The assessment of complexity in internal medicine patients. The FADOI Medicomplex Study.

Background: Although the number of elderly people is progressively increasing in the world, old and very old patients have been under-represented and understudied in trials evaluating the efficacy of chronic illness management models. The usual hospital indicators and practice guidelines do not consider the effects of complexity - co-morbidity, social support, functional and cognitive status, patient adherence to therapy, risk of adverse drug reactions - in these subjects. The aim of this observational, multi-centric cohort study was to carefully assess factors contributing to the complexity of care for patients admitted to internal medicine wards.

Comprehensive complexity assessment as a key tool for the prediction of in-hospital mortality in heart failure of aged patients admitted to internal medicine wards.

Congestive heart failure (CHF) and cognitive impairment are both common problems in old age, associated with significant mortality, impaired quality of life and disability. This study evaluated patients with CHF, admitted to internal medicine and geriatric wards. We identified factors associated with a high risk of in-hospital mortality.

A prospective randomized trial of sclerotherapy versus ligation in the elective treatment of bleeding esophageal varices.

Background And Study Aims: Endoscopic ligation (EVL) and endoscopic variceal sclerotherapy (EVS) are known to be equally effective in eradicating bleeding esophageal varices in patients with hepatic cirrhosis, but the long-term safety and efficacy of the two techniques have not been clearly established. The aim of this study was to determine the relative frequency of rebleeding, recurrence of varices, and survival after treatment with the two techniques during a relatively long follow-up period.

Patients And Methods: A total of 111 patients without bleeding at the index endoscopy were randomly assigned to either EVL (n = 57) or EVS (n = 54).

Evaluation of undiluted N-butyl-2-cyanoacrylate in the endoscopic treatment of upper gastrointestinal tract varices.

Background And Study Aims: Endoscopic obliteration of upper gastrointestinal tract varices using N-butyl-2-cyanoacrylate has been proposed by some authors. The aim of the present study was to evaluate prospectively the efficacy and safety of this technique, using the undiluted substance, in obtaining hemostasis of bleeding upper gastrointestinal tract varices, as well as definitive eradication of varices located in the gastric fundus and duodenum.

Patients And Methods: We carried out variceal injections of N-butyl-2-cyanoacrylate in 80 patients (51 males, 29 females, mean age 68 years, range 19-80) with upper gastrointestinal tract varices.