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Biomedical subjects

F Landi

Publications and source records attributed to F Landi.

At least 73 records · Page 4Linked to original sources
PubMed1997

Usefulness of serology in preendoscopic screening. The Italian Helicobacter pylori Study Group.

BACKGROUND: Over the last 20 years, upper gastrointestinal endoscopy has become the investigation of choice for patients with symptoms referrable to the upper gastrointestinal tract. As the increasing number of patients referred for endoscopy has led to enlarged waiting lists and medical expenses, it has been recommended that preendoscopic screening strategies might identify patients at low risk of having major pathology. These patients could avoid prompt endoscopy and might safely undergo different management. Since the recognition of the major role played by Helicobacter pylori in gastroduodenal pathology, H. pylori serological and demographical features have been proposed as part of preendoscopic screening strategies in dyspeptic patients referred to endoscopy, in an attempt to reduce endoscopic workload and medical expenses. METHODS: We evaluate data presented in the literature and aim to give interpretations possibly helpful in the clinical practice. RESULTS: The analysis of the endoscopic findings showed that applying a preendoscopic strategy based on age and H. pylori status in local hospitals without a specific interest in H. pylori research would have meant missing a proportion of relevant pathology: 35 of 557 (6.3%) peptic ulcers (24 duodenal and 11 gastric ulcers) and two gastric cancers (0.3%). CONCLUSIONS: Although we do understand the need to increase the cost-effectiveness of endoscopy and realize that considering age and H. pylori status could help to get to this target, we conclude that similar preendoscopic screening strategies must be refined further before being adopted on a large scale.

Endoscopy, Gastrointestinal↗
PubMed1996

Pressure ulcers.

Explore the source record for details and available documents.

Aged↗
PubMed1996

Energy intake and in-hospital starvation. A clinically relevant relationship.

BACKGROUND: Malnutrition is a common finding in the acute-care hospital. OBJECTIVES: To assess the adequacy of nutritional intake to individual needs and the effects of the hospitalization on nutritional status and to identify the reasons for inadequate energy intake. METHODS: A total of 286 patients with a mean ( +/- SD) age of 79 +/- 6 years (range, 70 to 99 years), consecutively admitted to the geriatrics and internal medicine wards of an acute-care university hospital, underwent multidisciplinary assessment on admission and at discharge and daily dietary data collection. The needed, prescribed, and actual daily energy intake for each individual was measured. Nutritional depletion was diagnosed if midarm circumference decreased by 3.6% or more from admission to discharge. RESULTS: Nutritional depletion occurred in 27% of the patients and correlated with anorexia (86.4% vs 65.5% and 40% in patients whose midarm circumference was unchanged and increased, respectively; P < .001), Mini-Mental State Examination score (21.6 +/- 8.3 vs 23 +/- 6.9 and 26.5 +/- 3.6; P < .05), simplified premorbid Activities of Daily Living score (4.4 +/- 2.2 vs 5.1 +/- 1.8 and 5.0 +/- 1.8; P < .03), lymphocyte count (1.32 +/- 0.63 x 10(9)/L vs 1.62 +/- 0.88 x 10(9)/L and 1.47 +/- 0.50 x 10(9)/L; P < .03), serum albumin level (38 +/- 5g/L vs 40 +/- 4 g/L and 39 +/- 8 g/L; P < .002), ratio of actual to needed energy intake (56.9% +/- 22.1% vs 69.3% +/- 30.4% and 60.0% +/- 14.1%; P < .01), ratio of actual to prescribed energy intake (50.5% +/- 16.9% vs 60.5% +/- 20.%% and 65.5% +/- 15.7%; P < .001). Patients who consumed less than 40% of the prescribed food complained of anorexia and masticatory inefficiency and were unsatisfied with quality and timing of meals compared with other patients. CONCLUSIONS: In-hospital starvation affects mainly patients with baseline nutritional, functional, and cognitive deficits and is strongly related to the inadequate energy intake.

Activities of Daily Living↗
PubMed1996

A simple program to train case managers in community elderly care.

The case manager, like many "new professions" does not yet have a defined curriculum. We consider that the principal requisite for case managers is a proficient knowledge of assessment for the care of elderly. Therefore, we focused a four-week teaching course for future case managers on the National Resident Assessment Instrument (RAI) of the United States and the Long-Term Care Program Application and Admission Form of British Columbia, Canada. We verified that this simple program provides students with adequate skills to become case managers.

Aged↗
PubMed1996

Nutritional assessment: a primary component of multidimensional geriatric assessment in the acute care setting.

OBJECTIVE: To test the prognostic role of nutritional variables as a component of geriatric multidimensional assessment and to study the effect of hospitalization on nutritional status. DESIGN: Validation cohort study: multidimensional assessment on admission and at discharge and a weekly nutritional assessment. SETTING: General Medicine and Geriatrics wards in an acute-care university hospital. PATIENTS: A consecutive sample of 302 patients aged 79 +/- 6 years, range 70-96 years. MAIN OUTCOME MEASURES: Mortality, longstay (> 29 days), loss of lean body mass as expressed by a negative change in mid-arm muscle circumference (MAMC). RESULTS: Incidence of mortality, longstay, and decreased MAMC was 6.9%, 24.8%, and 64.2%, respectively. According to logistic regression analysis, mortality was independently predicted by preadmission dependency in at least one Activity of Daily Living (odds ratio = 2.08, confidence limits = 1.19-3.65), clinical diagnosis of malnutrition (OR = 1.89, CL = 1.11-3.21), serum albumin < 3.5 g/dL (OR = 1.82, CL = 1.06-3.14). This predictive model allowed us to recognize 75% of the patients at risk of death by targeting 23% of the population. Longstay was independently predicted by stroke (OR = 1.54, CL = 1.01-2.35), clinical diagnosis of malnutrition (OR = 1.41, CL = 1.04-1.93), and more than five comorbid diseases (OR = 1.39, CL = 1.01-1.94). Dependency in at least one ADL was the only independent predictor of decreased MAMC (OR = 1.71, CL = 1.27-2.30). CONCLUSIONS: Nutrition variables are a cardinal component of multidimensional assessment in the acute-care setting. Nutritional status deteriorates during the hospital stay, mostly in physically dependent patients.

Activities of Daily Living↗
PubMed1995

[Endosseous integrated implantation: multiple post-extraction implantationing threaded cyclindric titanium. Use of a semipermeable reabsorbable membrane].

On the basis of their experience of postextractive oral grafts, the authors examine all the surgical possibilities of this technique, at times using osteoinducing materials or at others semipermeable reabsorbable membrane; on other occasions an ostroinducing material associated with reabsorbable membrane is used to stimulate piloted regeneration of underlying bone tissue. Although not widely used, the post-extractive technique is presented as a fascinating reality that certainly, if used with due care, produces satisfactory and gratifying results. The authors are convinced that the contribution to simplifying surgical procedures and the reduced number of sessions that a patient has to undergo is without doubt a considerable advantage. In fact, using the postextractive technique with reabsorbable membrane the patient only undergoes a single operation. The authors have experience of three hundred post-extractive grafts with a very low failure rate (loss of seven grafts). These results can be attributed to clear rules: respect for antisepsis precautions, minimum surgery involving bone tissue, design of access flap to bone arch, positioning of fixture in correct spatial and occlusal direction, instant graft stability and perioplantar bone neoformation free of interference. The use of grafts has become a routine technique and is a valid alternative to prosthetic rehabilitation stages. It has become a true field with precise characteristics in the context of modern dentistry.

Adult↗
PubMed1991

Ostium secundum atrial septal defect in the elderly.

Atrial septal defect (ASD) is one of the most common congenital cardiac anomalies in adults. Life expectancy is shortened, and almost 90% of patients die by the age of 60 years. The progression of this congenital disease to congestive heart failure has been related to several factors such as the onset of pulmonary hypertension, arrhythmias, bronchopulmonary infections, or the development of other cardiovascular disease. We describe three cases of very old patients with significant ASDs and late development of symptoms. Given the higher risks and poorer long-term results of surgical closure of the defect in advanced age, the indications for such an intervention in elderly patients should be carefully evaluated.

Aged↗
PubMed1983

[Varicocele: cause of sub-fertility (therapeutic considerations)].

The Authors examined the seminal liquid of 60 patients suffering from non-obstructive oligosperma after different treatments. On the basis of the results obtained, they emphasize the importance, after operation, of the medical treatment in the normohormonal varicocelic patients. They suggest the surgical treatment in the non-varicocelic subjects, in who an inversion of the veenous flux in an inside spermatic vein was ascertained.

Adult↗