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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. Source

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. Source

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. Source

Objective. The aims of this study were: a) to study the relationship between depression and subjective physical and mental health status; b) to analyse comorbidity burden with related medical diseases c) to explore possible correlations. Methods. The sample consisted of 1077 hospitalised individuals in the INRCA of Fermo. The protocol included: Mini Mental State Examination (MMSE); Geriatric Depression Scale (GDS-15); Basic Activities of Daily Living (BADL); Instrumental Activities of Daily Living (IADL); Lubben Social Network Scale; SF-12 Health Survey; Comorbidity Index Rating Scale (CIRS). Regression analysis was used to explore possible correlations. Results. Depression was diagnosed in 38.1% of the total sample, most commonly in widowed and subjects with low educational status (p < 0.01). Subjects with high CIRS severity index were more depressed as compared to subjects with low/moderate severity index (p < 0.001). Similar results were observed in subjects with severe cognitive impairment (p < 0.001). Depressed subjects perceived their physical and mental health worse than non depressed subjects (p < 0.001). The explanatory variables of depression were MCS-12 and social isolation. Conclusions. Depressed subjects had low educational level, unfavourable economic level, poor subjective physical and mental health perception, poor social support, impaired functional status and high prevalence of cognitive decline. Source

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. Source

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