Annali di igiene : medicina preventiva e di comunità, Nov 1, 2007
This article reviews the health care system in the Czech Republic. It is aimed to point out the d... more This article reviews the health care system in the Czech Republic. It is aimed to point out the different matters in contrast to the Italian system. It summarizes the historical changes regarding the health care after the "fall of communism" in 1989 and the split of Czechoslovakia (1993) and basic organizational questions; particular consideration is devoted to the pharmaceutical care, hospitals accreditation, a responsibility of the physician and free and informed consent. The health care system in the Czech Republic has underwent many changes during the last years and its further transformation reflecting social requests can be expected.
In view of the fact that a considerable proportion of the population particularly at risk (the ag... more In view of the fact that a considerable proportion of the population particularly at risk (the aged, children, the sick, etc.) spend many hours of the day indoors, the authors report the results of an investigation carried out on the building characteristics of 1833 houses sampled in four towns in the Marches region. The questionnaire of Fusillo et al. was used. The results show an excellent situation with regard both to the quality of outdoor air and acoustic pollution (only 27% of the sample complained of the vicinity of their house to zones of intense traffic). The low index of overcrowding (0.7 inhabitants per room) as well as the overall surface area of the houses (in 60% more than 100 m2), the large number of bathrooms (almost 50% of the houses with two, and another 15% with three or more), and the prevalence of detached houses are factors that show how the Marchean population pay particular attention to building criteria. However, even though from the structural standpoint the housing situation might seem a very good one, specific problems can be found, also common to other Italian regions, regarding building techniques and the materials adopted (e.g. the use of reinforced concrete, which together with the undoubted advantages it offers also has a number of disadvantages). The authors therefore stress the need for incentivating a bioecologically based building tradition, even if this is economically more costly, and give guidelines on how to conciliate the bioecological and economic aspects with regard to choice and use of materials. Finally, they express the hope that the "EC" symbol foreseen for building materials by Law No. 246 of 21 April 1993 will be adequately used in the ways laid down in appendix A to that law.
The Authors, after outlining the problem of elderly people, refer to data from their research def... more The Authors, after outlining the problem of elderly people, refer to data from their research defining precisely the particular demographic-social situations of the elderly in the city of Camerino. Research, using the same questionnaire, was carried out into the most frequent state of health and pathology of elderly people living in the city of Camerino. The most significant data provided some points for discussion as well as considerations relative to prevention and care in old age. The occasion was taken for stimulating our Society to not neglect elderly people but rather to find the right solutions for maintaining their standard of living at the highest level possible.
To complete the picture of the daily dietary intake of minerals, sodium, potassium, calcium and m... more To complete the picture of the daily dietary intake of minerals, sodium, potassium, calcium and magnesium have now been considered. The study has been carried out in the Italian Marches Region after carefully evaluating the food consumption habits of the population. The foodstuffs comprising the 70 diets examined were collected in institutional canteens and private homes immediately prior to meals. The food was sampled ready for consumption as it had thus undergone the various preparation and cooking procedures, during which considerable changes in mineral content occur. In comparison with the various food consumption standards, the amount of sodium found appears excessively high (4.8 g/d) whereas that of magnesium is insufficient (0.24 g/d). A high sodium intake, and more recently a high Na/K ratio, have been associated with hypertension. Also a lack of magnesium and a high Ca/Mg ratio have repeatedly been associated with hypertension risk. The data to emerge from our study: a high sodium intake, an insufficiency of magnesium, and thus high Na/K and Ca/Mg ratios, would appear likely to enhance cardiovascular disease risk. Even though not all Authors agree on the existence of such correlations, a more correct diet as regards mineral intake is undoubtedly something to encourage.
This study aims to evaluate the quality of life (QoL) of chronic myeloid leukemia (CML) patients ... more This study aims to evaluate the quality of life (QoL) of chronic myeloid leukemia (CML) patients prescribed with nilotinib as a second-line therapy and explores the influential factors. A multicenter retrospective survey was conducted via face-to-face interviews based on the EORTC QLQ-C30 questionnaire. A total of 121 adult CML patients resistant to imatinib and used nilotinib for at least 3 months were enrolled. The influential features were assessed by multiple linear regression models. Patients had the mean age of 47.49 (SD = 13.67) years, dominated by middle-aged and male groups. The mean scores of functions ranged from 75 to 83, and those of symptoms were from 5 to 28, with the highest of fatigue (28.28), insomnia (22.87), and pain (21.07). The mean global health status/QoL score was 67.70 (SD = 16.80) with considerable financial difficulties (52.34 (SD = 32.15)). Male patients reported higher functional scores and fewer symptoms compared with female patients. All aspects of QoL became worse with increasing age. Besides age and gender, level of education, duration of nilotinib usage, and comorbidities were also significantly influential factors in many QoL domains. A predicted model for expected mean scores of QoL domains was built based on these factors. The CML patients treated with nilotinib had the above-moderate QoL scores, a light decrease of functional scores, great financial difficulties, and still experienced symptoms. Strategies and more therapeutic considerations to enhance QoL for CML patients targeted toward women, the old, low educational level, and long duration of nilotinib usage, and many comorbidities are needed in the setting.
Background: Healthcare acquired infections (HAIs) represent a significant burden for hospitalized... more Background: Healthcare acquired infections (HAIs) represent a significant burden for hospitalized patients in terms of mortality, morbidity, length of stay and costs. Also cause medical liability and medical malpractice litigation. Methods: Specific keywords combinations were analitically searched in PubMed and Scopus databases. Publications concerning medical liability, medical malpractice and litigation issues were reviewed. Results: The authors outlined the healthcare workers and healthcare settings mandatory duties in consideration of the Italian law. In case of infections occurred in hospital environment the patients must demonstrate the guilty nature of the physicians and healthcare settings, the existence of a harm and causal connection. Physicians and healthcare facilities defence is mainly based on demonstration that protocols and aseptic measures were adopted scrupulously applying the up to date scientific knowledge. Conclusions: HAI are a complex issue which need a multitask strategy and a surveillance system to control the phenomenon and help physicians and healthcare facilities to reduce malpractice litigation.
Annali di igiene : medicina preventiva e di comunità, Nov 1, 2007
This article reviews the health care system in the Czech Republic. It is aimed to point out the d... more This article reviews the health care system in the Czech Republic. It is aimed to point out the different matters in contrast to the Italian system. It summarizes the historical changes regarding the health care after the "fall of communism" in 1989 and the split of Czechoslovakia (1993) and basic organizational questions; particular consideration is devoted to the pharmaceutical care, hospitals accreditation, a responsibility of the physician and free and informed consent. The health care system in the Czech Republic has underwent many changes during the last years and its further transformation reflecting social requests can be expected.
In view of the fact that a considerable proportion of the population particularly at risk (the ag... more In view of the fact that a considerable proportion of the population particularly at risk (the aged, children, the sick, etc.) spend many hours of the day indoors, the authors report the results of an investigation carried out on the building characteristics of 1833 houses sampled in four towns in the Marches region. The questionnaire of Fusillo et al. was used. The results show an excellent situation with regard both to the quality of outdoor air and acoustic pollution (only 27% of the sample complained of the vicinity of their house to zones of intense traffic). The low index of overcrowding (0.7 inhabitants per room) as well as the overall surface area of the houses (in 60% more than 100 m2), the large number of bathrooms (almost 50% of the houses with two, and another 15% with three or more), and the prevalence of detached houses are factors that show how the Marchean population pay particular attention to building criteria. However, even though from the structural standpoint the housing situation might seem a very good one, specific problems can be found, also common to other Italian regions, regarding building techniques and the materials adopted (e.g. the use of reinforced concrete, which together with the undoubted advantages it offers also has a number of disadvantages). The authors therefore stress the need for incentivating a bioecologically based building tradition, even if this is economically more costly, and give guidelines on how to conciliate the bioecological and economic aspects with regard to choice and use of materials. Finally, they express the hope that the "EC" symbol foreseen for building materials by Law No. 246 of 21 April 1993 will be adequately used in the ways laid down in appendix A to that law.
The Authors, after outlining the problem of elderly people, refer to data from their research def... more The Authors, after outlining the problem of elderly people, refer to data from their research defining precisely the particular demographic-social situations of the elderly in the city of Camerino. Research, using the same questionnaire, was carried out into the most frequent state of health and pathology of elderly people living in the city of Camerino. The most significant data provided some points for discussion as well as considerations relative to prevention and care in old age. The occasion was taken for stimulating our Society to not neglect elderly people but rather to find the right solutions for maintaining their standard of living at the highest level possible.
To complete the picture of the daily dietary intake of minerals, sodium, potassium, calcium and m... more To complete the picture of the daily dietary intake of minerals, sodium, potassium, calcium and magnesium have now been considered. The study has been carried out in the Italian Marches Region after carefully evaluating the food consumption habits of the population. The foodstuffs comprising the 70 diets examined were collected in institutional canteens and private homes immediately prior to meals. The food was sampled ready for consumption as it had thus undergone the various preparation and cooking procedures, during which considerable changes in mineral content occur. In comparison with the various food consumption standards, the amount of sodium found appears excessively high (4.8 g/d) whereas that of magnesium is insufficient (0.24 g/d). A high sodium intake, and more recently a high Na/K ratio, have been associated with hypertension. Also a lack of magnesium and a high Ca/Mg ratio have repeatedly been associated with hypertension risk. The data to emerge from our study: a high sodium intake, an insufficiency of magnesium, and thus high Na/K and Ca/Mg ratios, would appear likely to enhance cardiovascular disease risk. Even though not all Authors agree on the existence of such correlations, a more correct diet as regards mineral intake is undoubtedly something to encourage.
This study aims to evaluate the quality of life (QoL) of chronic myeloid leukemia (CML) patients ... more This study aims to evaluate the quality of life (QoL) of chronic myeloid leukemia (CML) patients prescribed with nilotinib as a second-line therapy and explores the influential factors. A multicenter retrospective survey was conducted via face-to-face interviews based on the EORTC QLQ-C30 questionnaire. A total of 121 adult CML patients resistant to imatinib and used nilotinib for at least 3 months were enrolled. The influential features were assessed by multiple linear regression models. Patients had the mean age of 47.49 (SD = 13.67) years, dominated by middle-aged and male groups. The mean scores of functions ranged from 75 to 83, and those of symptoms were from 5 to 28, with the highest of fatigue (28.28), insomnia (22.87), and pain (21.07). The mean global health status/QoL score was 67.70 (SD = 16.80) with considerable financial difficulties (52.34 (SD = 32.15)). Male patients reported higher functional scores and fewer symptoms compared with female patients. All aspects of QoL became worse with increasing age. Besides age and gender, level of education, duration of nilotinib usage, and comorbidities were also significantly influential factors in many QoL domains. A predicted model for expected mean scores of QoL domains was built based on these factors. The CML patients treated with nilotinib had the above-moderate QoL scores, a light decrease of functional scores, great financial difficulties, and still experienced symptoms. Strategies and more therapeutic considerations to enhance QoL for CML patients targeted toward women, the old, low educational level, and long duration of nilotinib usage, and many comorbidities are needed in the setting.
Background: Healthcare acquired infections (HAIs) represent a significant burden for hospitalized... more Background: Healthcare acquired infections (HAIs) represent a significant burden for hospitalized patients in terms of mortality, morbidity, length of stay and costs. Also cause medical liability and medical malpractice litigation. Methods: Specific keywords combinations were analitically searched in PubMed and Scopus databases. Publications concerning medical liability, medical malpractice and litigation issues were reviewed. Results: The authors outlined the healthcare workers and healthcare settings mandatory duties in consideration of the Italian law. In case of infections occurred in hospital environment the patients must demonstrate the guilty nature of the physicians and healthcare settings, the existence of a harm and causal connection. Physicians and healthcare facilities defence is mainly based on demonstration that protocols and aseptic measures were adopted scrupulously applying the up to date scientific knowledge. Conclusions: HAI are a complex issue which need a multitask strategy and a surveillance system to control the phenomenon and help physicians and healthcare facilities to reduce malpractice litigation.
Uploads