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Biomedical subjects

G Farina

Publications and source records attributed to G Farina.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Five-year follow-up of 165 Italian patients with undifferentiated connective tissue diseases.

OBJECTIVE: To study those conditions with a proven or hypothesised immunologic pathogenesis and denominated under a working definition of undifferentiated connective tissue diseases (UCTD). METHODS: A multicentre prospective study was organised involving 10 tertiary referral centers of internal medicine in Italy, with the aim of describing the natural history of UCTD and the prevalence of its different clinical and immunological manifestations. RESULTS: After a five-year follow-up period, data on 165 patients were available for analysis. UCTDs occur mainly in females in their fourth decade of life. Articular and mucocutaneous features and Raynaud's phenomenon represent the most common findings. Nevertheless, we also detected a relatively high incidence of permanent major organ damage. Regarding the immunologic parameters, we documented some conflicting results in the correlation between serologic abnormalities and clinical features. In 10 patients UCTD evolved to a major disease, generally systemic lupus erythematosus or Sjögren's syndrome. CONCLUSION: A low rate of evolution to a defined autoimmune disease, the limited use of steroid or immunosuppressive therapy, and a favourable course in the majority of cases are the main characteristics of patients with UCTDs.

Adolescent↗
PubMedDate not supplied

[Work capacity evaluation: the final step of health surveillance].

Job fitness evaluation for specific jobs is the conclusive step of workers health surveillance. This should include a physical examination and specific tests for the evaluation of organ functions which are the target for risk factors in the working environment. Occupational physicians must assess job fitness following a specific procedure: cooperation with the employer in the process of risk assessment, creating of a medical surveillance protocol related to the existing risks, implementation of medical surveillance, evaluate of etiological diagnosis of workers' illnesses and express the job fitness assessment. Possible patterns of assessment are: no job limitations, some specific temporary or permanent job limitations, temporary or permanent unfitness. The competence of the occupational physician is crucial when addressing specific problems of the workers, such as indvidual hypersusceptibility, particular tasks, illnesses, pregnancy. The occupational physician's competence is also required after fitness evaluation when transferring the worker to a more suitable job when he is deemed unfit for a job at risk and in selecting adequate personal protective equipment. In addition, the physician must perform other duties according to the existing regulations such as informing workers to obtain their consensus and the assurance of maintaining of professional secrecy as regards personal information. The occupational physician is expected to be independent and impartial towards both employer and employees, which is obtained by up-dating professional skills and by acting with care and honesty.

Humans↗
PubMedDate not supplied

High incidence of Helicobacter pylori infection in patients with systemic sclerosis: association with Sicca Syndrome.

To test the incidence of Helicobacter pylori (HP) infection in patients affected by Systemic Sclerosis (SSc) a swift urease test, followed by histologic confirmation for the presence of HP was verified in 35 SSc patients. Serum samples from 46 patients were tested for HP IgG antibodies by an enzyme-linked immunosorbent assay. Urease test demonstrated the presence of HP in 23 patients out of 35 (66%); 12 of them were negative to colonization. A Sicca syndrome, with abnormal Schirmer’s test and dry mouth was detected in 66% of the patients. 78% of the patients with Sicca syndrome had a concomitant HP infection, compared to 42% of those without the syndrome (p=0,029). Altered peristalsis and reduced salivary clearance usually encourage HP infection. In patients with Systemic Sclerosis we found an enhanced frequency of HP infection.

Journal Article↗
PubMedDate not supplied

Evaluation of erythroid marrow response to recombinant human erythropoietin in patients with cancer anaemia.

BACKGROUND: Anaemia is a frequent finding in patients with cancer and may be due to different causes, including blunted erythropoietin production. MATERIALS AND METHODS: In a pilot study, we administered recombinant human erythropoietin (rHuEPO) to twelve patients with solid tumours and secondary anaemia. rHuEPO was given subcutaneously 5 d per week at escalating doses (75 to 150 U/kg per day): the aim of treatment was a Hb level > or = 10 g/dl without blood transfusion. We evaluated endogenous EPO production through serum EPO levels and erythroid marrow activity by means of serum transferrin receptor (TfR). RESULTS: Six out of 12 subjects had defective endogenous EPO production. All patients but two responded to treatment with steady increases in Hb levels above 10 g/dl, and the median dose of rHuEPO required for correction of anaemia was 75 U/kg. Response was associated with an early increase in serum TfR. Six patients developed functional iron deficiency and required iron supplementation to obtain response. Treatment improved functional ability in 4/10 responders. CONCLUSIONS: Subcutaneous rHuEPO can stimulate erythroid marrow activity in cancer anaemia, even in patients with advanced disease, and marrow response can be adequately monitored by serum TfR. Functional iron deficiency as a cause of nonresponse to rHuEPO is frequent in these patients and may require parenteral iron administration. Although erythropoietin can improve the anaemia of cancer, the decision to treat should be individualised for each patient, looking more at the quality of life and cost-effectiveness than at cosmetic increases in the haemoglobin level.

Aged↗
PubMedDate not supplied

[Biliary complications of laparoscopic cholecystectomy: our experience compared with laparotomic cholecystectomy].

Major bile ducts injuries during cholecystectomy were one of the most common complications, but they were becoming rare. With the introduction and the fast diffusion of laparoscopy their incidence has increased. For this reason we have reviewed our experience about open and laparoscopic cholecystectomy. We report 18 patients, 8 male and 10 female with age ranged from 27 to 73 years, with common bile duct injuries. Only three patients (20%) underwent surgery in our Department of Surgery of the University of Cagliari. Of these patients, two were operated on open and one laparoscopic cholecystectomy. They represent 0.08% and 0.36% of the respective groups. The most common cause of this complication is peritonitis (94.5%), followed by bleeding and congenital anomalies of the biliary tree, that were present in 5.5% respectively. The conversion to laparotomy was necessary in 3.9% of our patients, while residual choledocholithiasis in one patient was treated by laparotomic reexploration because of the unsuccessful ERCP. In summary in our opinion the prevention of this complication depends on appropriate indication and choice of the patients, as well as an adequate training. The ERCP, if indicated, must be done before laparoscopic cholecystectomy.

Adult↗
PubMedDate not supplied

[Work capacity and re-entry into the workforce for the cardiac patient].

BACKGROUND: Treatment and rehabilitation of patients with heart disease is focused on survival, work resumption, achievement of a state of subjective well-being and compliance with behavioural changes in order to prevent progression of the atherosclerotic process. OBJECTIVES: To propose a specific job fitness evaluation method for workers with heart disease, based on analysis of occupational factors influencing the cardiovascular system and the definition of a clinical and functional profile of the patient, with special regard to aspects influencing vocational attitude. METHODS: A literature review was performed. RESULTS AND CONCLUSION: Although resumption of work is not the sole objective in the rehabilitation process, it remains an important goal not only for economic reasons, but also because it is beneficial for most patients' psychological well-being. However, it must be admitted that specific job fitness evaluation is rarely performed during rehabilitation programmes of cardiac patients and this can cause problems at the time of return to work. Doubts and uncertainties are also due to the lack of standardized evaluation methods and to the clinical peculiarity of these patients, mainly due to the risk of sudden disability. The job fitness evaluation method used in this study allows physicians to perform assessments based on objective data, so improving patients' confidence in their work capacity. To achieve a satisfactory application of the method, close cooperation between the cardiologist and the occupational physician is necessary.

Disease Susceptibility↗
PubMedDate not supplied

Comparative prescription practices of family practice, internal medicine, and pediatrics residents.

The purpose of this study was to compare the prescribing practices among family practice, pediatric, and internal medicine third-year residents in an inner city ambulatory care setting. A four-month chart audit was made for the prescriptions provided for asthma, osteoarthritis, congestive heart failure, and upper respiratory infection patients by these residents. In general, family physicians prescribed medications that were not different from those used by internists and pediatricians. However, there were significant (p less than 0.01) differences in the number of visits and prescriptions among the specialties. The prescribing practices of the study group differed from a national survey of private practitioners in several drug categories.

Drug Prescriptions↗