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Attivitá SIGG

Giornale di Gerontologia

Numero 2, Aprile 2005 - Volume LIII

Copertina



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Editoriale

Papa Giovanni Paolo II e gli anziani

G. SALVIOLI

G GERONTOL 2005;53:47-49

Posti nelle Scuole di Specializzazione: il caso della Geriatria

C. MUSSI, M. FORONI, G. SALVIOLI

G GERONTOL 2005;53:50-56

Teorie dell´invecchiamento

N. FERRARA, G. CORBI, D. SCARPA, G. RENGO, G. LONGOBARDI, F. MAZZELLA, F. CACCIATORE, F. RENGO

G GERONTOL 2005;53:57-74

Articoli daggiornamento

Efficacia e sicurezza dei farmaci broncodilatatori nel paziente anziano affetto da broncopneumopatia
cronica ostruttiva (BPCO)


D.L. URSO, L. LUCHETTI

G GERONTOL 2005;53:75-78

Chronic obstructive pulmonary disease (COPD) is a leading cause of death anddisability in the elderly. Comorbidity plays a primary role, both as a determinant of health status and as a prognostic marker in older populations with COPD. Long-acting anticholinergic drugs are commonly effective and well tolerated in the elderly, and may represent the only therapy in moderate COPD. If needed,beta-2-agonist have additive effects. However, individuals differ in their sensitivity to both types of drugs. Multidimensional assessment tailored to the distinctive needs of respiratory patients.

Key words: Elderly - COPD - Long acting bronchodilators - Multidimensional assessment

Articoli originali

I livelli plasmatici dei radicali liberi nell´anziano: fattori di controllo

R. COGO, C. PELLEGRINO, R.C. RIPOLI, L. FONTE, S. SCHIEPPATI,
G. SCIVOLETTO

G GERONTOL 2005;53:79-86

Objective: Aim of this study is the evaluation of control of oxidative stress by Nacetilcysteine
(NAC), using laboratory tests for oxido-reductive status (Reactive
Oxigen Metabolites - d-ROMs) and for antioxidant reserves of organism (Biological
Antioxidant Potential - BAP), with the method FRAS 4 (Health & Diagnostics
Limited) for capillary blood.

Methods: This study involved more than 400 institutionalized with a mean age
over 80 years, randomized into 2 different groups: in one group NAC was added
to the normal therapy, 1200mg die, for 60 days. Three laboratory analysis were
taken at 1 month from one to another, in July, August and September 2004.

Results and conclusions: Data demonstrate how NAC can be usefully used in elderly
people with comorbility NAC controls oxidative stress, reducing Free Radicals
(FR) and reintegrating antioxidant defences, also for a long time.

Key words: N-acetylcysteine - Antioxidants - Oxidative stress - Frail Elderly

L´Istituto di Riabilitazione Geriatrica (IDRG): un modello clinico-assistenziale per le demenze?

D. GHIANDA, C. CORNALI, S. FRANZONI, I. DI FAZIO, L. ROZZINI, A. PADOVANI, M. TRABUCCHI

G GERONTOL 2005;53:87-96

Objectives: This study proposes a model of treatment which offers a good quality
of assistance to elderly patients suffering from a moderate-severe degree of
cognitive degeneration resulting in behavioural disturbances and disabilities
arising from acute illnesses or resurgence of chronic illnesses.

Methods: Research was carried out on 412 patients (average age 80.4 7.1years,
66.3% female) admitted to a ward of geriatric rehabilitation for dementia-related
problems (the IDR Alzheimer, Centro Medico Richiedei, in Palazzolo sul Oglio,
Brescia, Italy) during the first two and a half years of its activity. Some of these
patients (N = 125) were re-examined six months after discharge.

Results: The study included a period of 30 months, starting in November 2001,
during which the following topics were taken into consideration: setting, training,
objectives, outcome and organization. The outcome were established after
definition of the objectives. Specific instruments were utilized in the evaluation
of cognition, behaviour, daily activities, motor function and comorbility.

Conclusions: Data confirm that the development of a new model of treatment for
patients suffering from dementia, such as that offered by a Rehabilitation Unit,
is a process that requires time. The research helps to understand the methodological
problems, offering some suggestions for possible solutions and future
initiatives.

Key words: Geriatric Evaluation and Rehabilitation Unit (GERU) - Dementia -
Rehabilitation

Casi clinici

Uomo di 71 anni con cirrosi epatica ed ureteroileostomia: trattamento risolutivo di emorragia da varici peristomali mediante shunt porto-cavale intra-epatico per via transgiugulare (TIPS)

G. CARRAFIELLO, D. LAGANÁ, S. CUFFARI, M. MANGINI, C. RECALDINI,
G. BONOLDI, C. FUGAZZOLA

G GERONTOL 2005;53:97-100

We report an unusual case of 71-year-old man with liver cirrhosis who presented
recurred bleedings from the stoma of ileo conduit after radical cystoprostatectomy.
The haemorrhagic episodes could not be treated by local mesure, and
a trans-jugular intra hepatic porto-caval shunt was performed, displacing an endoprothesis
and a self expandable stent. We highlight the role of TIPS to treat recurrent
bleedings from the stoma in cirrhotic patients with ileal conduit and
portal hypertension.

Key words: TIPS - Varices - Stoma - Bleeding