Subject(s)
Deglutition Disorders , Humans , Deglutition Disorders/diagnosis , Deglutition , Eating , Surveys and QuestionnairesABSTRACT
BACKGROUND/OBJECTIVES: Disease-related malnutrition is a common comorbidity at hospital admission. The purpose of the present report was to describe the data on nutritional care routines collected during the Project: Iatrogenic MAlnutrition in Italy (PIMAI) study, as these may be helpful to avoid iatrogenic malnutrition and improve nutritional policies. SUBJECTS/METHODS: Standards of nutritional care were assessed on the basis of (1) adherence to study protocol (completeness of data collected); (2) attitude in assessing the nutritional status; (3) prescription of nutritional therapy (within 3 days) at least in patients presenting with overt malnutrition (body mass index (BMI) <18.5 kg/m(2) or significant weight loss (>or=10% in 3 months and/or >or=5% in the last month)), regardless of its adequacy, and adherence to current guidelines and (4) attitude in monitoring nutritional status during the stay (number of weight measurements performed compared with those expected). RESULTS: In total, 1583 subjects were assessed. A minimum data set for performing the Nutritional Risk Screening 2002 tool was available in 1284 patients (81.1%), but nutritional screening was possible in every patient by alternative analytical criteria related to food intake, anthropometry and biochemistry. However, several missing values were recorded, particularly in biochemical parameters due to lack of prescription by admission wards. According to ward practices, only 38.2% of the patients had the BMI calculated. A nutritional support was prescribed only to 26/191 patients (13.6%) presenting with overt malnutrition. Finally, we recorded that only 21.6% of the patients (207/960 were randomly selected) had their weight monitored on a scheduled basis. This reality was worse in surgical rather than medical departments (17 vs 26%; P<0.001). CONCLUSION: Present results confirm that in Italy, nutritional care routines are still poor and need improvements.
Subject(s)
Delivery of Health Care/standards , Hospitalization , Malnutrition/therapy , Nutrition Assessment , Nutritional Sciences , Nutritional Support/statistics & numerical data , Anthropometry , Attitude of Health Personnel , Biomarkers/analysis , Body Mass Index , Clinical Competence , Comorbidity , Energy Intake , Guidelines as Topic , Humans , Italy/epidemiology , Malnutrition/diagnosis , Malnutrition/epidemiology , Nutrition Surveys , Risk Assessment , Weight LossSubject(s)
Constipation , Chronic Disease , Constipation/diagnosis , Constipation/therapy , Humans , Nursing HomesABSTRACT
A case of association between pheochromocytoma and homolateral stenosis of renal artery is discussed. Until now, this is the first notification of such an association. The authors examine the possibility of a link between the two pathologies on the basis of congenital or physical factors. This association could have been so rarely just only due to the difficulty to prove it.
Subject(s)
Adrenal Gland Neoplasms/complications , Pheochromocytoma/complications , Renal Artery Obstruction/complications , Adrenal Gland Neoplasms/diagnostic imaging , Adult , Female , Humans , Pheochromocytoma/diagnostic imaging , Renal Artery Obstruction/diagnostic imaging , Tomography, X-Ray Computed , UltrasonographyABSTRACT
The authors discuss a case of thoracic-lumbar arachnoidal cyst, which was not diagnosed for a long period, despite an obvious presentation with back pain and sphincteral problems. The importance of new diagnostic techniques, such as nuclear magnetic resonance (NMR) is underlined.
Subject(s)
Arachnoid Cysts/diagnosis , Aged , Arachnoid Cysts/complications , Arachnoid Cysts/pathology , Arachnoid Cysts/surgery , Chronic Disease , Diagnosis, Differential , Female , Humans , Laminectomy , Lumbar Vertebrae/diagnostic imaging , Lumbar Vertebrae/pathology , Lumbar Vertebrae/surgery , Magnetic Resonance Imaging , Thoracic Vertebrae/diagnostic imaging , Thoracic Vertebrae/pathology , Thoracic Vertebrae/surgery , Tomography, X-Ray ComputedABSTRACT
A case of angiosarcoma of the thyroid, the most rare tumor of this gland, is discussed. The existence of this form has been denied by many authors, but recent immunochemical analyses (endothelial Factor VII related antigen) and electron microscopy (Weibel-Palade bodies) confirm definitively its vascular origin.
Subject(s)
Hemangiosarcoma/pathology , Thyroid Neoplasms/pathology , Aged , Aged, 80 and over , Female , Humans , Neoplasm Staging , Thyroid Gland/pathologySubject(s)
Pulmonary Embolism , Aged , Diagnosis, Differential , Female , Humans , Pulmonary Embolism/diagnosis , Pulmonary Embolism/therapyABSTRACT
Leukocyte aggregation induced by N-formylmethionyl-leucyl-phenylalanine (FMLP) has been measured in a group of patients with hypercholesterolaemia (n = 22) and in a group of control subjects (n = 26), age- and sex-matched. When hypercholesterolaemic patients were divided into two groups, with a discriminatory level of 7.7 mmol/l of plasma cholesterol, FMLP-induced leukocyte aggregation of patients with greater than 7.7 mmol/l of plasma cholesterol was significantly higher compared both with control subjects and patients with plasma cholesterol levels less than 7.7 mmol/l. A positive significant correlation was found between leukocyte aggregation and plasma cholesterol, whereas no correlation was observed between leukocyte aggregation and plasma triglycerides or APO-B levels. These findings provide further support for the hypothesis that elevated plasma cholesterol levels may induce a cellular membrane abnormality responsible for the increased leukocyte aggregation and, subsequently, endothelial damage.
