S. Ricotti

Return to work after thoracic organ transplantation in a clinically-stable population

To evaluate the rate of return to work after transplantation and its determinants in a clinically‐stable population of patients transplanted and followed‐up at a single institution in Italy.

Changes in quality of life and functional capacity after lung transplantation: A single-center experience

Lung transplantation (LT) increases the life expectancy of patients affected by end stage pulmonary disease; specifically, its ultimate aims are to improve survival and health related quality of life (HRQoL). The aim of the present longitudinal study was to determine the HRQoL trajectory and changes in functional capacity from time of entry in the waiting list for LT to 2 year after LT. The study included sixty-nine outpatients enrolled in a single medical center when they entered the waiting list for LT and who subsequently received it. They were then followed up over 2 years after LT. HRQoL was assessed by the physical and mental component summary (PCS and MCS) scores of the 36-item Short Form Health Survey (SF-36) and Saint Georges Respiratory Questionnaire (SGRQ). Psychological distress was evaluated with the General Health Questionnaire (GHQ), and functional capacity was investigated using the six-minute walk test (6MWT) and forced expiratory volume (FEV1). Patients showed low SF-36 PCS (30.5±7.8) and SGRQ total (61.8±17.5) scores at entry in the waiting list, but exhibited significant changes over time after LT (p<0.001). Furthermore, patients who showed an increase of at least 50% in SF36 PCS and SGRQ scores at 6 months survived longer. Both FEV1 and 6MWT distance as well as GHQ scores significantly changed over time, with improvements occurring in the first 6 months after LT but no major changes thereafter. Out of the 69 patients enrolled, 32 died over a median follow-up of 51 months. Although mortality tended to be slightly higher for patients with lower HRQoL at the baseline assessment, this difference was not statistically significant. HRQoL evaluations appear critical in the follow-up of LT candidates, in particularly SGRQ, because of its specificity in targeting respiratory symptoms and functional wellbeing.

Valutazione funzionale del rachide dopo spondilodiscite

Objective. To value the spinal functionality and the Quality of Life in patients with spondylodiscitis results, in comparison with a population affected by chronic low back pain, in order to verify the disability and the therapeutic management. Materials and methods. They considered 13 cases with spondylodiscitis results (SD group, 7M, 8F, medium age 61); 13 patients with chronic low back pain (LBP group, 3M, 10F, medium age 61) and 27 healthy check (C group, 11M 16F, medium age 22). It’s been estimated the spinal mobility and the rachis disability by using Roland Morris Disability Questionnaire in following checks. Results. The estimation of spinal mobility proves more rigidity in each esaminate plan movement in SD group, in comparison with LBP group (p<0.001). C group results more mobile than pathologic groups (p<0.001). In SD group the Roland Morris score improves during a space of time, without showing a complete disability reduction (p<0.01). At first follow up, therapeutic advices was given to 11 patients: at second follow up 8 subjects report to carry out the prescriptions (6 with complete benefits, 2 with partial benefits). Furthermore, in SD group, 8 (72%) report a wellbeing improving and 5 (45%) a walking one, in comparison with the first follow up time. Conclusion. Infectious spondylodiscitis causes a functional limitation in the time and a compromission of the Quality of Life more than in chronic low back pain subjects. The last follow up proves the utility of the physiatrical check, beyonde the orthopedical and the infectivology observation, in order to improve the functional outcome in patients affected by spondylodiscitis results.

Terapia riabilitativa dopo trattamento chirurgico per carcinoma mammario

INTRODUCTION: The objective of this study is to chart the incidence of morbidities and the prescription of rehabilitation therapies in patient with breast cancer who had surgical treatment. MATERIAL AND METHODS: 360 patients were seen after surgery and divided into 4 groups according to the surgical approach: quadrantectomy without axillary lymph node dissection (Q; n=74), quadrantectomy with axillary lymph node dissection (QL; n=97), mastectomy without axillary lymph node dissection (M; n=34) and mastectomy with axillary lymph node dissection (ML; n=148). Self-administered exercises were given to all of the patients. RESULTS: Groups QL and ML demonstrated a significantly greater incidence of morbidities and prescription of specific therapies when compared to groups Q and M (p<0.05). Patients who undergone axillary node dissection had more lymphedema (p<0.0001) and lymph drainage (p<0.05). There were no statistical differences between groups M and L, apart from impaired shoulder function (p<0.05). The number of patients with morbidities reduced over time; this reduction is evident in impaired shoulder function while there is no reduction in lymphedema prevalence. CONCLUSIONS: Morbidities, in particular lymphedema, and prescription of specific therapies were significantly more common after axillary lymph node dissection. Self-administered exercise rehabilitation programme is an effective way to improve shoulder mobility.

Functional recovery and electromyographic/electroneurography evaluation in Bell's and Ramsay-Hunt's palsy patients undergoing physical training.

In a previous study [3] we showed the course of Bell’s palsy in patients undergoing rehabilitation treatment; in this study, we compare Bell’s to Ramsay-Hunt’s palsy (R-H).