Patients' and relatives' satisfaction with psychiatric services: the state of the art of its measurement.

Despite reservations made on its use as a means for evaluating interventions, various findings in the recent literature point to patients' and relatives' satisfaction with psychiatric services as a particularly salient and appropriate measure of outcome and quality. Even though substantial improvements have occurred in the last decade, research in the field suffers various methodological limitations regarding the study design, the instruments' construction and the lack of attention to their psychometric properties. In the last few years the need for research that develops and refines measures of client satisfaction and establishes their psychometric properties has been considered a priority in service evaluation by a growing number of authors.

Adult patients with the nephrotic syndrome: really at high risk for deep venous thromboembolism? Report of a series and review of the literature.

Background: The reported incidence of thromboembolic episodes in people with nephrotic syndrome (NS) ranges from 6% to 44% and it has been ascribed to the presence of a hypercoagulable state, as suggested by abnormalities of several hemostatic parameters in these patients. However, the results of the studies are often contradictory and fragmented and are rarely based on prospective studies. To assess the incidence of venous thrombosis and the pattern of abnormalities of the hemostatic parameters in NS, we planned a prospective study of a group of patients with NS.

The clinical significance of the antiplatelet antibody test based on results for 265 thrombocytopenic patients.

Background: The usefulness of measuring antiplatelet antibodies by ELISA or cytofluorimetric techniques for the diagnosis of idiopathic thrombocytopenic purpura is still uncertain.

Methods: We evaluated the clinical significance of two widely applicable antiplatelet antibody tests for a series of 265 patients evaluated consecutively in our Department for the diagnosis or follow-up of thrombocytopenia. Flow cytofluorimetry was used to measure platelet-associated immunoglobulins (PAIg) and the enzyme-linked immunosorbent assay (ELISA) was used to detect antiplatelet antibodies in patients sera (S-PBIg).

Adverse reactions after high-dose intravenous immunoglobulin: incidence in 83 patients treated for idiopathic thrombocytopenic purpura (ITP) and review of the literature.

Background: High dose intravenous immunoglobulin (h.d. Ig) is increasingly used in several hematological diseases.

Is ticlopidine a safe alternative to aspirin for management of myeloproliferative disorders?

Background: Bleeding and thrombosis are frequent complications in patients with chronic myeloproliferative disorders (cMPD). Antiplatelet therapy is extensively used by many physicians for primary prophylaxis of thrombotic events, even though there have been no prospective trials that demonstrate clinical benefit. The use of aspirin has been associated with a heavy incidence of serious hemorrhages, particularly of gastrointestinal origin.

Polycythemia vera and essential thrombocythemia in young patients.

Background And Methods: Polycythemia vera (PV) and essential thrombocythemia (ET) in young patients are rarely reported. Their natural histories seem to differ from those of older patients and the best treatment is still uncertain. In this follow-up study we have evaluated a cohort of 64 consecutive patients younger than 40 to determine the incidence of thrombohemorrhagic events and the long-term outcome.

An endocrinological study of patients with primary cutis verticis gyrata.

An endocrinological study of 15 psychiatric patients with primary cutis verticis gyrata (CVG) and 7 control patients was carried out. The investigation of the pituitary-gonadal axis, pituitary-adrenal axis, pituitary-thyroid axis, prolactin and human growth hormone (basal values and circadian biorhythms) did not show any significant difference between the CVG and the control patients. Only levels of free testosterone were significantly lower in patients with CVG than in the control group (p < 0.

Acute renal failure after high-dose intravenous immune globulin in a patient with idiopathic thrombocytopenic purpura.

High-dose intravenous immunoglobulin (IVIG) is considered a safe and efficacious treatment for patients with a variety of hematological and non hematological diseases, including patients with idiopathic thrombocytopenic purpura (ITP) not responsive or with contraindications to corticosteroids and/or splenectomy. Side-effects are usually minor, but severe reactions have been rarely reported. We describe the case of a patient with ITP, without pre-existing renal disease, who developed a severe transitory acute renal failure following administration of IVIG, promptly reversed after hemodialysis.

[Plasma fibronectin in chronic liver diseases].

This study was carried out to evaluated the role of the fibronectin (FN) in chronic liver diseases. For these reasons FN plasmatic concentration was assayed in patient with different degrees of chronic liver disease. For these reasons FN plasmatic concentration was assayed in patient with different degrees of chronic liver disease; the correlation between FN and the most common parameters of liver function was also evaluated.

The development and use of the Verona Expectations for Care Scale (VECS) and the Verona Service Satisfaction Scale (VSSS) for measuring expectations and satisfaction with community-based psychiatric services in patients, relatives and professionals.

In this paper the global design of a research project aiming at measuring expectations and satisfaction of patients, relatives, and professionals with community-based psychiatric services (CPS) in a multidimensional, sensitive, valid and reliable way is described. Some psychometric properties of two newly developed instruments, partly adapted from the Service Satisfaction Scale (SSS), the Verona Expectations for Care Scale (VECS) and the Verona Service Satisfaction Scale (VSSS), are discussed. Three groups were selected for inclusion in the study: all patients living with their families who had more than 18 contacts in the last three years, according to the South-Verona Psychiatric Case Register; the relative who had been mainly caring for the patient; and all professionals working in the South-Verona CPS for at least one year.

High levels of histidine-rich glycoprotein and thrombotic diathesis. Report of two unrelated families.

Two new families with history of thrombosis and high levels of histidine-rich glycoprotein (HRG) are described. The propositus of family 1 died of massive pulmonary embolism at age 34. Among his relatives, the mother and the maternal grandmother had suffered from deep and superficial vein thrombosis in their youth.

Serum trypsin in chronic renal failure and transplant patients.

The frequency and degree of elevated serum levels of trypsin (T) and correlation with other pancreatic enzymes were determined in several groups of patients with renal disease, i.e., patients with chronic renal failure (CRF), hemodialysis patients (HD), renal transplant recipients (RT), and in a control (C) group.

A follow-up study of 49 adult patients with idiopathic thrombocytopenic purpura treated with high-dose immunoglobulins and anti-D immunoglobulins.

Background: We analyze here short- and long-term results in 49 patients with idiopathic thrombocytopenic purpura (ITP), consecutively treated with high-dose (h.d.) immunoglobulins (Ig) or anti-D Ig.

The bleeding time in normal subjects is mainly determined by platelet von Willebrand factor and is independent from blood group.

Bleeding time (BT) is the most important test "in vivo" evaluating the primary hemostasis. No relationship between plasma von Willebrand factor (vWF) and BT has been found in normal subjects, whereas no data are available on the relationship between platelet vWF and blood group or BT in normal subjects. To clarify the reciprocal relationship between blood group, vWF and BT, we studied 177 normal subjects.

An unusually prolonged case of heparin-induced thrombocytopenia and disseminated intravascular coagulation.

An unusually prolonged case of heparin-induced severe thrombocytopenia and decompensated disseminated intravascular coagulation (DIC) is described. The patient, treated with heparin at a dosage of 25,000 units/day for 3 days and 12,500 units/day for an additional 4 days because of a clinically suspected deep venous thrombosis, developed (4 days after the discontinuation of heparin) a clinical and laboratory picture of severe DIC, manifested by subcutaneous hematomas and ecchymoses. Platelet count was 24 x 10(9)/l, fibrinogen level 89 mg/dl and fibrin-degradation products between 3,200 to 6,400 ng/ml.

Long-lasting remission after high-dose intravenous immunoglobulins in a case of relapsing thrombotic thrombocytopenic purpura.

Long-lasting remission after high-dose intravenous immunoglobulins in a case of relapsing thrombotic thrombocytopenic purpura (TTP) is reported. The patient had two early relapses after intensive plasma-exchange therapy. Serum platelet aggregating factor was absent.

Meta-analysis of double-blind placebo-controlled trials of antidepressants and benzodiazepines for patients with panic disorders.

Meta-analysis of 19 double-blind placebo-controlled trials of antidepressants (N = 13) and benzodiazepines (N = 6) for patients with panic disorders showed that active treatment had 25% greater success rate than placebo over a mean duration of 14 weeks. There were no statistically significant differences observed between treatment sub-groups (antidepressants--mean duration 16 weeks; and benzodiazepines--mean duration 7 weeks). On this basis antidepressants and benzodiazepines prescribed in clinical settings are likely to be equally effective in the short-term treatment of people with panic disorders.

Fibrinogen assays: a collaborative study of six different methods. C.I.S.M.E.L. Comitato Italiano per la Standardizzazione dei Metodi in Ematologia e Laboratorio.

This collaborative study, organized by the Hemostasis Subcommittee of C.I.S.

Fibrinolytic studies in 13 unrelated families with factor XII deficiency.

Background And Methods: We report the results of extensive "in vitro" fibrinolytic studies in 18 homozygous and 14 obligatory heterozygous subjects belonging to 13 unrelated families with factor XII deficiency. All homozygotes had unmeasurable factor XII activity (XII:C) and antigen (XII:Ag). None had bleeding symptoms, whereas a myocardial infarction occurred in one of them at age 51.