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1.
J Neurophysiol ; 102(3): 1623-31, 2009 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-19553476

RESUMO

This event-related functional MRI study examines the neural correlates of vibrotactile sensation within the context of different psychophysical demands. Nine subjects received vibrotactile stimuli on the right volar forearm during detection, localization, and passive tasks. In the detection task, subjects indicated the offset (end) of each stimulus by pressing a response key with their left hand. In the localization task, subjects identified the location of the stimulus ("distal?" or "proximal?") by pressing the appropriate response key 4 s after the end of the stimulus. In the passive task, subjects received the same vibrotactile stimuli, but no response was required. Analysis of stimulus-evoked activity compared with the resting baseline period revealed significant bilateral secondary somatosensory cortex activation for all three tasks. However, only in the offset-detection and localization tasks was stimulus-evoked activation observed in other expected areas of tactile processing, such as contralateral primary somatosensory cortex neighboring the posterior parietal cortex (SI/PPC) and in bilateral anterior insular cortex (aIC). During the localization task, we identified vibrotactile-evoked activation in the right aIC, which was maintained after the termination of the stimulus. Results suggest that vibrotactile-related activation within SI/PPC and aIC is enhanced by the increased levels of attention and cognitive demands required by the detection and localization tasks. Activation of aIC not only during vibrotactile stimulation, but also during the poststimulus delay in the localization trials, is consistent with the growing literature linking this area with the perception and short-term memory of tactile information.


Assuntos
Córtex Cerebral/fisiologia , Cognição/fisiologia , Potenciais Somatossensoriais Evocados/fisiologia , Tato/fisiologia , Vibração , Vias Aferentes/irrigação sanguínea , Vias Aferentes/fisiologia , Análise de Variância , Mapeamento Encefálico , Córtex Cerebral/irrigação sanguínea , Eletroencefalografia/métodos , Feminino , Lateralidade Funcional/fisiologia , Humanos , Processamento de Imagem Assistida por Computador/métodos , Imageamento por Ressonância Magnética/métodos , Masculino , Oxigênio/sangue , Psicofísica , Tempo de Reação
2.
J Prev Med Hyg ; 49(4): 152-7, 2008 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-19350964

RESUMO

INTRODUCTION: The quality of life (QoL) is an important outcome indicator for heart failure management. As the use of a validate questionnaire in a different cultural context can affect data interpretation our main objective is the Italian translation and linguistic validation of the Severe Heart Failure Questionnaire (SHF) and its comparison with the MLHF (Minnesota Living with Heart Failure) Questionnaire. METHODS: The SHF and "The Minnesota Living with Heart Failure Questionnaire" were translated. A consensus involving parallel back-translations was established among a group of cardiologists, psychologists and biostatisticians. SHF and MLHF were both administrated to a sample of 50 patients. RESULTS: The patients' median age was 63 years. Ace inhibitors therapy was administered in 88% of cases and betablockers in 56% of cases. Finally the Italian version of SHF correlates well with MLHF for all domains, except life satisfaction SHF domain. DISCUSSION: The Italian version of the SHF correlates well with MLHF for almost all domains and it represents a valid alternative for quality of life assessment in heart failure patients.


Assuntos
Insuficiência Cardíaca/psicologia , Linguística , Qualidade de Vida , Inquéritos e Questionários/normas , Traduções , Idoso , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Interpretação Estatística de Dados , Feminino , Insuficiência Cardíaca/tratamento farmacológico , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , População Branca
3.
Monaldi Arch Chest Dis ; 58(2): 95-100, 2002 Sep.
Artigo em Italiano | MEDLINE | ID: mdl-12418421

RESUMO

RATIONALE: In the management of heart failure the general practitioner (GP) plays an important role. However, international studies proved that the GP differs in the management of these patients from the cardiologist. This pilot study aims at investigating if such differences persist in the Italian community. MATERIALS AND METHODS: Seventy patients with heart failure have been enrolled prospectively by 10 GPs in the Udine district (ASL 4). All of them have been evaluated at the first and subsequent visits, both with respect to clinical and instrumental parameters, overall resource consumption and quality of life. RESULTS: We observed a high degree of heterogeneity in the follow up patterns; a low coordination between GP and cardiologists in managing patients; several co-morbidities; high social burden; a good adherence to treatment guidelines; a moderate workload, subjectively evaluated from the GP. CONCLUSIONS: This experience motivated the need of further research in the field, and, from the point of view of the daily practice, the need of integrating hospital and community management of patients with heart failure.


Assuntos
Insuficiência Cardíaca/terapia , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Feminino , Recursos em Saúde/estatística & dados numéricos , Humanos , Itália , Masculino , Projetos Piloto , Estudos Prospectivos
5.
Ital Heart J Suppl ; 2(4): 390-5, 2001 Apr.
Artigo em Italiano | MEDLINE | ID: mdl-19397013

RESUMO

BACKGROUND: The aim of this study was to evaluate the effectiveness of a health education intervention aimed at improving therapeutic compliance and quality of life of patients with chronic heart failure (CHF). In this 1100 bed Community hospital 97% of patients with CHF admitted to the Internal Medicine Unit have a high rate of readmission, mortality and negative quality of life. METHODS: Two hundred patients (123 males, 77 females, mean age 75 years) were enrolled and randomized. CHF patients admitted to the Internal Medicine Unit were randomly assigned to usual care (n=100) or intervention group (n=100), which consisted of a nurse-guided education program, facilitated telephone communication and regularly scheduled follow-up visits with an internist. The primary endpoints were quality of life and quality of service improvement, and improved compliance with the heart failure guidelines. All patients were submitted to echocardiography. RESULTS: Ejection fraction is available for 87% of them. Baseline quality of life is similar in both groups. Final data will be available after April 2001.


Assuntos
Insuficiência Cardíaca/terapia , Qualidade de Vida , Idoso , Feminino , Hospitais Públicos , Humanos , Masculino
6.
Am J Cardiol ; 86(3): 353-7, 2000 Aug 01.
Artigo em Inglês | MEDLINE | ID: mdl-10922453

RESUMO

Using information from the Italian Network on Congestive Heart Failure, we examined whether clinical epidemiologic characteristics, drug prescription patterns, and outcome of patients with congestive heart failure differed according to sex and whether gender was an independent risk factor for mortality and hospital admissions.


Assuntos
Insuficiência Cardíaca/mortalidade , Admissão do Paciente/estatística & dados numéricos , Fármacos Cardiovasculares/uso terapêutico , Causas de Morte , Doença Crônica , Feminino , Seguimentos , Insuficiência Cardíaca/tratamento farmacológico , Insuficiência Cardíaca/etiologia , Humanos , Itália/epidemiologia , Masculino , Fatores Sexuais , Taxa de Sobrevida , Resultado do Tratamento
7.
Eur J Heart Fail ; 1(4): 411-7, 1999 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-10937956

RESUMO

AIMS: To assess the prevalence, clinical characteristics, use of medical resources and quality of life in consecutive patients with chronic heart failure (CHF) hospitalized in a large community hospital during 3 months. METHODS AND RESULTS: The study group included 354 patients with CHF, admitted in the Departments of Internal Medicine (97%) and Cardiology. Median age was 78 years [72;85], 45% were males. CHF was the main diagnosis in 72%; 28% were in NYHA class III and 49% in class IV; 42% had atrial fibrillation. The median hospital stay was 8 days [5;14], in-hospital mortality 9% in those admitted for CHF and 19% in those admitted primarily for other diseases. Patients with CHF occupied 15% of the beds; 1330 ECGs, 389 chest X-rays, 112 echocardiograms and 10 coronary angiograms were performed. A quality of life questionnaire revealed that 82% had problems with mobility, 54% with self-care and 88% with everyday activity. Thirty-nine percent of patients had at least one hospitalization during the previous year. CONCLUSIONS: Ninety-seven percent of hospitalized patients with CHF are admitted in the Internal Medicine wards and occupy 15% of beds. The majority of the patients are 72 years or older, with severe heart failure. The frequency of rehospitalization(s) and mortality rate in this population remains high. Echocardiography is performed only in 27% of patients.


Assuntos
Recursos em Saúde/estatística & dados numéricos , Insuficiência Cardíaca/terapia , Qualidade de Vida , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Coleta de Dados , Feminino , Insuficiência Cardíaca/mortalidade , Mortalidade Hospitalar , Hospitais Comunitários , Humanos , Itália , Tempo de Internação , Masculino , Estudos Prospectivos , Inquéritos e Questionários
8.
J Heart Lung Transplant ; 14(6 Pt 1): 1065-72, 1995.
Artigo em Inglês | MEDLINE | ID: mdl-8719452

RESUMO

BACKGROUND AND METHODS: In a prospective protocol for noninvasive diagnosis of acute cardiac rejection, 83 routine endomyocardial biopsies, followed each time by the analysis of signal-averaged electrocardiography and by a cardiac Doppler echocardiographic study, were performed in 18 heart transplant recipients. The follow-up time was 5 +/- 3.6 months. To detect noninvasively acute cardiac rejection, we compared biopsy findings with the presence of late potentials at signal-averaged electrocardiography and with two diastolic indexes, pressure half-time, and isovolumic relaxation time obtained from Doppler echocardiographic study. RESULTS: Thirteen acute rejection crises requiring modification of immunosuppression were diagnosed by means of endomyocardial biopsy. This clinically relevant acute cardiac rejection was associated with the presence of late potentials in 69% of cases and with the presence of pressure half-time < or = 55 msec and isovolumic relaxation time < or = 60 msec in 69% and 62% of cases, respectively. Sensitivity and specificity were as follows: for late potentials, 69% and 71%; for pressure half-time < or = 55 msec, 69% and 76%; for isovolumic relaxation time < or = 60 msec, 62% and 83%, respectively. The presence in a single patient of at least one abnormal parameter showed a sensitivity of 100% and a specificity of 60% in detecting important rejection. CONCLUSIONS: These data support the use of combined signal-averaged electrocardiography and Doppler echocardiographic study of the left ventricular diastolic function in the screening of acute cardiac rejection. Such results can suggest when endomyocardial biopsy should be performed, with the reliance that a normal noninvasive study highly excludes the presence of acute cardiac rejection requiring intensified immunosuppression.


Assuntos
Ecocardiografia Doppler , Eletrocardiografia , Rejeição de Enxerto/diagnóstico , Transplante de Coração/fisiologia , Processamento de Sinais Assistido por Computador , Adulto , Idoso , Biópsia , Diástole/fisiologia , Endocárdio/patologia , Feminino , Seguimentos , Análise de Fourier , Rejeição de Enxerto/diagnóstico por imagem , Rejeição de Enxerto/fisiopatologia , Sistema de Condução Cardíaco/fisiopatologia , Transplante de Coração/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Contração Miocárdica/fisiologia , Miocárdio/patologia , Função Ventricular Esquerda/fisiologia
12.
G Ital Cardiol ; 11(7): 979-82, 1981.
Artigo em Italiano | MEDLINE | ID: mdl-7308654

RESUMO

39 patients aged 70 years and over, 24 males and 15 females underwent valve replacement at Groote Schuur Hospital between 1969 and 1979. 30 patients were affected from aortic valve disease, 6 from mitral valve disease and 3 from mixed mitral and aortic valve disease. The rate of postoperative complications have remained low, and specific complications for this age group have not been observed. 38 patients have been followed up for 1-120 months (mean 30 months). The majority of patients have experienced a remarkable functional improvement. The findings indicate that valve surgery can be performed in the older age group with the same low risk observed in the younger patients.


Assuntos
Doenças das Valvas Cardíacas/cirurgia , Próteses Valvulares Cardíacas , Fatores Etários , Idoso , Feminino , Humanos , Masculino , Complicações Pós-Operatórias
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