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2.
BMJ ; 367: l5367, 2019 10 08.
Artigo em Inglês | MEDLINE | ID: mdl-31594780

RESUMO

OBJECTIVE: To estimate the risk of acute myocardial infarction (AMI) or stroke in adults with non-alcoholic fatty liver disease (NAFLD) or non-alcoholic steatohepatitis (NASH). DESIGN: Matched cohort study. SETTING: Population based, electronic primary healthcare databases before 31 December 2015 from four European countries: Italy (n=1 542 672), Netherlands (n=2 225 925), Spain (n=5 488 397), and UK (n=12 695 046). PARTICIPANTS: 120 795 adults with a recorded diagnosis of NAFLD or NASH and no other liver diseases, matched at time of NAFLD diagnosis (index date) by age, sex, practice site, and visit, recorded at six months before or after the date of diagnosis, with up to 100 patients without NAFLD or NASH in the same database. MAIN OUTCOME MEASURES: Primary outcome was incident fatal or non-fatal AMI and ischaemic or unspecified stroke. Hazard ratios were estimated using Cox models and pooled across databases by random effect meta-analyses. RESULTS: 120 795 patients with recorded NAFLD or NASH diagnoses were identified with mean follow-up 2.1-5.5 years. After adjustment for age and smoking the pooled hazard ratio for AMI was 1.17 (95% confidence interval 1.05 to 1.30; 1035 events in participants with NAFLD or NASH, 67 823 in matched controls). In a group with more complete data on risk factors (86 098 NAFLD and 4 664 988 matched controls), the hazard ratio for AMI after adjustment for systolic blood pressure, type 2 diabetes, total cholesterol level, statin use, and hypertension was 1.01 (0.91 to 1.12; 747 events in participants with NAFLD or NASH, 37 462 in matched controls). After adjustment for age and smoking status the pooled hazard ratio for stroke was 1.18 (1.11 to 1.24; 2187 events in participants with NAFLD or NASH, 134 001 in matched controls). In the group with more complete data on risk factors, the hazard ratio for stroke was 1.04 (0.99 to 1.09; 1666 events in participants with NAFLD, 83 882 in matched controls) after further adjustment for type 2 diabetes, systolic blood pressure, total cholesterol level, statin use, and hypertension. CONCLUSIONS: The diagnosis of NAFLD in current routine care of 17.7 million patient appears not to be associated with AMI or stroke risk after adjustment for established cardiovascular risk factors. Cardiovascular risk assessment in adults with a diagnosis of NAFLD is important but should be done in the same way as for the general population.


Assuntos
Hipertensão/epidemiologia , Fígado/patologia , Infarto do Miocárdio/epidemiologia , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Fumar/epidemiologia , Acidente Vascular Cerebral/epidemiologia , Adulto , Idoso , Estudos de Coortes , Bases de Dados Factuais , Feminino , Seguimentos , Humanos , Incidência , Itália/epidemiologia , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/fisiopatologia , Países Baixos/epidemiologia , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/fisiopatologia , Modelos de Riscos Proporcionais , Medição de Risco , Fatores de Risco , Fumar/efeitos adversos , Espanha/epidemiologia , Acidente Vascular Cerebral/etiologia , Acidente Vascular Cerebral/fisiopatologia
3.
Medicine (Baltimore) ; 98(38): e17088, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31567944

RESUMO

An international consensus for rheumatoid arthritis (RA) patients at risk of developing interstitial lung disease (ILD) is still lacking. The aims of study were to evaluate: the prevalence of ILD involvement in RA over high-resolution computed tomography (HRCT); the relationships between pulmonary function tests (PFTs), patient-centered measurements, and ILD; and the potential risk factors contributing to RA-ILD patients.Data regarding the clinical characteristics (age, sex, age at onset of RA), laboratory findings (rheumatoid factor [RF] and anti-citrullinated protein antibodies [ACPA]), respiratory functional assessment (forced vital capacity [FVC] and carbon monoxide diffusion capacity [DLCO]), patient-centred measures of dyspnea (PCMD), Health Assessment Questionnaire-Disability Index (HAQ-DI), and HRCT have collected retrospectively. HRCT abnormalities were evaluated using a conventional visual reader-based score (CoVR) and a computer-aided method (CaM). The relationships between the 2 HRCT scores-PFTs and PCMD-were calculated using Pearson correlation. The area under the receiving-operating characteristic (AUC-ROC) curve was calculated to determine the discriminatory performance of measurements between patients with and without ILD. The multivariate regression model was used to evaluate the association force between ILD and RA characteristics.In all, 151 patients (45 males and 106 females, mean age 53.4 ±â€Š7.6 years) were included. ILD had been detected in 29 patients out of 151 (19.2%). Usual interstitial pneumonia was the most common HRCT. RA-ILD patients were older, and older at RA onset (both P < .01), with a higher HAQ-DI (P < .05) than patients without ILD. ACPA positivity and titer were higher in the RA-ILD group (P = .02). Extent and severity of ILD, and total CoVR and CaM score closely related to DLCO and PCMD (both P < .0001). A reduced DLCO was the most sensitive test for predicting the presence of ILD on HRCT (AUC-ROC 0.811 ±â€Š0.037). Advanced age (P < .0001), age at RA onset (P = .025), ACPA titer (P = .004), and smoking (P = .008) were independent explanatory variables of HRCT damage in multivariate analysis.The RA-ILD is associated with age and older age of RA onset, smoking, and ACPA titer. DLCO seems to be the most sensitive parameter to predict ILD on HRCT, followed by PCMD.


Assuntos
Artrite Reumatoide , Doenças Pulmonares Intersticiais/epidemiologia , Fatores Etários , Idoso , Feminino , Humanos , Itália/epidemiologia , Doenças Pulmonares Intersticiais/diagnóstico por imagem , Doenças Pulmonares Intersticiais/etiologia , Masculino , Pessoa de Meia-Idade , Prevalência , Curva ROC , Testes de Função Respiratória , Estudos Retrospectivos , Fatores de Risco , Sensibilidade e Especificidade , Inquéritos e Questionários , Tomografia Computadorizada por Raios X
4.
Ig Sanita Pubbl ; 75(3): 181-187, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31645060

RESUMO

The American College of Sports Medicine states that 150 minutes per week of moderate aerobic activity improves quality of life, also in patients treated for cancer. Physical activity before, during, and after oncological treatments increases rates of survival, interval free from sickness, and side effects of treatment. The importance of physical exercise is often underestimated in Oncology, above all because of the need for an individualized approach and for a lack of recommendations that are valid for everyone. The literature now states that rehabilitation and exercise are as important as medical care. The National Cancer Institute in Aviano (Italy) has started a rehabilitation program for patients treated for breast cancer, followed by an assisted path to encourage physical activity. Thanks to various co-production processes, this program allows women to benefit from a personalised plan and it will be possible to assist patients and encourage physical activity through use of a mobile app. A synergy between the health and fitness worlds has been created, through co-production, accustoming patients to exercise during and following treatments.


Assuntos
Neoplasias da Mama , Exercício , Tutoria , Qualidade de Vida , Neoplasias da Mama/psicologia , Exercício/fisiologia , Exercício/psicologia , Terapia por Exercício , Feminino , Humanos , Itália
5.
Ig Sanita Pubbl ; 75(3): 201-210, 2019.
Artigo em Italiano | MEDLINE | ID: mdl-31645062

RESUMO

The professional profile of health social care worker (OSS) was introduced in Italy in 2001 and has become a fundamental figure in the Italian healthcare and social-health services system. However, changes have occurred in Italian health, clinical care and social realities since the OSS profile was defined. This article reports the results of a national-level study to investigate the state of application of the State-Regions Agreement of 22 February 2001, establishing the professional profile of OSS and regulating its characteristics and competencies, as that of the agreement of 16 January 2003, regulating the complementary healthcare training for nursing assistants.


Assuntos
Assistência à Saúde , Assistentes de Enfermagem , Pessoal de Saúde , Humanos , Itália , Assistentes de Enfermagem/educação , Inquéritos e Questionários
6.
Ig Sanita Pubbl ; 75(3): 211-229, 2019.
Artigo em Italiano | MEDLINE | ID: mdl-31645063

RESUMO

Emergency Department (ED) waiting times are a relevant concern both to health care professionals and consumers, because ED crowding may affect the quality of and access to health care. This has prompted a large amount of studies in the scientific literature, addressing the problem of waiting times as an "international crisis". The causes of long waiting times are complex and multifaceted and feasible solutions must consider this and other aspects such as limitation of resources and unpredicted surges in demand. In the present article, we address the issue of modeling ED flow of patients with a low score at the triage evaluation. This study aimed to develop a model to predict expected waiting times for patients with a "green" or "white" code at triage, by analyzing the patient flow in a regional referral hospital in an Italian district. The simulation model was developed through flow analysis; moreover, input analysis was performed by using registration data collected in the ED during daily activities. The simulation results were compared to data collected through direct observation at the hospital ED and to data extracted from the existing hospital information system, which represents an online transaction system tailored for routine care and patient services in the ED as well as in other hospital departments. The applied model was shown to be able to emulate patient flow in the ED and to find key critical points of the health care process, for patients who received a low category score at the triage. To face the problem of ED waiting times, adoption of patient flow analysis and improvement strategies are recommended, together with improvement of triage evaluation procedures. Simulation models can help to manage this complex issue.


Assuntos
Serviço Hospitalar de Emergência , Qualidade da Assistência à Saúde , Listas de Espera , Serviço Hospitalar de Emergência/estatística & dados numéricos , Serviço Hospitalar de Emergência/tendências , Humanos , Itália , Percepção , Fatores de Tempo , Triagem
7.
Ig Sanita Pubbl ; 75(3): 249-261, 2019.
Artigo em Italiano | MEDLINE | ID: mdl-31645065

RESUMO

The Italian National Vaccine Prevention Plan (PNPV) of 2017-19 and subsequent mandatory vaccination law (Law 119/2017) both occurred in the context of a progressive decrease in vaccine coverage levels in Italy and led to important policy changes, including the introduction of new vaccine recommendations and increasing the number of mandatory vaccinations in childhood from four to ten. A survey on a sample of 446 Italian health care workers (HCW) was carried out in order to assess their opinions on policy changes introduced by the PNPV and by the mandatory vaccination law. The convenience sample was selected among participants in a training course on vaccination counselling. The large majority of participants expressed overall satisfaction about the policy changes introduced by the PNPV but some highlighted pitfalls related to its implementation. Moreover, the majority of HCW believe that vaccination coverage for both recommended and mandatory vaccinations has increased thanks to Law 119/2017, therefore expressing a positive attitude towards the enforcement of vaccine mandates.


Assuntos
Conhecimentos, Atitudes e Prática em Saúde , Pessoal de Saúde/psicologia , Vacinação/legislação & jurisprudência , Vacinação/psicologia , Criança , Pré-Escolar , Feminino , Humanos , Itália , Masculino , Vacinas/administração & dosagem
8.
Nature ; 574(7779): 486, 2019 10.
Artigo em Inglês | MEDLINE | ID: mdl-31641266
9.
J Environ Radioact ; 208-209: 106039, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31491585

RESUMO

An alpine ice core, extracted from the Adamello glacier (Central Italian Alps), was analyzed in its entire length through low background γ-spectroscopy, for the detection of 137Cs. Our results show that in glacier ice 137Cs is tightly bound to insoluble particulate matter inside the ice core, and it is therefore possible to restrict γ-spectroscopy analysis to particulate matter only. We show how the sensibility of the detection limit can be improved by almost one order of magnitude by using a well-type detector instead of a coaxial one. Hypothesis on the dating of some radioactive layers are also hereby presented.


Assuntos
Radioisótopos de Césio/análise , Camada de Gelo/química , Monitoramento de Radiação , Poluentes Radioativos/análise , Itália
10.
J Biol Regul Homeost Agents ; 33(3 Suppl. 1): 73-82, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31538452

RESUMO

The aim of present study is to evaluate the greater risk of periodontal disease in subjects affected by cardiovascular disease. The statistical study includes 200 patients equally divided into a test and a control group. The test group is made up of hospitalized patients from the cardiology division of the S. Salvatore hospital of L'Aquila and the second made up of subjects that frequented a dental clinic. All patients were subject to anamnesis and clinical evaluation for periodontal disease. The index used for this clinical examination were CPTIN index (Community Periodontal Index for Treatment Needs), pocket depth index (PPD), probing bleeding index (PBI), and plaque index (Silness, Loe). All data were collected and a comparative analysis was done of the results obtained from the two groups. Analysing the data concerning the average of lost and present teeth in the oral cavity and the damage of periodontal attachment we notice that cardiopathic subjects had a loss of periodontal attachment 2 times greater than in the control group and major condition of edentulism. A frequency test called the "chi-square test" showed that cardiopathic patients had a greater frequency of periodontal disease. The development of periodontal disease in subject suffering from coronary heart disease is faster and more aggressive than in healthy subjects. Therefore, the prevention of periodontal disease is simple and effective way to reduce the risk of cardiovascular disease.


Assuntos
Doença das Coronárias/complicações , Doenças Periodontais/complicações , Índice de Placa Dentária , Humanos , Itália
11.
Am J Orthod Dentofacial Orthop ; 156(3): 355-364, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31474265

RESUMO

INTRODUCTION: The aim of this work was to analyze data of patients with failed or delayed eruption of first and second permanent molars, to assess the effectiveness of the treatment methods used. METHODS: Epidemiologic and clinical data of 125 patients (mean age 14.08 ± 4.04 years) with 197 affected molars (30 first and 167 second molars) were retrospectively analyzed. The treatment outcome was known in 161 molars after patient drop-out (20 patients with 36 molars). The cases were categorized into 8 groups according to the choice of treatment: orthodontic uprighting, surgical-orthodontic uprighting, surgical uprighting, surgical repositioning, surgical exposure, first or second molar extraction, third molar extraction, or removal of pathologic conditions. RESULTS: The overall treatment outcome was positive in 141 molars (87.6%). It was positive in all cases treated with orthodontic uprighting (7 molars), surgical exposure (10 molars), surgical uprighting (38 molars), and surgical repositioning (8 molars), but it was significantly lower for surgical-orthodontic uprighting (34/48 molars, 70.8%). The positive outcome was significantly lower for inclusion (52/68 molars, 76.5%) than for early-diagnosed condition (11/11 molars, 100%) and retention (78/82 molars, 95.1%), and for total bone crown coverage (21/28 molars, 75.0%) than for osteomucosal or mucosal crown coverage (120/133 molars, 90.2%). CONCLUSIONS: This study demonstrates that an early diagnosis results in a better outcome regardless of the treatment used, with the number of cases with a positive outcome being higher in younger patients.


Assuntos
Dente Molar/patologia , Anormalidades Dentárias , Erupção Dentária , Técnicas de Movimentação Dentária/métodos , Dente Impactado/terapia , Adolescente , Adulto , Criança , Pré-Escolar , Feminino , Humanos , Itália , Modelos Logísticos , Masculino , Dente Molar/cirurgia , Dente Serotino/cirurgia , Estudos Retrospectivos , Dente Impactado/diagnóstico , Dente Impactado/cirurgia , Resultado do Tratamento , Adulto Jovem
12.
Waste Manag ; 99: 154-162, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31479845

RESUMO

The Environmental Life Cycle Costing (LCC) methodology was applied to assess the costs of the processing in Italy of municipal Residual Waste (RW) in Mechanical-Biological Treatment (MBT) plants aimed at the production of Solid Recovered Fuels (SRFs), delivered to dedicated waste-to-energy (WTE) plants or to co-combustion. Two different functional units were defined to consider two different perspectives: 1 tonne of residual waste in input of the MBT plant, and 1 MWh of exergy produced by the energy valorisation of the streams delivered by the MBT plant. Four strategies were analysed that differ for the type of MBT (single stream or separated streams) and the destiny of the SRF (dedicated WTE plant or cement kiln). The results appear to strongly recommend the treatment of the RW in a single stream MBT plant and the production of a SRF with characteristics suitable to meet the technological, economic and environmental needs for co-combustion, substituting fossil fuels.


Assuntos
Materiais de Construção , Eliminação de Resíduos , Itália , Fenômenos Físicos , Resíduos Sólidos
13.
Sci Total Environ ; 690: 1355-1368, 2019 Nov 10.
Artigo em Inglês | MEDLINE | ID: mdl-31470497

RESUMO

Native and transplanted lichens were analyzed as bioaccumulators of airborne particulate matter (PM) in an eastern district of Rome, Italy, where frequent fraudulent fires are set to recover metals, mostly copper, from waste electrical and electronic equipment (WEEE). The presence of native lichens was scarce, due to the drought of spring-summer 2017, thus, sampling was extended to a neighboring area for toughening the dataset to a similar context. The magnetic analyses revealed intense properties connected to the anthropic complexity of the zone, where industrial, traffic and arson-related dusts are emitted and bio-accumulated. Magnetic and chemical analyses were compared, leading to significant linear correlations between the concentration dependent magnetic parameters (susceptibility, saturation magnetization and saturation remanence) and the concentration of heavy metals, among which copper, chrome, lead and zinc. Moreover, selected magnetic particles were chemically and morphologically characterized by Scanning Electron Microscope and Energy Dispersion System microanalyses. Magnetic particles resulted incorporated into the lichens' tissues and their composition, morphology and grain size strongly supported their anthropogenic, mostly combustion-related, origin. Even if, given the complexity of the area, it was not feasible to fully discriminate the multiple anthropogenic sources, magnetic biomonitoring of lichens, especially when combined with microtextural and compositional analyses, confirmed to be an excellent methodology for a rapid characterization of environmental pollution.


Assuntos
Poluentes Atmosféricos/análise , Monitoramento Ambiental , Líquens/química , Material Particulado/análise , Itália , Magnetismo , Roma
14.
Psychiatr Danub ; 31(Suppl 3): 462-466, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488773

RESUMO

Individuals with multiple disabilities can have a wide range of characteristics depending on the combination and severity of the disabilities, such as intellectual disability, mobility issues, sensorial impairment, language issues and brain injury. New technologies can help therapists find an alternative way to engage and interact with clients by opening a communication window and starting to build the therapeutic relationship. The need to use more customized technological tools led us to develop the Painteraction system, an intuitive tool based on Augmented Reality that allows clients to be immersed in their own images. Just by moving their bodies individuals are able to make drawings and receive visual feedback, both from themselves and their therapists, as it appears on the screen. The pilot testing of Painteraction was performed on 21 inpatients at Istituto Serafico (Assisi, Italy) with severe/multiple disabilities in order to explore and assess reaction and responsiveness in a semi-structured art therapy setting. The sample was formed by 14 males and 7 females (N=21) between the ages of 7 and 35. All participants attended three twenty-minute individual art therapy sessions which were approximately one week apart. Through direct and indirect (video recordings) observation of the sessions, it appeared that the specific Augmented Reality tool introduced in the art therapy setting was easily accepted by most of the clients involved and generally allowed the development of an interpersonal therapist-client relationship. The present study therefore gave us the opportunity to test new digital tools in the challenging setting of severe/multiple disabilities and observe the huge potential of new media to empower clients to express themselves and their creativity, and ultimately overcome mental and physical barriers. We propose that Augmented Reality tools are particularly well-suited to art therapy and create an equally suitable therapeutic environment to address specific client needs.


Assuntos
Terapia pela Arte/métodos , Pessoas com Deficiência/reabilitação , Deficiência Intelectual/reabilitação , Adolescente , Adulto , Criança , Feminino , Humanos , Pacientes Internados , Itália , Masculino , Adulto Jovem
15.
Psychiatr Danub ; 31(Suppl 3): 490-496, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488778

RESUMO

BACKGROUND: Differentiating Borderline Personality Disorder (BPD) from Bipolar Disorder (BD) represents a very difficult challenge for clinicians. Dysphoria could be a possible key to differentiate these disorders. We currently define dysphoria as a complex and disorganized emotional state with proteiform phenomenology, characterized by a multitude of symptoms. Among them irritability, discontent, interpersonal resentment and surrender prevail. These dimensions can be detected using the Neapen Dysphoria Scale - Italian version (NDS-I). Dysphoria role in BPD has been highlighted by the recent theorization of the Interpersonal Dysphoria Model, according to which dysphoria could represent the "psychopathological organizer" of the BPD. On the other side, dysphoria role in BD has not yet been established. This is simply considered as an aspect, and not fundamental, of the symptomatology characterizing BD, especially in mixed states patients. The phenomenological analysis of the dimensional spectrum of dysphoria within BPD and DB could provide a valuable aid in the differential diagnosis between BPD and BD. AIMS: The aim of this paper is to verify if the dimensional spectrum of dysphoria differs between Borderline Personality Disorder (BPD) and Bipolar Disorder Spectrum (BD) through an observational comparative study SUBJECTS AND METHODS: In this study, 65 adult patients, males and females between the ages of 18 and 65, were enrolled from the Psychiatric Service of the Santa Maria della Misericordia Hospital in Perugia (PG), Italy, from January 1st 2018 to April 30th 2019. We have formed 2 groups. A BPD group composed of 33 patients (19 female patients, representing approximately 57.6% of the sample) and a BD group composed of 32 patients (18 Female patients, representing approximately 56.2% of the sample). Patient's comorbid with BD and BPD have been excluded from the study. After a preliminary assessment to exclude organic and psychiatric comorbidity, and after at least 72 hours from hospitalization, we administered them the Neapen Dysphoria Scale - Italian Version (NDS-I), a specific dimensional test for dysphoria. Starting from the dataset, with the aid of the statistical program SPSS 20, we have carried out a comparison between disorders groups selected and their NDS-I total score and subscales (irritability, discontent, interpersonal resentment, surrender); For this we have used the Mann-Whitney U test, a nonparametric test with 2 independent samples, by setting a significance level p<0.05. CONCLUSIONS: This study allowed us to explore and analyze dysphoria dimensions expressions in BPD and BD. Despite the small sample analyzed, the results show a significant different dimensional spectrum expression of the dysphoria between the two disorders. In particular, Irritability and Interpersonal Resentment dimensions show greater interest in BPD than BD spectrum. Further studies with a larger and stratified sample are needed to confirm these results.


Assuntos
Transtorno Bipolar/diagnóstico , Transtorno Bipolar/psicologia , Transtorno da Personalidade Borderline/diagnóstico , Transtorno da Personalidade Borderline/psicologia , Pacientes Internados/psicologia , Adolescente , Adulto , Idoso , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Adulto Jovem
16.
Psychiatr Danub ; 31(Suppl 3): 512-516, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31488782

RESUMO

BACKGROUND: Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Binge Eating Disorder (BED) are severe psychiatric illnesses which represent the main expression of Feeding and Eating Disorders (FED). Clinicians agree that emotional and behavioural dysregulation play a crucial role in FED. Dysphoria could help us to better understand these components. Indeed, we define dysphoria as a generic state of dissatisfaction and emotional instability, without any specific features. Among the multitude of symptoms, we find that irritability, discontent, interpersonal resentment and surrender prevail. These dimensions correspond to the four subscales of Neapean Dysphoria Scale - Italian version (NDS-I). Dysphoria role in FED has not yet been investigated. Using this test, we can characterize dysphoria both in quantitative and qualitative terms. Accordingly, domain evaluation could discriminate these disorders allowing us to assess possible differential phenomenological expressions. AIMS: The aim of this paper is to understand in which way the dimensional spectrum that composes dysphoria differs between Anorexia Nervosa, Bulimia Nervosa and Binge Eating Disorders through an observational comparative study. SUBJECTS AND METHODS: The enrolled sample (30 patients) is represented by patients with a history of FED (AN, BN or BED). Patients were males and females between the ages of 13 and 45 with a good knowledge of Italian language. Patients with severe cognitive impairment (MMSE <19) and civil incapacitation were excluded. Patients were recruited from the Psychiatric Service of the Santa Maria della Misericordia Hospital in Perugia (PG), and other residential and semi residential structures specialized in FED treatment (FED specialized center at Palazzo Francisci in Todi (PG), Nido delle Rondini in Todi (PG), BED (Binge Eating Disorders) center in Città della Pieve (PG) and ambulatory services for FED in Umbertide (PG)). We administered them the Neapen Dysphoria Scale - Italian Version (NDS-I), a specific dimensional test for dysphoria. Starting from the dataset, with the aid of the statistical program SPSS 20, we have carried out a comparison between disorders groups selected and NDS-I total score and subscales (irritability, discontent, interpersonal resentment, surrender). For this we have used the Mann-Whitney U test, a nonparametric test with 2 independent samples, by setting a significance level p<0.05. CONCLUSIONS: This study allowed us to better understand and characterize the most common Eating Disorders. Beyond that, despite the small sample size, we found in our analysis statistically significant difference in the expression of various dysphoria dimension spectrum inside our 3 groups.


Assuntos
Emoções , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Adolescente , Adulto , Anorexia Nervosa/psicologia , Transtorno da Compulsão Alimentar/psicologia , Bulimia Nervosa/psicologia , Feminino , Humanos , Itália , Masculino , Pessoa de Meia-Idade , Adulto Jovem
17.
Pol J Pathol ; 70(1): 7-13, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31556545

RESUMO

The anatomical museums are one of the most difficult categories of museums to deal with because the issues addressed and the stored materials are complex to communicate and often not suitable for all audiences. The history of medicine teaches us that the knowledge of our body is a fascinating topic that continues to be the subject of study and research. The Italian anatomical museums are mostly university property, often closed and with specimens in urgent need of restoration. Their rooms still house important collections of human biological samples, dry or in liquid, collected between the eighteenth and twentieth century: a historical heritage that testifies to the evolution of medical science and provides a searchable archive of biological and genetic data. The curator of such a museum must confront many issues - museological, legislative and ethical - many of which are unclear and incomplete. This article provides an overview of museological issues in the anatomical area in order to offer ideas and visions, from a comparison of three different examples: the Museum of Human Anatomy of the University of Pavia, the Museum of Pathological Anatomy at the University of Padua and the Gordon Museum of Pathology in London.


Assuntos
Anatomia , Museus , Universidades , Humanos , Itália , Londres
18.
Waste Manag ; 100: 249-258, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31563025

RESUMO

The challenge of increasing food demand due to population growth urges all stakeholders to act against food losses and waste, especially in light of their environmental, cost, and social impacts. In developed countries, awareness raising, and prevention are particularly important at the consumption level, where food waste mainly occurs. In this sense, public school canteens represent a unique setting, because of their capacity of conveying food habits, while sustainably managing available resources. This research assessed the environmental and cost impact of food consumption and wastage in public school canteens through a case study in Italy. It combined life cycle assessment, environmental life cycle costing, and quarter-waste visual methods. The functional unit was defined as the average meal provided by the catering service to 3-10 years old students. Primary data on type and amounts of purchased food, transport, and utilities consumption were provided by the catering service, while food waste assessment was performed in selected representative school canteens. Secondary data on background processes were mainly sourced from databases and literature. Food waste at schools represented 20-29% of the prepared meal, depending on students' age and seasonal menu. The global warming potential (GWP) of the average meal was 1.11-1.50 kg CO2-eq, mostly due to the food production impact. The meal preparation had the largest impact on costs. When considering embedded impacts, food waste was responsible for 14-18% of GWP and 6-11% of the costs. The sensitivity analysis showed promising environmental and cost reductions by introducing changes in the meal composition and preparation.


Assuntos
Serviços de Alimentação , Eliminação de Resíduos , Criança , Pré-Escolar , Alimentos , Humanos , Itália , Instituições Acadêmicas , Estudantes
19.
Med Lav ; 110(4): 271-277, 2019 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-31475688

RESUMO

BACKGROUND: Occupational tasks characterized by repetitive, awkward and forceful movements of the hand and wrist may heighten the risk of carpal tunnel syndrome (CTS) among dairy parlor workers. Median nerve impairment can be investigated with ultrasonography (US) and nerve conduction studies (NCS) but a structured questionnaire may help identify early symptoms. OBJECTIVES: Our objectives were to: a) compare the sensitivity of US investigations and NCS to detect early signs of CTS; b) explore the correlation of the results of these two tests with CTS symptoms obtained from the administration of a targeted questionnaire. METHODS: Forty male milking parlor workers were recruited. The study protocol included: 1) the identification of characteristic CTS symptoms through a targeted questionnaire; 2) US imaging of the carpal tunnel inlet (using a portable ultrasound device; 3) NCS of the distal median nerve. RESULTS: The symptom questionnaire was considered positive if at least one CTS symptom was present within two weeks prior to the examination. The symptom questionnaire showed a high level of specificity (92,6%) and sensitivity (61%) when compared with NCS results. Ultrasound results revealed a prevalence of median neuropathy of 55%, but when compared to NCS, the ultrasound showed quite low predictive values (NPV of 37% and PPV of 38%). DISCUSSION: The symptom questionnaire was associated with the median nerve pathology often seen in CTS. Moreover, the study results have shown the questionnaire to be the most effective screening method when compared to ultrasound.


Assuntos
Síndrome do Túnel Carpal , Indústria de Laticínios , Doenças Profissionais , Síndrome do Túnel Carpal/diagnóstico , Síndrome do Túnel Carpal/etiologia , Humanos , Itália , Masculino , Nervo Mediano , Condução Nervosa , Doenças Profissionais/etiologia , Sensibilidade e Especificidade
20.
Eur J Paediatr Dent ; 20(3): 204-208, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31489819

RESUMO

AIM: This cross-sectional study was carried out to evaluate the prevalence of malocclusion and associated factors in preschoolers with the aim of assessing the existence of an association between bad habits and mouth breathing with the most severe malocclusions. MATERIALS AND METHODS: A sample of 1616 children aged 3-6 years was visited by applying the Baby ROMA index, an orthodontic treatment need index for preschool age. The following were searched: the prevalence of malocclusion, the association of bad habits and mouth breathing with malocclusion, how often are found in association and how this association is statistically significant. Chi-square and Fischer test were applied to verify the statistical significance of the association between the variables. RESULTS: The data show that 38% of the sample need orthodontic treatment and 46% have signs of malocclusion of less severe degree that require a close monitoring and the elimination of risk factors so that they can improve spontaneously with growth. Moreover the prevalence of bad habits and oral breathing increases with increasing severity of the malocclusion, and sucking habits and oral breathing are both closely related to anterior open bite, posterior crossbite and increased overjet. CONCLUSIONS: In the context of prevention and early treatment of disorders of the craniofacial growth, bad habits and mouth breathing, being risk factors of malocclusion, should be intercepted and corrected early on to prevent the development of malocclusion, or the worsening of existing ones. From this point of view it is important to follow the patients with a multidisciplinary approach.


Assuntos
Má Oclusão , Respiração Bucal , Criança , Pré-Escolar , Estudos Transversais , Sucção de Dedo , Hábitos , Humanos , Lactente , Itália , Prevalência
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