Surveillance of tuberculosis treatment prescription in Italy. The Varese TB Study Group.

In industrialized countries, data on antituberculosis treatment are scanty. The aim of this study was to describe the tuberculosis (TB) treatment programme from diagnosis to drug intake in a model area of northern Italy, evaluating: 1) antiTB regimens prescribed and their adequacy; 2) dosage of drugs; 3) side-effects; and 4) drug resistance. Individual data on new TB cases from all the existing health facilities of the area were collected by means or a prospective surveillance system based on the systematic review of original clinical forms.

Reversible restrictive left ventricular diastolic filling with optimized oral therapy predicts a more favorable prognosis in patients with chronic heart failure.

Objectives: We sought to assess whether in clinically stable patients with chronic heart failure (CHF) the prolongation (i.e., increase) of an initially short (< or = 125 ms) Doppler transmitral deceleration time (DT) of early filling obtained with long-term optimal oral therapy predicts a more favorable prognosis.

Bronchoalveolar lavage causes decrease in PaO2, increase in (A-a) gradient value and bronchoconstriction in asthmatics.

The aims of this study were to (1) record the changes of (arterial oxygen partial pressure) PaO2, (arterial carbon dioxide partial pressure) PaCO2, (percentage saturation of haemoglobin with oxygen in arterial blood) SaO2 and alveolar-arterial (A-a) oxygen gradiant resulting from bronchoalveolar lavage (BAL) in asthmatic and normal subjects; (2) measure changes in forced expiratory volume in 1 s (FEV1), vital capacity forced (FVC) associated with BAL; and (3) assess possible predictive factors for the degree of hypoxaemia and impairment of spirometry resulting from BAL. Bronchoscopy and BAL (150 ml) were performed in 24 asthmatics and 15 healthy subjects. Serial arterial blood samples (radial artery) were obtained in all subjects: T1 and before T2 after local anaesthesia; T3 at end of bronchoscopy; T4 after BAL and 5 min, 15 min, 1 h, 2 h, 8 h and 24 h (T5-T10) after the procedure, FEV1 and FVC were measured immediately before and 5 min afer bronchoscopy.

[Validity and reliability of a new questionnaire on patient satisfaction in rehabilitative therapy].

Background: The aim of this study was to examine some psychometric properties of a new questionnaire measuring patients' satisfaction with respect to the quality of care during stay in a rehabilitation unit. The instrument (called SAT-16) is composed of 16 four-level items and 2 open-ended questions. The construct validity of the 16-item section was already demonstrated in a previous study based on factorial analysis.

[Functional state and indications for a rehabilitation program of patients in a dialysis center: a multidisciplinary study with ergonomic, physiatrical and psychological evaluation].

The following study describes the functional status of the entire chronic hemodialysis ambulatory population in treatment at our center. The patients were evaluated from 3 points of view: ergonomic, phyiatric and psychological, thus going a snapshot picture in time of their status. Based on these three evaluations, the need for rehabilitation intervention was determined and rehabilitation treatment program was elaborated.

Comparison of two methods of processing induced sputum: selected versus entire sputum.

Sputum analysis is increasingly used to assess airway inflammation in asthma. The analysis of sputum is currently performed with two techniques, i.e.

Induced sputum to assess airway inflammation: a study of reproducibility.

Background: Infiltration of the airways mucosa with activated inflammatory cells appears to be a major factor in the pathogenesis of asthma and other airway diseases. Examination of sputum provides a direct method to investigate airway inflammation non-invasively.

Objectives: The aim of the present study was to evaluate the reproducibility of cell counts on cytospins and fluid phase (eosinophil cationic protein, ECP) measurements in a selected portion of induced sputum.

Attenuation of unfavorable remodeling by exercise training in postinfarction patients with left ventricular dysfunction: results of the Exercise in Left Ventricular Dysfunction (ELVD) trial.

Background: Exercise is currently recommended for patients after myocardial infarction; however, the effects of regular exercise on the remodeling process remain to be defined. The aim of this multicenter, randomized study was to investigate whether a long-term physical training program influences left ventricular size and function in postinfarction patients with systolic dysfunction.

Methods And Results: Consecutive patients with <40% ejection fraction after a first Q-wave myocardial infarction were randomly assigned to a 6-month exercise training program (n=39) or control group (n=38).

[Principles of a rehabilitation treatment for returning to work after a stabilization intervention with the Colorado method].

The Authors report their experience on the method of Colorado Spinal System for reduction in spondylolisthesis; they describe a postoperative rehabilitative programme for a complete and quick functional recovery. They eventually report the clinical results achieved in 15 patients.

[Assessment of a patient satisfaction scale in rehabilitation].

Background: A new scale is presented, measuring patients' satisfaction with respect to the quality of care during stay in a rehabilitation unit. The questionnaire is self-administered and anonymous, and it includes 15 items, scored 1 to 4. The cumulative score may thus range 15-60; the higher the score, the higher the patient's satisfaction.

On crossed apraxia. Description of a right-handed apraxic patient with right supplementary motor area damage.

GP, a right-handed woman, without evidence of familial left-handedness, showed clearcut bilateral ideo-motor apraxia and oro-facial apraxia after a vascular lesion of the right hemisphere, encroaching upon the fronto-mesial region. She scored normally in most other cognitive tests, including language, but showed signs of callosal disconnection, left anarchic hand and mild unilateral spatial neglect. This cognitive profile points to the possibility of praxis being localized to the right hemisphere in this right-handed patient.

[The evaluation of the thermal threshold in those exposed to vibrations].

The results of a study carried out on 90 subjects exposed to vibratory trauma of the hand-arm compared to a non-risk control group of 54 subjects are reported. All subjects underwent a medical and neurological examination and Doppler ultrasound of the upper limbs, plethysmography of the hands, electromyography of the bilateral median nerve area and T.T.

A case of concomitant impairment of operational signs and punctuation marks.

A patient affected by amnestic aphasia, E.B., presented with a prevailing impairment in the use of operational signs and punctuation marks.

A unidimensional pain/disability measure for low-back pain syndromes.

A new measure is presented, suitable for documenting severity and response to treatment in chronic low-back pain syndromes. It is self-administered and combines two pain and seven mobility items. These were selected from pre-existing validated instruments on the basis of their sensitivity to change after treatment.

Environmental and urinary reference values as markers of exposure to hydrocarbons in urban areas.

A study using individual dosimetry to evaluate the daily inhaled dose of sixteen aromatic and aliphatic hydrocarbons in three groups of primary school children, living in three Italian towns with 50,000 inhabitants or less, (Treviglio-Lombardy; Poggibonsi-Tuscany; Valenza-Piedmont) is presented. The simultaneous use of two passive samplers (radial diffusion) for each child, for a 24 h period, determined both the indoor and indoor + outdoor environmental reference concentrations. We measured the urinary levels of benzene, toluene, ethylbenzene and xylenes for each child and hence determined the urinary reference values for BTEX.

Performance consistency in picture naming: a study of the rehabilitation effect on two aphasic patients.

We describe the effect of language rehabilitation on the naming deficits of 2 patients affected by longstanding amnestic aphasia. In particular, our aim was to study the evolution of the rate of inconsistent naming (i.e.

Skeletal muscle metabolism in experimental heart failure.

We studied peripheral skeletal muscle metabolism in monocrotaline-treated rats. Two distinct groups emerged: a percentage of the animals developed ventricular hypertrophy, with no signs of heart failure (compensated group), whilst others, besides ventricular hypertrophy, developed the syndrome of congestive heart failure (CFH group). Oxidative metabolism and redox cellular state were expressed in terms of creatine phosphate, purine (ATP, ADP and AMP) and pyridine (NAD and NADH) nucleotides tissue content.

Aorta and skeletal muscle NO synthase expression in experimental heart failure.

Nitric oxide (NO), the free radical that accounts for the biological activity of endothelium-derived relaxing factor, is synthesized from L-arginine by NO synthase (NOS). There is evidence that NO availability is reduced in the peripheral vasculature of patients with congestive heart failure (CHF). The aim of this study was to investigate the expression of NOS in the descending aorta and in the skeletal muscles of rats subjected to heart failure.

The influence of age on length of stay, functional independence and discharge destination of rehabilitation inpatients in Italy.

Advanced age in itself does not predict a poor functional outcome or a longer length of stay in rehabilitation units. Seven hundred and sixty-four adult cases were analysed, from 14 post-acute rehabilitation facilities throughout Italy. Data came from the national database run by the agency distributing the Italian version of an internationally validated scale of disability, the FIM [symbol: see text] sm (Functional Independence Measure).

Evaluation of the impact of guidelines on tuberculosis control in Italy. National AIPO "Tuberculosis" Study Group. Associazione Italiana Pneumologi Ospedalieri.

This study was performed in Italy, where a central tuberculosis (TB) unit and national guidelines on TB control are lacking. The objectives of the study were: 1) to design comprehensive guidelines on TB control; 2) to discuss them within the scientific community and to present them to administrators and politicians: and 3) to evaluate their impact from a public health perspective. The ultimate goal was to improve TB control nationwide through a consensus-based initiative.

[Decubitus ulcer in the calcaneus region: rapid development, difficult recovery].

Heel pressure sores frequently arise in patients kept in bed for a long time independently of their primary disease. In account of this event the authors completed a study concerning possible mutual relations between heel pressure sores and primary disease of the patients; to validate the pharmacological treatment in less severe sores and the surgical resolution in more serious cutaneous lesions. In the last 3 years (1992-1995) at the Rehabilitation Centre of Montescano the authors have treated 39 patients suffering from 63 different severe cutaneous lesions: from phlycten to deep necrosis.

Quantitative evaluation of normal muscle tone.

Forty-eight normal subjects were evaluated for the purpose of objectively quantifying muscle tone. Flexor carpi radialis and extensor digitorum communis electromyographic (EMG) activity was simultaneously recorded during wrist movements imposed by a torque motor. Each session was subdivided into three steps: (1) measurement of the 'intrinsic stiffness index' (ISI) at 10 degrees/s; (2) measurement of the 'total stiffness index' (TSI) at 500 degrees/s; (3) evaluation of the stretch reflex threshold speed (SRTS).