Search PubMed⌕ Search

Biomedical subjects

V Alberti

Publications and source records attributed to V Alberti.

7 recordsLinked to original sources

[Endoluminal radiofrequency ablation of the great saphenous vein versus stripping. A preliminary study].

AIM: To compare the postoperative courses of patients subjected to closure procedure or stripping of the great saphenous vein (GSV). METHODS: We examined 2 groups of 15 patients with ostial and truncular saphenous insufficiency matched for CEAP clinical and anatomic classes. Group A patients underwent saphenous closure; short stripping was performed on those of Group B. In the Group A surgery was performed under spinal (12) or local (3) anesthesia; the procedure was preceded by crossotomy (5), crossectomy (1) or saphenous ligation (8); in 11 cases micro-phlebotomies were associated. In the Group B surgery was performed under general (5), spinal (7) or local (3) anesthesia; the procedure always was preceded by crossectomy (1); in 11 cases micro-phlebotomies were associated. RESULTS: Group A patients were discharged 6-18 hours after surgery. None presented ecchymosis, hyperemia or skin lesions. Five complained of mild aching thigh pain, which did not require pain medication. All resumed normal daily activities the day after surgery and returned to work after 4.9 days. Six months after surgery, none of the patients had evidence of saphenous vein re-channeling. Group B patients were discharged 12-18 hours after surgery. Nine had ecchymosis on the thigh. Five reported mild thigh pain requiring analgesics. Normal daily activities and work were resumed 2.7 and 9.3 days after surgery. CONCLUSIONS: This retrospective study seems to confirm that endoluminal radiofrequency ablation of the GSV provides good immediate results with no significant complications and can reduce postoperative pain and the length of convalescence with respect to those of stripping.

Adult↗

[Preoperative laboratory testing].

The preoperative laboratory screening is commonplace in clinical practice and is traditionally defined as the practice of prescribing laboratory testing before surgery on patients undergoing a given procedure. The wide heterogeneity of the solutions prospected over the past decades emphasizes the objective difficulty at issuing definitive guidelines and recommendations. Despite its widespread use, a systematic evaluation of the clinical and cost-effectiveness of routine laboratory testing demonstrates that several approaches are as yet unsuitable, as inappropriate investigations may lead to evaluation of borderline or false-positive laboratory abnormalities. Three major difficulties can be identified when issuing reliable recommendations: articulation and appropriateness of diagnostic protocols, contestualization, in terms of surgical procedures and suitable clinical contests that might achieve the greatest advantages from results of laboratory testing, and impact of these tests on clinical management and outcome. This article aims to provide a comprehensive review of the current literature on this topic, attempting to suggest a suitable approach to the puzzling issue of preoperative laboratory testing.

Clinical Laboratory Techniques↗

[Coding and identification of heart failure].

The prevalence of the diagnosis of heart failure (HF) presents large differences, comparing the data of hospital discharge obtained from USA and Italy through te code 428 of ninth revision of International Classification of Diseases (ICD-9). As possibly the difference is related to classification, we reviewed homogeneous diagnosis in Padua General Hospital as a whole and the diagnosis at discharge in the department of Cardiology of the same hospital. Hospital HF discharge rate is on average 0.43% (0.37-0.51); while from department of Cardiology is on average 0.7% (0.15-0.85). Medical records of a group of patients (the first hundred of 1992) are analysed and recorded using the Boston criteria for scoring the certainty of HF diagnosis. The group with unlikely HF (68%) does'nt codes 428; there is 2 code 428 in group with possible (16%) and 2 in group with definite (16%) diagnosis of HF. The physician probably prefers sometimes an anatomical rather than a functional classification and therefore he underscores the impairment of left ventricular systolic function. A better code-use is needed before comparing prevalence rate from different centres.

Aged↗

[The quality of the data on hospital discharge].

Methods and results of a study on quality of the hospital discharge data are described. The study has been performed in the Hospital of Padova (Italy) and carried out on charts of all patients discharged in 1988. The completeness of discharge forms compilation, the appropriateness of diagnosis and surgical procedures coding, the correspondence between discharge forms and medical record data, the correspondence between discharge forms and computerized data have been analyzed. Four thousand seven hundred seventy six discharge forms were analyzed and 1226 (26.2%) showed one or more errors. Coding procedures have been incorrect in 18.6% of the cases. Improvement actions which have been adopted are described.

Data Collection↗

Comparison between manual and automatic coding of medical record statistical cards at a university hospital.

The coding error rate of systems for medical record statistical cards (MRSCs) throughout health services is about 30%. A program using automatic coding has been developed at the Institute of Clinical Surgery II, Padua University Hospital, with a view to reducing this percentage. Out of an overall sample of 4776 MRSCs from all departments of the hospital, 54 were automatically coded at our institute. Categories of discrepancy between the discharge diagnosis codes of the 4722 manually coded MRSCs and the other 54 MRSCs were classified as follows: types I-III, diagnosis assigned to an erroneous under-class, class or heading (ICD-9) respectively; type IV, incorrect diagnosis formulation precluding code assignment; type V, two or more discrepancies on MRSC; and type VI, secondary diagnosis not coded. Discrepancy rates were as follows: 22.3% and 0.0% for type I; 21.3% and 0.0% for type II; 17.6% and 0.0% for type III; 1.9% and 0.0% for type IV; 5.8% and 0.0% for type V; 31% and 1.9% for type VI. Code discrepancy rates for surgical procedures, which were also compared, ranged from 7.0 to 12.5% for manual coding, while no discrepancy was observed in automatically-coded MRSCs. The results clearly demonstrate the utility of the system reported on, and it is suggested that it should be used in a modified form in other hospital departments.

Abstracting and Indexing↗