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1.
Int J Mol Sci ; 24(18)2023 Sep 06.
Artículo en Inglés | MEDLINE | ID: mdl-37762029

RESUMEN

Although the safety and efficacy of COVID-19 vaccines in older people are critical to their success, little is known about their immunogenicity among elderly residents of long-term care facilities (LTCFs). A single-center prospective cohort study was conducted: a total IgG antibody titer, neutralizing antibodies against Wild-type, Delta Plus, and Omicron BA.2 variants and T cell response, were measured eight months after the second dose of BNT162b2 vaccine (T0) and at least 15 days after the booster (T1). Forty-nine LTCF residents, with a median age of 84.8 ± 10.6 years, were enrolled. Previous COVID-19 infection was documented in 42.9% of the subjects one year before T0. At T1, the IgG titers increased up to 10-fold. This ratio was lower in the subjects with previous COVID-19 infection. At T1, IgG levels were similar in both groups. The neutralizing activity against Omicron BA.2 was significantly lower (65%) than that measured against Wild-type and Delta Plus (90%). A significant increase of T cell-specific immune response was observed after the booster. Frailty, older age, sex, cognitive impairment, and comorbidities did not affect antibody titers or T cell response. In the elderly sample analyzed, the BNT162b2 mRNA COVID-19 vaccine produced immunogenicity regardless of frailty.


Asunto(s)
COVID-19 , Fragilidad , Anciano , Humanos , Anciano de 80 o más Años , Vacunas contra la COVID-19 , Vacuna BNT162 , Estudios Prospectivos , COVID-19/prevención & control , Inmunoglobulina G , Inmunidad Celular
2.
Epidemiol Prev ; 45(6): 559-567, 2021.
Artículo en Italiano | MEDLINE | ID: mdl-35001599

RESUMEN

OBJECTIVES: to describe the course of COVID-19 epidemic in the hospitals of the ASST of Mantua (Lombrady Region, Northern Italy) from February 2020 to April 2021. DESIGN: observational study. SETTING AND PARTICIPANTS: data from hospital discharging chart of all patients admitted to the hospitals of ASST were collected from 26.02.2020 to 30.04.2021 with COVID-19 diagnosis. Data from Emergency Rooms for patients evaluated but not admitted to departments were also collected. MAIN OUTCOME MEASURES: the data from hospital discharging were crossed for diagnosis with data from laboratory. The department were classified into 'low intensity' and 'middle/high intensity'. The comparison was according to the different periods of epidemic. RESULTS: patients admitted to the hospitals were 2,738: 510 died (17.3%) and 1,736 patients were evaluated in the Emergency Rooms but not admitted to departments. Among these patients, 166 died (9.6%). The prevailing age class were >=65 years, with a trend to reduction in the third wave. The proportion of admission in middle/high intensity departments was significantly higher in the second wave than in the first. N. 510 deaths by 2,738 (17.3%) were observed, with significant reduction in the second and third waves in the low intensity departments (from 21.9% to 14.3% and 12.7%) (p<0.001), while mortality was substantially unchanged in the middle/high intensity departments (28.0%, 29.6%, and 28.3%). The mortality for patients with >=65 years was 26.7%. Females showed lower mortality (OR 0.690; CI95% 0.560-0.840) and lower incidence of admissions in middle/high intensity departments (OR 0.556; CI95% 0.459-0.673) in the three waves. Finally, including also the patients not admitted, the general mortality was 15.1%. CONCLUSIONS: a worse outcome by mortality and severity of disease was observed for male gender compared to female and for older age classes. Moreover, a significant improvement of outcomes in the second and third waves, compared to the first, was pointed out.


Asunto(s)
COVID-19 , Anciano , Prueba de COVID-19 , Atención a la Salud , Femenino , Humanos , Italia/epidemiología , Masculino , SARS-CoV-2
3.
G Ital Med Lav Ergon ; 41(3): 221-235, 2019 07.
Artículo en Italiano | MEDLINE | ID: mdl-31242352

RESUMEN

SUMMARY: Introduction. Burnout syndrome (BOS) can be defined as a chronic work strain characterized by three dimensions: emotional exhaustion, depersonalization (or cynicism), reduced professional effectiveness. BOS typically strikes the helping professions like the teachers. Objective. The aims of this study are: 1) clarify the concept of BOS, as currently configured in the international scientific literature; 2) analyze the psychosocial risk factors in teachers; 3) develop a methodology for the assessment and prevention of the risk of BOS in the teachers. Methods. The literature review followed some of the PRISMA guidelines criteria. Results and discussion. The results of the study highlight BOS as a risk factor specific and distinct from labor-related stress. A strategy called VA.RI.B.O is proposed (Burn-Out Recognition) for teachers.


Asunto(s)
Agotamiento Profesional/epidemiología , Estrés Laboral/epidemiología , Maestros/psicología , Agotamiento Profesional/prevención & control , Humanos , Medición de Riesgo/métodos , Factores de Riesgo
4.
G Ital Med Lav Ergon ; 40(2): 76-82, 2018 06.
Artículo en Italiano | MEDLINE | ID: mdl-30480391

RESUMEN

OBJECTIVES: Aim of our study was to adapt the Claustrophobia Questionnaire (CLQ) to the Italian context. METHODS: In our study, a sample of 50 claustrophobic patients was compared to 50 healthy people (control group). All of them answered the Claustrophobia Questionnaire and the Stait-Trait Anxiety Inventory Form Y1 and Y2, as well as demographic questions. RESULTS: As it was theoretically expected, our results confirmed the two-factor structure and showed that the Italian version of the CLQ has good psychometric properties. Indeed, it was observed that claustrophobic patients scored higher in claustrophobia than those from the control group. CONCLUSIONS: In conclusion, the Italian version of the CLQ is a reliable and valid instrument to assess claustrophobic fear.


Asunto(s)
Salud Laboral , Trastornos Fóbicos/diagnóstico , Encuestas y Cuestionarios , Evaluación de Capacidad de Trabajo , Adulto , Estudios de Casos y Controles , Femenino , Humanos , Italia , Lenguaje , Masculino , Persona de Mediana Edad , Psicometría , Reproducibilidad de los Resultados , Adulto Joven
5.
Clin Transplant ; 31(9)2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28665524

RESUMEN

BACKGROUND: Prevention of transmission of malignancy from donors to recipients is an aim of donor assessment. We report the most stringent interpretation of the Italian National Guidelines. METHODS: A two-step ALERT process was used: ALERT1 consisting of clinical, radiological, and laboratory tests; ALERT2, consisting of intraoperative assessment in suspicious lesions. RESULTS: Four hundred of 506 potential deceased donors entered the ALERT system. Forty-one of 400 (10%) donors were excluded due to unacceptable risk of transmission. Of the remaining 359 193 required histopathology, which excluded malignancy or determined acceptable risk in 161/193 (83%). Thirty-five malignancies were identified: 19 (54%) at ALERT1, four (11%) at ALERT2, nine (26%) picked up at ALERT1 and confirmed by ALERT2. Three (9%) were missed by ALERT and diagnosed at postmortem examination. Prostate (n=12%, 34%) and renal cell (n=7%, 20%) were the most frequent carcinomas. The majority (92%) of prostate adenocarcinomas were of low risk and donation proceeded compared to 43% of renal carcinomas. Four renal carcinomas, two breast carcinomas, and a single case of nine different malignancies excluded donation. Positive ALERT donors had statistically more malignant reports than negative ALERT donors (P=<.05). CONCLUSION: Histopathology is an essential component of the multidisciplinary assessment of donors.


Asunto(s)
Selección de Donante/métodos , Tamizaje Masivo/métodos , Neoplasias/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Protocolos Clínicos , Selección de Donante/normas , Femenino , Humanos , Incidencia , Lactante , Italia/epidemiología , Masculino , Tamizaje Masivo/normas , Persona de Mediana Edad , Neoplasias/epidemiología , Neoplasias/patología , Guías de Práctica Clínica como Asunto , Medición de Riesgo , Adulto Joven
6.
Sensors (Basel) ; 15(2): 2662-79, 2015 Jan 26.
Artículo en Inglés | MEDLINE | ID: mdl-25629703

RESUMEN

Agricultural practices determine the level of food production and, to great extent, the state of the global environment. During the last decades, the indiscriminate recourse to fertilizers as well as the nitrogen losses from land application have been recognized as serious issues of modern agriculture, globally contributing to nitrate pollution. The development of a reliable Near-Infra-Red Spectroscopy (NIRS)-based method, for the simultaneous monitoring of nitrogen and chlorophyll in fresh apple (Malus domestica) leaves, was investigated on a set of 133 samples, with the aim of estimating the nutritional and physiological status of trees, in real time, cheaply and non-destructively. By means of a FT (Fourier Transform)-NIR instrument, Partial Least Squares (PLS) regression models were developed, spanning a concentration range of 0.577%-0.817% for the total Kjeldahl nitrogen (TKN) content (R2 = 0.983; SEC = 0.012; SEP = 0.028), and of 1.534-2.372 mg/g for the total chlorophyll content (R2 = 0.941; SEC = 0.132; SEP = 0.162). Chlorophyll-a and chlorophyll-b contents were also evaluated (R2 = 0.913; SEC = 0.076; SEP = 0.101 and R2 = 0.899; SEC = 0.059; SEP = 0.101, respectively). All calibration models were validated by means of 47 independent samples. The NIR approach allows a rapid evaluation of the nitrogen and chlorophyll contents, and may represent a useful tool for determining nutritional and physiological status of plants, in order to allow a correction of nutrition programs during the season.


Asunto(s)
Técnicas Biosensibles , Clorofila/aislamiento & purificación , Nitrógeno/aislamiento & purificación , Malus/química , Hojas de la Planta/química , Espectroscopía Infrarroja por Transformada de Fourier , Espectroscopía Infrarroja Corta
7.
Recenti Prog Med ; 100(1): 9-16, 2009 Jan.
Artículo en Italiano | MEDLINE | ID: mdl-19445275

RESUMEN

Aim of the study was to investigate polypharmacy and psychotropic drugs as risk factors for falls in a Long-term Care Setting for elderly patients. In a cross-sectional study we investigated the characteristics of 414 subjects: 207 fallen patients 44 (21.3%) male e 163 (78.7%) female mean age 84.16 +/- 8.3 y.o. First generation neuroleptics (OR 1.739 CI 95% 1.047-2.889), benzodiazepines (OR 2.357 CI 95% 1.5-3.702) and mood stabilizers (OR 1.889 CI 95% 1.091-3.270) were associated to falls when adjusted for age, sex and comorbidities. Polypharmacotherapy (> or = 4 drugs) was a risk factor for falls when associated to a risk medication in the daily regimen only (OR 2.157 CI 95% 1.447-3.217). What raised has to be taken into account in the prescriptive activities in a Long term Care Setting for elderly patients.


Asunto(s)
Accidentes por Caídas/estadística & datos numéricos , Envejecimiento , Evaluación Geriátrica , Cuidados a Largo Plazo/estadística & datos numéricos , Psicotrópicos/efectos adversos , Anciano de 80 o más Años , Estudios Transversales , Femenino , Humanos , Italia , Masculino , Polifarmacia , Psicotrópicos/administración & dosificación , Factores de Riesgo
8.
J Psychosom Res ; 62(3): 349-55, 2007 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-17324686

RESUMEN

BACKGROUND: Depression is considered the most frequent interferon (IFN)-alpha-induced psychiatric disorder. However, other neuropsychiatric side effects of IFN treatment, such as irritability, anxiety, and manic episodes, are reported as well. We analyzed the impact of lifetime manic-hypomanic symptoms and anxiety on the development of depression in hepatitis-C-virus-infected subjects treated with two different types of IFN-alpha. METHODS: At baseline, subjects received thorough diagnostic assessment to exclude lifetime or current psychiatric symptoms. During treatment, subjects were administered interviewer-based and self-report instruments. RESULTS: Six (12%) of 49 individuals with a negative history of psychiatric disorders developed major depression during treatment with IFN. The onset of depression was significantly associated with the presence of lifetime subthreshold manic-hypomanic symptoms. Subjects exceeding manic threshold were more likely to develop depression than those below threshold (33.3% vs. 7.5%, P=.033). CONCLUSIONS: Our data suggest that individuals treated with IFN with no past history of psychiatric disorders are more likely to develop depression if they experienced subthreshold manic-hypomanic symptoms in their lifetime. These findings derive from an exploratory study and may have important implications for the prevention of IFN-induced depression if replicated in larger studies.


Asunto(s)
Antivirales/efectos adversos , Trastorno Bipolar/diagnóstico , Trastorno Depresivo Mayor/inducido químicamente , Hepatitis C Crónica/tratamiento farmacológico , Interferón-alfa/efectos adversos , Administración Oral , Adulto , Anciano , Antivirales/uso terapéutico , Trastorno Bipolar/psicología , Trastorno Depresivo Mayor/diagnóstico , Trastorno Depresivo Mayor/psicología , Manual Diagnóstico y Estadístico de los Trastornos Mentales , Quimioterapia Combinada , Femenino , Hepatitis C Crónica/psicología , Humanos , Inyecciones Subcutáneas , Interferón alfa-2 , Interferón-alfa/uso terapéutico , Masculino , Persona de Mediana Edad , Proyectos Piloto , Proteínas Recombinantes , Ribavirina/uso terapéutico , Factores de Riesgo , Estadística como Asunto
9.
Am J Kidney Dis ; 40(2): 302-6, 2002 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-12148102

RESUMEN

BACKGROUND: The aim of this study is to evaluate the reliability of a self-administered questionnaire on leg discomfort and restlessness as a screening tool for restless legs syndrome (RLS) in a population of chronically dialyzed patients. METHODS: One hundred twenty-seven patients on chronic hemodialysis therapy filled in a self-administered questionnaire including 4 diagnostic questions for RLS and 12 subsequent questions on clinical characteristics of leg discomfort. Two neurologists trained in sleep medicine blinded to questionnaire answers evaluated all patients and diagnosed RLS according to criteria of the International Restless Legs Syndrome Study Group. We compared questionnaire results in terms of RLS diagnosis with direct patient evaluation performed by neurologists used as a gold standard. RESULTS: The questionnaire showed a low sensitivity and specificity and did not prove reliable for screening for RLS in uremic patients. False-positive results seem to be caused by the presence of other leg symptoms and neurological objective signs suggesting peripheral neuropathy; false-negative results may be caused by the moderate severity of leg discomfort and its poor appraisal. CONCLUSION: Our study suggests caution in evaluating results of questionnaires to screen for RLS in patients with chronic renal insufficiency on dialysis therapy.


Asunto(s)
Diálisis Renal/métodos , Síndrome de las Piernas Inquietas/epidemiología , Encuestas y Cuestionarios , Adulto , Anciano , Anciano de 80 o más Años , Reacciones Falso Negativas , Reacciones Falso Positivas , Femenino , Humanos , Fallo Renal Crónico/epidemiología , Fallo Renal Crónico/terapia , Masculino , Tamizaje Masivo/métodos , Persona de Mediana Edad , Sensibilidad y Especificidad , Método Simple Ciego , Uremia/epidemiología
10.
J Am Geriatr Soc ; 50(1): 77-83, 2002 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-12028250

RESUMEN

OBJECTIVES: To assess 1-week prevalence of International Classification of Disease, Tenth Edition (ICD-10) current depression, physical comorbidity, associated disability, and healthcare utilization in older primary care patients. Comparisons with younger patients are also reported. DESIGN: Cross-sectional, two-phase epidemiological study. SETTING: One hundred ninety-one primary care clinics. PARTICIPANTS: Six hundred six patients aged 60 and older and 1,290 patients aged 14 to 59. MEASUREMENTS: Screening was conducted using the General Health Questionnaire-12. Probable cases were assessed by primary care physicians (PCPs) with the World Health Organization ICD-10 Checklist for depression to diagnose ICD-10 current depression and subsyndromal depression. Other instruments included the Brief Disability Questionnaire and the PCPs' rating of the severity of physical illness. RESULTS: The prevalence of current depression was 8.6%; 3.6% for subsyndromal depression (8.3% and 5.5%, respectively, in younger subjects). Current depression was associated with physical illness, physical disability, days lost from work or days unable to perform activities of daily living, and frequency of PCP consultation. Both physical illness and current depression independently resulted in increased disability, and, when the two conditions coexisted, there was a further increase in disability. Comorbidity with physical illness was the hallmark of late-life depression, distinguishing this condition from depression in younger patients. Moreover, depressed older patients were more disabled and had a higher frequency of PCP consultation than younger depressed patients. CONCLUSION: The prevalence of current depression does not decrease with age in primary care, in contrast to that seen in community studies. Late-life depression is characterized by physical comorbidity and associated with significant disability. The specific features of late-life depression call for intervention programs taking into account the relationship between the mental, physical, and functional aspects of this condition.


Asunto(s)
Trastorno Depresivo/epidemiología , Adolescente , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Estudios Transversales , Depresión/epidemiología , Personas con Discapacidad/psicología , Femenino , Humanos , Italia/epidemiología , Masculino , Persona de Mediana Edad , Prevalencia
11.
J Affect Disord ; 81(1): 79-85, 2004 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-15183604

RESUMEN

BACKGROUND: The ADARB1 gene is located in 21q22.3 region, previously linked to familial bipolar disorder, and its product has a documented action in the editing of the pre-mRNA of glutamate receptor B subunit. Dysfunction of glutamatergic neurotransmission could play an important role in the pathophysiology of bipolar disorder (BD). Glutamate excitatory neurotransmission regulation is a possible mechanism of the initial effect of anticonvulsants in regulating mood. METHODS: To investigate the hypothesis of an involvement of ADARB1 gene in the BD, the ADARB1 cDNA has been cloned and sequenced in seven selected bipolar I disorder patients with evidence of familiarity of mood disorders. A detailed investigation of the gene nucleotide sequence in the open reading frame has been performed. RESULTS: No alteration in the sequence of the ADARB1 gene cDNA was found in any patient, except a common neutral polymorphism in three out of seven patients. CONCLUSIONS: Mutations in ADARB1 gene are not commonly associated with bipolar I disorder, therefore other genes in the 21q22 region could be associated with bipolar illness in some families, likely in the context of a multifactorial transmission model.


Asunto(s)
Adenosina Desaminasa/genética , Trastorno Bipolar/genética , Predisposición Genética a la Enfermedad/genética , Adolescente , Adulto , Anticonvulsivantes/uso terapéutico , Trastorno Bipolar/diagnóstico , Trastorno Bipolar/tratamiento farmacológico , Trastorno Bipolar/fisiopatología , Cromosomas Humanos Par 21 , Análisis Mutacional de ADN , Femenino , Ácido Glutámico/fisiología , Humanos , Masculino , Persona de Mediana Edad , Datos de Secuencia Molecular , Polimorfismo Genético/genética , Precursores del ARN/genética , Proteínas de Unión al ARN , Receptores de Glutamato/genética , Análisis de Secuencia de ADN , Transmisión Sináptica/genética , Transmisión Sináptica/fisiología
12.
Maturitas ; 48(2): 115-24, 2004 Jun 15.
Artículo en Inglés | MEDLINE | ID: mdl-15172085

RESUMEN

OBJECTIVES: To provide epidemiological data about psychological symptoms derived from a large Italian non-clinical sample, and to investigate the correlation with psychosocial factors. METHODS: The study design was a cross-sectional postal survey of a sample of menopausal women recruited from the General Registry Office in Ferrara's province. Four thousands and seventy-three women were sent a questionnaire designed on the basis of the Women Health Questionnaire (WHQ). Together with the WHQ, women were asked to fill out a personal file to define social status, cultural level, family's characteristics, recent menstrual cycles, gynaecological history and operations, drug's assumption, life events in the last year and lifetime depression. RESULTS: Factor analysis resulted in eight clusters of symptoms. Among psychiatric symptoms, three different clusters were identified: depressive symptoms, depressed mood with anxiety symptoms, and anxiety. The cluster "depressive symptoms" was more evident in the postmenopausal period with respect to the premenopausal one. CONCLUSION: The cluster "depressive symptoms" is significantly different in the premenopausal group with respect to the postmenopausal group, with greater levels of symptomatology in the postmenopausal group. On the contrary, the factor "depressed mood with anxiety symptoms" is present to the same extent in the pre-, peri- and postmenopausal groups. Prior depression is the most predictive variable of subsequent depression in postmenopausal women. Factors related to more pronounced depressive symptoms are number of life events, postmenopausal status, place of residence in rural areas and lower cultural level.


Asunto(s)
Menopausia/psicología , Trastornos Mentales/epidemiología , Estudios Transversales , Femenino , Humanos , Italia/epidemiología , Trastornos Mentales/etiología , Persona de Mediana Edad , Psicología , Sistema de Registros , Encuestas y Cuestionarios
13.
Hum Psychopharmacol ; 15(2): 79-85, 2000 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-12404336

RESUMEN

Residual psychopathology associated with EPS has been mainly assessed in experimental studies where neuroleptics were administered at standard, fixed dosages. The present study evaluates residual psychopathology in 69 schizophrenic patients treated with moderate, flexible doses of neuroleptics (430 mg eq. CPZ) at the out-patient Community Mental Health Services (CMHSs) in Bologna. Akathisia was present in 27.5 per cent of patients and parkinsonism in 27.5 per cent. A more severe psychopathological state was associated with both side-effects, as seen by significantly higher BPRS global scores. This severity was due to tension and anxiety-depression symptoms in patients with akathisia and to negative symptomatology in patients with parkinsonism, as shown by significant associations with BPRS subscales ANS-DEP and NEG, respectively. In conclusion, the present study underlines that EPS are frequent even in an out-patient setting where moderate neuroleptic doses are employed, and more importantly shows that in these conditions, the residual psychopathology resulting from EPS is clinically very significant. Copyright 2000 John Wiley & Sons, Ltd.

14.
Prim Care Companion J Clin Psychiatry ; 1(6): 180-183, 1999 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-15014669

RESUMEN

OVERVIEW: Management of anxiety and depressive disorders within the community necessitates collaboration between mental health services and primary care. While cooperative projects do exist in many countries, Italy's National Health System does not have a program designed to address this issue. In Bologna, a cooperative project arose as a spontaneous undertaking between mental health professionals and primary care physicians. A model of collaboration was designed specifically for the Italian National Health System, consisting of a network of primary care liaison services (PCLSs) instituted within the community mental health services. PCLSs are managed by a staff of specially trained mental health care professionals and are designed to facilitate communication between physicians, and they provide continual and multifaceted support consisting of diagnostic assessment and focused clinical intervention. PCLSs also provide formal consultation-liaison meetings and a telephone consultation service designed to promote communication and enrich diagnostic assessment and treatment. DISCUSSION: PCLSs are innovative, not only because they represent one of the first collaborative efforts in Italy to date, but also because of their innovative design, which is specific for the Italian National Health System. Overall, the project yielded a good result. Primary care physicians utilized the service extensively, and together with psychiatric personnel were satisfied with the outcome. These results, when compared with the traditional separation between the 2 services, are encouraging. Our model could be adapted for most communities in Italy, but must be preceded by shared recognition of local need.

15.
J Acupunct Meridian Stud ; 4(1): 69-74, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21440882

RESUMEN

The risk of falling is rather high among elderly people. Indexes obtained through the Romberg stabilometric test on a force platform have been suggested to be correlated with the risk of falling. This work aimed to test the effectiveness of auriculopuncture and ultralow-power laserpuncture versus placebo (sham stimulation) in improving postural control in an elderly population. Balance performance was measured on a force platform before and after both forms of stimulation. Main balance parameters pointed to an average short-term improvement of about 15% 1 hour after treatment and 5-10% after an interval of 3 days. However, a few participants showed a better than 30% improvement with the same parameters. Although the sample size does not allow reliable statistical analysis, the modifications are remarkable and some differences are observed between the two kinds of stimulation. Further testing with larger sized groups and including one further group using both stimulations is suggested. Although postural instability has to be defined as multi-factorial, it is often associated with balance dysfunctions that cannot be related to vestibular or central impairments but rather to proprioceptive deficits. A significant role may be ascribed to (even subliminal) nociceptive interferences with proprioceptive inputs and to a reduced capacity for updating cortical motor control models in the case of progressively declining locomotor capabilities. The explanation tentatively put forward to account for the results observed in the present preliminary study is that laser acupuncture and auriculopuncture stimulations reduce nociceptive interference and thus improve postural control.


Asunto(s)
Accidentes por Caídas/prevención & control , Terapia por Acupuntura/métodos , Acupuntura Auricular , Rayos Láser , Nociceptores , Equilibrio Postural , Trastornos de la Sensación/terapia , Anciano de 80 o más Años , Humanos , Locomoción , Trastornos de la Sensación/complicaciones , Resultado del Tratamiento
18.
Dement Geriatr Cogn Disord ; 19(2-3): 97-105, 2005.
Artículo en Inglés | MEDLINE | ID: mdl-15591799

RESUMEN

OBJECTIVE: To evaluate the age, gender and education distribution of both cognitive impairment and dementia in the whole old age range of the elderly (from 61 years of age and over). SUBJECTS AND METHODS: The study population consisted of all subjects born in 1930 or before, living in the municipality of Faenza and Granarolo, Italy (n = 7,930). A two-phase study design was implemented, by using the Mini-Mental State Examination and Global Deterioration Scale as screening instruments. The DSM-III-R diagnostic criteria were used for the clinical diagnosis of dementia. A subject was classified as affected by cognitive impairment, no dementia (CIND) if he/she scored 2 or more standard deviations lower than the corrected mean MMSE score. RESULTS: The prevalences of dementia and CIND were 6.5 per 100 (95% CI 5.9-7.0) and 5.1 per 100 (95% CI 4.6-5.6), respectively. The prevalence of CIND was higher than that of dementia in the youngest old groups (61-74 years), both in men and women, whereas the opposite pattern was present among the older old (75+). In the older age groups, dementia prevalence increased exponentially with age, while CIND prevalence was more stable. There was not a substantial gender difference in CIND prevalence in all ages. Only in the subpopulation of higher educated subjects, women had a higher prevalence of both dementia and CIND than men. Lower educated subjects had a higher prevalence of both dementia and CIND. When compared to higher educated persons, subjects without any schooling had odds ratios of 10.9 (CI 7.0-16.7) and 16.7 (CI 11.2-25.0) for dementia and CIND, respectively. CONCLUSIONS: Cognitive impairment is very common in the younger old ages (under 70 years of age), whereas dementia becomes predominant after 75 years of age. Both conditions are strongly related to the educational level.


Asunto(s)
Enfermedad de Alzheimer/epidemiología , Trastornos del Conocimiento/epidemiología , Anciano , Anciano de 80 o más Años , Enfermedad de Alzheimer/diagnóstico , Enfermedad de Alzheimer/psicología , Trastornos del Conocimiento/diagnóstico , Trastornos del Conocimiento/psicología , Estudios de Cohortes , Estudios Transversales , Escolaridad , Femenino , Encuestas Epidemiológicas , Humanos , Italia , Masculino , Escala del Estado Mental/estadística & datos numéricos , Persona de Mediana Edad , Pruebas Neuropsicológicas/estadística & datos numéricos , Oportunidad Relativa , Vigilancia de la Población , Pronóstico , Psicometría/estadística & datos numéricos
19.
Hum Psychopharmacol ; 17(2): 99-102, 2002 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-12404699

RESUMEN

Pharmacological risk factors for neuroleptic malignant syndrome (NMS) are better defined than clinical risk factors. We examined the psychopathological status preceding the onset of NMS in 20 patients. We evaluated four key psychiatric symptoms (psychomotor agitation, catatonia, disorganization and confusion) and grouped them into definite clinical syndromes. Six patients presented with an acute and severe catatonic syndrome, with all the four key psychiatric symptoms. Twelve patients presented with an acute and severe disorganized psychotic episode, with two or three key psychiatric symptoms, but not catatonia. Our study suggests that a clinical syndrome of acute disorganization, in addition to acute catatonia, is a potential clinical risk factor for NMS. The two syndromes, which can occur in the context of different mental disorders, are related to each other as both implicate alteration in behavioural monitoring, and were, in our experience, unresponsive to neuroleptics. In conclusion, we hypothesize that the recognition of these two syndromes should reduce NMS occurrence. We recommend a judicious use of neuroleptics not only in patients with acute catatonia, but also in patients with acute disorganization.


Asunto(s)
Antipsicóticos/efectos adversos , Catatonia/epidemiología , Síndrome Neuroléptico Maligno/psicología , Agitación Psicomotora/epidemiología , Esquizofrenia Hebefrénica/epidemiología , Psicología del Esquizofrénico , Adulto , Anciano , Antipsicóticos/uso terapéutico , Recolección de Datos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Síndrome Neuroléptico Maligno/etiología , Síndrome Neuroléptico Maligno/prevención & control , Factores de Riesgo , Síndrome
20.
Community Ment Health J ; 38(6): 439-45, 2002 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-12474932

RESUMEN

Primary care and mental health were recently integrated by the Italian health authorities. The Bologna Primary Care Liaison Service (PCLS) is ideally suited to the Italian National Health Care System, because most primary care physicians practice individually and mental health services provide first level care. The distinctive features of the program are: 1) location within a mental health center; 2) comprehensive mental health assessment and intervention; 3) collaboration between primary care physicians and mental health services which is facilitated through committees and communication. First year results met expectations. Integrating a PCLS program within a mental health center can be a viable means of implementing national policy.


Asunto(s)
Trastornos Mentales/terapia , Servicios de Salud Mental/organización & administración , Atención Primaria de Salud/organización & administración , Derivación y Consulta , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Atención Ambulatoria , Femenino , Humanos , Italia , Masculino , Trastornos Mentales/diagnóstico , Servicios de Salud Mental/normas , Persona de Mediana Edad , Atención Primaria de Salud/normas
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