O64 Psycological assessment and quality of life in HCV+ patients treated with interferon

Abstracts

I European

Journal

of Internal

063 Comparative analysis of stroke patients hospitalized in a stroke unit versus general ward A. Lourenco, M. Emiliano, A. Leitao, I. Palma, M.V Baptista, C. Angelo, C. Rodrigues, J.S. Nunes, A. Aleixo (Lisboa, P) Portugal has a high incidence of Stroke beeing this the first cause of death in the country, representing a major social and public health problem. Some factors have been pointed has the responsibles, namely the inexistence of proper Hospital Units for the acute fase treatment of Stroke. After the opening of Stroke Units (SU) for the treatment of these patients the authors (AA) made a retrospective comparative analysis of hospitalized Stroke patients in a General Ward (GW) versus those in the SU of a Central Hospital. Objectives: Establish the characteristics of each group concerning average delay, rate of complications, mortality and destiny after discharge. Methods: The data were obtained by consultation of the clinical records of hospitalized patients between 10 August 2001 and December 2002 (16 months). Results: There were 356 acute Stroke patients identified, 136 (38.2%) hospitalized in the SU and 220 (61.8%) in the GW. There were no diferences between the two groups in what concerns average age, gender and type of Stroke. Both groups had similar rate of complications but the average delay and mortality rate were significantly lower in the SU patients, although one of the admission criteria on the SU was the most critical patients. SU (n= 136): Average age=70.49 years, Male gender= 68, Female gender=68, Type of Stroke - TIA=17, lschemic Stroke= 105, Hemorrhagic Stroke= 14; Average stay=8.37 days, Mortality rate= 4.41%, Complication rate=43.38%. GW (n=220): Average age= 74.3years Male gender=104, Female gender=116, Type of Stroke TIA= 11, lschemic Stroke= 185, Hemorrhagic Stroke=24; Average stay=1545 days, Mortality rate= 18.63%, Complication rate=50.43%. Conclusion: Has other studies have shown there is an advantage in the treatment of acute Stroke in SU’s. However the global results are not still the desired ones since the SU includes a reduced number of patients with this patology compared to the total number of Stroke patients that come to the hospital.

Medicine confirm - other

14 (2003)

enhancement series.

SI-S159 of JFN-induced

s19 psychiatric

pathology

065 A 48-year-old man with proctalgia: a rare form tuberculosis S. Cardoso, H. Nunes, F. Azevedo (Evora, P)

as reported

in

of extrapulmonary

Background: We present a rare case of genital, anoperineal and laryngeal tuberculosis, secondary to pulmonary involvement, in a 48-year-old man. Most common locations of extrapulmonary tuberculosis are lymph nodes, bones and joints, and genitourinary tract. Anoperineal and laryngeal tuberculosis are both rare extrapulmonary forms of the disease. Methods: A 48-year-old immunocompetent man was admitted to the hospital with a 2-month history of severe anal pain. Anal, perineal, scrotal and penile exsudative ulcers were observed on physical examination. Blood count showed mild thrombocytosis, and an elevated erythrocyte sedimentation rate. Chest X-ray revealed bilateral apical infiltrate. Tuberculin skin testing, and search for acid-fast bacilli in bronchoalveolar lavage and gastric lavage fluids were negative. Fiberoptic bronchoscopy revealed extensive destruction of the epiglottis and larynx, as well as tracheal and bronchial infiltration; a biopsy was performed, revealing acid-fast bacilli. A skin biopsy of the perineal lesion showed tuberculoid granulomas. The patient was started on antibacillary treatment, with prompt clinical, laboratorial and radiographic improvement. Results; Pulmonary tuberculosis nearly always produces an abnormality on the chest radiograph, typically an upper lobe process. Manifestations of extrapulmonary tuberculosis tend to be much more protean and require a high level of suspicion. Tuberculin skin testing is often negative in severe disease, especially with extrapulmonary involvement. In this case, the radiographic findings pointed to an etiology for the laryngeal, genital and anoperineal lesions, which was confirmed through observation of tuberculoid granulomas and acid-fast bacilli on biopsies. Conclusion: Extrapulmonary tuberculosis should be considered in the differential diagnosis of atypical genital and anoperineal ulcers and of upper respiratory tract destructive and infiltrative lesions, especially in the context of typical chest radiograph abnormalities.

Infectious disease II 064 Psycological assessment and quality of life in HCV+ with interferon L. Vigna, E. Pozzi, E. Gellmann (Milano, I)

patients

treated

Adverse effects of interferon therapy on cognitive and behavioral functions are well known; several psychiatric events are also reported with deep influence on patients quality of life. Aim of study: Was to evaluate possible interference between patients self-perception and IFN therapy. Methods: 26 patients, 16 Males and 10 Females, mean age 47.2 years, - range 25-59, affected by chronic HCV hepatopaty treated for 12 months - with IFN. Before therapy all pts were submitted to: SSQ, Raven PM58, Minnesota - Multiphasic Personality Inventory, Wartegg Drawing Test. Monthly during therapy and at 1 and 3 months from therapy stoppage - analogic visual scales were used to test patient subjectivity. Results; Astenia, anxiety and depression, impaired memory, emotional - stress were strongly related either with personality either with illness either with IFN adverse effects; such symptoms withdrown after 2-3 month - of therapy in ptz with strong personality. Conclusions: Our results shown that both tipology and severity of subjective answer are related with patient personality and with it preexisting social and working integration. In our series we do not -

066 Bacteraemia in febrile elderly presenting to hospital emergency department A.K. Zacharof, G. Chartzoulakis, G. Svoukas, M. Filipoiou, G. Vassilopoulos, D. Poulikakos, A. Deliousis, R. Koutri, C. Petrogiannopoulos, C. Flevaris (Athens, GR) Objective: Determination of the prevalence of bacteraemia in elderly presenting to hospital emergency department. Patients and methods: We retrospectively study the records of eight hundred and twenty three patients (823) aged 65-85 years presenting to our Emergency Department with temperature 238.5 “C and without specific viral illnesses during the last 5 years. Bacteraemia (defined as presence of pathogenic bacteria in a blood culture), white blood cell count (WBC), and final diagnosis based on clinical features and laboratory investigations. Results: Bacteraemia was identified in 28 of 823 patients (3.4%). Pathogens isolated were Streptococcus pneumoniae (19). Neisseria meningitidis (2) and Klebsiella pneumoniae (7). Increased WBC counts (p or =20X10(9)/L) had