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Biomedical subjects

R Bruni

Publications and source records attributed to R Bruni.

121 records · Page 7Linked to original sources
PubMedDate not supplied

[The physician-patient relation in the light of the attachment theory. Attachment counseling].

INTRODUCTION: The doctor-patient relationship has always played a key role in the patient's treatment and recovery process. However, it is still difficult to interpret its dynamic healing aspects. Above all, the mechanisms that enable the patient to improve and to change are not still sufficiently clear. WORKING THEORY: The attachment theory assumes an emotional support of the doctor towards the patient. According to this, the patient completely "invests" the doctor of his emotions as in the ancestral model of family relationship. The possibility of obtaining success seems to be strictly linked to the doctors' capacity of accepting this "mandate" offered by the patient who autonomously takes this decision. CURRENT SITUATION: Physicians deal with the complexity of pathologies every day and this shows an increasing necessity of a "doctor-patient relationship", enabling the physician to identify the patients symptoms in a more extended way which involves pain and suffering as well. As for the pharmacological intervention, the patient's attitude and expectations of recovery have a definite effect on the simple assumption of medicine. CONCLUSION: Today's physicians' scientific education would be extremely insufficient, if it were not encouraged by the awareness that his/her duty goes beyond the simple medical prescription. It has to reach the patient's heart as well as arouse the understanding of events related to him/her. This is not just a cultural factor but also a precise way of interacting with the patient according to one's own Counselling models.

Counseling↗
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[Counseling for adolescents with eating disorders].

INTRODUCTION: The increase of disorders connected to eating behaviours arises serious problems in the social and health-care setting. These require long-term therapeutic interventions, which have to be strongly integrated on the pharmacological, psychotherapeutic, social and cultural aspects. At present the issues develops itself on three levels: a) increase of the number of subjects, especially adolescents, b) protraction of the illness, with frequent critical relapses, c) always less defined evolution of the pathology with a tendency to become chronic and develop other kinds of illnesses. OUTLINE OF THE SURVEY: The Clinical Psychology Service of the CBM University Hospital examined 300 records of adolescents with various forms of eating disorders. Some of these interventions were requested by various clinical departments while other cases were directly taken care of and offering pharmacological as well as therapeutic interventions. RESULTS: The analysis of adolescents' dynamics allows an interpretation of modern eating disorders as one of the issues characteristic of the always more difficult body-mind integration. For adolescents corporeality is a weight, some kind of foreign body they don't like, and it is not thought as the basic way to get in contact with others so to express one's own feelings and wishes. CONCLUSIONS: Eating disorders are very strong symptoms of personal and social malaise. For this reason they require an integrated intervention starting from the family environment, reaching the child in its uniqueness as well as the larger social context. Actually the latter sends messages to young people which are strongly destabilizing from an ethical point of view as well as for body aesthetics. A counseling service offered at first to parents becomes an effective way of preparing both sides to more complex and articulated types of treatment. These can be more expensive but can build up again a disturbed or not properly developed psychological balance in adolescents.

Adolescent↗
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[Angiodysplasia of the colon].

The Authors report their experience with a case of angiodysplasia of the colon. It is outlined how these lesions can be demonstrated by angiography and colonoscopy. The pathophysiology, diagnosis and management are discussed as well.

Aged↗
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Synthetic amphipathic sequences of surfactant protein-B mimic several physicochemical and in vivo properties of native pulmonary surfactant proteins.

A mixture of lipids and proteins unique to the lung lines the airspaces of all mammalian species. This mixture, termed pulmonary surfactant, is essential for normal lung function. We have synthesized selected amino acid sequences of one of the major low molecular weight surfactant proteins to find whether these peptides can duplicate effects of native protein. Peptide/lipid mixtures approximate results found with native surfactant proteins both in vitro and in vivo. Effects found with native proteins or synthetic peptides include association with, and ordering of, surfactant lipid; changes in surface tension with surface compression; rapid adsorption of lipids from subphase to surface; and improvements in oxygenation of surfactant-deficient rats.

Amino Acid Sequence↗
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Fludarabine in untreated and previously treated B-CLL patients: a report on efficacy and toxicity.

BACKGROUND: It has been shown that fludarabine (FLU) is superior to conventional treatment in B-CLL for rate and quality of response, leading to CR even at the molecular level. In this paper we report our preliminary results with this drug in B-CLL patients. METHODS AND PATIENTS: Twenty-seven B-CLL patients (16 refractory to previous therapy, 7 responsive and treated for subsequent disease reexpansion, 4 untreated with active disease) were administered FLU at a dose of 25 mg/sqm for 5 days every 4 weeks. RESULTS: Twenty-five patients were evaluable and 14 of them (56%) were responsive. All four untreated patients responded: 1 CR (PCR analysis showed the persistence of clonal VDJ rearrangement) and 3 PR, while 67% of the previously responsive group again showed a reaction: 2 PR (33%) and 2 nodular PR (33%). Among the refractory patients we recorded 6 responses (39%): 1 CR (6%) and 5 PR (33%). Besides 2 cases of lethal myelotoxicity, we observed 2 cases of encephalopathy and 2 cases of heart failure. Four deaths may have been related to FLU therapy (15%). CONCLUSIONS: We confirm the effectiveness of FLU and the improved outcome, in terms of toxicity and response rate, it provides in untreated B-CLL patients. Further studies are needed to explore the possible negative effects of FLU on neuronal and heart function, and the impact of this drug on survival in selected groups of patients.

Adult↗
PubMedDate not supplied

[The rational use of prosthesis in laparocele].

The Authors report their cases of incisional hernias observed from 1990 to 1995 involving 142 patients treated either in emergency or under normal conditions. A guideline in the choice of prosthetic materials of current use, considering the relative chemo-physical characteristics, the biocompatibility and the costs is outlined. Although not entering into the merit of the surgical technique some general criteria that should guide the surgeon facing the incisional hernial pathology are ruled out.

Biocompatible Materials↗