility, 54% with self-care and 88% with everyday activity. Thirty-nine percent of patients had at least one hospitalization during the previous year. CONCLUSIONS: Ninety-seven percent of hospitalized patients with CHF are admitted in the Internal Medicine wards and occupy 15% of beds. The majority of the patients are 72 years or older, with severe heart failure. The frequency of rehospitalization(s) and mortality rate in this population remains high. Echocardiography is performed only in 27% of patients.

Aged↗
PubMed1999

[Syncope in hospital internal medicine].

BACKGROUND: Syncope and presyncope are a relatively common problem in the general population. The differential diagnosis is complex, including benign forms and potentially life-threatening syndromes. In etiological terms, a variety of causes can be diagnosed, predominantly adopting a specialist approach to the problem. The aim of this study was to assess the epidemiological and clinical impact of syncope and presyncope in an internal medicine unit. METHODS: A prospective study was performed in cases of syncope and presyncope attending an internal medicine unit. A coded diagnostic and therapeutic protocol was used. The study included the cases discharged over a 6-month period (1/5/1998-31/10/1998). RESULTS: Syncope and presyncope were present in 6.73% of cases, mainly in elderly persons, female sex and with cardiovascular forms (6.25%). Neurally mediated syndrome was the most common form, followed by cardiac and cerebrovascular diseases, in accordance with most reports. This study confirmed the diagnostic value of an accurate anamnesis and in-depth objective examination, integrated by basic ECG. It is important to underline that this global approach to the problem allowed the recognition of gastrointestinal hemorrhage and pulmonary embolism with the trait of monosymptomatic syncope and presyncope. In the absence of significant electrocardiographic data, more extensive testing in patients restricted the cases of unknown form to 7.14%. CONCLUSIONS: Syncope and presyncope represent a multidisciplinary problem, frequently found in internal medicine, which benefits from the potential advantages of a global approach.

Adult↗
PubMed1995

[Mixed cryoglobulinemia and the hepatitis C virus].

Mixed cryoglobulinemia is a cryoprecipitable immune-complex mediated disease, in which cryoglobulins are type II and III of the immunochemical classification of Brouet. Essential mixed cryoglobulinemia, in opposition to secondary, is characterized by the absence of well-defined underlying disease and clinically it shows the classical triad of Meltzer and Franklin. Several reports point to the frequent, through various, liver involvement in essential-defined mixed cryoglobulinemia. Particularly, the clinical and biological evidence of liver disease is commonly soft, in spite of the common bioptic evidence of persistent or chronic active hepatitis. The problem about which comes first in this association had been widely investigated, including the possible pathogenetic role of hepatotropic viruses. Initially some studies focused attention on hepatitis B virus, but now its importance is de-emphasized because of critical epidemiological review, results of HBV-DNA in cryoprecipitates, electron microscopy data. The recent opportunity of diagnostic tests for hepatitis C virus gave proof of its great importance in apparently essential mixed cryoglobulinemia. In fact, many researches have found a variously high prevalence of anti HCV antibodies and HCV-RNA in serum and cryoprecipitates, with selective concentration in the latter. Alpha interferon treatment has been suggested as first choice drug in the management of HCV related cryoglobulinemia. The mechanism is postulated to be primarily due to its antiviral activity. Up to date optimal dose and treatment period needs to be established.

Cryoglobulinemia↗
PubMed1995

[Unusual presentation of celiac disease in adult age].

The author report the case of a 23 year old female, where a severe iron-deficiency anemia was the only clinical expression of coeliac disease. This nonspecific appearance and similar reported observations with selected intestinal malabsorption emphasize the risk of diagnostic misleading in the prospective of atypical symptoms. The subsequent result is no glutin free diet style, with its protective role against malignancy. The non invasive screening method with related antibodies determinations is stressed important diagnostic tool.

Adult↗
PubMed1992

[Epidemiologic study on the effectiveness and safety of dihydroergocristine in impaired memory and behavioral functions in aged humans].

Aim of the study was to assess the activity of dihydroergocristine (DHEC, CAS 17479-19-5) in aged patients with impaired cognitive function. Twenty-five university hospital centres and 250 physicians participated in the study. 2,600 patients (1,104 males and 1,496 females, age range 50-80 years) were admitted to the study. Each patient was administered 6 mg/d DHEC for 120 days. Clinical evaluation was made through the SCAG Rating Scale registered at basal time, after 60 and 120 days. Responsivity to treatment was considered high when the final score was reduced by 30% and none if less than 10%. Analysis of results demonstrated that at the end of the study responsivity was high in 73% of cases, moderate in 20.4% and absent in 6.5%. Tolerability was very good as side effects were reported only in 3.16% of patients. Most frequent side effects were: nausea (1.23%), gastralgia (1.11%), headache (0.29%), hypotension (0.12%), vertigo (0.12%) and rash (0.08%). Drop-outs for gastralgia were reported only in 0.53% of the patients.

Aged↗
PubMed1992

Inappropriate emergency test ordering in a general hospital: preliminary reports.

An assessment was made on emergency laboratory test ordering at Udine General Hospital (Italy) to investigate the reasons for the excessive number of requested tests. All the orders for emergency laboratory tests during one week in June 1990 were studied. For each test the time of the order was recorded for every day of the week. The most important aspect of our investigation is the distribution of the orders during the day: in fact, test orders reached two peaks, the upper between 7 and 11 a.m., and the lower between 3 and 6 p.m. The analysis of the record cards showed that 42% of the orders were inappropriate. These preliminary findings were very useful in making the consensus on a Quality Assurance program easier, to improve the use of the Emergency Laboratory by doctors and nurses. Some preliminary results in the Emergency Medicine Department confirmed the validity of this program.

Clinical Laboratory Techniques↗
PubMed1989

A quality assurance program for the evaluation of antimicrobic treatment of urinary tract infections.

In the course of a quality assurance (QA) activity on the use of antimicrobics the authors set out to assess the management of urinary tract infection (UTI) in 76 patients. From culture data they noted an excellent or correct use in 78% of the patients, but a misuse in 22%. A committee was organized, with representatives of all departments, which set out criteria for the correct treatment of UTI. Using these criteria, the medical records were retrospectively assessed and the results are described. The protocol will be communicated to all involved, and then a reassessment will be made, to evaluate change in behaviour.

Anti-Bacterial Agents↗
PubMed1986

[Epidemiological assessment of thyrotoxicosis in a hospitalized population].

This personal survey aims to provide further epidemiological data on thyrotoxicosis in view of the fact that reports in the literature refer solely to a limited number of geographical areas. In particular an assessment was conducted on patients admitted to Pordenone Hospital with thyrotoxicosis between 1-1-1983 and 31-12-1984. The results obtained were compared with those encountered in other studies of this pathology.

Adult↗
PubMedDate not supplied

[An epidemiological study of thyroid pathology in a group of hospitalized patients].

The epidemiological impact of thyroid disease was assessed in a group of in-patients from an area with a potential iodine deficiency. The overall frequency of thyroid disease in the three years studied was approximately 4.91%, with a prevalence of elderly patients and a bias towards the female sex of 8.14:1. Nodular, single and multiple lesions were observed in 3.74% of hospitalised patients, whereas malignant forms were limited to 1.98% of the patients with nodular pathologies. When thyrotoxic syndromes were classified it was found that there was a predominance of multinodular toxic goitres over Basedow's disease. These findings are discussed and compared to previously published data.

Adolescent↗
PubMedDate not supplied

[Zieve's syndrome. Case report].

The Zieve's syndrome consists of the transient association of cholestatic jaundice, hemolytic anemia, hyperlipemia, in a chronic alcoholic. The Authors, after a short introduction regarding physiopathological problems, describe and subsequently examine on the clinical ground a recent personal observation, which had been mentioned for the rarene-s of this disease.

Adult↗
PubMedDate not supplied

[A case of primary hyperparathyroidism. Clinical contribution].

The authors discusses some clinical, laboratory and instrumental problems of a reported case of primary hyperparathyroidism caused by adenoma from the point of view of medical literature. Nethertheless the lack of the specificity of the clinical manifestations and the slowly progressive evolution of this disease, primary hyperparatiroidism must be suspected in the presence of his most common multifarious complications. The finding of hypercalcemia in these conditions and from screening procedures requests parathyroid functional tests and exclusion of other causes of which chiefly pseudohyperparathyroidism may be difficult to be differentiated. The early diagnosis and correction of the parathyroid lesion avoid further damage and regression of many preoperatory complications.

Adenoma↗
PubMedDate not supplied

[A case of primary hyperaldosteronism. Case report].

The authors discuss a reported case of primary aldosteronism, which is relatively uncommon within hypertensive population. The diagnosis of primary aldosteronism must be suggested by the presence of the association of arterial hypertension and hypokaliemia, which nevertheless is not pathognomonic. It is emphasized the significance of the detection of this syndrome on account of the correction following surgical removal of the adenoma of the adrenal cortex. Two attacks of paroxismal hypertension, which are atypical in primary aldosteronism, had been observed in the reported case; however, apart from these exceptions, arterial hypertension has resulted generally constant and of moderate degree, as well as the majority of the others descriptions. The personal experience confirms the need to determine plasma levels of renin and aldosterone before the therapeutic or diagnostic use of spironolactone.

Adenoma↗