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Biomedical subjects

G Invernizzi

Publications and source records attributed to G Invernizzi.

At least 55 records · Page 3Linked to original sources

Risk of deliberate self-harm and factors associated with suicidal behaviour among asymptomatic individuals with human immunodeficiency virus infection.

The study was aimed at evaluating the risk of deliberate self-harm (DSH) and factors associated with suicidal behaviour in 213 asymptomatic individuals with human immunodeficiency virus (HIV) infection in 3 transmission categories (68 gay men, 123 intravenous drug users and 22 heterosexuals). The results showed that 12 HIV-seropositive (HIV+) subjects were involved in DSH after the notification of a positive HIV test result, of which 8 occurred within 6 months and 4 between 6 months and 3 years. HIV+ subjects with a past psychiatric history showed a 7.7-fold increase in the relative risk of DSH, and HIV+ subjects with a history of DSH showed a 5-fold increase in the relative risk of DSH compared with HIV+ individuals without a past psychiatric history and a history of DSH. Professionals involved in the care of HIV+ individuals need to be aware of this risk, especially in the first few months after notification of HIV status and also at later stages of acquired immunodeficiency syndrome.

Acquired Immunodeficiency Syndrome↗

Alexithymia and obesity. Study of the impaired symbolic function by the Rorschach test.

Many authors consider alexithymia a predisposing factor to psychosomatic and somatopsychic pathologies. In this study we investigated the presence of alexithymic characteristics in a group of 106 massive obese patients who requested a surgical intervention. 6 Rorschach alexithymia variables in the protocols of patients and a non-patient reference group (n = 600) were studied. Findings supported the presence of a striking alexithymic element among severely obese patients in comparison with their lean counterparts.

Adult↗

Expressed emotion and schizophrenia in Italy. A study of an urban population.

Forty-two schizophrenic patients and their close relatives took part in an Italian replication study of expressed emotion (EE). The patients were selected from the psychiatric ward of a general hospital in Milan and were subsequently followed up for nine months. All patients attended a community service clinic as out-patients, and all but one were prescribed neuroleptics for the duration of the study. Relatives were assigned to the high-EE group if they scored 4 or 5 on the emotional overinvolvement (EOI) scale, or showed hostility, or made six or more critical comments. On this basis, 18 (42%) families were rated as low EE and 24 (57%) as high EE. At follow-up, the admission rate for the 9-month period was significantly higher for the high-EE group (P less than 0.05). Furthermore, significantly fewer patients were readmitted from families showing high warmth (P less than 0.05). The presence of high warmth appeared to be associated with a lower admission rate, even in high-EE families.

Adult↗

Emotional profiles of families with a heart-operated patient: a pilot study.

Family interaction is a basic factor in determining the quality of life of patients undergoing heart surgery. The present study investigates the emotional attitudes in the relatives of 10 heart-operated patients. The results indicate that a high amount of relatives' emotional overinvolvement and warmth tends toward a correlation with lower anxiety and depression scores, and with a better 12-month outcome of the illness.

Anxiety↗

[The experience of the corporal self and the Rorschach test in severe obesity under medical-surgical treatment].

Purpose of this study is an investigation about the experience on the body Self and many relevant symbolic meanings in the massive obesity before and after the surgical therapy as well as a checking of the former obese patients in order to find out if such a heavy intervention may involve a modification of the body Self Perception in comparison with the former massive obesity situation. The investigation covered a sample group of 82 patients, and 12 of them were submitted again, after one year, to the Rorschach test with relevant evaluation through the Rausch de Trauenberg Self Representation Scale. The data thus obtained were considered again in a later phase by means of a sub-group of 10 obese patients compared with two checking groups consisting of subjects suffering from addiction pathologies (alcohol and opiate dependence) by means of the same method.

Alcoholism↗

[The Bentall technique for the treatment of aortic aneurysms and acute aortic dissections: our experience with 24 cases].

Authors report their experience between 1981 and 1989 in the surgical treatment of 24 patients, aged 11 to 68 years, with chronic aneurysm of the ascending aorta (14 cases) or acute aortic dissection (10 cases), 7 of them being in cardiogenic shock with cardiac tamponade. In 7 patients the classic Bentall technique was employed, in 7 a modified Bentall technique and in 10 cases reimplantation of the coronary arteries was performed. In 2 cases a coronary artery by-pass, by saphenous vein graft, was placed on the right coronary artery, which was involved in the dissection. Valved dacron conduits were always employed. Two patients died after the operation whereas no late deaths were recorded in a follow-up interval ranging from 3 months to 7 years. The modifications of the classic surgical technique described in 1968 by Bentall-De Bono are of primary importance in diminishing the operative mortality and the incidence of early and late complications in these patients, whose disease nonetheless remains a surgical challenge.

Acute Disease↗

[Circulatory assistance in high-risk coronary angioplasty].

Femoral vein to artery cardiopulmonary by-pass was used during coronary angioplasty in five high risk patients. In four patients the target vessel supplied more than half of the viable myocardium; in one of these, the ejection fraction of the left ventricle was less than 20%. In one patient the relative contraindications for surgery were the patient's age and the presence of concomitant renal failure. Cardiopulmonary support was established by using cut-down cannulae insertion in three patients and by using the percutaneous system in two. In the latter, the support was stand-by, but the abrupt closure of the artery ten minutes after the end of the successful procedure, required the prompt activation of the support and the patient was treated with emergency saphenous graft. The use of the cardiopulmonary support either as a prophylactic or as a stand-by, enabled coronary angioplasty to be performed on these high-risk patients. The clinical and anatomical data relative to the five patients as well as the possible use of the cardiopulmonary support system either as a prophylactic or standby application during high-risk PTCA are discussed.

Adult↗

Neurotic traits and disease duration in headache patients.

The purpose of this study was to test the hypothesis that duration of illness is correlated with neurotic personality traits. Four hundred and eighteen patients with migraine, tension, and mixed headaches were studied. The MMPI was used to evaluate the patients' personality characteristics. Scales employed were: scale 1--hypochondriasis, scale 2--depression, scale 3--hysteria, and scale 7--psychasthenia. The MMPI scale scores were analysed with regard to sex, diagnosis, and duration of illness. Patients with mixed headaches showed significantly more elevated scores on the MMPI scales than those suffering from migraine and tension headaches. No correlation was found between any of the MMPI scale scores and the duration of illness. No interaction was found between duration of illness and the diagnostic categories of headache in determining the MMPI neurotic scale scores. It is hypothesized that the higher MMPI scores found in patients with mixed headache is characteristic of these patients.

Adolescent↗

Fluoxetine compared with amitriptyline in elderly depression: a controlled clinical trial.

Twenty-eight elderly inpatients suffering from major depressive episodes (diagnosed according to DSM III) received randomly, on a double-blind basis, amitriptyline (75 mg/die) or fluoxetine (20 mg/die) for five weeks. There were four drop-outs in the amitriptyline group and two drop-outs in the fluoxetine group. Both groups showed a significant amelioration at the end point for Hamilton Rating Scale of Depression scores compared to the baseline value. Anticholinergic side-effects were significantly more severe in the amitriptyline group. Weight gain was detected only in patients receiving amitriptyline.

Aged↗

Efficacy and tolerability of fluoxetine in the elderly: a double-blind study versus amitryptiline.

Twenty-eight elderly in-patients suffering from major depressive episodes received randomly, on a double-blind basis, amitryptiline or fluoxetine for 5 weeks. There were 4 drop-outs in the amitryptiline group and 2 drop-outs in the fluoxetine group. Both groups showed a significant amelioration at the end point for HRS-D scores compared to the baseline value. Anticholinergic side-effects were significantly more severe in the amitryptiline group. Weight gain was detected only in patients receiving amitryptiline.

Aged↗

[Magnetic resonance of the thoracic aorta].

Various pathological conditions of the thoracic aorta were studied by MR Imaging in 31 patients: 23 were aneurysms (branching and non-branching), 2 arterio-venous fistulae, 2 aortic prostheses, 2 Marfan's syndromes, 1 coronary sinus aneurysm, and 1 isthmic stenosis. MRI studies were always performed on patients who had been examined by other imaging procedures. A comparative study was carried out on the results of MRI, angiography, computerized tomography, and ultrasounds. The possibility of propedeutic protocol was explored. Our experience, in accordance with the literature on the subject, indicates MRI as the procedure of choice in the study of aneurysms of the thoracic aorta. The advantages offered by MRI--the high natural contrast between circulating blood and the supporting structures, the possibility of obtaining multiplanar images as well as data on intraluminal, parietal, and extraparietal conditions--make it a highly competitive procedure if compared to either CT or angiography. While awaiting further evidence, the use of a propedeutic protocol in non-aneurysmatic diseases is still not advisable, due to insufficient patient population, and to the lack of a consistent literature on the subject.

Adult↗

Cross-sectional echocardiographic study of criss-cross hearts and superoinferior ventricles.

From August 1982 to October 1985, 8 consecutive patients, aged 4 months to 8 years (mean 2.6), with criss-cross or superoinferior ventricles, or both, were studied. Seven patients had usual atrial arrangement and 1 had mirror-image arrangement. In 5 patients there was atrioventricular (AV) concordance with crossed AV streams, the ventricular septum was horizontal in 4 and sagittal in 1, and the ventriculoarterial connections were discordant in all. The 3 patients with AV discordance had superoinferior ventricles, but a criss-cross AV relation was not present; the ventriculoarterial connections were concordant in 2 and double-outlet right ventricle in 1. The sequential connections and spatial relations of the cardiac chambers, as well as the associated anomalies, were accurately assessed by echocardiography. The diagnosis was confirmed by angiography in all patients, by surgery in 3 and by autopsy in 2.

Child↗

Life events and headache.

We have evaluated the incidence and the gravity of recent and early stressful life events in 149 patients with headache and in 43 healthy controls. The incidence of early stressful events was the same for the headache patients and the controls, and for the three subtypes of headache patients. Patients with headache had undergone more recent stressful events than the control individuals, and the difference was due to patients with migraine. The mean gravity of the recent stressful events did not differ significantly. This probably indicates that appearance of headache is not so much associated with the gravity of the events as with the fact that they have occurred in the lives of patients with other biological and/or psychological characteristics with which the stress interacts.

Adult↗

[Echocardiographic diagnosis of total anomalous pulmonary venous return].

Between March 83 and November 84, 20 patients with TAPVC were studied by cross-sectional echocardiography. The diagnosis was confirmed by catheterization, surgery or autopsy in each case. The anomalous drainage of the pulmonary veins was supracardiac in 10 patients, to the coronary sinus in 5, infracardiac in 4, mixed (supracardiac and infracardiac) in 1. The correct diagnosis was prospectively achieved in 17 patients (85); the echocardiographic examination could not show the precise site of the drainage in 2 (10); in only one patient (5) with right isomerism, double inlet indeterminate ventricle and severe pulmonary stenosis, the diagnosis of TAPVC infracardiac was missed. Seven patients (4 with TAPVC supracardiac, 3 to the coronary sinus) were sent to surgery without preoperative catheterization; the diagnosis was confirmed in all. Cross-sectional echocardiography proved to be a reliable diagnostic tool in the assessment of TAPVC. The patients in which the site of anomalous drainage is clearly identified by echo, can be sent to surgery without invasive investigation.

Coronary Circulation↗