[Towards a protocol for the good use of the day hospital: an analysis of the level of the care supplied]. / Verso un protocollo per il buon uso del Day Hospital: analisi del livello di assistenza fornita.

Day hospital (DH) is an intermediate way of assistance between ambulatory activity and ordinary hospitalization, with the object of increasing efficiency of hospital services. Nowadays data about real efficiency of DH use are lacking, but probably inappropriateness of DH use is high. Aim of our study has been to analyze the complexity of the services provided by DH in our hospital in 1996. Therefore, we have analyzed 100 case sheets, regarding medical DHs, selected at random among the DHs performed in the year. Our analysis has evidenced that 67.7% of DHs had only one access and in 37% of accesses only one service has been performed. 31.1% of DHs required only clinical evaluation, laboratory analyses, ECG or chest X-ray. 59% of DHs had diagnostic reasons, only 10% therapeutic reasons. Only in 35 of the 75 patients who used DH (46.6%), DH was the only recovery in the year, the others have been recovered more than one (from 1 to 6). In conclusion, our data show that complexity of DH is low and that DH seems substitute ambulatory services rather than ordinary hospitalization.

Mitochondrial permeability transition and release of cytochrome c induced by retinoic acids.

Retinoic acids, structurally related to vitamin A, inhibit the in vitro proliferation of different types of normal and neoplastic cells. The effects of all-trans, 9-cis, and 13-cis retinoic acids were tested on mitochondria isolated from rat liver. All the compounds were able to induce the membrane permeability transition observed as swelling and decrease in membrane potential, but 13-cis retinoic acid appeared to be the most effective. The latter was also shown to stimulate the release of cytochrome c from mitochondria, suggesting a potential target of retinoids in the induction of cell apoptosis. Interestingly, EGTA and cyclosporin A, which strongly inhibit the permeability transition induced by 13-cis retinoic acid, were without effect on the release of cytochrome c from the mitochondrial intermembrane space.