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Biomedical subjects

P Morosini

Publications and source records attributed to P Morosini.

At least 55 records · Page 3Linked to original sources
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↗
PubMed1982

[Blood amino acid pattern in thyreopathic patients. (pre- and post-operative analysis)].

On the basis of the effects, demonstrated in vitro, of the thyroid hormones on the amino-acidic metabolism at cellular level, the Authors analysed the aminoacidogram of 15 thyreopathic patients. They remarked significant preoperative modifications of some amino-acids, coming back to standard values after operation. The authors think the preoperative modifications are to be ascribed to thyreopathy, whereas the postoperative ones depend on the surgical trauma.

Adult↗
PubMedDate not supplied

[Cost of psychiatric patients by disability type].

OBJECTIVE: The study of the relation between treatment costs and disability of psychiatric patient groups. DESIGN: Perspective assessment of costs and disability of 1371 adult psychiatric patients in charge at two Operative Psychiatric Units (OPU), followed during an average period of 9 months. Data are related to all OPU's psychiatric services, including ambulatory, full or half-residential and psychiatric departments of acute hospital services. SETTING: OPUs of Magenta (MI) and Desio (MI). METHOD: The disability level has been measured by Health of the Nation Outcome Scales (HoNOS) filled in at the inclusion of the patient in the study and every three-months on average thereafter. Besides other HoNOSs have been filled in both at admission and discharge from psychiatric departments of acute hospitals, Residential Centres of psychiatric Therapies and Rehabilitation and Guarded Communities. All patients have been grouped using the main psychiatric diagnosis (first digit ICD-10) and the maximum disability level shown in the whole period of the study. Direct costs of publicly financed psychiatric services have only been considered. Their attribution to each patient has been made applying standard costs or tariffs (diagnostic procedures) to the data perspectively collected by the regional Register and a purposely designed protocol. RESULTS: Total cost of 1371 patients has been 9771.1 million lire with a cost per patient of 7,127,000 lire (sd 19,499,000) and a cost per "day in charge" of 27,172 lire (sd 68,358). The cost per day has been found unrelated with the length of observed time frame. At the inclusion the mean level of disability has been 4.26 points (sd 3.73) and 3.19 points (sd 3.26) at the end of the study. Its value, measured at maximum level shown by each problem in the whole period of study, has been 6.00 points (sd 4.64). Disability and treatment cost of each patient did result directly related (r = 0.626, p = 0.0001). All patients have been grouped in 12 classes with a significant (p = 0.0001) overall difference on both their disability level and treatment cost. CONCLUSIONS: All adult psychiatric patients could be grouped in disability related classes which sometimes have also a different treatment cost. A study on a greater number of patients is needed to confirm these results. It may also provide a more reliable basis for a new financing system of psychiatric services.

Adult↗
PubMedDate not supplied

[Group cognitive behavior therapy in the routine care at a Psychiatric Ward of Diagnosis and Treatment].

OBJECTIVE: To describe a preliminary evaluation of a group CBT approach which has been fully integrated into the routine care for acute psychotic inpatients, admitted to a typically overburdened inner-city psychiatric general hospital unit. DESIGN: The design is pre-post. A comparison of some indicators between the years preceding (1997) and following the beginning of the group therapy (1998) has been carried out. SETTING: Psychiatric ward of S. Filippo Neri in Rome, in 1998. METHOD: The study compared the rate of rehospitalization, the rate of compulsory admission, the use of physical restraints, the episodes of violent behaviour and the escape from the ward. During the last three months of 1998 patients' satisfaction was also measured. RESULTS: Overall 385 patients attended the group therapy, 79% of all inpatients in the period, with an average number of 4 sessions per patient. 59% of participants in the group in 1998 had a diagnosis of schizophrenia or paranoid disorder. The total compulsory admissions declined by 1/3 (p < 0.001), the "revolving door" patients declined by 1/3 (p < 0.05), compulsory admissions in "revolving door" patients declined by 3/4 (p < 0.005), violent episodes by almost half (p < 0.001), physical restraints and patients escape from the ward almost disappeared. Patients' opinion about the participation to the group was excellent. CONCLUSIONS: It is likely, but not sure, that the improvements were directly attributable to the introduction of the group treatment. Moreover, the group was clearly found to be useful by the majority of the participants. Some asked for further help of this type on discharge. These preliminary results are promising and make us confident they will act as stimuli for other colleagues to implement and evaluate this approach in other settings.

Adult↗
PubMedDate not supplied

[Variability of managerial and clinical decisions in mental health services of the Lombardy Region: the vignette method].

UNLABELLED: This paper concerns one of the four research projects developed during a training course in clinical epidemiology managed by the Lombardy training centers IREF. OBJECTIVES: To compare the recommendations for treatment concerning 9 vignettes derived from the Australian Quality Assurance Project. SETTING: Six Mental Health Services of Regione Lombardia. DESIGN AND PARTICIPANTS: For each vignette, all psychiatrists working in the 6 Mental Health Services were asked to fill in a questionnaire about treatment location, psychopharmacology, psychotherapy, priority between psychotherapy and psychopharmacology and degree of difficulty in answering. RESULTS: 44 out of 52 target psychiatrists took part to the study. Remarkable variability for treatment location and psychotherapies; moderate variation for psychodrugs prescriptions and a good agreement for diagnoses were observed. In drugs prescription an access of association was observed. The most prevalent model of psychotherapy was the psychodynamic, followed by the cognitive-behavioural and the family-systemic. There was a tendency toward a flexible approach, as suggested by recommendations of different psychotherapeutic models according to the nature of the disorder. No case were judged very difficult; only in 3 cases a judgement of "somewhat difficult" was expressed by more than 20% (but less than 30%) of the psychiatrists. CONCLUSIONS: Studies of this type are very easy to carry out and give useful information for continuous training programs and Continuous Quality Improvement projects.

Adult↗
PubMedDate not supplied

Reliability and accuracy in reporting CIN in 14 laboratories. Developing new indices of diagnostic variability in an interlaboratory study. The Working Group for External Quality Control in Cervical Cytopathology.

OBJECTIVE: To report the results of the second phase of a pilot study of an Italian national external quality evaluation program (EQA) aimed at assessing whether participation in the first phase had increased the reliability and accuracy of diagnoses and to what extent. STUDY DESIGN: In the second phase, two sets of cervical smears (similar to the ones examined in the first phase) were circulated among the 14 participating cytologic laboratories throughout Italy. Responses were recorded on a standardized form. Participants were asked to judge the adequacy of each smear and to formulate a diagnosis. They were also asked to recommend management of the patient on the basis of the smear report and to evaluate the degree of diagnostic difficulty of each slide. The results were discussed in workshops, and it was possible to reach a consensus diagnosis on 37 of 40 smears. In the statistical analysis, new indices of diagnostic variability were developed and calculated; a gross index of agreement, unweighted and weighted kappas, analysis of exchangeability, sensitivity and specificity were also estimated. RESULTS: The results of the second phase are similar to those of the first phase and no substantial improvement in accuracy and little reduction in variability were observed. The interventions carried out in this study (discussion between representatives of laboratories of diagnostic differences and reassessment of the most controversial slides) were aimed at increasing consensus among the participating pathologists but were insufficient to change the diagnostic routines in their laboratories. CONCLUSION: It may be advisable to promote two kinds of interlaboratory quality programs with two separate but integrated components: (1) a core component with slides having clear-cut diagnoses, and (2) a continuing education component.

Female↗
PubMedDate not supplied

[Diagnosis of fever of unknown origin: use of Bayes theorem].

Sophisticated tests and time are needed to establish the diagnosis of fever of unknown origin (FUO). Bayes theorem can guide the clinician to early probabilistic diagnosis. The authors had estimated the a priori probabilities in a previous study yet. In this paper the diagnostic probabilities of four clinical signs (arthralgias, myalgias, splenomegaly, multiple micro-lymphoadenopathies) and the probabilities of abnormalities of some routine laboratory tests (neutrophils count, lymphocytes count, platelets count, hemoglobin, lactic-dehydrogenase, C3 and C4 complement subunits and fibrinogen plasma concentrations, erythrocyte sedimentation rate) and of the positive bacterial cultures, were estimated in the main groups of FUO disease (indefinite, aspecific bacteria infections, non-bacterial or specific bacteria infections, neoplasias, connective tissue diseases, miscellaneous group). The data suggest that the a priori probability is not affected by the clinical signs. Arthralgias increase the probability of connective tissue diseases. Normal erythrocyte sedimentation rate and plasma fibrinogen concentrations increase the probability of paraneoplastic and indefinite fever. Thrombocytosis increases the probability of paraneoplastic fever. Over 1200 U/l serum lactic-dehydrogenase serum concentrations guide to non-bacterial or specific bacteria infectious diseases and to malignancies. Neutrophilia decreases the probability of indefinite diagnosis, even though it is not specific. The heterogeneity of the miscellaneous group makes the interpretations of the data very hard.

Arthralgia↗
PubMedDate not supplied

[The issue of authorship and proliferation of scientific research].

In conducting scientific research, certain ethical standards must be applied, not only in the actual performance of the research, in particular the choice of appropriate methodology, but also in writing about science. Authorship is an important aspect of ethical standards in scientific writing. In this article, we discuss the benefits and drawbacks of the most universally recognised guidelines for scientific authorship (i.e., those of the Vancouver Convention), in an attempt to contribute to resolving the recent debate on their presumed inapplicability. In addition to possible solutions to this problem, we provide indications regarding the closely related problem of the proliferation of scientific publications, which affects publication bias and contributes to the confusion surrounding the Impact Factor. Regardless of the specific solution adopted, it must be stressed that writing about science is an ethical decision.

Authorship↗
PubMedDate not supplied

[Assessment of working conditions in health care workers].

OBJECTIVE: Validation and first use of a self-completed questionnaire to assess opinion on working conditions in health professionals. METHODS: The questionnaire consisted of 40 items. It was developed via review of the literature and two focus groups. A reliability test-retest study was performed on 45 health professionals with different roles. Factorial validity and internal consistency of each derived subscale were evaluated on a wide sample of 514 professionals. In addition, the opinion of the health care professionals was evaluated and possible relationships were tested between total and subscale scores and the following variables: age, sex, professional role and years in the job. RESULTS: Weighted kappa was higher than 0.60 for 95% of the items, higher than 0.70 for 43% and higher than 0.80 for 20%. Factor analysis revealed that six factors--work content and organisation, physical fatigue, relationships, mental stress, hours of work, and physical environment--explained 57% of total variance. Cronbach's alpha coefficient of the subscales ranged from 0.70 to 0.91. Low levels of satisfaction in dfferent job aspects were found among general hospital staff. They were particularly dissatisfied with personal growth and development, fairness in incentives, dissemination of information, environment, support of new ideas and skills, career opportunities. In particular, satisfaction differed among the various professional roles. DISCUSSION: The questionnaire was found reliable and had a coherent factor structure, with six factors or subscales that showed good internal consistency. This questionnaire may be useful to assess satisfaction with work in health care staff. The preliminary results of its use suggest that satisfaction with different aspects of work is low.

Adult↗
PubMedDate not supplied

[Trisomy 18 (Edwards syndrome): two case reports].

Edwards (or trisomy 18) syndrome, with a frequency of about 1 over 8000 births, is commonly characterized by a very short survival; those rare cases reported with ages of 12 months or more, always were demonstrated to be chromosomic mosaicisms. Two affected children with completely different outcomes are here described; the first with a classic short-life evolution, in opposition to the second with long survival, the last a good example of all those various biological, psychological and social support interventions in these circumstances, very rare to match with, for this appears to be a trisomy 18 without mosaicism.

Chromosome Aberrations↗
PubMedDate not supplied

[Accessibility and quality to health social services in Italy for the patients with rare diseases: the opinion of associations].

This paper concerns the first phase of a study about the perception of social and health needs of people with rare diseases. The study was performed by the National Center for Rare Diseases at the Italian National Institute of Health (Istituto Superiore di Sanità - ISS). The project wants to be an example of collaboration between the research and the association worlds. Responsible of Associations of Patients and their relatives were asked their opinion about the accessibility and quality of important features of health and social services (accessibility and quality of diagnostic, pharmacological, psychological and rehabilitative interventions, social support, school and vocational training, information that was given to relatives). An ad hoc questionnaire was developed through focus groups. The questionnaire was completed by 108 associations (26,5% of the associations thar are recorded in the ISS database). Average scores showed satisfaction only for some variables and a negative gradient north-south was observed. The most frequent complaints were about information, quality of school and job training services and availability of psychological support. The study showed an high level of dissatisfaction with availability, quality and integration health and social services.

Academies and Institutes↗
PubMedDate not supplied

[Fever of unknown origin. Comparison of the diagnostic spectrum of 53 cases in a medical ward in an Italian hospital with those of other 9 countries].

In the Institute of Medical Pathology of Ancona University, 53 cases of fever of unknown origin (FUO) were reviewed. In 44 cases (83%) the diagnosis was certainly stated. The diagnostic spectrum of the diagnosed cases was: 31 infectious (58%), 3 neoplastic (6%), 8 autoimmune (15%), 2 miscellaneous diseases (4%). Nine cases (17%) were undiagnosed. The mortality rate of the diagnosed cases was 16% within 16 months. The diagnostic spectrum, compared with the FUO series from nine countries, is unlike because of a higher rate of infectious diseases and a lower rate of neoplastic diseases. The methods, successfully used to achieve the final diagnosis were: laboratory tests, including bacteriologic studies, in 39%, evaluation of the clinical course and follow-up in 25%, imaging scan tests, including radionuclide, ultrasound, magnetic resonance, computed tomography, in 23%, and anatomopathological studies in 13%. A three years' follow-up was successfully carried out in 7 out of the 9 undiagnosed patients: 5 were healed without any treatment, 1 healed through a course of non steroid anti-inflammatory drugs and only one died because of the FUO carrying disease. None was persistently sick. The data are discussed through a comparison with the series of FUO bearing patients from other 9 countries.

Adolescent↗