Bertorelli G.,University of Parma |
Gualtieri G.,University of Parma |
Nardelli A.,Unita Operativa di Geriatria
Rassegna di Patologia dell'Apparato Respiratorio | Year: 2013
We report a case of spinal tuberculosis (Pott's Disease) in a 83 year-old woman. She had longstanding back pain and progressive neurological deficit. Vertebral MRI showed tuberculous spondylitis. The patient underwent computed tomography (CT)-guided needle biopsy of the D6-D7 lesion. Histological examination revealed necrosis without granulomas. Acid-fast bacilli cultures were positive for Mycobacterium tuberculosis. She was placed on a 6-month course of isoniazid and rifampin, plus pyrazinamide and ethambutol for the first two months. The spine is the most frequent location of musculoskeletal TB. Advanced disease mimics other infections and malignancy. Tuberculous spinal infections should be suspected in patients with an insidious, progressive history of back pain, especially when the thoracic vertebrae are affected and a pattern of bone destruction with relative disc preservation and paravertebral and epidural soft tissue masses are observed. Doctors are unfamiliar with the skeletal manifestations of the tuberculous disease. These factors could explain the delay of the diagnosis and the progressive neurological deficit.
Ultori C.,Unita Operativa di Geriatria |
Cimetti L.,University of Insubria |
Stefanoni P.,Unita Operativa di Geriatria |
Pellegrini R.,Unita Operativa di Geriatria |
And 2 more authors.
Aging Clinical and Experimental Research | Year: 2013
Merkel cell carcinoma (MCC) is a rare neuroendocrine tumour of the skin, characterised by an aggressive clinical course. The incidence of this rare neoplasia is rapidly increasing. Herein we report our experience with a patient who developed a MCC of the inguinal region. © 2013 Springer International Publishing Switzerland.
Differential diagnosis between epilepsy and syncope. The Oesys study (overlapping between epilepsy and syncope study): Preliminary results [Diagnosi differenziale tra sincope ed epilessia. Lo studio Oesys (overlapping between epilepsy and syncope study): Risultati preliminari]
La Licata A.,Centro per le Epilessie |
Pescini F.,Centro per le Epilessie |
Ceccofiglio A.,Syncope Unit |
Rafanelli M.,Syncope Unit |
And 13 more authors.
Bollettino - Lega Italiana contro l'Epilessia | Year: 2013
There are few studies in literature regarding the differential diagnosis between syncope and epilepsy in patients with transient loss of consciousness (T-LOC) of uncertain etiology. Data obtained on few patients, however, seem to show a common "misdiagnosis" of epilepsy (20-30%) in patients with episodes of T-LOC likely to be syncope. For this reason the Italian Group of Syncope in the elderly (GIS) of the Italian Society of Gerontology and Geriatrics has started multicenter study (Overlapping Between Epilepsy and Syncope Study), with the primary purpose to evaluate the efficiency of cardiovascular tests and neuroautonomic assessments in patients diagnosed with T-LOC of epileptic origin and recurrences despite drug therapy, and as a secondary aim, to evaluate the diagnostic and therapeutic impact of the intervention in terms of recurrence of loss of consciousness.
The burden of caregivers of elderly patients in an acute care hospital and the role of psychologists in the management of the "fragile" caregiver [Burden del caregiver di anziani ricoverati in una unità operativa ospedaliera per acuti e ruolo dello psicologo nella gestione del caregiver "fragile"]
Luchetti L.,Consultorio Aziendale per i Disturbi Cognitivi |
Porcu N.,Unita Operativa di Geriatria |
Dordoni G.,Consultorio Aziendale per i Disturbi Cognitivi |
Gobbi G.,Unita Operativa di Geriatria |
Lorido A.,Consultorio Aziendale per i Disturbi Cognitivi
Giornale Italiano di Medicina del Lavoro ed Ergonomia | Year: 2012
Introduction: the purpose was to investigate and describe the subjective burden perceived by caregivers of elderly patients affected by multiple pathologies admitted to an acute ward and to consider the necessity of intervention with special reference to the analysis of psychological support need. Methods: a sample of 100 caregivers of elderly patients admitted to Geriatrics ward was interviewed using two instruments assessing care burden: the Family Strain Questionnaire - Short Form (FSQ-SF) and the Anxiety and Depression Short Scale (AD-R). Results: the FSQ-SF highlighted that 7% of caregivers showed adequate coping abilities to face the stress related to illness; 21% of caregivers could require psychological counselling intervention; for 48% an intervention of psychological evaluation and support was recommended; for 24% the psychological Intervention became urgent. Results from the AD-R showed that 36% and 10.5% of interviewed caregivers felt clinically significant levels of anxiety and depression. Despite psychological support need was widely spread (93%), only 35% of caregivers would like to go to a specialist, 18% would like to have more information about how to receive individual psychological support. Conclusions: results from caregiver burden analysis highlight a paradox which can be defined as an unexpressed need by family members: needing more support from health care services doesn 't turn into a tangible demand for intervention. This remark raises some questions: understanding the reasons of such refusing behaviour towards the opportunity of applying specialists in psychological support and identifying which health services could be improved in order to satisfy caregivers needs. © PI-ME Pavia 2012.
Marnini P.,Unita Operativa di Geriatria |
Stefanoni P.,Unita Operativa di Geriatria |
Rapazzini P.,Unita Operativa di Geriatria |
Borsani C.,Unita Operativa di Geriatria |
Acchini A.,Unita Operativa di Geriatria
Giornale Italiano di Diabetologia e Metabolismo | Year: 2011
Hypoglycaemia is a condition caused by low blood sugar which is insufficient to support the body's energy requirements. Only recently was taken the importance of hypoglycaemia in the elderly as a risk factor for morbidity and mortality. From 1 January 2000 to 31 December 2009 in Unità Operativa di Geriatria dell'Ospedale di Circolo e Fondazione Macchi di Varese, hospitalizations for severe hypoglycaemia are 81. Among the risk factors for the older age patients, showing the importance of environmental and social survey and of current treatment but also a lack of information on the risks of hypoglycaemia. It is crucial to have, especially for the elderly, a multidisciplinary team and an extended health education program on the prevention of hypoglycaemia.
Orsitto G.,Unita Operativa di Geriatria |
Venezia A.,Unita Operativa di Geriatria |
Turi V.,Unita Operativa di Geriatria |
Fulvio F.,Unita Operativa di Geriatria |
And 2 more authors.
Giornale di Gerontologia | Year: 2010
Introduction. Exposure to active and secondhand smoking in hospitalized elderly patients was evaluated in relation to coexistence of dementia (D), mild cognitive impairment (MCI) or normal cognition (C). Methods. All patients consecutively admitted to the Geriatric Unit of the "Paradiso" Hospital, Gioia del Colle (BA), from January 2008 to May 2009, were evaluated. The smoking history was classified into five groups: never smokers, former smokers stopped ≥ 10 years, former smokers stopped < 10 years, active smokers and secondhand smokers. The cognitive functioning was categorized into three levels - normal cognition, mild cognitive impairment, dementia - according to the neuropsychological evaluation. Results. Out of 856 elderly patients (males = 345, females = 511, mean age = 77.4 ± 6.2 years, range = 65-100 years) diagnoses of dementia and MCI were respectively done in 105 (AD = 35, VaD = 43, MD = 27) and 84 subjects, whereas 667 resulted normal (C). According to the smoking history, 35% of the sample study was assessed as never smoker, 44% as former smoker, 7% as active smoker and 14% as secondhand smoker. Patients with cognitive impairment had significantly lower frequency of never smokers (D = 22%, MCI = 11%, C = 40%, p < 0.001) than patients with normal cognition. Moreover patients with MCI had significantly higher frequency of active smokers (MCI = 14%, D = 5%, C = 7%, p < 0.05) or secondhand smokers (MCI = 23%, D = 11%, C = 13%, p < 0.05) than patients with dementia or normal cognition. Statistical analysis was carried out using the Pearson χ2, the Kruskal-Wallis test and the ANOVA post-hoc comparisons. Discussion. A history of smoking is very frequent in hospitalized elderly patients with cognitive deficit. Patients with MCI had even higher rate of exposure to active or secondhand smoking.
PubMed | Unita Operativa di Geriatria
Type: Case Reports | Journal: Aging clinical and experimental research | Year: 2013
Merkel cell carcinoma (MCC) is a rare neuroendocrine tumour of the skin, characterised by an aggressive clinical course. The incidence of this rare neoplasia is rapidly increasing. Herein we report our experience with a patient who developed a MCC of the inguinal region.