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Biomedical subjects

S Callegari

Publications and source records attributed to S Callegari.

10 recordsLinked to original sources

Relationship between cognitive impairment and clinical status in chronic heart failure patients.

BACKGROUND: In spite of its clinical importance, cognitive functioning is not always taken into account in studies on patients with chronic heart failure. The aim of the present study is to analyse the relationship between cognitive impairment and cardiovascular variables in a sample of patients with chronic heart failure for assessment or candidated for heart transplant. METHODS: Sixty-four male patients with chronic heart failure in NYHA class I-III, in a stable clinical condition, underwent cardiological evaluation and neuropsychological assessment by means of a wide battery of tests: Spinnler and Tognoni's tests and WAIS scale. RESULTS: Compared to the normative group, only 9% of patients did not have impairment in any cognitive function. 26% of patients had impairment of one cognitive function, and 30% of four or more cognitive functions. The cognitive functions that were most often impaired were short-term verbal memory, short-term visual spatial memory, differed verbal memory and verbal learning and visual spatial logical ability. On the whole, no statistical significant relationship was found between cognitive scores and the considered cardiovascular variables. CONCLUSIONS: Our data support the need to take into account the risk of cognitive impairment in CHF patients, regardless of age, disease severity or functional status. The high prevalence of short-term verbal memory impairment has important implications in clinical practice, since CHF patients should be actively involved in the medical management of their disease. Memory deficits could compromise patient's adherence to treatment as well as doctor-patient interactions. The practical consequences of these difficulties require some changes in doctors' behaviour and suggest the need for specific medical staff member training.

Chronic Disease↗

Relationship between psychological profile and cardiological variables in chronic heart failure. The role of patient subjectivity.

AIM: To analyse the relationships between the psychological profile, the satisfaction profile and cardiological variables in patients with chronic heart failure. MATERIAL AND METHODS: One hundred and fifty-two male patients with chronic heart failure in a stable clinical condition underwent cardiological evaluation and psychological assessment by means of two instruments: the Cognitive Behavioural Assessment 2.0 Battery and the Satisfaction Profile. RESULTS: Patients scored higher than healthy subjects in terms of psychophysiological disorders and depression. Patients in NYHA class III reported higher anxiety and depression scores and had more frequent problems in daily life than patients in NYHA classes I and II. Class III patients also reported lower satisfaction levels in many aspects of psychological and physical functioning. Pulmonary resistances >2.5 Wood units, pulmonary capillary wedge pressure >0. 18 mmHg and a diagnosis of ischaemic cardiomyopathy were associated with low satisfaction levels in the Satisfaction Profile 'physical functioning' factor. To be listed for heart transplantation and a history of more than three hospitalizations were related to low satisfaction levels in many items of the Satisfaction Profile. Finally, stepwise multiple regression showed that NYHA class, depression score and pulmonary capillary resistance accounted for 32% of the variance in the Satisfaction Profile physical functioning factor score. CONCLUSION: On the basis of chronic heart failure diagnosis only, a generic pattern of psychological distress can be predicted, common to many severe chronic diseases. Shifting from objective mental health measures towards the domain of subjective satisfaction, the only link which emerges is between objective cardiological data and satisfaction with physical functioning. Satisfaction in terms of other life aspects does not seem to be related to cardiological variables. These results support the importance of subjectivity in health related quality of life, as well as objective measures.

Adult↗

[Guidelines and clinical practice: anticoagulant therapy and cardioversion in atrial fibrillation].

UNLABELLED: The cardioversion of atrial fibrillation is linked to a substantial risk of systemic embolization. In an effort to reduce it, the American College of Chest Physicians (ACCP) periodically publishes guidelines for the use of anticoagulation in the conversion of atrial fibrillation. OBJECTIVE: Determination of the physician's compliance with the recommendations of the "Fourth ACCP Consensus Conference on Antithrombotic Therapy". METHODS: The charts of people admitted to a community hospital in 1998 with a diagnosis of atrial fibrillation (n = 202) were evaluated retrospectively. Consideration was given to the ACCP's recommendation to give anticoagulants 3 weeks before and 4 weeks after elective cardioversion to patients who had been in atrial fibrillation for more than 2 days. RESULTS: Ninety-one of the 202 patients admitted with atrial fibrillation reported the onset of arrhythmia more than 48 hours before. Thirty-four of them underwent elective cardioversion and 13 cases (33%) went without anticoagulation in the preceding 2 weeks. Of these 13 cases, 8 were patients aged over 75 (range 78-88, mean 84). After sinus rhythm had been restored in 30 people (spontaneously in 5 of them), the anticoagulant therapy was not administered during the 4 recommended weeks in 10 people (33%), all of them over 75 (range 77.94, mean 84). CONCLUSIONS: Anticoagulation for cardioversion of atrial fibrillation is underused, especially among elderly patients. In order not to let age itself be an obstacle to the correct treatment of patients with high embolic risk, our efforts must be improved in order to identify the correct therapeutic choice in each particular case. Initiatives aimed at identifying and removing any impediment to the application of guidelines may contribute to stimulating physicians in the process of evaluating the quality of hospital treatment.

Adult↗

[The psychological side of chronic heart failure. A pluriannual experience].

The present study summarizes the authors' experience reached in the last four years with chronic heart failure patients', particularly referring to the psychological aspects. The 218 male patients (age 51.7 +/- 8.3) psychological profile (obtained by means of the CBA 2.0 Primary Scales) has shown higher scores in the anxiety, depression and psychophysiological disorders scales and lower scores in some of the fear scales, compared with the reference normative group. The CBA 2.0 Schedule 4 has enlightened suicidal ideas, eating and sleep disorders, economic and sexual problems. The comparison between the psychological and the many cardiological variables taken into account, has not allowed to highlight significant relationships on the whole. Our data support the necessity to introduce other--likely subjective--variables in the studies aimed at analyzing the relationships between psychological and cardiological factors in the chronic heart failure patients.

Adult↗

The effects of a cognitive behavioural intervention in asthmatic patients.

There is evidence that educational programmes may improve patient's compliance with asthma treatment and control symptoms. Whilst medical parameters have been thoroughly studied, few data are available concerning psychological intervention. The aim of our open pilot study was to verify whether any difference in perceived illness and response style to asthma existed in the patients enrolled in an Asthma Rehabilitation Group (ARG) and in a Control Group (CG). Forty consecutive asthmatics were randomly enrolled, all of whom were diagnosed, treated and followed-up according to the International Guidelines. Both groups underwent a psychological assessment at baseline and after one year. A battery of questionnaires was used to obtain data relating to baseline characteristics (anxiety, depression, psychophysiological disorders), emotional reactions to asthma attacks (panic-fear, etc,) and cognitive variables (external control, psychological stigma, internal beliefs, external chance, etc.) involved in the perceived illness. In addition, the Asthma Rehabilitation Group patients underwent an educational programme and a cognitive-behavioural intervention. In both groups, a reduction of anxiety and depression scores was observed, as well as a significant improvement of the medical parameters evaluated. Only the Asthma Rehabilitation Group reported lower scores on the Psychophysiological Questionnaire and on the External Control Subscale after 1 year. The Control Group reported higher score on the External Chance Scale. The data of our study seem to confirm the effectiveness of psychological intervention on the cognitive skills involved in the perception and management of asthma. Larger scale studies on this topic are suggested.

Asthma↗

[Retrospective study on 778 patients with acute myocardial infarct: relation between sex, age and blood lipid picture].

To evaluate the relationship between myocardial infarction and serum lipid levels, 778 patients admitted to the Fidenza Coronary Unit were studied. These patients were divided by sex and into groups by age decade and the frequency of hyperlipidemia was investigated. In the first place the association between myocardial infarction (MI) with hypercholesterolemia, second with hypertriglyceridemias was considered. In addition the population was subdivided in respect to the 3 more frequent types of hyperlipidemia (hypercholesterolemia, hypercholesterolemia and hypertriglyceridemia, hypertriglyceridemia). The results show the presence at a positive correlation between MI and hypercholesterolemia in the younger groups in both sexes, but mainly in female. Similar results are obtained when the correlation between MI and hypertriglyceridemia was considered, but at a lower statistical significance. The statistical analysis of the different types of hyperlipidemia confines the important pathogenetic role of hypercholesterolemia by itself and in association with hypertriglyceridemia. On the other hand hypertriglyceridemia does not show any primary influence on MI, but it acts synergistically with hypercholesterolemia. The strong association of hyperlipidemia and MI in the younger group and in female, documented in this study, confirms the importance of hypercholesterolemia and hypertriglyceridemia as a risk factor in the early development of coronary heart disease.

Adult↗

[Neuropsychological course of patients with craniocerebral injuries in rehabilitation].

The aim of the present paper is to describe a neuropsychological assessment and intervention model in Traumatic Brain Injury (TBI) patients. The theoretical and methodological frameworks are described and the following diagnostic and rehabilitative flowchart is fully explained: 1. first visit with patient and his relatives; 2. clinical and testing assessment; 3. diagnostic balance and its communication to patient and his relatives; 4. neuropsychological rehabilitation and psychological counseling. Whenever necessary, patient's relatives are involved. Furthermore, TBI patients' health related quality of life is outlined as an important clinical and scientific issue deserving more attention, in spite of the objective methodological difficulties which its evaluation implies.

Brain Injuries↗

Multiple learning tasks in patients with ideomotor apraxia.

The Authors studied a group of patients with ideomotor apraxia (LBD+) to verify if these patients had some difficulties in multiple learning tasks in respect to non-apraxic patients and normal control subjects. All five groups were submitted to gesture learning task, motor skill learning task, supra-span (Corsi) learning task. The results indicate that learning difficulties were present in LBD+ patients, as demonstrated by their low performance in gesture sequence, motor skill and score of block-tapping supra-span task. This fact may be seen as a basic learning deficit and therefore linked to memory impairment. On the other hand, this could be tied to an aspecific more diffuse deterioration of attention if we consider that our apraxic patients had a greater cerebral lesion than non-apraxic patients.

Aged↗

Human lymphoblastoid interferon as vaccine adjuvant in cattle.

Human lymphoblastoid interferon from Namalwa cells was purified for clinical use by ethanol fractionation, and used as adjuvant of an inactivated Bovid Herpesvirus 1 vaccine in calves. In agreement with other in vitro and in vivo models, low and high interferon doses were shown to increase and depress the specific antibody response, respectively. The low, effective interferon dose (100 International Units/kg) also reduced the variability of antibody titres after the first vaccine injection. This latter dose had apparently no influence on the regulatory T cell circuits, as opposed to the other doses under study.

Adjuvants, Immunologic↗