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Biomedical subjects

A De Santis

Publications and source records attributed to A De Santis.

At least 127 records · Page 7Linked to original sources

Long-term prognosis of early epilepsy in juvenile head-injured patients (preliminary results).

The authors present the results of a long-term follow up of 52 juvenile head-injured patients who showed early epileptic seizures. The purpose of this study is to stress the role of long-term prognosis in the early seizures and to determine in which cases a treatment preventing late seizures is eligible. They consider long-term prognosis as to be favourable. Late epilepsy occurred in 15.3% of the cases and responded favourably to anticonvulsive therapy. They suggest prophylaptic treatment in those patients who had loss of consciousness immediately after trauma, recurring seizures, coma and/or surgery.

Adolescent↗

Early post traumatic seizures in adults. Study of 84 cases.

In a series of 2.980 brain-injured patients, 84 (2.8%) showed epileptic seizures. Epilepsy occurred with a higher incidence rate in operated patients (11.6%) than in non operated ones (1.2%). Seizures appeared within the first week since trauma in 91% of the cases. They have been single in 48%, recurring in 34%, with figures of status epilepticus in 16% partial in 61%, and GM in 33%. Prognosis quoad vitam of early epilepsy seems to be favourable, however, in severely brain-injured patients, seizures occur more frequently and may determine a worsening of the clinical picture even if they are not responsible for the death.

Adolescent↗

Increased energy expenditure in cirrhotic patients with hepatocellular carcinoma.

Basal energy expenditure was measured by indirect calorimetry in 12 cirrhotic patients with hepatocellular carcinoma. Values were compared to those observed in 12 cirrhotic patients without hepatocellular carcinoma but with similar nutrition status. Energy expenditure was also predicted in each patient by the Harris-Benedict equation. Basal energy expenditure, whether expressed as kilocalorie per day or corrected for kilogram body weight or for kilogram fat-free mass, was found increased in cirrhotic patients with hepatocellular carcinoma. These patients expended an average of 250 kcal/day more than was expected given their body size. The highest values were observed in the patients who experienced a recent significant weight loss. Our study demonstrates that the presence of hepatocellular carcinoma on liver cirrhosis increases the metabolic rate of patients. This factor could contribute to progressive malnutrition in patients with hepatocellular carcinoma and should be taken into consideration when these patients are given nutritional support.

Adult↗

[Educational and training issues in occupational first aid: the requisites for the teachers of the workers responsible for first aid].

BACKGROUND: The inter-ministerial decree (D.I.) 388/03 (the Italian law on first aid in the workplace) attaches particular importance to the organization of first aid and to the content of the teaching and training of designated workers, specifying teaching objectives, programme and duration of courses. However it provides less details on the requirements and qualifications of the teachers and trainers. OBJECTIVES: To discuss this topic in the light of the guidelines contained in the literature and the existing legislation. METHODS: We used the specific references of literature and legislation concerning first aid training of designated workers. RESULTS: The objectives and the content of the training courses call for a high level of professional competence and approach. Therefore, training of designated workers should be planned and carried out in accordance with the training standards used for the teaching and training of the so-called "lay rescuers". CONCLUSIONS: The need to achieve high training standards for workers responsible for first aid at the workplace is to a large extent justified by the difficulty of the role of employees. This need follows the current tendency in regulations to guarantee adequate and up-dated training also for other agents operating within the system of workplace prevention. In this context the occupational physician plays a significant role in the training programmes for designated workers.

Accidents, Occupational↗

[Effects of anesthesia and surgical trauma on the immune response of pediatric patients].

The AA. have evaluated the effects of anaesthesia and surgical trauma on the ability of lymphocytes from 10 patients to release Leukocyte Inhibiting Factor (LIF) after stimulation with phytohaemoagglutinin (PHA). In addition, they have studied the electrophoretic mobility of Polymorphonuclear-cells (PMN) and lymphocytes of 8 patients after incubation in autologus plasma. The experimental results show decrease of LIF production after operation in 6 individuals and reduction of eletrophoretic mobility of PMN and lymphocytes. The last finding is not significant on statistical point of view.

Adolescent↗

Chronic post-traumatic headache: clinical, psychopathological features and outcome determinants.

The epidemiological and clinical profile of Chronic Post-Traumatic Headache (CPTH) has been studied in 57 out of 130 consecutive patients hospitalized, following closed head injuries, at the Institute of Neurosurgery of the University of Milan. The incidence of CPTH has been 44%. Age of the patients ranged between 4 and 69 years. Clinical pictures included closed head injuries of different degree of severity: mild, moderate and severe. Time of onset, headache frequency, character, intensity, duration and associated symptoms showed a great degree of variability. However, chronic muscle contraction headache was the commonest clinical syndrome followed by migraine. Moderate correlations have been found between the severity of CPTH disturbance of consciousness, following the head trauma, and positive findings at CT scan. Moreover the comparison of personality profiles (MMPI) of CPTH (n=26) with a post-traumatic control group, without headache (n=17) showed higher scores on hypocondriasis, depression, hysteria and schizophrenia scales only in the severe CPTH group. Age of the patients, duration of unconsciousness, neurological deficits, course length and pending litigation or compensations were unrelated to the occurrence and outcome of CPTH. These findings suggest the importance of both physical and psychological determinants (social or emotional maladjustment) in the pathogenesis of CPTH.

Adolescent↗