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Biomedical subjects

M Ottonello

Publications and source records attributed to M Ottonello.

17 recordsLinked to original sources
PubMed2006

The influence of comorbidities and complications on discharge function in stroke rehabilitation inpatients.

AIM: The aims of this prospective study were: 1) to assess the frequency, type and severity of comorbidities (COMs) and complications (COMPLs) in acute stroke patients, according to the weighted comorbidity index (w-CI) of Liu et al. and 2 new indices, respectively COM severity index (COM-SI) and COMPL severity index (COMPL-SI); 2) to separately analyse the interference of COMs and COMPLs with functional status and recovery during stroke rehabilitation treatment; 3) to compare the ability of COM-SI and COMPL-SI to predict functional independence at discharge with that of w-CI. METHODS: Eighty-five stroke rehabilitation inpatients participated in the study. The type, incidence and severity of COM at admission and of COMPL during the whole hospital stay were studied prospectively. The Functional Independence Measure (FIM) scale was administered at both admission and discharge. RESULTS: About 1/3 suffered from some significant COM and another 1/3 developed COMPLs needing specific medical treatment and/or clinical monitoring. The most frequent COMs and COMPLs were cardiovascular and psychiatric/psychological diseases. The odds of having a high efficiency in the daily functional gain (FIM score) were greater for patients without any COM (3.5) and/or COMPL (4.6). Similarly, the odds of having a high FIM score at discharge were greater (3.5) for patients without COM or COMPL. The COM-SI demonstrated a higher predictive capacity of the FIM score at discharge (5%) than w-CI (4%), and COMPL-SI (1%). CONCLUSIONS: COM-SI resulted as the most interesting predictive index of functional outcome at discharge, after accounting for the functional status at admission.

Activities of Daily Living↗
PubMed2006

Falls in a rehabilitation setting: functional independence and fall risk.

AIM: With this study we wanted to determine the incidence, characteristics and consequences of falls in our rehabilitation setting. METHODS: An observational study was carried out in a rehabilitation setting for postacute orthopedic and neurological inpatients. Three-hundred and twenty patients were enrolled. Falls risk factors (Downton index [DI] and other known parameters), disability (functional independence measure [FIM]) and balance (Berg balance scale [BBS]) were assessed at admission. Falls that occurred during the rehabilitation stay were prospectively classified (St. Louis Older Adult Service and Information System [OASIS] system) and analyzed. RESULTS: Forty patients experienced a fall (12.5%). The faller group was characterized by a major clinical complexity; 70% of fallers were neurological patients and 30% presented cognitive impairment (mini mental state examination [MMSE] <24). They presented a statistically significant worse score on FIM (motor and cognitive), BBS and DI at admission, with 74% predictability of falls as measured by total FIM score and age. Falls recorded with the OASIS classification showed a prevalence (52.5%) for not bipedal (wheelchair transfer) and self-generated falls; 35% were intrinsic falls (caused by subject-specific factors) and 12.5% extrinsic falls (caused by environmental factors). Falls resulted in only minor clinical consequences, except for one rib fracture, but led to a significant increase in length of stay. CONCLUSIONS: In a rehabilitation centre, for good management of resources and safe prescriptions of a patient's independence in activities of daily living, fall risk is better evaluated with appropriate scales.

Accident Proneness↗
PubMed1998

[Validity and reliability of a new questionnaire on patient satisfaction in rehabilitative therapy].

BACKGROUND: The aim of this study was to examine some psychometric properties of a new questionnaire measuring patients' satisfaction with respect to the quality of care during stay in a rehabilitation unit. The instrument (called SAT-16) is composed of 16 four-level items and 2 open-ended questions. The construct validity of the 16-item section was already demonstrated in a previous study based on factorial analysis. In this study the concurrent validity, further aspects of the construct validity and test-retest reliability were analyzed. METHODS: The SAT-16 was administered to 339 inpatients, admitted consecutively to a Rehabilitation Center. RESULTS: 262 questionnaires (77%) were returned, of which 221 with all items filled in. The SAT-16 correlated well with two other measures of satisfaction (CSQ-8 and global satisfaction regarding the hospital stay). The answers to two open-ended questions came out to be consistent with those to the 16 closed-ended questions. The high values for the indices of test-retest reliability (ICC and kappa) are evidence of the stability of the scores in two repeated administrations. CONCLUSIONS: The SAT-16 was found to be provided with good psychometric characteristics. It can be proposed as a valid instrument for use in clinical practice for the continuous quality improvement of inpatient medical rehabilitation programmes.

Adult↗
PubMed1997

[Assessment of a patient satisfaction scale in rehabilitation].

BACKGROUND: A new scale is presented, measuring patients' satisfaction with respect to the quality of care during stay in a rehabilitation unit. The questionnaire is self-administered and anonymous, and it includes 15 items, scored 1 to 4. The cumulative score may thus range 15-60; the higher the score, the higher the patient's satisfaction. MATERIALS AND METHODS: The instrument was proposed to 175 disabled patients, admitted to a free-standing Centre for rehabilitation following neurological or orthopedic impairments. RESULTS: One hundred and forty questionnaires were completed. Of these, 131 could be analyzed. The mean score was > 3 in every item. Factor analysis disclosed that the questionnaire comprises 5 factors, which may be defined as "medical care", "physiotherapy", "nursing care", "food" and "physical environment and facilities". A satisfactory internal consistency of the items was found (item-remainder correlations > 0.5, Cronbach alpha > 0.9). This suggests that the scale is sufficiently unidimensional to permit cumulative summing of the item scores. CONCLUSIONS: The results suggest the content and construct validity of the scale. The questionnaire thus merits further psychometric investigation.

Adult↗
PubMed1994

[Caudal anesthesia in proctological surgery].

The technique and advantages of caudal peridural anesthesia for proctology surgery are reported. The scarce invasivity of this methodology, the scarce or lack of interference with respiratory and cardiocirculatory functionality, the good analgesic effect postoperatively in our patients operated for proctology pathology, established the reason why we consider caudal analgesia particularly indicated for proctology surgery.

Anesthesia, Caudal↗
PubMed1993

[Mechanical obstruction of the small intestine due to phytobezoars].

The authors report 3 cases of small bowel obstruction due to phytobezoar, and they describe various aetiological factors of this pathology. The surgical treatment of choice is the removal of phytobezoar by enterotomy. Particularly important is the intraoperative exploration of gastrointestinal tract to localize other phytobezoars.

Aged↗
PubMed1991

[Malignant neoplasms of the male breast. Our clinical contribution].

A survey of literature data on male breast cancer is reported: on this basis the authors report their experience of five cases observed between 1980 and 1989 at Ospedale "S. Corona" Pietra Ligure, out of 500 female breast cancers treated in the same period. Epidemiological data and follow-up records are analysed, reporting survival rate similar to that of larger series.

Adult↗
PubMed1990

[Nuclear DNA content in tumors of the colon and rectum. Relationship between ploidy and site of the neoplasm].

The DNA distribution pattern was determined 30 colo-rectal carcinomas. The DNA content in individual cells was measured according to a cytophotometric method based on light transmission measurement of Feulgen-stained nuclei. The DNA non diploid carcinomas were significantly more common from the left (descending and sigmoid) colon and rectum (P = 0.0002). No relationship existed between DNA pattern and age, sex, Dukes' stage, tumor grade.

Adenocarcinoma↗
PubMed1990

[The reliability of the grading assessment of the biopsy samples in malignant colorectal neoplasms].

The authors evaluate the results of preoperative bioptic grading compared with those obtained from postoperative specimens. Altogether, there was nonagreement in 45% of cases; therefore there is the risk of underestimating the biological aggressiveness of the disease. In fact, 68% of patients who were assessed as G1 in preoperative staging were found to have a higher degree of neoplastic dedifferentiation.

Adult↗
PubMedDate not supplied

Life Satisfaction Index: Italian version and validation of a short form.

The Life Satisfaction Index-version A (LSIA) is a 20-item questionnaire providing a cumulative score acknowledged as a valid index of quality of life. In the present study, an Italian version was produced through validated procedures of repeated back-translations. The final Italian version (LSIA.it) was administered to 90 healthy subjects (55 women; aged 40-65 yr, median 51). Cronbach alpha was 0.74, in agreement with previous studies on English, Greek, and Spanish versions, suggesting satisfactory internal consistency of the scale. Also in agreement with previous studies, factor analysis identified three factors (mood tone, zest for life, and congruence between desired and achieved goals), with eigenvalues of 2.80, 1.72, and 1.34, respectively. Nine of the original 20 items were dropped because of inconsistency with the overall scale and/or because of ambiguous loading onto the extracted factors. The resulting 11-item short form (LSI-11) had alpha = 0.69 and Kaiser-Meyer-Olkin measure of sample adequacy = 0.65. In our sample, the mean score of LSIA.it was almost the same as that previously reported in the literature for LSIA, and the correlation between LSIA and LSI-11 was very high (r = 0.91). In a test-retest trial, the cumulative score of LSI-11 showed a percentage of agreement ranging from 73.9 to 100 and Cohen's k statistic for reliability ranging from 0.51 to 1. The individual items of the LSI-11 presented substantial (k > 0.6) to excellent (k > 0.8) levels of agreement. The responsiveness of LSIA and LSI-11 during a hospital stay for 30 consecutive inpatients for medical rehabilitation programs, as measured by effect size, was 0.57 and 0.63, respectively. The results suggest that (1) the LSIA it has cultural equivalence with the English LSIA and that (2) the 11-item short form of LSIA is not only simpler but also more valid from a psychometric standpoint.

Achievement↗
PubMedDate not supplied

[Selection criteria of mobile lifters in the hospital setting].

The manual handling of patients with limited mobility represents the major cause of musculoskeletal injury to the spine in paramedical health care workers. Within the hospital, the more complex procedures of patient transfer often require the use of mobile hoists. The aim of this paper is to describe the basic criteria for the selection of such hoists. The main characteristics of a hoist are its stability, the sling attachment, the speed of operation, range of movement of the spreader bar, safety of the operation being performed, patient comfort, the physical effort required on the part of the health care worker, manoeuvrability and simplicity of use. Important organizational-structural features to evaluate include: the type of patient normally present in the unit concerned, the specific movement to be performed, the structural characteristics of the environment, and the work organization of the personnel.

Equipment Design↗
PubMedDate not supplied

[Anesthesia in videolaparoscopic cholecystectomy. Our experience].

In this work authors describe physiopathological problems and possible complications relative to intraperitoneal insufflation in videolaparoscopic-surgery. Furthermore they illustrate the anesthesiologic protocol executed by themselves in videolaparoscopic cholecystectomy, and they describe results obtained following their anesthesiologic technique of the grounds of a retrospective study on 88 patients treated by videolaparoscopic cholecystectomy.

Anesthesia↗
PubMedDate not supplied

[Intestinal angiodysplasia: diagnosis and therapy].

On the basis of two personal cases of angiodysplasia authors describe this rare pathology and its relative diagnostic difficulties. On the grounds of their experience and the international literature on this pathology, authors considered the angiography as the selected method for the diagnosis of intestinal angiodysplasia, and they consider surgical therapy as the best curative method for this pathology.

Adult↗