Search PubMed⌕ Search

Biomedical subjects

A Bulfoni

Publications and source records attributed to A Bulfoni.

At least 19 recordsLinked to original sources
PubMed2006

Laparoscopic creation of a neovagina and recovery of menstrual function in a patient with Rokitansky syndrome: a case report.

A 16-year-old woman experiencing primary amenorrhoea and cyclic pelvic pain was diagnosed with Rokitansky syndrome, which was characterized by the absence of the uterus and the upper two-thirds of the vagina, normal salpinges and ovaries and a 4 x 3 cm Müllerian remnant containing functioning endometrium located near the left adnexa. With a combined laparoscopic-vaginal operation, the remnant was anastomized with the apex of the retrohymenal fovea. The operation allowed not only the creation of a neovagina but also the recovery of a regular menstrual activity and the theoretical restoration of the reproductive capacity of this patient. An accurate pre- and intra-operative evaluation of patients with Rokitansky syndrome is necessary to identify those who might benefit from this procedure.

Adolescent↗
PubMed2004

[Artificial nutrition and hydration: basic care or medical therapy].

The development of the healthcare systems has spread the use of artificial nutrition, both parenteral and enteral, as a solution for all the problems related to those diseases that prevent oral nutrition. The need for hydration and nutrition is a basic one for humans and its fulfilment is generally considered an ordinary care, always due, however the techniques of artificial nutrition raise the question whether they can be considered therapy that can be with holded or withdrawed according to criteria that avoid useless abuses (therapeutic fury). From an ethical point of view it is very important to define the futility (a term that comprises the evaluation of the proportionality, the adequacy and the ordinariness) of the means that medicine can offer. In the reviewed clinical studies the resort to artificial nutrition and hydration is justified only as a means of improving the quality of life, while the medical decision making on the usefulness or uselessness of a treatment must take into account the efficacy of the cure from a clinical point of view and its endurance by the patient and the caregiver. The adequacy and the proportionality of the cure or of the nutritional therapy do not depend thus on the disease or its stage, but on the clinical situation of the patient, on his caregivers and on the competence of the medical staff.

Fluid Therapy↗
PubMed1999

Use of medical resources and quality of life of patients with chronic heart failure: a prospective survey in a large Italian community hospital.

AIMS: To assess the prevalence, clinical characteristics, use of medical resources and quality of life in consecutive patients with chronic heart failure (CHF) hospitalized in a large community hospital during 3 months. METHODS AND RESULTS: The study group included 354 patients with CHF, admitted in the Departments of Internal Medicine (97%) and Cardiology. Median age was 78 years [72;85], 45% were males. CHF was the main diagnosis in 72%; 28% were in NYHA class III and 49% in class IV; 42% had atrial fibrillation. The median hospital stay was 8 days [5;14], in-hospital mortality 9% in those admitted for CHF and 19% in those admitted primarily for other diseases. Patients with CHF occupied 15% of the beds; 1330 ECGs, 389 chest X-rays, 112 echocardiograms and 10 coronary angiograms were performed. A quality of life questionnaire revealed that 82% had problems with mobility, 54% with self-care and 88% with everyday activity. Thirty-nine percent of patients had at least one hospitalization during the previous year. CONCLUSIONS: Ninety-seven percent of hospitalized patients with CHF are admitted in the Internal Medicine wards and occupy 15% of beds. The majority of the patients are 72 years or older, with severe heart failure. The frequency of rehospitalization(s) and mortality rate in this population remains high. Echocardiography is performed only in 27% of patients.

Aged↗
PubMed1999

[Syncope in hospital internal medicine].

BACKGROUND: Syncope and presyncope are a relatively common problem in the general population. The differential diagnosis is complex, including benign forms and potentially life-threatening syndromes. In etiological terms, a variety of causes can be diagnosed, predominantly adopting a specialist approach to the problem. The aim of this study was to assess the epidemiological and clinical impact of syncope and presyncope in an internal medicine unit. METHODS: A prospective study was performed in cases of syncope and presyncope attending an internal medicine unit. A coded diagnostic and therapeutic protocol was used. The study included the cases discharged over a 6-month period (1/5/1998-31/10/1998). RESULTS: Syncope and presyncope were present in 6.73% of cases, mainly in elderly persons, female sex and with cardiovascular forms (6.25%). Neurally mediated syndrome was the most common form, followed by cardiac and cerebrovascular diseases, in accordance with most reports. This study confirmed the diagnostic value of an accurate anamnesis and in-depth objective examination, integrated by basic ECG. It is important to underline that this global approach to the problem allowed the recognition of gastrointestinal hemorrhage and pulmonary embolism with the trait of monosymptomatic syncope and presyncope. In the absence of significant electrocardiographic data, more extensive testing in patients restricted the cases of unknown form to 7.14%. CONCLUSIONS: Syncope and presyncope represent a multidisciplinary problem, frequently found in internal medicine, which benefits from the potential advantages of a global approach.

Adult↗
PubMed1998

[Hospital load of bacterial intestinal infections].

BACKGROUND: Infectious diarrhea is a worldwide problem, with differences from country to country, and it is an important cause of infant morbidity and mortality in the underdeveloped countries. METHODS: The present study is a retrospective assessment on bacterial intestinal infections, referring to a hospital survey during the 1995-1996 period. The aim of the work is to verify epidemiological and clinical weight of this diseases. The total number of notifications appears rather small, although the limit relating to non-inclusion of paediatric admissions and Clostridium difficile infections. With regard to this problem, it must be emphasized that non-serious and speed recovering clinical pictures probably escape hospitalization. RESULTS: In the personal research it has been proved the clear supremacy of the group D Salmonella, as referred in other Italian studies. In our investigation, the greater number of cases occurred in summer and the suspected vehicle of infection was frequently foul eggs. The analysis of case reports proved that no importance was ascribed to the research of fecal leucocytes in the diagnostics of diarrhea. With regard to this easy examination, it must be stressed the non-specific role as a screening test for bacterial enteroinvasive infections. CONCLUSIONS: The treatment effected constantly involved the maintenance of adequate fluid-electrolyte balance. However the use of an antimicrobical agent recurred frequently, with preference for ciprofloxacin. In relation to the literature reports, this specifical therapeutic approach is discussed.

English Abstract↗
PubMed1995

[Mixed cryoglobulinemia and the hepatitis C virus].

Mixed cryoglobulinemia is a cryoprecipitable immune-complex mediated disease, in which cryoglobulins are type II and III of the immunochemical classification of Brouet. Essential mixed cryoglobulinemia, in opposition to secondary, is characterized by the absence of well-defined underlying disease and clinically it shows the classical triad of Meltzer and Franklin. Several reports point to the frequent, through various, liver involvement in essential-defined mixed cryoglobulinemia. Particularly, the clinical and biological evidence of liver disease is commonly soft, in spite of the common bioptic evidence of persistent or chronic active hepatitis. The problem about which comes first in this association had been widely investigated, including the possible pathogenetic role of hepatotropic viruses. Initially some studies focused attention on hepatitis B virus, but now its importance is de-emphasized because of critical epidemiological review, results of HBV-DNA in cryoprecipitates, electron microscopy data. The recent opportunity of diagnostic tests for hepatitis C virus gave proof of its great importance in apparently essential mixed cryoglobulinemia. In fact, many researches have found a variously high prevalence of anti HCV antibodies and HCV-RNA in serum and cryoprecipitates, with selective concentration in the latter. Alpha interferon treatment has been suggested as first choice drug in the management of HCV related cryoglobulinemia. The mechanism is postulated to be primarily due to its antiviral activity. Up to date optimal dose and treatment period needs to be established.

Cryoglobulinemia↗
PubMed1995

[Unusual presentation of celiac disease in adult age].

The author report the case of a 23 year old female, where a severe iron-deficiency anemia was the only clinical expression of coeliac disease. This nonspecific appearance and similar reported observations with selected intestinal malabsorption emphasize the risk of diagnostic misleading in the prospective of atypical symptoms. The subsequent result is no glutin free diet style, with its protective role against malignancy. The non invasive screening method with related antibodies determinations is stressed important diagnostic tool.

Adult↗
PubMed1992

[Epidemiologic study on the effectiveness and safety of dihydroergocristine in impaired memory and behavioral functions in aged humans].

Aim of the study was to assess the activity of dihydroergocristine (DHEC, CAS 17479-19-5) in aged patients with impaired cognitive function. Twenty-five university hospital centres and 250 physicians participated in the study. 2,600 patients (1,104 males and 1,496 females, age range 50-80 years) were admitted to the study. Each patient was administered 6 mg/d DHEC for 120 days. Clinical evaluation was made through the SCAG Rating Scale registered at basal time, after 60 and 120 days. Responsivity to treatment was considered high when the final score was reduced by 30% and none if less than 10%. Analysis of results demonstrated that at the end of the study responsivity was high in 73% of cases, moderate in 20.4% and absent in 6.5%. Tolerability was very good as side effects were reported only in 3.16% of patients. Most frequent side effects were: nausea (1.23%), gastralgia (1.11%), headache (0.29%), hypotension (0.12%), vertigo (0.12%) and rash (0.08%). Drop-outs for gastralgia were reported only in 0.53% of the patients.

Aged↗
PubMed1992

Inappropriate emergency test ordering in a general hospital: preliminary reports.

An assessment was made on emergency laboratory test ordering at Udine General Hospital (Italy) to investigate the reasons for the excessive number of requested tests. All the orders for emergency laboratory tests during one week in June 1990 were studied. For each test the time of the order was recorded for every day of the week. The most important aspect of our investigation is the distribution of the orders during the day: in fact, test orders reached two peaks, the upper between 7 and 11 a.m., and the lower between 3 and 6 p.m. The analysis of the record cards showed that 42% of the orders were inappropriate. These preliminary findings were very useful in making the consensus on a Quality Assurance program easier, to improve the use of the Emergency Laboratory by doctors and nurses. Some preliminary results in the Emergency Medicine Department confirmed the validity of this program.

Clinical Laboratory Techniques↗
PubMed1989

A quality assurance program for the evaluation of antimicrobic treatment of urinary tract infections.

In the course of a quality assurance (QA) activity on the use of antimicrobics the authors set out to assess the management of urinary tract infection (UTI) in 76 patients. From culture data they noted an excellent or correct use in 78% of the patients, but a misuse in 22%. A committee was organized, with representatives of all departments, which set out criteria for the correct treatment of UTI. Using these criteria, the medical records were retrospectively assessed and the results are described. The protocol will be communicated to all involved, and then a reassessment will be made, to evaluate change in behaviour.

Anti-Bacterial Agents↗
PubMed1986

[Epidemiological assessment of thyrotoxicosis in a hospitalized population].

This personal survey aims to provide further epidemiological data on thyrotoxicosis in view of the fact that reports in the literature refer solely to a limited number of geographical areas. In particular an assessment was conducted on patients admitted to Pordenone Hospital with thyrotoxicosis between 1-1-1983 and 31-12-1984. The results obtained were compared with those encountered in other studies of this pathology.

Adult↗
PubMedDate not supplied

[Association of hyponatremia and eosinophilia: correlated idiopathic hypereosinophilic syndrome and SIADH or adrenal insufficiency with secondary eosinophilia].

A 56 year old man was admitted cause he had increasing symptoms as weakness, lethargy, disorientation. The total eosinophil count was 3000/mm3, the serum sodium concentration was 120 mmol per litre. In spite of severe hyponatriemia, urinary sodium excretion was not suppressed and serum osmolality (240 mOsm/Kg was lower than urine osmolality (488 mOsm/Kg). SIADH and Idiopathic Hypereosinophilic Syndrome was diagnosed because we found systemic failure signs due to hypereosinophilia (hepatitis, gastritis, pulmonary hypertension, and encefalopathy). Cortisonic treatment was started with symptoms improving, natriemia, eosynophil count and hepatitis signs normalization. After treatment stopping, reappeared asymptomatic hypereosinophilia, than we choosed Idrossiurea but, non-standing hypereosinophilia disappeared, appeared signs of preexisting adrenal insufficiency, emphasized by stopping cortisone therapy. A RMN showed an hypofiseal adenoma. Many cases of SIADH and Hypereosinophilia hiding adrenocortical insufficiency are reported with severe and unusual hypereosinophilia.

Adenoma↗