Operative Clinical Unit

NEUROLOGY CLINIC STROKE UNIT

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INTEGRATED ACTIVITY DEPARTMENT HEAD & NECK

Director: Prof. Mario Russolo

Operative Clinical Unit NEUROLOGY CLINIC - STROKE UNIT

Director: Prof. Gilberto Pizzolato

Tel: 040 – 399 4321; Fax: 040 – 910 861 e-mail: segreteria.neurologia@fmc.units.it

Nurse Coordinator: Diego Stefi

Tel: 040 – 399 4569; Fax: 040 – 399 4284 e-mail: neurologia@aots.sanita.fvg.it

USEFUL NUMBERS TELEPHONE FAX

MANAGEMENT- ADMIN. OFFICE 040 – 399 4321 040 – 91 08 61 8th floor Medical tower

CLINICAL INQUIRIES – INFORMATION OFFICE

040 – 399 4282 040 – 399 4284 8th floor Medical tower

WARDS – HEAD NURSE 040 - 399 4569 040 - 399 8th floor Medical tower

S.S. STROKE UNIT 040 – 399 4568 8th floor Medical tower

NEUROSONOLOGY 040 – 399 4225 8th floor Medical tower

S.S. NEUROPATHOPHYSIOLOGY Cattinara Hospital

040– 399 4332 040–399 4355 Ground floor

Maggiore Hospital 040– 399 2208 040–399 2436 Ground floor

OUTPATIENT CLINICS Cattinara Hospital

040– 399 4908 Poliambulatori N° 46 - 48

OUTPATIENT-INFOPOINT Maggiore Hospital 040– 399 2208

Ground floor

Strada di Fiume 447 – 34149 Trieste www.aots.sanita.fvg.it

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This booklet aims at providing patients and their f amilies with useful information for their stay at the Neurology Clinic – Stroke Unit.

The Neurology Clinic is a hospital division providing assistance to patients as well as research and teaching activities (it is seat of a Post-graduate School in Neurology). The wards of the Neurology Clinic are located on the 8th floor of the Medical Tower and include 35 beds (of which 8 semi-intensive care beds in the Stroke Unit , 4 Neuro-rehabilitation beds and 1 Video-EEG bed) plus 2 beds for Day-Hospital care.

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The Neurology Clinic offers outpatient clinics where highly specialized physicians carry out specialist examinations to assess the main neurological diseases. The clinics are located on the ground floor of the “Palazzina Poliambulatori” of Cattinara Hospital and on the ground floor of Maggiore Hospital. It also includes a Clinical Neuropsychology Service for the diagnosis of memory and cognitive disorders. Furthermore, the Neurology Clinic carries out specialized tests (e.g. Electroencephalography, Electromyography, Evoked Potentials) and Neurosonology (extra- and intra-cranial doppler) at the Neuropathophysiology (ground floor) and Neurosonology Units (8th floor of the Medical Tower) at Cattinara. EEG and EMG examinations are carried out on the ground floor of Maggiore Hospital, where you can also find a number of outpatient clinics and an INFOPOINT on neurologic disorders.

DURING HOSPITAL STAYS

The physicians’ and nursing staff’s activity, in providing care to patients, is particularly busy at certain hours of the day.

Visits to patients are, therefore, NOT allowed outside the following

VISITING HOURS

12 noon – 2.00 pm 5.30 pm – 8.00 pm

For patients requiring continuous care, please contact the Head Nurse.

Whenever medical or nursing procedures have to be carried out on a patient, visitors will be requested to leave the patient’s room.

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In-patients need a quiet environment: please, speak in a soft voice and do not allow more than one visitor at a time at the side of each bed. If you have a radio or television, please use headsets. Remember to keep with you only the personal belongings that you may need. Do not bring jewels or other valuables, but only small sums of money. Medications shall be administered by nurses at the prescribed time and according to the doctor’s instructions. DO NOT TAKE DRUGS BROUGHT INTO HOSPITAL FROM HOME without the doctor’s prior permission. During hospital stays, patients cannot leave the Ho spital without permission and a written authorization by t he ward physician.

FOOD, DRINKS and SMOKING

Breakfast is served around 9 am, lunch after 12 noon and dinner after 6 pm. The menu has some degree of flexibility, within the limits of the diet prescribed to each patient. In particular cases, a customized diet can be obtained through the hospital Dietary Service. Food or drinks should not be given to patients without the doctor’s prior approval. ALCOHOLIC DRINKS AND CIGARETTES ARE HARMFUL EVEN TO HEALTHY PEOPLE: they are certainly contraindicated for patients.

CELL PHONES

FOR SAFETY REASONS, CELL PHONES MUST REMAIN SWITCHED OFF, AS THEY CAN INTERFERE WITH THE MEDICAL ELECTRONIC EQUIPMENT.

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WARD STAFF

In addition to physicians, the Nurse Coordinator (Head Nurse), registered and general nurses, and auxiliary staff, there are other workers - such as physical therapists, staff of the patient transport service, housekeepers - carrying out their activities in the wards. The Neurology Clinic also hosts a Post-graduate School of Neurology , which means that patients may also be followed by graduate residents who provide care under the supervision and responsibility of an expert attending physician. The names of the Physicians taking care of you are listed outside your hospital room and included in the fold er at the foot of your bed.

INFORMATION ON IN-PATIENTS HEALTH

Information is provided by the physician in charge, if authorized by the patient, all working days at 12 noon ; appointments must be booked, at least one hour earlier, through the nursing staff or by calling 040 – 399 4569. In very severe or urgent cases, information will be provided at any time. In such circumstances, it is often the physician who will get in touch with you.

AT DISCHARGE

The patient will receive a discharge summary for his/her GP, including the diagnosis, the recommended treatment plan and the results of the main tests carried out. If you have to complete your diagnostic investigations after discharge, please arrive at the Ward half an hour before the appointment. Should an in-patient like to have a copy of his/her clinical records, this can be requested at discharge (a fee shall be charged for this service).

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If a patient needs to plan his/her discharge to be transported home by ambulance, this shall be communicated in due time to the nursing staff. A transport fee shall be charged.

ANYTHING ELSE?

The opening hours of the Clinical Inquiries Office, located at the entrance of the Ward, go from 8 am to 1 pm, Mondays to Fridays. If you wish to contact a Physician on the telephone, please call after 12 noon, so as not to interfere with the physician’s ward rounds. The Director of the Clinic is at your disposal for any further information and to receive suggestions for improvements, notifications or complaints. Please, make an appointment through the Clinical Inquiries Office or call 040 – 399 4321. If you wish to leave a donation to this or any other ward of the hospital, request the relevant form from the Head Nurse and fill it in.

DAY HOSPITAL CARE

This service allows to carry out complex investigations while avoiding long hospital stays. It can be used to manage several neurological diseases; regional regulations specify the circumstances and the feasibility limits of this type of hospitalization. Day cases have to be agreed upon with a ward physician, usually after a neurological examination.

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OUTPATIENT CLINICS and SERVICES General neurology outpatient clinics, also dealing with urgent cases, and Specialized outpatient clinics dedicated to the most important neurological diseases are available to the public. All services can be booked through the CUP (central booking office). General neurology outpatient clinic Outpatient clinic for specialist neurological examinations requested by general practitioners, medical advice for retirement and disability purposes, as well as mandatory medical examinations to obtain a driving license. It is located on the ground floor, Room 47, of the “Poliambulatori” building of Cattinara Hospital ; tel. 040 – 399 4908. Opening hours: Mondays, Tuesdays, Thursdays, Frida ys 9.30 am - 11.30 am. Outpatient clinic for neurological emergencies Outpatient clinic for “URGENT” or “RED CODE” specialized neurological examinations requested by general practitioners, to be carried out within 72 hours from the request. It is located on the ground floor, Room 47, of the “Poliambulatori” building of Cattinara Hospital ; tel. 040 – 399 4908. Opening hours: Mondays, Tuesdays, Thursdays, Frida ys 12 noon - 1.30 pm.

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Center for the Study of Multiple Sclerosis: Physicians in charge: dr. M. Zorzon, dr. A. Bosco, dr. A. Bratina Its objectives include: early diagnosis and timely therapies based on drugs capable of changing the course of the disease and slowing down disability; monitoring the evolution of the disease and the clinical surveillance of the patient; limiting the consequences of relapses. Every three months, about 350 patients are examined, 20% of whom come from throughout the Region or even outside it. The outpatient clinic works in collaboration with the Radiodiagnostics, Urology, Rehabilitation and IT divisions. The Center relies on the Day Hospital service of the Neurology Clinic – 8th floor of the Medical Tower of Cattinara Hospital – for diagnostic investigations and specific therapies. Outpatient examinations are carried out in the “Poliambulatori” building of Cattinara Hospital – Ground floor - Room 47 ; tel. 040 – 399 4908. Opening hours: Tuesdays to Fridays 2.00 pm – 5.00 pm. Center for the diagnosis and treatment of Dementias and Memory and Cognitive disorders Physicians in charge: dr. V.M. Sarra; dr. T. Cattaruzza The Center is dedicated to the diagnosis of memory and cognitive disorders as well as the diagnosis and treatment of dementias. It also monitors pharmacological response and the therapeutic assessment of behavioral disorders. Over 300 cases/year are assessed here. In-depth neuropsychological assessments are carried out by the Clinical Neuropsychology Service . It is located in the “Poliambulatori” building of Cattinara Hospital – Ground floor, Room 46 ; tel. 040 – 399 4908. Opening hours: Mondays, Thursdays 2.00 pm – 6.00 pm (Neuropsychological tests: Thursdays 9.00 am – 1.00 pm).

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Outpatient clinic for Parkinson’s disease and Movem ent disorders Physicians in charge: dr. L. Antonutti, dr. M. Catalan This outpatient clinic aims at optimizing the differential diagnosis between Parkinson’s disease and other parkinsonisms, by developing the best therapeutic strategy for the different stage of the disease. The clinic is currently taking care of 360 patients from the Region and other areas. It is located in the “Poliambulatori” building of Cattinara Hospital – Ground floor, Room 46 ; tel. 040 – 399 4908. Opening hours: Tuesdays, Wednesdays 2 pm – 5 pm; F ridays 1 pm – 3 pm. Appointment: through the Central Booking Office (CUP). Outpatient clinic for dystonias and treatment with botulinum toxin Physician in charge: dr. M. Tomaselli The clinic deals with the diagnosis and therapy of dystonia, in particular its focal forms (e.g. blepharospasm, spasmodic torticollis, oromandibular dystonia, dystonic dysphonia) and facial hemispasm. It is currently taking care of 100 cases. It is located in the “Poliambulatori” building of Cattinara Hospital – Ground floor, Room 46 ; tel. 040 – 399 4908. Opening hours: Mondays 9 am – 11.30 am Center for the diagnosis and treatment of headaches Physician in charge: dr. A. Granato The Center is dedicated to the diagnosis, therapy and monitoring of headaches. Its outpatient clinic receives about 750 cases/year. It is the only center of its kind in the Region and is a reference point at regional and extra-regional level. It collaborates with the Center of diagnosis and treatment of headaches of Padua University for the

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diagnosis and treatment of chronic headache due to analgesic abuse. It is located on the ground floor of Maggiore Hospital , in the outpatient clinics of the Neurology Clinic-Neuropathophysiology unit; tel 040 – 399 2208. Opening hours: Mondays and Thursdays 8.30 am – 1 pm . Outpatient clinic for the Study of Cerebrovascular diseases Physicians in charge: dr. F. Chiodo Grandi; dr. N. Koscica; dr. M. Naccarato S.S. Stroke Unit Physician in charge: dr. F. Chiodo Grandi This outpatient clinic gives advice for the primary and secondary prevention of stroke, by relying on the medical team working for the Stroke Unit. Services are provided to the whole provinces of Trieste and Gorizia. It is located in the “Poliambulatori” building of Cattinara Hospital – Ground floor, Room 46 ; tel. 040 – 399 4908. Opening hours: Tuesdays 11 am – 1 pm. Epilepsy Outpatient Clinic Physicians in charge: dr. F. Monti, dr. M. Tomaselli Its purpose is the diagnosis, treatment and follow-up of patients with epilepsy. It has taken care of about 600 patients. The medical team also uses the spaces and equipment of Neuropathophysiology to complete instrumental investigations. It is located in the “Poliambulatori” building of the Cattinara Hospital – Ground floor, Rooms 46 and 47 ; tel. 040 – 399 4908. Opening hours: Mondays 11.30 am - 1.30 pm (room 46) , Mondays 2 pm - 4.30 pm (room 47).

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Neuropathophysiology Unit Physician in charge: dr. F. Monti This unit carries out different types of tests for a total of 9000 cases/year. In addition to the activity carried out for the various hospital wards, it also collaborates with the Institutes of human physiology and electronics of the University of Trieste. Besides physicians, it includes part of the Neuropathophysiology technical staff. The Clinical neurophysiology unit provides a whole range of tests for both in-patients and out-patients:

- standard electroencephalography (EEG) and with activation - electroencephalography (EEG) + spectral analysis - dynamic electroencephalography ( EEG) - electromyography (EMG) - electroneurography (ENG) - electrodiagnosis - stimulus-evoked potentials - event-correlated evoked potentials - intraoperative monitoring - pronouncement of brain death

Laboratories are located on the ground floor of Cattinara Hospital (tel. 040 – 399 4332 or 040 – 399 4958) and the gro und floor of Maggiore Hospital (tel. 040 – 399 2208).

This Unit also provides specialist advice to other wards of Cattinara Hospital, Maggiore Hospital and IRCSS Burlo Garofolo.

Opening hours: from Mondays to Fridays 7 am – 7 pm.

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Neurosonology Service Physician in charge: dr. N. Carraro The service carries out echocolordoppler tests of the supra-aortic trunks and transcranial echocolordoppler aiming at documenting evidence of alterations of the afferent cerebral vessels in bothe the extra- and intra-cranial region. In addition to the assessment of carotid artery stenosis and the cerebrovascular dynamics, tests are carried out to detect the presence of right-to-left cardiac shunt, also by using suitable contrast media.

The Labs are located at the CIEU, on the 3 rd floor of Cattinara Hospital (tel. 040 – 399 4225) and at the entrance of the wards floor of the Neurology Clinic on the 8 th floor of Cattinara Hospital (tel. 040 – 399 4453).

Opening hours: Mondays to Fridays 7 am – 7 pm. At the CUP you will find a list of priority (red code) tests which are carried out within three days from request.

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THE NEUROHELP PROJECT

The Neurology Clinic and the Rehabilitation Medicine Unit have launched a project, called Neurohelp , with the aim of providing patients and their family members with information and training tools to manage diseases of the central nervous system and their consequences. Furthermore, the Neurohelp project is a tool to improve care and contribute to a more appropriate use of healthcare and social resources. The targeted neurological diseases, chosen as a target for the project, include: Stroke, Multiple Sclerosis, Alzheimer and other dementias, Epilepsy, Parkinson’s, Headaches .

The Neurohelp Project includes the following activities: 1. INFO-POINT and TOLL FREE NUMBER with dedicated staff in the outpatient clinics of the Neurology – Neuropathophysiology Clinic on the ground floor of the Maggiore Hospital, supported by a member of one of the many patients’ associations. Toll-free number from a fixed telephone:

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Mondays to Fridays from 11.00 am to 1.00 pm

TOLL FREE NUMBER: 800 178 018 A neurologist expert in several different diseases is available on call

2. FOCUS GROUP for patients and family members in collaboration with Patients’ Associations. 3. INFORMATION COLLECTION ON POST-DISCHARGE NEEDS of both patients and caregivers by means of printed questionnaires. 4. INFORMATION and TRAINING EVENTS for patients and caregivers.

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ACCREDITED FOR ORGANIZATION BY

JOINT COMMISSION INTERNATIONAL

Drafted by the Communication Office, on the basis of a text supplied by the “Neurology Clinic” Operative Clinical Unit in compliance with the Accreditation standards of Joint Commission Interna tional tel. 040 – 399 6301; 040 – 399 6300; fax 040 399 6298 e-mail: comunicazione@aots.sanita.fvg.it Strada di Fiume 447 – 34 149 Trieste