The influence of comorbidities and complications on discharge function in stroke rehabilitation inpatients.

Aim: The aims of this prospective study were: 1) to assess the frequency, type and severity of comorbidities (COMs) and complications (COMPLs) in acute stroke patients, according to the weighted comorbidity index (w-CI) of Liu et al. and 2 new indices, respectively COM severity index (COM-SI) and COMPL severity index (COMPL-SI); 2) to separately analyse the interference of COMs and COMPLs with functional status and recovery during stroke rehabilitation treatment; 3) to compare the ability of COM-SI and COMPL-SI to predict functional independence at discharge with that of w-CI.

Methods: Eighty-five stroke rehabilitation inpatients participated in the study.

[Chronic heart failure as a crisis event of the family].

The family greatly influences any of its members and significantly contributes to the patient rehabilitation. A limited and superficial interest from the family as well as an overprotective and anxiogenic behavior may lead to chronicization, relapse or even to progression of the disease. The close relationship between the patient and the physician is an illusion, since family members deeply affect this interaction.

[Work-related musculoskeletal disorders in dentistry professionals. 2. Prevention, ergonomic strategies and therapeutic programs].

In dental professionals the risk of developing work-related musculoskeletal disorders (WMSD) can be minimized through a combination of prevention, ergonomic strategies, and specific therapeutic programs. Prevention includes early identification of symptoms, analysis of working posture and activity, and the evaluation of equipment (such as dental instruments, position of the dental unit, patient and operator chairs, and lighting). The ergonomic strategies are based on identifying the best daily timetable (including periodic pauses) and most efficient team organization, as well as establishing the correct position that should be held at the patient chair.

Impact of children's respiratory allergies on caregivers.

Background: Despite the great attention that has been paid to HRQoL in children with respiratory allergy, few studies have addressed this aspect in relation to caregivers. The aim of our study was to evaluate the impact of childhood respiratory allergies on caregivers by means of a new method.

Methods: 119 parents of children suffering from allergies (75 suffering from asthma and 44 suffering from rhinitis) were recruited from three Italian Allergy Units.

Walking and disability after rehabilitation in patients with cerebellar stroke.

Aim: Aim of this study is to verify if the presence of extracerebellar stroke lesions negatively affects walking and functional capacities recovery of patients with cerebellar stroke.

Methods: This study was carried out on 43 patients. Patients' selection was made through CT and MRI scans.

[Work-related musculoskeletal diseases in dental professionals. 1. Prevalence and risk factors].

The past two decades have witnessed a sharp rise in the incidence of work-related musculoskeletal disorders (WMSD). All occupations are involved; in dental professionals (dentists, dental hygienists and dental auxiliaries) this problem occurs in 54-93% of subjects, with higher risk in elderly subjects and women. Spine, shoulder, elbow and hand are mostly involved.

Nutritional status and airflow obstruction: two independent contributors to CO diffusing capacity impairment in COPD.

Background: The association between weight loss and Chronic Obstructive Pulmonary Disease (COPD) has been recognised from many years. Based on the evidence that nutritional status reflects metabolic disturbances in COPD, the relationship between body mass index (BMI), severity of airflow obstruction and CO diffusing capacity (DL(CO)), that is the functional hallmark of emphysema, is relevant to the management of COPD phenotypes.

Methods: We reviewed 104 patients with COPD (82 males), aged 66 +/- 9 years (mean +/- SD).

Irritant vocal cord dysfunction at first misdiagnosed as reactive airway dysfunction syndrome.

Objectives: This report describes a case of vocal cord dysfunction at first misdiagnosed as reactive airway dysfunction syndrome (RADS).

Methods: A woman developed recurrent episodes of cough, dyspnea, and wheezing unresponsive to asthma therapy after irritant exposure to glutaraldehyde. Direct laryngoscopy was performed immediately after the induction of symptoms.

A rehabilitative approach to the patient with brain cancer.

The aim of this essay is to describe our experience with patients affected by cerebral neoplasia within a diagnostic-clinical path based on a rehabilitative viewpoint. Our rehabilitative model is first of all an organisational process based on the patient's global management and on teamwork. It is also defined and qualified to be multidisciplinary.

[The painful hemiplegic shoulder: effects of exercises program according to Bobath].

Aim: To verify whether a shoulder exercises program according to Bobath reduced the shoulder pain in hemiplegic patients.

Methods: We studied a total of 20 patients with pain shoulder. Ten patients are assigned to group R (submitted to rehabilitation) and ten to group R+E (submitted to rehabilitation and shoulder exercises program according to Bobath).

Subjective impact of osteoarthritis flare-ups on patients' quality of life.

Background: Clinical trials on osteoarthritis (OA) flare-ups treatment usually focus only on objective measures of health status, albeit recent literature suggestions on the importance of patients' subjectivity. Aim of the study was to evaluate the effects of OA and of its different types of medical treatment(s) on Health Related Quality of Life (HRQoL) in terms of both subjective satisfaction and functional status.

Methods: An observational study on prospective data collected from the Evaluation of Quality of life in OA (EQuO) clinical trial (April 1999-November 2000) was conducted; outpatients from 70 participating centers (Orthopedy or Rheumatology Departments in Italy) with a diagnosis of OA of the hip or knee were consecutively enrolled.

[End-of-life care in elderly heart failure patients].

Even if improved, the prognosis of chronic heart failure is still malignant, survival rate being similar to that of cancer. Due to the relevant epidemiology of the disease in the elderly, the terminal care of heart failure has a significant impact. Improving end-of-life care (by improving quality of life, quality of cure and care at the end of life and quality of dying and death) is a major challenge for health providers involved in heart failure care.

Severe humeral erosion in a bedridden patient: a comprehensive intervention to prevent bone fracture.

This article reports a 1-yr prospective study related to a bedridden patient with rotator cuff tear arthropathy featuring severe erosion of the proximal part of the humerus. To prevent spontaneous humeral fracture, a comprehensive intervention was planned. This included drug therapy for osteoporosis and pain, nurse team training on patient handling techniques, and patient and caregiver education.

[Assessment of function recovery in patients with total knee prosthesis].

The aim of this study was to analyse the evolution of motor performance in a group of patients who underwent surgical knee replacement. We also assessed patient satisfaction at 3 and 9 months after the operation. Sixty-two patients (40 women, 22 men, mean age 72.

[A model for psychological assessment of mobbing].

The phenomenon "mobbing" has been studied scientifically for twenty years. In this period, researchers have elaborated progressively more complex explanations for it. Despite the attempts to examine mobbing closely, and to define it accurately, further investigation, aimed at quantifying the factors that characterize it, is still needed.

[Return to work of a pacemaker bearing worker: the relationship between health problems and electromagnetic interferences].

The potential effects of electromagnetic fields is a problem that interest the public opinion, as the modern society expose all people to electromagnetic non ionizing radiations. The problem has a particular and important meaning facing the return to normal life and work conditions of a cardiopatic subject bearing a pacemaker (PM) or implantable cardioverter defibrillator (ICD). Electromagnetic interferences can produce temporary or permanent malfunctions in these devices.

[Anxiety, depression, and stressed life in patients awaiting heart transplantation: are these factors to be considered?].

Rationale: Heart transplantation is a therapeutic procedure in which biological, psychological, social and ethical aspects play an important role, none of them has to be underestimated. It is known that the waiting period up to heart transplantation is extremely stressful for patients and their families, causing psychopathological and disadaptive reactions. Aim of the present study was to investigate psychological tract characteristics, stress reactions and quality of life in a group of patients registered for heart transplantation.

[Sleep-disordered breathing and occupational medicine: considerations on three clinical cases].

Three subjects suffering from sleep-disordered breathing are described. Two of them (a 37-year-old lorry driver with obstructive sleep apnea, and a 47-year-old bricklayer with upper airway resistance syndrome) had suffered several accidents at work in few months, due to daytime sleepiness. The third patient (45-year-old) had developed (central and obstructive) sleep apnea after having been exposed to organic solvents for 15 years as a painter.

A field method for sampling toluene in end-exhaled air, as a biomarker of occupational exposure: correlation with other exposure indices.

A sensitive and rapid method for the determination of toluene in exhaled air is described. We have developed a device for direct breath sampling consisting of a sampler inserted into an empty 58 mL glass vial closed by a Teflon rubber septum. The sorbent cartridge functions as a diffusive sampler and employs a Tenax resin (300 mg, 35/50 mesh) to trap volatile organic compounds from the exhaled air.

Exacerbation of asthma related to Eucalyptus pollens and to herb infusion containing Eucalyptus.

Eucalyptus is known as a potential cause of cutaneous diseases due to contact with oil or pollens, and of respiratory allergic diseases due to exposure to pollens. We report the case of a 30-year-old woman with asthma and rhinoconjunctivitis in which symptoms appeared to be exacerbated by Eucalyptus pollens and by ingestion of an infusion containing Eucalyptus. Specific IgE were positive for Eucalyptus pollens and negative for common aeroallergens.

[Airborne asbestos fibers: law references, TLV, considerations].

The ACGIH proposal of 0.1 fibers/liter as TLV for airborne asbestos fibers isn't a properly parameter, because it is applicable in work environments and the Italian legislation has forbidden every work which employs asbestos from 1993 [Law 257/92 and Min.Dec.

[Occupational asthma and biological damage: adequate compensation?].

The evaluation of the damage to biological and relational capacities of the subject is the novel approach of the Italian Insurance Regulation Decree N(o) 38/2000 for compensating occupational asthma (OA). In this study we aimed to apply retrospectively the novel rating system to mild OA. From a data base of 201 diagnosis of OA collected in the 1987-97 decade 85 eligible consecutive cases of mild asthma according to the criteria of NIH/WHO guidelines on asthma were studied.

Reconstitution dynamics of plasmacytoid and myeloid dendritic cell precursors after allogeneic myeloablative hematopoietic stem cell transplantation.

Dendritic cells (DCs) are fundamental for immunity. We investigated reconstitution of plasmacytoid DC (PDC) and myeloid DC (My-DC) precursors in the first 2 months after allogeneic hematopoietic stem cell transplantation (Allo-HSCT). Circulating DCs were monitored from the earliest phase of hematopoietic reconstitution in 43 children given standard therapy to prevent graft-versus-host disease (GVHD) and either treated or untreated with granulocyte colony-stimulating factor (G-CSF) after HSCT.

[Disability and rehabilitation outcome in hemiplegia with global aphasia and neglect].

Purpose: Global aphasia and neglect are considered to be the neuropsychological disorders mostly affecting the hemiplegia outcome. The aim of this study is to examine which of the two disorders is making worse the recovery from hemiplegia.

Methods: The study was conduced on 45 patients suffering from hemiplegia: 15 subject with global aphasia, 15 with neglect and 15 without neuropsychological disorders (control group).