A prospective evaluation of the efficacy of preoperative coagulation testing.

The efficacy of routine screening coagulation tests was studied to identify occult coagulopathies in patients prior to elective general and vascular surgery procedures. The efficacy of screening tests was compared to that of indicated tests performed for predefined clinical indications, which were elicited by history and physical examination and a detailed coagulation history questionnaire. Tests were prothrombin time (PT), partial thromboplastin time (PTT), platelet count (PC), and bleeding time (BT). Of 514 screening tests done in the 282 patients, 4.1% were abnormal, but none of them identified a clinically significant coagulopathy. Of the 605 indicated tests, 7.4% were abnormal, and all significant coagulopathies were found in this group. The study shows that preoperative screening tests for coagulopathies not suspected on the basis of detailed clinical information are unnecessary and should not be done. In the authors' institution 46% of screening coagulation tests could be eliminated.

[Analysis of a case series of 1,500 suicide attempts in Parma (1971-1983)]. / Analisi di una casistica di 1.500 tentativi di suicidio a Parma (1971-1983).

The authors analyse data from a case series of 1500 attempted suicides, gathered by the University of Parma, Institute of Psychiatry. The attempted suicides were studied according to sex, age, class, place where the subject was born and where the attempt took place, marital status, family background, level of education, financial position, occupation, as well as the method of the attempted suicide and the mental condition of the patient when under observation. The main points to emerge were the similarities between these data and those of the literature, as well as the psychological features and social background of these patients. Our study also confirms the results of a previous research on 500 attempted suicides, here included: the obtained out of the last 1.000 cases confirms those out of previous 500.

[Neuropsychologic and behavioral sequelae of cranial injuries: remarks on classification, diagnosis and correlation with injury variables]. / I postumi neuropsicologici e comportamentali dei traumi cranici: osservazioni sulla classificazione, sulla diagnostica e sulle correlazioni con le variabili del trauma.

The psychological and behavioural impairment following head injury has been investigated in order to throw light on and assess the related epidemiological aspects, methodological approaches, clinical manifestations, and the correlations between the sequelae and the variables of head trauma, i.e. degree of severity of trauma, age of patients, presence or absence of fractures and haematoma. This study was conducted on 117 head- injured patients and 43 matched "control" subjects. The findings point out the following: a) Even the medical staff is often largely misinformed about this type of sequelae. The methods used for assessment should therefore be further developed and a more systematic evaluation of the higher functions following head injury appears to be necessary. b) The syndromes observed are mostly of a composite and diffuse type. It is therefore difficult to classify them according to strict criteria; indeed, it appears that the only possible approach is to define large groups of head- injured patients based on clinical description, which are partly borne out and partly described ex novo in the present series. c) As regards the correlations between the variables of the injury and the resulting neuropsychological impairment, the age factor should be distinguished from the severity of injury. If it is true that the older patients, the greater the impairment, such a direct correlation no longer exists when severity of the injury is considered. Indeed, the latter does not appear to be a significant differential factor in determining the degree of impairment. Similarly, whether the injury is an "open" or "closed" one, or the presence of haematoma do not appear to be differential factors, either.

[Anti-androgens. Their use in dermatology]. / Antiandrógenos. Su uso en dermatologia.

Cyproterone acetate acts as an antiandrogen through competitive inhibition of the androgens at cellular level on the peripheral effectors. Associated with ethynyl estradiol potentiates its action upon the cutaneous effectors, and at the same time has a potent ovulostatic action. Forty one women with seborrhea, acne, hirsutism and androgenic alopecia were treated. In 18 cases serum testosterone level were measured by radioimmunoassay before treatment. Most had levels above the normal range. In 7 cases testosterone level were repeated during treatment. Some did not show changes, but in most testosterone plasma increased. Most of the cases with acne and seborrhea showed a definite improvement between 3 and 6 months. Alopecia and hirsutism needed a longer treatment and the results were not so satisfactory. The tolerance was excellent and the side effects were those usually found with other oestrogens and gestagens associations. No rebound was observed when the medication was discontinued, although most of the cases showed a tendency to mild recurrence.

[Repeated attempted suicides: a clinical study (author's transl)]. / Tentativi di suicidio recidivanti. Analisi di una casistica.

In this work we have again examined a sample of 500 attempted suicides which took place in Parma between September 1971 and January 1976. We have made a distinction between the various types--those who tried only once and those who repeated their attempts, and have also taken into consideration other factors--sex, marital status, family background, level of education, financial position, as well as the method of the attempted suicide and the mental condition of the patient when under observation. The main points to emerge were: a) there was a much higher rate of mental illness among the patients who had repeated their attempts, (66,6%), in comparison to those who had tried only once (19,5%). b) while there was already a high proprotion of females who made one attempt (74%), the rate rose even higher so with those who repeated their attempts (88,8%).