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Biomedical subjects

G D'Elia

Publications and source records attributed to G D'Elia.

At least 19 recordsLinked to original sources
PubMed2000

[Attachment theory: a biological basis for the patient-physician relation?].

Attachment theory is an evolutionary sociobiological theory of development which postulates that the propensity to make emotional bonds to a differentiated and preferred person, conceived as stronger and/or wiser, is a basic component of human nature, distinct from feeding and sexuality. Attachment behavior is present in germinal form in the neonate and continues to be present "from the cradle to the grave". When faced with loss, threat, distress or illness we tend to seek out an attachment figure from which we can obtain protection. Attachment theory has implications for the patient-doctor relationship. The doctor who is responsive to the patient's verbal and nonverbal attachment signals may be seen as a supplementary attachment figure. Doctors are powerful social figures, expected to manifest appropriate empathic behavior upon encountering the biologically grounded need for attention and listening.

Animals↗
PubMed1999

Correlation between clinical and ultrasound assessment of the knee in children with mono-articular or pauci-articular juvenile rheumatoid arthritis.

BACKGROUND: Ultrasonography of the knee is a non-invasive, readily available and low-cost tool for demonstrating peri-articular tissues. OBJECTIVE: To correlate clinical features with US findings in the detection, quantification and follow-up of inflammatory signs of the knee in children with pauci-articular juvenile rheumatoid arthritis (JRA). MATERIALS AND METHODS: US of both knees was performed in 49 patients on the same day as the clinical examination. All joints were classified into two groups by clinical criteria: group A (active disease) or group B (quiescent disease). Thirteen patients underwent one or more follow-up examinations. US was performed with a small-parts, 7.5-MHz, electronic linear probe by using a technique previously reported. Quantitative assessment of any effusion and synovial thickening was evaluated at the level of the suprapatellar bursa. Wilcoxon and Spearman tests were employed to compare US findings between the two groups and to correlate clinical and US findings within each group, respectively. RESULTS: US demonstrated significant increase of effusion and synovial thickening in group A joints. US enabled visualisation of clinically undetected popliteal cysts in three patients. Correlation between clinical and US findings was significant in group A and positive, though not significant, in group B. CONCLUSIONS: US seems to be a sensitive and reliable method for the assessment and monitoring of knee joint involvement in pauci-articular JRA.

Adolescent↗
PubMed1998

[Loco-regional fibrinolysis in the treatment of acute, non-traumatic ischemia of an artery. Use of PTFE, homologous vein, and Dacron in the treatment of acute thrombosis].

The acute thrombosis of a bypass graft can always be a common and challenging problem for the vascular surgeon, since surgical revascularization procedures can often result in failure, limb loss and infection. Since over the past 15 years literature reports emphasize the efficacy of intraarterial thrombolytic therapy (IATT) in achieving clot lysis and initial patency of thrombosed arteries and grafts, the purpose of this study is to verify if IATT with urokinase represents a valid alternative procedure to surgery. From our experience of 18 cases of lower limb ischemia, 9 of which graft thrombosis and 9 native artery occlusions, 3 cases of acute thrombosis of lower extremity bypass grafts, successfully treated with IATT are considered. After arteriography proof of lower extremity artery or bypass graft occlusion, thrombolytic therapy with urokinase was delivered at a rate of 100,000 UI/hour for 24/48 hours. At the conclusion of the thrombolytic treatment, percutaneous transluminal angioplasty (PTA) was performed on any residual stenosis of the bypass graft. In all three cases complete clot lysis within 48 hours was obtained, with patency of the bypass graft at two years follow-up. Urokinase in our experience, has always given good results. In many cases restoration of normal blood flow was obtained in bypass grafts thrombosed a three days. Urokinase has also been helpful in defining the causes of the occlusion (stenosis proximal or distal to the bypass) or of the anastomosis itself. Regional urokinase thrombolytic therapy, even if expensive, represents a primary tool for the vascular surgeon, since excellent results may be obtained, especially in cases where surgery is of high risk.

Acute Disease↗
PubMed1998

Disappearance of PML/RAR alpha acute promyelocytic leukemia-associated transcript during consolidation chemotherapy.

BACKGROUND AND OBJECTIVE: Acute promyelocytic leukemia (APL) (M3 according to FAB classification) is a subtype of acute myelogenous leukemia characterized by a specific t(15;17) (q22;q12) chromosomal translocation. The majority of APL patients achieve morphologic remission after induction chemotherapy. They can be followed from this point by cytogenetic and molecular analysis of the persistence of the PML/RAR alpha transcript. In order to determine the influence of successive courses of consolidation chemotherapy on clinical and molecular outcome, APL patients treated with all-trans retinoic acid (ATRA) and chemotherapy (AIDA-GIMEMA-LAP0493 protocol) were investigated. DESIGN AND METHODS: Twenty-four APL patients (pts) (15 males; 9 females) were studied by RT-PCR and cytogenetic analysis at diagnosis, after induction chemotherapy, at each point after any of three consolidation courses, and every 3 months during the first years of maintenance therapy. The median follow-up was 24 months (mths) (range 7-40 mths). RESULTS: All pts achieved hematologic remission after induction chemotherapy. Our results demonstrate that the majority (87%) of APL patients were still molecularly positive for the APL associated transcript after induction chemotherapy, while the majority (80%) of APL patients became PCR-after the second consolidation chemotherapy. INTERPRETATION AND CONCLUSIONS: The role of the third consolidation chemotherapy course in converting patients with persistent molecular evidence of disease from PCR+ to PCR- was minimal. We confirm the validity of molecular follow-up after single courses of chemotherapy in monitoring the role of molecular remission.

Adolescent↗
PubMed1994

[Gastric angiodysplasia: a rare cause of bleeding from the upper digestive tract].

Two cases of bleeding gastric angiodysplasia treated with a different approach, on the basis of the endoscopic features, are reported. Arteriovenous malformations may arise from any site of the digestive tract: gastric angiodysplasia represents one of the less frequent localizations, causing 2-5% of upper gastrointestinal bleeding. Several diagnostic tools are currently available and the choice of the most appropriate therapeutic strategy depends on many features: site and number of the lesions, patient's hemodynamic conditions, endoscopic skill. Surgery is preferred only when multiple and disseminated lesions within the gastric wall occur or when endoscopic approach fails.

Angiodysplasia↗
PubMed1994

Transanal endoscopic anorectal mucosectomy with ileal pouch anal anastomosis for familial adenomatous polyposis. A case report.

In patients with familial adenomatous polyposis (FAP) who are undergoing ileal pouch-anal anastomosis (IPAA), transanal mucosectomy can be performed without excessive anal dilatation and manipulation using the operative proctoscope introduced by Buess. In this way, mucosectomy under a direct three-dimensional six-fold magnified view is accurate and bloodless.

Adenomatous Polyposis Coli↗
PubMed1994

Management of large malignant rectal polyps with transanal endoscopic microsurgery. Is there anything better for the patient?

The authors report their experience with transanal endoscopic microsurgery (TEM), a technique that allows all the standard surgical manoeuvres such as tissue excision, suction, control of bleeding and suturing in the entire length of the rectal cavity. Main indications for TEM are the removal of large sessile polyps and early rectal cancers' (T1, G1-G2). Out of 50 patients submitted to TEM the authors consider in this study 24 cases with a preoperative diagnosis of benign large sessile polyps. The procedures included: 14 (58.3%) total wall excision, four (16.6%) total wall excision with perirectal fat, three (12.5%) mucosectomy, one mucosectomy + total wall excision, one partial wall excision + total wall excision, and the remaining case was converted to laparotomy due to a large intraperitoneal perforation. There was no operative mortality and an 8.3% rate of major complications. With a median follow up of 19 months there was no evidence of local or distant recurrence. The authors compare their results with those of alternative endoscopic and surgical techniques and highlight the advantages of TEM in the management of large and giant rectal polyps.

Adenocarcinoma↗
PubMed1992

HCV incidence in a dialysis center: preliminary reports.

Incidence of seroconversion to anti-HCV from December 1989 to May 1991 was evaluated in patients and in their sexual partners. In December '89, 13 of 66 and in May '91, 26 of 75 patients were HCV positive. 9 of 13 new, seroconverted patients had been transfused. Seroconverted mean dialytic age was lower than that of previous HCV-positive patients. All the sexual partners were HCV negative. Blood transfusion seems to be the main risk factor for HCV infection, while environmental contamination is still debatable.

Adult↗
PubMed1992

Psychotherapists' attitudes towards and observations of nonverbal communication in a greeting situation: II. Relationships to background variables.

An interview study of 79 Swedish psychotherapists was performed to investigate their attitudes towards and observation of nonverbal communication in a reference situation in relation to background factors such as gender, length of professional experience, and theoretical approach. The greeting situation, i.e., the first time a therapist and patient meet in a waiting-room, was chosen as the reference situation. Face communication in that greeting situation was significantly less achieved by male psychotherapists with relatively short experience than by female therapists. However, this sex difference was not significant among therapists whose psychotherapeutic experience was longer than 13 years. Attaching great importance to nonverbal communication in psychotherapy was related to an intention to be well-kept and to perform correctly in front of the patient, to establish direct communication in the greeting situation, and to background factors such as frequent work in psychotherapy and an eclectic psychotherapeutic approach.

Attitude of Health Personnel↗
PubMed1991

Psychotherapists' attitudes toward observations of nonverbal communication in a greeting situation: I. Psychometrics of a questionnaire.

A questionnaire was designed for the assessment of psychotherapists' attitudes toward nonverbal communication and their observation of it in a reference situation, i.e., the first time the therapist and the patient meet in a waiting room. The interrater reliability of the questionnaire was measured. Upon minor modifications, a final version of the questionnaire was completed, and the intrarater (test-retest) reliability, the discriminating capacity, and the homogeneity of the questionnaire were studied. The questionnaire has satisfactory psychometric qualities for use in research on nonverbal communication in psychotherapeutic greeting.

Attitude of Health Personnel↗
PubMed1987

Resuscitation of the elderly.

Concerns about quality of life and the cost of medical care raise questions about the effectiveness of cardiopulmonary resuscitation (CPR) efforts. This study explores the role of age in resuscitation outcome by focusing on the CPR experience of all patients age 75 years and older in a community hospital during a one-year period. Data are based on a retrospective study of the medical records of 86 such patients. While 41 percent survived the initial resuscitation effort, only 23 percent regained conscious functioning, 12 percent left the hospital, and only 7 percent survived to be discharged from the hospital and were alive one year later. None of the 26 patients over the age of 85 survived resuscitation. Among the 75 to 84-year-old patients, the diagnosis of acute onset arrhythmia and dementia were associated with a better survival prognosis. Crude estimates of cost based on charges for crash carts, intensive care, and bed rates totalled over $100,000; over one-half the amount was allocated to the 21 patients who were unconscious before finally dying the hospital. The study suggests the importance of continuing discussion about quality of life and cost implications of resuscitation of elderly patients.

Aged↗
PubMed1986

Changes in supply and distribution of family physicians in the United States.

From 1970 to 1980, the supply of family and general physicians in the United States increased by 4 percent. The overall increase was not felt uniformly among the states. Rather, the distribution reflected general regional trends in the United States. The analysis derives from a comparison of 1970 and 1980 American Medical Association and Bureau of the Census data. A study is made of changes in the supply of family and general physicians, in the number of residents in family practice programs, in the supply of general internists and pediatricians, in the population, and in the per capita income of each state. Regions with economic and population growth also benefited from immigration of family physicians and from new residency programs. They had fewer barriers to growth in the form of primary care competitors and elderly general practitioners requiring replacement. The dominance of market forces in channeling the effects of educational and manpower politics raises challenges for the specialty of family practice.

Aged↗
PubMed1983

The effect of regional medical education on physician distribution in Illinois.

Changes in the distribution of physicians among the 102 counties in Illinois in 1969 and 1979 were analyzed. During the decade, the supply of patient care physicians increased from 12,884 to 17,363 (35 percent). The 49 counties with populations of fewer than 25,000 experienced only minimal increases (14 physicians). The state's major population center, the Chicago Standard Metropolitan Statistical Area (SMSA), had a stable rate of increase to maintain its 76 percent of the total patient care physician supply in Illinois. The major change was the increase in physicians in counties with middle-sized cities. The authors relate the changes to the establishment of regional medical education centers in the state and argue that the major result of the program was not a general diffusion of physicians but the concentration of physicians in the tertiary care centers with the new educational programs.

Chicago↗
PubMed1983

[Histo-radiologic correlations in patients with primary hyperoxaluria].

The use of new dialythic technics has increased the survival times for patients with primary hyperoxaluria. From here the possibility of visualizing X-rays signs specific of oxalosis besides the typical bone lesions of hyperparathyroidism secondary to chronic renal failure. Recent hysto-pathological studies allowed to correlate such radiological findings to a new pathogenetical mechanism that would be responsible of the bone lesion specific for oxalosis and that might be caused by the presence of reabsorption cavities made up by macrophagic cells fagocyting cristals.

Adolescent↗