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R Baldi

Publications and source records attributed to R Baldi.

8 recordsLinked to original sources
PubMed1992

[Major ambulatory surgery: organizational models].

In this essay, the authors provide a definition for those medical care facilities representing a consolidated alternative to traditional hospitalization. These facilities can be basically ascribed to the following patterns: day case surgery; day-hospital activity; home-care. Day case surgery is a complex and, in most cases, interdisciplinary procedure; this type of activity necessitates a pre-hospitalization period and often also a "protected discharge" or even a home-care service. Some specific criteria regarding day surgery activity have been defined as follows: the main criteria have a clinical nature, but they interact with others belonging to a social and structural-organizational order. The Royal College of Surgeons of United Kingdom has officially recognized in 1985 this medical care typology as one of the constituents of surgical care, and has evaluated that at least 1/3 of the overall operations could be carried out as day care surgery. In the United States, besides hospital and ambulatory surgery activity, a new pattern known as "free-standing center" has been promoted; in 1993, 35% of the operations is expected to be carried out in day case surgery centers. As far as Italy is concerned, in 1988 only day-hospital practice has been adequately recognized as an alternative medical care facility to traditional hospitalization. The Emilia Romagna region, in order to increase day case surgery activity, has issued in 1991 a list of 53 DRGs, in which day bed units treatment was possible. Up to now, however, only a small part of these diseases is treated on a day case surgery basis.

Ambulatory Care Facilities↗
PubMed1987

Combined therapy for selected chronic uremic patients: infrequent hemodialysis and nutritional management.

The results are described of a combined nutritional (supplemented diet) and dialytic (once a week hemodialysis) therapy, employed in 17 selected chronic uremics for a mean period of 18.2 months/patient. The clinical findings, blood chemical abnormalities and changes of renal function were examined and compared with those of patients on the standard thrice-a-week dialysis schedule and free diet. The clinical findings were not significantly different in the two groups. The residual renal function of patients on combined therapy declined faster than in patients on conservative treatment, but at a slower rate than in those on thrice-a-week dialysis. The time averages of serum urea, methylguanidine and phosphate concentrations and their postdialytic rebounds were lower in the patients on combined therapy than in those on thrice-a-week dialysis, whereas the time averages of the serum creatinine concentration were higher, and those of serum bicarbonate and serum oxalate were not significantly different in the two groups. It is concluded that this combined therapy is a valid alternative to the conventional thrice-a-week hemodialysis and free diet for selected patients and for periods of time whose duration is conditioned by the rate of decline of the residual renal function.

Adult↗
PubMed1986

Effects of a low phosphorus, low nitrogen diet supplemented with essential amino acids and ketoanalogues on serum triglycerides of chronic uremic patients.

The effects were studied of a vegetarian low-protein, low-phosphorus diet supplemented with essential amino acids and ketoanalogues and those of maintenance hemodialysis (MHD) and free diet on the serum triglycerides (STG) of 85 patients with chronic renal failure. Following dietary therapy STG decreased significantly in the 61 male patients (from 185.7 +/- 89.8 to 153.5 +/- 68.7 mg/dl; p less than 0.001), whereas in the females the decrease was not significant (from 189.1 +/- 83.9 to 167.0 +/- 62.2 mg/dl; NS). When patients changed to MHD therapy and free diet STG increased again. We can conclude that the correction of hypogonadism of chronic male uremics largely accounts for the improvement of hypertriglyceridemia, though other factors are likely to contribute.

Adult↗
PubMed1984

The decline of renal function slowed by very low phosphorus intake in chronic renal patients following a low nitrogen diet.

The rate of progression of renal failure has been evaluated in two homogenous groups of chronic renal patients with early insufficiency. In both groups the diet supplied the same amount of calories (approximately 35 Kcal/kg/day) and the protein intake was equally restricted (approximately, 0.6 g/kg/day); however, in Group 1 the phosphorus intake was lower (6.5 mg/kg/day) than in Group 2 (12 mg/kg/day). In both groups the rate of decline of creatinine clearance decreased when patients changed from a free mixed diet to the specially controlled diets, but in Group 1 (lower phosphorus intake) this change was much more marked than in Group 2. Elevated mean levels of serum phosphate and of urinary output of phosphate per unit of creatinine clearance, and elevated mean levels of serum iPTH were found in the patients of Group 2, whereas Group 1 patients had normal mean levels of serum phosphate and of iPTH, and the phosphaturia per unit of creatinine clearance was almost normal. The role of such abnormalities in urinary and serum phosphate, and of secondary hyperparathyroidism, on the progression of renal failure is discussed.

Adult↗