102,800 research outputs found
Trialogue Plus: Management of cardiovascular risk in hyperglycaemic/diabetic patients at hospital discharge. Beltramello G, Manicardi V, Mazzuoli F, Rivellese A.
No full text
Studio dei meccanismi neuro-cognitivi sottintesi alla tossicodipendenza con utilizzo di tecniche avanzate di Risonanza Magnetica ad alto campo (cap. 14)
No full textAssessment of the healthcare managerial skills offered by the Italian post-graduate schools of public health
No full textBackground. The Italian National Health Service (Servizio Sanitario Nazionale, SSN) is facing relevant challenges due to decreased financing and increased healthcare costs (1). In this complex framework, most of the Italian Medical Doctors, after obtaining their Specialization degree in Public Health, develop their careers in organizational and managerial roles in public and private health organizations, i.e. hospitals, local health units, health districts or national and international agencies (1, 2). Public health technical competencies, in particular policy and management, are of crucial importance to develop, run and support healthcare services. However, some gaps exist between current public health needs and the extent to which Public Health Residents are trained in the above fields (3, 4). Study design. The study is a cross-sectional cognitive survey carried out through a questionnaire sent by e-mail to Residents and Directors of the Italian Schools of Public Health, from May to November 2018. The questionnaire was sent only to the accredited Schools which had all four years of the course running. Methods. The questionnaire investigated 35 managerial topics divided into 4 macro-areas. It was sent to both Directors of the SPHs and the Residents of 32 Schools. The latter were asked to provide a single collective answer per School. Respondents could assign a score from 1 (topic not addressed at all) to 4 (topic addressed extensively and linked to other related topics) to each item, also taking into account the skills acquired through internships, seminars, etc. that involved all the Residents. Results. Answers were received from the Residents of 30/32 (93.8%) SPHs and from 15/32 (46.9%) of the Directors. Scores given by the Directors were higher than the ones of the Residents for every topic, and for 17 out of 35 items (48.6%) a statistically significant difference has been obtained. In the overall score of 3 macro-areas out of 4 (General issues, Managerial tools and macro-organisational Models) there are statistically significant differences. In Soft skills macro-area, the single scores of all topics are generally low for both Directors and Residents. Conclusion. The study shows that the Residents declare a strong need for training improvement in the field pf healthcare organization and management: the median score is equal to or greater than 3 (topic addressed extensively) in only a few answers. The comparison between Directors’ and Residents’ scores highlights a different perception of the training offered in these areas. The study results could be pivotal for the improvement of the managerial skills provided to the Residents in Public Health of the Country
Paradoxically greater interhemispheric transfer deficits in partial than complete callosal agenesis
No full textSymptoms of interhemispheric disconnection are typically much less severe in callosal agenesis than after surgical section of the corpus callosum. Sperry [Sperry, R. W., Plasticity of neural maturation. Developmental Biology, 1968, 2 (Suppl.), 306-327.] has attributed this difference to two interconnected factors: (1) the callosal section is usually performed after the brain has lost the maximal degree of functional plasticity associated with the early stages of development and (2) the removal of an already formed structure is more disruptive for functional brain organization than the failure of the same structure to develop. It has been suggested that functional compensation is less efficient if callosal agenesis is partial rather than complete [Dennis, M., Impaired sensory and motor differentiation with corpus callosum agenesis: A lack of callosal inhibition during ontogeny? Neuropsychologia, 1976, 14, 455-469.]. This suggestion is supported by the present findings of partial left-hand anomia, partial left-field alexia and poor tactile cross-localization in a subject with a congenital absence of the posterior part of the corpus callosum due to an arteriovenous malformation. In agreement with many previous studies, similar, though more severe, symptoms of interhemispheric disconnection were found in a subject with a complete section of the corpus callosum, but not in a subject with complete callosal agenesis. Praxic control of the left hand on verbal commands was severely deficient in the callosotomy subject, but it was normal in the subject with callosal hypogenesis. The lesser degree of compensation in partial compared to complete callosal agenesis may be explained by a reduced pressure to develop extracallosal means of interhemispheric communication, contingent on the partial existence of callosal connections, as well as by the later occurrence in development of the causes of callosal hypogenesis compared to those of total callosal agenesis
Paradoxically greater interhemispheric transfer deficits in partial than complete callosal agenesis
No full textSymptoms of interhemispheric disconnection are typically much less severe in callosal agenesis than after surgical section of the corpus callosum. Sperry [Sperry, R. W., Plasticity of neural maturation. Developmental Biology, 1968, 2 (Suppl.), 306-327.] has attributed this difference to two interconnected factors: (1) the callosal section is usually performed after the brain has lost the maximal degree of functional plasticity associated with the early stages of development and (2) the removal of an already formed structure is more disruptive for functional brain organization than the failure of the same structure ta develop. It has been suggested that functional compensation is less efficient if callosal agenesis is partial rather than complete [Dennis, M., Impaired sensory and motor differentiation with corpus callosum agenesis: A lack of callosal inhibition during ontogeny? Neuropsychologia, 1976, 14, 455-469.]. This suggestion is supported by the present findings of partial left-hand anemia, partial left-field alexia and poor tactile cross-localization in a subject with a congenital absence of the posterior part of the corpus callosum due to an arteriovenous malformation. In agreement with many previous studies, similar, though more severe, symptoms of interhemispheric disconnection were found in a subject with a complete section of the corpus callosum, but not in a subject with,complete callosal agenesis. Praxic control of the left hand on verbal commands was severely deficient in the callosotomy subject, but it was normal in the subject with callosal hypogenesis. The lesser degree of compensation in partial compared to complete callosal agenesis may be explained by a reduced pressure to develop extracallosal means of interhemispheric communication, contingent on the partial existence of callosal connections, as well as by the later occurrence in development of the causes of callosal hypogenesis compared to those of total callosal agenesis. (C) 1998 Elsevier Science Ltd. All rights reserved
The Risk of Cancer Progression in Women With Gynecological Malignancies andThrombophilic Polymorphisms: A Pilot Case-Control Study.
No full textClin Appl Thromb Hemost. 2009 Oct;15(5):535-9. Epub 2008 Jun 29.
The risk of cancer progression in women with gynecological malignancies and
thrombophilic polymorphisms: a pilot case-control study.
Tormene D, Beltramello P, Perlati M, Brandolin B, Barbar S, De Toffoli G, Simioni
P.
Department of Medical and Surgical Sciences, Second Chair of Internal Medicine,
University of Padua Medical School, Padua, Italy. [email protected]
Cancer produces a hypercoagulable state, which might lead to thrombosis, and on
contrary, unprovoked venous thromboembolism might be the manifestation of an
occult cancer. In this pilot case-control study, we assessed the risk of
gynecological malignant diseases related to the presence of the factor V Leiden
and prothrombin G20210A polymorphisms. Fifty-two women underwent an operation for
gynecological malignancy and were enrolled in the study. Women who underwent an
operation for gynecological nonmalignant disease in the same days of cases were
considered as controls. The presence of factor V Leiden and prothrombin G20210A
was assessed in case and control groups. In all, 7 out of 52 cases were carriers
of the 2 polymorphisms compared with 20 out of 198 controls (odds ratio = 1.3;
95% confidence interval, 0.6-3.0). The results were also similar when the risk
was considered separately for the site of cancer. As for advanced and metastatic
malignancies, the odds ratios were 2.3 (95% confidence interval, 0.9-6.0) and 3.3
(95% confidence interval, 1.0-11), respectively, compared to noncancer patients.
When these 2 groups were compared to nonadvanced cancer group, the odds ratios
for carriers of polymorphisms were 2.7 (95%confidence interval, 0.7-11.0) and 3.9
(95%confidence interval, 0.8-18.6) for advanced cancer and metastatic
malignancies, respectively. Women with factor V Leiden or prothrombin G20210A
polymorphisms who developed gynecological malignancy might present with a higher
stage of cancer at the time of surgery. Larger case-control studies in similar
cohort of patients are needed to confirm these findings.
PMID: 18591179 [PubMed - indexed for MEDLINE
Demystifying the role of magnetic resonance in identifying intraocular foreign bodies: a case of ocular siderosis
No full textBackground: Ocular siderosis (OS) is a significant cause of visual loss due to retained ferrous intraocular foreign bodies (IOFB). Despite its rarity, OS can lead to severe visual impairment if not promptly diagnosed and treated. This case is notable due to the occult nature of the IOFB, which was undetected by standard imaging modalities, emphasizing the critical role of magnetic resonance imaging (MRI) in such scenarios.
Case presentation: A 51-year-old Caucasian male presented with progressive vision loss in his right eye over 20 days. Best corrected visual acuity (BCVA) was 20/1000 in the right eye and 20/20 in the left eye. Intraocular pressure (IOP) was 9 mmHg in both eyes. Slit-lamp examination revealed a small linear corneal wound and an iris defect in the right eye, along with a cataract featuring brownish deposits on the anterior capsule. The left eye was normal. Fundus examination of the right eye was hindered by media opacities. Ultrasonography showed a flat retina and choroid with no detectable IOFB. Despite a strong clinical suspicion of OS, computed tomography (CT) did not detect any IOFB. MRI subsequently identified an artifact in the inferior sectors of the right eye, indicative of a metallic IOFB. Surgical intervention involved a 23-gauge vitrectomy, phacoemulsification, IOFB removal and silicon oil (SO) tamponade resulting in a fully restored VA of 20/20 and normal IOP one month post-operation. SO was removed 2 months later. The retina remained adherent with no PVR development, and optical coherence tomography (OCT) scans showed a normal macula.
Conclusions: This case underscores the importance of considering OS in patients with unexplained vision loss and history of ocular trauma, even when initial imaging fails to detect an IOFB. MRI proved crucial in identifying the IOFB, highlighting its value in the diagnostic process. Early detection and surgical removal of IOFBs are essential to prevent irreversible visual damage. This case demonstrates that MRI should be employed when CT and ultrasonography are inconclusive, ensuring accurate diagnosis and timely intervention to preserve vision
L’internista ospedaliero nella gestione del paziente diabetico complesso
No full textL’internista deve occuparsi (e rioccuparsi) del paziente diabetico complesso in Ospedale
A. Fontanella, L. Magnani
Diagnosi, classificazione, epidemiologia clinica del diabete mellito
V. Provenzano, D. Brancato
Up-date degli studi disponibili
P. Gnerre, T.M. Attardo, A. Maffettone, G. Beltramello
Il diabete mellito costituisce ancora un equivalente di rischio cardiovascolare?
G. Augello, T.M. Attardo
Le terapie del diabete tipo 2 sono tutte uguali ai fini della riduzione della morbilità e mortalità cardiovascolare?
V. Provenzano
Le nuove tecnologie nella cura del diabete mellito
D. Brancato, V. Provenzano
Insuline prandiali e insuline basali
R. Pastorelli
Quali target nel diabete mellito: il dogma dell’emoglobina glicata è davvero imprescindibile?
V. Manicardi
Il controllo dell’iperglicemia nel paziente anziano polipatologico: è sempre necessario iniziare l’insulina?
G. Gulli, M. Nizzoli
La nefropatia diabetica
F. Salvati, D. Manfellotto, M. Stornello
Cirrosi epatica e diabete
M. Imparato, L. Fontanella
La terapia personalizzata nel diabete di tipo 2
A. Maffettone, C. Peirce, M. Rinaldi
La gestione dell’iperglicemia nel paziente critico e instabile
C. Nozzoli
La disfunzione erettile nel paziente diabetico di tipo 2
N. Artom, A. Bosio, G. Pinna
Quali obiettivi di approccio integrato nella gestione del diabete mellito?
E. Romboli, D. Panuccio
Iperglicemia, normoglicemia ed ipoglicemia nei pazienti anziani fragili: situazioni a rischio, politerapia e comorbilità
A. Greco, M. Greco, D. Sancarlo, F. Addante, G. D’Onofrio, D. Antonacci, S. De Cosmo
L’impatto clinico-prognostico dell’ipoglicemia nel paziente ospedalizzato
V. Borzì, L. Morbidoni, A. Fontanella
L’internista chiamato in consulenza per un diabete gestazionale: quale approccio pragmatico?
P. Novati, L. Sali
La frugalità nella gestione del diabete mellito: qualità assistenziale, governo clinico e costi correlati
P. Gnerre, G. Carta, D. Montemurro
La gestione dell’iperglicemia in area medica, ma senza esagerare.
L. Magnani, G. Beltramello
APPENDICE I
Un approccio pragmatico per la valutazione globale e la gestione del paziente diabetico
F. Pieralli, A. Crociani, C. Bazzini
APPENDICE II
Le insuline e i farmaci ipoglicemizzanti orali disponibili
P. Zuccheri, L. Alberghini, E. Sora
APPENDICE III
Le scale di correzione insulinica: pro e contro
V. Borz
Temporary and permanent signs of interhemispheric disconnection after traumatic brain injury
No full textThe corpus callosum is frequently damaged by closed head traumas, and the resulting deficits of interhemispheric communication may vary according to the specific position of the lesion within the corpus callosum. This paper describes a single case who suffered a severe traumatic brain injury resulting in a lesion of the posterior body of the corpus callosum. Among the classical symptoms of interhemispheric disconnection, left hand anomia, left upper limb ideomotor dyspraxia, left visual field dyslexia and dysnomia, and left ear suppression in a dichotic listening task were observed shortly after the injury but recovered completely or almost completely with the passage of time. The only symptom of interhemispheric disconnection which was found to persist more than 4 years after the injury was an abnormal prolongation of the crossed-uncrossed difference in a simple visuomotor reaction time task. This prolongation was comparable with that observed in subjects with complete callosal lesions or agenesis. The results suggest that the posterior body of the corpus callosum may be an obligatory interhemispheric communication channel for mediating fast visuo-motor responses. The transient nature of other symptoms of interhemispheric disconnection suggests a relatively wide dispersion of fibers with different functions through the callosal body, such that parts of them can survive a restricted lesion and allow functional recovery of hemispheric interactions. An assessment of the evolution in time of symptoms of interhemispheric disconnection following restricted callosal lesions may reveal fine and coarse features of the anatomo-functional topography of the corpus callosum
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