216 research outputs found
Frattura mediale del femore prossimale - analisi del rischio e valutazione del danno
No full textAbbiamo trattato gli aspetti più complessi e controversi nella gestione clinico-chirurgica, con il confronto di esperti italiani e svizzeri coinvolti nella gestione del paziente anziano, ponendo l'accento sulle innovazioni delle tecniche riabilitative e sul confronto della valutazione del danno post-traumatico, a volte in relazione alla frequente pre-esistenza di una lesione articolare
Terapia farmacologica del disturbo ossessivo-compulsivo: rapporto tra risposta clinica, livello plasmatico del farmaco e sistemi monoaminergici
No full text25 hydroxyvitamin D deficiency and its relationship to autoimmune thyroid disease in the elderly
No full textBackground: Low 25(OH) vitamin D levels have been associated with several autoimmune diseases and recently with autoimmune thyroiditis (AT). The aim of the study was to investigate the association of AT with low 25(OH) vitamin D levels in the elderly. Methods: One hundred sixty-eight elderly subjects (mean age: 81.6 ± 9.4 years) were enrolled. Serum levels of 25(OH) vitamin D, anti-thyroid peroxidase (TPO-Ab), anti-thyroglobulin (TG-Ab) antibodies, free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) were measured. Results: The prevalence of AT was significantly higher in subjects with vitamin D deficiency (25(OH) vitamin D < 20 ng/mL) when compared with subjects with normal 25(OH) vitamin D (25(OH) vitamin D ≥ 20 ng/mL) levels (28% vs. 8%, respectively, p = 0.002). Patients with AT and vitamin D deficiency had a comparable hormonal profile compared to patients with AT and vitamin D sufficiency in terms of TSH (p = 0.39), FT3 (p = 0.30), FT4 (p = 0.31), TG-Ab (0.44) and TPO-Ab (0.35). Interestingly, a significant correlation between 25(OH) vitamin D and TPO-Ab (r = −0.27, p = 0.03) and FT3 (r = 0.35, p = 0.006) has been found in subjects with AT while no correlation was found between 25(OH) vitamin D levels and TG-Ab (r = −0.15, p = 0.25), TSH (r = −0.014, p = 0.09) and FT4 (r = 0.13, p = 0.32). Conclusions: These findings suggest that vitamin D deficiency was significantly associated with AT in the elderly. Therefore, the screening for AT should be suggested in subjects with vitamin D deficiency
25 Hydroxyvitamin D Deficiency and Its Relationship to Autoimmune Thyroid Disease in the Elderly
No full textBACKGROUND:
Low 25(OH) vitamin D levels have been associated with several autoimmune diseases and recently with autoimmune thyroiditis (AT). The aim of the study was to investigate the association of AT with low 25(OH) vitamin D levels in the elderly.
METHODS:
One hundred sixty-eight elderly subjects (mean age: 81.6 ± 9.4 years) were enrolled. Serum levels of 25(OH) vitamin D, anti-thyroid peroxidase (TPO-Ab), anti-thyroglobulin (TG-Ab) antibodies, free triiodothyronine (FT3), free thyroxine (FT4) and thyroid stimulating hormone (TSH) were measured.
RESULTS:
The prevalence of AT was significantly higher in subjects with vitamin D deficiency (25(OH) vitamin D < 20 ng/mL) when compared with subjects with normal 25(OH) vitamin D (25(OH) vitamin D ≥ 20 ng/mL) levels (28% vs. 8%, respectively, p = 0.002). Patients with AT and vitamin D deficiency had a comparable hormonal profile compared to patients with AT and vitamin D sufficiency in terms of TSH (p = 0.39), FT3 (p = 0.30), FT4 (p = 0.31), TG-Ab (0.44) and TPO-Ab (0.35). Interestingly, a significant correlation between 25(OH) vitamin D and TPO-Ab (r = -0.27, p = 0.03) and FT3 (r = 0.35, p = 0.006) has been found in subjects with AT while no correlation was found between 25(OH) vitamin D levels and TG-Ab (r = -0.15, p = 0.25), TSH (r = -0.014, p = 0.09) and FT4 (r = 0.13, p = 0.32).
CONCLUSIONS:
These findings suggest that vitamin D deficiency was significantly associated with AT in the elderly. Therefore, the screening for AT should be suggested in subjects with vitamin D deficiency
Monoaminergic systems in patients with obsessive-compulsive disorder before and after fluoxetine treatment
No full textDETERMINATION OF FLUOXETINE AND NORFLUOXETINE IN HUMAN PLASMA BY ION-INTERACTION RP-HPLC
No full textPostoperative delirium in patients aged 75 and more undergoing elective non-cardiac surger
No full textIntroduction: An increasing number of very old patients undergo surgical procedures.
Nevertheless, few data are available about postoperative delirium in this population.
Aims: To assess the incidence of delirium in a population of patients aged 75 years and more
undergoing elective non-cardiac surgery under general anesthesia and to evaluate pre-operative
characteristics and perioperative events associated with delirium occurrence.
Methods: In 43 patients medical history and cognitive status were assessed preoperatively.
Intraoperative mean arterial pressure (MAP) and Bispectral Index (BIS) were measured
continuously. Delirium was assessed in the first 7 post-operative days using the Confusion
Assessment Method for the Intensive Care Unit. Characteristics of patients with or without delirium
were compared using Mann-Whitney Rank Sum Test or Fisher Exact Test, as appropriate.
Results: Post-operative delirium was diagnosed in 6 patients (14%). Table 1 summarizes patients’
characteristics divided by the presence or absence of delirium.
Variables Delirium (n=6) No-delirium (n=37) p
Age, years 81 (77-84) 79 (77-82) 0.418
Major surgery, no. (%) 4 (67) 10 (27) 0.077
Mini mental state examination 26.5 (25.1-26.7) 27.6 (26.4-28.6) 0.228
Charlson Comorbidity Index 5 (2-7) 2 (1-3) 0.040
ASA score 3 (2-3) 2 (2-3) 0.086
Anesthesia duration, minutes 266 (191-429) 164 (111-202) 0.018
Surgery duration, minutes 164 (104-328) 116 (61-161) 0.111
Hypotension time, % 8 (5-18) 4 (1-27) 0.390
Hypertension time,% 13 (1-38) 2 (0-8) 0.154
BIS <40 time, % 15 (0-46) (n=4) 10 (3-27) (n=32) 0.960
Admission to ICU, no. (%) 4 (66%) 5 (14%) 0.012
Table 1. Data are presented as median (interquartile range) unless otherwise stated.
Hypotension/hypertension time and BIS<40 time were defined as percent of anesthesia time spent
with MAP below/above 20% of baseline values and BIS<40, respectively.
Conclusions: In our population, 14% of patients developed postoperative delirium. Patients
developing delirium had more comorbidities and spent more time under general anesthesia.
Furthermore, a higher rate of ICU admissions was observed. Time spent in hypotension or
hypertension and depth of anesthesia did not differ between the groups
EFFECTS OF LONG-TERM EUGLYCEMIA ON VON WILLEBRAND AND ENTOTHELIN-1 VASCULAR EXPRESSION IN UREMIC TYPE 1 DIABETIC PATIENTS AFTER SUCCESSFUL KIDNEY-PANCREAS TRANSPLANTATION
No full text- …
