Consultation-Liaison Psychiatry-From Theory to Clinical Practice: an Observational Study in a Psychiatric Unit in the General Hospital of Perugia

BACKGROUND

Subjects suffering from psychiatric disorders are frequently hospitalized due to medical comorbidities. In the present study, we analyzed consultation-liaison psychiatry (CLP) activity in a General Hospital, describing the sociodemographic, diagnostic, and therapeutic characteristics of the evaluated subjects, as well as reasons for consultation requests.

SUBJECTS AND METHODS

Data concerning psychiatric consultation performed at the Perugia General Hospital during a 1-year period (01/06/2022-20/06/2023) were collected and analyzed by means of descriptive statistics.

RESULTS

A total of 707 psychiatric consultations were performed. The primary reason that led to psychiatric consultations was psychomotor agitation. 85 (18.5%) patients attempted suicide; the most frequent modality was the assumption of drugs at non-therapeutic doses. The 72% of the sample (n=509) presented a clear-cut medical comorbidity. In most cases, subjects were referred to Community Mental Health and Addiction services (n=22, 32.4%).

CONCLUSIONS

CLP plays a crucial role in the perspective of the overall well-being of hospitalized subjects, but also for the overall management of complex cases. Despite this, a homogeneous approach with standardized guidelines is needed in this field.

Cutaneous manifestations in an Italian military COVID hub

BACKGROUND

The outbreak of the pandemic Coronavirus disease 2019 (COVID-19), caused by a novel coronavirus named Severe acute respiratory syndrome Coronavirus-2 (SARS-CoV-2), affecting a high number of patients in Italy, forced a great number of doctors, even dermatologists, to work in the first lines in the dedicated departments. We analyzed the features and the incidence of dermatological issues emerged during the hospitalization due to COVID-19 and absent before.

METHODS

All the SARS-CoV-2 positive patients hospitalized in Celio Military Hospital - COVID hub no-intensive care wards from March 16, 2020 until May 4, 2020 were evaluated by dermatologists several times during the hospital stay.

RESULTS

Ninety-six patients (15 civilians and 81 Italian servicepeople) were enrolled: 34 (35.4%) patients developed cutaneous manifestations; 15 (16.0%) suffered from skin dryness; 5 (5.2%) irritant contact dermatitis; 4 (4.2%) seborrheic dermatitis; 4 (4.2%) morbilliform rashes; 3 (3.1%) petechial rashes and 3 (3.1%) widespread hives.

CONCLUSIONS

A deeper knowledge of cutaneous manifestations in military and civilian hospitalized COVID-19 patients could suggest more effective treatments to win the battle against SARS-CoV-2.

Prediction of Responsiveness of Gait Variables to Rehabilitation Training in Parkinson's Disease

Background: Gait disorders represent one of the most disabling features of Parkinson's disease, which may benefit from rehabilitation. No consistent evidence exists about which gait biomechanical factors can be modified by rehabilitation and which clinical characteristic can predict rehabilitation-induced improvements.

Objectives: The aims of the study were as follows: (i) to recognize the gait parameters modifiable by a short-term rehabilitation program; (ii) to evaluate the gait parameters that can normalize after rehabilitation; and (iii) to identify clinical variables predicting improvements in gait function after rehabilitation.

Methods: Thirty-six patients affected by idiopathic Parkinson's disease in Hoehn-Yahr stage 1–3 and 22 healthy controls were included in the study. Both clinical and instrumental (gait analysis) evaluations were performed before and after a 10-weeks rehabilitation treatment. Time-distance parameters, lower limb joint, and trunk kinematics were measured.

Results: At baseline evaluation with matched speed, almost all gait parameters were significantly different between patients and healthy controls. After the 10-weeks rehabilitation, most gait parameters improved, and spatial asymmetry and trunk rotation normalized. Multiple linear regression of gender combined with Unified Parkinson's Disease Rating Scale-III predicted both ΔSpeed and ΔStep length of both sides; gender combined with Unified Parkinson's Disease Rating Scale-II predicted ΔCadence; age combined with Hoehn-Yahr score and disease duration predicted Δtrunk rotation range of motion.

Conclusions: Impaired gait parameters are susceptible to improvement by rehabilitation, and younger men with Parkinson's disease who are less severely affected and at early disease stage are more susceptible to improvements in gait function after a 10-weeks rehabilitation program.

[Heterotopic heart transplantation in the rat: a preliminary study]

The aims of this study are to settle and verify how trustful is the heterotopic transplantation of the heart in an experimental model utilizing the original technique of Abbott modified by Ono and Lindsey distinguishing from it for the administration of the anaesthesia and the preservation of the organ. In this type of operation is necessary to realize only two micro-surgical vascular anastomosis that represent the basis of any other micro-surgical operation of organ's transplantation in the rat. There have been used 30 rats of the Wistar stock of male sex and weighing about 200-300 grs. both as donor and as receiving. The anaesthesia consisted in the administration of methoxyflourane by inhalation during the operation. The heart is kept in a container with Stanford solution on ice. The 77% of the cases (23 on 30) have been successful, even considering the ischaemic damage that has been evaluated examining the cardiac beat and the color of the organ. The study of Ono and Lindsey gave as result the success of the operation on 91% of cases (147 on 161 operated), compared to the result obtained by us, on a smaller number of cases (77% of success on 30 operated rats) permits to consider this experimental model to be utilizable even for further more complex studies.