Biomedical subjects

G Antonucci

Publications and source records attributed to G Antonucci.

77 records · Page 5Linked to original sources

PubMedDate not supplied

One-year follow-Up in stroke patients discharged from rehabilitation hospital.

This study was designed to evaluate functional status at a 1-year follow-up in consecutive first-stroke patients after discharge from rehabilitation hospital and to identify reliable prognostic factors associated with changes in their abilities. Functional evaluation was made of consecutive patients 1 year after discharge to their own homes. Two multiple logistic regressions (forward stepwise) were performed using both improvement and worsening of the Barthel Index score between discharge and follow-up as dependent variables. Independent variables were medical, demographic and social factors. The final sample included 157 out of 172 patients. During the follow-up, 10 patients (5.81%) died because of a new cerebrovascular event, 1 patient died of myocardial infarction, 2 patients had new strokes and 2 fractured their paretic legs. Functionally, 43.3% of the patients maintained the level they achieved during inpatient rehabilitation treatment, 23.6% improved and the remaining 33.1% worsened. Patients with hemineglect and aged >/=65 years had a higher probability of functional worsening (odds ratio, OR = 3.77, 95% confidence interval, CI = 1.42- 10.0 and OR = 3.93, 95% CI = 1. 72-8.95, respectively). Postdischarge rehabilitation (performed for 46.5% of the final sample) was significantly and positively associated with functional improvement (OR = 7.23, 95% CI = 2.89-18. 05), and its absence with functional worsening (OR = 12.32, 95% CI = 4.47-37.01). In conclusion, in nearly half of the cases, functional status was still not stabilized at the time of discharge from the rehabilitation hospital. Postdischarge outpatient treatment was useful for preventing worsening of the functional ability achived during inpatient treatment and increased the possibility of further functional improvement. Age >/=65 years and hemineglect were predictors of functional worsening at follow-up.

Activities of Daily Living↗

PubMedDate not supplied

[Acute pulmonary edema from contrast media. A clinical case].

A rare and strong adverse reaction to contrast media (mdc) i.v. injected to carry out an abdominal vessels' angiography is reported. The patient suffered from non cardiogenic pulmonary edema and hypoxia. Chest X-ray detected the same radiological patterns of ARDS: in contrast alveolar edema became insignificant in 5 days. Serum immunocomplexes levels were high in the early phase of the reaction. Serum IgE, C3 and C4 were within the normal ranges. The case can be considered strongly significative because of the rarity of this syndrome; moreover, the early monitoring detected some data which could contribute to the knowledge of the physiopathology of contrast media adverse reaction. Overall, the presence of an immunological disease can increase the risk for adverse reactions to contrast media.

Aged↗

PubMedDate not supplied

Tuberculosis and HIV: a deadly interaction.

The spread of the HIV epidemic has been one of the major factors contributing to the worldwide resurgence of the tuberculosis epidemic. It was estimated that in 1997 8% of global tuberculosis cases may be attributed to HIV infection. The highest burden of HIV-associated tuberculosis is concentrated in resource-poor countries. HIV infection increases the individual's susceptibility to tuberculosis by impairing immune response to mycobacterial infection. In addition, HIV-associated tuberculosis is more difficult both to diagnose and to treat. A strong international commitment to the development of innovative strategies of diagnosis, treatment, and the prevention and integration between tuberculosis and HIV prevention programs are urgently needed to face the threat of HIV-associated tuberculosis.

Cytokines↗

PubMedDate not supplied

Home care for persons with AIds: a case-control study to identify determinants of referral to a hospital-based scheme.

We conducted a multicenter, hospital-based case-control study to identify specific characteristics of AIDS patients which determine referral to hospital care at home. The cases were patients referred to a hospital-based home care scheme, in the metropolitan area of Rome, during 1997. Each case was matched with two controls. Social, demographic and clinical characteristics were collected at referral. Univariate and multivariate analysis were performed. In the study period, 119 cases and 238 controls were recruited. In logistic regression analysis, social characteristics were not found to affect referral to the hospital-at-home scheme. A severely impaired functional status--assessed by the Functional Independent Measure--identified by a score below 100 (Odds Ratio [OR]=15.2, 95% confidence interval [CI] 2.8-82.7), and the need for prolonged intravenous therapy (OR=12.4, 95% CI=3.3-46.3) were the only two independent predictors of home-care referral. We conclude that home care, even in a period when new potent combination antiretroviral therapies are widely available, is an important integrated service component for persons with AIDS with severe functional impairment or requiring intravenous therapy.

Acquired Immunodeficiency Syndrome↗

PubMedDate not supplied

Heterogeneity of HVR-1 quasispecies is predictive of early but not sustained virological response in genotype 1b-infected patients undergoing combined treatment with PEG- or STD-IFN plus RBV.

ISDR mutation pattern and HVR-1 quasispecies were analyzed in HCV genotype 1b-infected patients treated with either PEG- or STD-IFN plus ribavirin, in order to find virological correlates of therapy outcome. ISDR region analysis, performed at baseline (T0) and at 4 weeks of therapy (T1), indicated that ISDR mutation pattern was not predictive of response to treatment. Moreover, no selection of putative resistant strains in the first month of therapy was observed. Viral load was not correlated with any parameter of HVR-1 heterogeneity. Among the HVR-1 heterogeneity parameters considered, complexity was inversely correlated to viral load decline at T1. In univariate analysis, complexity, proportion of non synonymous substitutions (NS) and NS/S ratio were lower in patients showing virological response at 6 months of treatment. Complexity was the only parameter independently associated with both decline of viral load at T1 and virological response after 6 months, even after adjustment for confounding variables. At the end of treatment or later, these correlations were lost. Evolution pattern of the HVR-1 quasispecies indicated a strong selective pressure in sustained responders, with complete substitution of pre-existing quasispecies, while minor changes occured in non responders. In relapsers both patterns were present at a similar rate. In conclusion, this study shows that HVR-1 heterogeneity may be involved in the early response to combined IFN-RBV therapy. The loss of correlation between viral heterogeneity and therapy outcome at 6 months of therapy, or later, suggests that other factors may play a role in maintaining sustained response to treatment.

Antiviral Agents↗