5,438 results match your criteria Recenti Progressi in Medicina [Journal]
Recenti Prog Med 2018 Oct;109(10):513-517
Neurologo libero professionista, Vicenza.
To what extent is current clinical practice capable of gathering relevant patient data, observing them and giving them adequate information back? To what extent does the clinical pathway play a role of real care and not simply technology delivery? The neurology clinic is an excellent case study for these questions. Experience shows that the available time is often inadequate to the complexity of the clinical and human cases. In particular, the patterns of clinical history in use ignore the individuality of the patient and his existential dimension. Read More
Recenti Prog Med 2018 Oct;109(10):509-512
UOC Malattie Endocrine, del Ricambio e della Nutrizione, PO "Paolo Borsellino", Marsala (Trapani).
Introduction: Type 1 Diabetes Mellitus is one of the most common chronic diseases in children. School children with diabetes may have special needs during their school attendance. Teachers are responsible for the safety of children at school, therefore, to safely manage a student with diabetes, especially in cases of emergency, they should be in possession of adequate informations and a good level of knowledge of the disease. Read More
Recenti Prog Med 2018 Oct;109(10):494-508
Unità Operativa Dipartimentale di Pronto Soccorso Medico, Azienda Ospedaliero Universitaria Policlinico Umberto I, Roma.
Introduction: Acute chest pain (CP) is a potentially related both to acute coronary syndrome and to other morbidities; this means that 2%-10% patients with cardiogenic CP are improperly discharged from the Emergency Room (ER). In order to identify risk to develop cardiovascular (CV) events in patients admitted to ER with CP, we used Heart Risk Score (HRS).
Materials And Methods: We included 165 patients referred to the ER for non-traumatic acute CP. Read More
Recenti Prog Med 2018 Oct;109(10):487-493
Fondazione Tender to Nave Italia ONLUS, Genova.
The high rates of psychological distress, disability and/or chronic illness reported among children, adolescents and young adults, are a recent stimulus for the development and evaluation of new initiatives. Adventure therapy, realized through sailing navigation or stay in the mountains are effective strategies to raise the welfare of the beneficiaries, implementing self-esteem, autonomy and social skills. A "Nave Italia" model is described and prospects for development in a sector not yet capable to produce high quality research and training, according to traditional gold standard criteria by medical research, are discussed. Read More
Recenti Prog Med 2018 Oct;109(10):1e-19e
Recenti Prog Med 2018 Oct;109(10):474-486
Dipartimento di Epidemiologia del SSR Lazio ASL Roma1.
Background: The World Health Organization (WHO) estimates that depression affects about 121 million people in the world and in terms of years of illness, by the year 2020 could become the second most prevalent disease in the world population after cardiovascular diseases. Second-generation antipsychotics (SGAs) seems to induce remission in depression when added to an antidepressant.
Aim: To evaluate the efficacy and safety of SGAs for the treatment of depression. Read More
Recenti Prog Med 2018 Oct;109(10):469-473
USD Psicologia Clinica, Dipartimento di Scienze della Salute, Università di Milano.
Clinicians will have to face an increasing numbers of older HIV-infected patients in coming years. The age cut-off of 50 years often adopted to define "elderly" patients with HIV/AIDS is younger than that usually used in most other settings. The present contribution discusses the main peculiarities and new outcomes of interest of this class of patient from the clinical psychology perspective; the contribution is divided in three section exploring cognitive disorders, psycho-emotional problems and health-related quality of life proposing both a brief synthesis of the main evidence from the literature and some insights and proposals for the importance of involving a psychologist in the clinical care of these patients. Read More
Recenti Prog Med 2018 Oct;109(10):459-468
Il Pensiero Scientifico Editore.
On May 13, 1978 the Italian Mental health act [Law 180] was approved, better known as the Basaglia law, named after of the psychiatrist who inspired it. It represents the basis of the Italian mental health legislation: the outdated custodial care in psychiatric hospitals was shifted away from mental hospitals to community mental health centres. Alternative community care restored dignity and rights to locked up people. Read More
Recenti Prog Med 2018 Oct;109(10):457-458
Clinical guidelines are a valuable tool for doctors: they are the "type of document" most downloaded from publishers' websites and the "type of article" most cited in scientific literature. They are also an important driver of health system expenditure. To avoid conflicts of interest and to overcome an overly specialized approach, guidelines should not be prepared by scientific professional associations involved in the subject addressed. Read More
Recenti Prog Med 2018 Sep;109(9):447-448
Recenti Prog Med 2018 Sep;109(9):443-446
Neurologo libero professionista, Vicenza.
More than with other diseases, the diagnosis of dementia must be made carefully, as it can have a huge impact on both the patient's social and legal status and the caregiver's own health. Special attention should be put in avoiding diagnostic errors at the time of symptom onset, because a diagnosis made explicitly can affect the patient's self-esteem. If the diagnosis is uncertain, we would recommend not performing unnecessary investigation but rather waiting to get a clearer clinical picture. Read More
Recenti Prog Med 2018 Sep;109(9):432-442
Ambulatorio di Psichiatria e Psicofarmacologia Perinatale "DeGra", Ancona, Rimini, Verona.
Antepartum depression, frequently in comorbidity with anxiety disorders, is a severe psychopathological condition frequently reported in pregnancy and in many cases associated with obstetric and neonatal complications and potential negative consequences on child neurodevelopment. However, the pharmacological treatment of depression, during pregnancy generates a lot of concerns about the risks of such treatment for the fetus development and the neonatal health. The aim of this review is to present a selection of the latest international literature including recent original studies, systematic reviews, meta-analyses and recommendations from the guidelines, both on the risks of an untreated depressive disorders and on the risk of antidepressant therapy during gestation with drugs belonging to the SSRI and SNRI (SRI) class. Read More
Recenti Prog Med 2018 Sep;109(9):27e-29e
Recenti Prog Med 2018 Sep;109(9):1e-26e
Recenti Prog Med 2018 Sep;109(9):421-431
School of Social and Community Medicine, University of Bristol, UK.
Objective: To develop ROBIS, a new tool for assessing the risk of bias in systematic reviews (rather than in primary studies).
Study Design And Setting: We used four-stage approach to develop ROBIS: define the scope, review the evidence base, hold a face-to-face meeting, and refine the tool through piloting.
Results: ROBIS is currently aimed at four broad categories of reviews mainly within health care settings: interventions, diagnosis, prognosis, and etiology. Read More
Recenti Prog Med 2018 Sep;109(9):417-420
Direttore Sanitario IRCCS San Raffaele Pisana, Roma.
We have reached the awareness that diseases, far from being simple altered health states, are characterized by intrinsic emerging and adaptive properties, requiring an interdisciplinary, global and systemic approach, oriented towards integration and coordination, rather than an atomic and disintegrated logic. A new approach is needed, "systems medicine", defined as an interdisciplinary field of study that looks at the systems of the human body as part of an integrated whole, incorporating biochemical, physiological, and environment interactions. This new kind of medicine addresses diseases and their interrelationships in a scale invariant, holistic and systematic "multi-axial" way, analysing apparati, organs, tissues, cells, molecules, always taking care of the relationships with the relative ecosystem. Read More
Recenti Prog Med 2018 Sep;109(9):413-416
Freelance health & data journalist, Consultant for communication/social media of the Italian Office of the World Health Organization.
Since 2014 1.8 million migrant people arrived in Europe from Italy, Spain and Greece. It represents a quarter of the London population. Read More
Recenti Prog Med 2018 Jul-Aug;109(7):401-404
Neurologo libero professionista, Vicenza.
The falls frequently occurring as a result of impaired postural reflexes, due to degenerative changes that accompany the aging process, have a great impact on quality of life in the elderly. Falls and the fear of falling can trigger restraints and limits to freedom, ultimately leading to definitive care from professional or other. In nursing homes, security regulations often predominate over any other consideration and become a source of suffering and oppression. Read More
Recenti Prog Med 2018 Jul-Aug;109(7):398-400
Dipartimento Area Medica ASL TO4, Torino.
Mycotic aneurysm secondary to tuberculous infection (TB) of the aorta is a rare and life-threatening disease. We report a case report of a 78-year-old woman with a tuberculous mycotic aortic aneurysm (TBAA). Early diagnosis and a combination of surgical intervention (aortic reconstruction and extensive excision of the infected field) and prolonged antituberculous drug therapy provide long-term survival without evidence of recurrence after tuberculous aortic involvement. Read More
Recenti Prog Med 2018 Jul-Aug;109(7):393-397
Dipartimento di Scienze Biomediche, Odontoiatriche e delle Immagini Morfologiche e Funzionali, Università di Messina.
Introduction: Several studies highlighted the presence of anxiety, depression and anger in headache patients, however the results are not always consistent. The aim of this work was to explore the link between the different components of anger, the level of depression, trait and state anxiety, and the diagnostic parameters such as frequency and duration of the headache attacks.
Materials And Methods: Eighty patients referred to the Headache center of Messina University Hospital G. Read More
Recenti Prog Med 2018 Jul-Aug;109(7):388-392
Accademia Lancisiana, Roma.
The main aim of this critical review on the pulmonary sequestration is to focus the attention of pneumologists, thoracic surgeons and oncologists on some features concerning the heart, vessels, lungs, pleura, diaphragm as well as unusual infections and neoplasms, closely related to such rare disease. The Author emphasizes the importance of these aforementioned peculiarities with reference to the diagnosis timelines as well as to treatment appropriateness. He believes that the new advanced tools to day available makes to achieve this target: it is a must to take in more greater account the rare and insidious pulmonary sequestration at least in the context of post-graduate specialty courses. Read More
Recenti Prog Med 2018 Jul-Aug;109(7):384-387
Dipartimento di Scienze Biomediche e Oncologia Umana, Università Aldo Moro, Bari.
Authors discuss therapeutic potential of reading activity, partially still unknown. Starting from Menninger's work in the early 30's until most recent studies from Frude, Berns, Comer who confirmed its efficacy in both the so-called non-organic diseases and chronic pathological conditions. Their studies strongly suggested psychobiological mechanisms through which reading activity exerts its therapeutic effects. Read More
Recenti Prog Med 2018 Jul-Aug;109(7):374-383
Dipartimento di Scienze Farmaceutiche, Università di Perugia.
Communication in health is an emerging and constantly evolving topic, taking more and more new aspects and concepts over time. The objective of this work is to present, through a narrative review, the most important aspects of communication in health field. Communication in health traditionally is known as interpersonal communication between health care workers and patients. Read More
Recenti Prog Med 2018 Jul-Aug;109(7):371-373
Medicina Legale, Istituto Nazionale della Previdenza Sociale, Roma.
In Italy, blindness and low vision are ruled by Law 138/2001: two categories of blindness (corresponding to the one in the current WHO classification), receiving economical remuneration, and three categories of low vision, not directly remunerated. The problem ensues that low vision patients, who better gain from rehabilitation, have no economical contribution to undergo such care pathways; moreover, in Italy the evaluation has not yet shifted from "visual function" to "functional vision", thus lacking a holistic evaluation of visual dysfunction impact on the patient's daily life skills. To quantify the visual function of the examinee, only subjective performance (visual acuity and/or visual field) is evaluated in accordance with Law 138/2001, thus paving the way to malingerers: the "false blinds" phenomenon has recently reached the media. Read More
Recenti Prog Med 2018 Jul-Aug;109(7):369-370
Medico, studioso di medicina narrativa. Istituto CHANGE, Torino.
Market is an ambivalent word. Thinking of the global market, we imagine flows of goods and money moved from one continent to another. Otherwise, those lucky enough to be able to shop in a local market know what it means to have the opportunity to meet other residents of the neighborhood, the producers of fruit and vegetables, the street vendors and share with them feelings, expectations, joys and concerns. Read More
Recenti Prog Med 2018 Jul-Aug;109(7):367-368
Già Presidente della International Epidemiological Association.
The number of migrants to Italy by the Central Mediterranean route is decreasing while the risk of dying of those attempting the crossing is markedly increasing. It can be hypothesized that with reinforced barriers to migration only the most desperate, in poorest overall conditions (including those of their boats) dare to try the crossing. Whatever the explanation the raising death rates at sea point to the inadequacy of the salvage system, raising the question of whether the priority of the European Union is , as declared, "to save lives at sea" or, de facto, only to reduce the migrants' flow. Read More
Recenti Prog Med 2018 Jun;109(6):359-360
Recenti Prog Med 2018 06;109(6):352-358
Department of Oncology, Mater Salutis Hospital, Az. ULSS 9 Scaligera - Legnago (VR), Italy.
Recenti Prog Med 2018 Jun;109(6):350-351
Oncologia Medica, Ospedale San Salvatore, L'Aquila.
The earthquake that shook Central Italy during 2016 and 2017 confirmed once again the country's vulnerability. These catastrophic events have serious consequences both on the lives of cancer patients and on the organization of healthcare assistance. After the earthquake that devastated the city of L'Aquila in 2009, the nearby hospitals were declared unfit, thus, patients were deprived of their natural reference center. Read More
Recenti Prog Med 2018 Jun;109(6):342-349
SSD Psicologia Clinica, Fondazione IRCCS - Istituto Nazionale dei Tumori, Milano - Dipartimento di Oncologia ed Emato-Oncologia, Università di Milano.
Divorces and separations have become more frequent over the last 20 years and for this reason they are issues of great importance with possible effects on medical treatments. Conflicts between the adults frequently affect the children involved in the separation of their parents. If, on the one hand, the parental conflict is a hard and distressing experience for the whole family, on the other hand this situation gets even more complicated if a child is affected by a serious illness. Read More
Recenti Prog Med 2018 Jun;109(6):337-341
Dipartimento di Onco-Ematologia, UO di Oncologia, Ospedale Guglielmo da Saliceto, Piacenza.
Introduction: In the field of oncology, we are all stimulated by the desire to improve the lives of patients with cancer; however little data are available about the amount of time and travel discomfort that patients and families typically spend for clinical examinations and for antitumoral/supportive treatments. The purpose of this study was to determine the advantages for cancer patients to receive clinical, test examinations, and anticancer treatment near their residence in a territorial clinical structure called "Casa della Salute" (CdS).
Methods: Since July 2016 to all the cancer patients treated at the Oncology Unit of the General Hospital in Piacenza, was offered the possibility to be treated near their residence at the CdS located in the mid valley (Val Nure), or to continue the treatment at the Oncology Unit of the General Hospital in Piacenza. Read More
Recenti Prog Med 2018 Jun;109(6):333-336
Registro Tumori Umbro di Popolazione.
Evidence on outcome-volume relation and resource shortage are forcing the oncology department towards concentrating of cancer care in large specialized centres. We report a study on radiotherapy for breast cancer patients in Umbria, Italy, where geographic barriers reduced appropriate radiotherapy for patients with a travel burden as low as >40 minutes and the under-treatment was associated with low survival probabilities. The creation of additional radiotherapy centres (i. Read More
Recenti Prog Med 2018 Jun;109(6):328-332
Ospedale Policlinico San Martino, Genova.
The checkpoint inhibitors opened a new era in the treatment of advanced non-small-cell lung cancer (NSCLC) initially by replacing second-line standard chemotherapy with docetaxel and subsequently by replacing platinum-based chemotherapy in the first line, albeit in patients selected for a high expression of PD-L1. The decision algorithm has therefore been radically modified for patients who do not have activating mutations. However, we are only at the beginning of a new era from which we expect in the near future the use of immunotherapy in most patients as a first line treatment in substitution or in combination with chemotherapy. Read More
Recenti Prog Med 2018 Jun;109(6):324-327
Servizio di Epidemiologia e Registro Tumori, IRCCS Istituto Nazionale Tumori "Regina Elena" - IFO, Roma.
To introduce a systematic narrative approach into clinical practice, not only training to improve narrative skills among physicians, but also a change in their perspective towards care, is required. This paper describes the development of a narrative path started at the IRCSS "Regina Elena" National Cancer Institute, based on training and research projects. The programme started in 2015 with a story-sharing intervention, named "Raccontami di te" ("Tell me about you"), involving patients, their relatives and health professionals, with the aim to improve the knowledge about the role of self-narration as well as the listening attitude. Read More
Recenti Prog Med 2018 Jun;109(6):319-321
Associazione Culturale Camici & Pigiami ONLUS.
Several new health technologies are going to be introduced in the healthcare system, as well as new ways of making diagnoses, new drugs, new strategies for customizing therapy. Introducing innovation requires a considerable effort from healthcare decision-makers. In fact, every innovation may have an impact in terms of altering diagnostic and clinical pathways, but also in terms of processes, organizational structures, services and interventions delivery, costs. Read More
Recenti Prog Med 2018 06;109(6):317-318
Fondazione Ricerca e Salute.
Oncology drugs have been traditionally approved for the treatment of specific cancer diseases. Recently, regulatory decisions about new cancer therapies have been taken by the Food and Drug Administration starting from biomarker data irrespective of organ site or histology. This new pattern can be defined as a "mutational model". Read More
Recenti Prog Med 2018 May;109(5):307-308
Recenti Prog Med 2018 May;109(5):294-306
Direzione Sanitaria ASL4 Liguria, Chiavari e SC Medicina Interna ASL5 Liguria, La Spezia.
Introduction: The knowledge of principles and methods of Evidence Based Medicine (EBM) and the use of Clinical Practice Guidelines to inform clinical decisions are recognised as key instruments to improve the quality of care. In Italy the Parliament has revised the legal system that rules the responsibilities of health professionals and health care safety, prescribing health professionals to adhere to guidelines and good practice recommendations. The objective of the study was to evaluate guidelines and clinical pathways developed at local level and to assess knowledge and attitudes of healthcare workers toward EBM and guidelines. Read More
Recenti Prog Med 2018 May;109(5):272-293
Department of Health Research Methods, Evidence, and Impact (formerly Clinical Epidemiology and Biostatistics), McMaster University, Hamilton, Canada - Department of Medicine, McMaster University, Hamilton, Canada.
In the first article in this series we described the GRADE (Grading of Recommendations Assessment, Development and Evaluation) Evidence to Decision (EtD) frameworks and their rationale for different types of decisions. In this second article, we describe the use of EtD frameworks for clinical recommendations and how it can help clinicians and patients who use those recommendations. EtD frameworks for clinical practice recommendations provide a structured and transparent approach for guideline panels. Read More
Recenti Prog Med 2018 May;109(5):267-271
Dipartimento di Biotecnologie e Scienze della Vita, Università dell'Insubria, Varese.
The Italian Parliament has recently approved the Law n. 219/2017 concerning "Rules on informed consent and advance directives". The manuscript points out the main key points of the new law, in order to clarify the role of the advance directives and to provide clear operational guidelines for healthcare personnel. Read More
Recenti Prog Med 2018 May;109(5):263-266
Research Institute of Nyíregyháza, IAREF, University of Debrecen, Nyíregyháza, Hungary.
Nonostante i cambiamenti in corso nell'ambito delle pubblicazioni scientifiche (STEM - scienza, tecnologia, ingegneria e medicina), è indubbio che i direttori delle riviste restano i più importanti custodi del processo editoriale. In questo articolo vengono analizzati i motivi per cui i direttori delle riviste devono continuare ad attenersi ai principi editoriali fondamentali e a utilizzare le nuove tecnologie digitali solo per dare forza al contenuto, ma non per sostituirlo nella sua qualità. Per raggiungere questo obiettivo, in un'epoca caratterizzata da controlli ed equilibri, i direttori delle riviste devono essere attentamente sorvegliati e ritenuti responsabili tanto quanto gli autori che essi stessi valutano. Read More
Recenti Prog Med 2018 05;109(5):261-262
Agenzia Italiana del Farmaco (AIFA).
The Italian Medicines Agency (AIFA), which has the dual function of a regulatory and a reimbursement authority, has recently established new criteria to define innovative medicinal products. Indeed, the decision making process to grant the innovative status is based on the evaluation of the unmet medical need, the added therapeutic value compared to existing therapeutic options and the overall quality of clinical evidence, which is assessed based on the GRADE system. Following this evaluation, if a medicinal product is granted the status of "full innovativeness" for a specific therapeutic indication, its manufacturer can access dedicated yearly funds amounting to 500 million Euros each, depending on the type of medicine (one fund for oncology, the other for all other innovative medicinal products). Read More
Recenti Prog Med 2018 Apr;109(4):257e-265e
Dipartimento di Otorinolaringoiatria, Università di Bari.
Inflammatory rhinitis is a very common disorder. It includes allergic rhinitis (AR) and non-allergic rhinitis (NAR). Nasal inflammation is shared by both disorders. Read More
Recenti Prog Med 2018 Apr;109(4):255-256
Recenti Prog Med 2018 Apr;109(4):249-253
Dipartimento di Scienze Mediche di Base, Neuroscienze ed Organi di Senso, Università di Bari.
Alzheimer's disease is one of the biggest challenges for anyone involved in research in this area, because unfortunately there is little evidence that one of the various forms of therapy offered has some beneficial and lasting effect. Approximately 1,200 annual publications in scientific journals on this disease have still failed to provide a homogenous picture of the disease, its causes, and its evolution. For these reasons, Alzheimer's disease can be considered as a planetary health emergency of our time. Read More
Recenti Prog Med 2018 Apr;109(4):242-248
Istituto mediterraneo per i trapianti e le terapie ad alta specializzazione (ISMETT), IRCCS, Palermo.
Background: Management of therapy in elderly patients is a critical issue in primary care. The physiopathological status is usually complex, and the prescription of multiple drugs is typically required, with a consequent higher risk of adverse effects. Many tools have been developed to cope with this problem, and identify drugs that are inappropriate in the elderly. Read More
Recenti Prog Med 2018 Apr;109(4):236-241
UOC Pronto Soccorso e Medicina d'Urgenza, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano.
Differential diagnosis of one or more wide QRS complexes on an electrocardiogram under emergency conditions takes into account three main sets of clinical conditions: ventricular pre-excitation, aberrant conduction and ventricular beats and it is based on the morphological analysis of the ECG and patient's anamnestic data. Several criteria can facilitate the differential diagnosis and if properly used and integrated with clinic data they can achieve good diagnostic accuracy in most cases. In this review several criteria based on evidence and literature are presented, paying attention in recognizing some morphologic pathways that can be used in emergency room and allow a correct ECG assessment. Read More
Recenti Prog Med 2018 Apr;109(4):226-235
Cattedra di Psicologia Clinica, Dipartimento di Scienze Cliniche e Sperimentali, Università di Brescia.
About the relationship between medicine and psychoanalysis it has been written a lot, in primis in the psycho-somatic perspective, in secundis in the psychic modulation of health and disease. In this paper a different perspective is adopted. Both psychoanalysis and medicine are currently confronted with different patients than in the past, indeed nowadays patients are often more fragile, as in the somatic as in the psychic problems. Read More
Recenti Prog Med 2018 Apr;109(4):220-225
Dipartimento di Radiologia, Ospedale Monaldi AO dei Colli, Napoli.
Pulmonary tuberculosis (TB) is nowadays one of the most common causes of infectious disease-related morbility and mortality worldwide. The differential diagnosis between TB and some others conditions is an emerging problem, particularly challenging when TB imaging mimicks sarcoidosis, lymphoproliferative disorders and pulmonary neoplasms. In these cases, the correct diagnoses can be made with certainty only with trans-bronchial or CT guided biopsy. Read More