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Biomedical subjects

D Marcelli

Publications and source records attributed to D Marcelli.

At least 55 records · Page 3Linked to original sources
PubMed1992

Factors affecting chronic renal failure progression: results from a multicentre trial. The Northern Italian Cooperative Study Group.

In order to evaluate the prognostic factors concerning the rate of progressive deterioration of renal function, we made an inductive analysis of the behaviour of 456 patients in a multicentre, formal prospective trial aimed at clarifying the possible role of protein restriction in retarding the progression of chronic renal insufficiency (CRI). The main clinical and laboratory findings in patients whose plasma creatinine (PCr) levels doubled in comparison with baseline randomization values or who needed dialysis within 24 months after onset of the study were compared with those of the other patients. In addition, independently of the assigned diet, we tested the main variables that might affect CRI progression (sex, systolic and diastolic blood pressure, change in body weight, hematocrit, calcium-phosphate product, proteinuria, protein catabolic rate, total cholesterol and triglycerides). We used multiple regression analyses and also plotted the mean values of these parameters in each patient against an estimate of the deterioration of chronic renal failure based on the difference between the final and the initial reciprocal of the PCr and the creatinine clearance (CCr) levels. A descriptive analysis of the behaviour of PCr in the three CRI groups and in the four underlying diseases groups was made. PCr levels at entry, underlying disease and proteinuria were prognostic factors for CRI progression. The increase in PCr was 0.0102 mg/dl/month in patients with nephrosclerosis, 0.0203 mg/dl/month in interstitial nephropathy, 0.0360 mg/dl/month in glomerulonephritis and 0.0704 mg/dl/month in polycystic kidney disease.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1992

[The role of microrhythms and macrorhythms in the emergence of thought in the infant].

Cathexis of time and even more of waiting is considered critical for the development of thought, as S. Freud himself often pointed out. The author discusses the means available to the infant for growing out of the hallucinatory perceptual system and coming to a representational activity which implies a capacity to tolerate the frustration provoked by the waiting. Two distinct interactive processes play a role in the appearance of thought: on one part the macrorythms of repetition involving the interaction partners, mainly in their care-giving activities; on the other part the microrythms with their discontinued rhythms, unsatisfied waiting involving the partners in short sequences, mainly in play activities. The author tentatively demonstrates on the basis of clinical examples and various sources that these seemingly opposed moments give a structure to a unique element of the dyad: the interactive rythm. Rythm is a condition of the capacity to wait and thus of the capacity to think.

Child Development↗
PubMed1983

[An amnesic adolescent].

Personality amnesia is a difficult and fairly uncommon problem in psychiatric practice. We report the case of a 15-year-old adolescent who experienced total amnesia for two months. His identity could be established only by publishing his photo and history in a widely read newspaper. After discussing diagnostic problems, we remain unsure as to the psychopathological diagnosis, a difficult issue in personality amnesia, and prognosis, which is unpredictable as a result of the changes inherent to adolescence.

Adolescent↗
PubMed1983

[Course of an adolescent diagnosed as schizophrenic: uncertainty].

This paper reports the case of a female patient hospitalized twice at a twelve-year interval in the same department. During the first hospitalization at the age of fifteen clinical findings and results of projective tests had led to consider schizophrenia. The patient had been entered upon a Sakel cure. Twelve years later, this twenty-seven-year-old patient has no symptoms pointing to schizophrenia. Her mental organization and the nature of the relationships she establishes with others rather suggest pathologic personality organizations which are now better known, especially narcissic pathology. While the answers to projective tests performed at a twelve-year interval are very similar, the interpretation of these tests no longer focuses upon the same issues. This observation is especially interesting as an illustration of the developments which have taken place in the psychopathological approach and as material for an a posteriori discussion of the Sakel cure which has now been practically abandoned. Lastly, this observation clearly shows that strict focusing upon the diagnostic neurosis-psychosis alternative is an oversimplification. From this viewpoint, the wide field of conditions designated as "borderline" has led to more dynamic discussions and more subtle therapeutic choices.

Adult↗
PubMed1983

[Interview with the adolescent and his parents].

The author proposes a sequence of two or three "investigation" interviews prior to any therapeutic decision. Besides their diagnostic purpose, these interviews are designed to evaluate the adolescent-consultant, parent-consultant and adolescent-parent relationships, with special attention being given both to current interactions and to the adolescent's position in the family history. The author concludes with a few remarks on the implementation of these interviews whose results determine therapeutic proposals.

Adolescent↗
PubMed1983

[Clinical study of the siblings of the handicapped child].

The consequences of the presence of a child with an encephalopathy on the siblings was studied through interviews and questionnaires. The preliminary findings are reported on. The siblings' outlook depends primarily on the parents' conscious, but also subconscious, attitude towards the handicapped child. The relationships between the siblings are always profoundly affected; they no longer serve, as they usually do, in the course of the oedipian process or in providing reciprocal support (a relationship based on competition but also on identification and mutual exchange between siblings). Aggressiveness is always strongly repressed; the author believes that the minor symptoms, such as inhibition and enuresis, which are common occurrences in the siblings, originate in this repression. In order to exemplify these points, a few clinical instances are given, with, in particular, the partial report of a psychotherapy.

Adolescent↗
PubMed1979

[Unusual sequelae of a cranial injury].

A 13 year old child who had an apparently mild head injury presented with psychiatric sequelae. The main feature was a variable level of consciousness. The only explanation for the symptoms lay within the family environment. A hysterical converion symptom was possible but the start of a psychosis could not be excluded.

Adolescent↗
PubMed1979

[The traveler without luggage. A case of lost identity in an adolescent (author's transl)].

Loss of personal identity is a difficult problem which is relatively rarely encountered in psychiatric practice. A case is reported of an adolescent of 15 years of age with total amnesia over a period of two months. His true identity was discovered only after his photograph and story had been published in a widely-read daily newspaper. Following a discussion on the possible etiological mechanisms involved, two problems remained unresolved: the difficulty of establishing a psychopathological basis for a loss of identity, and the prognostic uncertainty inherent in restoring the adolescent's identity.

Adolescent↗