Indication for small bowel transplantation in children with gastrointestinal pathology on long-term parenteral nutrition.
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Age of Onset↗
Biomedical subjects
A M Colombo
Publications and source records attributed to A M Colombo.
Intractable diarrhea and small bowel transplant.
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Child↗
Quality-of-life assessment in a home care program for advanced cancer patients: a study using the Symptom Distress Scale.
Quality-of-life assessment in advanced cancer patients should include the study of physical function, psychological status, social interactions, and symptoms. "Symptom distress" relates to the degree of discomfort caused by specific symptoms. A Symptom Distress Scale, which has been developed by McCorkle and Young, is a self-rating instrument that evaluates 13 symptoms. In the present study, the Italian version of the Symptom Distress Scale (SDS) was used to assess the quality of life in advanced cancer patients. The internal consistency of this version was found to be good (Cronbach's coefficient alpha = 0.78). A sample group of 43 patients treated in a home care program was asked to fill out the SDS on a weekly basis. The scores showed a reduction in symptom distress, which was primarily due to improvement in pain, nausea, and bowel pattern. Home care was less effective in improving concentration and, more generally, psychological aspects. This study confirms the validity of a quality-of-life monitoring system that uses a patient self-rating symptom assessment instrument.
Aged↗
Nursing care planning for terminally ill cancer patients receiving home care.
Nursing home care for terminally ill cancer patients was organized according to nursing care plans that were based on diagnoses as recommended by the North American Nursing Diagnosis Association (NANDA). This study was carried out among a sample of 40 patients receiving home health care for a period of 1 to 19 weeks. More than 697 nursing diagnoses were identified in the study. The most frequently recorded nursing diagnoses were anxiety, constipation, and diminished food intake. Fifteen of the 40 patients in the study were able to complete a weekly self-report of their symptoms. The patients' own descriptions of their symptoms were then compared with their symptoms as identified by nursing staff. There was a congruence in 63% of reported instances. Although nurses' assessments were not always in agreement with the symptoms reported by the patients, agreement was more frequently found with somatic symptoms than with psychological ones. One conclusion is that nursing plans should incorporate multidimensional methods for assessing patients' real needs.
Adult↗
Evaluation of hypothalamic dopaminergic function by neuropharmacologic means in aged women.
The function of the hypothalamic tuberoinfundibular dopaminergic (TIDA) neurons involved in the control of prolactin secretion was investigated in aged subjects with the use of nomifensine, an indirect-acting dopamine (DA) agonist, domperidone, a DA receptor antagonist, and DA, which acts directly on the pituitary lactotropes. In all 33 women, aged 69-92 yr, were studied. Baseline prolactin values were slightly but significantly higher in aged women (13 +/- 1.2 ng/ml, M +/- S.E.M.) than in a group of control fertile women (8 +/- 0.7 ng/ml). Oral administration of nomifensine (200 mg), in 14 aged women suppressed plasma prolactin (greater than or equal to 30% of baseline) in 8 subjects, a proportion not different from that present in fertile women (7/15) also receiving a single oral dose of nomifensine. Intravenous infusion of DA (0.04 microgram/kg min, 120 min) induced a similar inhibition in plasma prolactin in the aged and the fertile women, while administration of domperidone (4 mg i.v.) evoked a higher plasma prolactin rise, 15 min post-administration, in fertile than aged women. In all, presence of baseline prolactin levels only slightly elevated and prolactin responsiveness to nomifensine and DA not different from that of fertile women denote preservation of TIDA neuronal function in old women. The blunted response to domperidone of the old women is likely attibutable to a reduced pituitary pool of prolactin.
Adolescent↗
[Arrhythmias in the elderly].
A survey was made on a population of 6059 subjects aged more than 60 years with the aim to assess 1. the prevalence of heart arrhythmias and 2. the relationships between arrhythmias and some other ecg alterations. Arrhythmias resulted present in 29.0% of the whole population with a significantly higher prevalence among males (30.7% vs 28.1%, P less than 0.05) and among subjects over 75 years of age (33.2% vs 23.9%, P less than 0.001). Supraventricular extrasystoles (SE, 11.55%), atrial fibrillation (AF, 10.44%) and ventricular extrasystoles (VE, 8.91%) were the most frequent arrhythmias, followed by sinus bradycardia (SB, 2.04%), sinus arrhythmia (SA, 1.35%), atrial flutter (AFL, 1.09%) and junctional rhythms (JR, 0.20%). AF and AFL resulted significantly more frequent among females, whilst SE, VE and SB were more frequent among males. All the above arrhythmias, with the exception of AFL and JR resulted significantly more frequent among subjects over 75. A significantly higher prevalence of ecg signs of left ventricular hypertrophy, ischemia, previous myocardial infarction (MI) and of the so-called "minor" T-wave changes (MTC) was found among the subjects with arrhythmia as compared with those free from rhythm disturbances. Ecg signs of MI and MTC were significantly more frequent among males and MTC were more frequent among females and among subjects over 75. It is concluded that in an old person the presence of an arrhythmia should lead to a careful evaluation of the general and cardiological clinical situation in order to avoid 1. to prescribe an unnecessary and potentially dangerous antiarrhythmic treatment, and 2. to misdiagnose an underlying clinical condition liable to a decisive improvement under adequate treatment.
Aged↗
Anomalous growth hormone responses to thyrotropin-releasing hormone and glucose in cirrhotic patients: the effect of metergoline.
The anomalous GH response to TRH or glucose loading was evaluated in patients with severe liver disease untreated or pretreated with metergoline (MCE), a potent antiserotoninergic drug. In 9 patients, injection of 400 micrograms TRH as a bolus induced a clear-cut GH rise (> 8 ng/ml), with peak levels 15-90 min post injection. Pretreatment with MCE did not modify baseline GH levels but potentiated the TRH-induced GH rise in 4 patients. In addition, 2 of 8 TRH nonresponder patients developed the anomalous GH response after MCE pretreatment. Like MCE, methysergide, another antiserotoninergic drug, potentiated the TRH-induced GH rise in 2 of 4 patients. Glucose administration (100 g, orally) induced a paradoxical rise of GH in 9 of 10 patients; after MCE, the paradoxical GH response to glucose was potentiated in 6 patients. These data provide the first experimental evidence that a derangement in brain monoamine (serotonin) function is actually involved in the occurrence of anomalous GH responses in subjects with severe liver disease.
Ergolines↗
[IgA-class antigliadin antibodies in the screening and follow-up of celiac disease patients].
IgA antigliadin antibodies (IgA-AGA) have been determined with an enzyme immunoassay in 2.141 pediatric patients. High levels of IgA were found in 98% of 53 celiac patients (1st biopsy), in 81% of 16 celiac patients after gluten challenge, while high levels of these antibodies were not found in 200 patients on gluten-free diet. Moreover high levels of IgA-AGA were found in 29% of 48 patients with normal jejunal biopsy and in 4% of 1.824 patients with gastrointestinal problems other than celiac disease. Our results confirm the data report in literature about the sensibility and the specificity of the IgA-AGA dosage as a screening test for celiac disease, but the possibility of false pathological and false normal values confirms the intestinal biopsy, as the main procedure for the diagnosis of celiac disease.
Antibodies↗
[Hemodynamic and oxygen transport effects of dobutamine in critically ill patients].
The study evaluates the cardiocirculatory and oxymetric effects of dobutamine infusion in doses between 5 and 15 g/kg/min for a period of 48 hours in 18 critical patients of whom 9 with a low cardiac index (mean 2.1) and 9 with a normal or increased cardiac index (mean 3.3). The beta mimetic effect of the drug is particularly evident in the 9 hypodynamic patients who benefited from a 28% increase in the cardiac index. Likewise, oxygen transport and consumption improved by 22% and 15% respectively. In overall terms, the variables which revealed significant modifications were: cardiac index (CI), systolic index (SI), mean pulmonary pressure (MPAP), pulmonary impaction pressure (PAWP), systemic and pulmonary vascular resistance (SVRO), PVRI), oxygen transport and consumption (DO2, VO2) (No major changes were observed in mean arterial pressure (MAP) and heart rate (HR). No tachyphylaxia was noted after 48 hours of continuous infusion.
Adult↗